The Dose-Response Relationship of Neuromuscular Training to Prevent Lower Extremity Injuries in Young Soccer Players. A Cluster Randomised Controlled Trial

Abstract

The regular execution of neuromuscular training has been shown to reduce injuries of the lower extremities in youth athletes. However, to date there are inconsistent results on the dose-response relationship of neuromuscular training. PURPOSE: The aim of this study was to evaluate the optimal duration of neuromuscular training to prevent injuries of the lower extremities in young soccer players. METHODS: 342 (15.4±1.7 years) male soccer players were included in the study, and cluster-randomized into two intervention groups. Both groups completed the same soccer specific warm-up program (FIFA 11+) twice a week, but for a different duration: one intervention group (INT10, n=175) twice a week for 10 minutes, the other (INT20, n=167) twice a week for 20 minutes. The player exposure hours (hrs) were collected monthly over six months during one soccer season. Primary outcome was the incidence of lower extremity (LE) injuries. Secondary outcomes were injury type, severity, mechanism and compliance to the intervention. RESULTS: During the entire season 123 young soccer players sustained a total of 145 lower extremity injuries (INT 10: 55; INT 20: 90). (INT 10: 55; INT 20: 90). No significant group difference was found between INT10 (6.37 per 1000 hrs) and INT20 (7.20 per 1000 hrs) for the relative risk of injuries of the lower extremities (RR= 1.03, 95 % confidence interval 0.59, 1.79), nor for the distribution of injury location, type, severity, mechanism or conditions. CONCLUSION: The results suggest that performing preventive exercises for 10 minutes is just as effective as a performance of 20 minutes. Consequently, the implementation of a neuromuscular training for 10 minutes twice a week seems to be sufficient to reduce injuries of the lower extremities in young male football players.