Higher compliance to a neuromuscular injury prevention program improves overall injury rate in male football players

PURPOSE: The 11+ injury prevention program has been shown to decrease injury rate. However, few studies have investigated compliance and if it is correlated to time loss. The purpose of this study was to (1) analyze how differences in compliance may impact injury rate and (2) if compliance may impact time loss due to injury. METHODS: This study was a Level 1 prospective cluster randomized controlled trial conducted in NCAA men's football (soccer) teams that examined the efficacy of the 11+ injury prevention program. The two outcome variables examined were number of injuries and number of days missed from competition. Twenty-seven teams (n = 675 players) used the 11+ program. Compliance, injuries and time loss were recorded. There were three compliance categories, low (LC, 1-19 doses/season), moderate (MC, 20-39 doses/season), and high (HC, > 40 doses/season). RESULTS: = 0.23. The LC group mean (M) = 13.25, 95% confidence interval (CI) 9.82-16.68, injury rate (IR) = 10.35 ± 2.21 had a significantly higher injury rate than the HC group (M = 8.33, 95%CI 6.05-10.62, IR = 10.35 ± 2.21), p = 0.02. The MC group (M = 11.21, 95%CI 9.38-13.05, IR = 8.55 ± 2.46) was not significantly different than the LC group, p = 0.29, but was significantly greater than the HC group, p = 0.05. When examined as a continuous variable, compliance was significantly negatively related to injury rate (p = 0.004). It was also significantly negatively related to number of days missed (p = 0.012). CONCLUSIONS: When compliance was high, there was a significant reduction in injury and time loss. This evidence reinforces the importance of consistent injury prevention program utilization. Clinically, these findings have important implications when discussing the importance of consistent utilization of an injury prevention protocol in sport. LEVEL OF EVIDENCE: Level 1-Randomized controlled trial (RCT).