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Neuromuscular Training for Sports Injury Prevention: A Systematic Review


Medicine & Science in Sports & Exercise: March 2010 - Volume 42 - Issue 3 - p 413-421
doi: 10.1249/MSS.0b013e3181b88d37
Clinical Sciences

Purpose: 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.

Conclusion: 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.

1Department of Sports Medicine, Goethe-University Frankfurt, Frankfurt, GERMANY; 2Department of Sports Science and Sports, University of Erlangen-Nuremberg, Erlangen, GERMANY; and 3Department of Sports Science, University of Darmstadt, Darmstadt, GERMANY

Address for correspondence: Markus Hübscher, Ph.D., Department of Sports Medicine, Goethe-University Frankfurt, Ginnheimer Landstraβe 39, 60487 Frankfurt, Germany; E-mail:

Submitted for publication April 2009.

Accepted for publication July 2009.

©2010The American College of Sports Medicine