Neuromuscular conditioning strategies and their effectiveness in preventing injuries in soccer players: a systematic review

Background The objective of this review is to define the advances in neuromuscular training and its effectiveness in preventing injuries in soccer. Methods Eligibility criteria were randomized clinical trials on the research topic. To evaluate the number of available studies, a population comprised of soccer players who performed physical training using neuromuscular control and its effect on injury prevention was established. The articles were selected according to the 2020 PRISMA declaration, obtained from databases such as PubMed, MEDLINE, Embase, CENTRAL, and Web of Science. For the research design, a research question was posed to define the search: What are the advances in neuromuscular training and its effectiveness in preventing injuries in soccer? Risk of bias of individual studies was measured using the RoB2 risk of bias tool. The results were summarized in Excel spreadsheets based on the population and interventions performed, and a descriptive analysis of the results obtained regarding training progress and its role in injury prevention was performed. Results The studies included in the selection were those focused on reducing injuries in soccer; a total of 15 randomized controlled trials met the inclusion criteria. Three studies were excluded because they did not focus on reducing injuries, although they did improve skills and knowledge. This study focuses on the importance of establishing injury prevention strategies in soccer, considering the different types and varieties of physical training currently used due to the high injury rate. Strength and balance training reduced ankle instability and kinesiophobia ( P < 0.001). The additional post-FIFA 11+ exercise program significantly reduced the total number of injuries ( P = 0.001) and the initial injury incidence ( P = 0.003) compared to the pre-FIFA 11+ training program. Lower extremity injuries for the M11+, F11+, and control groups were 2.00, 5.79, and 7.55 per 1,000 hours of training, respectively, with M11+ having the lowest injury incidence ( P = 0.02). A significant reduction in the risk of anterior cruciate ligament (ACL) injury was observed after the FIFA 11+ program compared to the pre-program rate ( P = 0.031). The extended knee control training group had a 29% lower incidence of injuries than the comparison group ( P = 0.083) (incidence ratio 0.71; 95% CI 0.52 to 0.98). The extended knee control program included a running warm-up and six exercises focused on muscle strength and neuromuscular control, with 10 variations. Discussion Limitations of the evidence show poor program adherence and limited research on the causes of dropouts and their relationship to injuries. Data are based on heterogeneous populations to integrate results on a large scale; However, more high-quality research in specific populations is needed. Interpretation of the role of physical training in injury prevention yielded significantly high results, highlighting the importance of its implementation. Factors that have a negative effect on injuries, such as training discontinuation, were also observed. Systematic Review Registration identifier 1140426.