Heterogeneous effects of eccentric training and nordic hamstring exercise on the biceps femoris fascicle length based on ultrasound assessment and extrapolation methods: A systematic review of randomised controlled trials with meta-analyses.

Abstract

ObjectiveTo systematically review the effects of eccentric training based on biceps femoris fascicle length using ultrasound assessment and extrapolation methods.DesignSystematic review and meta-analysis of randomised controlled trials.Data sourcesCENTRAL, CINAHL Plus with full text, PubMed and OpenGrey databases were searched on 6 July 2021.Eligibility criteria for selecting studiesRandomised controlled trials (RCTs) lasting at least four weeks and presenting data about biceps femoris (BF) fascicle length (FL) as an outcome.MethodSearching databases, screening studies, performing risk of bias assessments and determining the level of evidence (LoE) for each meta-analysis were applied during the study. PRISMA 2020 statement and Cochrane Handbook for Systematic Reviews of Interventions were used as the guidelines of this systematic review.ResultsEight randomised controlled trials included in meta-analyses. Based on the very low and low LoE, eccentric training has small (g = 0.29, 95% CI [-0.26, 0.85]), moderate (g = 0.72, 95% CI [0.17, 1.28]) and large (g = 2.20, 95% CI [0.99, 3.41]) effect sizes (ES) based on manual linear extrapolation (MLE), panoramic ultrasound scanning and trigonometric equation methods, respectively. Similarly, Nordic hamstring exercise (NHE) has small (g = 0.23 [-1.02, 1.47]), small (g = 0.38, 95% CI [-0.50, 1.27]) and large (g = 1.98, 95% CI [0.52, 3.44]) ES based on the MLE, panoramic ultrasound scanning and trigonometric equation methods, respectively.ConclusionES of eccentric training, including NHE, vary between the MLE, panoramic ultrasound scanning, and equation methods. The relevant scientific community should have a consensus on measurement standards of the BF FL measurements. Further studies can be conducted to compare the effects of eccentric training based on the ultrasound assessment and extrapolation methods.