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Ayala F, Robles-Palazón FJ, Blázquez-Rincón D, López-Valenciano A, López-López JA, De Ste Croix M. A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns. Ann Med 2024; 56:2337724. [PMID: 38614120 PMCID: PMC11018023 DOI: 10.1080/07853890.2024.2337724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 04/15/2024] Open
Abstract
The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.
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Affiliation(s)
- Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
| | - Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK
| | - Desirée Blázquez-Rincón
- Department of Psychology and Education, Faculty of Health Sciences and Education, Madrid Open University (UDIMA), Madrid, Spain
| | - Alejandro López-Valenciano
- Department of Education Science, School of Humanities and Communication Sciences, CEU-Cardenal Herrera University, Castellón de la Plana, Spain
| | - José Antonio López-López
- Department of Basic Psychology and Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Mark De Ste Croix
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
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Ramos AP, de Mesquita RS, Migliorini F, Maffulli N, Okubo R. FIFA 11+ KIDS in the prevention of soccer injuries in children: a systematic review. J Orthop Surg Res 2024; 19:413. [PMID: 39026353 PMCID: PMC11264619 DOI: 10.1186/s13018-024-04876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The "FIFA 11+" is an injury prevention program conceived for soccer athletes aged over 14. The use of FIFA 11+ Kids in soccer was associated with a reduction of the overall risk of injuries in children by 48%, and of 74% for serious injuries. However, to the best of our knowledge, a systematic review of the literature on the effects of FIFA 11+ Kids is still missing. Therefore, a systematic review was conducted to ascertain the benefits of the "FIFA 11+ KIDS" program in children who practice soccer. METHODS This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO. The electronic search was conducted in the following databases: Web of Science, PubMed, Medline via Ovid, EMBASE and SportDiscuss via EBSCO. Database searches were performed in January 2024. This review included studies that evaluated the effects of the "FIFA 11+ KIDS" program. Eligible studies had to describe program implementation and the mean age of the children. RESULTS A total of 11 articles were included in this systematic review from a pool of 8513 articles screened across various databases. These articles involved over 10,000 young participants from 8 countries, primarily aged 7-14 years, with the majority being soccer athletes. Study quality varied, with four categorized as high, four as good, and three as fair quality. Objectives varied across studies, with four focusing on FIFA 11+ Kids' efficacy in injury prevention, five examining its impact on performance and physical abilities, and two assessing its effects on children's focus and attention skills. Notably, injury prevention studies reported around a 50% reduction in overall injuries and nearly 60% in severe injuries, with a dose-response relationship observed with increased weekly sessions. Significant improvements were noted in physical and functional tests such as the Y balance, jump tests, and various soccer skills, along with positive effects on children's focus and attention, as indicated by 13-18% improvements in Attention Scale for Elementary School Children (ASESC) scores. CONCLUSION The FIFA 11+ KIDS injury prevention program appears to be effective in reducing injuries in young football players. This can positively influence player and team overall performance and might support the long-term athlete development of these young athletes. These findings highlight the importance and necessity of injury prevention in young athletes.
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Affiliation(s)
- Ana Paula Ramos
- Departament of Physiotherapy, University of South of Santa Catarina (UNISUL), Florianópolis, SC, Brazil
| | - Raphael Schmidt de Mesquita
- Physical Therapy Graduate Program, Department of Physiotherapy, University of the State of Santa Catarina, Florianópolis, SC, Brazil
| | - Filippo Migliorini
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler 5, 39100, Bolzano, Italy.
- Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy.
| | - Nicola Maffulli
- Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy
- Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke on Trent, ST4 7QB, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, London, E1 4DG, England
| | - Rodrigo Okubo
- Physical Therapy Graduate Program, Department of Physiotherapy, University of the State of Santa Catarina, Florianópolis, SC, Brazil
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Pinheiro LSP, Silva A, Madaleno FO, Verhagen E, de Mello MT, Ocarino JM, Resende RA. Prevalence and incidence of health problems and their characteristics in Brazilian para athletes: A one-season single-center prospective pilot study. Disabil Health J 2024; 17:101511. [PMID: 37612205 DOI: 10.1016/j.dhjo.2023.101511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Para athletes experience high prevalence and incidence of health problems related to sport. Despite this, there are few longitudinal studies. OBJECTIVE To describe the characteristics, prevalence, incidence, and severity of health problems in para athletes from one of the Brazilian Paralympic Reference Centers during a sports season and to compare the prevalence of health problems between para athletics, para powerlifting, and para swimming. METHODS This prospective pilot study was conducted from October 2019 to March 2020. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to record injuries and illnesses every week for 24 weeks. The characteristics, prevalence, incidence, and severity of health problems were described for each modality. The prevalence of health problems was compared among the three sport modalities. RESULTS Thirty-five para athletes participated. Most of the injuries occurred in the shoulder, and most illnesses caused respiratory and gastrointestinal symptoms. The average weekly prevalence and the incidence rate of health problems were 40.6% (95% CI 17.0-64.4) and 12.7 (95% CI 9.6-15.9) per 1000 athlete hours, respectively. Para powerlifting had the highest prevalence of all and substantial health problems; para swimming had the lowest prevalence of injuries; and para athletics had the lowest prevalence of illnesses. CONCLUSIONS This group of Brazilian para athletes showed a high prevalence and incidence of health problems throughout the season. Para athletics, para powerlifting, and para swimming each had a different prevalence of injuries and illnesses.
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Affiliation(s)
- Larissa Santos Pinto Pinheiro
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andressa Silva
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernanda Oliveira Madaleno
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marco Tulio de Mello
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana Melo Ocarino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renan Alves Resende
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Taghizadeh Kerman M, Brunetti C, Yalfani A, Atri AE, Sforza C. The Effects of FIFA 11+ Kids Prevention Program on Kinematic Risk Factors for ACL Injury in Preadolescent Female Soccer Players: A Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1206. [PMID: 37508703 PMCID: PMC10377808 DOI: 10.3390/children10071206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
This study aimed to investigate the effects of the 8-week FIFA 11+ Kids program on kinematic risk factors for ACL injury in preadolescent female soccer players during single-leg drop landing. For this, 36 preadolescent female soccer players (10-12 years old) were randomly allocated to the FIFA 11+ Kids program and control groups (18 players per group). The intervention group performed the FIFA 11+ Kids warm-up program twice per week for 8 weeks, while the control group continued with regular warm-up. Trunk, hip, and knee peak angles (from initial ground contact to peak knee flexion) were collected during the single-leg drop landing using a 3D motion capture system. A repeated measure ANOVA was used to analyze groups over time. Significant group × time interactions were found for the peak knee flexion, with a medium effect size (p = 0.05; effect size = 0.11), and peak hip internal rotation angles, with a large effect size (p < 0.01; effect size = 0.28). We found that the FIFA 11+ Kids program was effective in improving knee flexion and hip internal rotation, likely resulting in reducing ACL stress during single-leg drop landing in young soccer players.
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Affiliation(s)
- Maedeh Taghizadeh Kerman
- Department of Sports Injury and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamadan 65167-38695, Iran
| | - Claudia Brunetti
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20133 Milan, Italy
| | - Ali Yalfani
- Department of Sports Injury and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamadan 65167-38695, Iran
| | - Ahmad Ebrahimi Atri
- Department of Sports Physiology, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad 91779-48974, Iran
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20133 Milan, Italy
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Behm DG, Alizadeh S, Daneshjoo A, Konrad A. Potential Effects of Dynamic Stretching on Injury Incidence of Athletes: A Narrative Review of Risk Factors. Sports Med 2023; 53:1359-1373. [PMID: 37162736 PMCID: PMC10289929 DOI: 10.1007/s40279-023-01847-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 05/11/2023]
Abstract
The use of dynamic stretching as a replacement for static stretching in the warm-up is widespread based on the reports of static stretching-induced performance impairments. While acute and chronic static stretching has been reported to reduce musculotendinous injuries, especially with explosive and change of direction actions, the influence of dynamic stretching on injury incidence lacks a similar volume of literature for acute and chronic responses. It was the objective of this narrative review to examine the acute and training effects of dynamic stretching on injury incidence and possible moderating variables such as dynamic stretching effects on range of motion, strength, balance, proprioception, muscle morphology, and psycho-physiological responses. One study demonstrated no significant difference regarding injury incidence when comparing a dynamic stretching-only group versus a combined dynamic stretching plus static stretching group. The only other study examined functional dynamic stretching training with injured dancers and reported improved ankle joint stability. However, several studies have shown that dynamic activity with some dynamic stretching exercises within a warm-up consistently demonstrates positive effects on injury incidence. Regarding moderating variables, while there is evidence that an acute bout of dynamic stretching can enhance range of motion, the acute and training effects of dynamic stretching on strength, balance, proprioception, and musculotendinous stiffness/compliance are less clear. The acute effects of dynamic stretching on thixotropic effects and psycho-physiological responses could be beneficial for injury reduction. However, the overall conflicting studies and a lack of substantial literature compared with SS effects points to a need for more extensive studies in this area.
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Affiliation(s)
- David G. Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
| | - Abdolhamid Daneshjoo
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Andreas Konrad
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
- Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
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Teixeira VA, Queiroz TM, Leão IV, Innecco LDG, Marcelino EL, Lobato DFM. FIFA 11+ Kids program effects on jump kinetics in soccer players - A randomized controlled clinical trial. Res Sports Med 2023; 31:562-573. [PMID: 34823416 DOI: 10.1080/15438627.2021.2010204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to analyse the effects of the FIFA 11+ Kids programme on jump kinetics in soccer players. Twenty-four athletes (aged 9-11 years) were randomly allocated to the following groups: 1) the FIFA 11+ Kids programme (FT, n = 12), and 2) control training (CT, n = 12). Kinetic assessments of vertical jump (VJ), drop landing (DL), and anterior jump + maximum vertical jump (AJ) were performed on a force platform before and after eight weeks of training. Post-intervention impulse peak force and maximum impulse force (VJ) were significantly greater than the baseline values in the FT group (P < 0.001). Post-intervention landing peak force values for the first and second landings (DL) were significantly greater than the baseline values in the FT group (P = 0.01 and P = 0.05, respectively). Post-intervention landing peak force in the first landing (AJ) was significantly greater than the baseline values in the FT group (P = 0.005). The FT was effective in improving the impulsion performance during VJ. However, it increased the landing forces during DL and VJ.
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Affiliation(s)
- Vitória A Teixeira
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Thiago M Queiroz
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Isadora V Leão
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Lucas D G Innecco
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Erica L Marcelino
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Daniel F M Lobato
- Department of Applied Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
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Peden AE, Cullen P, Bhandari B, Testa L, Wang A, Ma T, Möller H, Peden M, Sawyer SM, Ivers R. A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents. JOURNAL OF SAFETY RESEARCH 2023; 85:321-338. [PMID: 37330882 DOI: 10.1016/j.jsr.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/26/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Globally, injuries are a leading cause of mortality and morbidity for adolescents, which disproportionately affect the disadvantaged. To build an investment case for adolescent injury prevention, evidence is needed as to effective interventions. METHODS A systematic review of peer-reviewed original research published between 2010-2022 was conducted. CINAHL, Cochrane Central, Embase, Medline and PsycINFO databases were searched for studies reporting the effectiveness of unintentional injury prevention interventions for adolescents (10-24 years), with assessment of study quality and equity (e.g., age, gender, ethnicity, socio-economic status). RESULTS Sixty-two studies were included; 59 (95.2%) from high-income countries (HIC). Thirty-eight studies (61.3%) reported no aspect of equity. Thirty-six studies (58.1%) reported prevention of sports injuries (commonly neuromuscular training often focused on soccer-related injuries, rule changes and protective equipment). Twenty-one studies (33.9%) reported prevention of road traffic injury, with legislative approaches, commonly graduated driver licensing schemes, found to be effective in reducing fatal and nonfatal road traffic injury. Seven studies reported interventions for other unintentional injuries (e.g., falls). DISCUSSION Interventions were strongly biased towards HIC, which does not reflect the global distribution of adolescent injury burden. Low consideration of equity in included studies indicates current evidence largely excludes adolescent populations at increased risk of injury. A large proportion of studies evaluated interventions to prevent sports injury, a prevalent yet low severity injury mechanism. Findings highlight the importance of education and enforcement alongside legislative approaches for preventing adolescent transport injuries. Despite drowning being a leading cause of injury-related harm among adolescents, no interventions were identified. CONCLUSION This review provides evidence to support investment in effective adolescent injury prevention interventions. Further evidence of effectiveness is needed, especially for low- and middle-income countries, populations at increased risk of injury who would benefit from greater consideration of equity and for high lethality injury mechanisms like drowning.
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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Queensland, Australia.
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Australia
| | - Buna Bhandari
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; Central Department of Public Health, Tribhuvan University Institute of Medicine, 44600, Nepal; Department of Global Health and Population, Harvard TH Chan School of Public Health, 02115, USA
| | - Luke Testa
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Amy Wang
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Tracey Ma
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Holger Möller
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia
| | - Margie Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health UK, Imperial College London, London, United Kingdom
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne; Murdoch Children's Research Institute; and Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia
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Seyedi M, Zarei M, Daneshjoo A, Rajabi R, Shirzad E, Mozafaripour E, Mohammadpour S. Effects of FIFA 11 + warm-up program on kinematics and proprioception in adolescent soccer players: a parallel‑group randomized control trial. Sci Rep 2023; 13:5527. [PMID: 37016130 PMCID: PMC10073194 DOI: 10.1038/s41598-023-32774-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/02/2023] [Indexed: 04/06/2023] Open
Abstract
This study aimed to compare the effects of 8 weeks 11 + warm-up injury prevention program on kinematics and proprioception in adolescent male and female soccer players. Forty adolescent soccer players (20 males, 20 females) aged between 14-16 years old were randomly assigned into four groups. The experimental group performed the 11 + program for 8 weeks and the control group did their warm-up program. The kinematic variable in a cutting maneuver was measured using VICON motion analysis and ankle and knees' proprioception by joint position sense (JPS) was measured using a digital inclinometer. For kinematic variables only significant differences in knee valgus among females 11 + compared with female and male control groups were found (P < 0.05). Moreover, there were significant improvements in joint position sense variables in 11 + groups compared to control groups (P < 0.05). In conclusion, the 11 + program was proven to be a useful warm-up protocol in improving knee valgus and JPS among female and male adolescent soccer players. We suggest adding more training elements to the 11 + program that aimed to enhance the proper alignment of lower extremities which may consequently improve joint kinematics.
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Affiliation(s)
- Mohammadreza Seyedi
- Department of Sport Medicine, Sport Sciences Research Institute, Tehran, Iran.
| | - Mostafa Zarei
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Abdolhamid Daneshjoo
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport Science, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Reza Rajabi
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Elham Shirzad
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Esmaeil Mozafaripour
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Shadan Mohammadpour
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Obërtinca R, Hoxha I, Meha R, Lama A, Bimbashi A, Kuqi D, Shabani B, Meyer T, der Fünten KA. Efficacy of Multi-Component Exercise-Based Injury Prevention Programs on Injury Risk Among Footballers of All Age Groups: A Systematic Review and Meta-analysis. Sports Med 2023; 53:837-848. [PMID: 36752977 PMCID: PMC10036279 DOI: 10.1007/s40279-022-01797-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Playing football is associated with a high risk of injury. Injury prevention is a priority as injuries not only negatively impact health but also potentially performance. Various multi-component exercise-based injury prevention programs for football players have been examined in studies. OBJECTIVE We aimed to investigate the efficacy of multi-component exercise-based injury prevention programs among footballers of all age groups in comparison to a control group. METHODS We conducted a systematic review and meta-analysis of randomized and cluster-randomized controlled trials. CINAHL, Cochrane, PubMed, Scopus, and Web of Science databases were searched from inception to June 2022. The following inclusion criteria were used for studies to determine their eligibility: they (1) include football (soccer) players; (2) investigate the preventive effect of multi-component exercise-based injury prevention programs in football; (3) contain original data from a randomized or cluster-randomized trial; and (4) investigate football injuries as the outcome. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The outcome measures were the risk ratio (RR) between the intervention and the control group for the overall number of injuries and body region-specific, contact, and non-contact injuries sustained during the study period in training and match play. RESULTS Fifteen randomized and cluster-randomized controlled trials with 22,177 players, 5080 injuries, and 1,587,327 exposure hours fulfilled the inclusion criteria and reported the required outcome measures. The point estimate (RR) for the overall number of injuries was 0.71 (95% confidence interval [CI] 0.59-0.85; 95% prediction interval [PI] 0.38-1.32) with very low-quality evidence. The point estimate (RR) for lower limb injuries was 0.82 (95% CI 0.71-0.94; 95% PI 0.58-1.15) with moderate-quality evidence; for hip/groin injuries, the RR was 0.56 (95% CI 0.30-1.05; 95% PI 0.00-102.92) with low-quality evidence; for knee injuries, the RR was 0.69 (95% CI 0.52-0.90; 95% PI 0.31-1.50) with low-quality evidence; for ankle injuries, the RR was 0.73 (95% CI 0.55-0.96; 95% PI 0.36-1.46) with moderate-quality evidence; and for hamstring injuries, the RR was 0.83 (95% CI 0.50-1.37) with low-quality evidence. The point estimate (RR) for contact injuries was 0.70 (95% CI 0.56-0.88; 95% PI 0.40-1.24) with moderate-quality evidence, while for non-contact injuries, the RR was 0.78 (95% CI 0.55-1.10; 95% PI 0.25-2.47) with low-quality evidence. CONCLUSIONS This systematic review and meta-analysis indicated that the treatment effect associated with the use of multi-component exercise-based injury prevention programs in football is uncertain and inconclusive. In addition, the majority of the results are based on low-quality evidence. Therefore, future high-quality trials are needed to provide more reliable evidence. CLINICAL TRIAL REGISTRATION PROSPERO CRD42020221772.
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Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany.
- Department of Physiotherapy, University of Gjakova "Fehmi Agani", Gjakova, Kosovo.
| | - Ilir Hoxha
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
| | - Rina Meha
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
- Research Unit, Heimerer College, Pristina, Kosovo
| | - Arber Lama
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | | | | | - Bujar Shabani
- Research Unit, Heimerer College, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
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Hu C, Du Z, Tao M, Song Y. Effects of Different Hamstring Eccentric Exercise Programs on Preventing Lower Extremity Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2057. [PMID: 36767424 PMCID: PMC9916392 DOI: 10.3390/ijerph20032057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
This systematic review and meta-analysis aims to investigate the effects and differences of various hamstring eccentric training protocols for the prevention of lower limb injuries, and we further propose a more refined hamstring eccentric training protocol for the prevention of lower limb injuries. A literature search for the effects of hamstring eccentric training on lower extremity sports injuries was conducted using the PubMed, Web of Science, and EMBASE databases, and the literature was searched covering the period from the date of the database's creation to 20 August 2022. A meta-analysis of the included literature was performed using R.4.21 for lower extremity injuries, injuries in various parts of the lower extremity, and subgroup analysis for exercise frequency, exercise cycle, and exercise population. A total of 23 randomized controlled trial (RCT) studies were found to be included in the meta-analysis, and 15 of these trials, totaling 14,721 patients, were determined to be included in the overall lower extremity injury prevention effect. The analysis showed that the implementation of a hamstring eccentric training program reduced lower extremity injuries by 28%, and it resulted in a 46% decrease in hamstring injury rate and a 34% decrease in knee injury rate. The subgroup analysis revealed that the frequency of exercise was most significant in the twice-a-week exercise group, that the exercise program was most effective in preventing injuries in the 21-30-week exercise period, and that the program was most effective in preventing injuries in elite athletes and amateur adult athletic populations, compared with adolescents.
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11
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Robles-Palazón FJ, López-Valenciano A, De Ste Croix M, Oliver JL, García-Gómez A, Sainz de Baranda P, Ayala F. Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:681-695. [PMID: 34700052 PMCID: PMC9729930 DOI: 10.1016/j.jshs.2021.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/10/2021] [Accepted: 07/21/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players. METHODS Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model. RESULTS Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play. CONCLUSION The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.
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Affiliation(s)
- Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | | | - Mark De Ste Croix
- School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - Jon L Oliver
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland 0632, New Zealand
| | - Alberto García-Gómez
- Operative Research Centre, Miguel Hernández University of Elche, Elche 03202, Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain; School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
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12
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Al Attar WSA, Bakhsh JM, Khaledi EH, Ghulam H, Sanders RH. Injury prevention programs that include plyometric exercises reduce the incidence of anterior cruciate ligament injury: a systematic review of cluster randomised trials. J Physiother 2022; 68:255-261. [PMID: 36244964 DOI: 10.1016/j.jphys.2022.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/05/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
QUESTION Do injury prevention programs that include plyometric exercises reduce the incidence of anterior cruciate ligament (ACL) injuries in sport? DESIGN Systematic review of (cluster) randomised trials with meta-analysis. PARTICIPANTS Sporting participants of any age, sex or competition level. INTERVENTIONS The experimental intervention was an injury prevention program that included plyometric exercises. The control intervention was the usual warm-up program, which did not include plyometric exercises. OUTCOME MEASURES Exposure-based ACL injury rates. RESULTS The initial search yielded 7,302 articles, of which nine met the inclusion criteria. All nine articles reported cluster randomised trials, providing data on 14,394 participants. The pooled results showed that injury prevention programs that include plyometric exercises reduce the risk of ACL injury by 60% per 1,000 hours of exposure compared with the control group, with an injury risk ratio (IRR) of 0.40 (95% CI 0.26 to 0.63). Data from subgroups of these trials estimated that this preventative effect may be stronger in males (IRR 0.21, 95% CI 0.07 to 0.62) and weaker in females (IRR 0.51, 95% CI 0.30 to 0.87), albeit with less precise estimates. Subgroup analysis also suggested a stronger effect on non-contact ACL injuries (IRR 0.34, 95% CI 0.18 to 0.65), whereas the effect on contact ACL injuries remained uncertain (IRR 0.59, 95% CI 0.15 to 2.30). CONCLUSIONS Injury prevention programs that incorporate plyometric exercises substantially decrease the risk of ACL injuries more than warm-up programs that do not include plyometric exercises. The preventive effect appears to be stronger among males and in the prevention of ACL injuries that do not involve contact with another player. PROSPERO CRD42020196982.
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia; Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia; Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland.
| | - Jumana M Bakhsh
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Ehdaa H Khaledi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia; Department of Physical Therapy, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Hussain Ghulam
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
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13
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Yang J, Wang Y, Chen J, Yang J, Li N, Wang C, Liao Y. Effects of the "FIFA11+ Kids" Program on Injury Prevention in Children: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12044. [PMID: 36231344 PMCID: PMC9566496 DOI: 10.3390/ijerph191912044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
FIFA11+ Kids is a warm-up program specially designed to prevent football injuries in children. This systematic review and meta-analysis aimed to summarize the effects of FIFA11+ Kids on injury prevention in young football players. PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure were searched from 1 January 2016 to 24 August 2022. The primary outcome was overall injuries, and the secondary outcomes were severe, ankle, knee, and lower extremity injuries. Risk ratios (RRs) were calculated for each outcome. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. A total of 230 articles were screened, 6 of which were finally included in the meta-analysis. Compared with normal warm-up training, FIFA11+ Kids significantly reduced overall injury risk (RR = 0.52 [95% CI, 0.44-0.62]; p < 0.00001), severe injury risk (RR = 0.33 [95% CI, 0.18-0.61]; p = 0.0004), lower extremity injury risk (RR = 0.51 [95% CI, 0.41-0.65]; p < 0.00001), knee injury risk (RR = 0.45 [95% CI, 0.29-0.72]; p = 0.0009), and ankle injury risk (RR = 0.56 [95% CI, 0.35-0.89]; p = 0.01) in young football players. FIFA11+ Kids was found to be an effective approach to decrease the injury risk among young football players, which is worth generalizing extensively.
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Affiliation(s)
- Jinfeng Yang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Yang Wang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Jianxin Chen
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Jinqi Yang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Na Li
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Chun Wang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Yuanpeng Liao
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Affiliated Hospital of Chengdu Sport University, Chengdu Sport University, Chengdu 610041, China
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14
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Yu Y, Li X, Yan W, Feng B, Yu J, Wang Y. Cross-sectional study of gender differences in physical activity-related injuries amongst Chinese college students majoring in rehabilitation. Front Public Health 2022; 10:912965. [PMID: 36159284 PMCID: PMC9493078 DOI: 10.3389/fpubh.2022.912965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/17/2022] [Indexed: 01/22/2023] Open
Abstract
The main objective of the paper was to explore the potential risk factors for physical activity-related injuries (PARI) amongst college students majoring in rehabilitation and to analyse gender differences. A random whole group sampling method was used to recruit freshmen to seniors aged 15-25 years from over 90 universities in China that offer rehabilitation. The total number of people included was 6,032, of which 1,989 were male and 4,043 were female. The underlying risk factors for PARI of different genders were assessed using a structured self-management questionnaire including sociodemographic characteristics, physical activity levels, risk-taking and protective behaviors, and PARI. Totally 6,032 questionnaires were obtained for final analysis, with 792 total number of injured persons (415 males, 377 females), the sum of the cumulative frequency of injuries to injured persons is 1,607 (881 males, 726 females) and a PARI risk of 0.27 (males: 0.44, females: 0.18; p < 0.001; sum of the cumulative frequency of injuries/total number of people surveyed/year). For male and female students, participation in sports teams, having a high level of PA as well as with antisocial behavior were risk factors for developing PARI. Regarding female students, regional differences was associated with elevated odds to suffer from PARI. The prevalence rates of PARI vary between male and female students. The research subjects were university students in rehabilitation. Compared to general college students, rehabilitation students have a certain knowledge base related to injuries, which defines the specificity and research value of this subjects. This study provides guidance for reducing PARI in students in rehabilitation and may provide a basis for developing future injury prevention mechanisms for university students in general.
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Affiliation(s)
- Yanling Yu
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xian Li
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wangwang Yan
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Beibei Feng
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiadan Yu
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Al Attar WSA, Bizzini M, Alzahrani H, Alarifi S, Ghulam H, Alyami M, Alzhrani M, Sanders RH. The FIFA 11+ Kids Injury Prevention Program Reduces Injury Rates Among Male Children Soccer Players: A Clustered Randomized Controlled Trial. Sports Health 2022; 15:397-409. [PMID: 35903029 PMCID: PMC10170224 DOI: 10.1177/19417381221109224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Fédération Internationale de Football Association (FIFA) 11+ Kids is an exercise-based injury prevention program developed by an international group of experts to prevent injuries among child soccer players. HYPOTHESIS It was hypothesized that the FIFA 11+ Kids program would be more effective than performing a typical warm-up regimen in reducing overall injuries among soccer players aged 7 to 13 years. STUDY DESIGN A clustered randomized controlled trial. LEVEL OF EVIDENCE Level 1. METHODS A total of 94 boys' soccer teams, including 780 players, were randomly allocated into an experimental or control group. Complete datasets were collected from 45 teams (377 players) and 43 teams (363 players) in the experimental and control groups, respectively. The experimental group underwent the FIFA 11+ Kids program as a warm-up during training sessions and matches at least twice a week, and the control group continued performing their usual warm-ups. Participants were prospectively followed during 1 season (6 months). The primary outcomes included the incidence of overall and recurrent injuries and their mechanism and severity. The secondary outcome was the rate of compliance with the intervention program. RESULTS A total of 43 injuries were reported in the experimental group in 50,120 hours of exposure (0.85 injuries/1000 exposure hours). A total of 86 injuries were reported in the control group in 42,616 hours of exposure (2.01 injuries/1000 exposure hours). The injury risk ratio was 0.43 (0.29-0.61), suggesting that the experimental group experienced 57% fewer injuries than those in the control group. CONCLUSION The FIFA 11+ Kids program reduced overall injury rates in children playing soccer more than the usual warm-ups. CLINICAL RELEVANCE The results of this study provide evidence for children's coaches to consider including the FIFA 11+ Kids program in their warm-up regimen. Such a program may prevent injury risk and decrease absenteeism and injury-related financial burdens.
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16
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Leppänen M, Uotila A, Tokola K, Forsman-Lampinen H, Kujala UM, Parkkari J, Kannus P, Pasanen K, Vasankari T. Players with high physical fitness are at greater risk of injury in youth football. Scand J Med Sci Sports 2022; 32:1625-1638. [PMID: 35621388 DOI: 10.1111/sms.14199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate physical fitness, football-specific skills, and their association with injury risk in youth football. Altogether 447 male and female players aged 9-14 years (median 12 years) participated in performance tests and prospective follow-up. The physical fitness tests included five-jump test for distance, 30-m sprint, football-specific figure of eight agility, countermovement jump, and Yo-Yo intermittent endurance test level 1. The football-specific skill tests included dribbling and passing tests. Injuries and exposure were registered during the 20-week follow-up. Our candidate risk factors were low/high level of physical fitness measured with a composite score of physical fitness tests and low/high level of football-specific skills measured with a composite score of dribbling and passing tests. Secondarily, we investigated performance in individual tests and their association with injury risk. During the follow-up, players reported 565 injuries (264 acute and 301 overuse injuries). High level of physical fitness was associated with increased rate of all injuries (age-, sex-, and mean team exposure-adjusted IRR: 1.28, 95% CI: 1.04-1.58). The level of football-specific skills had no influence on the overall injury rate. Burden of overuse injuries, but not acute injuries was significantly higher in most fit players compared with the players in the reference group (IRR: 2.09, 95% CI: 1.04-4.24). In conclusion, most fit players were at greater risk of sustaining injuries in youth competitive football.
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Affiliation(s)
- Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
| | - Aliisa Uotila
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | | | | | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Tommi Vasankari
- UKK Institute, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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17
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Effectiveness of Warm-Up Intervention Programs to Prevent Sports Injuries among Children and Adolescents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106336. [PMID: 35627873 PMCID: PMC9140806 DOI: 10.3390/ijerph19106336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022]
Abstract
Sports participation by children and adolescents often results in injuries. Therefore, injury prevention warm-up programs are imperative for youth sports safety. The purpose of this paper was to assess the effectiveness of Warm-up Intervention Programs (WIP) on upper and lower limb sports injuries through a systematic review and meta-analysis. Searches for relevant studies were performed on PubMed, EMBASE, Web of Science, SPORTDiscus, and Cochrane databases. Studies selected met the following criteria: original data; analytic prospective design; investigated a WIP and included outcomes for injury sustained during sports participation. Two authors assessed the quality of evidence using Furlan’s criteria. Comprehensive Meta-Analysis 3.3 software was used to process and analyze the outcome indicators of the literature. Across fifteen studies, the pooled point estimated injury rate ratio (IRR) was 0.64 (95% CI = 0.54−0.75; 36% reduction) while accounting for hours of risk exposure. Publication bias assessment suggested a 6% reduction in the estimate (IRR = 0.70, 95% CI = 0.60−0.82), and the prediction interval intimated that any study estimate could still fall between 0.34 and 1.19. Subgroup analyses identified one significant moderator that existed in the subgroup of compliance (p < 0.01) and might be the source of heterogeneity. Compared with the control group, WIPs significantly reduced the injury rate ratio of upper and lower limb sports injuries in children and adolescents.
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18
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Most amateur football teams do not implement essential components of neuromuscular training to prevent anterior cruciate ligament injuries and lateral ankle sprains. Knee Surg Sports Traumatol Arthrosc 2022; 30:1169-1179. [PMID: 35190881 PMCID: PMC9007793 DOI: 10.1007/s00167-022-06878-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Neuromuscular training (NMT) is effective at reducing football injuries. The purpose of this study was to document the use of NMT to prevent anterior cruciate ligament injuries and lateral ankle sprains in adult amateur football and to identify barriers for using NMT. METHODS A preseason and in-season online survey was completed by players and coaches of 164 football teams. The survey contained questions concerning injury history, type and frequency of NMT, and barriers when NMT was not used. RESULTS A total of 2013 players (40% female) and 180 coaches (10% female) completed the preseason survey, whereas 1253 players and 140 coaches completed the in-season survey. Thirty-four percent (preseason) to 21% (in-season) of players used NMT, but only 8% (preseason) to 5% (in-season) performed adequate NMT (i.e. both balance and plyometric exercises, at least twice per week). In the subpopulation of players with an injury history, 12% (preseason) and 7% (in-season) performed adequate NMT. With respect to the coaches, only 5% (preseason) and 2% (in-season) implemented adequate NMT. Most important barriers for using NMT for both players and coaches were a lack of belief in its effectiveness, a lack of knowledge, the belief that stretching is sufficient, and not feeling the need for it. CONCLUSION Most amateur football teams do not implement essential components of NMT. The results highlight the urgent need for developing strategies to enhance the adequate use of NMT in amateur football. LEVEL OF EVIDENCE II.
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19
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Hilska M, Leppänen M, Vasankari T, Aaltonen S, Raitanen J, Räisänen AM, Steffen K, Forsman H, Konttinen N, Kujala UM, Pasanen K. Adherence to an Injury Prevention Warm-Up Program in Children's Soccer-A Secondary Analysis of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13134. [PMID: 34948744 PMCID: PMC8701740 DOI: 10.3390/ijerph182413134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
This study examined the impact of high adherence to a neuromuscular training (NMT) warm-up on the risk of lower extremity (LE) injuries in children's soccer. Twenty U11-U14 youth clubs (n = 92 teams, 1409 players) were randomized into intervention (n = 44 teams) and control (n = 48 teams) groups. The intervention group was advised to perform an NMT warm-up 2 to 3 times a week for 20 weeks. Team adherence, injuries, and exposure were registered throughout the follow-up. Primary outcomes were the incidence of soccer-related acute LE injuries and the prevalence of overuse LE injuries. Intervention teams conducted mean 1.7 (SD 1.0) NMT warm-ups weekly through follow-up. The seasonal trend for adherence declined significantly by -1.9% (95% CI -0.8% to -3.1%) a week. There was no difference in the incidence of acute injuries nor the prevalence of overuse LE injuries in high team adherence group (n = 17 teams) compared to controls. However, the risk for acute noncontact LE injuries was 31% lower in the high team adherence group compared to controls (IRR 0.69, 95% CI 0.49 to 0.97). In an efficacy analysis (n = 7 teams), there was a significant reduction of 47% in the rate of noncontact LE injuries (IRR 0.53, 95% CI 0.29 to 0.97). In conclusion, teams conducted NMT warm-up sessions regularly, but with a declining trend. A greater protective effect was seen in teams with the highest adherence to the NMT warm-up.
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Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
- Tampere University Hospital, 33500 Tampere, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (T.V.); (J.R.)
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM), University of Helsinki, 00290 Helsinki, Finland;
| | - Jani Raitanen
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (T.V.); (J.R.)
- Faculty of Social Sciences (Health Sciences), Tampere University, 33520 Tampere, Finland
| | - Anu M. Räisänen
- Department of Physical Therapy Education—Oregon, College of Health Sciences—Northwest, Western University of Health Sciences, Lebanon, OR 97355, USA;
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Kathrin Steffen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, 0806 Oslo, Norway;
| | - Hannele Forsman
- Eerikkilä Sports Institute Training Center, Eerikkilä, 31370 Tammela, Finland;
| | - Niilo Konttinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland; (N.K.); (U.M.K.)
- Research Institute for Olympic Sports, 40700 Jyväskylä, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland; (N.K.); (U.M.K.)
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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20
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Hilska M, Leppänen M, Vasankari T, Clarsen B, Aaltonen S, Bahr R, Haapasalo H, Parkkari J, Kannus P, Pasanen K. Neuromuscular training warm‐up in the prevention of overuse lower extremity injuries in children's football: A cluster‐randomized controlled trial. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Tampere University Hospital Tampere Finland
| | - Tommi Vasankari
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo Norway
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM) University of Helsinki Helsinki Finland
| | - Roald Bahr
- Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo Norway
| | - Heidi Haapasalo
- Department of Orthopaedics and Traumatology Tampere University Hospital Tampere Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Tampere University Hospital Tampere Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary AB Canada
- Alberta Children's Hospital Research InstituteUniversity of Calgary Calgary AB Canada
- McCaig Institute for Bone and Joint Health Cumming School of Medicine University of Calgary Calgary AB Canada
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Effects of 8-Week FIFA 11+ for Kids Intervention on Physical Fitness and Attention in Elementary School Children. J Phys Act Health 2021; 18:686-693. [PMID: 33894690 DOI: 10.1123/jpah.2020-0823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The psychological and physiological adaptations in response to the FIFA 11+ for kids (FIFA11+kid) program has not been examined in school children. This study aimed to investigate the effects of 8-week FIFA11+kid intervention on physical fitness and attentional capacity in elementary school children. METHODS A total of 55 elementary school students voluntarily participated in the study. Participants were assigned to either the FIFA11+kid (n = 28, 5 times per week) or the control (n = 27) group. At baseline and after 8 weeks, all participants were asked to perform a battery of physical fitness tests (sit-and-reach, broad jump, sit-up test, and 800-m run) and the Attention Scale for Elementary School Children, including 5 subscales: focused, sustained, selective, alternating, and divided attentions. RESULTS The FIFA11+kid group demonstrated larger pre-post change in sit-and-reach (P < .001) and sit-up test (P < .001) than that of control group. Moreover, the FIFA11+kid group demonstrated large improvements pre-post change in Attention Scale for Elementary School Children scores of total score (P < .001), focused (P < .001), sustained (P < .001), and selective attentions (P < .001) compared with the control group. CONCLUSION A total of 8 weeks of FIFA11+kid exercise intervention can improve general physical fitness and attentional capacities in elementary school children.
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Hilska M, Leppänen M, Vasankari T, Aaltonen S, Kannus P, Parkkari J, Steffen K, Kujala UM, Konttinen N, Räisänen AM, Pasanen K. Neuromuscular Training Warm-up Prevents Acute Noncontact Lower Extremity Injuries in Children's Soccer: A Cluster Randomized Controlled Trial. Orthop J Sports Med 2021; 9:23259671211005769. [PMID: 35146027 PMCID: PMC8822004 DOI: 10.1177/23259671211005769] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Prevention of sports injuries is essential in youth, as injuries are associated with less future physical activity and thus greater all-cause morbidity. Purpose: To investigate whether a neuromuscular training warm-up operated by team coaches is effective in preventing acute lower extremity (LE) injuries in competitive U11-U14 soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Twenty top-level U11 to U14 soccer clubs in Finland were randomized into intervention and control groups and assessed for 20 weeks. Participants included 1403 players (280 female, 1123 male; age range, 9-14 years): 673 players (44 teams) in the intervention group and 730 players (48 teams) in the control group. The intervention group team coaches were introduced to a neuromuscular training warm-up to replace the standard warm-up 2 to 3 times per week. The control teams were asked to perform their standard warm-up. Injury data collection was done via weekly text messages. The primary outcome measure was a soccer-related acute LE injury, and the secondary outcome measure was an acute noncontact LE injury. Results: A total of 656 acute LE injuries occurred: 310 in the intervention group and 346 in the control group. The overall acute LE injury incidence was 4.4 per 1000 hours of exposure in the intervention group and 5.5 per 1000 hours of exposure in the control group, with no significant difference between groups (incidence rate ratio [IRR], 0.82 [95% CI, 0.64-1.04]). There were 302 acute noncontact LE injuries: 129 in the intervention group (incidence, 1.8 per 1000 hours) and 173 in the control group (2.7 per 1000 hours). A significant reduction in acute noncontact LE injuries of 32% (IRR, 0.68 [95% CI, 0.51-0.93]) was observed in the intervention group compared with the control group. Furthermore, significant reductions in injury incidence in favor of the intervention group were seen in the subanalyses of acute noncontact LE injuries, leading to ≤7 days of time loss and fewer ankle and joint/ligament injuries. Conclusion: A neuromuscular training warm-up operated by team coaches was found to be effective in preventing acute noncontact LE injuries in children’s soccer, but this was not seen in all acute LE injuries. Clinical Relevance: We encourage children’s soccer coaches and health care professionals to implement neuromuscular training warm-up in youth sports. Registration: ISRCTN14046021 (ISRCTN registry).
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Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
- Matias Hilska, BM, UKK Institute, Kaupinpuistonkatu 1, 33500 Tampere, Finland ()
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kathrin Steffen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niilo Konttinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Research Institute for Olympic Sports, Jyväskylä, Finland
| | - Anu M. Räisänen
- Department of Physical Therapy Education, College of Health Sciences, Western University of Health Sciences, Lebanon, Oregon, USA
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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