Association between dynamic balance and change‑of‑direction performance in athletes: A systematic review and three‑level meta‑analysis

Dynamic balance is considered relevant to change-of-direction (COD) performance in athletes, but evidence remains inconsistent. This systematic review and meta-analysis quantified this association and examined whether it varied by balance test direction, movement plane, COD angle, and sex. PubMed, Web of Science, Embase, Scopus, and Cochrane Library were searched from inception to 31 December 2025. Methodological quality was assessed using the Joanna Briggs Institute checklist for analytical cross-sectional studies. Thirteen observational studies involving 722 athletes were included. A small but significant negative correlation was observed between dynamic balance and COD completion time (r = -0.217, p = 0.006). Heterogeneity was substantial and mainly attributable to between-study differences (I² = 65.9%). Balance test direction significantly moderated the association (p < 0.001). Significant small negative correlations were observed for frontal-plane (r = -0.277, p = 0.002) and 45° diagonal-plane balance (r =  -0.192, p = 0.023), but not sagittal-plane balance. Tests limited to anterior, posteromedial, and posterolateral directions showed a medium correlation (r =  -0.329, p < 0.001). COD angle and sex were not significant moderators. These findings suggest that dynamic balance should be assessed alongside direct COD testing and other relevant capacities.