Effects of neuromuscular training on dynamic balance ability in athletes: A systematic review and meta-analysis

Objectives: This study aimed to quantitatively analyze the effects of neuromuscular training (NMT) on dynamic balance in healthy athletes through a systematic review and meta-analysis of randomized controlled trials. Methods: Searches on six databases for randomized controlled trials examining the impact of NMT on athletes' balance ability. The search period extended from the inception of the database to March 16, 2024, languages are limited to Chinese and English. Review Manager 5.1 was used for literature quality assessment and data analysis. Stata 15.0 software was used for assessing publication bias, employing the clipping method, and conducting sensitivity analysis. The Grading of recommendations assessment development and evaluation (GRADE) was used to assess the certainty of evidence. Effect size (ES) was used to evaluate the impact effect of the results. Results: (1) Meta-analysis: A total of 7 papers met the inclusion criteria, and the meta-analysis indicated that NMT had a positive impact on the dynamic balance ability of the right (SMD = 0.74) and left (SMD = 0.70) lower limb of athletes, and a statistically significant difference was observed (p p < 0.01). Subgroup analysis revealed that NMT did not have a positive effect (p p > 0.05) on the right anterior (SMD = 0.35); However, it had a positive effect (p p < 0.05) on the right posteromedial (SMD = 1.22), right posterolateral (SMD = 0.82), right composite score (SMD = 0.79), left anterior (SMD = 0.38), left posteromedial (SMD = 1.19), left posterolateral (SMD = 0.57) and left composite score (SMD = 0.86). (2) Reporting bias: Funnel plot indicated evidence of publication bias, but there was no significant asymmetry in the funnel plot after trimming and filling. The results were not reversed, indicating the robustness of the combined results. (3) Sensitivity analysis: The results of the sensitivity analysis suggest that the data in this meta- analysis are relatively stable and credible. (4) Grading the evidence: Based on GRADE scale the certainty of evidence from the included studies was determined to be moderate. Conclusion: Neuromuscular training can enhance the dynamic balance ability of athletes on both the left and right sides. Therefore, neuromuscular training is an effective method for enhancing the unilateral dynamic balance ability of athletes.