The Effect of Integrative Neuromuscular Training on Physical Performance and Skills in Young Athletes: A Systematic Review

Abstract

Aim: Although success in sports depends on many factors, it is generally attributed to the development of physical performance parameters and specific skill level. It is imperative that these components, which are the leading indicators of sportive success, be developed with scientific training methods. Previous systematic reviews have evaluated the effects of BNA on injury prevention in general. However, there is a lack of studies in the literature evaluating the effect of BNA on physical performance and specific skill. The purpose of this review is to determine the effectiveness of studies reporting the effects of BNA added to the routine training program on physical performance and specific skills in young athletes, to present the results in a systematic way and to make suggestions for future research.

Methods: The current study used the systematic review method and acted according to the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Selected keywords were systematically searched in 4 international electronic databases (PubMed, Scopus, Web of Science and EBSCO Medline) in English. Keywords scanned are: (“integrative* neuromuscular training” OR “neuromuscular training” OR “concurrent training” OR “combined training” OR “plyometric training” OR “strenght* training” OR “sprint* training” OR “agility* training” OR "balance training" OR "dynamic stability training" OR "coordination* training" OR "fatigue endurance training") NOT ("older*" OR "elder*" OR "adult*"). Broadcasts were limited to January 2018-June 2022, and the last scan was carried out on 26 June 2022.

Results: According to the keywords, 1846 publications were reached at the beginning and 943 studies that were stated to be duplicates were eliminated. After the titles and abstracts of the remaining publications were evaluated independently by two authors, 816 publications that did not meet the study criteria were removed. Among the remaining 87 studies, the full text of 8 publications could not be reached. When the full texts of 79 publications were examined, 60 studies were excluded because they did not meet the eligibility criteria of the current research. The remaining 19 studies were included in this systematic review. In addition, the references (n=902) of the 19 included articles were also reviewed for potential relevance, and 1 more study was added to the existing research. As a result, 20 studies were analyzed in the systematic review.

Conclusion: It has been demonstrated that BNA applied for at least 4 weeks after the general warm-up and at least 2 sessions per week can generally improve performance and skill in the pediatric population. However, it has been shown that combined exercises have a greater effect on performance compared to the single component exercise variant. Within the study findings, it is recommended that coaches and athletes include all skill-integrated sub-component BNA in their normal training programs, taking into account the specificity of the sport in terms of improving performance and skill. Researchers are encouraged to examine the effect of all subcomponent BNA combined with fatigue resistance and dexterity, particularly on speed, endurance, and strength performance in the female population.

Keywords

• Integrative Neuromuscular Training
• Physical Performance
• Skills

Genç Sporcularda Bütünleştirici Nöromüsküler Antrenmanın Fiziksel Performans ve Beceri Üzerindeki Etkisi: Sistematik Bir Derleme Çalışması

Abstract

Amaç: Sporda başarı birçok faktöre bağlı olmakla birlikte genel olarak fiziksel performans parametreleri ve spesifik beceri düzeyinin gelişmiş olmasına atfedilir. Sportif başarının öncü göstergelerinden olan bu bileşenlerin bilimsel antrenman yöntemleriyle geliştirilmesi zorunludur. Önceki sistematik incelemelerde BNA’nın genel olarak yaralanma önleme üzerindeki etkileri değerlendirilmiştir. Fakat, literatürde BNA’nın fiziksel performans ve spesifik beceriye etkisini değerlendiren çalışma eksikliği vardır. Bu derlemenin amacı, rutin antrenman programına ilave edilen BNA’nın genç sporcularda fiziksel performans ve spesifik beceriye olan etkilerini rapor eden çalışmaların etkinliğini belirleyerek sonuçları sistematik bir şekilde sunmak ve gelecek araştırmalar için önerilerde bulunmaktır.

Materyal ve Metot: Mevcut çalışmada sistematik derleme yöntemi kullanılmış ve güncellenmiş PRISMA (Sistematik İncelemeler ve Meta-Analizler için Tercih Edilen Raporlama Öğeleri) kılavuzuna göre hareket edilmiştir. Seçili anahtar kelimeler İngilizce dilde uluslararası 4 elektronik veri tabanında (PubMed, Scopus, Web of Science ve EBSCO Medline) sistematik biçimde taranmıştır. Taranan anahtar kelimeler şunlardır: (“integrative* neuromuscular training” OR “neuromuscular training” OR “concurrent training” OR “combined training” OR "plyometric training" OR "strenght* training" OR "sprint* training" OR "agility* training" OR "balance training" OR "dynamic stability training" OR "coordination* training" OR "fatigue endurance training") NOT ("older*" OR "elder*" OR "adult*"). Yayınlar Ocak 2018-Haziran 2022 aralığı ile sınırlı tutulmuş ve son tarama 26 Haziran 2022’de gerçekleştirilmiştir.

Bulgular: Anahtar kelimelere göre başlangıçta 1846 yayına ulaşılmış ve yinelendiği belirtilen 943 çalışma elenmiştir. Kalan yayınların başlık ve özet kısımları iki yazar tarafından bağımsız olarak değerlendirildikten sonra çalışma kriterlerini karşılamayan 816 yayın daha kaldırılmıştır. Kalan 87 çalışma içerisinde de 8 yayının tam metnine ulaşılamamıştır. 79 yayının tam metinleri incelendiğinde ise 60 çalışma mevcut araştırmanın uygunluk kriterlerini karşılamadığından çıkarılmıştır. Kalan 19 çalışma bu sistematik derlemeye dahil edilmiştir. Ayrıca, dahil edilen 19 makalenin referansları da (n=902) potansiyel uygunluk açısından incelenmiş ve 1 çalışma daha mevcut araştırmaya eklenmiştir. Sonuç olarak, 20 çalışma sistematik derleme kapsamında analiz edilmiştir.

Sonuç: Genel ısınma sonrası en az 4 hafta süreyle ve haftada en az 2 seans uygulanan BNA’nın pediatrik popülasyonda performans ve beceriyi genel olarak geliştirebildiği ortaya konmuştur. Bununla birlikte, tek bileşenli egzersiz çeşidine kıyasla kombine uygulamaların performans üzerinde daha büyük bir etkiye sahip olduğu gösterilmiştir. Çalışma bulguları dahilinde, antrenörler ve sporculara performans ve beceriyi geliştirebilme açısından spor dalının spesifikliği de göz önünde bulundurularak beceri ile bütünleştirilmiş tüm alt bileşenli BNA’yı normal antrenman programlarına dahil etmeleri tavsiye edilir. Araştırmacılara ise kadın popülasyonda yorgunluk direnci ve beceri ile birleştirilmiş tüm alt bileşenli BNA’nın özellikle sürat, dayanıklılık ve kuvvet performansı üzerindeki etkisini incelemeleri önerilir.

Keywords

• Bütünleştirici Nöromüsküler Antrenman
• Fiziksel Performans
• Beceri

References

1. Aktepe, K. (2013). Sporda beceri. Ankara: Nobel Akademik Yayıncılık.
2. Aloui, G., Hermassi, S., Bartels, T., Hayes, L. D., Bouhafs, E. G., Chelly, M. S. & Schwesig, R. (2022). Combined plyometric and short sprint training in u-15 male soccer players: effects on measures of jump, speed, change of direction, repeated sprint, and balance. Frontiers in Physiology, 13, 1-9. DOI: 10.3389/fphys.2022.757663.
3. Aloui, G., Hermassi, S., Khemiri, A., Bartels, T., Hayes, L. D., Bouhafs, E. G., … Schwesig, R. (2021). An 8-week program of plyometrics and sprints with changes of direction improved anaerobic fitness in young male soccer players. International Journal of Environmental Research and Public Health, 18(19), 1-13. DOI: 10.3390/ijerph181910446.
4. Arede, J., Fernandes, J., Moran, J., Leite, N., Romero-Rodríguez, D. & Madruga, M. (2021). Effects of an integrative neuromuscular training protocol vs. FIFA 11+ on sprint, change of direction performance and inter-limb asymmetries in young soccer players. International Journal of Sports Science & Coaching, 17(1), 54-62. DOI:10.1177/17479541211011438.
5. Balaban, Ö., Nacır, B., Erdem, H. R. & Karagöz, A. (2009). Denge fonksiyonunun değerlendirilmesi. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 12, 133-139.
6. Bedoya, A. A., Miltenberger, M. R. & Lopez, R. M. (2015). Plyometric training effects on athletic performance in youth soccer athletes: a systematic review. Journal of Strength and Conditioning Research, 29(8), 2351-2360. DOI: 10.1519/JSC.0000000000000877.
7. Behm, D. G. & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. European Journal of Applied Physiolpgy, 111(11), 2633-2651. DOI: 10.1007/s00421-011-1879-2.
8. Bergkamp, T. L. G., Niessen, A. S. M., den Hartigh, RJ. R., Frencken, W. G. P. & Meijer, R. R. (2019). Methodological issues in soccer talent identification research. Sports Medicine (Auckland N.Z.), 49(9), 1317-1335. DOI: 10.1007/s40279-019-01113-w.

9. Bompa, T. O. & Buzzichelli, C. A. (2021). Dönemleme antrenman kuramı ve yöntemi (Çev. T. Bağırgan). 6. Baskı. Ankara: Spor Yayınevi ve Kitabevi.
10. Bouteraa, I., Negra, Y., Shephard, R. J. & Chelly, M. S. (2020). Effects of combined balance and plyometric training on athletic performance in female basketball players. Journal of Strength and Conditioning Research, 34(7), 1967-1973. DOI: 10.1519/JSC.0000000000002546.
11. Brown, L. E. & Ferrigno, V. A. (2018). Sprint, çeviklik, çabukluk antrenmanı (Çev. T. Bağırgan). Ankara: Spor Yayınevi ve Kitabevi.
12. Buchheit, M., Mendez-Villanueva, A., Quod, M., Quesnel, T. & Ahmaidi, S. (2010). Improving acceleration and repeated sprint ability in well-trained adolescent handball players: speed versus sprint interval training. International Journal of Sports Physiology and Performance, 5(2), 152-164. DOI: 10.1123/ijspp.5.2.152.
13. Caldemeyer, L. E., Brown, S. M. & Mulcahey, M. K. (2020). Neuromuscular training for the prevention of ankle sprains in female athletes: a systematic review. The Physician and Sportsmedicine, 48(4), 363-369. DOI: 10.1080/00913847.2020.1732246.
14. Cattuzzo, M. T., Dos Santos Henrique, R., Ré, A. H., de Oliveira, I. S., Melo, B. M., de Sousa Moura, M., … Stodden, D. (2016). Motor competence and health related physical fitness in youth: a systematic review. Journal of Science and Medicine in Sport, 19(2),123-129. DOI: 10.1016/j.jsams.2014.12.004.
15. Dardouri, W., Selmi, M. A, Haj Sassi, R., Gharbi, Z., Rebhi, A. & Moalla, W. (2014). Reliability and discriminative power of soccer-specific field tests and skill index in young soccer players. Science & Sports, 29(2), 88-94. DOI: 10.1016/j.scispo.2013.06.004.
16. De Morton, N.A. (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. The Australian Journal of Physiotheraphy, 55(2), 129-133. DOI: 10.1016/s0004-9514(09)70043-1.
17. Faigenbaum, A. D., Myer, G. D., Farrell, A., Radler, T., Fabiano, M., Kang, J., … Hewett, T. E. (2014). Integrative neuromuscular training and sex-specific fitness performance in 7-year-old children: an exploratory investigation. Journal of Athletic Training, 49(2), 145-153. DOI: 10.4085/1062-6050-49.1.08.
18. Fathi, A., Hammami, R., Moran, J., Borji, R., Sahli, S. & Rebai, H. (2019). Effect of a 16-week combined strength and plyometric training program followed by a detraining period on athletic performance in pubertal volleyball players. Journal of Strength and Conditioning Research, 33(8), 2117-2127. DOI: 10.1519/JSC.0000000000002461.
19. Figueira, B., Gonçalves, B., Abade, E., Paulauskas, R., Masiulis, N., Kamarauskas, P., & Sampaio, J. (2021). Repeated sprint ability in elite basketball players: the effects of 10 × 30 m vs. 20 × 15 m exercise protocols on physiological variables and sprint performance. Journal of Human Kinetics, 77, 181-189. DOI: 10.2478/hukin-2020-0048.
20. Fischetti, F., Cataldi, S. & Greco, G. A. (2019). A combined plyometric and resistance training program improves fitness performance in 12 to 14-years-old boys. Sport Sciences for Health, 15, 615–621. DOI: 10.1007/s11332-019-00560-2.
21. Foley, N. C., Teasell, R. W., Bhogal, S. K. & Speechley, M. R. (2003). Stroke rehabilitation evidence-based review: methodology. Topics in Stroke Rehabilitation, 10(1), 1-7.
22. Fort-Vanmeerhaeghe, A., Romero-Rodriguez, D., Lloyd, R. S., Kushner, A. B. S. & Myer, G. D. (2016). Integrative neuromuscular training in youth athletes. Part ıı: strategies to prevent injuries and improve performance. Strength and Conditioning Journal, 38(4), 9-27. DOI: 10.1519/SSC.0000000000000234.
23. Gäbler, M., Prieske, O., Hortobágyi, T. & Granacher, U. (2018). The effects of concurrent strength and endurance training on physical fitness and athletic performance in youth: a systematic review and meta-analysis. Frontiers in Physiology, 7(9), 1-28. DOI: 10.3389/fphys.2018.01057.
24. Gallahue, D. L., Ozmun, J. C. & Goodway, J. D. (2020). Motor gelişimi anlamak. D.S. Özer ve A. Aktop, (Ed.). (7. Basımdan çeviri). Ankara: Nobel Akademik Yayıncılık.
25. Glaise, P., Morel, B., Rogowski, I., Cornu, B. & Martin, C. (2022). Influence of repeated-sprint ability on the in-game activity profiles of semiprofessional rugby union players according to position. Frontiers in Sports and Active Living, 25(4), 1-9. DOI: 10.3389/fspor.2022.857373.
26. Hammami, M., Gaamouri, N., Aloui, G., Shephard, R. & Chelly, M. S. (2019). Effects of combined plyometric and short sprint with change-of-direction training on athletic performance of male u15 handball players. Journal of Strength and Conditioning Research, 33(3), 662-675 DOI: 10.1519/JSC.0000000000002870.
27. Hammami, M., Gaamouri, N., Ramirez-Campillo, R., Shephard, R. J., Bragazzi, N. L., Chelly, M., … Gaied, S. (2021). Effects of high-intensity interval training and plyometric exercise on the physical fitness of junior male handball players. European Review for Medical and Pharmacological Sciences, 25(23), 7380-7389. DOI: 10.26355/eurrev_202112_27434.
28. Hilska, M., Leppänen, M., Vasankari, T., Aaltonen, S., Raitanen, J., Räisänen, A. M., … Pasanen, K. (2021). Adherence to an ınjury prevention warm-up program in children's soccer-a secondary analysis of a randomized controlled trial. International Journal of Environmental Research and Public Health, 18(24), 1-12. DOI: 10.3390/ijerph182413134.
29. Hrysomallis, C. (2011). Balance ability and athletic performance. Sports Medicine, 41(3), 221-232. DOI: 10.2165/11538560-000000000-00000.
30. Kean, C. O., Behm, D. G. & Young, W. B. (2006). Fixed foot balance training increases rectus femoris activation during landing and jump height in recreationally active women. Journal of Sports Science & Medicine, 5(1), 138–148.
31. Latorre Román, P. Á., Villar Macias, F. J. & García Pinillos, F. (2018). Effects of a contrast training programme on jumping, sprinting and agility performance of prepubertal basketball players. Journal of Sports Science, 36(7), 802-808. DOI: 10.1080/02640414.2017.1340662.
32. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6(7), 1-28. DOI: 10.1371/journal.pmed.1000100.
33. Lima, C. D., Ruas, C. V., Behm, D. G. & Brown, L. E. (2019). Acute effects of stretching on flexibility and performance: a narrative review. Journal of Science in Sport and Exercise, 1, 29-37. DOI: 10.1007/s42978-019-0011-x.
34. Makhlouf, I., Chaouachi, A., Chaouachi, M., Othman, A. B., Granacher, U. & Behm, D. G. (2018). Combination of agility and plyometric training provides similar training benefits as combined balance and plyometric training in young soccer players. Frontiers in Physiology,9, 1-17. DOI:10.3389/fphys.2018.01611.
35. Michailidis, Y., Tabouris, A. & Metaxas, T. (2019). Effects of plyometric and directional training on physical fitness parameters in youth soccer players. International Journal of Sports Physiologoy and Performance, 14(3), 392-398. DOI: 10.1123/ijspp.2018-0545.
36. Milanović, Z., Sporiš, G. & Weston, M. (2015). Effectiveness of high-intensity interval training (hit) and continuous endurance training for VO2max improvements: a systematic review and meta-analysis of controlled trials. Sports Medicine (Auckland N.Z.), 45(10), 1469-1481. DOI: 10.1007/s40279-015-0365-0.
37. Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A. & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 1-7. DOI: 10.1186/s12874-018-0611-x.
38. Myer, G. D., Faigenbaum, A. D., Ford, K. R., Best, T. M., Bergeron, M. F. & Hewett, T. E. (2011). When to initiate integrative neuromuscular training to reduce sports-related injuries and enhance health in youth? Current Sports Medicine Reports, 10(3), 155-166. DOI: 10.1249/JSR.0b013e31821b1442.
39. Nunes, A. C. C. A., Cattuzzo, M. T., Faigenbaum, A. D. & Mortatti, A. L. (2021). Effects of integrative neuromuscular training and detraining on countermovement jump performance in youth volleyball players. Journal of Strength and Conditioning Research, 35(8), 2242-2247. DOI: 10.1519/JSC.0000000000003092.
40. Ooi, C. H., Tan, A., Ahmad, A., Kwong, K. W., Sompong, R., Ghazali, K. A. M., … Thompson, M. W. (2009). Physiological characteristics of elite and sub-elite badminton players. Journal of Sports Sciences, 27(14), 1591-1599. DOI: 10.1080/02640410903352907.
41. Padrón-Cabo, A., Lorenzo-Martínez, M., Pérez-Ferreirós, A., Costa, P. B. & Rey, E. (2021). Effects of plyometric training with agility ladder on physical fitness in youth soccer players. International Journal of Sports Medicine, 42(10), 896-904. DOI: 10.1055/a-1308-3316.
42. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, D. C., ... Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical Research Ed.), (372), 1-9. DOI: 10.1136/bmj.n71.
43. Panagoulis, C., Chatzinikolaou, A., Avloniti, A., Leontsini, D., Deli, C. K., Draganidis, D., … Fatouros, I. G. (2020). In-season integrative neuromuscular strength training ımproves performance of early-adolescent soccer athletes. Journal of Strength and Conditioning Research, 34(2), 516-526. DOI: 10.1519/JSC.0000000000002938.
44. Pomares-Noguera, C., Ayala, F., Robles-Palazón, F. J., Alomoto-Burneo, J. F., López-Valenciano, A., Elvira, J. L. L., … De Ste Croix, M. (2018). Training effects of the fifa 11+ kids on physical performance in youth football players: a randomized control trial. Frontiers in Pediatrics,6, 1-9. DOI:10.3389/fped.2018.00040.
45. Sañudo, B., Sánchez-Hernández, J., Bernardo-Filho, M., Abdi, E., Taiar, R. & Núñez, J. (2019). Integrative neuromuscular training in young athletes, injury prevention, and performance optimization: a systematic review. Applied Sciences, 9, 1-18. DOI: 10.3390/app9183839.
46. Singh, J., Raza, S. & Mohammad, A. (2011). Physical characteristics and level of performance in badminton: a relationship study. Journal of Education and Practice, 2(5), 6-9.
47. Slimani, M., Chamari, K., Miarka, B., Del Vecchio, F. B. & Chéour, F. (2016). Effects of plyometric training on physical fitness in team sport athletes: a systematic review. Journal of Human Kinetics, 53, 231-247. DOI: 10.1515/hukin-2016-0026.
48. Streepey, J. W. & Angulo-Kinzler, R. M. (2002). The role of task difficulty in the control of dynamic balance in children and adults. Human Movement Science, 21(4), 423-438. DOI: 10.1016/s0167-9457(02)00104-5.
49. Sugimoto, D., Myer, G. D., Bush, H. M., Klugman, M. F., Medina McKeon, J. M. & Hewett, T. E. (2012). Compliance with neuromuscular training and anterior cruciate ligament injury risk reduction in female athletes: a meta-analysis. Journal of Athletic Training, 47(6), 714-723. DOI: 10.4085/1062-6050-47.6.10.
50. Trajković, N. & Bogataj, Š. (2020). Effects of neuromuscular training on motor competence and physical performance in young female volleyball players. International Journal of Environmental Research and Public Health, 17(5), 1-12. DOI: 10.3390/ijerph17051755.
51. Vitale, J. A., La Torre, A., Banfi, G. & Bonato, M. (2018). Effects of an 8-week body-weight neuromuscular training on dynamic balance and vertical jump performances in elite junior skiing athletes: a randomized controlled trial. Journal of Strength and Conditioning Research, 32(4), 911-920. DOI: 10.1519/JSC.0000000000002478.
52. Wang, Z. H., Pan, R. C., Huang, M. R. & Wang, D. (2022). Effects of integrative neuromuscular training combined with regular tennis training program on sprint and change of direction of children. Frontiers in Physiology, 10(13), 1-8. DOI: 10.3389/fphys.2022.831248.
53. Zeng, J., Liu, Q., Lei, Z., Sun., Z. & Wang, Y. (2022). Evaluation of integrated neuromuscular training on the recovery of joint injury: a protocol for systematic review and meta-analysis. Medicine, 101(5), 1-5. DOI: 10.1097/MD.0000000000028737.
54. Zghal, F., Colson, S. S., Blain, G., Behm, D. G., Granacher, U. & Chaouachi, A. (2019). Combined resistance and plyometric training are more effective than plyometric training alone for improving physical fitness of pubertal soccer players. Frontiers in Physiology, 10, 1-11. DOI:10.3389/fphys.2019.01026.
55. Zouhal, H., Abderrahman, A. B., Dupont, G., Truptin, P., Le Bris, R., Le Postec, E., … Bideau, B. (2019). Effects of neuromuscular training on agility performance in elite soccer players. Frontiers in Physiology, 10, 1-9. DOI: 10.3389/fphys.2019.00947.