PA 05-5-1993 A school-based program to reduce injuries through neuromuscular training: isprint a cluster-randomized controlled trial

Background Sport-specific neuromuscular training (NMT) warm-up programs have been shown to be effective in reducing injuries in youth sport but the effectiveness in school physical education (PE) is unknown. Objective To evaluate the effectiveness of iSPRINT, a NMT warm-up program implemented in junior high school (ages 11–15) PE classes in reducing sport and recreational (S and R) injury risk. Methods This is a c luster-randomized controlled trial. Participants were 1067 grade 7–9 students (53.7% female, 46.3% male) from 12 Calgary, Canada schools. iSPRINT is a 15 min NMT warm-up including aerobic, agility, strength, and balance exercises. Teachers in intervention schools (n=6) implemented the iSPRINT 12 week warm-up program in PE classes, while control schools (n=6) implemented a standard-of-practice warm-up. All teachers participated in a training workshop; only intervention school teachers participated in practical NMT components, receiving NMT video. An athletic therapist blinded to study group allocation, visited schools on a weekly basis to assess S and R injuries over 12 weeks. Injuries were those that resulted in the inability to complete a session, time loss and/or medical attention. Incidence rate ratios (IRR) were estimated based on multivariable Poisson regression analyses (adjusting for sex, clustering by class, offset by S and R participation hours). Findings The S and R injury incidence rates (IR) for all injury for the intervention and control groups respectively were1.5 and 1.8 injuries/1000 participation hours (IRR=0.73, 95% CI 0.46 to 1.16), for medical attention injuries were 0.7 and 1.3 (IRR=0.59, 95% CI 0.42 to 0.82), and 0.9 and 1.3 for lower extremity injuries (IRR=0.81, 95% CI 0.56 to 1.19). The injury incidence rate was significantly higher in females compared to males (IRR=1.59, 95% CI 1.12 to 2.22). Conclusion The iSPRINT NMT warm-up was effective in preventing medically treated S and R injuries in junior high school students. Further analysis will consider program adherence. Policy implications This research will inform safety policy considerations in junior high school PE programs.