Adding a post-training FIFA 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduces injury rates among male amateur soccer players: a cluster-randomised trial

Question: Does adding a post-training Fédération Internationale de Football Association (FIFA) 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduce injury rates among male amateur soccer players? Design: Cluster-randomised, controlled trial with concealed allocation. Participants: Twenty-one teams of male amateur soccer players aged 14 to 35 years were randomly assigned to the experimental group (n = 10 teams, 160 players) or the control group (n = 11 teams, 184 players). Intervention: Both groups performed pre-training FIFA 11+ exercises for 20 minutes. The experimental group also performed post-training FIFA 11+ exercises for 10 minutes. Outcome measures: The primary outcomes measures were incidence of overall injury, incidence of initial and recurrent injury, and injury severity. The secondary outcome measure was compliance to the experimental intervention (pre and post FIFA 11+ program) and the control intervention (pre FIFA 11+ program). Results: During one season, 26 injuries (team mean = 0.081 injuries/1000 exposure hours, SD = 0.064) were reported in the experimental group, and 82 injuries were reported in the control group (team mean = 0.324 injuries/1000 hours, SD = 0.084). Generalised Estimating Equations were applied with an intention-to-treat analysis. The pre and post FIFA 11+ program reduced the total number of injuries (χ2 (1) = 11.549, p = 0.001) and the incidence of initial injury (χ2 (2) = 8.987, p = 0.003) significantly more than the pre FIFA 11+ program alone. However, the odds of suffering a recurrent injury were not different between the two groups (χ2 (1) = 2.350, p = 0.125). Moreover, the severity level of injuries was not dependent upon whether or not the pre and post FIFA 11+ program was implemented (χ2 (1) = 0.016, p = 0.898). Conclusion: Implementation of the FIFA 11+ program pre-training and post-training reduced overall injury rates in male amateur soccer players more than the pre FIFA 11+ program alone. Trial registration: ACTRN12615001206516. [Al Attar WSA, Soomro N, Pappas E, Sinclair PJ, Sanders RH (2017) Adding a post-training FIFA 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduces injury rates among male amateur soccer players: a cluster-randomised trial. Journal of Physiotherapy 63: 235–242