Injury Prevention in Futsal: An Observational Longitudinal Prospective Study to Assess the Influence of the Modified FIFA “11+” Injury Prevention Program
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Futsal, a five-a-side version of the association football, has experienced significant growth globally, as well as in New Zealand (NZ). Due to the growing population of futsal players, the issue of safety has become more important. However, there has been little investigation regarding the effects of any injury-prevention measures in amateur futsal players. This thesis is, therefore, focused on the development of a novel injury-prevention warm-up programme and the evaluation of its effectiveness in NZ community futsal. The first step in developing an effective, injury-prevention programme, was to understand the frequency of injuries and their characteristics in NZ community futsal. Data was collected from 420 teams of both genders and different age groups (junior, high school, adult) during a year-long futsal competition. A total of 131 injuries were sustained during 1723 matches, which is equivalent to an incidence rate (IR) of 11.4 injuries per 1000 player hours. Most injuries affected the lower extremity (56%), followed by head and neck (24%), and upper extremity (17%). The most common body parts injured were the ankle (25%), head (22%), and knee (17%). Most injuries occurred during contact situations (88%). Over half of the injuries (52%) stopped players finishing the match while 13% of injuries required medical attention. Based on this injury data and the input from key stakeholders (coaches, players, sport medicine professionals), via two focus groups, a novel futsal-specific warm-up programme (“Futsal FastStart”) was developed. The structure consisted of futsal-related movements adapted from the 11+ warm-up, previously shown to reduce injuries in football. The effectiveness of the programme to reduce the risk of injuries in amateur players was assessed using a quasi-experimental study over the course of the 2019 futsal season (a total of 20 weeks). A total of 878 teams agreed to participate in the study. Teams in the intervention group (n=458 teams) were given information about the study and the implementation of the warm-up programme. Teams in the control group (n=420 teams) were asked to warm up via their usual routine. The intervention group had a significantly lower risk of contact injuries (incidence rate ratio (IRR)=0.68, p=0.035), especially injuries caused by contact with the ball (IRR=0.48, p=0.040). Subgroup analysis, based on adherence to the warm-up, revealed a significantly lower number of injuries overall (IRR=0.52, p=0.038) and lower extremity injuries (IRR=0.32, p=0.015) in teams with high adherence compared to teams with low adherence. Significantly fewer injuries overall (IRR=0.50, p=0.041) were also found in the high adherence group compared to the intermediate adherence group. Although the Futsal FastStart warm-up programme has not been found effective for preventing injuries overall, there were significantly fewer contact injuries that are common in amateur futsal. There is also preliminary evidence the warm-up could be effective in reducing injuries in community futsal players if adherence is high.