Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes

Abstract

Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+ Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio of 0.75 (95% CI 0.57 to 0.98), p=0.04, in favour of the FIFA injury prevention programmes. Secondary analyses revealed that when pooling the 4 studies applying the FIFA 11+ prevention programme, a reduction in the overall injury risk ratio (incidence rate ratio (IRR) 0.61; 95% CI 0.48 to 0.77, p<0.001) was present in favour of the FIFA 11+ prevention programme. No reduction was present when pooling the 2 studies including the FIFA 11 prevention programme (IRR 0.99; 95% CI 0.80 to 1.23, p=0.940). Conclusions An injury-preventing effect of the FIFA injury prevention programmes compared with controls was shown in football. This effect was induced by the FIFA 11+ prevention programme which has a substantial injurypreventing effect by reducing football injuries by 39%, whereas a preventive effect of the FIFA 11 prevention programme could not be documented. Trial registration number PROSPERO CRD42015024120.

The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial

“…The preventive effect from structured interventions like the FIFA 11+ is well known;4 however, the specific effects of these general programmes are unclear. Only two papers report effects on hip/groin injuries, with conflicting results 5 6.…”

“…To date, the effect of groin-specific prevention programmes has not been established 3. A recent systematic review and meta-analysis indicates that the FIFA 11+ may have a preventive effect on hip and groin injuries 4. However, this analysis was based on two studies only.…”

Getting the systematic review basics right helps clinical practice: 4 common pitfalls for systematic review authors to avoid

“…3. The Cochrane Handbook for Systematic Reviews of Interventions provides guidance for every step of the systematic review process4 that you can apply to systematic reviews of randomised controlled trials studying the effects of exercise, surgery or training on injury prevention, recovery or fitness.…”

“…Summary estimate of FIFA injury prevention programmes compared with control interventions3 (used with permission). IRR, incidence rate ratio .…”

Prevention forecast: cloudy with a chance of injury

“…Programmes such as the FIFA 11+ exercise programme reduce injury rates at various levels of sport in a range of populations10; we need to get athletes actually performing the programmes. We should also aim to replicate the simplicity and efficacy of the Nordic hamstring injury prevention exercise for other common injuries, such as those that affect the shoulder and groin.…”