Neuromuscular Training for Sports
Injury Prevention: A Systematic Review

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:     Frankp@chiro.org

FROM:   Med Sci Sports Exerc. 2010 (Mar); 42 (3): 413—421

Hübscher M, Zech A, Pfeifer K, Hänsel F, Vogt L, Banzer W.

Department of Sports Medicine,
Goethe-University Frankfurt,
Frankfurt, Germany.
m.huebscher@sport.uni-frankfurt.de

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This systematic review conducted in Germany underscores the value of neuromuscular training in preventing sports injuries. They concluded that “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.” The pivoting sports included basketball, hockey, handball, volleyball, soccer and floorball. Multiple high quality studies now support the use of training programs to improve proprioception and the research further supports that this proprioceptive improvement translates to reduced risk of sports associated injuries. [2–4] The benefit is even greater for those with a previous history of sports injury. 2.   Balance Improvements in Female High School Basketball Players       After a 6-week Neuromuscular-training Program       J Sport Rehabil 2009 (Nov); 18 (4): 465–481       Athletic Training Program, A.T. Still University, Mesa, AZ, USA 3.   Effect of Proprioception Training on Knee Joint Position Sense       in Female Team Handball Players       Br J Sports Med 2008 (Jun); 42 (6): 472–476 ~ Epub 2008 Apr 7       Faculty of Physical Education and Sports Science, Semmelweis University,       Budapest, Hungary. gergelypanics@gmail.com 4.   Neuromuscular Control of Trunk Stability:       Clinical Implications for Sports Injury Prevention       J Am Acad Orthop Surg 2008 (Sep); 16 (9): 497–505       Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA

The Abstract

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.

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