Background The intermittent fasting period of Ramadan is associated with reductions in training volumes and intensities to maintain physical fitness levels and reduce injury occurrence. Accordingly, it might be beneficial to include neuromuscular training (NMT) applied during Ramadan to avoid detraining and promote injury prevention in soccer players. This study aimed to analyze NMT effects on physical fitness and injury prevention during the Ramadan fasting period in young soccer players. Methods Forty young highly-trained male soccer players (U17/U19) were randomly assigned to a NMT (n = 20) or a traditional soccer-specific training group (TT, n = 20). NMT was conducted during Ramadan, lasted four weeks, and included two weekly sessions with exercises to promote muscle strength, power (plyometrics), speed, balance. TT contents were similar to the training period before Ramadan and comprised two weekly sessions including endurance and sprint-based exercises. The training volume was similar between groups. Body composition (body fat), linear sprint (5-m, 10-m, 30-m sprint), and change-of-direction (CoD) speed (T-test with and without ball), muscle power (squat [SJ], countermovement jump [CMJ]), peak isokinetic torque of the knee flexors, extensors, and soccer-specific performance (Loughborough soccer passing test [LSPT], Yoyo intermittent test level 1 [YYIRT L1], repeated-shuttle-sprint ability test [RSSA]) were determined before and after the Ramadan period. The overall injury rate per 1000 h of exposure (training, match) was carried out during and after the four-week Ramadan period and until the end of the soccer season (overall 8 weeks). Results No significant between group baseline differences were noted. Group-by-time interactions were significant for most assessed variables (0.001 < p < 0.004, 0.22 < d < 0.76) in favor of NMT. Variations in body mass, body fat, and BMI determined by post-hoc tests indicated significant decreases in NMT but not TT (0.026 < p < 0.047, 0.65 < d < 0.73). Moreover, post-hoc tests showed that NMT provided linear and COD speed improvements, enhanced muscle power (SJ, CMJ) and improved soccer-specific performance (p < 0.001, 0.71 < d < 2.53). Additionally, post-hoc tests revealed significant isokinetic strength increases in favor of NMT for all peak torque variables (0.015 < p < 0.049, 0.64 < d < 0.81). The overall injury rate was significantly lower in NMT (8.00/1000 h exposure) compared to TT (13.33/1000 h exposure) (p = 0.049; d = 0.66). Conclusions Findings suggest that a four-week NMT conducted during Ramadan fasting helped to maintain or even improve measures of physical fitness including isokinetic strength. In addition, significant NMT-related reductions in injury occurrence were noted in highly-trained young male soccer players.
