School-Based Injury Prevention Program to Reduce Sport Injury Risk and Improve Healthy
Outcomes in Youth: A Pilot Cluster-Randomized Controlled Trial

SA, Kang J, Doyle-Baker PK, Nettel-Aguirre A, & Emery CA.  Clin J
Sport Med
. 2016;26:291–298. doi: 10.1097/JSM.0000000000000261

Take Home Message: An injury prevention warm-up two to three
times a week in a junior high school physical education class decreased
injuries and improved overall fitness.

We have had multiple posts on Sports Med Res about the effectiveness
of injury prevention programs for reducing the risk of injuries among high
school and collegiate athletes.  Researchers
have not evaluated the effectiveness of these programs in many younger groups
and have not taken into consideration aerobic intensity.  The authors of this randomized trial wanted
to evaluate the effectiveness of an injury prevention program in reducing
injuries as well as improving body composition and fitness levels in a youth
school-based population (11 to 15 year olds). 
Baseline measurements were taken in junior high school physical
education classes and then schools were randomly assigned to either the injury
prevention or standard warm-up program. 
The warm-up programs lasted for 12 weeks and were conducted two to three
times per week in the beginning (first 15 minutes) of physical education
classes. The warm-ups consisted of either standard warm-up (i.e., lower
intensity aerobic with dynamic and static stretching) or injury prevention
(i.e., moderate intensity aerobic with neuromuscular, strength, and balance training).  The authors defined a sports injury as an
injury that occurred during sport or a recreational activity that required the
student to stop playing, seek medical attention, or miss at least one day from
sport.  Overall, the authors found that
students who received the injury prevention program were ~70% less likely to
have sport injury or more specifically, lower extremity injury, ankle sprain,
or knee sprain. Student who performed the injury prevention program also had
less time lost to injury compared with the standard warm-up group.  In secondary fitness measure outcomes, the
intervention group had greater time in higher exercise heart rate ranges than
the standard warm-up participants.  Both
groups increased in waist circumference, but the intervention group had less
change than the standard warm-up group.

This research study confirms
findings that an injury prevention program can aid in reducing the number of
injuries and amount of time lost among students in junior high schools.  The interesting thing about this study is
that it was conducted within the school setting.  This helps to improve compliance and regular
integration of the program.  It would
have been interesting to see how program compliance compared to programs that
were typically completed with sport teams. 
Interestingly, the authors of this study begin to uncover that the
injury prevention program may help in physical activity minutes and overall
fitness within a young junior high school group.  These students are susceptible to decreased
activity levels and the possibility of gaining weight.  It is an important time in the students’
lives to integrate a healthy lifestyle. 
This includes maintaining or increasing overall physical activity
intensity as well as decreasing injuries. 
Injuries lead to decreased physical activity and potentially put these
students at risk for adopting a less active lifestyle.  It would be interesting to see if there are
any long-term benefits to these programs if they were implemented in
consecutive years in physical education curriculums.  For example, would injury risk continue to   decline, would fitness measures show
improvements, or would students integrate these warm-ups into their
recreational activities, Ultimately, we see the importance of having young
physically active participants perform injury prevention warm ups.  They don’t take much time, and clearly they have
positive outcomes on risk of injury, fitness, and athletic performance.   

for Discussion:  What do you think about
the possibility of integrating these warm ups into physical education courses?  Where do you think these warm-up programs
would have the best long-term success for students to continue doing once they
are no longer in school?

Nicole Cattano
by: Jeffrey Driban


Richmond, S., Kang, J., Doyle-Baker, P., Nettel-Aguirre, A., & Emery, C. (2016). A School-Based Injury Prevention Program to Reduce Sport Injury Risk and Improve Healthy Outcomes in Youth Clinical Journal of Sport Medicine, 26 (4), 291-298 DOI: 10.1097/JSM.0000000000000261