High compliance with the injury prevention exercise programme Knee Control is associated with a greater injury preventive effect in male, but not in female, youth floorball players

Abstract

Purpose Evaluate team and player compliance with the Knee Control injury prevention exercise programme, study the association between player compliance and injury rates, and compare coach demographics, baseline prevention expectancies, and programme utilisation between teams with high and low compliance. Methods Prospective one-season cohort study based on a cluster randomised controlled trial on 301 (107 female) floorball players aged 12–17 years. Floorball exposure and injuries were self-reported weekly by players using the Oslo Sports Trauma Research Center questionnaire. Team and player compliance to Knee Control was reported monthly by coaches. Additionally, coaches answered pre- and post-season surveys. Teams were divided into a high (≥ 80%) or low (< 80%) compliance group based on their use of Knee Control during the season. Players were divided into three compliance groups based on their average weekly number of Knee Control sessions; high (≥ 2 sessions), intermediate (≥ 1 to < 2 sessions), and low dose (< 1 session). Results Mean team compliance for the high and low compliance groups were 95% (range 82–100) and 50% (range 13–66), respectively. Mean ± SD weekly Knee Control dose in the three player compliance groups were 2.4 ± 0.3, 1.4 ± 0.3, and 0.7 ± 0.3 sessions, respectively. There were no differences in total injury incidence between the player compliance groups, but players in the high-dose group had a 35% lower prevalence of injuries overall [adjusted prevalence rate ratio (PRR) 0.65, 95% CI 0.48–0.89] and 60% lower prevalence of substantial injuries (adjusted PRR 0.40, 95% CI 0.26–0.61) compared with the low-dose group. Male players in the high-dose group had consistently lower injury incidence and prevalence, while no between compliance group differences were seen in female players. There were no differences in sex, years of coaching experience, or baseline prevention expectancies in general between coaches for teams in the high vs. low compliance groups, but teams in the high compliance group had a better utilisation fidelity. Conclusion There was a clear dose–response relationship between more frequent Knee Control use and lower injury rates in male floorball players, but not in female players. Teams with higher compliance also showed a better utilisation fidelity with the programme. Level of evidence Level II.

Perceptions, facilitators, and barriers regarding use of the injury prevention exercise programme Knee Control among players and coaches in youth floorball: a cross-sectional survey study

“…The Swedish IPEP Knee Control has been shown to reduce the risk of anterior cruciate ligament (ACL) injuries by 64% in female youth football players [9] and the risk of overall acute injuries by 45% in male and female youth floorball players [10]. A dose-response relationship, with a greater reduction in injury risk with higher IPEP dose, was seen in both football and floorball [11,12].…”

Preliminary Report on the Train the Brain Project, Part II: Neuroplasticity of Augmented Neuromuscular Training and Improved Injury-Risk Biomechanics

“…The current standard of care to prevent ACL injuries is neuromuscular training (NMT), and while moderately effective when implemented, injury-resistant movement is not always achieved or sustained, 5 especially in high-risk female athletes 6 . Further, ACL injury incidence has remained unchanged, or is even increasing in female athletes.…”

Most amateur football teams do not implement essential components of neuromuscular training to prevent anterior cruciate ligament injuries and lateral ankle sprains

“…jump-landing) and strengthening exercises is effective in reducing the risk for an ACL injury [ 18 , 30 ] and (recurrent) lateral ankle sprain [ 9 , 29 ]. The effectiveness of NMT programmes is dependent on the compliance [ 1 , 25 ]. NMT programmes are of preventive benefit when performed at least twice per week throughout the entire season [ 18 , 29 ].…”

“…Although there is a vast body of literature on the prevention of ACL injuries and lateral ankle sprains, the degree of use has mainly been investigated in controlled study scenarios such as the control arm of an RCT, [ 1 ] but scarecely evaluated in a real-life, uncontrolled scenario [ 7 ]. Barriers towards the use of prevention programmes have been studied in multiple populations, ranging from professional teams to participants in effectiveness studies regarding injury prevention [ 4 , 16 , 17 ].…”