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A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to
Roland Rössler1,2, Astrid Junge3,4,5, Mario Bizzini3,4
1Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland. roland.roessler@unibas.ch.
Insights
The '11+ Kids' warm-up program significantly reduces football injuries in children by 48%. This program effectively lowers overall, severe, and lower extremity injuries, with greater benefits seen from more frequent participation.
Area of Science:
- Sports Medicine
- Pediatric Sports Injury Prevention
- Football (Soccer)
Background:
- Childhood football participation is high, but injury risk is a concern.
- Existing warm-up protocols may not be optimized for young athletes.
- The '11+ Kids' program was developed to address injury prevention in youth football.
Purpose of the Study:
- To evaluate the effectiveness of the '11+ Kids' warm-up program in reducing football-related injuries among children.
- To compare injury rates between children using '11+ Kids' and those following standard warm-ups.
Main Methods:
- A randomized controlled trial involving children's football teams (U9, U11, U13) across four European countries.
- Clubs were assigned to either the '11+ Kids' intervention or a control group (usual warm-up).
- Data on injuries and player exposure were collected over one season, with analyses using Cox models.
Main Results:
- A total of 3895 players accumulated 292,749 hours of play.
- The '11+ Kids' group showed a 48% reduction in overall injury rates compared to the control group.
- Significant reductions were also observed for severe injuries (74%) and lower extremity injuries (55%).
Conclusions:
- The '11+ Kids' program is a highly effective intervention for preventing football injuries in children.
- The program demonstrates substantial benefits for overall, severe, and lower extremity injuries.
- Performing the program at least once weekly is beneficial, with two sessions per week recommended for enhanced protection.
Objective:
The objective of this study was to assess the efficacy of a newly developed warm-up programme ('11+ Kids') regarding its potential to reduce injuries in children's football.
Methods:
Children's football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group replaced their usual warm-up by '11+ Kids', while the control group warmed up as usual. The primary outcome was the overall risk of football-related injuries. Secondary outcomes were the risks of severe and lower extremity injuries. We calculated hazard ratios using extended Cox models, and performed a compliance analysis.
Results:
In total, 292,749 h of football exposure of 3895 players were recorded. The mean age of players was 10.8 (standard deviation 1.4) years. During the study period, 374 (intervention group = 139; control group = 235) injuries occurred. The overall injury rate in the intervention group was reduced by 48% compared with the control group (hazard ratio 0.52; 95% confidence interval 0.32-0.86). Severe (74% reduction, hazard ratio 0.26; 95% confidence interval 0.10-0.64) and lower extremity injuries (55% reduction, hazard ratio 0.45; 95% confidence interval 0.24-0.84) were also reduced. Injury incidence decreased with increasing compliance.
Conclusion:
'11+ Kids' is efficacious in reducing injuries in children's football. We observed considerable effects for overall, severe and lower extremity injuries. The programme should be performed at least once per week to profit from an injury preventive effect. However, two sessions per week can be recommended to further increase the protective benefit.
Trial Registration:
ClinicalTrials.gov identifier: NCT02222025.
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