年龄相关差异对神经肌肉训练预防运动员前交叉韧带损伤效果的影响：系统综述与Meta分析
简介
本系统评价与Meta分析纳入19项研究，评估神经肌肉训练（NMT）对不同年龄段运动员前交叉韧带（ACL）损伤的预防效果。结果显示，NMT可显著降低ACL损伤风险（OR=0.456，95% CI: 0.331-0.627）；亚组分析中，<18岁运动员效果显著（OR=0.365），≥18岁运动员效果不显著（OR=0.567），但组间差异无统计学意义。Meta回归…
英文摘要
OBJECTIVE: Anterior cruciate ligament (ACL) injuries are common in competitive sports and may lead to long-term functional impairment and substantial career burden. Neuromuscular training (NMT) has been proposed to reduce the risk of ACL injury; however, whether its preventive effectiveness differs by age remains controversial. This systematic review and meta-analysis quantitatively evaluated the protective effects of NMT across different age groups. METHODS: Five databases were systematically searched for studies evaluating the effect of NMT on the incidence of ACL injury. Pooled effects were synthesized using random-effects models and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Age-stratified subgroup analyses and meta-regression (using the study-level mean age as a continuous moderator) were conducted to explore potential age-related differences in effectiveness. RESULTS: A total of 19 studies met the inclusion criteria and contributed to the primary meta-analysis. The random-effects meta-analysis showed that NMT significantly reduced ACL injury risk (OR = 0.456, 95% CI: 0.331-0.627, p < 0.001; I 2 = 14.9%). In age-stratified analyses, the effect was significant in athletes aged <18 years (OR = 0.365, 95% CI: 0.252-0.529) but not in those aged ≥18 years (OR = 0.567, 95% CI: 0.291-1.104); the between-subgroup difference was not statistically significant (p = 0.258). Meta-regression indicated a positive association between mean age and effect size (β = 0.099, p = 0.027), suggesting that the protective effect of NMT attenuated with increasing age. Findings were consistent in female-only studies (OR = 0.490, 95% CI: 0.343-0.699, p < 0.001). No significant publication bias was detected (Egger's test p = 0.126). CONCLUSION: NMT significantly reduces the risk of ACL injury in athletes. Current evidence suggests that its protective effect may be greater in younger athletes and may attenuate with increasing age. As the available evidence is derived predominantly from female cohorts, further research is needed to clarify whether a similar age-related pattern exists in male athletes. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251218902, identifier: CRD420251218902.