Comparison of the 11+ Kids' injury prevention programme and a regular warmup in children's football (soccer): A cost effectiveness analysis

Roland Rössler, Evert Verhagen, Nikki Rommers, Jiri Dvorak, Astrid Junge, Eric Lichtenstein, Lars Donath, Oliver Faude

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Objective: To evaluate a potential reduction in injury related healthcare costs when using the 11+ Kids' injury prevention programme compared with a usual warmup in children's football. Methods: This cost effectiveness analysis was based on data collected in a cluster randomised controlled trial over one season from football teams (under-9 to under-13 age groups) in Switzerland. The intervention group (INT) replaced their usual warmup with 11+ Kids', while the control group (CON) warmed up as usual. Injuries, healthcare resource use and football exposure (in hours) were collected prospectively. We calculated the mean injury related costs in Swiss Francs (CHF) per 1000 hours of football. We calculated the cost effectiveness (the direct net healthcare costs divided by the net health effects of the 11+ Kids' intervention) based on the actual data in our study (trial based) and for a countrywide implementation scenario (model based). Results: Costs per 1000 hours of exposure were CHF228.34 (95% CI 137.45, 335.77) in the INT group and CHF469.00 (95% CI 273.30, 691.11) in the CON group. The cost difference per 1000 hours of exposure was CHF-240.66 (95%CI -406.89, -74.32). A countrywide implementation would reduce healthcare costs in Switzerland by CHF1.48 million per year. 1002 players with a mean age of 10.9 (SD 1.2) years participated. During 76 373 hours of football, 99 injuries occurred. Conclusion: The 11+ Kids' programme reduced the healthcare costs by 51% and was dominant (ie, the INT group had lower costs and a lower injury risk) compared with a usual warmup. This provides a compelling case for widespread implementation.

Original languageEnglish
Pages (from-to)309-314
JournalBritish Journal of Sports Medicine
Issue number5
Publication statusPublished - Mar 2019


  • FIFA 11+ Kids
  • children
  • football
  • injury prevention
  • soccer

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