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Lower re-injury rate with a coach-controlled rehabilitation program in amateur male soccer: A randomized controlled trial
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-6883-1471
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2007 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 35, no 9, p. 1433-1442Article in journal (Refereed) Published
Abstract [en]

Background: Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury.

Hypothesis: The rate of reinjury is reduced using a coach-controlled rehabilitation program.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups.

Results: There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16–0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11–0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%).

Conclusion: The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.

Place, publisher, year, edition, pages
2007. Vol. 35, no 9, p. 1433-1442
Keyword [en]
soccer, football, recurrent injury, prevention, rehabilitation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-14342DOI: 10.1177/0363546507300063OAI: oai:DiVA.org:liu-14342DiVA, id: diva2:23278
Available from: 2007-03-14 Created: 2007-03-14 Last updated: 2017-12-13
In thesis
1. Epidemiology and prevention of football injuries
Open this publication in new window or tab >>Epidemiology and prevention of football injuries
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this thesis were to study the incidence, severity and pattern of injury in male and female elite football players; to study time trends in injury risk; to identify risk factors for injury; and to test the effectiveness of an intervention programme aimed at preventing re-injury.

All studies followed a prospective design using standardised definitions and data collection forms. Individual training and match exposure was registered for all players participating. Time loss injuries were documented by each team’s medical staff.

The amount of training increased by 68% between the 1982 and 2001 Swedish top male division seasons, reflecting the shift from semi-professionalism to full professionalism. No difference in injury incidence or injury severity was found between seasons. The injury incidence was 4.6 vs. 5.2/1000 training hours and 20.6 vs. 25.9/1000 match hours. The incidence of severe injury (absence >4 weeks) was 0.8/1000 hours in both seasons.

The Swedish and Danish top male divisions were followed during the spring season of 2001. A higher risk for training injury (11.8 vs. 6.0/1000 hours, p<0.01) and severe injury (1.8 vs. 0.7/1000 hours, p=0.002) was observed among the Danish players. Re-injury accounted for 30% and 24% of injuries in Denmark and Sweden respectively.

The Swedish top male division was studied over two consecutive seasons, 2001 and 2002, and comparison of training and match injury incidences between seasons showed similar results. Players who were injured in the 2001 season were at greater risk for injury in the following season compared to non-injured players (relative risk 2.7; 95% CI 1.7-4.3). Players with a previous hamstring injury, groin injury and knee joint trauma were two to three times more likely to suffer an identical injury to the same limb in the following season, but no such relationship was found for ankle sprain. Age was not associated with an increased injury risk.

The effectiveness of a coach-controlled rehabilitation programme on the rate of re-injury was studied in a randomised controlled trial at amateur male level. In the control group, 23 of 79 injured players suffered a recurrence during the season compared to 10 of 90 players in the intervention group. There was a 75% lower re-injury risk in the intervention group for lower limb injuries (relative risk 0.25; 95% CI 0.11-0.57). The preventive effect was greatest during the first weeks after return to play.

Both the male and female Swedish top divisions were followed during the 2005 season. Male elite players had a higher risk for training injury (4.7 vs. 3.8/1000 hours, p<0.05) and match injury (28.1 vs. 16.1/1000 hours, p<0.001) than women. However, no difference was observed in the rate of severe injury (0.7/1000 hours in both groups). The thigh was the most common site of injury in both men and women, while injury to the hip/groin was more frequent in men and to the knee in women. Knee sprain accounted for 31% and 37% of the time lost from training and match play in men and women respectively.

Place, publisher, year, edition, pages
Institutionen för hälsa och samhälle, 2007
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 988
Keyword
Football, Injury prevention, Incidence, Re-injury, Rehabilitation, Elite
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-8500 (URN)978-91-85715-51-0 (ISBN)
Public defence
2007-03-30, Aulan, Hälsans Hus, Universitetssjukhuset, Linköping, 13:00 (English)
Opponent
Supervisors
Note
Serienumret i serien Linköping University medical dissertation är fel. Det korrkta numret är 988. The serial number in the series Linköping University medical dissertation is incorrect. The correct number is 988.Available from: 2007-03-14 Created: 2007-03-14 Last updated: 2013-09-04

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Hägglund, MartinWaldén, MarkusEkstrand, Jan

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