Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2023) 22, 288 - 309   DOI:

Review article
The Health and Functional Benefits of Eccentric versus Concentric Exercise Training: A Systematic Review and Meta-Analysis
Misha Ansari , Sibella Hardcastle, Stephen Myers, Andrew D. Williams
Author Information
School of Health Sciences, University of Tasmania, Launceston, Australia

Misha Ansari
‚úČ School of Health Sciences, University of Tasmania, Launceston, Australia
Publish Date
Received: 08-03-2023
Accepted: 15-05-2023
Published (online): 01-06-2023
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This review compared the effects of eccentric versus concentric exercise training in healthy people and people with metabolic disease. A systematic search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, SPORTDiscus, Web of Science, SCOPUS and PubMed was conducted in February 2022. Randomised controlled trials conducted on sedentary healthy adults or those with an existing metabolic disease that compared eccentric versus concentric exercise training interventions of four weeks or longer that involved multiple joints and large muscle groups (e.g., walking, whole-body resistance training) were included in the review. The primary outcome was glucose handling, measured as HbA1c, HOMA, fasting glucose or insulin. Measures of cardiovascular health, muscle strength, and functional physical fitness were secondary outcomes. Nineteen trials involving 618 people were included. Results of meta-analyses showed that eccentric exercise had no benefit to glucose handling (HbA1c level; SMD - 0.99; 95% CI, -2.96 to 0.98; n = 74; P = 0.32) but resulted in significant increases in overall muscle strength (SMD 0.70; 95% CI 0.25 to 1.15; n = 224; P = 0.003) and decreases in blood pressure (Systolic Blood Pressure; MD -6.84; 95% CI, -9.84 to -3.84; n = 47, P = 0.00001, and Diastolic Blood Pressure; MD -6.39; 95% CI -9.62 to -3.15; n = 47, P = 0.0001). Eccentric exercise is effective for improving strength and some markers of cardiovascular health compared to traditional exercise modalities. Additional high-quality studies are necessary to validate these results. (PROSPERO registration: CRD42021232167).

Key words: Non-traditional exercise modalities, physical fitness, markers of health

           Key Points
  • Eccentric exercise (e.g., downhill walking) is widely perceived as easier to perform than traditional exercise (e.g., flat or uphill walking).
  • Eccentric exercise may have more significant benefits for muscle strength and some markers of health than traditional exercise.
  • Eccentric exercise may be an attractive alternative to traditional exercise in encouraging sedentary people to become more active.
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