{
  "abstract": "Background and Objectives: This review evaluated whether strength and tendon stiffness show similar proportional responses to chronic mechanical loading. Methods: Six databases and citation chasing identified 57 reports from 50 cohorts. The primary analysis paired within-group longitudinal log response ratios (lnRRs) across 70 matched units, 62 participant samples, and 37 analytic cohorts, using multilevel models and cohort-clustered inference. This estimand was not a control-adjusted treatment effect. Results: Strength increased by 16.12% (lnRR 0.1495, 95% CI 0.1210 to 0.1779) and stiffness by 24.06% (lnRR 0.2156, 95% CI 0.1638 to 0.2674). The strength-stiffness contrast was -0.0661 (95% CI -0.1190 to -0.0132). Restriction to controlled designs attenuated the contrast, and its interval included zero. A reviewer-requested control-adjusted sensitivity analysis was directionally supportive but exploratory, with only 11 cohorts and low effective degrees of freedom. Strict maximal tendon strain showed no clear change (-4.77%, 95% CI -11.45% to 2.42%). Conclusions: The paired within-group analysis identified a small average proportional contrast, with a larger average stiffness response. The functional significance of this difference remains uncertain, and causal interpretation is limited.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Sports & Health Science, Shinhan University, 95 Hoam-ro, Uijeongbu-si 11644, Gyeonggi-do, Republic of Korea."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Keren Pang",
      "orcid": "0009-0007-2506-9206"
    },
    {
      "affs": [
        0
      ],
      "name": "Zirui Li",
      "orcid": "0009-0003-4240-8354"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fp14sdaqaz32n.bib",
  "cited_by": 0,
  "doi": "10.3390/jfmk11040393",
  "fulltext_url": "https://europepmc.org/articles/PMC13692497",
  "id": "fp14sdaqaz32n",
  "issns": [
    "2411-5142"
  ],
  "landing_url": "https://europepmc.org/article/MED/42924672",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Tendon Structure and Treatment"
    ]
  ],
  "openalex": "W7214734243",
  "pdf_url": "https://europepmc.org/articles/PMC13692497?pdf=render",
  "pmcid": "PMC13692497",
  "pmid": "42924672",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fp14sdaqaz32n.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42924672",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42924672"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Tendon Structure and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Do Strength and Tendon Stiffness Adapt in Parallel? A Systematic Review and Multilevel Meta-Analysis of Chronic Mechanical Loading in Healthy Humans.",
  "title_text": "Do Strength and Tendon Stiffness Adapt in Parallel? A Systematic Review and Multilevel Meta-Analysis of Chronic Mechanical Loading in Healthy Humans.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/fp14sdaqaz32n",
  "venue": "Journal of functional morphology and kinesiology",
  "versions": []
}