Table 2. Main characteristics of the studies.
Study Population Intervention Duration Health related measures Functional fitness measures Results
Hajihasani et al. (2014) Diabetes Type 2
(n = 28)
mean age 51.79
Intervention 1: Eccentric Exercise (Running on treadmill with ramp slop controlled for – 4°) n= 14
Intervention 2: Concentric Exercise (Running on treadmill with ramp slop controlled for + 4°) n = 14
Eight weeks N/A 6MWT,
TUG
Eccentric and concentric exercises significantly decreased the result of TUG.
There was a significant difference in 6MWT b/w concentric and eccentric groups (P = 0.036), although, in both groups, the distance walked increased after the intervention.
Chen et al. (2017a) Elderly Obese Women
Women (n = 30)
Mean age 66
Intervention 1: Descending stair walking. n = 15
Intervention 2: Ascending stair walking. n = 15
12 weeks
(2 sessions x week)
HbA1C
HOMA
OGTT
Lipids
HR
6MWT,
MVCiso,
30-s chair stand,
8-ft up-and-go, 2-min step,
and 6-m Tandem walk
Decreases in serum triacylglycerols, total and low-density lipoprotein cholesterols, glucose, insulin, HOMA, HbA1c, and increases in high-density lipoprotein cholesterols were greater (P < 0.05) after Descending Stair Walking (DSW) than Ascending Stair Walking (ASW).
MVCiso increased greater for DSW (34%) than ASW (15%). Physical fitness improved for both groups; however, the 30-s chair stand and 6MWT showed greater improvement for DSW than ASW
Chen et al. 2017b) Healthy Elderly Men
(n = 26)
Mean age 66
Intervention 1: Eccentric training on Leg extension machine, 30-60 contractions of knee extensors once a week, intensity progressively increased from 10-100% of 1 RM. n = 13
Intervention 2: Concentric training of knee extensors on the same device with intensity increased from 50 – 100% of 1 RM. n = 13
12 weeks
(1 session x week)
HbA1C
HOMA
OGTT
Lipids
1 RM,
MVCcon
MVCiso,
6MWT,
30-s chair stand (CS),
2-m step (2MS),
8-foot up-and-go (8UG),
one-leg stand with eyes
open (OLST), 6-meter
tandem walk (6-mTW)
Functional physical fitness (e.g., 30-s chair stand) and maximal concentric contraction strength of the knee extensors increased greater (P ≤ 0.05) after Eccentric training than concentric training.
HOMA, OGTT and HbA1c showed improvement in insulin sensitivity only after eccentric training (P ≤ 0.05).
Greater (P ≤ 0.05) decreases in fasting TG, TC, and LDLC were evident after eccentric training than concentric training, and HDLC increased only after eccentric training.
Regnersgaard et al. (2022) Healthy men and women
(n=21)
Mean age 70
Intervention 1: Descending stair walking. N = 07
Intervention 2: Ascending stair walking. N = 07
Intervention 3: Descending stair walking with carrying additional weight. N = 07
3 weeks or 6 weeks (3 sessions x week) Leg muscle mass (kg),
Thigh muscle mass,
calf muscle mass,
calf circumference,
6MWT, Sit to stand
test (Chair stand test),
power-CST,
relative power-CST (W/kg),
leg press 3RM (kg),
leg extension power (W)
Leg muscle mass increased more in eccentric + (+0.29 ± 0.09 kg) vs concentric (+0.08 ± 0.05 kg) (P<0.05) but not different from eccentric (+0.16 ± 0.06 kg). The 6MWT increased after 6 weeks more (P<0.05) in eccentric + (+85 ± 23 m) compared with eccentric (+37 ± 13 m) and concentric (+27 ± 12 m).
Leg press (3 RM) was higher (P=0.028) after training with no possible distinction between training groups.
Drexel et al. (2008) Healthy sedentary people
Men (n = 14)
Women (n = 28)
Mean age 48
Intervention 1: Eccentric training (Hiking Downwards) n=23
Intervention 2: Concentric training (Hiking upwards) n=22
8 weeks
(3-5 sessions x week)
HOMA
Lipids
Glucose
N/A Eccentric exercise significantly lowered insulin resistance, fasting serum insulin, and the HOMA index of insulin resistance.
An improvement in glucose tolerance was seen after both eccentric and concentric exercise but only the difference obtained by eccentric exercise reached statistical significance.
TC, apolipoprotein B, and the apo B/apo A1 ratio were decreased by both.
Duncan et al. (1989) Healthy men
(n = 48)
Mean age 24
Intervention 1: Eccentric training on KIN-COM Dynamometer (10 reps x session, Intensity = MVC) n=16
Intervention 2: Concentric training on the same device (10 reps x session, Intensity = MVC) n=14
Control: No exercise performed. n=18
6 weeks
(3 sessions x week)
N/A Eccentric strength,
concentric strength
Eccentric and concentric training improved eccentric and concentric strength respectively, and gains after eccentric training were more mode specific.
Franchi et al. (2014) Young male
(n = 12)
Mean age 25
Intervention 1: Eccentric training on the leg press machine. (4 sets of 8-10 reps at 80% of eccentric 1RM) n=06
Intervention 2: Concentric training on the same device. (4 sets of 8-10 reps at 80% of CON 1RM) n=06
10 weeks
(3 sessions x week)
N/A MVCiso,
1-RM
Similar increases in muscle volume (+6% eccentric and +8% concentric) and in MVCiso (+11% eccentric and +9%) were found after training among both groups.
Gault et al. (2012) Healthy adults
(n = 24)
Mean age 67
Intervention 1: Downhill walking on a treadmill (30 min, -10% decline, self-selected walking speed). N=13
Intervention 2: Level walking on a treadmill (30 min at self-selected walking speed). N=11
12 weeks
(3 sessions x week)
N/A Concentric strength,
Eccentric strength,
5-RSTS,
maximal walking speed (MWS),
TUG,
dynamic strength
Improvements in 5-RSTS, MWS and TUG was substantial and similar for both groups.
5-RSTS improved by 32 and 34% in LTW and DTW.
TUG improved by 22% for both groups. Peak eccentric and concentric torque did not
change.
Hortobagyi et
al. (1996a)
Sedentary Women
(n = 42)
Mean age 21
Intervention 1: Eccentric training on KIN-CON dynamometer, (4 sets of 6-10 reps) n=14
Intervention 2: Concentric training on the same device and parameters n=14
Control: No exercise performed. n=14
6 weeks
(4 sessions x week)
N/A concentric strength,
eccentric strength,
Isometric strength
Eccentric training improved isometric strength significantly (P < 0.05) more than concentric training.
Eccentric training improved concentric strength by 14% (P > 0.05) and increased eccentric strength significantly (P < 0.05) more than concentric training increased concentric strength.
Hortobagyi et al. (1996b) Sedentary Men
(n = 21)
Mean age 21
Intervention 1: Eccentric training on KIN-CON dynamometer (Almost 50 reps x session, Intensity = MVC) n=07
Intervention 2: Concentric training on the same device and parameters. n=08
Control: No exercise performed. n=06
12 weeks
(3 sessions x week)
concentric strength,
eccentric strength,
Isometric strength
Eccentric training increased eccentric strength 3.5 times more (pre/post 46%, P < 0.05) than concentric training increased concentric strength (pre/post 13%). Eccentric training increased concentric strength and Concentric training increased eccentric strength by about the same magnitude (5 and 10%, respectively, P > 0.05).
Kudiarasu et al.(2021) Adults with T2DM
(n=18)
Mean age
Intervention 1: Eccentric training on Cybex. Exercises included chest press, lateral pulldown, bicep curl, triceps extension, leg extension, leg curl, calf raise, abdominal crunch (2–3 sets of 10 eccentric-only for 5 s) n=09
Intervention 2: Concentric training on the same device (2–3 sets of 10 concentric-only (1-2 s). n=09
12 weeks
(2 sessions x week)
plasma glucose,
serum insulin, HbA1c,
Lipids,
HOMA
muscle strength,
6MWT,
chair rise test,
TUG
No significant changes in blood biomarkers were found for both groups. One-repetition maximal strength of each exercise increased (p < 0.05) for both eccentric (12–37%) and concentric (27–68%). Both groups improved (p < 0.05) 6MWT distance and chair rise time but only eccentric improved
(p < 0.05) the TUG.
Lewis et al. (2018) Middle-aged male
(n=17)
Mean age 42
Intervention 1: Eccentric cycling at 60% peak concentric workload. N= 09
Intervention 2: Concentric cycling. N=08
8 weeks
(2 sessions x week)
N/A 6RM
MVIC
Both groups significantly increased 6RM and MVIC relative to their baseline (P < 0.05). Therefore, improved leg strength was equivalent between concentric and eccentric groups.
Miller et al. (2006) Healthy Women
(n =38)
Mean age 20
Intervention 1: Eccentric training on Iso-kinetic Dynamometer, Intensity=MVC. n= 17
Intervention 2: Concentric training on the same device and parameters. n=21
20 week
(3 sessions x week)
N/A Isokinetic Strength Eccentric training increased eccentric knee extension and flexion peak torque more than concentric training.
Nickols-Richardson et al. (2007) Healthy Women
(n = 70)
Mean age 20
Intervention 1: Eccentric training on Isokinetic Dynamometer (30 reps x session, Intensity = MVC). n=33
Intervention 2: Concentric training on the same device and parameters. n=37
20 weeks
(3 sessions x week)
N/A Concentric peak torque (Nm)
Eccentric peak torque (Nm)
Muscular strength (peak torque) of the trained leg was significantly higher after training in both the concentric (18.6%) and eccentric (28.9%) training groups
Pavone and Moffat (1985) Healthy Women
(n = 27)
Mean age 29
Intervention 1: Eccentric training on Cybex II Isokinetic Dynamometer, 30 reps x session, Intensity=% 1RM Eccentric. N=11
Intervention 2: Concentric training on the same device. 30 repetitions per session, Intensity=% 1RM Con. n=08
Intervention 3: Isometric training on the same device by holding the load at 60 of knee flexion. N=08
6 week
(3 sessions x week)
N/A MVCiso Significant strength gain was achieved through concentric, eccentric, and isometric training. No one method of training is superior to other.
Raue (2005) Healthy sedentary male
(n = 15)
Mean age 23
Intervention 1: Eccentric exercise training on knee extensor device Cybex (4 sets of 8 reps, Intensity = starting at 80% of 1 RM Con). n=06
Intervention 2: Concentric exercise training on the same device and parameters. n=06
Control: No exercise training. n=03
4 weeks
(3 sessions x week)
N/A Knee extensors strength Concentric training increased knee extensor strength by 19% (p <0.05)—no difference in knee extensor strength pre to post-training for eccentric or Control group.
Rodio and Fattorini (2014) Healthy young adults
Women (n = 28)
Mean age 26
Intervention 1: Level walking on a treadmill (30 min at 1 m/s). n=07
Intervention 2: Uphill walking on a treadmill (30 min, +20% incline, 0.75m/s). n=08
Intervention 3: Downhill walking on a treadmill (30 min, -20% decline, 1.36m/s). n=07
Intervention 4: Mixed walking on a treadmill (+20% incline, 0.75 m/s, 15 min and -20% decline, 1.36m/s, 15 min). n=06
6 weeks
(3 sessions x week)
N/A MVCiso In all groups, strength values were increased from baseline to post-intervention but resulted in statistically different only in the Downhill walking group.
Tomberlin et al. (1991) Healthy people
Men (n = 31)
Women (n = 32)
Mean age 27
Intervention 1: Eccentric training on KIN-COM Dynamometer. n=21
Intervention 2: Concentric training on the same device. N=19
Control: no exercise performed. n=23
6 weeks
(3 sessions x week)
N/A Concentric
peak torque (Nm)
Eccentric
peak torque (Nm)
Eccentric and concentric training increased eccentric and concentric strength respectively.
Zeppetzauer et al. (2013) healthy sedentary
Men (n = 16)
Women (n = 29)
Mean age 48
Intervention 1: Hiking downwards (eccentric training) on 540 meters trial. n=22
Intervention 2: Hiking upwards (Concentric exercise) on the same path. n=23
8 weeks
(3-5 sessions x week)
Lipids
Glucose
Creatine kinase
CRP
Heart Rate
N/A Eccentric training improved glucose tolerance (AUC) per unit of energy expenditure significantly more than concentric training. The decrease of LDLC per kilocalorie spent was significantly stronger with eccentric exercise.
HOMA: Homeostasis model assessment, MVCcon: maximal voluntary concentric contraction torque, MVCiso: maximal voluntary isometric contraction torque, 6MWT: Six-minute walk test, TUG: Timed up and go test, TC: total cholesterol, TG: serum triacylglycerols, LDLC: low-density lipoprotein cholesterol, HDLC: high-density lipoprotein cholesterol, RM: repetition maximum, HbA1c: glycosylated haemoglobin, 5-RSTS: five repetition sit-to-stand.