Plyometric training positively affects muscular strength, jump performance, and physical performance in older adults. |
Given the scarcity of plyometric training research in older adults, only limited evidence demonstrates superiority of plyometric training over other types of training with similar volume and intensity. |
Plyometric training was demonstrated to be a safe training option in older adults when properly programmed, especially when administered in a supervised setting. |
1 Background
2 Methods
2.1 Search Strategy
((((eccentric AND concentric) OR (stretch AND shortening) OR (deceleration AND acceleration) OR (stretch AND elastic)) AND muscle) OR (jump* OR hop OR hops OR hopping OR skipping OR countermovement OR bounding) OR plyometr*) AND (exercis*[tiab] OR “training”[tiab]) AND (aged[mh] OR middle aged[mh] OR aging [mh] OR aging[tiab] OR ageing [tiab] OR elder*[tiab] OR older[tiab] OR geriatr*[tiab] OR postmeno*[tiab]) |
2.2 Eligibility Criteria
2.3 Quality Assessment
2.4 Data Extraction and Synthesis
3 Results
3.1 Study Selection
Studya | Groups (sample size) | Mean age (SD) of the whole sample | Participant characteristics | Length of the intervention (length of follow-up) | Plyometric intervention description | Weekly volume |
---|---|---|---|---|---|---|
Unilateral intervention of one-leg hopping (35) | 69.9 (4) | Healthy males | 52 weeks | Unilateral hopping exercises (on a hard, even surface while barefoot) with multidirectional hops introduced in the ninth week | Frequency progressing from 3 to 7 times per week, number of sets progressing from 3 to 5 sets of 10 hops interspersed with 15 s rest period | |
Bolton et al. [54] | Combined exercises (19) and control (18) | 60.3 (5.6)b | Postmenopausal females with osteopenia | 52 weeks | Supervised resistance training, impact loading and balance exercises with individualized progression of the duration and intensity plus home program consisting of daily jumps introduced 12 weeks after commencing the intervention | 3 times per week for 60 min (supervised) plus up to 10 jumps, 3 times daily at home |
Resistance (37), balance-jumping (35), combination of resistance and balance-jumping (36), and control (36) | 72.9 (2.3)b | Healthy females | 52 weeks (with follow-ups 12 months and 5 years after cessation of the intervention) | Balance, agility, and impact exercises including jumps in the form of regularly alternating aerobics or step aerobics training programs with gradually increasing difficulty of movements | 3 times per week, 40–50 min | |
Bolam et al. [59] | High-dose jumping (13), low-dose jumping (15), or control (14) | 62.1 (6.9)b | Healthy males | 40 weeks | Two supervised sessions of combined impact-loading (multidirectional jumping, drop jumping, and bounding over soft foam hurdles) and upper-body resistance exercise. Two home sessions of multidirectional and vertical jumps | 4 times per week, 80 (high-dose) or 40 (low-dose) jumps per session in sets of 5–14 repetitions with rest periods of 1 min between sets |
Whole-body vibration (15), multicomponent training (13), and control (10) | 60.0 (6.3) | Postmenopausal females | 24 weeks | Multicomponent training consisted of aerobic activity and a series of drop jumps with progressive load imposed by increasing height from 5 up to 25 cm | 3 times per week, 30–60 min, 4–6 sets of 10 jumps | |
Ramírez Villada et al. [62] | Jump training (15), concurrent jump and machine training (15), and control (15) | 59.5 (6.4) | Healthy females | 22 weeks | Various multiple jumps ranging from basic jumps with the support of both lower limbs to jumps with turns and obstacles | 2 times per week with the total repetitions per week ranging from 128 to 144 |
Correa et al. [63] | Strength (14), power (13), plyometric (14) exercises, and control (17) | 67.0 (5.0) | Healthy females | 12 weeks | Leg press, knee extension, and knee flexion in the first 6 weeks. In the second 6-week phase, leg press was replaced with lateral box jump exercise on a box with a height of 10–30 cm | 3–4 times per week, 3–4 sets (15–20 sec) |
Piirainen et al. [64] | Plyometric (9) and pneumatic (11) training | 63 (2)b | Healthy males | 12 weeks | Continuous countermovement jumps using a sledge apparatus that enables drop jumps to be performed more safely than standard vertical jumping | 2–3 times per week, 5 sets of 6 repetitions |
Hopping (10) and control (10) | 73 (4)b | Healthy males | 11 weeks | Continuous bilateral hopping on the balls of the feet at submaximal intensity (75–90% of the maximal ground reaction force) | 3 times per week, 5–7 sets (10 sec) | |
Váczi et al. [67] | Stretch-shortening cycle contractions (8) and isokinetic eccentric contractions (8) | 64.4 (4.1)b | Healthy males | 10 weeks | Unilateral knee extensions with both legs in which a dynamometer rapidly applied a preset amount of energy to stretch the quadriceps and subjects were instructed to resist the rotating lever arm maximally, stop it within the shortest range of motion, and then extend the knee without a time delay and as fast as possible | 2–3 times per week, 4 sets of 8–14 repetitions with rest periods of 2 min between sets |
Cakar et al. [43] | Combined exercises (30) and combined exercises plus jumping (36) | 79.4 (5.4)b | Males (n = 26) and females (n = 40) living in a long-term care facility | 6 weeks | 10 min of vertical jumping with self-paced intensity. The participants were encouraged to maintain a high level of effort. Combined exercises included stretching, strength, and aerobic exercises | 3 times per week, 30–45 min of combined exercises plus 10 min of jumping |
Park et al. [68] | Jumping plus therapeutic exercises (16) and therapeutic exercises alone (15) | 76.7 (8.6)b | Males (n = 14) and females (n = 17) living in a long-term care facility | 4 weeks | At least 30 jumps of > 2 cm above the ground per session. The jumping frequency was not limited. Therapeutic exercises included stretching, fast walking, squats, etc. | 5 times per week, 40 min of therapeutic exercises plus 20 min of jumping exercises |
3.2 Methodological Quality
Studya | Eligibility criteria | Randomization | Concealed allocation | Similar group baselines | Blinding of all subjects | Blinding of all therapists | Blinding of all assessors | Dropout < 15% | Intention-to-treat method | Statistical between-group comparison | Point measures and measures of variability | Score |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Allison et al. [52] | + | + | + | + | − | − | + | − | + | + | + | 7 |
Bolton et al. [54] | + | + | + | − | − | − | + | + | + | + | + | 7 |
Karinkanta et al. [55] | + | + | + | + | − | − | − | + | + | + | + | 7 |
Park et al. [68] | + | + | + | + | − | − | − | + | + | + | + | 7 |
Bolam et al. [59] | + | + | − | + | − | − | − | + | + | + | + | 6 |
Cakar et al. [43] | + | + | + | + | − | − | − | − | + | + | + | 6 |
Correa et al. [63] | − | + | − | + | − | − | − | + | + | + | + | 6 |
Piirainen et al. [64] | − | + | − | + | − | − | − | + | + | + | + | 6 |
Rantalainen et al. [65] | + | + | + | + | − | − | − | − | + | + | + | 6 |
Marín-Cascales et al. [60] | + | + | − | + | − | − | − | − | + | + | + | 5 |
Váczi et al. [67] | + | + | − | − | − | − | − | + | + | + | + | 5 |
Ramírez Villada et al. [62] | − | − | − | + | − | − | − | − | + | + | + | 4 |
3.3 Study Characteristics
3.4 Plyometric Training
3.5 Study Outcomes
Outcome | Measure | Overall effect | Referencesa |
---|---|---|---|
Muscular strength | Hip flexion, knee extension, and ankle plantar- and dorsiflexion assessed by a handheld dynamometer | Positive | [68] |
Rate of torque development of the quadriceps femoris assessed by a dynamometer | Positive | [67] | |
Knee extension test (1RM) assessed on a knee extension machine | Positive: similar to others without plyometrics | [63] | |
Leg extensor force assessed by a leg press dynamometer | Positive: similar to others without plyometrics, but disappeared after 1 year | ||
Plantar flexion and knee extension maximal voluntary contractions assessed by an isokinetic dynamometer | Positive: similar to others without plyometrics | [64] | |
Maximal voluntary isometric concentric and isokinetic eccentric torque, work during a concentric contraction, work during a plyometric contraction, time of the plyometric contraction | Positive: similar to others without plyometrics | [67] | |
Isokinetic knee extension, dorsal and plantar flexion, and eversion and inversion assessed by an isokinetic dynamometer | Likely positive: similar to others without plyometrics | ||
Maximum voluntary isometric dominant knee extension and back extension assessed by an isokinetic dynamometer; dominant leg hip abduction and hip flexion assessed by a handheld dynamometer | Unclear: likely positive effect, but similar to control group | [54] | |
Leg press (1RM) | No effect | [59] | |
Bone health | BMD and content of proximal femur assessed by DXA | Positive | [52] |
BMD of the total hip and lumbar spine assessed by DXA | Positive | [54] | |
Cortical, trabecular, and integral bone mineral content at traditional regions of interest within the proximal femur assessed by QCT | Likely positive: site-specific, but not global, increases compared to control group | [53] | |
BMD of the hip and trochanter assessed by DXA | Unclear: possible positive effect for high-dose group | [59] | |
Total hip, femoral neck, trochanter, and lumbar spine BMD assessed by DXA | No effect | [59] | |
Bone turnover markers (bone-specific alkaline phosphatase and C-terminal telopeptide of type 1 collagen) | No effect | [59] | |
BMD and content of the right proximal femur assessed by DXA | No effect | ||
QCT performed at the distal sites (trabecular bone) and at midshaft (cortical bone) of the right radius and tibia | No effect | ||
BMD assessed by DXA | No effect | ||
Bone turnover markers (C-terminal propeptide of type 1 collagen, bone-specific alkaline phosphatase, and C-terminal telopeptide of type 1 collagen) | No effect | [65] | |
Body composition | Body mass, lean body mass (calculated by the Rose formula), and fat mass (estimated by Brozek’s equation) | Positive | [62] |
Anatomical cross-sectional area measured by magnetic resonance imaging on the components of the quadriceps | Positive: same as others without plyometrics | [67] | |
Total fat mass, lean mass, and body fat percentage assessed by DXA | Likely positive: similar to others without plyometrics, but better than control | ||
Muscle thickness (vastus lateralis, medialis, and rectus femoris) assessed by ultrasonography | Unclear: positive effect for vastus lateralis, which was similar to others without plyometrics; no effects for other muscles | [63] | |
Fat and lean tissue mass of the whole body assessed by DXA | No effect | [52] | |
Whole-body lean mass, fat mass, percentage body fat assessed by DXA | No effect | [59] | |
Skinfolds (biceps, triceps, subscapular, suprailiac) measured by Holtain calliper | No effect | [62] | |
Postural stability | Berg balance test; dynamic balance on a balance platform | Positive | [43] |
Berg balance test; postural sway on a force plate | Positive | [68] | |
Dynamic balance on a balance platform | Unclear: directional-specific and time-specific effects present, some similar to others without plyometrics | [64] | |
Static and dynamic balance in barefoot standing with eyes open on a balance platform | No effect | [54] | |
Static posturography on a force plate assessed by center-of-pressure velocity | No effect | [65] | |
Jump performance | Countermovement jump on a force plate | Positive | [63] |
Maximal drop jump performance and optimal dropping height on a sledge ergometer | Positive: time-specific changes, but similar to others without plyometrics | [64] | |
Ground contact time, ground reaction force, and ankle joint stiffness during repeated two-legged hopping on a force plate, reactive strength index, jump height | Positive: time-specific changes, but generally better for plyometric group | [66] | |
Peak vertical ground reaction forces during take-off and landing averaged over 10 hops on a force plate | Likely positive | [52] | |
Squat jump, countermovement jump, and countermovement jumps with arm swing on an OptoGait system (jump height, take-off velocity, flight time) | Likely positive: data in original article’s tables somewhat confusing | [62] | |
Jump height and ground reaction forces determined from 2–4 maximal jump efforts during repetitive two-legged hopping on a force plate | No effect | [65] | |
Physical performance | 30-s sit-to-stand test | Positive | [63] |
A standardized figure-of-8 running test around two poles placed 10 m apart | Positive: similar to others without plyometrics, but effect may disappear if training is not continued | ||
Timed up-and-go test | Positive | [68] | |
Velocity-agility test (30 m) and shuttle run test (30 m) | Likely positive: effect similar to others without plyometrics | [62] | |
6-m fast walk | Unclear: positive effect for moderate-dose group, but no effect for high-dose group | [59] | |
6-m usual walk, backwards tandem walk, stair climb, or sit-to-stand test | No effect | [59] | |
Quality of life /daily function | Health-related quality of life, assessed by the SF-36 survey | Positive: to the same degree as others without plyometrics | [43] |
Finnish Physical Functioning Scale of the SF-36, fear of falling | Positive: effect likely to disappear if training stops | ||
Quality of life assessed by the Assessment of Quality of Life survey, mental health assessed by the SF-36 survey, and physical activity assessed on the Physical Activity Scale for the Elderly questionnaire | Likely positive: all variables generally better maintained in exercise group | [54] | |
Physical activity measured by the Godin Leisure Time Exercise Questionnaire | No effect | [59] | |
Other | Muscle onset latency and reaction time assessed by electromyography | Positive | [63] |
Capillary glucose | Positive | [62] | |
Fractures and injurious falls experienced during a 5-year follow-up period | Positive | [58] | |
Maximal muscle activity by maximal electromyography root mean square (vastus lateralis, medialis, and rectus femoris). | Likely positive: effect similar to others without plyometrics | [63] | |
Kinematics of ankle and knee joint angles | Unclear: possibly a minor effect, data varied at different training times and hopping intensities | [66] | |
Gastrocnemius medialis–muscle fascicle and its outer Achilles tendon length changes examined by ultrasonography | Unclear: possibly a minor effect, data varied at different training times and hopping intensities | [66] | |
H-reflex during standing rest and drop jumps, EMG activity during drop jumps | Unclear: plyometric group likely experienced positive explosive/reflex-specific changes, but not during slow/maximal strength tasks | [64] | |
EMG activities of calf muscles | No effect | [66] | |
Testosterone, estradiol, vitamin D levels, blood calcium levels | No effect | [59] | |
Total testosterone and cortisol serum levels | No effect | [67] |