title: Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.
abstract: BACKGROUND
  Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown.
  
  
  OBJECTIVE
  To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football.
  
  
  METHODS
  Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs).
  
  
  RESULTS
  Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07).
  
  
  CONCLUSIONS
  These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.
authors.affiliation: Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia.
authors.forename: Caroline F
authors.identifier: http://orcid.org/0000-0003-1711-1930
authors.initials: CF
authors.lastname: Finch
authors.affiliation: Faculty of Health, Federation University Australia, Ballarat, Victoria, Australia.
authors.forename: Dara M
authors.initials: DM
authors.lastname: Twomey
authors.affiliation: Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia.
authors.forename: Lauren V
authors.initials: LV
authors.lastname: Fortington
authors.affiliation: Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Tim L A
authors.initials: TL
authors.lastname: Doyle
authors.affiliation: School of Sport Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Elliott
authors.affiliation: Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akram
authors.affiliation: Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia School of Sport Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Lloyd
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control*; D001315:Australia / Q000453:epidemiology; D001696:Biomechanical Phenomena; D016000:Cluster Analysis; D015444:Exercise; D005538:Football; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology / Q000517:prevention & control*; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D010806:Physical Education and Training / Q000379:methods; D015397:Program Evaluation