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Sex-Related Differences After a Single Bout of Maximal Eccentric Exercise in Response to Acute Effects

A Systematic Review and Meta-analysis

Morawetz, David1; Blank, Cornelia1; Koller, Arnold1; Arvandi, Marjan2; Siebert, Uwe2,3,4; Schobersberger, Wolfgang1

The Journal of Strength & Conditioning Research: March 15, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1519/JSC.0000000000002867
Brief Review: PDF Only

Morawetz, D, Blank, C, Koller, A, Arvandi, M, Siebert, U, and Schobersberger, W. Sex-related differences after a single bout of maximal eccentric exercise in response to acute effects: a systematic review and meta-analysis. J Strength Cond Res XX(X): 000–000, 2018—The most prominent effects after unaccustomed eccentric exercise are muscle damage, muscle soreness, strength loss, and higher concentrations of muscle proteins in the plasma. The aim of this systematic review is to evaluate sex-related differences in these acute effects. A systematic literature search in MEDLINE following the PRISMA guidelines was performed. Inclusion criteria were the difference in absolute outcomes between sexes in eccentric muscle strength, strength loss after eccentric exercise, blood concentrations of creatine kinase (CK), and delayed onset muscle soreness (DOMS). Results for maximal eccentric torque and CK data were pooled using a random-effect meta-analysis. A meta-regression was conducted to explain heterogeneity. Based on the 23 included trials, men showed significantly higher absolute eccentric strength. No sex-related differences were detected when normalizing strength for body mass, cross-sectional area of the muscle, or fat-free mass. Women displayed a tendency toward greater relative strength loss immediately after exercise. The absolute CK concentrations of men were significantly higher after exercise-induced muscle damage. No significant difference was found between sexes in DOMS. Untrained men and women display similar responses in all measures of relative muscle strength and DOMS. Apart from the enzymatic activity after exercise and the levels of absolute eccentric torque, there is no evidence for sex-related differences immediately after eccentric exercise. Therefore, eccentric training might have the same impact on men and women. One potential sex difference with practical relevance would be the possible difference in fatigue pattern immediately after eccentric exercise.

1Institute for Sports Medicine, Alpine Medicine and Health Tourism, Tirol Kliniken GmbH Innsbruck, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria;

2Department of Public Health, Health Services Research and Health Technology Assessment, Institute for Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria;

3Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; and

4Program on Cardiovascular Research, Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence to David Morawetz,

Copyright © 2019 by the National Strength & Conditioning Association.