THE EFFECT of ONE-ON-ONE INTERVENTION in ATHLETES with MULTIPLE RISK FACTORS for INJURY

Abstract

Background: Lower extremity injuries in soccer players are extremely common. Implementation of group injury prevention programs has gained popularity due to time and cost-effectiveness. Unfortunately, players with greater number of risk factors are most likely to sustain an injury, yet less likely to benefit from a group injury prevention program. The purpose of this study was to determine if targeting these high risk players with one-on-one treatment would result in a reduction in the number of risk factors they possess. The authors hypothesized that fifty percent or more of subjects receiving one-on-one intervention would have a reduction of ≥1 risk factor(s).

Study design: Quasi-experimental pretest-posttest design.

Methods: Division I men's and women's soccer players were screened for modifiable risk factors using a battery of tests which assessed mobility, fundamental movement pattern performance, motor control, and pain. Players with ≥ 3 risk factors ("high risk") received one-on-one treatment from a physical therapist via an algorithm twice per week for four weeks. Players with < 3 risk factors ("low risk") did not receive one-on-one intervention.

Results: The proportion of treatment successes in the intervention group was 0.923 (95% CI 0.640-0.998). A significant proportion of high risk subjects (0.846) became low risk at posttest (p = 0.003). A significant between group difference was noted in risk factor change from pretest to posttest (p = 0.002), with the median risk factor change in the intervention group being -3.

Conclusion: Utilizing one-on-one interventions designed to target evidence-based risk factors is an effective strategy to eliminate LE musculoskeletal injury risk factors in high risk individuals.

Levels of evidence: 2b.

Keywords: injury prevention; injury risk; movement system; soccer.

Figure 1.

Intervention algorithm and associated treatment “packages”. Risk factors are ranked from top to bottom and left to right.

Figure 2.

CONSORT flowchart. *Subjects were originally allocated to the intervention group, but declined treatment and attended posttesting only. These subjects’ data was combined with the “true controls” in the final analysis.

Figure 3.

Frequency of mobility risk factors at pretest and posttest by group. Abbreviations: Closed kinetic chain dorsiflexion (CKC DF); Range of motion (ROM); External rotation (ER).

Figure 4.

Frequency of asymmetry in fundamental pattern risk factors at pretest and posttest by group.

Figure 5.

Frequency of neuromuscular control risk factors at pretest and posttest by group. Abbreviations: Lower quarter Y Balance Test (YBT-LQ); Anterior (Ant); Upper quarter Y Balance Test (YBT-UQ).