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Effects of Plyometric Jump Training on the Reactive Strength Index in Healthy Individuals Across the Lifespan: A Systematic Review with Meta-analysis
(Springer Science and Business Media Deutschland GmbH, 2023-05) Ramirez-Campillo, Rodrigo; Thapa, Rohit K.; Afonso, José; Perez-Castilla, Alejandro; Bishop, Chris; Byrne, Paul J.; Granacher, Urs
Background: The reactive strength index (RSI) is meaningfully associated with independent markers of athletic (e.g., linear sprint speed) and neuromuscular performance [e.g., stretch–shortening cycle (SSC)]. Plyometric jump training (PJT) is particularly suitable to improve the RSI due to exercises performed in the SSC. However, no literature review has attempted to meta-analyse the large number of studies regarding the potential effects of PJT on the RSI in healthy individuals across the lifespan. Objective: The aim of this systematic review with meta-analysis was to examine the effects of PJT on the RSI of healthy individuals across the lifespan compared with active/specific-active controls. Methods: Three electronic databases (PubMed, Scopus, Web of Science) were searched up to May 2022. According to the PICOS approach, the eligibility criteria were: (1) healthy participants, (2) PJT interventions of ≥ 3 weeks, (3) active (e.g., athletes involved in standard training) and specific-active (e.g., individuals using heavy resistance training) control group(s), (4) a measure of jump-based RSI pre-post training, and (5) controlled studies with multi-groups in randomised and non-randomised designs. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias. The random-effects model was used to compute the meta-analyses, reporting Hedges’ g effect sizes (ES) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Subgroup analyses were performed (chronological age; PJT duration, frequency, number of sessions, total number of jumps; randomization). A meta-regression was conducted to verify if PJT frequency, duration, and total number of sessions predicted the effects of PJT on the RSI. Certainty or confidence in the body of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Potential adverse health effects derived from PJT were researched and reported. Results: Sixty-one articles were meta-analysed, with a median PEDro score of 6.0, a low risk of bias and good methodological quality, comprising 2576 participants with an age range of 8.1–73.1 years (males, ~ 78%; aged under 18 years, ~ 60%); 42 studies included participants with a sport background (e.g., soccer, runners). The PJT duration ranged from 4 to 96 weeks, with one to three weekly exercise sessions. The RSI testing protocols involved the use of contact mats (n = 42) and force platforms (n = 19). Most studies reported RSI as mm/ms (n = 25 studies) from drop jump analysis (n = 47 studies). In general, PJT groups improved RSI compared to controls: ES = 0.54, 95% CI 0.46–0.62, p < 0.001. Training-induced RSI changes were greater (p = 0.023) for adults [i.e., age ≥ 18 years (group mean)] compared with youth. PJT was more effective with a duration of > 7 weeks versus ≤ 7 weeks, > 14 total PJT sessions versus ≤ 14 sessions, and three weekly sessions versus < three sessions (p = 0.027–0.060). Similar RSI improvements were noted after ≤ 1080 versus > 1080 total jumps, and for non-randomised versus randomised studies. Heterogeneity (I2) was low (0.0–22.2%) in nine analyses and moderate in three analyses (29.1–58.1%). According to the meta-regression, none of the analysed training variables explained the effects of PJT on RSI (p = 0.714–0.984, R2 = 0.0). The certainty of the evidence was moderate for the main analysis, and low-to-moderate across the moderator analyses. Most studies did not report soreness, pain, injury or related adverse effects related to PJT. Conclusions: The effects of PJT on the RSI were greater compared with active/specific-active controls, including traditional sport-specific training as well as alternative training interventions (e.g., high-load slow-speed resistance training). This conclusion is derived from 61 articles with low risk of bias (good methodological quality), low heterogeneity, and moderate certainty of evidence, comprising 2576 participants. PJT-related improvements on RSI were greater for adults versus youths, after > 7 training weeks versus ≤ 7 weeks, with > 14 total PJT versus ≤ 14 sessions, and with three versus < three weekly sessions. © 2023, The Author(s).
Effects of Therapies Involving Plyometric-Jump Training on Physical Fitness of Youth with Cerebral Palsy: A Systematic Review with Meta-Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-06) Garcia-Carrillo, Exal; Ramirez-Campillo, Rodrigo; Izquierdo, Mikel; Elnaggar, Ragab K.; Afonso, José; Peñailillo, Luis; Araneda, Rodrigo; Ebner-Karestinos, Daniela; Granacher, Urs
The aim of this systematic review was to assess the effects of plyometric-jump training (PJT) on the physical fitness of youth with cerebral palsy (CP) compared with controls (i.e., standard therapy). The PRISMA 2020 guidelines were followed. Eligibility was assessed using the PICOS approach. Literature searches were conducted using the PubMed, Web of Science, and SCOPUS databases. Methodological study quality was assessed using the PEDro scale. Data were meta-analyzed by applying a random-effects model to calculate Hedges’ g effect sizes (ES), along with 95% confidence intervals (95% CI). The impact of heterogeneity was assessed (I2 statistic), and the certainty of evidence was determined using the GRADE approach. Eight randomized-controlled studies with low-to-moderate methodological quality were included, involving male (n = 225) and female (n = 138) youth aged 9.5 to 14.6 years. PJT interventions lasted between 8 and 12 weeks with 2–4 weekly sessions. Compared with controls, PJT improved the muscle strength (ES = 0.66 [moderate], 95% CI = 0.36–0.96, p < 0.001, I2 = 5.4%), static (ES = 0.69 [moderate], 95% CI= 0.33–1.04, p < 0.001, I2 = 0.0%) and dynamic balance (ES = 0.85 [moderate], 95% CI = 0.12–1.58, p = 0.023, I2 = 81.6%) of youth with CP. Therefore, PJT improves muscle strength and static and dynamic balance in youth with CP compared with controls. However, more high-quality randomized-controlled trials with larger sample sizes are needed to provide a more definitive recommendation regarding the use and safety of PJT to improve measures of physical fitness.
Effects of Upper-Body Plyometric Training on Physical Fitness in Healthy Youth and Young Adult Participants: A Systematic Review with Meta-Analysis
(Springer Science and Business Media Deutschland GmbH, 2023-12) Garcia-Carrillo, Exal; Ramirez-Campillo, Rodrigo; Thapa, Rohit K.; Afonso, José; Granacher, Urs; Izquierdo, Mikel
Background: Upper-body plyometric training (UBPT) is a commonly used training method, yet its effects on physical fitness are inconsistent and there is a lack of comprehensive reviews on the topic. Objective: To examine the effects of UBPT on physical fitness in healthy youth and young adult participants compared to active, specific-active, and passive controls. Methods: This systematic review followed PRISMA 2020 guidelines and utilized the PICOS framework. PubMed, WOS, and SCOPUS were searched. Studies were assessed for eligibility using the PICOS framework. The effects of UBPT on upper-body physical fitness were assessed, including maximal strength, medicine ball throw performance, sport-specific throwing performance, and upper limb muscle volume. The risk of bias was evaluated using the PEDro scale. Means and standard deviations were used to calculate effect sizes, and the I 2 statistic was used to assess heterogeneity. Publication bias was assessed using the extended Egger's test. Certainty of evidence was rated using the GRADE scale. Additional analyses included sensitivity analyses and adverse effects. Results: Thirty-five studies were included in the systematic review and 30 studies in meta-analyses, involving 1412 male and female participants from various sport-fitness backgrounds. Training duration ranged from 4 to 16 weeks. Compared to controls, UBPT improved maximal strength (small ES = 0.39 95% CI = 0.15–0.63, p = 0.002, I 2 = 29.7%), medicine ball throw performance (moderate ES = 0.64, 95% CI = 0.43–0.85, p < 0.001, I 2 = 46.3%), sport-specific throwing performance (small ES = 0.55, 95% CI = 0.25–0.86, p < 0.001, I 2 = 36.8%), and upper limbs muscle volume (moderate ES = 0.64, 95% CI = 0.20–1.08, p = 0.005, I 2 = 0.0%). The GRADE analyses provided low or very low certainty for the recommendation of UBPT for improving physical fitness in healthy participants. One study reported one participant with an injury due to UBPT. The other 34 included studies provided no report measure for adverse effects linked to UBPT. Conclusions: UBPT interventions may enhance physical fitness in healthy youth and young adult individuals compared to control conditions. However, the certainty of evidence for these recommendations is low or very low. Further research is needed to establish the optimal dose of UBPT and to determine its effect on female participants and its transfer to other upper-body dominated sports.
Overweight and Obese Adult Patients Show Larger Benefits from Concurrent Training Compared with Pharmacological Metformin Treatment on Insulin Resistance and Fat Oxidation
(MDPI, 2022-11) Azócar Gallardo, Jairo; Ramirez Campillo, Rodrigo; Afonso, José; Sá, Mário; Granacher, Urs; González Rojas, Luis; Ojeda Aravena, Alex; García García, José Manuel
Metformin, a drug widely used to treat insulin resistance, and training that combines aerobic and strength exercise modalities (i.e., concurrent training) may improve insulin sensitivity. However, there is a paucity of clinical trials investigating the effects of concurrent training, particularly on insulin resistance and fat oxidation in overweight and obese patients. Furthermore, only a few studies have compared the effects of concurrent training with metformin treatment. Therefore, the aim of this study was to examine the effects of a 12-week concurrent training program versus pharmaceutical treatment with metformin on maximum fat oxidation, glucose metabolism, and insulin resistance in overweight or obese adult patients. Male and female patients with insulin resistance were allocated by convenience to a concurrent training group (n = 7 (2 males); age = 32.9 ± 8.3 years; body mass index = 30 ± 4.0 kg·m−2) or a metformin group (n = 7 (2 males); age = 34.4 ± 14.0 years; body mass index = 34.4 ± 6.0 kg·m−2). Before and after the interventions, all participants were assessed for total body mass, body mass index, fat mass, fat-free mass, maximum oxygen consumption, maximal fat oxidization during exercise, fasting glucose, and insulin resistance through the homeostatic model assessment (HOMA-IR). Due to non-normal distribution of the variable maximal fat oxidation, the Mann–Whitney U test was applied and revealed better maximal fat oxidization (Δ = 308%) in the exercise compared with the metformin group (Δ = −30.3%; p = 0.035). All other outcome variables were normally distributed, and significant group-by-time interactions were found for HOMA-IR (p < 0.001, Δ = −84.5%), fasting insulin (p < 0.001, Δ = −84.6%), and increased maximum oxygen consumption (p = 0.046, Δ = 12.3%) in favor of the exercise group. Similar changes were found in both groups for the remaining dependent variables. Concurrent training seems to be more effective compared with pharmaceutical metformin treatment to improve insulin resistance and fat oxidation in overweight and obese adult patients with insulin resistance. The rather small sample size calls for more research in this area. © 2022 by the authors.
PLYOMETRIC TRAINING PROGRAMS IN HANDBALL: A SYSTEMATIC SCOPING REVIEW
(University of Zagreb - Faculty of Kinesiology, 2023) Rocha Henrique, José; Ramirez-Campillo, Rodrigo; Afonso, José; Silva, Rui Miguel; Moran, Jason; Clemente, Filipe Manuel
This systematic scoping review aimed to comprehensively identify and analyze the available evidence pertaining to the effects of plyometric training interventions on handball players. The search for relevant literature was conducted across prominent databases, including PubMed, Scopus, SPORTDiscus, and Web of Science Core Collection. The eligibility criteria focused on healthy handball players, without restrictions on age, sex, or competitive level, who were exposed to plyometric training interventions, either alone or in combination with other training methods. A meticulous screening process was conducted, whereby 3,195 titles were carefully evaluated, resulting in the inclusion of 35 eligible studies in this systematic scoping review, involving a total of 891 participants. Most studies on plyometric training in handball focused on indoor settings, conducted during the in-season period, and involved tier two athletes. The training frequency typically ranged from twice per week, with a duration of between 5 and 12 weeks, and incorporated some form of progressive overload. The number of total floor contacts varied between 20 and 600. There was a considerable variation in outcomes across the included studies, but most of them demonstrated a positive impact of plyometric training on improving jumping ability, sprinting speed, change of direction, strength, and balance. In conclusion, the predominant focus of the studies was on the lower limb, specifically aiming to assess the intervention influence on variables associated with strength and power. Notably, these investigations consistently highlighted favorable effects on enhancing these parameters among handball players. However, further research is needed to explore the effects of plyometric training in handball, particularly regarding exercise selection, optimal volume and intensity, rest intervals, and tapering protocols. © 2023, University of Zagreb - Faculty of Kinesiology. All rights reserved.
Relationship between Bioelectrical Impedance Phase Angle and Upper and Lower Limb Muscle Strength in Athletes from Several Sports: A Systematic Review with Meta-Analysis
(MDPI, 2023-05) Cirillo, Everton; Pompeo, Alberto; Cirillo, Fabiane Tavares; Vilaça-Alves, José; Costa, Pablo; Ramirez-Campillo, Rodrigo; Dourado, Antonio Carlos; Afonso, José; Casanova, Filipe
The phase angle (PhA) of bioelectrical impedance is determined by primary factors such as age, body mass index and sex. The researchers’ interest in applying PhA to better understand the skeletal muscle property and ability has grown, but the results are still heterogeneous. This systematic review with a meta-analysis aimed to examine the existence of the relationship between PhA and muscle strength in athletes. The data sources used were PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science and the study eligibility criteria were based on the PECOS. The searches identified 846 titles. From those, thirteen articles were eligible. Results showed a positive correlation between PhA and lower limb strength (r = 0.691 [95% CI 0.249 to 0.895]; p = 0.005), while no meta-analysis was possible for the relationships between PhA and lower limb strength. Furthermore, GRADE shows very low certainty of evidence. In conclusion, it was found that most studies showed a positive correlation between PhA and vertical jump or handgrip strength. The meta-analysis showed the relationship between PhA and vertical jump, however, little is known for the upper limbs as was not possible to perform a meta-analysis, and for the lower limbs we performed it with four studies and only with vertical jump. © 2023 by the authors.

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