Do Strength and Tendon Stiffness Adapt in Parallel? A Systematic Review and Multilevel Meta-Analysis of Chronic Mechanical Loading in Healthy Humans.
- 1Department of Sports & Health Science, Shinhan University, 95 Hoam-ro, Uijeongbu-si 11644, Gyeonggi-do, Republic of Korea.
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.
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BibTeX
@article{pang2026strength,
title = {{Do Strength and Tendon Stiffness Adapt in Parallel? A Systematic Review and Multilevel Meta-Analysis of Chronic Mechanical Loading in Healthy Humans.}},
author = {Keren Pang and Zirui Li},
journal = {Journal of functional morphology and kinesiology},
year = {2026},
month = sep,
doi = {10.3390/jfmk11040393},
url = {https://europepmc.org/article/MED/42924672},
note = {CC BY},
}
RIS
TY - JOUR
TI - Do Strength and Tendon Stiffness Adapt in Parallel? A Systematic Review and Multilevel Meta-Analysis of Chronic Mechanical Loading in Healthy Humans.
AU - Keren Pang
AU - Zirui Li
PY - 2026
DA - 2026/09/29
JO - Journal of functional morphology and kinesiology
DO - 10.3390/jfmk11040393
UR - https://europepmc.org/article/MED/42924672
AB - 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.
SN - 2411-5142
ER -