Abstract / Summary
Core stability training (CST) is widely used in athletic conditioning, but evidence for its effects on lower-limb performance remains inconsistent across performance domains and assessment methods. This review evaluated the effects of CST on lower-limb performance in athletes. This systematic review and meta-analysis followed PRISMA 2020. Five databases were searched from inception to 7 March 2026, and full-text eligibility was re-evaluated using prespecified athlete and randomized-trial criteria. Risk of bias was assessed with RoB 2 at the outcome-specific result level. Random-effects models were supplemented by REML/Hartung-Knapp analyses, prediction intervals, influence analyses, construct-restricted sensitivity analyses, and targeted change-score sensitivities. Certainty was assessed using GRADE. Forty-four randomized controlled trials involving 1,301 analyzed athletes were included. Primary analyses favoured CST for countermovement jump (CMJ), vertical jump (VJ), sport-specific strength/power, Illinois agility, T-test, other agility/change-of-direction outcomes, and Star Excursion Balance Test (SEBT). However, CMJ and Illinois findings were sensitive to alternative modelling or influence analyses, and the Hartung-Knapp interval for sport-specific strength/power crossed the null. No clear pooled effects were found for standing long jump (SLJ), 10-m, 20-m, or exact 30-m sprint, Y-Balance Test, other dynamic balance, or static balance. Certainty was low for VJ and T-test and very low for all other outcomes. CST may improve selected aspects of lower-limb performance, particularly VJ, some agility/change-of-direction tasks, SEBT, and selected sport-specific explosive outcomes, but effects are not consistent across domains. Sprint-related benefits were not supported after eligibility and construct corrections. Given low to very low certainty and substantial heterogeneity in several outcomes, CST is best considered a complementary rather than stand-alone component of athletic training. PROSPERO CRD420251238579.