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Background <p>Adolescent female soccer players exhibit a disproportionately high risk of non-contact anterior cruciate ligament (ACL) injuries, with dynamic knee valgus (DKV) representing one of the major modifiable biomechanical risk factors, particularly under conditions of functional fatigue. The FIFA 11+ injury prevention program has demonstrated efficacy in reducing lower extremity injury risk, yet its impact on landing mechanics under fatigued conditions in this population remains underexplored. This study aimed to investigate the effects of an 8-week FIFA 11+ program on Landing Error Scoring System (LESS) scores following a functional fatigue protocol in adolescent female soccer players with DKV.</p> Methods <p>This parallel-group randomized controlled trial included 21 adolescent female soccer players (aged 13–17 years) exhibiting DKV, allocated to an intervention group (<i>n</i> = 11) receiving the FIFA 11+ program or a control group (<i>n</i> = 10) maintaining standard warm-up routines. LESS assessments were conducted before and after a validated youth soccer fatigue simulation protocol (YoSFS⁵) at baseline and after 8 weeks. A 2 × 2 × 2 mixed-design ANOVA examined the effects of group, time, and fatigue on LESS scores.</p> Results <p>Significant main effects were observed for time (<i>F</i><sub><i>1,19</i></sub>= 4.90,<i>p</i> = 0.039, <i>partial η²</i> = 0.205) and fatigue (<i>F</i><sub><i>1,19</i></sub>= 73.49, <i>p</i> &lt; 0.001, <i>partial η²</i> = 0.795). Critically, significant interactions emerged for time × group (<i>F</i><sub><i>1,19</i></sub>= 13.51,<i>p</i> = 0.002, <i>partial η²</i> = 0.416), time × fatigue (<i>F</i><sub><i>1,19</i></sub>= 15.95,<i>p</i> &lt; 0.001, <i>partial η²</i> = 0.456), and time × fatigue × group (<i>F</i><sub><i>1,19</i></sub>= 4.62, <i>p</i> = 0.045, <i>partial η²</i> = 0.196). The intervention group demonstrated substantial reductions in LESS scores post-intervention, particularly under fatigued conditions (-34.2% vs. +3.1% in controls).</p> Conclusion <p>The 8-week FIFA 11+ program significantly improved landing mechanics and attenuated fatigue-induced deteriorations in adolescent female soccer players with DKV. These findings highlight the program’s potential to improve the maintenance of landing mechanics during high-risk fatigued states, with potential implications for improving biomechanical factors associated with ACL injury risk during fatigue.</p> Trial registration <p>Iranian Registry of Clinical Trials (IRCT), IRCT20250818066901N1, registered 24/09/2025.</p>

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The effect of an eight-week FIFA 11+ program on the landing error scoring system following functional fatigue in adolescent female soccer players with dynamic knee valgus

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  • 发表日期：

    2026年7月21日

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  • Fatemeh Asadi,
  • Mansour Sahebozamani,
  • Saeid Bahiraei

摘要

Background

Adolescent female soccer players exhibit a disproportionately high risk of non-contact anterior cruciate ligament (ACL) injuries, with dynamic knee valgus (DKV) representing one of the major modifiable biomechanical risk factors, particularly under conditions of functional fatigue. The FIFA 11+ injury prevention program has demonstrated efficacy in reducing lower extremity injury risk, yet its impact on landing mechanics under fatigued conditions in this population remains underexplored. This study aimed to investigate the effects of an 8-week FIFA 11+ program on Landing Error Scoring System (LESS) scores following a functional fatigue protocol in adolescent female soccer players with DKV.

Methods

This parallel-group randomized controlled trial included 21 adolescent female soccer players (aged 13–17 years) exhibiting DKV, allocated to an intervention group (n = 11) receiving the FIFA 11+ program or a control group (n = 10) maintaining standard warm-up routines. LESS assessments were conducted before and after a validated youth soccer fatigue simulation protocol (YoSFS⁵) at baseline and after 8 weeks. A 2 × 2 × 2 mixed-design ANOVA examined the effects of group, time, and fatigue on LESS scores.

Results

Significant main effects were observed for time (F1,19= 4.90,p = 0.039, partial η² = 0.205) and fatigue (F1,19= 73.49, p < 0.001, partial η² = 0.795). Critically, significant interactions emerged for time × group (F1,19= 13.51,p = 0.002, partial η² = 0.416), time × fatigue (F1,19= 15.95,p < 0.001, partial η² = 0.456), and time × fatigue × group (F1,19= 4.62, p = 0.045, partial η² = 0.196). The intervention group demonstrated substantial reductions in LESS scores post-intervention, particularly under fatigued conditions (-34.2% vs. +3.1% in controls).

Conclusion

The 8-week FIFA 11+ program significantly improved landing mechanics and attenuated fatigue-induced deteriorations in adolescent female soccer players with DKV. These findings highlight the program’s potential to improve the maintenance of landing mechanics during high-risk fatigued states, with potential implications for improving biomechanical factors associated with ACL injury risk during fatigue.

Trial registration

Iranian Registry of Clinical Trials (IRCT), IRCT20250818066901N1, registered 24/09/2025.