The preventive effects of neuromuscular training on lower extremity sports injuries in adolescent and young athletes: a systematic review and meta-analysis.

Abstract

Adolescents and young athletes who frequently engage in sports face a high risk of lower extremity injuries. Neuromuscular training (NMT) has been shown to effectively reduce sports-related injury incidence in this population. However, the intervention efficacy of NMT varies under the influence of different factors. This meta-analysis aimed to determine the preventive effects of NMT on various types of lower extremity injuries and investigate the impact of five moderating factors-Age, Sex, Training Duration, Training Frequency, and Intervention Period-on NMT program quality. A systematic search of Web of Science, PubMed, Scopus, Cochrane Library, and PEDro databases was conducted in November 2024 using the search strategy: (Neuromuscular Training OR NMT) AND (Sport Injury OR Injury Prevention). Eligible studies met the following criteria: 1) evaluated NMT programs; 2) reported clear mean age or age range of participants; 3) employed a randomized controlled trial (RCTs) design; 4) provided detailed raw data; and 5) included comprehensive injury data. Two reviewers independently extracted data and assessed study quality. Meta-analyses were performed to pool rate ratios (RRs) for lower extremity injuries and analyze the effects of moderating factors. Data from 24 included studies demonstrated that NMT reduced the overall risk of lower extremity injuries by 27 % (0.73, 95 % CI 0.67-0.79). Subgroup analyses by injury type yielded the following RRs: mixed lower extremity injuries (0.72, 95 % CI 0.63-0.83), knee injuries (0.72, 95 % CI 0.62-0.84), and ankle injuries (0.73, 95 % CI 0.63-0.84). Comprehensive moderator analyses revealed that NMT programs exhibited optimal preventive effects for knee injuries, males, and adolescents aged 12-18 years. Regarding training dosage, the greatest risk reduction was observed with programs involving 20-30 min per session, 1-2 sessions per week, and an intervention period exceeding 6 months. NMT programs involving 20-30 min per session, 1-2 weekly sessions, and an intervention period of ≥ 6 months are most effective in preventing knee injuries among male adolescents aged 12-18 years.