I INTRODUCTION

Athletes are often subjected to musculoskeletal conditions and football players,

in particular, frequently experience strains, sprains and contusion especially in the
thighs and knee for both ligamentous and meniscal lesion (Ekstrand et al, 2011).

Football is a game of constant action and requires constant / continuous

adaptation to changing situation by the team as whole, as well as by individual
players. Although it is a team game, there is a ample room for players to display their
brilliance through individual players with ball as well as through team play involving
improvisation and tactile knowledge (Thomas J.P 1964 & Diallo et al. 2012)

Football is among the popular sport in the world in which reported injury rates
are high. Injuries in professional footballers result in significant absence from the
increased health care cost and may even be carrier ending (Mandeep S Dhillon et al,
2016)

It has been demonstrated that the overall risk of injury to professional football
players is approximately 1000 times higher than for industrial occupation generally
regarded as high risk ( J.Ekstrand et al ,2011)

Football is world’s largest biggest team sport and in recent year 2007, more than
207 association affiliated to FIFA- Federation of international football. Playing
football involves running, slopping, twisting, jumping, kicking, and turning
movements that places the players to a greater risk of injury.(Young sul yoon et al.
,2014)

The game football which is also known as soccer is one of the most popular
games in the world where players need technical fact and physical skills such as
endurance, strength and speed. The importance of Strength, power, speed, and agility
is the success of the football players (RIENZI et al., 2014)

1
 Prevent Injury enhance performance programme (PEP) which Suggested
injuries could be reduced by a particular kind of training that includes eccentric,
isometric and concentric movements for both hamstring and quadriceps. PEP
emphasize in use of proper technique during all of the exercise correct postures during
the jump, straight up and down, and reinforce the landings... programme takes around
this 20 minutes to complete (Mandelbaum et al., 2013)

Currently, many learning programmes have been developed for the prevention
of knee injury such as PEP, Sportmetics, IH, KLIP; Myklebust. Rating their
comparative effectiveness with regards to result from previous studies suggest that
only PEP, sportmetrics have the potential to significantly reduce knee injury incidence
rates (Yarsiasat J. et-all 2019)

The most used test to assess agility was the T-test. It is well accepted as a
standard test of agility. It is simple to administer and requires minimal equipment and
preparation. The test involves speed with four directional changes.

So in this study focuses on best protocol for preventing injury and enhancing
performance in football players. So in this study aims to find out the effect of PEP
program in knee function among football players.

2
1.1 NEED FOR THE STUDY:

Knee injuries in football are of great concern because they result in substantial
physical disability, financial cost and lost playing hours, and may even end a career.
Knee injuries are the most common reason for surgery in football and of all injuries
observed in football, knee injuries accounted for the most time lost.

ACL injuries have the highest morbidity of knee injuries for football players and
result in the most time lost. The incidence of ACL injury ranges from 0.06 to 3.7 per
1000 hours of active soccer play, with females being 2. 8 times more likely to sustain
non-contact ACL injury than males

Hence the need for this study is to analyze the effect of prevent injury and
enhance performance for improving knee function in football players

3
1.2 AIM OF THE STUDY

The aim of the study is to analyze the effect of prevent injury and enhance
performance for improving knee function among football players.

1.3 OBJECTIVES OF THE STUDY

 To find out the effect of prevent injury enhance performance for improving
knee function among football players.
 To find out the effect of prevent injury enhance performance for improving
agility among football players.
 To find out the effect of regular training programme for improving knee
function among football players.
 To find out the effect of regular training programme for improving agility
among football players.
 To compare the effect of prevent injury enhance performance and regular
training programme for improving knee function among football players.
 To compare the effect of prevent injury enhance performance and regular
training for improving agility among football players.

1.4 HYPOTHESIS

HYPOTHESIS 1

Null Hypothesis- There is no significant difference in improving agility by

using regular training among football players.

Alternate Hypothesis- There is significant difference in improving agility by

using regular training among football players.

4
HYPOTHESIS 2

Null Hypothesis- There is no significant difference in improving agility by using

prevent injury enhance performance among football players.

Alternate Hypothesis- There is significant difference in improving agility by

using prevent injury enhance performance among football players.

HYPOTHESIS 3

Null Hypothesis- There is no significant difference in comparing the prevent

injury enhance performance and regular training in improving agility among football
players.

Alternate Hypothesis- There is significant difference in comparing the prevent

injury enhance performance and regular training in improving agility among football
players.

HYPOTHESIS 4

Null Hypothesis- There is no significant difference in improving knee function

by using regular training among football players.

Alternate Hypothesis- There is significant difference in improving knee

function by using regular training among football players.

HYPOTHESIS 5

Null Hypothesis- There is no significant difference in improving knee function

by using prevent injury enhance performance among football players.

Alternate Hypothesis- There is significant difference in improving knee

function by using prevent injury enhance performance among football players .

5
HYPOTHESIS 6

Null Hypothesis- There is no significant difference in comparing the prevent

injury enhance performance and regular training in improving knee function among
football players.

Alternate Hypothesis- There is significant difference in comparing the prevent

injury enhance performance and regular training in improving knee function among
football players.

1.5 KEY WORDS

 Prevent injury and enhance performance

 Agility
 Plyometrics

6
 II REVIEW OF LITERATURE

Review of literature consist of review include prevent injury enhance

performance, single leg hop test and agility t test.

REVIEWS ON PREVENT INJURY ENHANCE PERFORMANCE

Vlachas, T; Paraskevopoulos et al., 2022

The systematic review investigated the effect of the FIFA11+ warm up program
in injury prevention and performance in football players. The result showed that the
FIFA11+ is an effective warm up program which every team should include their
training session because it reduces the incidence of injury.

Shahnaz hasan et al., 2021

Plyometrics training can show improvement in leg strength and muscle power,
acceleration, running performance and can lead to increase in agility. Plyometric
training involves an immediate shortening after pre-stretching to active muscle and has
traditionally been used for various sport which are dependent on speed and power.

Mohammad noor Mohamed et al., 2020

Plyometrics are exercise that involves the enhancement of muscle performance.

Most of the training in sport involving jumping, hopping and skipping movements.
The exercises also facilitate muscle activities in energetic activities, during which the
movement would come with a stretch of the muscle instantly by an explosive
modification of the muscle. Plyometric is an essential component of the recreationally
trained football players training program based on results that support the theoretical
principle for using these forms of training principles for using these forms of training
to increase speed and agility performance.

7
Antoni pajuelo Molina et al., 2020

Plyometrics type of exercise is essential an prevention programme in relation to

the specified injury. It can be defined by the decrease in the maximum reaction force
to the ground, the decrease in hip abduction and adduction during the landing phase, in
addition to increasing the muscular power of lower extremity

Sumannont .S et al., 2019

PEP consisting of strengthening manoeuvre and plyometric and sport specific

agility which improve neuromuscular control thereby compromise the functional joint
stability. PEP focusing on muscle strength, balance and flexibility.

Cristina RODRIGCEZ et al., 2018

PEP emphasizes in the use of proper technique during all of the exercise and
correct posture during jumps, straight up and down, reinforce the landings. The
program takes around 20 minutes to complete.

RB Frobell et al., 2017

Football players are physically active and thus have better knee function
compared to inactive individuals .on the other hand football players are prone to knee
injury and therefore knee function will be reduced.

REVIEW ON SINGLE LEG HOP TEST

Paige guild et al., 2021

The use of the Single leg hop test as a functional performance test to identify
female college players at risk for injury should consider consistent method. The Single
leg hop is an easy, field expedient, inexpensive test for health care provides to
administer to college SA, and is commonly used for return to play decisions after
injuries.

8
Bart dingenen et al., 2019

Excellent test-retest reliability of forward, medial and rotational hop tests was
single leg hop test. This allows clinicians to make informed interpretations of changes
in hop test distances when retesting athletes. Medial and rotational hop tests are more
likely to show limb asymmetries in ACL-reconstructed participants compared to
forward hop test.

Ted sueyoshi et al., 2017

The single-leg hop tests and isokinetic strength measurements were both useful
for a bilateral comparison of knee functional performance and strength. Knee flexion
strength deficits and flexion-to-extension ratios seemed to be correlated with single-
leg hop test performance.

Augustsson et al., 2016

Single leg hop test are used clinically to assess knee function in patient
following knee injury or surgery, as it is thought that single leg hops represent an
activity which places high demands on the ability of leg musculature to generate
substantial knee joint moment and power during takeoff.

Daniel pfirrmann et al., 2016

Injury rates were higher for matches than for training for both youth and adult
players. Youth players had a higher incidence of training injuries than professionals;
efforts must be made to reduce the overall injury rates in matches. Therefore,
preventive interventions ,such as adequately enforcing rules and focusing on fair play,
must be particular focusing on fair play ,must be analysed and developed to reduce
match related injury incidence.

9
Barber et al., 2012

Assessed the functional disabilities in normal and ACL deficient patients and
concluded that the three hop tests used for outcome measures were more specific in
comparisons of lower limb performance.

Andrea Reid et al., 2012

Concluded that four hop test used as outcome measure for ACL reconstructed
patient proved reliable and valid on performance basis. This result provide support to
use the series of hop test such as single leg hop test, 6m timed hop test and cross over
hop test in the clinical and research practice.

REVIEW ON AGILITY T TEST

Bahar ATES et al., 2018

It was used to administer the test. To set up the agility T test track, four cones
were placed to form a T. one of the cones was placed from the starting cone and 2
additional cones placed either side of the second cone. Following the start command,
the participants start from cone A, runs straight to cone with the left hand.

Souhail Hermassi et al., 2011

Agility T test is significantly associated with the selected of athletic quality

related to handball .T test is a unique fitness quality that is associated to several
important physiological variables simultaneously.

Goran sporis et al., 2010

According to the result of the study, the agility T test proved to be the most
appropriate for estimating the agility of defenders. Having had to adapt to a specific
position task, they were more in the T test than the players in other positions.

10
 III METHODOLOGY

3.1 STUDY DESIGN

Pre-test and post-test experimental study design

3.2 STUDY SETTING

KG College of physiotherapy, Coimbatore

3.3 STUDY SAMPLE

Based on selection criteria, 30 players were selected and they were allotted into
2 groups by simple random sampling method. N=30

GROUP A (n=15)

GROUP B (n=15)

Group A – Control group

Subjects received regular warm up by jogging and stretching about 20 minutes.

Group B – Experimental group

Subjects received PEP program in warm up period. PEP program consist of

warm up, stretching, Strengthening, Plyometrics and sport specific agility training for
about 20 minutes.

3.4 STUDY DURATION

The total study was conducted for a period of 6 months.

11
3.5 CRITERIA FOR SELECTION OF SUBJECTS

INCLUSION CRITERIA:

 Players under regular practice

 Male football players
 Age between 18 -25 years
 Undergone injury more than 1 year

EXCLUSION CRITERIA:

 Musculoskeletal and neurological abnormality

 Any injury within 3 months
 Players with low back pain and radiating symptom
 Overweight and underweight players
 Players who are not willing to participate in this study.
 Leg length discrepancy

3.6 VARIABLES

INDEPENDENT VARIABLES:

 Prevent injury and enhance performance protocol

DEPENDENT VARIABLES:

 Muscle strength
 Agility

3.7 OUTCOME MEASURE:

 Single leg hop test
 Agility ‘t’ test

12
3.7.1 MEASUREMENT TOOLS:
 Stop watch
 Measuring tape
 Cones for agility
 Chalk
3.8 PROCEDURE

Football players from the KG Campus were selected by giving a notification to

all the players, those who are interested register their names in the OPD of KG
College of physiotherapy .A clear explanation about the study was given to all the
patients. A written consent was obtained from them.30 subjects were selected based
on the inclusion and exclusion criteria.

GROUP – A: CONTROL GROUP (n=15)

Subjects underwent regular training warm up programme.

The training time consist of 20 minutes of programme:

Number of session: 1 session per day

Training duration: 20 minutes

Sr. no Warm up Duration

1. Jogging 10 minutes

2. Stretching 10 minutes

13
GROUP –B: EXPERIMENTAL GROUP (n=15)

Subjects underwent prevent injury and enhance performance programme.

This protocol was taken from “Effectiveness of prevent injury enhance

performance training program in reducing injury incidence rates among
adolescent female sepak takraw players”: a randomised controlled trial. Yarsiasat J,
Sumannont S, Manimmanakorn., 2019

The training time consist of 20 minutes of programme:

Number of session: 1 session per day

Training duration : 20 minutes

Warm up Jog line to line 30 seconds for each

Shuttle run activity
Backward running

Stretching Calf stretch 30 seconds for 2 sets

Quadriceps stretch each muscle group
Hamstring stretch
Hip flexor stretch
Strengthening Walking lunges 3 sets 10 repetitions for
Russian hamstring each
Single toe raise

Plyometrics Lateral hops over cone 20 repetitions

Forward/backward hopes
over cone
Single leg hops over cone

14
 Vertical jumps with headers
Scissors jump

Agilities Shuttle run with 1 minute

forward/backward running
Diagonal runs
Bounding runs
Alternatives Bridging with alternating 30 repetition on each
hip flexion side
Abdominal crunches
Single and double knee to
chest

15
PREVENT INJURY ENHANCE PERFORMANCE

Figure -1 Figure -2
Abdominal crunches Bridging with alternating hip
flexion

Figure -3 Figure -4
Walking lunges Standing hip swings

16
3.9 ETHICAL CONCERN

The study was approved by college Ethics committee, KG College of

physiotherapy.

3.10 STATISTICAL TOOLS

The following statistical tool were used to compare pre and post test values of
Group A and Group B on Agility t test and Single leg hop test.

Paired t -test

The paired ‘t’ test was used to compare the pre and post test values for Group
A and Group B.

Formula : paired t-test

Where,

d = difference between the pre test versus post test

d = Mean difference

n = Total number of subjects

S = Standard deviation

∑d² =Sum of squared deviation

17
Unpaired t –test:

The unpaired ‘t’test was used to comparethe pre test and post test
values between the two groups.

Formula : Unpaired t –test

Where,

X1 = Mean of Group A

X2 = Mean of Group B

∑ = Sum of the value

n1 = Number of subjects in Group A

n2 = Number of subjects in Group B

S = Standard deviation

X1= Difference between pre –test and post- test group –A

X2 = Difference between pre-test and post-test group –B

18
Paired “t” test :

Paired t test is used when we try to identify the difference between two
variables for the same subject.

Unpaired “t” test:

Unpaired t test is a statistical procedure that compares the means of

independent or between the groups.

t- value

t –value is calculated difference represented in units of error. The greater the

magnitude of T , is greter the evidence against the null hypothesis.

p-value

p- value is probability of obtaining test results actually observed atleast as

extreme as results actually observed.

For example if the p value is less than 0.05 is implies that there is significant
difference between the values.

Level of significance at 5%

19
 IV DATA ANALYSIS AND INTERPRETATION

TABLE –I

DEMOGRAPHIC DATA

S.NO AGE MALE

1. 19 8

2. 20 9

3. 21 8

4. 22 6

TOTAL 30

Table I shows the demographic data of age classification from 19-22

20
 GRAPH –I

DEMOGRAPHIC DATA

AGE

6 8

19

8 20
21
9
22

Graph-I shows the demographic data of age classification from 19-22

21
 TABLE- II

PAIRED ‘T’ TEST VALUES OF

AGILITY T TEST

GROUP A – REGULAR TRAINING

S.NO GROUP MEAN MEAN STANDARD T

–A DIFFERENCE DEVIATION VALUES

1. Pre test 13.78 1.3

2.59 5.86
2. Post test 11.19 0.7

The means of pre test and post test are significant different at p< 0.05

The table II shows the analysis of agility t test in Group A. Using paired ‘t’ test
with 14 degrees of freedom and 0.05 as a level of significance, the calculated ‘t’ value
is 5.86, which was greater than the tabulated t value or critical value is 1.761. The
result shows that there was marked difference between pre test and post test values.
Post test values have clinical significance than the pre test values.

22
 GRAPH – II

PAIRED ‘T’ TEST VALUES OF

AGILITY T TEST

GROUP A –REGULAR TRAINING

14

12

10
13.78

8 POST TEST
11.19
PRE TEST
6

0
PRE TEST POST TEST

Graph II shows that mean value of pre test and post test analysis of agility‘t’ test
in group A, that y-axis is denoting agility‘t’ test values, in x-axis the pre and post test
values are compared, in pre test mean is 13.78 and post test mean is 11.19, so there is
significant difference between pre and post test values. Post test value has clinical
significance than the pre test values.

23
 TABLE –III

PRE TEST AND POST TEST VALUES OF

AGILITY T TEST

GROUP B – PREVENT INJURY ENHANCE PERFORMANCE

S.NO GROUP – MEAN MEAN STANDARD T VALUE

B DIFFERENCE DEVIATION

1. Pre test 13.3 1.3

3.5 8.51

2. Post test 9.8 0.54

The means of pre test and post test are significant different at p < 0.05

The table III shows the analysis of agility t test in Group B. Using paired‘t’ test
with 14 degrees of freedom and 0.05 as a level of significance, the calculated ‘t’ value
is 8.51, which was greater than the tabulated t value or critical value is 1.761. The
result shows that there was marked difference between pre test and post test values.
Post test values have clinical significance than the pre test values.

24
 GRAPH – III

PAIRED ‘T’ TEST VALUES OF

AGILITY T TEST

GROUP B – PREVENT INJURY ENHANCE PERFORMANCE

14

12

10 13.3

8
9.8 POST TEST
PRE TEST
6

0
PRE TEST POST TEST

Graph III shows that mean value of pre test and post test analysis of agility‘t’
test in group B, that y-axis is denoting agility‘t’ test values, in x-axis the pre and post
test values are compared, in pre test mean is 13.3 and post test mean is 9.8, so there is
significant difference between pre and post test values. Post test value has clinical
significance than the pre test values

25
 TABLE –IV

AGILITY T TEST

UNPAIRED T TEST OF GROUP A AND GROUP B

S.NO POST MEAN MEAN STANDARD T VALUES

TEST DIFFERENCE DEVIATION

1. Group-A 11.19 0.76

1.31 5.40

2. Group- B 9.88 0.54

The means of post test values of group A and group B are significant

different at p < 0.05.

The table IV shows the analysis of agility t test between Group A and Group B.
Using unpaired‘t’ test with 28 degrees of freedom and 0.05 as a level of significance,
the calculated ‘t’ value is 5.40, which was greater than the tabulated t value is 1.701.
The result shows that there was marked difference between Group A and Group B
values. Group B shows clinical significance than the Group A.

26
 GRAPH –IV

AGILITY T TEST

UNPAIRED T TEST OF GROUP A AND GROUP B

12

10

11.19
8
9.88
GROUP B
6 GROUP A

0
GROUP A GROUP B

Graph IV shows that mean value of GROUP A and GROUP B post test analysis
of agility‘t test, that y-axis is denoting agility‘t’ test values, in x-axis the group A and
group B post test values are compared, in group A post test mean is 11.19 and group B
post test mean is 9.88, so there is significant difference between group A and group B.
So group B shows clinical significance than the group A value.

27
 TABLE –V

PAIRED ‘T’ TEST VALUES OF

SINGLE LEG HOP TEST

GROUP A- REGULAR TRAINING

S.NO GROUP MEAN MEAN STANDARD ‘t’

-A DIFFERENCE DEVIATION VALUES

1. Pre test 187.73 3.15

3.4 3.25

2. Post test 191.13 2.07

The means of pre test and the post test are significant different at p< 0.05

The table V shows the analysis of single leg hop test in Group A. Using paired‘t’
test with 14 degrees of freedom and 0.05 as a level of significance, the calculated‘t’
value is 3.25, which was greater than the tabulated t value is 1.761 .the result shows
that there was marked difference between pre test and post test values. A post test
value has clinical significance than the pre test values.

28
 GRAPH V

PAIRED ‘T’ TEST VALUES OF

SINGLE LEG HOP TEST

GROUP A – REGULAR TRAINING

200

180 191.13
187.73 POST TEST
PRE TEST

160

140
PRE TEST POST TEST

Graph V shows that mean value of pre test and post test analysis of single leg
hop test in group A, that y-axis is denoting single leg hop test values, in x-axis the pre
and post test values are compared, in pre test mean is 187.73 and post test mean is
191.13, so there is significant difference between pre and post test values. Post test
value has clinical significance than the pre test values.

29
 TABLE –VI

PAIRED ‘T’ TEST VALUES OF

SINGLE LEG HOP TEST

GROUP B- PREVENT INJURY ENHANCE PERFORMANCE

S.NO GROUP- MEAN MEAN STANDARD T

B DIFFERENCE DEVIATION VALUES

1. Pre test 188.73 3.67

6.67 6.70

2. Post test 195.40 1.96

The means of pre test and the post test are significant different at p< 0.05

The table VI shows the analysis of single leg hop test in Group B. Using paired‘t’
test with 14 degrees of freedom and 0.05 as a level of significance, the calculated‘t’
value is 6.70, which was greater than the tabulated t value is 1.761 .the result shows
that there was marked difference between pre test and post test values. Post test value
has clinical significance than the pre test value.

30
 GRAPH –VI

PAIRED ‘T’ TEST VALUES OF

SINGLE LEG HOP TEST

GROUP B- PREVENT INJURY ENHANCE PERFORMANCE

200

180
188.73 195.4
POST TEST
PRE TEST

160

140
PRE TEST POST TEST

Graph VI shows that mean value of pre test and post test analysis of single leg
hop test in group B, that y-axis is denoting single leg hop test values, in x-axis the pre
and post test values are compared, in pre test mean is 188.73 and post test mean is
195.40, so there is significant difference between pre and post test values. Post test
value has clinical significance than the pre test values.

31
 TABLE –VII

SINGLE LEG HOP TEST

UNPAIRED T TEST OF GROUP A AND GROUP B

S.NO POST MEAN MEAN STANDARD T VALUES

TEST DIFFERENCE DEVIATION

1. Group-A 190.20 2.14

5.2 6.93

2. Group- B 195.40 1.96

The means of post test values of group A and group B are significant

different at p < 0.05.

The table VII shows the analysis of single leg hop test between Group A and
Group B. Using unpaired‘t’ test with 28 degrees of freedom and 0.05 as a level of
significance, the calculated‘t’ value is 6.93, which was greater than the tabulated t
value is 1.701 .the result shows that there was marked difference between Group A
and Group B values. Group B shows clinical significance than Group A.

32
 GRAPH –VII

SINGLE LEG HOP TEST

UNPAIRED T TEST OF GROUP A AND GROUP B

200

180 195.4

190.2 GROUP B
GROUP A

160

140
GROUP A GROUP B

Graph VII shows that mean value of GROUP A and GROUP B post test
analysis of agility‘t’ test, that y-axis is denoting single leg hop test values, in x-axis the
group A and group B post test values are compared, in group A post test mean is
190.20 and group B post test mean is 195.40, so there is significant difference between
group A and group B. So group B shows clinical significance than the group A value.

33
 V. RESULT

The study was conducted to find out the effect of prevent injury enhance
performance programme for improving knee function in football players.

Agility‘t’ test is used to find the agility performance and single leg hop test is
used to find the knee function in male collegiate football athletes. All are prior to the
intervention and after 12 weeks of training session.

Statistic analysis was done using SPSS, Paired‘t’ test was used to find the
difference within the group and Unpaired ‘t’ test was used to find the difference
between the groups.

Paired‘t’ test of agility ‘t’ test for Group A PRE TEST mean value 13.78 and
standard deviation 1.339, POST TEST mean value 11.19 and standard deviation
0.763, T value – 5.86. This result rejects null hypothesis1 and accepts alternate
hypothesis 1.

Paired‘t’ test of agility’t’ test for Group B PRE TEST mean value 13.3 and
standard deviation 1.3, POST TEST mean value 9.8 and standard deviation 0.54, T
value – 8.51. This result rejects null hypothesis 2 and accepts alternate hypothesis 2.

Unpaired ‘t’ test of agility‘t’ test for Group A mean value 11.19 and standard
deviation 0.76 , Group B mean value 9.88, standard deviation 0.54 , T value - 5. 40.
This result rejects null hypothesis 3 and accepts alternate hypothesis 3.

Paired "t” test for single leg hop test for Group A PRE TEST mean value 187.73
and standard deviation 3.15, POST TEST mean value 191.13 standard deviation 2.07 ,
T value – 3.25. This result rejects null hypothesis 4 and accepts alternate hypothesis 4.

Paired ‘t’ test for single leg hop test for Group B PRE TEST mean value 188.73
and standard deviation 3.67, POST TEST mean value 195.40 and standard deviation

34
1.96, T value – 6.70. This result rejects null hypothesis 5 and accepts alternate
hypothesis 5.

Unpaired‘t’ test for single leg hop test for Group A mean value 190.20 and
standard deviation 2.14, Group B mean value 195.40, standard deviation 1.96 ,T value
– 6.93. This result rejects null hypothesis 6 and accepts alternate hypothesis 6.

On comparing the pre test and post test value Group A and Group B, Group B
who undergone prevent injury enhance performance training shows significant
improvement on knee function in football players.

This study rejects the null hypothesis and accepts alternate hypothesis.

35
 VI. DISCUSSION

The purpose of the study is to analyse the effect of prevent injury enhance
performance on improving knee function for football players. Most of the studies
suggest that there is improvement in knee function in football players who underwent
prevent injury enhance performance programme. But there are not many studies
analysing the effect of prevent injury enhance performance training.

A total of about 30 subjects who fulfilled inclusive and exclusive criteria were
selected by simple random sampling method, out of them 15 were allotted in Group A
and 15 in Group B.

Group A underwent warm up and stretching where as Group B underwent

prevent injury enhance performance programme. In physical performance, knee
function was tested using single leg hop test whereas agility was tested using agility t
test. All are prior to the intervention and after 8 weeks of training session.

Statistic analysis was done using SPSS, Paired‘t’ test was used to find the
difference within the group and Unpaired ‘t’ test was used to find the difference
between the groups. PEP consisted of strengthening manoeuvre, plyometrics and
sport specific agility, stretching also improved neuromuscular control which could
thereby compromise the functional joint instability.

The proprioceptive consisted of the receptor (muscle spindle and Golgi tendon
organ); these were the essential of feedback system. The effective counter the stimuli
response to central nervous system, being the one of protective factor could decrease
the injury during movement.

The result of the study indicate that peak power and jump heights increased
from pre to post training within the PEP group , with significant difference between
PEP and control groups , but with no change in flight times. However some studies
36
developing a training programme based on PEP found difference involving 57% of the
athletes, who showed improvements after training. As a result we might suggest that
football players fundamentally require high developed bio motor abilities within the
sport in order to demonstrate the peak skills necessary, for example, to jump, block,
kick and serve effectively.

Several studies investigating the effects of plyometric training on vertical jump

ability found that this can be improved by means of plyometric jumps. This arguably
explains the improvements in jump heights and peak power when players are trained
with plyometric exercise routines. From the literature, plyometric exercises that
involve stretching an active muscle prior to shortening cycle have been shown to
enhance performance during the concentric phase of muscular contraction.

From the results, the significant differences found for the agility t tests within
the groups are consistent with results were not replicated in female football players
measured by pro-agility and the Illinois agility test.

Analysis of result also shows that there is an increase in experimental group

when compared with the control group that has less increase in the outcome measure
of agility t test. Results obtained in single leg hop test also shows that there is increase
in the experimental group when compared with increase in the control group. This
shows that the superiority of prevent injury enhance performance given to
experimental group than that of warm up and stretching given to control group.

The finding presented incidence rate in trained group less than untrained group.
So the effectiveness of PEP program has a chance of indicating the knee injury. PEP
shows better improvement in training of knee function in football players.

37
 VII. SUMMARY AND CONCLUSION

The purpose of the study is to analyse the effect of prevent injury enhance
performance for improving the knee function in football players.

30 subjects were selected and divided into 2 groups using simple random
sampling method. Group A subjects underwent warm up and stretching programme
whereas Group B underwent prevent injury enhance performance programme for a
period of 8 weeks. In physical performance knee function and agility were measured.
Knee function was measured using single leg hop test. Agility was measured by using
agility‘t’ test. Both the pre and post test measure was obtained, by use of this value
within group analysis and between group analysis was done. Based on the findings the
result was obtained.

The study concludes that, prevent injury enhance performance was improving
the knee function of the football players.

The study concludes that, prevent injury enhance performance was improving
the agility in football players.

The study concludes that prevent injury enhance performance was improving
the knee function and agility compared to the regular training.

The study rejects the null hypothesis and accepts the alternate hypothesis, thus
concludes that prevent injury enhance performance improves knee function.

38
 VIII. LIMITATIONS AND RECOMMENDATIONS

LIMITATIONS

 Small number of samples were included

 Study included only collegiate football players
 Study does not focus on dominant and non dominant limbs
 Only male players were included.
 Only agility and single leg hop test were assessed

RECOMMENDATIONS

 Future study should be made on large sample size, with long term follow
ups.
 Future research should be focussed on other sports also
 Future research should focus on different frequencies of exercises.
 Different kind of knee function measurement can be done with scientific
advanced tools
 Elite athletes can be involved in the study.

39
 IX BIBLIOGRAPHY

1. Antoni Pajuelo Molina et al (2021) Strength training in relation to injury

prevention in professional and semi professional women’s football: a systematic
review : International journal of sports medicine. Volume 56, DOI:
10.1016/j.apunsm.2020.100342.
2. Augustsson J, Thomee R, Linden C et al., (2006) Single leg hop testing
following fatiguing exercise: reliability and biomechanical analysis. Scand J
Med Sci Sports16 (111-120). DOI: 10.1111/j.1600-0838.2005.00446.x
3. Atsushi Imai et al (2014) Effect of two types of trunk exercises on balance and
athletic performance in youth soccer players. International journal of sports
physical therapy, volume 9., 47-57.
4. Bahar ATES (2018) Age related effect of speed and power on Agility
performance of young soccer players: Journal of Education and Learning, vol 7,
Pg.no: 93-99. DOI: 10.5539/jel.v7n6p93.
5. Bart Dingenen et al (2019) Test –retest reliability and discriminative ability of
forward, medial and rotational single leg hop tests: The Knee., volume 26 978-
987. DOI: 10.1016/j.knee.2019.06.010.
6. B.Sachin murali (2016) An experimental study to analyze the effectiveness of
crosses eccentric quadriceps strength training on functional disability in
collegiate football players with ACL reconstruction.
7. Cristina Rodriguez et al (2018) The effect of prevent injury and enhance
performance program in a female soccer team. Journal of sports medicine and
physical fitness. 659-663. DOI: 10.23736/S0022-4707.17.07024.
8. J.Ausustsson et al (2012) single leg hop testing following fatiguing exercise:
reliability and biomechanical analysis. Scand J Med Sci Sports volume 16: 111-
120. DOI: 10.1111/j.1600-0838.2005.00446x.

40
9. J. Ekstrand et al (2018) Epidemiology of football injuries. Journal of science
and sports 23; 73-77. DOI: 10.1016/j.scispo.2007.10.012.

10. Kukumoni Patir, Dr.Laishram santhosh singh et al (2021) Effects of plyometric

training on muscular endurance of football players. Volume 36 No. (IX) pg.no-
182-186, DOI: 10.13140/RG.2.2.27720.44802.

11. Mandeep S Dhilon, Jan Ekstrand et al (2016) Stress fracture in football

players, JISAKOS; 1:229-238, DOI: 10.1136/jisakos-2015-000010.

12. Markus Walden et al (2021) Prevention of acute knee injuries in adolescent

female football players: cluster randomized controlled trial. British medical
journal. DOI: 10.1136/bmj.e3042.

13. Muhammad Hazman bin Shanshuddin, Hosni hasan, Mohd syrianz Azli et al
(2020) Effects of plyometric training on speed and agility among recreational
football players. International journal of human movement and sports science
8(5):174-180 DOI: 10.13189/saj.2020.080503.

14. Nicole .J.Chimera et al (2004) Effects of plyometric training on muscle

activation strategies and performance in female athletes: Journal of athletic
training. Volume 39:24-31.

15. Paige Guild et al (2021) The Association Between the Single Leg Hop Test ans
Lower –Extremity Injuries in Female Athletes Critical Appraised Topic.,
Journal of Sports Rehabilitation .,volume 30.,320-326 .DOI: 10.1123/jsr.2019-
0391.

16. R.B.Frobell et al (2008) Self-reported activity level and knee function in

amateur football players: the influence of age, gender, history of knee injury and
level of competition: Knee surgery sports traumatol arthroscopy, volume
16:713-719. DOI: 10.1007/s00167-008-0509-y.

41
17. Radhouane Haj Sassi ,Wajdi Dardouri ,Mohammad Haj Yahmed et al
(2009)Relative and Absolute Reliability of a Modified Agility T Test and its
relation with Vertical Jump and Straight Sprint. Journal of strength and
conditioning research. Volume 23(6) 1644-1651.

DOI: 10.1519/JSC.0b013e3181b425d2.

18. Ross Armstrong , Dr.Matt Greig (2018)The functional Movement Screen and
Modified Star excursion Balance Test as predictors of T test agility
performance in university rugby union and netball players. DOI:
10.1016/j.ptsp.2018.01.003.

19. Shahnaz Hasan et al (2021) Effect of resisted sprint and plyometric training on
lower limb functional performance in collegiate male football players: a
randomized control trial: international journal of environmental research and
public health. Volume 18. DOI: 10.3390/ijerph181336702.

20. Souhail Hermassi, Mourad Fadhloun et al (2011) Relationship between agility

T test and physical fitness measure as indicator of performance in elite
adolescent handball players. Volume 5. pg.no:125-131.

21. Tapas K pal et al (2017) Effectiveness of FIFAs 11 exercise program on the

agility performance in young adult football players: Journal of society of Indian
physiotherapists .,volume 1.pg.no: 60-66. DOI: 10.1016/j.jshs.2022.05.001.

22. Ted Sueyoshi et al (2017) single leg hop test performance and isokinetic knee
strength after ACL reconstruction. DOI: 10.1177/232596711739811.

42
 X APPENDIX- I

CONSENT FORM

This is certify that …………………………freely and voluntarily agree to

participate in the study “ANALYZE THE EFFECT OF PREVENT INJURY
ENHANCE PERFORMANCE FOR IMPROVING KNEE FUNCTION IN
FOOTBALL PLAYERS”

I have been explained about the procedure and the risk that would occur during
the study, questions have been answered to satisfaction.

Signature of the Participant:

Signature of the Witness:

Date:

I have explained and defined procedure to which subject has consented to

participate.

Signature of the researcher:

Date:

43
 APPENDIX- II

SCREENING QUESTIONNAIRE

1 NAME:

2 AGE:

3 GENDER:

4 How many years you have been playing

football?

5 How many hours do you play football

per day?

6 Have you had undergone any injury

while playing football?

7 Which area of the body have injured

more often?

8 In which position do you play in the

football?

9 Have you played football after injury

44
EVALUATION CHART:

Outcome
Measure Pre-test Post-test

Agility t test

Single leg hop Test

45
 APPENDIX – III

AGILITY T TEST

Four cones are set out as T alphabet (5 yards=4.75m, 10 yards=9.14m) . The

subject begins at cone A. At the command, subject will sprint to cone B and use their
right hand to touch the base of the cone .they then turned left and invert sideways to
cone C, while touching the cone with their left hand. They then turn sideways to the
right of cone D, touching it with their right hand. Then they shuffle back to cone B,
touching it with their left hand, and then run back to cone A. The time was stopped
when they pass back to cone A.

INTERPRETATION:

 < 9.50 seconds = excellent

 9.51- 10.50 seconds = good
 10.51 -11.51 seconds = average
 > 11.51 seconds = needs to be improved

46
47
 APPENDIX- IV

SINGLE LEG HOP TEST

For single leg hopping, stand on one foot with your toes behind a line marked
on the floor.

Hop forward as far as possible, landing on the same foot from which you took
off. Measure and record the distance you hopped in centimetres (cm)

Repeat the test, recording the distance hopped each time for each player.

Figure -1

Starting position

48
 Figure – 2

Hoping

Figure -3

Landing position

49
 APPENDIX- V

PREVENT INJURY AND ENHANCE PERFORMANCE

PROTOCOL

This prevention program consist of a warm up ,stretching ,strengthening ,

plyometrics and sports specific agility to improve strength and coordination of
stabilizing the muscle around the knee joint.

This program should be completed 3 times a week.

1. WARM- UP:

A.JOG LINE TO LINE:

 Complete a slow jog from near to far side line.
 Duration : 0.5 minutes

B. SHUTTLE RUN:
 Continuous running back and forth between two line markers at a
certain pace, and vary in degree of intensity, duration and distance
 Duration : 0.5 to 1 minute

C.BACKWARD RUNNING:
 Run backwards from side line to side line. Land on your toes
without snapping the knee back.
 Duration :1-1.5 minute

50
D.STANDING HIP SWINGS (FORWARD /BACKWARD)
 Standing with wall support swinging leg forward and backward
with a slowly increasing arc up to full range.
 Complete 15 repetitions gradually increasing speed to stimulate a
kick.

E. STANDING HIP SWING (OUTSIDE/ INSIDE)

 Standing with wall support slowly swinging leg sideways in and
out slowly increasing arc up to full range.

2. STRENGTHENING

A.WALKING LUNGES:
 Lunge forward leading with right leg. Push off with right leg and
lunge forward with left leg. Drop the back knee straight down.
 Duration : 1 minute

B.RUSSIAN HAMSTRING:
 Kneel on the ground with hands at your side. Have a person hold
firmly at your ankle. With a straight back, lean forward with your
hip.
 Duration :1 minute

C.SINGLE TOE RAISE:

 Stand up with your arms at side. Bend the left knee up and
maintain balance. Slowly rise up on right toes with good balance.
 Duration : 1 minute

51
3. PLYOMETRICS:

A.LATERAL HOPS OVER CONE:

 Stand with a cone to your left. Hop to the left over the cone softly
landing on the ball of feet landing bending at the knee.
 Duration :30 seconds

B. FORWARD /BACKWARD HOPS OVER CONE:

 Hop the cone softly landing on the ball of feet bending at the knee.
Now, hop backwards over the ball using the same landing
technique.
 Duration: 30 seconds.

C.SINGLE LEG HOPS OVER CONE:

 Hop over the cone landing on the ball of foot bending at the knee.
Now, hop backwards over the cone with one leg using the same
landing technique.
 Duration :30 seconds

D. VERTICAL JUMP WITH HEADERS:

 Stand forward with hands at your side. Slightly bend the knees and
push off jumping straight up.
 Duration : 30 seconds

E.SCISSORS JUMP:
 Lunge forward leading with your right. Keep your knee over your
ankle. Now, push off with your right foot and propel left leg
forward into a lunge position.

52
4. AGILITIES:

A.FORWARD RUNS WITH 3 STEP DECELERATION:

 Starting at the first cone, sprint forward to the second cone .use a 3
step quick stop to decelerate.

B. LATERAL DIAGONAL RUNS:

 Face forward and laterally runs to the first cone on the right. Pivot
off the right foot and shuttle run to the second cone. Now, pivot off
the left leg and shuttle run to the third cone.

C.BOUNDING RUN:
 Starting on the near sideline, run to the far side with knees up
towards chest. Bringing your knees up high. Land on the ball of
your foot with a slight bend at the knee and a straight hip.

5. STRETCHING:

A.CALF STRETCH:
 Stand leading with your right leg. Bend forward at the waist and
place your hands on the ground. Keep right knee slightly bend and
left leg straight.
 Hold for 30 seconds
 Switch sides and repeat

53
B.QUADRICEPS STRETCH:
 Place left hand support over the wall. Reach back with right hand
and grab the front of right ankle. bring heel to the buttock
 Hold the stretch for 30 seconds.

C.FIGURE FOUR HAMSTRINGS STRETCH:

 Place left hand support over the wall. Reach back with right hand
and grab the front of right ankle. bring heel to the buttock
 Hold the stretch for 30 seconds

D.INNER THIGH STRETCH:

 Seated on the ground. Spread your legs wide apart, lower to the
centre with a straight back.
 Hold the stretch for 30 seconds

E.HIP FLEXOR STRETCH:

 Lunge forward leading with right leg. Drop left knee down to the
ground. Placing hand on top of right thigh, lean forward with hips.
 Hold the stretch for 30 seconds.

54
 APPENDIX – VI
GROUP –A(REGULAR TRAINING)

AGILITY T TEST

PRE TEST POST TEST

12.4 11.3

11.3 12.6

13.4 11.9

14.5 10.5

12.6 10.2

13.9 11.5

14.2 10.1

15.3 12.3

15.6 11.6

13.8 11.1

12.6 10.8

14.7 10.6

15.9 10.4

14.3 11.2

12.3 11.8

55
GROUP –B(PREVENT INJURY ENHANCE PERFORMANCE)

AGILITY –T TEST

PRE TEST POST TEST

11.3 10.5

12.4 9.1

11.6 10.1

13.5 9.9

14.5 9.5

13.4 10.2

14.8 9.3

15.3 9.8

14.3 10.7

14.9 9.6

14.4 9.7

12.5 10.4

12.4 10.8

11.5 9.5

13.2 9.2

56
 GROUP –A(REGULAR TRAINING)

SINGLE LEG HOP TEST

PRE TEST POST TEST

190 189

191 190

189 191

187 194

191 188

184 193

187 190

188 192

185 190

190 191

185 189

192 185

191 189

184 191

182 191

57
GROUP –B(PREVENT INJURY ENHANCE PERFORMANCE)

SINGLE LEG HOP TEST

PRE TEST POST TEST

188 195

192 196

185 195

190 198

188 199

183 194

192 196

194 192

188 193

189 195

182 194

195 197

188 198

187 194

190 195

58