Effects of neuromuscular training on tennis players: a systematic review and meta-analysis

To evaluate the effects of neuromuscular training (NT) on tennis performance metrics and determine the influence of age, training variables, and NT modalities.

This systematic review and meta-analysis involved a comprehensive search of PubMed, MEDLINE, Embase, Google Scholar, and Web of Science from inception to October 2024. Randomized controlled trials comparing neuromuscular training (NT) modalities-plyometric training (PT), resistance training (RT), and core stability training (CT)-with conventional training in tennis players were included, focusing on outcomes such as service velocity, service precision, agility, sprint performance, muscular strength, and power. Study quality was assessed with ROB2 tool, and evidence certainty graded through GRADE framework. Statistical synthesis was performed using R software (Version 4.4.1) with 'metafor' and 'gemtc' package, calculating Hedges' g effect sizes for outcomes.

Twenty-three studies involving 743 participants demonstrated that NT significantly improved service velocity (standardized mean difference [SMD] = 0.72; 95% CI, 0.47 to 0.99), agility (SMD = -0.64; 95% CI, -0.92 to -0.35), sprint performance (SMD = -0.33; 95% CI, -0.60 to -0.07), muscular strength (SMD = 0.57; 95% CI, 0.35 to 0.80), and power (SMD = 0.74; 95% CI, 0.41 to 1.08). However, no significant improvement was observed in service precision (SMD = 0.36; 95% CI, -0.13 to 0.86; p = 0.1126). Furthermore, age appeared to play a role, as players over 18 years showed greater gains in service velocity and power compared to their younger counterparts. Regarding training duration, interventions lasting over 12 weeks (> 24 sessions) did not provide additional benefits in agility and sprint performance. Interestingly, a training frequency of twice per week proved more effective than three times per week for improving sprint performance. When analyzing training modalities, PT emerged as the most effective for enhancing service velocity, sprint performance, and power. On the other hand, CT was found to be optimal for improving agility, while RT yielded the greatest gains in muscular strength.

NT effectively enhances key performance metrics in tennis players, with outcomes influenced by age, training variables, and NT modality. Coaches should tailor NT programs to the athlete's age and specific performance goals, emphasizing PT for explosive actions, CT for agility, and RT for strength.