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Neuromuscular Training for Rehabilitation of Sports Injuries: A Systematic Review


Medicine & Science in Sports & Exercise: October 2009 - Volume 41 - Issue 10 - p 1831-1841
doi: 10.1249/MSS.0b013e3181a3cf0d
Clinical Sciences

Purpose: Although proprioceptive and neuromuscular exercises are considered to be part and parcel of rehabilitation programs after sport injuries, there is an uncertainty regarding the effectiveness of corresponding training interventions. The objective of this review was to evaluate the effectiveness of proprioceptive and neuromuscular training (PT/NT) for the treatment of ankle, knee, and shoulder joint injuries.

Methods: Two independent reviewers performed a literature search in various databases and reference lists of articles. Data of included trials were then extracted, and methodological quality was assessed by using predetermined forms.

Results: Fifteen trials met the inclusion criteria. PT/NT was effective at increasing functionality as well as at decreasing the incidence of recurrent injuries and "giving way" episodes after ankle sprains and in conservative treatment of anterior cruciate ligament injuries. However, conflicting results or no efficacy of training were reported for static postural control, joint position sense, neuromuscular control, joint laxity, and lower extremity strength. No study that examined PT/NT after shoulder injuries was found.

Conclusions: From this review, it can be concluded that proprioceptive and neuromuscular interventions after ankle and knee joint injuries can be effective for the prevention of recurrent injuries and the improvement of joint functionality.

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

Author for correspondence: Astrid Zech, Ph.D., Institute of Sports Science and Sports, Friedrich-Alexander-University, Gebbertstr. 123b, 91058 Erlangen, Germany; E-mail:

Submitted for publication January 2009.

Accepted for publication March 2009.

©2009The American College of Sports Medicine