Football (soccer) is the most popular team sport in the world
DISSERTATION SYNOPSIS
SUBMITTED TO
RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA
BANGALORE
TOWARD PARTIAL FULFILMENT OF
MASTER OF PHYSIOTHERAPY DEGREE COURSE
By
SACHIN GUNADHAR SHETTI
UNDER THE GUIDANCE OF
J. BALAMURUGAN
VIKAS COLLEGE OF PHYSIOTHERAPY
MARYHILL, KONCHADY, MANGALORE-575008
2011-13
RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA
BANGALORE
REGISTRATION OF SUBJECTS FOR DISSERTATION
| | | |
|1. |Name of the Candidate |SACHIN GUNADHAR SHETTI |
| |and Address |VIKAS COLLEGE OF PHYSIOTHERAPY |
| | |AIRPORT ROAD |
| | |MARYHILL, KONCHADY |
| | |MANGALORE – 575008 |
| | | |
|2. |Name of the Institution |VIKAS COLLEGE OF PHYSIOTHERAPY |
| | |Mangalore. |
| | | |
|3. |Course of study and subject |Master of Physiotherapy (MPT) |
| | |Physiotherapy in Musculoskeletal Disorders and Sports Physiotherapy |
| | | |
|4. |Date of admission to Course |23-06-2011 |
| | |
|5. |Title of the Topic |
| | |
| |EFFECTIVENESS OF ‘THE 11’ INJURY PREVENTION PROGRAMME IN ADULT MALE AMATEUR SOCCER PLAYERS |
| | |
|6 |BRIEF RESUME OF THE INTENDED WORK |
| | |
| |6.1) Need for the study |
| | |
| |Sport is considered a vital component of an active and healthy lifestyle, reducing the risk of various diseases and |
| |contributing to better social and physical performance. The beneficial effects of playing sports must be balanced against|
| |injuries that are to some extent inevitable.1 |
| | |
| |Football (soccer) is the most popular team sport in the world. There are already more than 265 million registered |
| |players, and the number of participants is continuing to grow.2 Playing football, however, entails a substantial risk of |
| |injury, and studies on elite and non-elite footballers,3,4 and the most common being injuries to the knee and ankle |
| |ligament and thigh muscle strains.5 |
| | |
| |An injury is defined as: Any physical complaint sustained by a player that results from a football match or football |
| |training, irrespective of the need for medical attention or time loss from football activities. An injury that results in|
| |a player receiving medical attention is referred to as a “medical attention” injury, and an injury that results in a |
| |player being unable to take a full part in future football training or match play as a “time loss” injury.6 |
| | |
| |Most soccer injuries are located in the lower extremities, the majority concerning the ankle, knee, or hamstring.5 These |
| |injuries mainly consist of sprains and strains (50%) and contusions (33%).7 Outdoor soccer is a high intensity sport with|
| |continuous changes of direction and high-load unipodal actions. Participating in this sport puts high demands on |
| |neuromuscular control, agility, and eccentric/plyometric strength.1 |
| | |
| |The high injury rate among football players constitutes a considerable problem for the player, the club, and—given the |
| |popularity of the sport—for society at large. Health consequences are seen not just in the short term but also in the |
| |dramatic increase in the risk of early osteoarthritis.8 |
| | |
| |Healthcare costs include the expenses of visits to medical specialists, additional visits to other healthcare providers |
| |(general practitioners and physiotherapists), prescription medication, resources to improve recovery, hospitalisation, |
| |x-rays and other diagnostic procedures. The economic evaluation will assess the balance between costs and effects.1 |
| | |
| |Despite the urgent need to develop programmes to prevent knee and ankle injuries in footballers, there exist only a few |
| |small or non-randomised studies on prevention of injury in football players.9,10,11 Several studies have shown that |
| |intervention programmes containing specific exercises can significantly reduce injury risks to the lower |
| |extremities.12-16 |
| | |
| |An injury prevention programme called ‘The11’, developed with the support of the World Football Association FIFA, |
| |significantly reduced injury rates (21% fewer injuries) in Swiss male junior soccer players.17 However, this injury |
| |prevention effect was not observed in Norwegian female junior soccer players, most likely because compliance with the |
| |programme was low.18 |
| | |
| |Objectives |
| | |
| |The objective of this study is to investigate the effectiveness of ‘The 11’ injury prevention programme to prevent |
| |injuries in amateur male soccer players in a randomized controlled study. |
| | |
| |6.2) Review of Literature |
| | |
| |Inklaar states that identified intrinsic risk factors for soccer injuries are joint flexibility including pathological |
| |ligamentous laxity and muscle tightness, functional instability, previous injuries and inadequate rehabilitation. |
| |Extrinsic risk factors include the exercise load in soccer (competition and practice), inadequate equipment (shinguards, |
| |taping, shoes), playing field conditions and foul play. The aetiology of soccer injuries may differ between different |
| |subgroups of the soccer population. As a consequence, different subgroups of soccer players may need different |
| |prophylactic programmes to achieve a major reduction in incidence and severity of soccer injuries. More research is |
| |needed to identify high risk groups and independent predictor variables of injury within those subgroups. The outcome of |
| |these studies must lead to the development of effective prophylactic programmes.19 |
| | |
| |Alentorn-Geli et al conducted a literature review that reports potential mechanisms and risk factors for non-contact ACL |
| |injury in soccer players as this sport has higher risk of injury to the anterior cruciate ligament (ACL) relative to |
| |other sports. Common playing situations precluding a non-contact ACL injury include: change of direction or cutting |
| |maneuvers combined with deceleration, landing from a jump in or near full extension, and pivoting with knee near full |
| |extension and a planted foot. The most common non-contact ACL injury mechanism include a deceleration task with high knee|
| |internal extension torque (with or without perturbation) combined with dynamic valgus rotation with the body weight |
| |shifted over the injured leg and the plantar surface of the foot fixed flat on the playing surface.20 |
| | |
| |Commonly purported intrinsic risk factors include: generalized and specific knee joint laxity, small and narrow |
| |intercondylar notch width, decreased relative (to quadriceps) hamstring strength and recruitment, muscular fatigue by |
| |altering neuromuscular control, decreased "core" strength and proprioception, low trunk, hip, and knee flexion angles, |
| |and high dorsiflexion of the ankle when performing sport tasks, lateral trunk displacement and hip adduction combined |
| |with increased knee abduction moments, and increased hip internal rotation and tibial external rotation with or without |
| |foot pronation. The identification of those athletes at increased risk may be a salient first step before designing and |
| |implementing specific pre-season and in-season training programs aimed to modify the identified risk factors and to |
| |decrease ACL injury rates.20 |
| | |
| |Parkkari et al conducted a review of controlled clinical trials to determine if it is possible to prevent sports |
| |injuries. The results revealed the general injury rate can be reduced by a multifactorial injury prevention programme in |
| |soccer, or by ankle disk training, combined with a thorough warm-up, in European team handball. Ankle sprains can be |
| |prevented by ankle supports in high-risk sporting activities, such as soccer and basketball, and stress fractures of the |
| |lower limb by the use of shock-absorbing insoles in footwear. They concluded that well-designed randomised studies are |
| |needed on preventive actions and devices that are in common use, such as preseason medical screenings, warming up, |
| |proprioceptive training, stretching, muscle strengthening, taping, protective equipment, rehabilitation programmes and |
| |education interventions.21 |
| | |
| |Aaltonen et al conducted a systematic review of the effects of randomized controlled interventions to prevent sports |
| |injuries. Results showed evidence of the preventive effect of 3 types of injury prevention interventions. They concluded |
| |that a decreased risk of sports injuries was associated with the use of insoles, external joint supports, and |
| |multi-intervention training programs and suggested more high-quality randomized controlled trials in different sports and|
| |populations.22 |
| | |
| |The injury prevention programme The11 has been developed with the support of the World Football Association FIFA. The |
| |programme aims to reduce the impact of intrinsic injury risk factors in soccer.23 It includes 10 exercises focusing on |
| |core stability, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation, and plyometrics with|
| |straight leg alignment. The 11th component, fair play advice, is not included in the present trial. The exercises of |
| |The11 are the bench, sideways bench, hamstrings, cross country skiing, chest-passing in single-leg stance, forward bend |
| |in single-leg stance, figures-of-eight in single-leg stance, jumps over a line, zigzag shuffle, and bounding. The |
| |programme takes about 10–15 min after the players have familiarised themselves with the exercises.1 |
| | |
| |van Beijsterveldt et al designed a cluster-randomised controlled trial to investigate the effectiveness and |
| |cost-effectiveness of an injury prevention programme (‘The11’) developed with the support of the World Football |
| |Association FIFA, for male amateur soccer players. They concluded that integrating the The11 exercises in the warm-up |
| |for each practice session is effective in terms of injury incidence, injury severity, healthcare use, and its associated |
| |costs and/or absenteeism. Prevention of soccer injuries is expected to be beneficial to adult soccer players, soccer |
| |clubs, Football Association, health insurance companies and society.1 |
| | |
| |Soligard et al examined the effect of a comprehensive warm-up programme designed to reduce the risk of injuries in female|
| |youth football in a cluster randomised controlled trial. Warm-up programme included intreventions to improve strength, |
| |awareness, and neuromuscular control during static and dynamic movements. Results showed that the intervention group had |
| |a significantly lower risk of injuries overall, overuse injuries, and severe injuries. They concluded that though the |
| |primary outcome of reduction in lower extremity injury did not reach significance, the risk of severe injuries, overuse |
| |injuries, and injuries overall was reduced. This indicates that a structured warm-up programme can prevent injuries in |
| |young female football players.24 |
| | |
| |Alentorn-Geli et al conducted a review to sequence the most recent literature relating the effects of prevention programs|
| |that were developed to alter risk factors associated with non-contact ACL injuries and to reduce the rate of non-contact |
| |ACL injuries in soccer players. Results showed no standardized intervention program established for soccer to prevent |
| |non-contact ACL injuries and Multi-component programs rather than single-component preventive programs, lower extremity |
| |plyometrics, dynamic balance and strength, stretching, body awareness and decision-making and targeted core and trunk |
| |control appear to be successful training components to reduce non-contact ACL injury risk factors and prevent non-contact|
| |ACL injuries in soccer players. They concluded that pre-season injury prevention combined with an in-season maintenance |
| |program and techniques to improve compliance should be advocated.25 |
| | |
| |Caraffa et al studied the possible preventive effect of a gradually increasing proprioceptive training on four different |
| |types of wobble-boards to avoid ACL injury. The first phase consisted of balance training without any balance board; |
| |phase 2 of training on a rectangular balance board; phase 3 of training on a round board; phase 4 of training on a |
| |combined round and rectangular board; phase 5 of training on a so-called BABS board. The results showed an incidence of |
| |1.15 ACL injuries per team per year in the proprioceptively trained group and they concluded that proprioceptive training|
| |can significantly reduce the incidence of ACL injuries in soccer players.12 |
| | |
| |Emery and Meeuwisse examined the effectiveness of a neuromuscular prevention strategy in reducing injury in youth soccer |
| |players in a cluster-randomised controlled trial. The training programme was a soccer-specific neuromuscular training |
| |programme including dynamic stretching, eccentric strength, agility, jumping and balance (including a home-based balance |
| |training programme using a wobble board). The control programme was a standardised warm-up (static and dynamic stretching|
| |and aerobic components) and a home-based stretching programme. Results showed a significantly lower injury rate in the |
| |training group and protection of lower extremity, ankle and knee sprain injuries. They concluded that a neuromuscular |
| |training programme is protective of all injuries and acute onset injury in youth soccer players.13 |
| | |
| |Heidt et al conducted a study to evaluate the effect of a preseason conditioning program on the occurrence and severity |
| |of soccer injuries over a 1-year period. The type, mechanism, and severity of the injury, when the injury occurred, the |
| |number of games or practices missed, and type of shoe worn were recorded. All injuries occurred in the lower extremities,|
| |with 61.2% occurring at the knee and ankle. Results revealed that the trained group experienced a significantly lower |
| |incidence of injury than the untrained group. Although not statistically significant, the trained group also had a lower |
| |percentage of anterior cruciate ligament injuries compared with the untrained group. These results suggest that preseason|
| |conditioning has a significant influence on lowering the incidence of injury in female adolescent soccer players.15 |
| | |
| |6.3) Objectives of the study |
| | |
| |The objective of this study is to investigate, in a randomized, prospective controlled study, the effectiveness of an |
| |injury prevention programme for adult male amateur soccer players. |
|7 |MATERIALS AND METHODS |
| | |
| |7.1 Source of data |
| | |
| |Data will be collected from 90 amateur male soccer players who train under Dakshina Kannada district football |
| |association, Mangalore. |
| | |
| |Method of collection of data |
| | |
| |Hypothesis |
| | |
| |There is a significant reduction in injuries to amateur male soccer players following a preseason training (The 11) |
| |programme. |
| | |
| |Null Hypothesis |
| |There is no significant reduction in injuries to amateur male soccer players following a preseason training (The 11) |
| |programme. |
| | |
| |Research Design |
| | |
| |Experimental design will be used for this study. |
| | |
| | |
| |Sampling method |
| | |
| |Random sampling method |
| | |
| | |
| |Tools used |
| | |
| |Training program record |
| |Injury record |
| | |
| |METHODOLOGY |
| | |
| |90 male amateur soccer players within the age group of 18-30 years will be recruited after obtaining informed consent and|
| |asked to fill in a questionnaire to record baseline characteristics: date of birth, height, weight, years of experience |
| |as a soccer player, educational level, profession, numbers of working hours per week, dominant leg, position in the |
| |soccer field, preventive measures taken (such as shin guards, taping, braces), chronic diseases, and prior soccer |
| |injuries sustained during the previous year (number and localisation). To be eligible for the study the subjects should |
| |fulfill the following inclusion and exclusion criteria. |
| | |
| |Inclusion Criteria |
| | |
| |Amateur male soccer players |
| | |
| |Age between 18 and 30 years |
| | |
| |Willingness to undergo preseason injury prevention training programme (The 11) at least 3 times a week for 3 months |
| | |
| |Willingness to incorporate (The 11) as part of warm up routine during season |
| | |
| |Willingness to maintain a record of number of training programme undergone and any injury sustained |
| | |
| | |
| |Exclusion criteria |
| | |
| |Previous injury within the past three months |
| | |
| |Previous lower limb surgery |
| | |
| |Lower limb trauma within the previous three months |
| | |
| |Excessive ligamentous laxity |
| | |
| |Musculokeletal disorders |
| | |
| |Neuromuscular disorders |
| | |
| |Cardiopulmonary disorders |
| | |
| |Generalized connective tissue inflammatory disorders |
| | |
| |Inflammatory or infective arthritis |
| | |
| |Chronic diseases like diabetes, hypertension etc. |
| | |
| | |
| |Study Design |
| | |
| |The subjects who fulfill the inclusion and exclusion criteria and willing to participate in the study will be randomly |
| |assigned one of two groups after obtaining written informed consent. |
| | |
| |Group 1: This group will consist of 60 subjects (N=60) and they will undergo The 11 injury prevention exercise programme |
| |as part of routine warm up during both preseason and season. It includes 10 exercises focusing on core stability, |
| |eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation, and plyometrics with straight leg |
| |alignment. The 11th component, fair play advice, is not included in the trial. (Experimental group) |
| | |
| |Group 2: This group will consist of 30 subjects (N=30) and they will undergo routine warm up during both preseason and |
| |season as instructed by their coach. (Control group) |
| | |
| |Interventions |
| | |
| |Both groups will undertake the respective interventions 3 times a week as part of warm up routine for 3 months during |
| |preseason and during football season. |
| | |
| |Instructions and repetitions for the exercises of The11 |
| | |
| |Exercise |
| |Instructions |
| |Repetitions/duration |
| | |
| |1. The bench |
| |Head, shoulders, back, and hips in a straight line, parallel to the ground. Elbows directly under the shoulders. Lift one|
| |leg a few centimetres off the ground. |
| |Hold the position for 15 s. Repeat twice for each leg. |
| | |
| |2. Sideways bench |
| |Upper shoulder, hip, and upper leg in a straight line parallel to the ground. Elbow directly under the shoulders. From |
| |above, shoulders, elbow, hips, and both knees are in a straight line. Don't drop the hips. |
|8 |REFERENCES |
| | |
| |Anna M C van Beijsterveldt, Mark R Krist, Sandor L Schmikli, Janine H Stubbe, G Ardine de Wit, Han Inklaar, Ingrid G L |
| |van de Port, and Frank J G Backx. Effectiveness and cost-effectiveness of an injury prevention programme for adult male |
| |amateur soccer players: design of a cluster-randomised controlled trial. Inj Prev. 2011 February; 17(1): e2. |
| |FIFA. FIFA big count 2006: 270 million people active in football aboutfifa/media/newsid=529882.html. |
| |Engström B, Johansson C, Törnkvist H. Soccer injuries among elite female players. Am J Sports Med 1991;19:372-5. |
| |Östenberg A, Roos H. Injury risk factors in female European football. A prospective study of 123 players during one |
| |season. Scand J Med Sci Sports 2000;10:279-85. |
| |Wong P, Hong Y. Soccer injury in the lower extremities. Br J Sports Med 2005;39:473–82. |
| |Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH. Consensus statement |
| |on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med |
| |2006;40:193-201 |
| |Arnason A, Sigurdsson SB, Gudmundsson A, et al. Risk factors for injuries in football. Am J Sports Med 2004;32(Suppl |
| |1):5S–16. |
| |Lohmander LS, Östenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in|
| |female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004;50:3145-52. |
| |Heidt RS Jr, Sweeterman LM, Carlonas RL, Traub JA, Tekulve FX. Avoidance of soccer injuries with preseason conditioning. |
| |Am J Sports Med 2000;28:659-62. |
| |Söderman K, Werner S, Pietila T, Engström B, Alfredson H. Balance board training: prevention of traumatic injuries of the|
| |lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol |
| |Arthrosc 2000;8:356-63. |
| |Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, Thomas SD, Griffin LY, et al. Effectiveness of a neuromuscular and |
| |proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. |
| |Am J Sports Med 2005;33:1003-10. |
| |Caraffa A, Cerulli G, Projetti M, et al. Prevention of anterior cruciate ligament injuries in soccer. A prospective |
| |controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc 1996;4:19–21. |
| |Emery CA, Meeuwisse WH. The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a |
| |cluster-randomised controlled trial. Br J Sports Med 2010;44:555–62. |
| |Grindstaff TL, Hammill RR, Tuzson AE, et al. Neuromuscular control training programs and noncontact anterior cruciate |
| |ligament injury rates in female athletes: a numbers-needed-to-treat analysis. J Athl Train 2006;41:450–6. |
| |Heidt RS, Jr, Sweeterman LM, Carlonas RL, et al. Avoidance of soccer injuries with preseason conditioning. Am J Sports |
| |Med 2000;28:659–62. |
| |Verhagen E, van der Beek A, Twisk J, et al. The effect of a proprioceptive balance board training program for the |
| |prevention of ankle sprains: a prospective controlled trial. Am J Sports Med 2004;32:1385–93. |
| |Junge A, Rosch D, Peterson L, et al. Prevention of soccer injuries: a prospective intervention study in youth amateur |
| |players. Am J Sports Med 2002;30:652–9. |
| |Steffen K, Myklebust G, Olsen OE, et al. Preventing injuries in female youth football–a cluster-randomized controlled |
| |trial. Scand J Med Sci Sports 2008;18:605–14. |
| |Inklaar H. Soccer injuries. II: Aetiology and prevention. Sports Med 1994;18:81–93. |
| |Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lázaro-Haro C, Cugat R. Prevention of non-contact anterior |
| |cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to|
| |reduce injury rates. Knee Surg Sports Traumatol Arthrosc. 2009 Aug;17(8):859-79. |
| |Parkkari J, Kujala UM, Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and |
| |recommendations for future work. Sports Med. 2001; 31(14):985-95. |
| |Aaltonen S, Karjalainen H, Heinonen A, Parkkari J, Kujala UM. Prevention of sports injuries: systematic review of |
| |randomized controlled trials. Arch Intern Med. 2007 Aug 13-27;167(15):1585-92. |
| |Dvorak J, Junge A. Football medicine manual. Zurich: F-MARC, 2005:81–93. |
| |Soligard T, Myklebust G, Kathrin K, Holme I, Silvers H, Bizzini M, Junge A, Dvorak J, Bahr R, Andersen TE. Comprehensive |
| |warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. |
| |Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lázaro-Haro C, Cugat R. Prevention of non-contact anterior |
| |cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to|
| |reduce injury rates. Knee Surg Sports Traumatol Arthrosc. 2009 Aug;17(8):859-79. |
| | |
|9. |Signature of the candidate : |
| | |
|10. |Remarks of the Guide |
| | |
| | |
| | |
| | |
| | |
|11. |Name and Designation of |
| | |
| |Guide : BALAMURUGAN M.P.T. |
| | |
| |Signature : |
| | |
| |Co-Guide : - |
| | |
| |Signature : - |
| | |
| |Head of the Department : Prof. S. NATARAJAN M.P.T. |
| | |
| |Signature : |
| | |
|12. |12.1 Remarks of the Chairman and Principal |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| |12.2 Signature : |
| | |
| | |
| | |
| | |
[pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic][pic]
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.