Effects of proprioceptive neuromuscular facilitation on flexibility and neuromuscular performance in gymnastics: a systematic review

Abstract

The purpose of this review is to describe the available evidence on proprioceptive neuromuscular facilitation interventions in gymnastics and to identify the limitations of the current evidence base. A comprehensive search of PubMed, EBSCO, Scopus and SPORTDiscus identified five studies that met the eligibility criteria. The risk of bias in the included studies was assessed via the ROBINS-I tool. The included studies exhibited heterogeneity in study design, sample size, interventions, and outcomes. Three studies assessed neuromuscular outcomes, examining muscle contractile properties, strength, stability, and activation patterns; however, the findings were inconsistent and did not permit definitive conclusions. A comparative trial reported no significant effects on leg or vertical stiffness following acute PNF application, while a small rehabilitation study provided only preliminary descriptive data after an 8‑week intervention, without inferential statistical support. Overall, the certainty of evidence is very low according to GRADE assessment; therefore, current findings are exploratory and insufficient to establish effectiveness. The primary contribution of this review is to highlight the evidence and knowledge gaps, underscoring the need for robust, adequately powered trials before any clinical or training recommendations can be made.