{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:17:39Z","timestamp":1787944659503,"version":"build-2784847793"},"reference-count":86,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sports-related knee injuries are common and may cause pain, joint damage, reduced sport participation, and long-term physical activity limitations. Although neuromuscular training (NMT) is widely used for injury prevention, whether its effectiveness is moderated by age or intervention characteristics remains unclear. This systematic review and meta-analysis evaluated the effectiveness of NMT for preventing sports-related knee injuries and examined the influence of age and training characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, The Cochrane Library, and EBSCO (SPORTDiscus) were searched from inception to September 30, 2025. Thirty studies were included following PRISMA guidelines. Random-effects meta-analysis, subgroup analyses, meta-regression, heterogeneity assessment, and risk-of-bias assessment using RoB 2 and ROBINS-I were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty studies were included. NMT significantly reduced knee injury risk in athletes (effect estimate\u202f=\u202f0.670, 95% CI: 0.547\u20130.820,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), with moderate heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f58.5%). Age subgroup analyses showed protective effects in athletes aged &amp;gt;18\u202fyears (effect estimate\u202f=\u202f0.566) and \u226418\u202fyears (effect estimate\u202f=\u202f0.718), with no significant between-subgroup difference. Meta-regression did not identify study-level moderation by mean age or female proportion. Interventions incorporating landing-stabilization, plyometric, core, agility, or lower-limb strength training showed significant preventive effects, although between-subgroup differences for individual components were not significant. Multicomponent programs (\u22653 components) were associated with significant risk reduction (effect estimate\u202f=\u202f0.643), whereas programs with &amp;lt;3 components were not; the between-subgroup difference was significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.045). Standardized programs significantly reduced injury risk (effect estimate\u202f=\u202f0.592), whereas non-standardized programs did not. Dose-related analyses suggested that 15\u201320\u202fmin\/session, 2\u20133 sessions\/week, and durations &amp;gt;25\u202fweeks may represent relatively stable and clinically interpretable patterns, although dose-related between-subgroup differences were not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NMT significantly reduces knee injury risk in athletes, with no clear evidence of age-related moderation. Structured, multicomponent, and standardized programs may have practical advantages, but findings on program structure, components, standardization, and dose should be interpreted cautiously because these analyses were exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO, under registration number CRD420261327352.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1822715","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:40:20Z","timestamp":1787942420000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-moderating effects and training characteristics of neuromuscular training for preventing knee injuries: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Youwei","family":"Yao","sequence":"first","affiliation":[{"name":"School of Strength and Conditioning, Shenyang Sport University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Niu","sequence":"additional","affiliation":[{"name":"School of Strength and Conditioning, Shenyang Sport University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1016\/j.injury.2023.04.035","article-title":"The epidemiology of sports and leisure-related injury hospitalisations in Queensland: a five-year review","volume":"54","author":"Brimm","year":"2023","journal-title":"Injury"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.jsams.2006.03.002","article-title":"The public health impact of injury during sport and active recreation","volume":"9","author":"Finch","year":"2006","journal-title":"J Sci Med Sport"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e082984","DOI":"10.1136\/bmjopen-2023-082984","article-title":"Epidemiology of adverse events related to sports among community people: a scoping review","volume":"14","author":"Hirata","year":"2024","journal-title":"BMJ Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jsams.2024.03.001","article-title":"Estimating the cost of sports injuries: a scoping review","volume":"27","author":"Turnbull","year":"2024","journal-title":"J Sci Med Sport"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1177\/0363546508314400","article-title":"Epidemiology of knee injuries among boys and girls in US high school athletics","volume":"36","author":"Ingram","year":"2008","journal-title":"Am J Sports Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1136\/bjsports-2013-092538","article-title":"The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials","volume":"48","author":"Lauersen","year":"2014","journal-title":"Br J Sports Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1136\/bjsm.2007.035360","article-title":"Epidemiology of knee injuries among adolescents: a systematic review","volume":"42","author":"Louw","year":"2008","journal-title":"Br J Sports Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1590\/1413-78522014220300475","article-title":"Common injuries in athletes' knee: experience of a specialized center","volume":"22","author":"Nicolini","year":"2014","journal-title":"Acta Ortop Bras"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1177\/0363546519844481","article-title":"Secondary meniscal tears in patients with anterior cruciate ligament injury: relationship among operative management, osteoarthritis, and arthroplasty at 18-year mean follow-up","volume":"47","author":"Hagmeijer","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1097\/jsm.0000000000001366","article-title":"Step it up to level up: after anterior cruciate ligament reconstruction, do individuals reach internationally recommended physical activity levels and how do these levels compare with uninjured controls? 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