How effective are F-MARC injury prevention programs for soccer players? A systematic review and meta-analysis

Abstract

Background: The FIFA Medical and Research Centre (F-MARC) have designed a comprehensive warm-up program targeting muscular strength, body kinaesthetic awareness, and neuromuscular control during static and dynamic movements to decrease injury risk for soccer players. Prior studies have investigated the effectiveness of the F-MARC programs but have not consistently reported a benefit from the programs The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials and interventional studies that evaluated the efficacy of the F-MARC injury prevention programs in soccer. Methods: Two independent researchers performed a search on the Cochrane Central Register of Controlled Trials via OvidSP, AMED: Allied and Complementary Medicine via OvidSP (1985-present), Embase, PubMed, MEDLINE, SPORTDiscus, Web of Science, CINAHL and AusSportMed. The keyword domains used during the search were F-MARC, FIFA 11+, the11+, injury prevention programs, soccer, and variations of these keywords. The initial search resulted in 4299 articles which were filtered to 9 articles that met the inclusion criteria. Main inclusion criteria were RCT or interventional studies, use of F-MARC injury prevention programs, and primary outcome measuring overall and lower extremity injuries. Extracted data were entered and analysed using Comprehensive Meta-Analysis software, Version 2 (CMA.V2). Results: The pooled results based on total injuries per 1000 h of exposure showed that the F-MARC injury prevention programs had a statistically significant reduction in the overall injury risk ratio to 0.771 (95% CI: 0.647-0.918, p = 0.003) and lower extremity injury risk ratio of 0.762 (95% CI: 0.621-0.935, p = 0.009). Moreover, F-MARC '11+' had a statistically significant reduction in the overall injury risk ratio of 0.654 (95% CI: 0.537-0.798, p < 0.001) and lower extremity injury risk ratio of 0.612 (95% CI: 0.475-0.788, p < 0.001). However, F-MARC '11' did not reach significance for overall and lower extremity injury reduction. It can be suggested that teams involved in F-MARC '11+' warm up program will reduce injury rates between 30% and 50% in the long term compared to the teams that do not engage in the F-MARC programs. Discussion: This systematic review and meta-analysis indicated that use of the F-MARC injury prevention programs, particularly the '11+' program, decreases the risk of injuries among soccer players. These data also support the case for the development and introduction of sport specific programs.