Effect of the FIFA 11+ soccer specific warm up programme on the incidence of injuries: A cluster-randomised controlled trial

Assuman Nuhu; Jennifer Jelsma; Kim Dunleavy; Theresa Burgess

doi:10.1371/journal.pone.0251839

Effect of the FIFA 11+ soccer specific warm up programme on the incidence of injuries: A cluster-randomised controlled trial

PLoS One. 2021 May 24;16(5):e0251839. doi: 10.1371/journal.pone.0251839. eCollection 2021.

Authors

Assuman Nuhu^{1

2}, Jennifer Jelsma², Kim Dunleavy³, Theresa Burgess²

Affiliations

¹ Department of Physiotherapy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
² Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
³ Department of Physical Therapy, University of Florida, Gainesville, FL, United States of America.

Abstract

Background: Soccer players incur injuries that typically affect their performance. Injuries are caused by intrinsic and extrinsic factors that call for multifactorial preventive interventions. The study examines the impact of the FIFA 11+ warm up programme on the incidence and severity of injuries in second division soccer players in Rwanda.

Methods: Twelve teams (309 players) were randomised in the intervention group and 12 teams (317 players) in the control group using a cluster randomized controlled trial with teams as the unit of randomization. Intervention group teams implemented the FIFA 11+ soccer specific warm-up programme during training and matches at least three times a week over seven months of the Rwandan soccer season. Control group teams continued with usual warm up exercises. The primary outcome of this study was the overall incidence of training and match injuries. Injuries, training and match exposure as well as severity categories were recorded per the F-MARC guidelines.

Results: A lower proportion of players sustained injuries in the intervention group (52%) compared to the control group (63%) (Odd ratio: 0.7; 95%CI: 0.5-0.9). A significantly lower rate ratio was observed in the intervention group for overall (RR = 0.6; 95%CI: 0.5-0.8) and match (RR = 0.6; 95%CI: 0.5-0.8) injuries. Compliance to the injury prevention programme was 77%. In the intervention group, the incidence of injury was similar across all teams and across the medium and highly compliant teams. There was a statistically significant 55% and 71% reduction of the rate of moderate and severe injuries in the intervention group respectively.

Conclusion: The 11+ warm up injury prevention programme resulted in a significant reduction in the odds of sustaining injuries. In addition, injuries sustained were less severe. The programme should be rolled out to all teams in Rwanda and may well result in a decrease in the incidence and severity of injury in similar contexts.

Trial registration: Pan African Clinical Trial Registry (PACTR201505001045388).

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Athletic Injuries / epidemiology
Athletic Injuries / physiopathology
Athletic Injuries / prevention & control*
Humans
Male
Rwanda / epidemiology
Soccer / injuries
Soccer / physiology*
Warm-Up Exercise / physiology*

Associated data

PACTR/PACTR201505001045388

Grants and funding

The study was funded by the Government of Rwanda though a PhD scholarship by the Rwanda Education Board. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.