BACKGROUND: To assess the effectiveness of the Wrestling plus injury prevention program on incidence of injuries, neuromuscular mechanisms and dynamic balance of freestyle (FS) wrestler. METHODS: The participants of this study consisted of FS wrestling players in Qom province (Iran). A total of 80 participants were assigned to this study and using simple and random method with computer divided into experimental (EXP, n = 40) and control (CON, n = 40) groups. The groups were blinded against each other. The follow-up period was one season (6 months). EXP replaced their warm-up by Wrestling plus program. CON performed a standard warm-up program. The primary outcome was the injury incidence density (injuries per 1000 h of wrestling exposure), compared between groups by incidence rate ratios (RR). Also, the secondary outcome was neuromuscular mechanisms and dynamic balance. RESULTS: The per-protocol analysis showed a reduction of the overall injury incidence density in the EXP group by 58% compared to the CON group. Additionally, within-group analyses revealed significant improvements in neuromuscular mechanisms and dynamic balance for both the EXP and CON groups following 24 weeks of warm-up programs (p < 0.05). Furthermore, between-group comparisons indicated significant differences favoring the EXP group relative to the CON group (p < 0.05). CONCLUSION: The Wrestling plus program is effective in reducing injuries among FS wrestlers with overall injuries reduced by 58%. Moreover, the results indicate that the Wrestling plus program is more effective than traditional warm-up routines in improving neuromuscular mechanisms and dynamic balance among FS wrestlers. Therefore, it is recommended that coaches use a Wrestling plus program to reduce the incidence of injury in FS wrestlers.

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