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Inclan PM, Hicks JJ, Retzky JS, Janosky JJ, Pearle AD. Team Approach: Neuromuscular Training for Primary and Secondary Prevention of Anterior Cruciate Ligament Injury. JBJS Rev 2024; 12:e23.00207. [PMID: 38994007 PMCID: PMC11236273 DOI: 10.2106/jbjs.rvw.23.00207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Neuromuscular training is a method of performance optimization-typically combining plyometrics, balancing training, agility, and dynamic stabilization-predicated on improving the efficiency of fundamental movement patterns. Neuromuscular training has consistently been shown to reduce the risk of anterior cruciate ligament injury, particularly for athletes engaged in activities associated with noncontact knee injuries (i.e., women's soccer). Successful implementation of neuromuscular training programs requires input from coaches, physical therapists, athletic trainers, and physicians to generate efficacious programs with high rates of adherence.
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Affiliation(s)
- Paul M Inclan
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York
| | - Justin J Hicks
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York
| | - Julia S Retzky
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York
| | - Joseph J Janosky
- Department of Athlete Health, Hospital for Special Surgery, New York, New York
| | - Andrew D Pearle
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York
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Muller MR, Lemes ÍR, Silva MSDC, Silva NS, Hernández AGM, Pinto RZ. The efficacy of neuromuscular training, with minimal or no equipment, on performance of youth athletes: A systematic review with meta-analysis. Phys Ther Sport 2023; 64:104-116. [PMID: 37820456 DOI: 10.1016/j.ptsp.2023.09.010] [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: 06/15/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES To investigate the effects of neuromuscular training, with minimal or no equipment, on physical performance of youth athletes. DESIGN Systematic review with meta-analysis. METHODS MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SportDiscuss from inception to March/2022. SELECTION CRITERIA youth athletes (15-24years), from Olympic team sports; used neuromuscular training 2-3 times/week for, at least, 6 weeks; had a control group/usual training group; physical performance as outcomes; randomized controlled trial. DATA SYNTHESIS Pooled estimate of standardized mean difference (SMD), and 95% confidence interval (95%CI). RESULTS Thirty-four studies (1111 participants) were included. Results showed that neuromuscular training improved power (SMD: 0.84 [95%CI: 0.58, 1.10]; n = 805; I2 = 64%), speed (SMD: -1.12 [95%CI: -1.68, -0.57]; n = 688; I2 = 90%) and agility (SMD: -1.21 [95%CI: -1.60, -0.83]; n = 571; I2 = 76%) compared to control group, but showed no difference between groups for muscle strength (Quadriceps SMD: 0.34 [95%CI: -0.02, 0.69]; n = 132; I2 = 0%, Hamstrings: SMD: 0.64 [95%CI: -0.04, 1.33]; n = 132; I2 = 71%), balance and flexibility. CONCLUSION Clinically, neuromuscular training with minimal equipment may be useful for teams with limited resources to improve mainly athletes' power and agility, including those interventions that were designed to injury prevention. Future high-quality studies are likely to change these estimates.
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Affiliation(s)
- Marina R Muller
- Autonomous University of Querétaro (UAQ) - Faculty of Nursing, Master of Science in the Rehabilitation of the Human Movement, Research Line: Sports, Queretaro, Queretaro, Mexico.
| | - Ítalo R Lemes
- Department of Physical Therapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil; Applied Physiology & Nutrition Research Group, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Michelle S de C Silva
- Department of Physical Therapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Nayara S Silva
- Department of Physical Therapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Arely G M Hernández
- Coordination of the Master of Science in Rehabilitation of the Human Movement - Autonomous University of Querétaro (UAQ), Queretaro, Queretato, Mexico
| | - Rafael Z Pinto
- Department of Physical Therapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Asgari M, Nazari B, Bizzini M, Jaitner T. Effects of the FIFA 11+ program on performance, biomechanical measures, and physiological responses: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:226-235. [PMID: 35659964 PMCID: PMC10105015 DOI: 10.1016/j.jshs.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/12/2022] [Accepted: 04/22/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND The side effects of the FIFA 11+ program on performance have not been generally reviewed. The objective of this study was to synthesize the literature on the effects of the 11+ on players' performance. METHODS Five online databases (PubMed, Scopus, ScienceDirect, Springer, and Google Scholar) were searched (from April 2006 to March 2022) using predefined keywords and sub-keywords. The potential references were primarily recorded through Endnote and imported to Covidence. Out of the 123 references screened by 2 blinded researchers through the software, 59 full texts were assessed for eligibility, 33 of which were ultimately included. The quality of the studies and the risk of bias were then assessed. Study ID, title, place, aim, design, start/end dates, population description, study criteria, statistical analysis, and outcomes were extracted. RESULTS Studies were conducted on male and female players aged 10-32 years old. The quality of the studies was moderate to high, and except for unclear bias for blinding outcome assessment, the risk of bias for all domains was low. Long-term application of the 11+ improved most biomechanical measures and physiological responses except for lower extremity stability, ankle evertors time latency, ankle dorsiflexion, and proprioception. Conversely, the 11+ showed acute negative effects on physical performance compared to dynamic warm-ups and non-significant effects on technical abilities. CONCLUSION Mid-to-long-term implementation of the 11+ improved the majority of biomechanical and a couple of physical measures but showed no effects on technical skills. Precaution must be observed for using the 11+ before competitions, as it could acutely decrease physical/technical performance. Given the contradictory nature of the literature, further studies should evaluate the short-to-mid-term effects of the 11+. Further studies are required to address ankle responses to the 11+ intervention.
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Affiliation(s)
- Mojtaba Asgari
- Institute for Sport and Sports Science, TU Dortmund University, Dortmund 44221, Germany.
| | - Bahareh Nazari
- Faculty of Physical Education and Sports Science, University of Tehran, Kish Island branch, Kish Island 79416, Iran
| | - Mario Bizzini
- Human Performance Lab, Schulthess Clinic Lengghalde, Zürich 8008, Switzerland
| | - Thomas Jaitner
- Institute for Sport and Sports Science, TU Dortmund University, Dortmund 44221, Germany
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Rosado-Portillo A, Chamorro-Moriana G, Gonzalez-Medina G, Perez-Cabezas V. Acute Hamstring Injury Prevention Programs in Eleven-a-Side Football Players Based on Physical Exercises: Systematic Review. J Clin Med 2021; 10:2029. [PMID: 34065138 PMCID: PMC8125962 DOI: 10.3390/jcm10092029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/01/2021] [Accepted: 05/06/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Objective: To analyze the exercise programs used to prevent of acute hamstring injuries in eleven-a-side football players, and their effectiveness. (2) Methods: A systematic review (PRISMA) was conducted (2008-2020), including RCTs, that exclusively used physical exercises as a prevention method. (3) Results: Ten studies were selected considering 14 interventions, including nine different programs: FIFA11+ (11+), Harmoknee, eccentric Nordic Hamstring Exercise (NHE) exclusively, with eccentric exercises, with stretching or with proprioceptive, New Warm-up Program (NWP), Bounding Exercise Program (BEP), the only one with no positive results, and proprioceptive exercises. Incidence of injuries and strength were the most considered variables, both with favorable evidences. Programs including NHE, which assessed injury incidence, were always effective. The 11+ program was effective in injury incidence and strength; NWP was effective in balance, stability, and strength. (4) Conclusions: The exercise programs discussed were effective to prevent acute hamstring injuries in football players except BEP and partially Harmoknee. Exercises mostly used to reduce the risk of hamstring injuries are those of eccentric force due to its functionality, especially NHE. Only concentric contractions and isometric contractions obtained significant favorable results. The most complete and promising programs were 11+ (in injury incidence and strength) and NWP (strength, balance, and stability). NWP was the best in strength.
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Affiliation(s)
| | - Gema Chamorro-Moriana
- Head of Research Group “Area of Physiotherapy” CTS-305, Department of Physiotherapy, University of Seville, 41009 Seville, Spain
| | - Gloria Gonzalez-Medina
- Research Group “Physiotherapy and Health” CTS 986, Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain;
| | - Veronica Perez-Cabezas
- Research Group “Empowering Health by Physical Activity, Exercise and Nutrition” [CTS1038], Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain;
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Lopes M, Oliveira J, Ribeiro F. Injury prevention in futsal players: is the FIFA 11+ a simple answer to a complex problem? PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1731177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Mário Lopes
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
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Jadczak Ł, Grygorowicz M, Dzudziński W, Śliwowski R. Comparison of Static and Dynamic Balance at Different Levels of Sport Competition in Professional and Junior Elite Soccer Players. J Strength Cond Res 2020; 33:3384-3391. [PMID: 29652679 DOI: 10.1519/jsc.0000000000002476] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Jadczak, Ł, Grygorowicz, M, Dzudziński, W, and Śliwowski, R. Comparison of static and dynamic balance at different levels of sport competition in professional and junior elite soccer players. J Strength Cond Res 33(12): 3384-3391, 2019-The purpose of this study was to compare body balance control and balance recovery strategies of professional football players, representing various sports levels in static (eyes open, eyes closed) and dynamic conditions, both on the dominant and nondominant leg. Three groups of professional and junior elite soccer players were investigated: a PRO group (n = 52), a U-21 group (n = 55), and a U-19 group (n = 47). The study of body balance control was performed using a Delos Postural Proprioceptive System measurement tool. The analysis of the results showed an effect of group (p < 0.01) and leg significance (p < 0.95) in the dynamic test. Three-way analysis of variance (3 [group] × 2 [leg] × 2 [eyes]) of static test data showed that the main effect of eyes (p < 0.0001), group (p < 0.0001), and leg (p = 0.0092) and the 2-way interaction of eyes × group (p = 0.0003) were significant. To represent statistical significance, the cutoff value was set to be p ≤ 0.005 for all measures. Our results indicate the importance of evaluation and monitoring of dynamic and static balance on both legs, which allows for a comprehensive comparison of body balance control and the balance recovery strategy depending on the represented sport level. Our study indicates that the higher the sport level of football players (the PRO group), the better their balance, which may indirectly contribute to the prevention of injuries and more effective performance of any actions directly related to the game.
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Affiliation(s)
- Łukasz Jadczak
- Department of Team Sports Games, University School of Physical Education, Poznań, Poland
| | - Monika Grygorowicz
- Research and Development Department, Rehasport Clinic, FIFA Medical Center of Excellence, Poznań, Poland
| | | | - Robert Śliwowski
- Department of Team Sports Games, University School of Physical Education, Poznań, Poland
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Lopes M, Lopes S, Patinha T, Araújo F, Rodrigues M, Costa R, Oliveira J, Ribeiro F. Balance and proprioception responses to FIFA 11+ in amateur futsal players: Short and long-term effects. J Sports Sci 2019; 37:2300-2308. [PMID: 31200633 DOI: 10.1080/02640414.2019.1628626] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: The FIFA 11+ has shown positive effects on balance and proprioception parameters in football players. As there have been very few research studies involving futsal, we examined the short and long term effects of the FIFA 11+ on static and dynamic balance, as well as proprioception in male amateur futsal players. Methods: Seventy-one male futsal players were randomized to two groups (FIFA 11+: n = 37, age: 27.33 ± 4.33 years; Control: n = 34, age: 25.55 ± 4.65 years). Intervention lasted 10 weeks, 2 sessions per week, succeeded by a 10-week follow-up period. For balance testing, we assessed the single-legged postural sway with a force platform (static balance) and the Y balance test (dynamic balance). Proprioception was assessed with active joint position sense testing. Results: Complete pre-post intervention and follow-up tests were available for 61 players. The FIFA 11+ group showed higher training exposure and lower body mass index and body weight. After adjustment for baseline differences, no significant differences between groups were observed in the pre-post changes for centre of pressure measures, Y-balance and proprioception parameters both at short and long-term. Conclusions: Performing FIFA 11+ for 10 weeks did not improve static and dynamic balance as well as proprioception in amateur futsal players.
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Affiliation(s)
- Mário Lopes
- a School of Health Sciences, University of Aveiro , Aveiro , Portugal
| | - Susana Lopes
- a School of Health Sciences, University of Aveiro , Aveiro , Portugal
| | - Telma Patinha
- a School of Health Sciences, University of Aveiro , Aveiro , Portugal
| | - Fábio Araújo
- b Institute of Public Health, University of Porto , Porto , Portugal
| | - Mário Rodrigues
- a School of Health Sciences, University of Aveiro , Aveiro , Portugal
| | - Rui Costa
- c School of Health Sciences and CINTESIS@UA, University of Aveiro , Aveiro , Portugal
| | - José Oliveira
- d Research Center in Physical Activity, Health and Leisure -CIAFEL, Faculty of Sport, University of Porto , Porto , Portugal
| | - Fernando Ribeiro
- e School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro , Aveiro , Portugal
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Lopes M, Rodrigues JM, Monteiro P, Rodrigues M, Costa R, Oliveira J, Ribeiro F. Effects of the FIFA 11+ on ankle evertors latency time and knee muscle strength in amateur futsal players. Eur J Sport Sci 2019; 20:24-34. [PMID: 31092112 DOI: 10.1080/17461391.2019.1609588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The FIFA 11+ has shown to increase muscle strength and reduce injury risk. The purpose of this study was to assess the short and long-term effects of the FIFA 11+ on knee strength, and muscle latency after sudden inversion of amateur futsal players.Methods: Seventy-one male futsal players were recruited and randomized to a FIFA 11+ (n = 37, age: 27.0 ± 5.1 years) and a control group (n = 34, age: 26.0 ± 5.1 years). The FIFA 11+ programme was executed twice a week, for 10 weeks, followed-up after 10 weeks where both groups executed regular warm-ups. Concentric and eccentric isokinetic knee muscle strength was tested and latency time of the evertor muscles after sudden inversion of the ankle was executed with a trapdoor mechanism following an EMG protocol of selected leg muscles (peroneus brevis and peroneus longus).Results: No significant difference were observed between groups for short-term changes in isokinetic strength after adjustment for baseline differences. At long-term, significant gains were obtained after adjustment for baseline differences in eccentric strength for both lower limbs as for the H/Q ratios for the dominant limb. No changes between groups were observed in the peroneus brevis and peroneus longus latency time.Conclusions: Performing FIFA 11+ did not have short-term effects on knee strength and muscle latency after sudden inversion in amateur futsal players. However, significant long-term benefits were observed for eccentric strength and H/Q ratios.
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Affiliation(s)
- Mário Lopes
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - João Manuel Rodrigues
- IEETA - Institute of Electronics and Informatics Engineering of Aveiro and DETI - Department of Electronics, Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - Pedro Monteiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Mário Rodrigues
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Rui Costa
- School of Health Sciences and CINTESIS@UA, University of Aveiro, Aveiro, Portugal
| | - José Oliveira
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
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Soares ATDS, Teixeira LP, Lara S. Desempenho isocinético de atletas de futsal sub-13 após a prática do protocolo Fifa 11+. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18000226012019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar o desempenho isocinético da musculatura flexora e extensora do joelho de jogadores de futsal sub-13 após a prática de 18 semanas do protocolo Fifa 11+. Participaram 14 jogadores de futsal do sexo masculino com idade média de 12,58±0,66 anos. A avaliação da força foi realizada através do dinamômetro isocinético (Biodex System Pro 4™), nas velocidades de 60°/s, 180°/s e 300°/s, pré e pós-intervenção. O protocolo Fifa 11+ foi aplicado antes do início de cada treino regular, duas vezes por semana, durante 18 semanas, com duração aproximada de 25 minutos. Na análise pré-intervenção foi encontrada uma diferença entre o membro dominante e o não dominante superior a 10% no pico de torque de flexores e extensores a 60°/s e 180°/s, respectivamente. Já na análise pós-intervenção não foram encontradas tais assimetrias. Houve um aumento da relação agonista/antagonista no lado dominante na velocidade de 60°/s, pós-intervenção, aproximando-se do valor ideal proposto pela literatura (de 60%). Houve, ainda, aumento do desempenho isocinético dos atletas após a intervenção. Neste sentido, conclui-se que a aplicação de 18 semanas do protocolo Fifa 11+ promoveu uma melhora do desempenho isocinético das musculaturas extensoras e flexoras de joelho, além de diminuir as assimetrias musculares entre os membros em jovens atletas de futsal.
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