Neuromuscular training for sports injury prevention: a systematic review.
OBJECTIVE
The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence from methodologically well-conducted randomized controlled trials and controlled clinical trials without randomization.


METHODS
Two independent researchers performed a literature search in various electronic databases and reference lists. The reviewers independently assessed trials for inclusion criteria and methodological quality and extracted the data. Focusing on studies of high methodological quality, relative risks (RR) and 95% confidence intervals (CI) were used to estimate treatment effects.


RESULTS
From a total of 32 relevant studies, 7 methodologically well-conducted studies were considered for this review. Pooled analysis revealed that multi-intervention training was effective in reducing the risk of lower limb injuries (RR = 0.61, 95% CI = 0.49-0.77, P < 0.01), acute knee injuries (RR = 0.46, 95% CI = 0.28-0.76, P < 0.01), and ankle sprain injuries (RR = 0.50, 95% CI = 0.31-0.79, P < 0.01). Balance training alone resulted in a significant risk reduction of ankle sprain injuries (RR = 0.64, 95% CI = 0.46-0.9, P < 0.01) and a nonsignificant risk reduction for injuries overall (RR = 0.49, 95% CI = 0.13-1.8, P = 0.28). Exercise interventions were more effective in athletes with a history of sports injury than in those without.


CONCLUSIONS
On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports. Future research should focus on the conduct of comparative trials to identify the most appropriate and effective training components for preventing injuries in specific sports and populations.
Hübscher
Markus
M
Department of Sports Medicine, Goethe-University Frankfurt, Frankfurt, Germany. m.huebscher@sport.uni-frankfurt.de
Zech
Astrid
A
Pfeifer
Klaus
K
Hänsel
Frank
F
Vogt
Lutz
L
Banzer
Winfried
W
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000517:prevention & control; D001265:Athletic Injuries / Q000517:prevention & control*; D002648:Child; D002986:Clinical Trials as Topic; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000517:prevention & control; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D009424:Nervous System Physiological Phenomena; D011434:Proprioception; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult