The Effect of the FIFA-11+ ACL Injury Prevention Program on Drop Vertical Jump Biomechanics in Varsity Athletes: A Prospective Observational Cohort Study.

BACKGROUND

Anterior cruciate ligament (ACL) injuries can pose significant challenges for athletes, leading to significant morbidity, loss of playing time, and impaired performance. Neuromuscular training programs, such as the FIFA 11+, have shown promise in reducing the risk of lower extremity injuries in this high-risk population.

PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the effect of the FIFA 11+ program on lower extremity biomechanics during a drop vertical jump (DVJ) and to determine whether it modifies the athlete's risk of an ACL injury. It was hypothesized that the FIFA 11+ program would positively affect lower limb biomechanics during a DVJ in varsity athletes by decreasing initial coronal (IC) and peak coronal (PC) knee abduction angles while increasing peak sagittal (PS) knee flexion angles.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

A total of 36 collegiate varsity athletes (72 knees) were recruited for this investigation. The intervention group included female and male soccer players who incorporated the FIFA 11+ program into their pregame warm-up. The control group consisted of female hockey players who participated in a "standard" warm-up. The FIFA 11+ program was conducted twice weekly over 10 weeks. Biomechanical data before and after the intervention during DVJs, captured using a motion sensor, were compared between the intervention and control groups.

RESULTS

The intervention group showed a significant reduction in PC angles from high risk to low risk and a significant decrease in PS angles, while IC angles remained unchanged. Conversely, the control group showed a significant increase in IC angles from low risk to high risk, with no notable changes in PC and PS angles.

CONCLUSION

This study demonstrated that the FIFA 11+ program effectively reduced PC knee abduction angles, with a decrease in this parameter indicating an overall shift from high- to low-risk biomechanics in the intervention group. Additionally, worsening postseason knee biomechanics in the control group highlighted that the injury risk increased throughout the season when a targeted neuromuscular training program was not incorporated into pregame warm-ups. This suggests that the FIFA 11+ program mitigates key biomechanical risk factors for noncontact ACL injuries.