THE EFFECT OF COMPREHENSIVE WARM UP (FIFA 11+ PROGRAM) ON MOTOR ABILITIES IN YOUNG BASKETBALL PLAYERS: A PILOT STUDY

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1 Acta Medica Mediterranea, 2018, 34: 703 THE EFFECT OF COMPREHENSIVE WARM UP (FIFA 11+ PROGRAM) ON MOTOR ABILITIES IN YOUNG BASKETBALL PLAYERS: A PILOT STUDY NEŞE SAHIN 1, VELI VOLKAN GÜRSES 2, BILGEHAN BAYDIL 2, MUSTAFA ŞAKIR AKGÜL 2, KALTRINA FEKA 3, ANGELO IOVANE 4, GIUSEPPE MESSINA 4 1 Faculty of Sport Science, Ankara Üniversity - 2 School of Physical Education and Sport, Kastamonu University - 3 PhD Program in Health Promotion and Cognitive Sciences, Sport and Exercise Sciences Research Unit, University of Palermo - 4 Department of Psychology, Pedagogical and Educational Science, Sport and Exercise Sciences Research Unit, University of Palermo, Italy ABSTRACT Aim: Recent findings indicated that dedicated warm up activities may significantly affect performance and prevent injuries. Furthermore, since it is known that comprehensive warm up program helps in prevention injuries, the purpose of this study was to investigate the effects of a comprehensive warm-up program (F-MARC The 11+) on performance and injuries in young basketball players. While knowing the specifics and possible injuries of basketball game, the prevention of injuries must be considered as an important issue. Methods: Twenty children (mean ± SD: age 10,7 ± 0,3 yr; height 149,20 ± 7.51, weight 47,61 ± 12,30 kg, percentage of body fat: 14,44 ± 7,68 %) were recruited from two local basketball clubs to participate in this study. Players were randomly selected and assigned to either group: experimental (Exp. n = 10) or a control (Con. n = 10), respectively. They were trained 3 days per week (2,1 ± 0,6 years of experience), for 10 weeks in a row. The experimental group followed the F-MARC 11+ program for 20 minutes during warm up phase in each training season for ten weeks while control group performed their regular warm up routine. Both groups performed vertical jumps and pro agility tests at the beginning and at the end of the tenth-week training sessions. Moreover, nonparametric Wilcoxon signed rank tests were performed to compare the pre and post test scores. Results: The agility pre-test result was found 6,358 ± 0, 27 seconds and post-test was found 6,121 ± 0, 34 seconds. A significant difference was found between agility test values ( p<0,05) Discussion: Comprehensive warm-up program leads to a significant change in agility in the present study. Therefore, this is a desirable result since basketball is characterized by many quick movements such as sudden speed-ups, stops and turns. Eventually, previous studies indicated that the FIFA 11+ program resulted to be an important way to warm up properly before training sessions. Conclusion: Based on the results of this study we may conclude that "The F-MARC 11+" comprehensive warm-up is an appropriate and effective tool for improving basketball-specific performance such as agility in young basketball players. Keywords: physical fitness, performance, agility, FIFA 11+, injury prevention. DOI: / _2018_3_108 Received November 30, 2017; Accepted January 20, 2018 Introduction Basketball is one of the most popular sport worldwide. Knowing all the specifics of basketball, we may say that injuries come along the way. Furthermore, the literature suggests that physical performance is affected by the seasonal number of injuries and as consequence by not proper and dedicated warm up programs (1,2). Moreover, wide spread injuries in basketball mostly affect the lower limbs, notably the knee and the ankle (3-5). This is a result from the fact that basketball is a sport which is characterized complicated movements such as: running, changes of direction, lateral movements, jumps, and uncontrolled landings. However, the rate of injuries in game situations were 2 times higher than in practices (6,7), and this is due to the fact that movements during the

2 704 Neşe Sahin, Veli Volkan Gürses et Al game are unpredictable. Therefore, a player should have a high level of cardiovascular and musculoskeletal fitness in order to perform the workload and basketball specific rapid movements. In order to minimize the injuries, improving aerobic and anaerobic capacity as well as neuromuscular performance such as power, balance and agility is needed (8-10). Nevertheless, numerous of studies have shown that comprehensive warm-up programs are used to prevent sport injuries by enhancing physical fitness in general. Although, there is no specific injury prevention warm-up developed for basketball players, it is known that The 11+ developed with the support of the Fédération Internationale Football Association (FIFA) by FİFA Medical and Research Center (F-MARC), aims to reduce the effect of intrinsic injury risk factor (11-13). However, several parameters can be related to the injury risk of athletes (14). According to all the data about injury mechanism in basketball (5,15) the success of the program (The 11+) is related to improvement of core stability during running and landing, it also improves balance and proprioception. However, there is only one study that evaluated the effectiveness of FIFA 11+ on injury prevention in basketball (11), based on that the aim of this pilot study was to determine suitability and effectiveness of The 11+ comprehensive warm-up program in developing physical competencies in young basketball players. Methods Subjects Twenty six children were recruited from two local basketball clubs to participate in this study. They trained 3 days per week (with 2.1 ± 0,6 years of experience) for 10 weeks in a row. Players were randomly selected and assigned to either group; experimental (Exp. n=13) or a control (Con. n=13) (Diagram 1). However, 6 participants were excluded from this study because they missed at least two consecutive sessions within the first three weeks of intervention, while twenty participants completed this study. The study has been approved from ethical committee of Faculty of Sport Science, Ankara Üniversity and Helsinki declaration s principles were taken into consideration. Study Design This study was matched participants design, with an observational (pre-post) study on a subset of the controls (n=10) who completed 10 weeks of a F-MARC 11+ program during warm up protocols before training interventions. The Consolidated Standards of Reporting Trials (Consort) Statement was set as a standard (16) (Diagram 1). Diagram 1: Flowchart of the study. Training Interventions The FIFA 11+ program of warming up consisted of 3 parts with 15 exercises, which were executed in the specified sequence at the beginning of each training session. Part 1, slow-speed during running mixed with active stretching, and controlled contacts with a partner; part 2 contained 6 sets of strength, balance, and jumping drills, each with 3 levels of increasing difficulty; and the last part 3 consisted of speed running combined with changes in direction. The experimental group followed F-MARC 11+ program for 20 minutes during warm up phase in each training season for ten weeks, while control group performed their regular warm up routine (all warm up exercises were balanced in terms of volume, intensity and frequency). Both groups performed vertical jumps and pro agility tests at the beginning and at the end of the ten-week training sessions. Testing Procedures Body Composition Body weight and percentage of body fat -PBF (%), were measured by bioelectric impedance

3 The effect of comprehensive warm up (FIFA 11+ program) on motor abilities in young basketball players: a pilot study 705 analysis (BIA) (Jawon Segmental Body Composition Analyzer, model AVIS 333 Plus). Physical Performance Measures Both groups performed the vertical jumps and pro-agility tests at the beginning and at the end of the tenth-week of training session in this study. One week before and another week after the intervention of performance tests, participants performed two adaptation trails of tests. In addition, agility was evaluated by the pro agility tests, while in the other hand jumping abilities were assessed using vertical jump test. Furthermore, time in the pro-agility test was assessed by means of photoelectric cells, (Newtest Powertimer 300-U, Newtest Oy, Finland). Firstly, participants started with straddling the 4.57 m line (midline) in a three-point distance, secondly, they continued with sprints towards the right, touching the goal line with their right hand. Afterwards, they immediately turned around and did another sprint to the 9.14 m line; they touched this line with their left hand. Finally, they turned around and did the sprints through the finishing line (the midline located at the 4.57 m line). The test is illustrated in Figure 1. The image was published by Robert Lockie et al 2016 (17). Statistical Analysis All data were entered into a database using SPPS Software Version Chicago: SPSS Inc. Descriptive statistics were computed in the form of means and standard deviations. Nonparametric Wilcoxon signed ranked test were performed to compare the mean scores of the pre-test and posttest. (dependent variables: player height, body fat percentage, pro-agility test results expressed in seconds, vertical jump height in centimeters). Significance was set at Results As mentioned above, 20 young athletes were enrolled in this study (mean ± SD: age 10.7 ± 0,3 yrs; height 149,20 ± 7,51, weight 47,61 ± 12,30 kg, percentage of body fat: 14.44). The means and standard deviations for height, percentage of body fat, agility and vertical jump performance measures, for each of experimental and control group used in the study are shown in Table 1. The results of the nonparametric Wilcoxon signed rank test suggested that statistically significant difference was observed in experimental group for the pro-agility test (P < 0.001). On the other hand there were no significant differences observed for height, body fat percentage, and vertical jump height. Discussion Fig. 1: Pro-Agility Test adopted by Robert Lockie et al in 2016 (17). Each player had three trials interspersed with three minutes of rest. The best test times were used for the analysis. Furthermore, vertical jump height was obtained using a platform with specific design software (Newtest Powertimer 300-U, Newtest Oy, Finland) (18). Moreover, jumping height was determined as the centre of mass displacement calculated from force development and measured body mass. The 11+ is a program developed by F-MARC, the medical research centre of The Federation Internationale de Football Association (FIFA). This protocol was created as a strategy for accident prevention (19). It helps to improve the neuromuscular control that reduces the risk of injury (20). Furthermore, we evaluated the efficacy of the FIFA 11+ program in developing physical competencies. According to Hanni R. Cowey et al (21) the sports in which injuries happens more often are in soccer with 21% and in basketball with 20%, and since there is one paper published regarding this issue (19), we decided to make another similar study related to the one mentioned above. In our knowledge our pilot intervention is the second randomized controlled trial to evaluate the effectiveness of this specific program in basketball players. Nevertheless, different studies have shown that agility is defined as rapid whole-body movement with change of velocity or direction in response to a stimulus and is viewed as a complex motor skill

4 706 Neşe Sahin, Veli Volkan Gürses et Al involving physical, as well as cognitive, factors (22). Experimental Control Pre-Test mean Std. Post-test Std. p value Pre-test mean Std. Post-test Std. p value Height (cm) , ,32 0, , ,441 0,22 Weight (kg) 51,60 12,37 49,35 12,46 0,007** 43,61 11,93 41,5 10,54 0,002** Body Fat (%) , ,517 0,062 13,33 8, ,67 0,182 Vertical jump (cm) 26,57 3, ,367 0, , ,66 0,441 Agility (sec) ,3450 6,06 0,3495 0,03* 6.3 0, ,5356 0,476 Table 1: Experimental group and control group results in pre and post test. The results of the current study showed a significant difference in change of direction performance between control and experimental groups, which is in accordance with the results reported by Condello et al (22). However, agility performance features are needed to be investigated in basketball players and these changes are desirable regardless of a players age or playing level. Knowing the specifics of the basketball game the ability to change of directions with speed during the game is fundamental for this sport. Thus, exercises that improve these characteristics can be crucial in enhancement of basketball players performance. These results confirm findings of Kilding, A. E. et al (23). The 11+ program improve the strength, neuromuscular recruitment and coordination of muscle (24). Our data are in line with the study of Gomes et al (25). Authors proved that FIFA 11+ was able to improve dynamic balance and agility (25). Furthermore, we can attribute these improvements to the physical training program. In our pilot intervention the sample was homogeneous and the scores were compared to a control group consisting of athletes practicing the same sport like other researchers already did before (26). Kilding, A. E. et al showed an adherence rate for completion of all exercises of 72% (23). This is also confirmed in our study, with only the 23,1% of the players that declined to participate (Diagram 1). However, the researchers described a high degree of boredom in the subjects in the execution of the protocol (23). In conclusion, based on the results of this pilot study we may conclude that The F-MARC 11+ comprehensive warm-up program is an appropriate and effective program for improving basketballspecific performance such as agility in young basketball players. References 1) Pasanen K, Parkkari J, Pasanen M, Kannus P. Effect of a neuromuscular warm-up programme on muscle power, balance, speed and agility: a randomised controlled study. British journal of sports medicine. 2009; 43(13): ) Kilding AE, Tunstall H, Kuzmic D. Suitability of FIFA s The 11 training programme for young football players-impact on physical performance. J Sports Sci Med. 2008; 7: ) Adirim TA, Barouh A. Common orthopaedic injuries in young athletes. Current Paediatrics. 2006; 16(3): ) Vanderlei FM, Bastos FN, de Lemes ÍR, Vanderlei LC, Júnior JN, et al. Sports injuries among adolescent basketball players according to position on the court. International archives of medicine. 2013; 6(1):5-. 5) Meeuwisse WH, Sellmer R, Hagel BE. Rates and risks of injury during intercollegiate basketball. The American Journal of Sports Medicine. 2003; 31(3): ) Dick R, Hertel J, Agel J, Grossman J, Marshall SW. Descriptive epidemiology of collegiate men s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, through Journal of Athletic Training. 2007; 42(2): ) Agel J, Olson DE, Dick R, Arendt EA, Marshall SW, et al. Descriptive epidemiology of collegiate women's basketball injuries: National Collegiate Athletic Association Injury Surveillance System, through Journal of athletic training. 2007; 42(2): ) Battaglia G, Giustino V, Iovane A, Bellafiore M, Martines F, et al. Influence of occlusal vertical dimension on cervical spine mobility in sports subjects. Acta Medica Mediterranea. 2016; 32(5): ) Patti A, Bianco A, Messina G, Paoli A, Bellafiore M, et al. The influence of the stomatognathic system on explosive strength: a pilot study. J Phys Ther Sci Jan; 28(1): ) Sahin N, Bianco A, Patti A, Paoli A, Palma A, et al. Evaluation of knee joint proprioception and balance of young female volleyball players: a pilot study. J Phys Ther Sci Feb; 27(2): ) Longo UG, Loppini M, Berton A, Marinozzi A, Maffulli N, et al. The FIFA 11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players A Cluster Randomized Controlled Trial. The American

5 The effect of comprehensive warm up (FIFA 11+ program) on motor abilities in young basketball players: a pilot study 707 journal of sports medicine. 2012; 40(5): ) Brito J, Figueiredo P, Fernandes L, Seabra A, Soares JM, et al. Isokinetic strength effects of FIFA's" The 11+" injury prevention training programme. Isokinetics and Exercise Science. 2010; 18(4): ) Steffen K, Meeuwisse WH, Romiti M, Kang J, McKay C, et al. Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. British journal of sports medicine. 2013;47(8): ) Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. British Journal of Sports Medicine. 2005; 39(6): ) Krosshaug T, Nakamae A, Boden BP, Engebretsen L, Smith G, et al. Mechanisms of anterior cruciate ligament injury in basketball video analysis of 39 cases. The American Journal of Sports Medicine. 2007; 35(3): ) Schulz KF, Altman DG, Moher D, Group C. CON- SORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2011;9(8): ) Lockie R, Lazar A, Orjalo A, Davis D, Moreno M, et al. Profiling of Junior College Football Players and Differences between Position Groups. Sports. 2016; 4(3): ) Enoksen E, Tonnessen E, Shalfawi S. Validity and reliability of the Newtest Powertimer 300-series testing system. J Sports Sci Jan 1; 27(1): ) Longo UG, Loppini M, Berton A, Marinozzi A, Maffulli N, et al. The FIFA 11+ program is effective in preventing injuries in elite male basketball players: a cluster randomized controlled trial. Am J Sports Med May; 40(5): ) Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc Jul; 17(7): ) Cowley HR, Ford KR, Myer GD, Kernozek TW, Hewett TE. Differences in neuromuscular strategies between landing and cutting tasks in female basketball and soccer athletes. J Athl Train Jan-Mar; 41(1): ) Condello G, Kernozek TW, Tessitore A, Foster C. Biomechanical Analysis of a Change-of-Direction Task in Collegiate Soccer Players. Int J Sports Physiol Perform Jan; 11(1): ) Kilding AE, Tunstall H, Kuzmic D. Suitability of FIFA's The 11 Training Programme for Young Football Players - Impact on Physical Performance. J Sports Sci Med. 2008; 7(3): ) Chimera NJ, Swanik KA, Swanik CB, Straub SJ. Effects of Plyometric Training on Muscle-Activation Strategies and Performance in Female Athletes. J Athl Train Mar; 39(1): ) Gomes Neto M, Conceicao CS, de Lima Brasileiro AJA, de Sousa CS, Carvalho VO, et al. Effects of the FIFA 11 training program on injury prevention and performance in football players: a systematic review and meta-analysis. Clin Rehabil May; 31(5): ) Bianco A, Patti A, Thomas E, Palma R, Maggio MC, et al. Evaluation of fitness levels of children with a diagnosis of acute leukemia and lymphoma after completion of chemotherapy and autologous hematopoietic stem cell transplantation. Cancer Med Apr; 3(2): Corresponding author GIUSEPPE MESSINA giuseppe.messina17@unipa.it Via Giovanni Pascoli Palermo (Italy)

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