The Effects of Adherence to the FIFA 11+ Program on Injury Risk in Soccer Players: A Systematic Review and Meta-analysis

Abstract

Background:

The FIFA 11+ warm-up program for injury prevention was developed in soccer given its high risk of injuries. However, the overall effect on injury rates remains uncertain because of the existence of variability in how players adhere to this program.

Purpose:

To assess the effects of adherence to the FIFA 11+ program on injury risk in soccer players.

Study Design:

Systematic review and meta-analysis; Level of evidence, 1.

Method:

The authors systematically searched randomized controlled trials in the databases, including Web of Science, PubMed, and Scopus, for publications in English from 2008 onward following the PRISMA guidelines. Data from 5 randomized controlled trials were included in this meta-analysis, involving 2025 participants. A random effects model was used to calculate the risk ratios and the I² statistic for heterogeneity.

Results:

The risk ratios revealed a significant reduction in injury risk for soccer players who adhered to the FIFA 11+ program (95% CI, 0.12-0.22; P = .001). There was substantial heterogeneity (I² = 88.98%), suggesting noteworthy variability in the outcomes of the included studies. Additionally, no significant predictors of effect size were identified in meta-regression analysis, implying that unmeasured factors may play a role in the program's effectiveness.

Conclusion:

Findings revealed that adhering to the FIFA 11+ program effectively reduced injury risk. Despite the present findings underscoring the efficacy of the FIFA 11+ program in decreasing injury risk in soccer players, future investigations are warranted to explore strategies to improve implementation and adherence to this program, while considering the diversity of performance and team characteristics.