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Pooled and subgroup meta-analyses were performed using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-nine studies involving 773 participants were included. Although considerable variance exists in certain outcomes, our estimated effects suggest that, compared to constant-load RT, AEL results in (1) similar acute responses in loads lifted during the concentric phase (standardized mean difference [SMD]\u2009=\u2009\u2009\u2212\u20090.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.48), mechanical performance at submaximal loads during the concentric phase (SMD\u2009=\u2009\u2009\u2212\u20090.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.37), countermovement jump height both immediately (SMD\u2009=\u2009\u2009\u2212\u20090.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.86) and delayed (SMD\u2009=\u2009\u2009\u2212\u20090.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.44) post-intervention, maximal voluntary isometric force immediately post-intervention (SMD\u2009=\u20090.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.89), blood lactate concentration during the intervention (SMD\u2009=\u2009\u2009\u2212\u20090.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78), testosterone concentration immediately post-intervention (SMD\u2009=\u20090.68;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15), creatine kinase concentration both immediately (SMD\u2009=\u20090.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.72) and delayed (SMD\u2009=\u20090.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.48) post-intervention, cortisol concentration immediately post-intervention (SMD\u2009=\u20090.39;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), heart rate during the intervention (SMD\u2009=\u20091.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07), acute muscle swelling immediately post-intervention (SMD\u2009=\u20090.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.42), muscle electrical activity during the concentric phase (SMD\u2009=\u2009\u2009\u2212\u20090.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.90), and muscle soreness both immediately (SMD\u2009=\u20090.28;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.30) and delayed (SMD\u2009=\u20090.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.28) post-intervention; (2) greater acute responses in blood lactate concentration immediately post-intervention (SMD\u2009=\u20090.44;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), growth hormone concentration immediately post-intervention (SMD\u2009=\u20090.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), muscle electrical activity during the eccentric phase (SMD\u2009=\u20090.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and rating of perceived exertion immediately post-intervention (SMD\u2009=\u20091.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01); (3) similar chronic adaptations in maximal concentric strength (SMD\u2009=\u20090.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41), maximal eccentric strength (SMD\u2009=\u20090.19;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.58), maximal isometric strength (SMD\u2009=\u20090.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.93), countermovement jump height (SMD\u2009=\u20090.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.87), muscle fascicle angle (SMD\u2009=\u2009\u2009\u2212\u20090.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.77), muscle fascicle length (SMD\u2009=\u20090.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17), and muscle cross-sectional area (SMD\u2009=\u2009\u2009\u2212\u20090.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.84).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While AEL augments the eccentric-phase stimulus (higher eccentric load and muscle electrical activity), it also increases metabolic stress and perceived effort, implying a need for longer, more frequent inter-set rests and longer between-session recovery. Given the lack of evidence for superior chronic benefits in strength or muscle architecture over constant-load RT, practitioners should consider these factors carefully.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Protocol Registration<\/jats:title>\n                    <jats:p>The original protocol for this review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) in July 2024 (CRD42024561673).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40279-026-02422-7","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:27:14Z","timestamp":1775568434000},"page":"1749-1770","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute and Chronic Effects of Accentuated Eccentric Loading vs. Constant-Load Resistance Training: A Systematic Review and Meta-analysis"],"prefix":"10.1007","volume":"56","author":[{"given":"Xing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Weakley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Marcos-Frutos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0608-8755","authenticated-orcid":false,"given":"Amador","family":"Garc\u00eda-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"2422_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.651112","volume":"12","author":"X Zhang","year":"2021","unstructured":"Zhang X, Li H, Bi S, Luo Y, Cao Y, Zhang G. 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