The systematic review and meta-analysis conducted by Lan et al. (2026) investigates the efficacy of eccentric overload training (EOT) on various physical performance metrics in older adults. The study focuses on lower-limb muscle strength, gait performance, balance, and explosive power, which are critical for maintaining mobility and independence in the elderly population.
Background
As individuals age, maintaining physical performance becomes increasingly important for overall health and quality of life. Eccentric overload training, which emphasizes the lengthening phase of muscle contractions, has gained attention for its potential benefits in enhancing muscle strength and power.
Methods
The authors systematically searched seven databases, including PubMed and Cochrane Library, for randomized controlled trials (RCTs) up to March 2026. A total of fifteen RCTs involving 438 participants were included in the analysis. The primary outcome measured was lower-limb strength, while secondary outcomes included gait performance, balance, and explosive power.
Results
The findings suggest that EOT may significantly enhance lower-limb strength with a standardized mean difference (SMD) of 0.50 and explosive power with an SMD of 0.39. Notably, EOT showed superior results compared to inactive controls and demonstrated a non-inferiority trend when compared to conventional resistance training.
Subgroup analyses revealed that using flywheel devices was particularly effective, yielding an SMD of 0.54 for lower-limb strength and 0.44 for explosive power. Additionally, the frequency of training sessions played a role in effectiveness, with more frequent sessions (>2 per week) being more beneficial for strength gains, while less frequent sessions (≤2 per week) were advantageous for explosive power improvements.
Long-term training protocols (≥8 weeks) were associated with greater enhancements in both lower-limb strength and explosive power.
Conclusion
The authors conclude that eccentric overload training shows promising potential for improving lower-limb strength and explosive power in older adults. They recommend that future exercise prescriptions should consider both standardization and personalization to optimize outcomes.
What this study does not show
This study does not establish a direct cause-and-effect relationship between eccentric overload training and improvements in all measured outcomes, nor does it address the long-term sustainability of these benefits.
Evidence scorecard
- Analytic validity: Established
- Clinical validity: Established
- Clinical utility: Established