title: Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: cluster randomized controlled trial.
abstract: OBJECTIVE
  To determine the effectiveness of coach-led neuromuscular warm-up on reducing lower extremity (LE) injuries in female athletes in a mixed-ethnicity, predominantly low-income, urban population.
  
  
  METHODS
  Cluster randomized controlled trial.
  
  
  METHODS
  Chicago public high schools.
  
  
  METHODS
  Of 258 coaches invited to participate, 95 (36.8%) enrolled (1558 athletes). Ninety coaches and 1492 athletes completed the study.
  
  
  METHODS
  We randomized schools to intervention and control groups. We trained intervention coaches to implement a 20-minute neuromuscular warm-up. Control coaches used their usual warm-up.
  
  
  METHODS
  Coach compliance was tracked by self-report and direct observation. Coaches reported weekly athlete exposures (AEs) and LE injuries causing a missed practice or game. Research assistants interviewed injured athletes. Injury rates were compared between the control and intervention groups using χ(2) and Fisher exact tests. Significance was set at P < .05. Poisson regression analysis adjusted for clustering and covariates in an athlete subset reporting personal information (n = 855; 57.3%).
  
  
  RESULTS
  There were 28 023 intervention AEs and 22 925 control AEs. Intervention coaches used prescribed warm-up in 1425 of 1773 practices (80.4%). Intervention athletes had lower rates per 1000 AEs of gradual-onset LE injuries (0.43 vs 1.22, P < .01), acute-onset noncontact LE injuries (0.71 vs 1.61, P < .01), noncontact ankle sprains (0.25 vs 0.74, P = .01), and LE injuries treated surgically (0 vs 0.17, P = .04). Regression analysis showed significant incidence rate ratios for acute-onset noncontact LE injuries (0.33; 95% CI, 0.17-0.61), noncontact ankle sprains (0.38; 95% CI, 0.15-0.98), noncontact knee sprains (0.30; 95% CI, 0.10-0.86), and noncontact anterior cruciate ligament injuries (0.20; 95% CI, 0.04-0.95).
  
  
  CONCLUSIONS
  Coach-led neuromuscular warm-up reduces noncontact LE injuries in female high school soccer and basketball athletes from a mixed-ethnicity, predominantly low-income, urban population. TRIAL REGISTRATION CLINICALTRIALS.ORG IDENTIFIER: NCT01092286.
authors: Department of Pediatrics, Northwestern University, Chicago, Illinois, USA. clabella@childrensmemorial.org
authors: Cynthia R
authors: CR
authors: LaBella
authors: Michael R
authors: MR
authors: Huxford
authors: Joe
authors: J
authors: Grissom
authors: Kwang-Youn
authors: KY
authors: Kim
authors: Jie
authors: J
authors: Peng
authors: Katherine Kaufer
authors: KK
authors: Christoffel
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000517:prevention & control; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000517:prevention & control*; D001490:Basketball / Q000293:injuries*; D002641:Chicago; D015444:Exercise; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000517:prevention & control; D035002:Lower Extremity; D011204:Poverty Areas; D012916:Soccer / Q000293:injuries*; D013180:Sprains and Strains / Q000517:prevention & control; D014505:Urban Population