Background: The Fédération Internationale de Football Association (FIFA) has promoted the FIFA 11+ injury prevention program worldwide. The FIFA 11+ injury prevention program for kids was developed and shown to be effective in reducing soccer-related injuries in numerous studies. Objective: To assess the awareness, implementation, and opinion of worldwide children's soccer coaches regarding the FIFA 11+ Kids injury prevention program. Design: Cross-sectional study. Setting: An online survey for all continental football federations. Patients (or Participants): A total of 486 children's soccer coaches completed the survey. Interventions (or Assessment of Risk Factors): The questionnaire consisted of questions relating to awareness, implementation, and coaches' opinions of the FIFA 11+ Kids injury prevention program. Main Outcome Measurements: The awareness level, implementation rate, and opinion of the the FIFA 11+ Kids injury prevention program efficacy. Results: A total of 202 (41.6%) of the children's soccer coaches reported awareness of the FIFA 11+ Kids injury prevention program and 155 (31.9%) were reported implementing the FIFA 11+ Kids injury prevention program in their current practice. Participants who reported implementation of the FIFA 11+ Kids injury prevention program also reported a positive attitude towards the program efficacy, with a score of 8.19±0.88 out of 10. Conclusions: Globally, children's soccer coaches showed poor awareness levels of the FIFA 11+ Kids injury prevention program, however, the implementation level among coaches who reported awareness was relatively high. A high number of children's soccer coaches reported a positive perception regarding the efficacy of the FIFA 11+ Kids injury prevention program in reducing and preventing injuries. Therefore, there is a need for further efforts and research to increase the international awareness and implementation rate of the FIFA 11+ Kids injury prevention program. Results Eight teams [n=118 players; 83 males, 35 females] consented to participate. All control teams and 3/4 of the intervention teams completed all 6 sessions [median 85 days (range 42-102)]. No adverse events were reported. There were 6 concussions in the intervention group (n=65) and 4 in the control group (n=53). Exploratory univariate Poisson regression analysis adjusted for cluster by team revealed no difference in concussion risk between groups [incidence rate ratio (IRR)=0.99 concussions/100 players/season (95%CI; 0.28-3.48). For males alone, there was also no difference in IRR [IRRmales=0.37 (95%CI; 0.068-1.94)]. Both female teams were allocated to the intervention group. Conclusions The implementation of a neuromuscular and sensorimotor training program with youth ice hockey teams was feasible and safe. Future evaluation in a larger sample over a longer training period to examine the effects of neuromuscular and sensorimotor training strategies on the risk of concussion in youth ice hockey players, including consideration of sex and age group is warranted.
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