Effects of school-based neuromuscular training on fundamental movement skills and physical fitness in children: a systematic review

OBJECTIVES: The primary purpose of this review was to clarify the effects of school-based integrated neuromuscular training (INT) on fundamental movement skills and physical fitness in children. The secondary purpose was to examine whether school-based INT intervention is superior to physical education (PE) intervention in enhancing motor skills and fitness. METHODS: A systematic literature search was performed in four electronic databases: PubMed, Web of Science, MEDLINE (EBSCOhost), and Cochrane Central Register of Controlled Trials. The last search was performed on December 21, 2021, and was limited to the English language, human species, and peer reviewed journals. Randomized controlled trials and cluster randomized controlled trials that examine the effects of school-based INT on motor skills and/or fitness in healthy children who were aged up to 14 years old were included. Moreover, studies included in this study should compare school-based INT-induced adaptions with those generated by PE interventions. Studies that involve athletic children and additional exercise training were excluded. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the study. RESULTS: Of 1,026 studies identified, seven original trials that meet the inclusion criteria were included in this review. Based on the PEDro scale, the PEDro score of seven studies was between six and eight points with a mean score of 5.29. Among the seven studies included in this study, four studies assessed physical fitness including muscular fitness (n = 4), speed (n = 3), endurance (n = 2), and flexibility (n = 2). Three studies examined the effects of INT on postural control and three studies explored its effects on motor skills. Concerning movement competence, significant and greater improvements in postural control and fundamental motor skills were observed following school-based INT interventions compared to PE intervention in two and three studies, respectively. Regarding physical fitness, neuromuscular training significantly increased muscular fitness, speed, endurance, flexibility in three, two, one, and one studies, respectively. However, only greater improvements in muscle fitness were observed in school-based INT group compared to PE group. The main limitations of this review were the lack of descriptions of training intensity and volume and the low methodological quality of the included studies. CONCLUSION: This review provides evidence that school-based neuromuscular training programs are superior to PE lessons in improving postural control, fundamental motor skills and muscular strength. Therefore, INT could be incorporated into traditional physical education classes in school. Trial registration number: CRD42022297349.