Attitudes, beliefs and factors influencing football coaches’ adherence to the 11+ injury prevention programme

Shamlaye, Julie; Tomsovsky, Lubos; Fulcher, Mark

doi:10.1136/bmjsem-2020-000830

Cited by 12 publications

(25 citation statements)

References 37 publications

(44 reference statements)

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“…When implementing the programme, the current study shows that delivery agents in professional football usually modify the ASP to fit their team’s training philosophy and schedule. Similar findings have been demonstrated for the NH24 26 and the FIFA 11+ 27 28. So far, no other studies on specific modifications of single-exercise injury prevention programmes exist.…”

Section: Methodssupporting

confidence: 82%

Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study

2022

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ObjectivesGroin injuries represent a substantial problem in male football, with the Adductor Strengthening Programme (ASP) being the only exercise programme demonstrated to significantly reduce the risk of groin problems. We aimed first, to use the Reach Adoption Effectiveness Implementation Maintenance (RE-AIM) framework to investigate attitudes, beliefs and behaviour to the ASP among primary delivery agents of injury prevention exercises in Norwegian male professional football teams. Second, we aimed to identify a real-world application of the ASP protocol used in a professional team setting.DesignA descriptive cross-sectional survey, using a questionnaire designed to cover all five dimensions of the RE-AIM framework.SettingThe top two divisions of Norwegian male professional football.Participants32 primary injury prevention delivery agents.Primary and secondary outcome measuresPrimarily, the proportion of respondents being aware of the ASP and its effect; having adopted it; having implemented it as intended; and considering maintaining using it. Secondary, the most often used ASP modifications.ResultsTwenty-nine (91%) participants responded. All (100%) respondents were aware of the ASP and its injury preventive effect. The two most stated reasons for using the ASP were its injury preventive effect and that it does not require equipment. The ASP was adopted by all (100%) delivery agents, but only 10% used it in accordance with the original protocol. The main modifications were that the players in 72% of the teams were instructed to perform a non-progressive number of repetitions during pre-season, and in 86% of the teams instructed to perform more sets, but fewer repetitions per set, during in season. In total, 97% of the delivery agents planned to continue using the ASP.ConclusionThe delivery agents have positive attitudes and beliefs to the ASP, but they frequently modify it. We identified and reported a real-world application of the ASP protocol.

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Section: Methodssupporting

confidence: 82%

Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study

2022

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“…One noteworthy difference was that coaches in the high team compliance group believed that the players' performance would increase from using Knee Control, while coaches in low compliance teams had the opposite perception. A recent study showed that IPEP adherence could be improved by promoting the performance enhancing effects [23], and our findings seem to support this. Other factors that could affect the uptake of the intervention are coaches' task self-efficacy, i.e., how confident they are to use the IPEP in different situations [18], and if coaches think that injury prevention is a part of their role and responsibilities [23].…”

Section: High Vs Low Compliance Teamssupporting

confidence: 87%

“…A recent study showed that IPEP adherence could be improved by promoting the performance enhancing effects [23], and our findings seem to support this. Other factors that could affect the uptake of the intervention are coaches' task self-efficacy, i.e., how confident they are to use the IPEP in different situations [18], and if coaches think that injury prevention is a part of their role and responsibilities [23]. We have also previously reported that youth sport coaches desire support and confirmation from other peers, their club and sport associations, in using Knee Control [24].…”

Section: High Vs Low Compliance Teamssupporting

confidence: 87%

“…We have also previously reported that youth sport coaches desire support and confirmation from other peers, their club and sport associations, in using Knee Control [ 24 ]. Adherence may also be improved by providing greater adaptation possibility of an IPEP to suit the coaches’ and players’ needs and use of sport-specific equipment and skills training [ 23 ]. Our research group has therefore developed a Knee Control + programme with more levels of progression, variation, and skills training, which has been pilot tested in football [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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High compliance with the injury prevention exercise programme Knee Control is associated with a greater injury preventive effect in male, but not in female, youth floorball players

Åkerlund

Waldén

Sonesson

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Evaluate team and player compliance with the Knee Control injury prevention exercise programme, study the association between player compliance and injury rates, and compare coach demographics, baseline prevention expectancies, and programme utilisation between teams with high and low compliance. Methods Prospective one-season cohort study based on a cluster randomised controlled trial on 301 (107 female) floorball players aged 12–17 years. Floorball exposure and injuries were self-reported weekly by players using the Oslo Sports Trauma Research Center questionnaire. Team and player compliance to Knee Control was reported monthly by coaches. Additionally, coaches answered pre- and post-season surveys. Teams were divided into a high (≥ 80%) or low (< 80%) compliance group based on their use of Knee Control during the season. Players were divided into three compliance groups based on their average weekly number of Knee Control sessions; high (≥ 2 sessions), intermediate (≥ 1 to < 2 sessions), and low dose (< 1 session). Results Mean team compliance for the high and low compliance groups were 95% (range 82–100) and 50% (range 13–66), respectively. Mean ± SD weekly Knee Control dose in the three player compliance groups were 2.4 ± 0.3, 1.4 ± 0.3, and 0.7 ± 0.3 sessions, respectively. There were no differences in total injury incidence between the player compliance groups, but players in the high-dose group had a 35% lower prevalence of injuries overall [adjusted prevalence rate ratio (PRR) 0.65, 95% CI 0.48–0.89] and 60% lower prevalence of substantial injuries (adjusted PRR 0.40, 95% CI 0.26–0.61) compared with the low-dose group. Male players in the high-dose group had consistently lower injury incidence and prevalence, while no between compliance group differences were seen in female players. There were no differences in sex, years of coaching experience, or baseline prevention expectancies in general between coaches for teams in the high vs. low compliance groups, but teams in the high compliance group had a better utilisation fidelity. Conclusion There was a clear dose–response relationship between more frequent Knee Control use and lower injury rates in male floorball players, but not in female players. Teams with higher compliance also showed a better utilisation fidelity with the programme. Level of evidence Level II.

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“…As an example, university‐level footballers in the United Kingdom have a limited pre‐season and typically have two training sessions and one game each week during the in‐season. While previous research has demonstrated large increases in eccentric hip adduction strength can be achieved in sub‐elite footballers using a high‐dose intervention, 8 low‐dose training interventions which have a reduced time burden may be more appropriate for these athletes as this is expected to increase exercise compliance, while still potentially reducing the risk of injury 17 . However, whether improvements in eccentric adduction strength can be achieved in sub‐elite footballers with low‐dose training protocols and thus augment the eccentric hip adduction strength risk factor is unknown.…”

Section: Introductionmentioning

confidence: 99%

Effects of a low‐dose Copenhagen adduction exercise intervention on adduction strength in sub‐elite male footballers: A randomised controlled trial

et al. 2021

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Footballers with weak hip adductors are at increased risk of groin injury, and adductor strengthening has been shown to reduce this risk. However, the minimal effective dose of strength training to improve hip adductor strength and mitigate the risk of adductor problems remains unknown. The aim of this randomised controlled trial was to investigate the training and detraining effects of a low‐dose Copenhagen adduction exercise (CA) intervention in sub‐elite male footballers on eccentric hip adduction strength (primary outcome) and peak adductor squeeze strength (secondary outcome). Thirty‐nine male footballers were randomised into two groups: The intervention group completed the CA twice weekly during six in‐season weeks in addition to normal football training, while the control group continued normal football training. Strength testing was performed at weeks 0, 3, 6 (training period), and weeks 7‐9 (detraining period). There was no between‐group difference in eccentric strength at week 6 and 9. There was a significant group by time interaction at 6 weeks (0.52 Nm/kg, 95% CI 0.17‐0.86) and 9 weeks (0.59 Nm/kg, 95% CI 0.25‐0.93) at which the intervention group displayed greater adductor squeeze strength. These results suggest the low‐dose CA intervention is insufficient to modify eccentric hip adduction strength but improves peak adductor squeeze strength.

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Attitudes, beliefs and factors influencing football coaches’ adherence to the 11+ injury prevention programme

Cited by 12 publications

References 37 publications

Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study

Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study

High compliance with the injury prevention exercise programme Knee Control is associated with a greater injury preventive effect in male, but not in female, youth floorball players

Effects of a low‐dose Copenhagen adduction exercise intervention on adduction strength in sub‐elite male footballers: A randomised controlled trial

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