There are more football injury prevention reviews than randomized controlled trials : Time for more RCT action!

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Applicability of a Change of Direction Ability Field Test in Soccer Assistant Referees

The aim of this study was to examine the applicability of a test for change of direction ability (10-8-8-10 test, involving line and sideward sprinting, 36 m) in elite-level soccer assistant referees (ARs). One hundred AR of the first-second and third Italian Championships (ARA-B and ARC, n = 50, respectively) performed the 10-8-8-10 on 3 separate occasions. Twenty AR authorities scored test relevance (1-5 scale, from trivial to very large) for logical validity using a questionnaire. Construct validity was examined comparing ARA-B and ARC for the 10-8-8-10 performance. Short-term reliability was assessed testing a random selection of ARs (n = 64) over 3 separate occasions every other day. Performance in the 10-8-8-10 test was assumed as total coverage time using telemetric photocells. Results showed that the 10-8-8-10 test was perceived as possessing from large (n = 4/20) to very-large (n = 16/20) relevance to AR physical match performance. No significant performance difference was found between competitive levels (p = 0.57). Area under the curve (= 0.49; p = 0.87) showed no significant sensitivity of 10-8-8-10 in detecting competitive-level difference. The intraclass correlation coefficient (n = 64) and typical error of measurement (test 2 vs. 3) values were 0.90 (p < 0.0001) and 0.18 seconds, respectively. This study showed that the 10-8-8-10 test possesses logical validity, good reliability, and it is independent of the competitive level. As such, this original investigation represents the first step in the identification and assessment of a valid and reliable AR change of direction test. Given the strength of our findings, governing bodies should look to integrate the 10-8-8-10 test into the fitness test protocols devised for ARs, with scores 65 9.67 being considered as a starting point for the empirical validation of minimum selection criteria for elite-level ARs

Epidemiology of traumatic and overuse injuries in Swiss professional male ice hockey players

Background: Ice hockey injury patterns in Europe were last evaluated in the 1990s. Purpose: The aim of this study was to assess the frequency, type, location, and incidence of traumatic injuries, as well as the prevalence and relative effect of overuse injuries in professional male ice hockey players. Study Design: Descriptive epidemiology study. Methods: Traumatic injuries were assessed using a standardized injury report form over a 1-year period (including the preparatory phase and season). The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire was used to determine overall and substantial overuse injuries and their relative effect on ice hockey players. Results: Five Swiss National League teams participated in the study. From a total of 321 recorded injuries, 179 led to time loss from sport. The game-related time-loss injury incidence during the season was 88.6/1000 player-game hours.Time-loss injuries affected mainly the hip/groin/thigh region (23%), followed by the head (17%). Most time-loss injuries were classified as muscle strains (24%), followed by concussions (18%). The most common injury mechanism involved collision with an opponent’s body (31%), and right forward players (23%) were most likely to report a game-related injury. Most injuries (27%) occurred within the defending zone along the boards. The average prevalence rates of all overuse and substantial overuse injuries were 49% and 13%, respectively. The hip/groin displayed the highest average prevalence for all overuse problems (16%), translating to the highest relative effect. Conclusion: Muscle strains and concussions were the most frequent time-loss injuries in Swiss professional ice hockey players. The hip/groin was the most affected region for both traumatic and overuse injuries

FIFA Women's World Cup 2011: Pre-Competition Medical Assessment of female referees and assistant referees

BACKGROUND: Precompetition screening was implemented for male referees during the 2010 Fédération Internationale de Football Association (FIFA) Word Cup. In contrast, female football referees have been neglected in this respect although they experience similar physical work loads compared to male referees. METHODS: The standardised football-specific Pre-Competition Medical Assessment (PCMA) was performed in 51 referees and assistant referees selected for the 2011 FIFA Women's World Cup. RESULTS: Family history for sudden cardiac death (SCD) was positive in four referees (7.8%), but cardiac examinations did not reveal any pathological findings. Training-unrelated ECG changes were identified in three referees (5.9%), all without correlates in echocardiography or clinical examination. Most common echocardiography findings (66.6%, n=34) were asymptomatic tricuspid and mitral regurgitations. CONCLUSIONS: During the present screening, no elite female referee was identified being at risk for SCD, and no referee had to be excluded from participating in the 2011 FIFA Women's World Cup

High Compliance with the 11+ Injury Prevention Program Results in Better Win-Loss Records

# Background The 11+ injury prevention program (IPP) has been shown to decrease injury rates. However, few studies have investigated compliance and its overall relationship to team performance. # Hypothesis/Purpose To examine if level of compliance while implementing the 11+ would impact team performance outcomes (wins, losses and ties). The authors hypothesized that higher team compliance to the IPP would be consistent with improved overall team performance (more wins and fewer losses). # Study Design Prospective, cluster randomized controlled trial # Methods This study was conducted in NCAA men's soccer teams for one season and examined the efficacy of the 11+ IPP. The outcome variables examined were levels of compliance and team performance record: wins, losses, and ties. Twenty-seven teams (n=675 players) served as the intervention group (IG) and used the 11+ program while 34 teams (n=850 players) served as the control group (CG). Compliance and team performance were recorded. There were three compliance categories that were defined prospectively, low (LC, \1 and \2 doses/week). Descriptive and inferential tests were used to compare the CG, the IG, and compliance to team performance. Three independent t-tests were used to analyze outcome to group (IG vs. CG). A one way-MANOVA test was used to analyze compliance to win/loss/tie record, followed up by one-way ANOVA tests to analyze how compliance impacted wins, losses and ties, independently. Partial η2 measures were calculated to determine the effect size of level of compliance on outcome. A Tukey post-hoc analysis was used to analyze specific differences between levels of compliance and specific outcome measures. # Results There were significantly more wins (IG: 10.67±2.63 versus CG: 8.15±3.83, CI, 7.95 -- 9.69, p = 0.005) and fewer losses (IG: 5.56±1.97 versus CG: 8.12±3.59, CI, 5.66 to 7.43, p = 0.002) recorded for the teams using the 11+ program. There was a statistically significant difference between levels of compliance (high, moderate or low) on the dependent variables (wins, losses, and ties), F(3, 22) = 3.780, p =0.004; Wilks' Λ = .435; partial η2 = .340. # Conclusion The 11+ has the capacity to improve overall team performance in male collegiate soccer teams. The higher the compliance, the more favorable the team performance. This research may be a vital addition when attempting to persuade coaching staffs to adopt an IPP into their training regimen. # Level of Evidence Level

Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial

Objective To examine the effect of a comprehensive warm-up programme designed to reduce the risk of injuries in female youth football

Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams

Purpose The available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams. Methods A survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup. Results Following responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric. Conclusions The present study showed that many of the National football (soccer) teams’ injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices

High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players : A cluster randomised trial

Background A protective effect on injury risk in youth sports through neuromuscular warm-up training routines has consistently been demonstrated. However, there is a paucity of information regarding the quantity and quality of coach-led injury prevention programmes and its impact on the physical performance of players. Objective The aim of this cluster-randomised controlled trial was to assess whether different delivery methods of an injury prevention programme (FIFA 11+) to coaches could improve player performance, and to examine the effect of player adherence on performance and injury risk. Method During the 2011 football season (May- August), coaches of 31 tiers 1-3 level teams were introduced to the 11+ through either an unsupervised website or a coach-focused workshop with and without additional on-field supervisions. Playing exposure, adherence to the 11+, and injuries were recorded for female 13-year-old to 18-year-old players. Performance testing included the Star Excursion Balance Test (SEBT), single-leg balance, triple hop and jumping-over-a-bar tests. Results Complete preseason and postseason performance tests were available for 226 players (66.5%). Compared to the unsupervised group, singleleg balance (OR=2.8; 95% CI 1.1 to 4.6) and the anterior direction of the SEBT improved significantly in the onfield supervised group of players (OR=4.7; 95% CI 2.2 to 7.1), while 2-leg jumping performance decreased (OR=-5.1; 95% CI -9.9 to -0.2). However, significant improvements in 5 of 6 reach distances in the SEBT were found, favouring players who highly adhered to the 11+. Also, injury risk was lower for those players (injury rate ratio, IRR=0.28, 95% CI 0.10 to 0.79). Conclusions Different delivery methods of the FIFA 11+ to coaches influenced players' physical performance minimally. However, high player adherence to the 11+ resulted in significant improvements in functional balance and reduced injury risk