Peter Alexander van de Hoef1, Michel S Brink1,2, Bionka M A Huisstede1, Maarten van Smeden3, Niels de Vries4, Edwin A Goedhart4, Vincent Gouttebarge5,6,7,8,9, Frank J G Backx1. 1. University Medical Center Utrecht, Rudolf Magnus Institute of Neurosciences, Department Rehabilitation, Physical Therapy Science & Sports, Utrecht University, Utrecht, The Netherlands. 2. University Medical Center Groningen, Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands. 3. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. 4. FIFA Medical Center, Royal Netherlands Football Association, Zeist, The Netherlands. 5. Dutch Consumer Safety Institute, Amsterdam, The Netherlands. 6. Amsterdam Collaboration for Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands. 7. World Players' Union (FIFPro), Hoofddorp, The Netherlands. 8. Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands. 9. Division of Exercise Science and Sports Medicine (ESSM), University of Cape Town, Cape Town, South Africa.
Abstract
BACKGROUND: Although the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long-term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players. PURPOSE: To determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players. STUDY DESIGN: A cluster-Randomized Controlled Trial. METHODS:Thirty-two soccer teams competing in the first-class amateur league were cluster-randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016-2017). RESULTS: The data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46-1.75) or severity between the groups (P > 0.48). CONCLUSION: In this large cluster-randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.
RCT Entities:
BACKGROUND: Although the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long-term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players. PURPOSE: To determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players. STUDY DESIGN: A cluster-Randomized Controlled Trial. METHODS: Thirty-two soccer teams competing in the first-class amateur league were cluster-randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016-2017). RESULTS: The data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46-1.75) or severity between the groups (P > 0.48). CONCLUSION: In this large cluster-randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.
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