Effects of Single- Versus Multicomponent Neuromuscular Training on Balance Performance in Recreational Athletes: A Systematic Review and Network Meta-Analysis

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CONTEXT: Neuromuscular training (NMT) enhances balance among recreational athletes, but the effectiveness of single- versus multicomponent NMT remains unclear. OBJECTIVE: To compare the effectiveness of single- and multicomponent NMT on balance performance among recreational athletes and explore the influence of age, injury status, athletic demands, and frequency/length of training. EVIDENCE ACQUISITION: Five databases (Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PubMed, SPORTDiscus, and Web of Science) from inception to October 2024 for randomized controlled trials comparing single- versus multicomponent NMT with non-NMT controls. Random effects meta-analysis and network meta-analysis were conducted. EVIDENCE SYNTHESIS: Seventeen studies (n = 716 participants) were included. No significant differences in overall balance performance were found between single (standard mean difference [SMD]single: 0.15; 95% CI, -0.05 to 0.34) and multicomponent NMT (SMDmulti: 0.20; 95% CI, -0.01 to 0.41). Similar trends were observed in subgroup analysis: static (SMDsingle: 0.15; 95% CI, -0.10 to 0.40 vs SMDmulti: 0.08; 95% CI, -0.17 to 0.34) and dynamic balance test (SMDsingle: 0.30; 95% CI, -0.14 to 0.75 vs SMDmulti: 0.40; 95% CI, -0.09 to 0.88). Sensitivity analysis indicated multicomponent NMT significantly benefited injured adults (SMDmulti: 0.06; 95% CI, 0.02 to 0.09) and younger adults under 50 years (SMDmulti: 0.05; 95% CI, 0.03 to 0.08). CONCLUSIONS: While no overall difference was found between single- and multicomponent NMT, age and injury status influenced the outcomes. Tailored NMT protocols may optimize balance and prevent injuries in recreational athletes. PROSPERO (CRD42023391531).