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Prevention of injuries among male soccer players: a prospective, randomized intervention study targeting players with previous injuries or reduced function
Engebretsen AH, Myklebust G, Holme I, Engebretsen L, Bahr R
The American Journal of Sports Medicine 2008 Jun;36(6):1052-1060
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: This study was conducted to investigate whether the most common injuries in soccer could be prevented, and to determine if a simple questionnaire could identify players at increased risk. HYPOTHESIS: Introduction of targeted exercise programs to male soccer players with a history of previous injury or reduced function in the ankle, knee, hamstring, or groin will prevent injuries. STUDY DESIGN: Randomized controlled trial; level of evidence, 2. METHODS: A total of 508 players representing 31 teams were included in the study. A questionnaire indicating previous injury and/or reduced function as inclusion criteria was used to divide the players into high-risk (HR) (76%) and low-risk (LR) groups. The HR players were randomized individually into an HR intervention group or HR control group. RESULTS: A total of 505 injuries were reported, sustained by 56% of the players. The total injury incidence was a mean of 3.2 (95% confidence interval (CI) 2.5 to 3.9) in the LR control group, 5.3 (95% CI 4.6 to 6.0) in the HR control group (p = 0.0001 versus the LR control group), and 4.9 (95% CI 4.3 to 5.6) in the HR intervention group (p = 0.50 versus the HR control group). For the main outcome measure, the sum of injuries to the ankle, knee, hamstring, and groin, there was also a significantly lower injury risk in the LR control group compared with the 2 other groups, but no difference between the HR intervention group and the HR control group. Compliance with the training programs in the HR intervention group was poor, with only 27.5% in the ankle group, 29.2% in the knee group, 21.1% in the hamstring group, and 19.4% in the groin defined as having carried out the minimum recommended training volume. CONCLUSION: The players with a significantly increased risk of injury were able to be identified through the use of a questionnaire, but player compliance with the training programs prescribed was low and any effect of the intervention on injury risk could not be detected.

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