The effect of exposure to the FIFA 11+ warm-up program on injury risk knowledge and prevention beliefs in elite female youth soccer Carly D McKay, Kathrin Steffen, Maria Romiti, Caroline F Finch, Carolyn A Emery
Background The FIFA 11+ has demonstrated efficacy at reducing injuries in female youth soccer 29-43% incidence reduction over a single season Emery et al 2010: Soligard et al 2010: Hagglund et al 2013; Steffen et al 2013
Background The FIFA 11+ has demonstrated efficacy at reducing injuries in female youth soccer 29-43% incidence reduction over a single season Adherence to the program is necessary for protective effect Highest adherence groups demonstrate superior injury risk reductions Emery et al 2010: Soligard et al 2010: Hagglund et al 2013; Steffen et al 2013
Background Increasing awareness does not necessarily translate to injury reduction Coaches with poor knowledge of prevention strategies do not routinely use them in training One study has shown that participating in prevention programs (in soccer) does not change attitudes, beliefs, or behaviour Arnason et al 2005; Twomey et al 2008; Gilchrist et al 2008
Objective To explore the effect of exposure to the FIFA 11+ on injury knowledge and beliefs in female youth soccer Players Coaches
Design Included 31 teams in 2011 season Female teams only Player ages 13-18 Tiers 1-3 Alberta, Canada Sub-cohort analysis Coaches (n = 29) Players (n = 258) Steffen et al 2013a; Steffen et al 2013b
Outcome Measures Pre-season and post-season questionnaires Coach and player versions Knowledge, prevention beliefs Teams recorded adherence to FIFA 11+ during the season Daily recording sheet the
Results At baseline, coaches were more likely than players to believe injuries are preventable (z = -3.90, p = 0.0001) At post-season, this difference was no longer significant (z = -1.76, p = 0.08) No effect of FIFA 11+ adherence on these beliefs
Results Is inadequate warm-up an injury risk factor? PRE-SEASON Coaches 69.0% (95% CI: 52.2, 85.8) POST-SEASON Coaches 51.7 (95% CI: 33.5, 69.9) Players 77.9% (95% CI: 72.8, 83.0) Players 78.7%* (95% CI: 73.7, 83.7) No effect of FIFA 11+ adherence on these beliefs
Results Can a warm-up prevent injury? PRE-SEASON Coaches Muscle: 13.8% (1.3, 26.4) Knee: 0 Ankle: 0 POST-SEASON Coaches Muscle: 10.3% (0, 21.4) Knee: 0 Ankle: 0 Players Muscle: 9.7% (6.1, 13.3) Knee: 4.7* (2.1, 7.3) Ankle: 4.7* (2.1, 7.3) Players Muscle: 9.3% (5.8, 12.8) Knee: 1.2 (0, 2.5) Ankle: 4.3* (1.8, 6.8) No effect of Presented FIFA at the International 11+ Olympic Committee adherence World Conference: Prevention on of Injury and Illness in Sport, Aprtil 2014 these beliefs
Results What is the best method for preventing injury? PRE-SEASON Coaches Muscle: Stretching (24.1%) Knee: Strengthening (13.8%) Ankle: Strengthening (13.8%) POST-SEASON Coaches Muscle: Stretching (27.6%) Knee: Strengthening (27.6%) Ankle: Strengthening (10.3%) Players Muscle: Stretching (38.8%) Knee: Strengthening (14.3%) Ankle: Stretching (18.2%) Players Muscle: Stretching (36.0%) Knee: Strengthening (9.7%) Ankle: Stretching (18.2%)
Discussion Few coaches and players believed injuries were preventable Inadequate warm-up was identified as a risk factor, but few endorsed it as a prevention strategy Stretching still endorsed as the best prevention strategy by players (coaches less so)
Conclusions Exposure to the FIFA 11+ is insufficient for changing risk or prevention beliefs in a single season This could influence sustained program use Delivery methods must be supplemented with additional behaviour change strategies
Acknowledgements AO ALBERTA Osteoarthritis Team The UofC Sport Injury Prevention Research Centre is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee @Dr_CMcKay www.ucalgary.ca/siprc