The efficacy of neuromuscular training, with minimal or no equipment, on performance of youth athletes: A systematic review with meta-analysis

Objectives: To investigate the effects of neuromuscular training, with minimal or no equipment, on physical performance of youth athletes.Design: Systematic review with meta-analysis.Methods: MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SportDiscuss from inception to March/2022. Selection Criteria: youth athletes (15-24years), from Olympic team sports; used neuromuscular training 2-3 times/ week for, at least, 6 weeks; had a control group/usual training group; physical performance as outcomes; randomized controlled trial. Data Synthesis: Pooled estimate of standardized mean difference (SMD), and 95% confidence interval (95%CI).Results: Thirty-four studies (1111 participants) were included. Results showed that neuromuscular training improved power (SMD: 0.84 [95%CI: 0.58, 1.10]; n = 805; I2 = 64%), speed (SMD:-1.12 [95%CI:-1.68, -0.57]; n = 688; I2 = 90%) and agility (SMD:-1.21 [95%CI:-1.60,-0.83]; n = 571; I2 = 76%) compared to control group, but showed no difference between groups for muscle strength (Quadriceps SMD: 0.34 [95%CI: -0.02, 0.69]; n = 132; I2 = 0%, Hamstrings: SMD: 0.64 [95%CI:-0.04, 1.33]; n = 132; I2 = 71%), balance and flexibility. Conclusion: Clinically, neuromuscular training with minimal equipment may be useful for teams with limited resources to improve mainly athletes' power and agility, including those interventions that were designed to injury prevention. Future high-quality studies are likely to change these estimates.