Impact of the FIFA 11+ Injury Prevention Programme on Dynamic Balance Performance in Football Players: A Systematic Review and Meta-Analysis
Abstract
Background. Even though FIFA 11+ helps lower injury chances in football, findings on how it affects balance during movement remain unclear. What little exists has not been combined in a way that truly compares results across studies – no solid summary of data yet exists.
Aim. This work looks at how well the FIFA 11+ method helps football players stay balanced during movement. Evidence from multiple studies was gathered and compared carefully.
Methods. A literature search was conducted in the SCOPUS database following PRISMA guidelines. Four eligible studies were selected based on specific criteria, including the use of the FIFA 11+ programme and validated balance tests. Data were synthesised using a random-effects model in Review Manager (RevMan 5.4), with analyses centred on post-intervention outcomes and pre–post differences in dynamic balance performance, to ensure comprehensive evaluation.
Results. The pooled analysis of post-intervention values demonstrated a standardised mean difference (SMD) of 0.36 (95% CI −0.18 to 0.89; p = 0.54) for anterior SEBT performance of the dominant leg, indicating no statistically significant difference between the FIFA 11+ and control groups. Heterogeneity was negligible (I² = 0%), suggesting high consistency across studies. In contrast, analysis based on pre–post change scores revealed a significant improvement in favour of the FIFA 11+ group (MD = 5.00 cm, 95% CI 3.29 to 6.71; p < 0.00001). As this outcome was derived from a single study, heterogeneity could not be assessed. Overall, the findings indicate that the effects of FIFA 11+ on dynamic balance are more sensitively detected through change-score analysis than through post-intervention comparisons alone.
Conclusions. FIFA 11+ might boost how well players stay balanced during movement, based on before-and-after studies, yet score differences alone do not always show it. How much impact occurs depends on how old they are, how often they do it, and whether they actually follow through with each drill.
Keywords: FIFA 11+; dynamic balance; football; injury prevention; meta-analysis
References
Bizzini, M., Junge, A., Bahr, R., & Dvořák, J. (2011). Injuries of football referees: A representative survey of Swiss referees officiating at all levels of play. Scandinavian Journal of Medicine and Science in Sports, 21(1), 42–47. https://doi.org/10.1111/j.1600-0838.2009.01003.x
Brito, J., Figueiredo, P., Fernandes, L., Seabra, A., Soares, J. M., Krustrup, P., & Rebelo, A. (2010). Isokinetic strength effects of FIFA’s “The 11+” injury prevention training programme. Isokinetics and Exercise Science, 18(4), 211–215. https://doi.org/10.3233/IES-2010-0386
Daneshjoo, A., Mokhtar, A. H., Rahnama, N., & Yusof, A. (2012). The effects of injury preventive warm-up programs on knee strength ratio in young male professional soccer players. PLoS ONE, 7(12), e50979. https://doi.org/10.1371/journal.pone.0050979
Drozdova-Statkevičienė, M., Nemeravičiūtė, A., & Česnaitienė, V. J. (2019). Statinės ir dinaminės pusiausvyros sąsajos atliekant dvigubą užduotį [Connection between static and dynamic balance during dual task performance]. Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija, 1(18). https://doi.org/10.33607/rmske.v1i18.747
Ferdinand, L., Hanief, Y. N., & Manimtim, R. M. (2025). Injury pattern and risk factors in grassroots football: A study of 10-year-old athletes. Sport, Exercise, and Injury, 1(1), 27–39. https://doi.org/10.56003/sei.v1i1.512
Georgiadis, G., van Gaal Appelhof, R., Stoop, R., Peters, J., & Essers, J. (2024). Association between external load and injury incidence in professional and elite-youth football players. Physical Education and Sports: Studies and Research, 3(1), 10–25. https://doi.org/10.56003/pessr.v3i1.316
Hanief, Y. N., Azidin, R. M. F. R., Sumartiningsih, S., & Firmansyah, A. (2025). The effect of 12 times training of the FIFA 11+ on fundamental movements in football academy athletes aged 14–17 as an effort to prevent injury. Sportis. Scientific Journal of School Sport, Physical Education and Psychomotricity, 11(2), 1–18. https://doi.org/10.17979/sportis.2025.11.2.11354
Hanief, Y. N., Sannicandro, I., & Azidin, R. M. F. R. (2025). The effects of the FIFA 11+ programme on lower limb functional outcomes: A systematic review. Sport, Exercise, and Injury, 1(2), 122–138. https://doi.org/10.56003/sei.v1i2.670
Impellizzeri, F. M., Bizzini, M., Dvorak, J., Pellegrini, B., Schena, F., & Junge, A. (2013). Physiological and performance responses to the FIFA 11+ (part 2): A randomised controlled trial on the training effects. Journal of Sports Sciences, 31(13), 1491–1502. https://doi.org/10.1080/02640414.2013.802926
Karvelytė, A., & Sipavičienė, S. (2023). Pusiausvyros ir propriocepcijos lavinimo pratimų poveikis ledo ritulio žaidėjų pusiausvyrai ir kojų traumų rizikai [Effects of balance and proprioceptive exercises on the balance of ice hockey players and the risk of lower limb injuries]. Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija, 2(29), 1–12. https://doi.org/10.33607/rmske.v2i29.1420
Kaziūnas, G., & Zachovajevienė, B. (2020). Propriorecepcijos ir liemens stabilumo pratimų poveikis jaunųjų futbolininkų pusiausvyrai [The effect of proprioception and core stability exercises on the balance of young football players]. Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija, 2(21). https://doi.org/10.33607/rmske.v2i21.828
Kilding, A. E., Tunstall, H., & Kuzmic, D. (2008). Suitability of FIFA’s “The 11” training programme for young football players–Impact on physical performance. Journal of Sports Science & Medicine, 7(3), 320. https://pubmed.ncbi.nlm.nih.gov/24149898/
Onofrei, R. R., & Amaricai, E. (2022). Postural balance in relation with vision and physical activity in healthy young adults. International Journal of Environmental Research and Public Health, 19(9), 5021. https://doi.org/10.3390/ijerph19095021
Pardos-Mainer, E., Casajús, J. A., & Gonzalo-Skok, O. (2019). Adolescent female soccer players’ soccer-specific warm-up effects on performance and inter-limb asymmetries. Biology of Sport, 36(3), 199–207. https://doi.org/10.5114/biolsport.2019.85453
Parsons, J. L., Carswell, J., Nwoba, I. M., & Stenberg, H. (2019). Athlete perceptions and physical performance effects of the FIFA 11 + programme in 9–11 year-old female soccer players: A cluster randomized trial. International Journal of Sports Physical Therapy, 14(5), 740–752.
Shalaj, I., Tishukaj, F., Bachl, N., Tschan, H., Wessner, B., & Csapo, R. (2016). Injuries in professional male football players in Kosovo: A descriptive epidemiological study. BMC Musculoskeletal Disorders, 17(1), 338. https://doi.org/10.1186/s12891-016-1202-9
Steffen, K., Bakka, H. M., Myklebust, G., & Bahr, R. (2008). Performance aspects of an injury prevention program: A ten‐week intervention in adolescent female football players. Scandinavian Journal of Medicine & Science in Sports, 18(5), 596–604. https://doi.org/10.1111/j.1600-0838.2007.00708.x
Steffen, K., Emery, C. A., Romiti, M., Kang, J., Bizzini, M., Dvorak, J., Finch, C. F., & Meeuwisse, W. H. (2013). High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: A cluster randomised trial. British Journal of Sports Medicine, 47(12), 794–802. https://doi.org/10.1136/bjsports-2012-091886
Sumartiningsih, S., Risdiyanto, A., Yusof, A., Rahayu, S., Handoyo, E., Puspita, M. A., Mukarromah, S. B., Hooi, L. B., Lubis, J., & Hanief, Y. N. (2022). The FIFA 11+ for kids warm-up programme improved balance and leg muscle strength in children (9–12 years old). Journal of Physical Education and Sport, 22(12), 3122–3127. https://doi.org/10.7752/jpes.2022.12395
Turner, J. A., Hartshorne, M. L., & Padua, D. A. (2024). Role of thigh muscle strength and joint kinematics in dynamic stability: Implications for Y-Balance Test performance. Journal of Sport Rehabilitation, 33(8), 654–662. https://doi.org/10.1123/jsr.2024-0081
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