Background: Promoting physical activity (PA) is a global objective; however, participating in PA has an inherent injury risk. Injury prevention strategies (IPS) aim at reducing injury risk and enhancing physical fitness. Fundamental movement skills (FMS) are commonly used in IPS and physical literacy, which focuses in promoting lifelong PA. Understanding the overall effect of IPS on FMS may help to promote PA safely.
Objective: To summarize the evidence on the effects of IPS on the biomechanics and neuromuscular performance of FMS in children and adolescents.

Methods: We conducted a systematic review with meta-analysis of four databases (PubMed, SPORTDiscus, Web of Science, SCOPUS). We included randomized controlled trials analyzing the effects of IPS in injury-free participants younger than 18 years of age. We evaluated eligibility and methodological quality and extracted means and standard deviations for each outcome. We used the inverse-variance random-effects model for the statistical analyses.

Results: We included 29 studies conducted on 1487 participants (median age 13.7 years; range [10.0,17.3]). Studies reported positive effects of IPS on lower limb biomechanics and postural stability. IPS induced positive effects on vertical jump (g=0.38; 95 CI[0.23,0.52]; p< 0.01), basic speed (g=0.47;95 CI[0.05,0.90];p=0.03), acceleration (g=0.65; 95 CI[0.06,1.25]; p<0.03), dynamic balance (g=0.20; 95 CI[-0.01,0.41]; p=0.06), and dribbling (g=0.25; 95 CI[-0.58,2.31]; p<0.45). We did not observe a positive effect in Horizontal jump (g=-0.04; 95 CI[-0.28,0.20]; p<0.45). Subgroup analyses showed significant differences (p<0.01) only for intervention type in basic speed and dynamic balance.

Conclusion: Including IPS in different contexts (e.g., physical literacy, physical education) may help to promote PA safely. IPS can lead to functional and structural adaptations that may reduce potential biomechanical risk factors for injury and improve neuromuscular performance of FMS.