The Impact of the FIFA11+ Training
Program on Injury Prevention in Football Players: A Systematic Review

NC, Meneses-Echavez JF, Ramierez-Velez R, Cohen DD, Tovar G, & Bautista JE.
Int J Envrion Res Public Health. 2014.
11: 11986-12000.

Take Home Message: The FIFA11+
program reduced injuries and improved functional performance.  It is more effective if compliance and
adherence are high, both of which are better if a coach educated on the program
administers the program to the team.

FIFA 11+ injury prevention program is an exercise program that can be
easily incorporated into a team’s warm-up to help prevent sports injury.  The exercises include core stability,
proprioception, dynamic stability, and plyometric strengthening and only take
less than 15 minutes to complete.  The
authors of this systematic review aimed to evaluate the effectiveness of the
FIFA11+ program in soccer players on injury risk and performance.  Thirteen studies were included in the final
analysis that involved a pre- and post-intervention analysis of outcomes in a
soccer population.  The 13 articles were
then methodologically assessed with the Physiotherapy Evidence Database scale
(randomized controlled trials) or the Critical Appraisal Skills Programme
(cohort studies) and the authors eliminated one study due to low methodological
quality.  Injury incidence was
investigated in 6 studies, where 4 reported a reduction in injuries while 2
reported no reduction in injury incidence. 
Both studies that showed no injury-prevention benefit only did the
program once/week. The FIFA11+ program improved multiple performance outcomes in
the 7 studies that reported these outcomes such as proprioception/balance,
strength, jump height, and sprint speed pre- to post-intervention which could
have direct implications for injury prevention. 
The authors of one of the included studies reported that higher
compliance was associated with lower injury risk, and that adherence was better
in teams that had a coach delivered/supervised the program.

systematic review reinforces that the FIFA11+ program can be successful at
reducing injuries, improving physical performance measures, and is best
delivered by a coach because adherence and compliance are linked with decreased
injury risk.  These findings are specific
for the soccer population, and we need to find out if this intervention program
is as effective in other sporting populations. The authors interestingly point
out that this type of program has a public health impact because sport injuries
are expensive and preventing them could reduce healthcare costs.  A program like this could also have a drastic
help decrease the number of athletes with long-term negative outcomes from
sport injury, such as osteoarthritis.  It
would be interesting to see what the player and coaches’ perceptions of the
FIFA11+ program are.  Many coaches are
hesitant to dedicate practice time to such programs, but the authors confirm
that we may be able to get coaches to “buy in” by continuing to show evidence
of improved functional measures as well as the added benefit of injury
reduction.  This systematic review is
further evidence that we should start implementing injury prevention programs
with our teams. It may be helpful to get parents, coaches, and athletes to buy
into the programs if we remind them that not only does the program reduce the
risk of injury but also can improve performance.

Questions for Discussion:  Do
any of the sports teams that you work with utilize an injury prevention
program?  Are there any barriers that you
might be able to identify in trying to get coaches to implement this type of a

Nicole Cattano
by: Jeffrey Driban

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Related Material:

Barengo, N., Meneses-Echávez, J., Ramírez-Vélez, R., Cohen, D., Tovar, G., & Bautista, J. (2014). The Impact of the FIFA 11+ Training Program on Injury Prevention in Football Players: A Systematic Review International Journal of Environmental Research and Public Health, 11 (11), 11986-12000 DOI: 10.3390/ijerph111111986