***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background A protective effect on injury risk in youth sports through neuromuscular warm-up training routines has consistently been demonstrated . However , there is a paucity of information regarding the quantity and quality of coach-led injury prevention programmes and its impact on the physical performance of players . Objective The aim of this cluster-r and omised controlled trial was to assess whether different delivery methods of an injury prevention programme ( FIFA 11 + ) to coaches could improve player performance , and to examine the effect of player adherence on performance and injury risk . Method During the 2011 football season ( May – August ) , coaches of 31 tiers 1–3 level teams were introduced to the 11 + through either an unsupervised website or a coach-focused workshop with and without additional on-field supervisions . Playing exposure , adherence to the 11 + , and injuries were recorded for female 13-year-old to 18-year-old players . Performance testing included the Star Excursion Balance Test ( SEBT ) , single-leg balance , triple hop and jumping-over-a-bar tests . Results Complete preseason and postseason performance tests were available for 226 players ( 66.5 % ) . Compared to the unsupervised group , single-leg balance ( OR=2.8 ; 95 % CI 1.1 to 4.6 ) and the anterior direction of the SEBT improved significantly in the onfield supervised group of players ( OR=4.7 ; 95 % CI 2.2 to 7.1 ) , while 2-leg jumping performance decreased ( OR=−5.1 ; 95 % CI −9.9 to −0.2 ) . However , significant improvements in 5 of 6 reach distances in the SEBT were found , favouring players who highly adhered to the 11 + . Also , injury risk was lower for those players ( injury rate ratio , IRR=0.28 , 95 % CI 0.10 to 0.79 ) . Conclusions Different delivery methods of the FIFA 11 + to coaches influenced players ’ physical performance minimally . However , high player adherence to the 11 + result ed in significant improvements in functional balance and reduced injury risk Background and Purpose — We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers , linked to evidence -based treatment algorithms and reference guides ( the longer-term stroke care system of care ) to address the poor longer-term recovery experienced by many patients with stroke . Methods — A pragmatic , multicentre , cluster r and omized controlled trial of this system of care . Eligible patients referred to community-based Stroke Care Coordinators were r and omized to receive the new system of care or usual practice . The primary outcome was improved patient psychological well-being ( General Health Question naire-12 ) at 6 months ; secondary outcomes included functional outcomes for patients , carer outcomes , and cost-effectiveness . Follow-up was through self-completed postal question naires at 6 and 12 months . Results — Thirty-two stroke services were r and omized ( 29 participated ) ; 800 patients ( 399 control ; 401 intervention ) and 208 carers ( 100 control ; 108 intervention ) were recruited . In intention to treat analysis , the adjusted difference in patient General Health Question naire-12 mean scores at 6 months was −0.6 points ( 95 % confidence interval , −1.8 to 0.7 ; P=0.394 ) indicating no evidence of statistically significant difference between the groups . Costs of Stroke Care Coordinator inputs , total health and social care costs , and quality -adjusted life year gains at 6 months , 12 months , and over the year were similar between the groups . Conclusions — This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice . Clinical Trial Registration — URL : http://www.controlled-trials.com . Unique identifier : IS RCT N 67932305 Background Participants ' compliance , attitudes and beliefs have the potential to influence the efficacy of an intervention greatly . Objective To characterise team and player compliance with a comprehensive injury prevention warm-up programme for football ( The 11 + ) , and to assess attitudes towards injury prevention among coaches and their association with compliance and injury risk . Study Design A prospect i ve cohort study and retrospective survey based on a cluster-r and omised controlled trial with teams as the unit of r and omisation . Methods Compliance , exposure and injuries were registered prospect ively in 65 of 125 football teams ( 1055 of 1892 female Norwegian players aged 13–17 years and 65 of 125 coaches ) throughout one football season ( March – October 2007 ) . St and ardised telephone interviews were conducted to assess coaches ' attitudes towards injury prevention . Results Teams completed the injury prevention programme in 77 % ( mean 1.3 sessions per week ) of all training and match sessions , and players in 79 % ( mean 0.8 sessions per week ) of the sessions they attended . Compared with players with intermediate compliance , players with high compliance with the programme had a 35 % lower risk of all injuries ( RR 0.65 , 95 % CI 0.46 to 0.91 , p=0.011 ) . Coaches who had previously utilised injury prevention training coached teams with a 46 % lower risk of injury ( OR 0.54 , 95 % CI 0.33 to 0.87 , p=0.011 ) . Conclusions Compliance with the injury prevention programme was high , and players with high compliance had significantly lower injury risk than players with intermediate compliance . Positive attitudes towards injury prevention correlated with high compliance and lower injury risk Background Injury prevention programme delivery on adherence and injury risk , specifically involving regular supervisions with coaches and players on programme execution on field , has not been examined . Aim The objective of this cluster-r and omised study was to evaluate different delivery methods of an effective injury prevention programme ( FIFA 11 + ) on adherence and injury risk among female youth football teams . Method During the 4-month 2011 football season , coaches and 13-year-old to 18-year-old players from 31 tier 1–3 level teams were introduced to the 11 + through either an unsupervised website ( ‘ control ’ ) or a coach-focused workshop with ( ‘ comprehensive ’ ) and without ( ‘ regular ’ ) additional supervisions by a physiotherapist .  Team and player adherence to the 11 + , playing exposure , history and injuries were recorded . Results Teams in the comprehensive and regular intervention groups demonstrated adherence to the 11 + programme of 85.6 % and 81.3 % completion of total possible sessions , compared to 73.5 % for teams in the control group . These differences were not statistically significant , after adjustment for cluster by team , age , level and injury history . Compared to players with low adherence , players with high adherence to the 11 + had a 57 % lower injury risk ( IRR 0.43 , 95 % CI 0.19 to 1.00 ) . However , adjusting for covariates , this between-group difference was not statistically significant ( IRR=0.44 , 95 % CI 0.18 to 1.06 ) . Conclusion Following a coach workshop , coach-led delivery of the FIFA 11 + was equally successful with or without the additional field involvement of a physiotherapist . Proper education of coaches during an extensive preseason workshop was more effective in terms of team adherence than an unsupervised delivery of the 11 + programme to the team . Trial registration IS RCT N67835569 Background Injury knowledge and beliefs influence uptake of prevention programmes , but the relationship between knowledge , beliefs and adherence remains unclear . Aim To describe injury knowledge and beliefs among youth female soccer coaches and players , and to identify the relationship between these factors , different delivery strategies of the FIFA 11 + programme and adherence . Methods A subcohort analysis from a cluster-r and omised controlled trial of 31 female soccer teams ( coaches n=29 , players ( ages 13–18 ) n=258 ) .  Preseason and postseason question naires were used to assess knowledge and beliefs . Teams recorded FIFA 11 + adherence during the season . Results At baseline , 62.8 % ( 95 % CI 48.4 % to 77.3 % ) of coaches and 75.8 % ( 95 % CI 71.5 % to 80.1 % ) of players considered ‘ inadequate warm-up ’ a risk factor for injury . There was no effect of delivery method ( OR=1.1 ; 95 % CI 0.8 to 1.5 ) or adherence ( OR=1.0 ; 95 % CI 0.9 to 1.1 ) on this belief . At baseline , 13.8 % ( 95 % CI 1.3 % to 26.4 % ) of coaches believed a warm-up could prevent muscle injuries , but none believed it could prevent knee and ankle injuries . For players , 9.7 % ( 95 % CI 6.1 % to 13.3 % ) , 4.7 % ( 95 % CI 2.1 % to 7.3 % ) and 4.7 % ( 95 % CI 2.1 % to 7.3 % ) believed a warm-up would prevent muscle , knee and ankle injuries , respectively . Years of playing experience were negatively associated with high adherence for coaches ( OR=0.93 ; 0.88 to 0.99 ) and players ( OR=0.92 ; 0.85 to 0.98 ) . Conclusions There were gaps in injury knowledge and beliefs , which differed for coaches and players . Beliefs did not significantly affect adherence to the FIFA 11 + , suggesting additional motivational factors should be considered Purpose We aim ed to investigate the effect of FIFA 11 + ( 11 + ) and HarmoKnee injury preventive warm-up programs on conventional strength ratio ( CSR ) , dynamic control ratio ( DCR ) and fast/slow speed ratio ( FSR ) in young male professional soccer players . These ratios are related to the risk of injury to the knee in soccer players . Methods Thirty-six players were divided into 3 groups ; FIFA 11 + , HarmoKnee and control ( n = 12 per group ) . These exercises were performed 3 times per week for 2 months ( 24 sessions ) . The CSR , DCR and FSR  were measured before and after the intervention . Results After training , the CSR and DCR of knee muscles in both groups were found to be lower than the published normal values ( 0.61 , 0.72 , and 0.78 during 60 ° .s−1 , 180 ° .s−1 and 300 ° .s−1 , respectively ) . The CSR ( 60 ° .s−1 ) increased by 8 % and FSR in the quadriceps of the non-dominant leg by 8 % in the 11 + . Meanwhile , the DCR in the dominant and non-dominant legs were reduced by 40 % and 30 % respectively in the 11 + . The CSR ( 60 ° .s−1 ) in the non-dominant leg showed significant differences between the 11 + , HarmoKnee and control groups ( p = 0.02 ) . As for the DCR analysis between groups , there were significant differences in the non-dominant leg between both programs with the control group ( p = 0.04 ) . For FSR no significant changes were found between groups . Conclusions It can be concluded that the 11 +  improved CSR and FSR , but the HarmoKnee program did not demonstrate improvement . We suggest adding more training elements to the HarmoKnee program that aim ed to enhance hamstring strength ( CSR , DCR and FSR ) . Professional soccer players have higher predisposition of getting knee injuries because hamstring to quadriceps ratio were found to be lower than the average values . It seems that the 11 + have potentials to improve CSR and FSR as well as prevent knee injuries in soccer players Background : The Fédération Internationale de Football Association ( FIFA ) 11 + program has been shown to be an effective injury prevention program in the female soccer cohort , but there is a paucity of research to demonstrate its efficacy in the male population . Hypothesis : To examine the efficacy of the FIFA 11 + program in men ’s collegiate United States National Collegiate Athletic Association ( NCAA ) Division I and Division II soccer . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : Before the commencement of the fall 2012 season , every NCAA Division I and Division II men ’s collegiate soccer team ( N = 396 ) was solicited to participate in this research study . Human ethics review board approval was obtained through Quorum Review IRB . Sixty-five teams were r and omized : 34 to the control group ( CG ; 850 players ) and 31 to the intervention group ( IG ; 675 players ) . Four teams in the IG did not complete the study , reducing the number for analysis to 61 . The FIFA 11 + injury prevention program served as the intervention and was utilized weekly . Athlete-exposures ( AEs ) , compliance , and injury data were recorded using a secure Internet-based system . Results : In the CG , 665 injuries ( mean ± SD , 19.56 ± 11.01 ) were reported for 34 teams , which corresponded to an incidence rate ( IR ) of 15.04 injuries per 1000 AEs . In the IG , 285 injuries ( mean ± SD , 10.56 ± 3.64 ) were reported for 27 teams , which corresponded to an IR of 8.09 injuries per 1000 AEs . Total days missed because of injury were significantly higher for the CG ( mean ± SD , 13.20 ± 26.6 days ) than for the IG ( 
    Output:
    
Conclusions An injury-preventing effect of the FIFA injury prevention programmes compared with controls was shown in football .
This effect was induced by the FIFA 11 + prevention programme which has a substantial injury-preventing effect by reducing football injuries by 39 % , whereas a preventive effect of the FIFA 11 prevention programme could not be documented .