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The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial [with consumer summary]
Emery CA, Meeuwisse WH
British Journal of Sports Medicine 2010 Jun;44(8):555-562
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; 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: Soccer is a leading sport for participation and injury in youth. OBJECTIVE: To examine the effectiveness of a neuromuscular prevention strategy in reducing injury in youth soccer players. DESIGN: Cluster-randomised controlled trial. SETTING: Calgary soccer clubs (male or female, U13 to U18, tier 1 to 2, indoor soccer). PARTICIPANTS: Eighty-two soccer teams were approached for recruitment. Players from 60 teams completed the study (32 training (n = 380), 28 control (n = 364)). INTERVENTION: The training programme was a soccer-specific neuromuscular training programme including dynamic stretching, eccentric strength, agility, jumping and balance (including a home-based balance training programme using a wobble board). The control programme was a standardised warm-up (static and dynamic stretching and aerobic components) and a home-based stretching programme. MAIN OUTCOME MEASURES: Previously validated injury surveillance included injury assessment by a study therapist. The injury definition was soccer injury resulting in medical attention and/or removal from a session and/or time loss. RESULTS: The injury rate in the training group was 2.08 injuries/1,000 player-hours, and in the control group 3.35 injuries/1,000 player-hours. Based on Poisson regression analysis, adjusted for clustering by team and covariates, the incidence rate ratios (IRR) for all injuries and acute onset injury were 0.62 (95% CI 0.39 to 0.99) and 0.57 (95% CI 0.35 to 0.91). Point estimates also suggest protection of lower extremity, ankle and knee sprain injuries (IRR 0.68 (95% CI 0.42 to 1.11), IRR 0.5 (95% CI 0.24 to 1.04) and IRR 0.38 (95% CI 0.08 to 1.75)). CONCLUSIONS: A neuromuscular training programme is protective of all injuries and acute onset injury in youth soccer players.
Reproduced with permission from the BMJ Publishing Group.

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