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M. Sc. Adili Dritan, doctoral studies student, Sports University of Tirana, Faculty of Movement Sciences E-mail: dritana2712@hotmail.com
PROPRIOCEPTIVE EXERCISE TRAINING IN YOUTH FOOTBALL PLAYERS (A REVIEW)
Abstract: Proprioception is defined as the ability of an individual to integrate sensory signals from different receptors to determine body position and movement in space [3, 1176-1184].
The aim of this paper was to review the latest literature regarding studies focusing on proprioceptive exercises implemented in youth football players training. We searched in PubMed, ResearchGate. More research studies should focus on the more complex effects of the proprioceptive exercise training with more specific requirements on the subjects practicing football.
Keywords: Football, proprioceptive training, proprioceptive exercises.
Introduction
Football is one of the highest-ranked sports around the world but like most other sports it is associated with a certain risk of injury to players, both at the competitive and recreational level [5, 929-938]. Proprioception is defined as the ability of an individual to integrate sensory signals from different receptors to determine body position and movement in space [3, 1176-1184].
Football is a sport that requires many technical skills, at the same time a static, semi-dynamic and dynamic balance. Most of these skills, such as passing, manipulating the ball into the air, dribing or taking the ball, are achieved by standing on one leg. The balance plays a major role in difficult situations for a footballer during a football match, situations such as; opponents pushing, slipping into the grass of the field, changes in the direction of the ball, etc. Therefore, the successful and effective execution of any technical skill depends to a large extent on the ability of the players to control their balance and to adapt as best and faster to the various positions of the body posture in the field. Football is a sport that requires high intensity and is characterized by constant course changes but also with high-legged footwork. Participation in football imposes high demands on neuromuscular control, agility and centric / concentric strength. Most of the injuries in football are related to the lower limbs, in which muscle injuries are among the major problems [1, 1226-32; 2, 1882-91].
In childhood, inadequate levels of physical activity can cause significant health problems at the individual level but also in society [5, 871-876]. Children are immature in the skeleton and when they participate in sports, they are susceptible to a variety of injuries, both in hard tissue and soft tissues [6, 356-66].
There is convincing evidence that training programs focusing on preventing injuries can reduce their overall level by
about 40% to children and adolescents who deal with sports [7, 1733-1748]. Neuromuscular performance can be considered as the ability of the neuromuscular system to control and coordinate movements by appropriate use and coordination of muscular strength and muscular endurance, muscle recruitment pattern, proprioceptive responses and reflex activity [8, 427-436; 9, 392-403].
Objectives: Main objective of this paper of this study was to review the latest literature regarding studies focusing on proprioceptive exercise training implemented in football. We searched in PubMed, ReserachGate.
Methodology: Literature review research is conducted using some of the main search engines like; PubMed, Re-searchGate.
Results and Discussion
From many studies, only 7 fulfilled the criterias and were selected:
1. Mandelbaum R. B., 2005;
2. Kilding AE et al., 2008;
3. Daneshjoo et al., 2012;
4. Evangelos. B et al., 2012;
5. Gioftdisidou. A et al., 2012;
6. Finch CF et al., 2013;
7. Dinc E et al., 2017.
Mandelbaum R. B., 2005, study pourpose was to determine whether a neuromuscular and proprioceptive performance program was effective in decreasing the incidence of anterior cruciate ligament injury within a select population of competitive female youth soccer players. A total of 1041 female subjects ages of 14 and 18 from 52 teams received a sports-specific training intervention in a prospective nonrandomized trial. The control group consisted of the remaining 1905 female soccer players from 95 teams participating in the same league who were age and skill matched. participated
in either their traditional warm-up or a sports-specific. The intervention consisted of education, stretching, strengthening, plyometrics, and sports-specific agility drills designed to replace the traditional warm-up. There was an 88% decrease
Table
in anterior cruciate ligament injury in the enrolled subjects compared to the control group. In year 2, there was a 74% reduction in anterior cruciate ligament tears in the intervention group compared to the age- and skill-matched controls.
Nr Author's Name Type of study Title of the study Number of the subjects Type of intervention
1 2 3 4 5 6
1. Mandelbaum R. B., 2005 Prospective study where subjects are not randomly selected Effectiveness of a Neuro-muscular and Proprioceptive Training Program in Preventing the Incidence of Anterior Cruciate Ligament Injuries in Female Athletes 2-Year Follow-up 1041 female subjects out of 52 teams Education, stretching, strength, pliometrics, and specific exercises for programmed football to replace traditional warmth.
2. Kilding AE et al., 2008 Clinical trial / exercise intervention Suitability of FIFA's "The 11" training programme for young football players - impact on physical performance 24 young players (age 10.4 ± 1.4 years) (12 Gr. Experimental), 12 Gr. control) The training program lasted 6 weeks with 5 training days per week
3. Daneshjoo et al., 2012 Clinical trial / exercise intervention The Effects of Comprehensive Warm-Up Programs on Proprioception, Static and Dynamic Balance on Male Soccer Players U21 year old football players (n = 36) randomly split in those who would be part of the 11+ HarmoKnee and control group Programs were conducted for 2 months (24 sessions). Proprioception was matched bilaterally at 30u, 45u and 60u flexion of the knees using Dynamometer Bioksex Isokinet-ic. Static and dynamic balances were evaluated using the stork stay test and the Star Balance Test (SEBT), respectively.
4. Evangelos. B et al., 2012 Clinical trial / exercise intervention Proprioception and balance training can improve amateur soccer players' technical skills. 29 amateur football players were the current research group. 15 players aged 16.83 ± 0.24 were the experimental group, while the control group consisted of 14 players aged 16.60 ± 0.22. Training program for propriocep-sion and equilibrium
5. Gioftdisi-dou. A et al., 2012 Clinical trial / exercise intervention Balance training programs for soccer injuries prevention 38 professional football players were randomly divided into 3 groups One group, trained 6 times a week, for 3 weeks, group B trained 3 times a week, for 6 weeks and group C (control) did not undergo a very special exercise to improve equilibrium but only a standard soccer exercise
1 2 3 4 5 6
6. Finch CF et al., 2013 Randomised controlled trial 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 1564 community football players in Australia The exercise test started 8 weeks before the beginning of the season until the 5th week of the game season. The intervention was 26 weeks (Before the 8-week season and 18 weeks in the season) The program was designed to be conducted for about 10-20 min during warm-up time within the training session.
7. DincEet al., 2017 Intervention study Effects of special exercise programs on functional movement screen scores and injury prevention in preprofessional young football players The study was attended by 67 young male players from 14 to 19 years of age from a Super League Soccer Academy, Turkey The intervention program consisted of 1 hour twice a week for a total of 12 weeks with 4 weeks of mobility exercises, 4 week exercises for stability, and 4 weeks of integration exercises.
Kilding AE et al., 2008 study aim determining the suitability and effectiveness of "The 11" for younger football players. Twenty-four [12 experimental (EXP), 12 control (CON)] young football players (age 10.4 ± 1.4 yr) participated. The EXP group followed "The 11" training programme 5 days per week, for 6 weeks, completing all but one of the 10 exercises. Prior to, and after the intervention, both EXP and CON groups performed a battery of football-specific physical tests. Changes in performance scores within each group were compared using independent f-tests (p < 0.05). Feedback was also gathered on the young players' perceptions of "The 11". No injuries occurred during the study in either group. Compliance to the intervention was 72%. Measures of leg power (3 step jump and counter-movement jump) increased significantly (3.4 and 6.0% respectively, p < 0.05). Speed over 20 m improved by 2% (p < 0.05).
Daneshjoo et al., 2012 study aim was to investigate the effects of FIFA 11+ and HarmoKnee, both being popular warm-up programs, on proprioception, and on the static and dynamic balance of professional male soccer players. 36 U21 soccer players were divided randomly into 11+, HarmoKnee and control groups. The programs were performed for 2 months (24 sessions). Proprioception was measured bilaterally at 30u, 45u and 60u knee flexion using the Biodex Isokinetic Dynamometer. Static and dynamic balances were evaluated using the stork stand test and Star Excursion Balance Test (SEBT), respectively. The proprioception error of dominant leg significantly decreased from pre- to post-test by 2.8% and 1.7% in the 11+ group at 45u and 60u knee flexion,
compared to 3% and 2.1% in the HarmoKnee group. The largest joint positioning error was in the non-dominant leg at 30u knee flexion (mean error value = 5.047), (p, 0.05). The static balance with the eyes opened increased in the 11+ by 10.9% and in the HarmoKnee by 6.1% (p, 0.05). The static balance with eyes closed significantly increased in the 11+ by 12.4% and in the HarmoKnee by 17.6%. The results indicated that static balance was significantly higher in eyes opened compared to eyes closed (p = 0.000). Significant improvements in SEBT in the 11+ (12.4%) and HarmoKnee (17.6%) groups were also found.
Evangelos. B et al., 2012 aim was to investigate the effect of a 10-week proprioception and balance training program on the improvement of amateur soccer players' specific techniques. 29 amateur soccer players comprised the sample of the present research. 15 soccer players aged 16.83 ± 0.24 comprised the experimental group, while the control group was made up of 14 soccer players aged 16.60 ± 0.22 years old. To evaluate the program efficiency, a series of technical skills tests was run prior to and following the program implementation. The data were statistically processed with the SPSS15 statistics program, and there was variance analysis with repeated measures by two factors. The statistically significant differences were checked at significance level a = 0.05 or 5%. Statistically significant improvements were found regarding juggling the ball in the air 'jug 200' (p-value = 0.002 < 0.05), 'jug body 1' (p-value = 0.005 < 0.05), 'jug body 2' (p-value= = 0.005 < 0.05) as well as short (pvalue = 0.009 < 0.05) and long (p-value = 0.022 < 0.05) passing.
Gioftdisidou. A et al., 2012, study purpose was to compare 2 different balance training programs, based on distinct exercise frequencies, with the aim of improving proprioceptive ability. 38 professional soccer players, were randomly assigned into 3 groups: the A group, exercised with a frequency of 6 times per week, for 3 weeks, the B group exercised with a frequency of 3 times per week, for 6 weeks and the C group (control) did not follow a highly specific balance training, but only a standard soccer training. All participants were evaluated with the use of an electronic stability system (indices-deviations) and of a wooden balance board (time on balance) before (pre-test) and after the training period (post test). Analyses of variance (ANOVAs), with repeated measures on the last factor, were conducted to determine effect of training programs and measures (pre-test, post-test) on balance test indices (SI, API, and MLI) and time on balance board. The results showed that both training groups improved their balance ability similarly (p < 0.05) despite the different frequency of the balance training program.
Finch CF et al., 2013, study aim was 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 x weekly for 8-week preseason and 18-week regularseason). 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).
Dinc E et al., 2017 study aim was to increase movement capacity and to reduce injury risk in young soccer players by implementing a special functional exercise program based on functional movement screen (FMS) and correctives. 67 young male athletes 14-19 years of age from a Super League Football Club Academy participated in the study. Functional movement patterns were evaluated with FMS assessment protocol. Deep squat, hurdle step, in-line lunge, shoulder mobil-
ity, active straight leg raises, trunk stability push-up, and rotatory stability were examined in FMS. Considering the FMS scores the number of intervention and control groups were de-fined as 24 and 43, respectively. Intervention program was composed of 1 hr twice a week session in total of 12 weeks with 4 weeks of mobility, 4 weeks of stability, and 4 weeks of integration exercises. At the end of 12-week intervention and control groups were re-evaluated with FMS protocol. Contact and noncontact sports injuries recorded during one season. In intervention group there was statistically significant difference in increase in total FMS scores (P < 0.01), deep squat (P < 0.001), hurdle step (P < 0.05), inline lunge (P < 0.01), and trunk stability push-up (P < 0.01). In control group total FMS, deep squat, and trunk stability push-up scores increased with a statistical difference (P < 0.01, P < 0.05, P < 0.01, respectively). The incidence of noncontact injury in control group was higher than intervention group (P < 0.05).
Cunclusion and Recommandations:
This paper main objective was to review the latest literature regarding studies focusing on proprioceptive exercise training implemented in football.
According to Kilding AE et al., 2008, most players considered "The 11" beneficial but not enjoyable in the prescribed format. Given the observed improvements in the physical abilities and the perceived benefits of "The 11", it would appear that a modified version of the programme is appropriate and should be included in the training of young football players, for both physical development and potential injury prevention purposes, as well as to promote fair play.
According to Daneshjoo et al., 2012, the 11+ and HarmoKnee programs were proven to be useful warm-up protocols in improving proprioception at 45u and 60u knee flexion as well as static and dynamic balance in professional male soccer players. Data from this research may be helpful in encouraging coaches or trainers to implement the two warm-up programs in their soccer teams.
According to Evangelos. B et al., 2012, proprioception and balance training can lead amateur soccer players to higher levels of technical ability, and therefore, its efficiency through the implementation of routines with different characteristics (frequency, quantity, types of stimuli) merits further investigation.
According to Gioftdisidou. A et al., 2012, the authors proposed that balance training program can be applied in soccer players on a daily basis or at least 3 times per week, according to the demands of the training period.
According to Finch CF et al., 2013 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. Fur-
ther injury reductions could be achieved with improved training attendance and participation in the programme.
According to Dinc E et al., 2017, Periodic movement screening and proper corrections with functional training is valuable in order to create better movement capacity to build better physical per-formance and more effective injury prevention.
Nevertheles, we think it would be very interesting to develop programs or other study projects focusing on the more complex effects of the proprioceptive exercise and the more specific requirements aimed at changing the visual, sensory information etc, on the subjects practicing football. Also, a special focus should be placed on preventing injuries, improving orientation, coordination, balance, etc.
Most of the studies underline the importance of proprioceptive exercise training programs that focus on improving the physical and functional capabilities of football players in general and young players in particular. These types of exercises have already become part of contemporary football training programs. Based on the review papers we can say that proprioceptive exercise overall can improve the physical and technical skills of football players, but it is necessary to further study the effectiveness the other training programs with different characteristics such as frequency, quantity, or types of exercises, at all ages not only in adolescents.
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