BJSM Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomised controlled trial Br J Sports Med 2012;46:1114–1118. doi:10.1136/bjsports-2012-091277 Anna M C van Beijsterveldt,1 Ingrid G L van de Port,1 Mark R Krist,1 Sandor L Schmikli,1 Janine H Stubbe,2 Janet E Frederiks,3 Frank J G Backx1 Samenvatting Abstract Background The incidence rate of soccer injuries is among the highest in sports, particularly for adult male soccer players. Purpose To investigate the effect of the ‘The11’ injury prevention programme on injury incidence and injury severity in adult male amateur soccer players. Study design Cluster-randomised controlled trial. Methods Teams from two high-level amateur soccer competitions were randomly assigned to an intervention (n=11 teams, 223 players) or control group (n=12 teams, 233 players). The intervention group was instructed to perform The11 in each practice session during one soccer season. The11 focuses on core stability, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation and plyometrics with straight leg alignment. All participants of the control group continued their practice sessions as usual. Results In total, 427 injuries were recorded, affecting 274 of 456 players (60.1%). Compliance with the intervention programme was good (team compliance=73%, player compliance=71%). Contrary to the hypothesis, injury incidences were almost equal between the two study groups: 9.6 per 1000 sports hours (8.4–11.0) for the intervention group and 9.7 (8.5–11.1) for the control group. No signifi cant differences were found in injury severity, but a signifi cant difference was observed in the location of the injuries: players in the intervention group sustained signifi cantly less knee injuries. Conclusions This study did not fi nd signifi cant differences in the overall injury incidence or injury severity between the intervention and control group of adult male soccer players. More research is recommended, focusing on injury aetiology and risk factors in adult male amateur soccer players. Introduction Participating in sports on a regular basis is considered a vital component of an active and healthy lifestyle to reduce the risk of various diseases and to contribute to better social and physical performance. To some extent, however, sports injuries are inevitable. The incidence rate of outdoor soccer injuries is among the highest of all sports, particularly for adult male soccer players.1,2 In the Netherlands, outdoor soccer causes the largest num6 Sport & Geneeskunde | december 2012 | nummer 5 ber of injuries each year (18% of all sports injuries), totalling approximately 620 000 injuries.3 Soccer is a high-intensity sport characterised by continuous changes of direction and highload unipodal actions. Participating in soccer imposes high demands on neuromuscular control, agility and eccentric/ concentric strength. Most soccer injuries are related to the lower extremities, in which muscle injuries are among the major problems.4–6 Signifi cant reductions of lower extremity injury risk have been reported to be achieved by intervention programmes focusing on intrinsic risk factors.7–9 Eccentric strength training reduced the risk of hamstring injury in heterogeneous populations of soccer players.10–12 In addition, plyometric training and agility drills, the main components of a preventive programme developed by Heidt et al,13 were found to be effective in lowering the incidence of injuries in soccer. It has also been shown that neuromuscular training can signifi cantly reduce the risk of anterior cruciate ligament (ACL) injury in both male and female soccer players.14,15 Finally, balance training proved to be effective in reducing noncontact ACL injuries in soccer players, especially in female athletes.14 An exercise programme called ‘The11’, developed with the Pagina 5

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