Objective: Referees are exposed to different injuries than players, therefor the development and implementation of injury prevention programs for female futsal referees can have positive economic, social, psychological, and health effects because financial issues after the injury, including surgery and rehabilitation costs and psycho-social factors, have made the use of preventive programs more prominent. The FIFA+11 referees program is one of the few structured exercise-based injury prevention programs for referees and there is no data about its effectiveness in reducing injury rates in female futsal referees. Therefore, this study investigated the effect of eight weeks of the FIFA+11 referees program on the knee joint proprioception and position sense of female futsal referees in Tehran province.
Method: 40 participants were selected from female futsal referees of the Tehran Premier League in 2023 whose mean ± standard deviation of their age was 23.45 and 6.50, respectively. The participants were randomly assigned into a control group (general warm-up, n=20) and an intervention group (FIFA+11 referees program, n=20). This randomized quasi-experimental study involved pre-test and post-test assessment. The Evaluation of the Knee joint proprioception and position sense at 15º/S, 45º/S, and 60º/S speeds by Biodex isokinetic system was administered as pre-test measures. Subsequently, the intervention group did an exercise protocol (twenty-four 20-minute sessions of the FIFA+11 referees program). Following the intervention, the Knee joint proprioception of all participants in both groups was assessed again as post-tests. A multivariate covariance (ANCOVA) analysis was utilized to analyze the data. The significance level was set at p<0.05. All analyses were conducted using SPSS24.
Results: The results showed that the 8-week implementation of the FIFA+11 referees program significantly affected the knee joint proprioception at 15º/S (ηp2=0.44, p<0.001, F=18.19), 45º/S (ηp2=0.15, p=0.056, F=4.07) and 60º/S (ηp2=0.22, p=0.017, F=6.63) speeds. Also, no significant difference was observed between the two groups in examining the Joint position sense (ηp2=0.006, p=0.72, F=0.13).
Conclusion: Sports interventions such as the FIFA+11 referees program with balance components may lead to some neuromuscular adaptations that increase the accuracy of afferent information to the CNS and enhance its ability to control movement. These adaptations could explain the improvement of knee joint proprioception as one of the important elements in the balance component. Also, during the warm-up, tissue temperature, viscoelastic properties, and oxygen delivery to different segments of knee joints increase which can enhance the sensitivity of various peripheral receptors in knee joints and finally improve the joint position sense.