Effects of a 4-week neuromuscular balance training program on knee proprioception, functional performance, and landing errors in national-level female wrestlers: a randomized controlled trial

BACKGROUND: Neuromuscular and balance-based training programs have been shown to reduce lower extremity injury risk by improving biomechanical and sensorimotor control. However, randomized controlled trials examining the effects of short-term interventions on landing mechanics (LESS-RT) and related sensorimotor outcomes in national-level female wrestlers are limited. METHODS: This parallel-group randomized controlled trial was conducted in a supervised training environment integrated with regular wrestling practice. Twenty-two female wrestlers were randomly assigned to an intervention group (n = 11) or a control group (n = 11). The intervention consisted of a 4-week neuromuscular balance-based training program. Landing mechanics were assessed using LESS-RT. Secondary outcomes included knee proprioception via joint position reproduction, force sense error using a Pressure Biofeedback Unit, static balance (Single-Leg Stance Test), and functional performance (Single-Leg Hop Test Battery). RESULTS: The intervention group demonstrated significant improvements in landing mechanics, with LESS-RT decreasing from 13.54 ± 1.29 to 9.18 ± 0.98 (p < < 0.001). Improvements were also observed in knee proprioception, static balance, and single-leg functional performance. Between-group comparisons favoured the intervention group across all outcome measures. CONCLUSION: A short-term neuromuscular balance training program leads to meaningful improvements in landing mechanics and associated sensorimotor functions, suggesting potential for reducing knee injury risk in female wrestlers. TRIAL REGISTRATION: ClinicalTrials.gov, NCT07504666, registered on March 18, 2026.