Effects of neuromuscular training on physical and tennis-specific performance in youth and young adult male tennis players: A systematic review and meta-analysis

Background: Neuromuscular training (NMT) is used to improve physical fitness and tennis-specific performance, but broad outcome classifications, mixed populations, and insufficient separation of accuracy and sprint outcomes have limited previous reviews. This systematic review and meta-analysis evaluated the effects of NMT in male tennis players, particularly youth and young adults. Methods: Five databases were searched from inception to 1 January 2026; the protocol was registered in PROSPERO (CRD420261337037). Eligible studies were randomized controlled trials (RCTs) or non-RCTs involving healthy male tennis players and comparing structured NMT with control or alternative training conditions. Outcomes included stroke velocity, shot placement accuracy, serve accuracy, sprint performance, countermovement jump (CMJ), and agility time. Risk of bias was assessed using RoB 2 and ROBINS-I, certainty of evidence was evaluated with GRADE, and random-effects meta-analyses were performed using Hedges’ g. Results: Eighteen studies involving 670 participants were included, of which 16 were RCTs and two were non-randomized controlled studies. Compared with control conditions, pooled estimates favored the intervention conditions for stroke velocity (g = 0.95), sprint performance (g = −0.58), CMJ (g = 0.73), agility time (g = −0.89), and serve accuracy (g = 0.47). No significant pooled effect was observed for shot placement accuracy (g = −0.41). For sprint performance, the pooled estimate favored the intervention conditions for the 10 m sprint but not for the 20 m sprint. GRADE certainty was low for stroke velocity and sprint performance and very low for shot placement accuracy, serve accuracy, CMJ, and agility time. Conclusions: Low-certainty evidence suggests favorable pooled effects on stroke velocity and short-distance sprint performance when the included interventions were considered collectively. Although pooled analyses favored the intervention conditions for CMJ, agility time, and serve accuracy, the certainty of evidence for these outcomes was very low, and accuracy-related outcomes remained inconsistent. These pooled findings do not establish the effectiveness of any specific training modality. Further rigorously designed and well-reported RCTs incorporating long-term follow-up are warranted.