Effect of neuromuscular training strategies on injury rates in adolescent males playing sport - a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to investigate the effectiveness of neuromuscular training strategies (NMTS) on injury rates in adolescent male athletes. Nineteen databases were searched from inception to August 2025. Randomised controlled trials (RCT) investigating the effectiveness of NMTS (13-18-year-old male athletes) were included. The JBI tool for RCTs was used for critical appraisal. Meta-analyses (inverse statistical method, random effects, 95% confidence interval (CI)) with pooled point estimate of relative risk (RR) was used for data synthesis. Eighteen studies (8480 participants) were included. Multifaceted warm-up NMTS (RR: 0.69 [95% CI: 0.55, 0.87]; n = 7521; I2 = 80%) reduced number of injuries (moderate certainty). Strength training (RR: 0.13 [95% CI: 0.02, 0.83]; n = 72; I2 = 0%) reduced incidence (moderate certainty). The effectiveness of eccentric thigh training was inconclusive. Functional Movement Screening training (RR: 0.25 [95% CI: 0.08, 0.82]; n = 71) was described narratively and reduced number of injuries after 12 weeks (high certainty). Overall NMTS reduced number of non-contact (RR: 0.47 [95% CI: 0.34, 0.65]; n = 883; I2 = 41%) injuries and severity. Multifaceted warm-up NMTS reduced injury rates. NMTS reduced number of non-contact- and severity of injuries overall. The varying effects and timeframes should be considered when implementing injury prevention strategies. PROSPERO (CRD42022327047).