Effects of concurrent training sequence on VO 2max and lower limb strength performance: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36776981 · doi:10.3389/fphys.2023.1072679
What was done
This systematic review and meta-analysis searched PubMed, EBSCO, Web of Science, Wanfang, and CNKI through December 2022 for randomized controlled trials comparing concurrent exercise sequences: strength before endurance (S-E) versus endurance before strength (E-S). Outcomes evaluated were VO2max, maximum knee extension strength, maximum knee flexion strength, and lower limb power. Methodological quality was evaluated using the Cochrane risk of bias tool, and random-effects meta-analyses calculated standardized mean differences (SMDs).
What was found
Nineteen randomized controlled trials were included (482 participants: 285 males, 197 females; 242 in S-E sequence, 240 in E-S sequence). - VO2max showed no significant difference between sequences (SMD = 0.02, 95% CI: -0.21 to 0.25, p = 0.859). - Lower limb strength favored the S-E sequence over the E-S sequence (SMD = 0.19, 95% CI: 0.02 to 0.37, p = 0.032). - The S-E advantage for strength was statistically significant in the elderly (p = 0.039), women (p = 0.017), training periods >8 weeks (p = 0.002), training frequencies twice weekly (p = 0.003), maximum knee flexion (p = 0.040), and maximum knee extension strength (p = 0.026). - Lower limb power showed no difference between sequences (p = 0.523).
Why it matters
Concurrent training sequence does not affect cardiorespiratory fitness adaptations, but performing resistance training prior to endurance exercise provides a small, statistically significant benefit for lower limb strength.
Limits
The observed strength benefit was small in magnitude (SMD = 0.19). The abstract does not detail specific exercise modalities, rest periods between bouts, or the risk of bias distribution across included trials. Upper body strength was not assessed.