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. 2021 Dec 18;18(24):13351. doi: 10.3390/ijerph182413351

Table 2.

Characteristics of the randomised-controlled trials included in the systematic review.

Reference Participants
Level
Intervention Comparator Outcomes Compliance Rate Reliability/SWC Results Comments
Gilchrist et al. 2008 [53] 1435 female soccer player (IG = 583, age: 19.88 years; CG = 852, age: 19.88 years)
NCAA Division I
IG: PEP Program
Duration: 12 weeks
Frequency: 3/week
Session duration: <30 min
Training components: Stretching, strengthening, plyometrics, agilities, and avoidance of high-risk positions depicted on a video. Replacement exercises to alleviate boredom.
CG: Their customary warm-up. Contact ACL injury, and non-contact ACL injury rate per 1000 AE. 72% NA ACL injury rate in practice, and non-contact ACL injury rate in those with history of past ACL injury and late in season in IG.
↔ ACL injury rate and non-contact ACL injury rate in IG and CG.
Supervision: Certified athletic trainer.
8 dropouts in IG.
Low compliance rate in IG.
Lack of control the drills executed and of the uses of the program.
Steffen et al. 2008 [80] 31 adolescent female football players (IG = 17, CG = 14; age: 17.1 ± 0.8 years)
Elite sport high school
IG: FIFA 11
Duration: 10 weeks
Frequency: 3/week
Session duration: ≈15 min
Training components: 10 exercises focusing on core stability, neuromuscular control, eccentric hamstrings strength and agility.
CG: Regular warm-up (running and ball exercises) Conventional H/Q ratio at 60 and 240 °/s and functional H/Q at 60 °/s.
Frontal plane knee angles during CMJ and DVJ.
73% NR/
NR
↔ No differences between groups in either H/Q ratios or valgus angle during CMJ and DVJ (p > 0.05) Supervision: Project coordinator.
Unbalanced groups.
2 dropouts in a small sample.
Low power to detect differences.
Brughelli et al. 2010 [62] 28 soccer players (IG = 13, age: 20.7 ± 1.6 years; CG = 11, age: 21.5 ± 1.3 years).
Professional
IG: Additional eccentric training
Duration: 4 weeks
Frequency: 3/week
Session duration: 10–15 min
Training components: 4–5 sets from 1–2 exercises, of 4 different eccentric exercises: Eccentric box drops, lunge pushes, forward deceleration steps, and reverse Nordic hamstrings.
CG: Regular field-based warm-up, but also training the Nordic hamstrings exercise (once a week, total of 2 sets of 6 reps) H/Q ratio at 60 °/s 100% Acknowledges another reliability data/
NR
↔ Q/H ratio at 60 °/s in both groups (p > 0.05) Supervisor not specified.
Drop of participants in CG (3).
Low volume of additional training, and only 4 weeks.
Daneshjoo et al. 2010 [63] 36 male soccer players (IG1 = 12, age: 19.2 ± 0.9; IG2 = 12, age: 17.7 ± 0.4; CG = 12, age: 19.7 ± 1.6)
Professional
IG1: FIFA 11+
Duration: 8 weeks
Frequency: 3/week
Session duration: ≈20–25 min
Training components: (1) Running exercises; (2) strength, balance, muscle control and core stability; and (3) advanced running exercises.
IG2: HarmoKnee
Duration: 8 weeks
Frequency: 3/week
Session duration: ≈20–25 min
Training components: (1) Warm up; (2) muscle activation; (3) balance; (4) strength; and (5) core stability
CG: Regular field-based warm-up Error of proprioception test at 30, 45 and 60°.
Distance excursion in SEBT.
Time in the stork stand balance test, with open and close eyes.
NR NR/
NR
↔ No significant difference between groups in either proprioception or static balance.
Static balance with eyes opened in the 11+ (ESc = 2.25, p = 0.043) and HarmoKnee (ESc = 0.81, p = 0.011) and closed in the 11+ (ESc = 2.78, p = 0.027; HarmoKnee (ESc = 2.45, p = 0.022) in post- vs. pre-intervention.
SEBT in the 11+ (ESc = 0.82, p = 0.004) and HarmoKnee (ESc = 0.91, p = 0.011) (time x group interaction: F = 3.767, p = 0.034).
Supervisor not specified.
Gioftsidou et al. 2012 [68] 38 male soccer players (age: 22.7 ± 3.5 years)
1st Greek division
IG: Balance training program
Duration: 6 weeks
Frequency: 3/week
Session duration: ≈20 min
Training components: Four different soccer-specific (controlling, passing, heading) balance exercises performed on a hemi-cylindrical board and on an hemi-spherical board.
CG: Standard soccer training Total (SI), anterior-posterior (API) and medial-lateral (MLI) index.
Maintenance time for the anterior-posterior (APM) and medial-lateral (MLM) movements.
NR ICC = 0.67–0.80/
NR
SI (ESc = 0.67–0.70), API (ESc = 0.65–0.74) and MLI (ESc = 1.36–1.62) in both legs in IG.
APM (ESc = 1.71–3.02) and MLM (ESc = 1.49–1.53) in both legs in IG
Supervisor not specified.
No p values.
Impellizzeri et al. 2013 [73] 81 male soccer players (CG = 39, age: 23.3 ± 2.8; IG = 42, age: 23.7 ± 3.7 years)
Amateur
IG: FIFA 11+
Duration: 9 weeks
Frequency: 3/week
Session duration: ≈20 min
Training components: (1) Running exercises; (2) core and leg strength, balance and plyometric/agility; and (3) higher-speed running drills with cutting manoeuvres. The key element is promotion of proper technique.
CG: Traditional warm-up SEBT.
Time-to-stabilisation on a single leg during a jump-landing task.
Unstable sitting posture test.
NR SWD = 0,2*SD Core stability (8%) in CG.
↔ Core stability (1.5%) in IG.
↔ Time-to-stabilisation (1.5%) in CG.
Time-to-stabilisation (−1.8%) in IG.
Supervisor: Fitness coach.
Results rounded to decimals: Problematic to detect differences.
Silvers-Granelli et al. 2015 [56] 1525 male soccer players (IG = 675, age: 20.40 ± 1.66; CG = 850, age: 20.68 ± 1.46 years)
NCAA Division I & II
IG: FIFA 11+
Duration: 1 competitive season
Frequency: 3/week
Session duration: ≈20 min
Training components: (1) Running exercises that encompass cutting, COD, decelerating and proper landing techniques; (2) strength, plyometric and balance exercises that focus on core strength, eccentric control and proprioception; (3) running exercises.
CG: Typical soccer warm-up ACL injury incidence per 1000 AE Mean utilisation: 30.47 ± 12.16 sessions (considered moderate; total 18 games and 51/52 sessions) NA ACL injury incidence rate (0.362/1000AEs vs. 0.085/1000AEs) in IG vs. CG.
Likelihood of incurring an ACL injury (RR = 0.236 [0.193–0.93]; NNT = 70, p < 0.001)
Supervisor: Certified athletic trainer.
Weeks of training not reported.
Dello Iacono et al. 2016 [65] 20 young male football players (IG = 10, age: 18.7 ± 0.67 years; CG = 10, age: 19 ± 0.063 years)
Elite team national Israel league
IG: Core stability training
Duration: 6 weeks
Frequency: 5/week
Session duration: ≈20 min
Training components: The program consists of two parts: (1) improving balance and core stability, and (2) developing lower limb strength and neuromuscular control.
CG: Regular warm-up H/Q conventional ratio at both 1.05 and 3.14 rad/s
IA from GRF peak in a one-leg CMJ.
NR 95% limits of agreement:
Isokinetic tests = −1.32–1.75
Jump tests = −2.12–1.96
ICC = 0.925–0.978/
NR
H/Q ratio at 1.05 rad/s (ES = 0.61–0.75), and 3.14 rad/s (ES = 0.71–0.95) in both legs in IG.
↔ H/Q ratio at both velocities in CG.
IA in IG (−71.4%, ES = 2.01).
IA in CG (33.3%, ES = 1.28).
Supervisor: Researcher.
Regular warm-up of the CG only consists of jogging, dynamic stretching and mobilisation.
Gonzalez-Jurado et al. 2016 [69] 18 male soccer players (IG = 9, age: 25,89 ± 3.85; IG2 = 10, age: 23.33 ± 3 years)
2nd Spanish division
IG1: Proprioceptive training on stable surface
Duration: 5 weeks (5 phases of one week each)
Frequency: 5/week (first 4 phases) and 3/week (last phase)
Session duration: ≈5 min (estimated)
Training components: Monopodal proprioceptive training exercises on a stable surface, adapted to football, and executed using a 4-station circuit.
IG2: Proprioceptive training on unstable surface
Duration: 5 weeks (5 phases of one week each)
Frequency: 5/week (first 4 phases) and 3/week (last phase)
Session duration: ≈5 min (estimated)
Training components: Monopodal proprioceptive training exercises on different unstable surfaces (soft mat, Freeman Dish, Fit-sit Platform and Dyn-air), adapted to football, and executed using a 4-station circuit.
Star Excursion Balance Test (maximum distance reached in 8 directions) NR NR/
NR
Front left, Ant-Lat left, Lat right, Back right, and Ant-Med right (ES = 0.13–0.55) in IG1 and Front right and left, Ant-Lat left, Lat left, Post-Lat right, Post right and left, Post-Med right and left, Med right, and AntMed left (ES = 0.06–0.43) in IG2
AntMed right in IG vs. IG2 (intergroup analysis)
Supervisor not specified.
Low sample size in each group.
Daily training too short (5 min?).
Silvers-Granelli et al. 2017 [57] 1525 male soccer players (IG = 675, age: 20.40 ± 1.66; CG = 850, age: 20.68 ± 1.46 years)
NCAA Division I & II
IG: FIFA 11+
Duration: 1 competitive season
Frequency: 3/week
Session duration: ≈20 min
Training components: (1) Running exercises that encompass cutting, COD, decelerating and proper landing techniques; (2) strength, plyometric and balance exercises that focus on core strength, eccentric control and proprioception; (3) running exercises.
CG: Typical soccer warm-up ACL injury incidence per 1000 AE NR NA ACL injury incidence rate (RR = 0.24 [0.07–0.81], p = 0.021) and non-contact ACL injury incidence rate (RR = 0.25 [0.06–1.15], p = 0.049) in IG vs. CG.
↔ Contact ACL injury incidence rate (RR = 0.21 [0.03–1.74], p = 0.148) in IG vs. CG.
Supervisor: Certified athletic trainer.
Low number of ACL injuries.
High amount of lost follow ups in the IG (100 players).
Per protocol analysis.
Ayala et al. 2017 [60] 41 male youth football players (age: 16.8 ± 0.7 years)
Amateur
IG1: FIFA 11+
Duration: 4 weeks
Frequency: 3/week
Session duration: ≈20–25 min
Training components: (1) Running exercises; (2) strength, balance, muscle control and core stability; and (3) advanced running exercises.
IG2: HarmoKnee
Duration: 4 weeks
Frequency: 3/week
Session duration: ≈20–25 min
Training components: (1) Warm up; (2) muscle activation; (3) balance; (4) strength; and (5) core stability
CG: Regular field-based warm-up Y-Balance test.
Ankle and hip ROM.
Single hop for distance (asymmetry).
Triple hop for distance (asymmetry).
NR Acknowledges another reliability data/
NR
Triple hop LSI score (very likely substantial difference [98%]), anterior distance (likely substantial difference [89%]), and posteriomedial distance (possibly substantial difference [60%]) in FIFA 11+ vs. CG
↔ No main effects in ankle ROM, LSI during single hop, posterolateral and composite score in FIFA 11 vs. CG and in all variables (possibly/likely trivial) in HarmoKnee vs. CG).
Supervisor: Trained rehabilitation specialist.
Low sample of each group.
Delextrat et al. 2018 [64] 21 female soccer players (IG1 = 10, age: 21.8 ± 4.0; IG2 = 11, age: 23.7 ± 7.2)
Amateur.
IG1: Strength endurance
Duration: 7 weeks
Frequency: 3/week
Session duration: 10–15 min
Training components: 6 sets of 12–20 rep progressing by decreasing the inter-set rest period (90 to 45s) of two hamstring strength exercises: (1) seated hamstrings curl, and (2) stiff-legged deadlifts.
IG2: Strength
Duration: 7 weeks
Frequency: 3/week
Session duration: 20–25 min
Training components: 6–10 sets of 6RM progressing by increasing load (80 to 100% of 6RM), with 3-min inter-set rest, of two hamstring strength exercises: (1) seated hamstrings curl, and (2) stiff-legged deadlifts.
H/Q functional ratio before and after BEAST90 test NR Acknowledges another reliability data/
NR
↔ Functional H/Q ratio before and after BEAST90 post-intervention only in IG1 in dominant leg (p = 0.045, n: 0.38) (intervention x match interaction)
Functional H/Q ratio before BEAST90 post-intervention in both IG2 (+14.6%, d = 0.73, p = 0.01) and IG1 in dominant leg (+4.9%, d = 0.25, p = 0.039)
Supervisor: Experienced S&C coach.
IG1 did not change the decline before/after BEAST90, but probably because the increase in the H/Q post- was higher than in IG2.
Rey et al. 2018 [78] 23 male soccer players (age: 24.7 ± 3.8 years)
Amateur
IG: FIFA 11+
Duration: 6 weeks
Frequency: 3/week
Session duration: ≈25 min
Training components: Fifa 11+ consisting on 3 parts: (1) 6 running exercises at low speed; (2) 6 exercises targeting strength, balance, neuromuscular control and core stability with 3 levels of increasing difficulty; (3) running exercises at moderate/high speed.
CG: Standard warm up with jogging, ball exercises and active stretching. FMS score, divided into FMSmove, FMSflex and FMSstab. NR Inter-rater: ICC = 0.899
Intra-rater: ICC = 0.991/
NR
↔ No between groups differences. Supervisor: Fitness trainer.
No p values shown.
Riela et al. 2019 [81] 30 male soccer players (IG = 15, age: 23.80 ± 4.6; CG = 15, age: 24.78 ± 2.08 years)
Italian 2nd division
IG: Movement-based program
Duration: 8 weeks
Frequency: 3/week
Session duration: ≈30 min
Training components: 15 min of exercises aimed at improving mobility and flexibility and 15 min of stability and posture, and strength with the use of elastic bands, medicine balls and foam rollers.
CG: Standard technical-tactical routing of warm up. FMS score, divided into advances movement, mobility and stability NR NR/
NR
Advanced movement (F(1,28) = 14.43, p = 0.03) and mobility (F(1,28) = 3.89, p = 0.50) in IG. Supervisor: Specialised trainer.
No p values.
No counterbalanced the intervention with the two groups.
Whalan et al. 2019 [58] 806 male soccer players (IG1 = 398, age: 24,8; IG = 408, age: 23.8 years)
Sub-elite
IG1: Rescheduled FIFA 11+
Duration: 1 season (28–34 weeks)
Frequency: 2/week (+ Parts 1 and 3 before matches)
Session duration: ≈20–25 min
Training components: 2 parts of the Fifa 11+ performed at the start of the warm-up (parts 1 and 3), and one part performed at the end of training during the cool down period (part 2). In Part 2, players remained at level 1 for a minimum of 2 weeks, and progressed to level 3 after a minimum of 6 weeks
IG2: FIFA 11+
Duration: 1 season (28–34 weeks)
Frequency: 2/week (+ Parts 1 and 3 before matches)
Session duration: ≈20–25 min
Training components: 3 parts of the Fifa 11+ performed at the start of the warm-up. In Part 2, players remained at level 1 for a minimum of 2 weeks, and progressed to level 3 after a minimum of 6 weeks.
Non-contact ACL injury incidence per 1000 h of AE. IG1 = 18.9 (doses), 32.7% (doses/sessions)
IG2 = 29.1 (doses), 57.7% (doses/sessions)
NA ↔ Non-contact ACL injury incidence (p = 0.238) in IG2 (IR/1000h = 0.06 [0.01–0.2]) compared to IG1 (IR/1000h = 0.15 [0.01–0.4]) Supervisor not specified.
Weeks of season not specified.

ACL—anterior cruciate ligament, FMS—functional movement score, GRF—ground reaction force, AE—athlete exposures, SWC—smallest worthwhile change, IG—intervention group, CG—control group, NR—non-reported, d—Cohens’d, ES—effect size, ESc—effect size calculated through Hedge’s g, CMJ—countermovement jump, DVJ—drop vertical jump, NA—non-applicable, ↓—decrease, ↑—increase, ↔—no change.