Table 1. Eligibility criteria for inclusion of studies in the review
Inclusion Exclusion
Population Sedentary healthy individuals or those with an existing metabolic disease as a primary medical condition who are ≥ 18 years of age and who are not performing structured exercise training in the previous six months are included in this review. Individuals with neurological conditions preventing safe exercise performance or with a primary medical condition other than metabolic disease are excluded.
Intervention All randomised controlled trials (RCT) with a treatment duration of four weeks or more, intervention delivered at least once a week, designed to compare eccentric vs concentric exercise or traditional exercise on treadmill/cycle ergometer or downhill vs uphill walking were included in this review.
RCTs utilising Eccentric-focused exercise training involving multiple joints and large muscle groups (e.g., walking, running, cycling, whole-body resistance training) will be included.
Eccentric-focused exercise compared with concentric-focused or combined movement exercise
Trials analysing cross-training effects (e.g., exercising one limb and assessing the effect from the other limb)
Trials studying acute effects of exercise (single bout or less than four weeks duration)
Trials involving non-exercise interventions, including diet or supplements, where exercise components cannot be isolated.
Trials conducted on animals.
Comparator Concentric training
Combined movement exercise
No comparator group
Outcomes Primary outcomes
Insulin resistance
Secondary outcomes
Muscle strength
Functional Physical fitness: Six-minute walk test(6MWT),
Time up and go test (TUG)
Heart rate
Brachial Blood pressure
Central Blood pressure
Arterial Stiffness
Studies that do not report at least one primary or secondary outcome.
1. Randomised controlled trials (blinded and open, parallel), including chronic Eccentric training (4 or more weeks) involving multiple joints and large muscle groups (e.g., walking, running, cycling, whole-body resistance training), will be included in this review.
2. Cross-over trials where pre-cross-over data is available from study authors.
Observational studies (case studies, case reports, cross-sectional studies, ecological studies,
cross-sectional studies, and cohort studies)
Qualitative research
Narrative reviews
Systematic reviews
cross-over and single-arm trials
Trials not reported in English.