Extended <i>Knee Control</i> programme lowers weekly hamstring, knee and ankle injury prevalence compared with an adductor strength programme or self-selected injury prevention exercises in adolescent and adult amateur football players: a two-armed cluster-randomised trial with an additional comparison arm.

Abstract

To evaluate the preventive efficacy of an extended version of the <i>Knee Control</i> injury prevention exercise programme (IPEP) compared with an adductor strength programme and to a comparison group using a self-selected IPEP in amateur adolescent and adult male and female football players. Two-armed cluster-randomised trial with an additional non-randomised arm. All 251 amateur teams (players 14-46 years) in one regional football district were approached. Teams meeting inclusion criteria were randomised to (1) extended <i>Knee Control</i> or (2) an adductor strength programme. Teams already using an IPEP were allocated to a comparison group and received no new intervention. Players responded to weekly questionnaires about football exposures and injuries during a 7-month season. Seventeen teams in the extended <i>Knee Control</i>, 12 in the adductor and 17 in the comparison group participated, with 502 players. For the primary outcomes, no difference in injury incidence in three lower-limb injury locations combined (hamstring, knee and ankle) was seen between extended <i>Knee Control</i> and the adductor group, whereas extended <i>Knee Control</i> had 29% lower incidence than the comparison group (incidence rate ratio 0.71, 95% CI 0.52 to 0.98). No between-group differences in groin injury incidence were seen. The weekly injury prevalence rates in the three lower limb locations combined (hamstring, knee and ankle) were 17% lower (prevalence rate ratio (PRR) 0.83, 95% CI 0.69 to 1.00) and 26% lower (PRR 0.74, 95% CI 0.63 to 0.87) in extended <i>Knee Control</i> compared with the adductor and comparison groups, respectively. No difference in injury incidence was seen between the extended <i>Knee Control</i> and the adductor programme whereas extended <i>Knee Control</i> reduced injury incidence by nearly one-third compared with a self-selected IPEP. Players in extended <i>Knee Control</i> had lower injury prevalence compared with an adductor or self-selected IPEP. NCT04272047; Clinical trials.