The effect of SportsMetrics training program on functional performance, landing error, dynamic knee valgus and hamstrings/quadriceps strength in athletes: a systematic review and meta-analysis

Abstract Objective The SportsMetrics training (SMT) program is a comprehensive injury prevention initiative designed for athletes, focusing on improving strength, flexibility, and overall performance through targeted exercises and assessments. Therefore, the purpose of this systematic review is to examine the effect of SMT program on functional performance, landing error, dynamic knee valgus and hamstrings/quadriceps strength ratio in athletes. Methods Primary sources were sourced from four databases: SCOPUS, PubMed, CENTRAL, and Web of Science. The search period spanned from the inception of these databases up to March 29, 2025. The inclusion criteria were defined as follows: (1) Population: Professional or recreational athletes; (2) Intervention: SMT program; (3) Comparator: Comparison of SMT program with either a non-training control group or conventional training (CT); (4) Outcomes: functional performance, landing error, dynamic knee valgus and muscle strength; (5) Study Designs: Randomized controlled trials; (6) Peer-reviewed articles published in English. Standardized mean differences (SMDs), and 95% confidence intervals (CIs) were computed using either random or fixed-effect models for the outcomes. Results After the screening process, a total of 20 studies comprising 825 participants were included in the systematic review. The results of the meta-analysis showed that SMT improved agility (1.24 [95% CI: 0.53–1.95], p = 0.001), core endurance (1.16 [95% CI: 0.43–1.89], p = 0.001), dynamic balance (1.29 [95% CI: 0.92–1.66], p = 0.001), jump height (0.44 [95% CI: 0.12–0.77], p = 0.007), power (1.02 [95% CI: 0.44–1.60], p = 0.001), speed (0.57 [95% CI: 0.28–0.87], p = 0.001), hamstring strength (1.29 [95% CI: 1.20–1.38], p = 0.001), quadriceps strength (2.43 [95% CI: 2.32–2.54], p = 0.001), and hamstrings/quadriceps strength ratio (1.22 [95% CI: 1.13–1.31], p = 0.001). Also, results showed that SMT reduced in the knee valgus (3.46 [95% CI: 2.10–4.81], p = 0.001), and landing errors (2.45 [95% CI: 2.06–2.78], p = 0.001). Conclusion The present meta-analysis demonstrates that the SMT program significantly improved functional performance, increased hamstrings/quadriceps strength, and reduced landing errors and dynamic knee valgus in athletes. Despite the robust evidence, there remains a gap in original research directly linking SMT to injury rates, underscoring the need for future studies to explore this relationship. Trial registration CRD420251020418.