The FIFA 11+ injury prevention program reduces the incidence of hamstring injury among soccer players: a systematic review and meta-analysis

Abstract

Introduction: Hamstring injury are among the most common non-contact injuries in sports. In soccer, which is the most popular sport worldwide, hamstring injuries represent between 15 and 50 % of all muscle injuries. Sports injury prevention programs have been showing promising results in reducing the risk of hamstring injury. The purpose of this systematic review and meta-analysis was to investigate the effectiveness of the FIFA 11+ Injury Prevention Program on reducing the incidence hamstring injury among soccer players. Methods: This systematic review with meta-analysis was based upon the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search for relevant studies published from 1985-2022 using the following databases: Cochrane Library, MEDLINE, AMED, PubMed, Web of Science, and PEDro was conducted. The keywords used in the search strategy were ‘neuromuscular training’, ‘injury prevention programs’, ‘FIFA 11+’, ‘hamstring injury’, ‘soccer, and variations of these search terms. Included studies had to be randomized controlled trials using FIFA 11+ Injury Prevention Program for soccer players with the primary outcome being hamstring injury rate. There were no restrictions of age or playing level. The random-effects model was used in analysing the extracted data by the RevMan Meta-Analysis software version 5. Results: The pooled results of 2949 players and 274032 exposure hours showed 66% hamstring injury reduction per 1000 hours of exposure in the intervention group compared to control group with an injury risk ratio [IRR] of 0.34 (95% confidence interval [CI] 0.21–0.55, P < 0.0001). Discussion/Conclusion: This is the first meta-analysis of randomized controlled trials to evaluate the effectiveness of FIFA 11+ Injury Prevention Program in reducing the incidence of hamstring injury among soccer players. This meta-analysis demonstrates that the FIFA 11+ Injury Prevention Program reduces the incidence of hamstring injury by 66% among soccer players. Impact/Application to the field: The results showed a 66 % hamstring injury reduction. Therefore, it's recommended that soccer players and coaches implement the FIFA 11+ Injury Prevention Program in their current practice. Conflict of interest statement: No conflict of interest of relevance to the submission of this abstract.