The effects of integrative neuromuscular training on injury risk and athletic performance in athletes: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41645324 · doi:10.1186/s13102-026-01549-4
What was done
A systematic review and meta-analysis was conducted across nine databases through August 31, 2025, to assess the effects of Integrative Neuromuscular Training (INT) in athletes. The authors included 25 randomized controlled trials comprising 10,124 participants. Quality assessment was conducted using the Cochrane Risk of Bias Assessment Tool (ROB2), and evidence certainty was evaluated with GRADE. Pooled effect sizes were calculated using risk ratios (RR) for dichotomous injury outcomes and standardized mean differences (SMD) with Hedges' g for continuous athletic performance measures.
What was found
INT was associated with: - Reduced injury risk: RR = 0.73 (95% CI: 0.58 to 0.91, p = 0.004). - Improved jump performance: SMD = 0.88 (95% CI: 0.58 to 1.17, p < 0.001). - Improved sprinting ability: SMD = 0.75 (95% CI: 0.44 to 1.06, p < 0.001). - Improved change-of-direction ability: SMD = 0.97 (95% CI: 0.38 to 1.57, p = 0.001). - Improved dynamic balance: SMD = 0.91 (95% CI: 0.31 to 1.51, p = 0.003). Subgroup analyses indicated greater effectiveness in adult athletes (≥18 years), female athletes, football players, and protocols delivering ≥3 sessions per week or >30 minutes per session.
Why it matters
This review synthesizes evidence across more than 10,000 athletes, confirming that multi-component neuromuscular conditioning simultaneously reduces injury incidence while driving moderate-to-large gains in core physical performance capabilities.
Limits
Significant heterogeneity was present across most pooled outcomes. Methodological quality was limited, as the majority of included RCTs were classified under ROB2 as having "some concerns." Specific injury subtypes, detailed exercise programming protocols, and adherence rates were not reported in the abstract.
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