Running Every Time, Planking Sometimes: Youth Adherence to a Neuromuscular Training Program

Abstract

Introduction/Purpose: Neuromuscular training warm-up programs are effective in reducing sport and recreation injuries when adherence is adequate. To understand how to improve adherence, it is important to analyze different measures of adherence, such as the utilization of different exercises and components. Methods: The intervention arm of a randomized controlled trial in junior high school hysical education (PE) was included in this study. After one school was excluded because of inadequate adherence data, five schools (32 classes) were analyzed. For 12 wk, the schools implemented the Implementing a School Prevention Program to Reduce Injuries Through Neuromuscular Training (iSPRINT) program comprising 15 exercises in four components (aerobic, agility, strength, balance). Utilization fidelity, cumulative utilization (program/component/exercise), and utilization frequency (program/component) were calculated. Results: An iSPRINT session was conducted (i.e., ≥1 exercise out of 15 was performed) during 858 out of 1572 (54.6%) PE classes. Utilization fidelity was 13 (Q1, Q3: 7, 14) out of 15 exercises. Between the five schools, utilization fidelity ranged from 5 to 14 exercises. The most frequently utilized exercise was the forward run (96% of all iSPRINT sessions), and the least frequently utilized exercise was forward running with intermittent stops (36%). Utilization frequency of different exercises in individual schools varied from 9% to 100%. On average, the program was conducted twice a week. Out of all the iSPRINT sessions, 98% included aerobic, 89% included agility, 90% included strength, and 78% included balance exercises. Conclusions: On average, the schools adhered well to the program, and all components were implemented to some extent. This indicates that there are no program components or exercises that are systematically underperformed. With adherence varying between the schools, it is important to take into account that the implementation context may differ across school environments and barriers to maximizing adherence require consideration.