Effects of Injury Prevention Exercises on Performance and Neuromuscular Function
Condition: Sport Injury; Adherence, Patient
MeSH terms: Wounds and Injuries; Athletic Injuries
Study type: Interventional

Summary: 
      This study evaluates the effects of two different injury prevention exercise programs on
      sports-relevant performance tests and neuromuscular function in youth football players. Half
      of participants will receive education on an existing and previously tested exercise program,
      while the other half will receive education on a newly developed exercise program.
    

Detailed description: 
      Injury prevention exercise programs have been developed for a variety of sporting contexts
      and many have proven to be efficacious in preventing injuries. Adherence with the training
      may, however, be an issue and poor adherence may limit the preventive effect. If using the
      preventive exercise programs can be shown to improve sports-relevant performance this may
      motivate both coaches and players to use these programs, since the reduction in injury risk
      is harder to notice for the individual.

      This study focuses on a Swedish injury prevention exercise program called Knee Control. The
      program has been found efficacious in preventing acute knee injuries in girls' adolescent
      football players in previous trials. We have found, however, that coaches often modify the
      Knee Control program to improve program fit and player buy-in among female youth football
      players. Careful changes must be made to the program since there is a risk of compromising
      the preventive effect and the effect on performance if the training dose is too low or if
      effective exercises are replaced with other exercises. We have therefore further developed
      the Knee Control program, to a Knee Control+ program, to support the coaches in the tailoring
      of the program to preserve the preventive effect and hopefully enhance performance effects.
      By introducing more variation with easier and more difficult exercises, pair-exercises,
      competitive and plyometric elements the new Knee Control+ program may better fit both the
      youngest and the oldest players, which in turn may facilitate fidelity with and maintenance
      of the program.

      The aim of the study is to compare the neuromuscular and performance effects of the original
      Knee Control and the new Knee Control+ programs among youth female and male football players.
      A secondary aim is to study player and coach experiences of the programs and their fidelity
      with the training protocol.

      Hypothesis: We expect similar effects of both programs, or superior effects of the Knee
      Control+ program, showing that the programs are compatible but the program adherence and
      fidelity being better with Knee Control+.

      Methods: Eight youth football teams (4 boys, 4 girls, age 13-17 years) with approximately 120
      players will be included in the study. Four teams will receive education about the Knee
      Control program and four teams about the Knee Control+ program. All coaches and two to three
      players per team will take part in a workshop at baseline where registered physiotherapists
      will give practical instructions of the intervention exercise programs. The workshops will
      also contain theoretical information about injuries in football and the background for either
      the Knee Control or the Knee Control+ programs. The attending coaches and players will be
      able to test all exercises and receive feedback about correct movement technique.

      Outcomes: Football-relevant performance and neuromuscular function will be tested at baseline
      and after 12 weeks of training.
    

Intervention name(s): Injury prevention exercise programs
Intervention type(s): Other
Intervention description(s): The two intervention programs contain exercises aiming to increase lower extremity strength, core stability, balance and neuromuscular function.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two-armed cluster randomized parallel trial
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention