Neuromuscular training for preventing knee injuries in female team athletes: a meta-analysis

OBJECTIVE: To evaluate the efficacy of neuromuscular training (NMT) in preventing knee injuries in female team sport athletes and identify dose-response relationships with intervention complexity, compliance, and session parameters. METHODS: This review followed the PRISMA 2020 guidelines. Randomized controlled trials on NMT for injury prevention in female team-sport athletes were retrieved from PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library up to December 2024. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models depending on heterogeneity. Subgroup analyses examined compliance, session duration, training frequency, and NMT components. CONCLUSION: NMT reduced knee injury risk in female team sport athletes, with compliance ≥75% indispensable. ≥15-minute sessions delivered 2-3 times weekly can optimise the outcomes. Meanwhile, clinical implementation should prioritize coach-led adherence strategies and evidence-based programs such as FIFA 11+ injury prevention programme (FIFA 11+). Finally, standardising exposure metrics and incorporating sensor-based compliance tracking will enhance scalability.