Background

Balance and resistance training applied as single-mode interventions have proven to enhance measures of balance and/or muscular fitness in youth and youth athletes. Less is known on the effectiveness of combined or sequenced balance and resistance training in youth and youth athletes.

Objective

The objective of this scoping review was to describe the effects of concurrently performed balance and resistance training (i.e., metastable resistance training) and different sequencing schemes of balance and resistance training on measures of balance and/or muscular fitness in healthy youth and youth athletes. We additionally aimed to identify knowledge gaps in the literature.

Methods

According to the principles of a scoping review, we followed a broad research question, identified gaps in the literature, and reported findings on the level of single studies but did not aggregate and meta-analyze outcomes across studies. For this purpose, systematic literature searches were conducted in the electronic databases PubMed (including MEDLINE), Web of Science, and SPORTDiscus from inception until August 2022. We included metastable resistance training and sequenced balance and resistance training studies in healthy youth and youth athletes aged 6–18 years that investigated the training-induced effects on measures of balance (e.g., stork balance test) and muscular fitness (e.g., countermovement jump test) in contrast to active/passive controls. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias. The Strength of Recommendation Taxonomy (SORT) was applied for the whole scoping review on levels A (high strength of recommendation) to C (low strength of recommendation) and for individual studies on levels 1 (high-quality evidence) to 3 (low-quality evidence).

Results

The strength of recommendation for the scoping review was level B based on inconsistent or limited-quality evidence. Eleven randomized controlled trials were eligible to be included in this scoping review and each study was rated as ‘limited-quality evidence’. A median PEDro score of 6 was computed across the included studies. Four studies examined the effects of metastable resistance training (e.g., plyometric training on unstable surfaces) on measures of balance and/or muscle fitness in youth athletes. The remaining seven studies investigated the impact of sequenced balance and resistance training (e.g., blocked balance training followed by blocked resistance training) on measures of balance and/or muscle fitness in youth and youth athletes. The duration of the intervention programs ranged from 6 to 10 weeks with 2-weekly to 3-weekly exercise sessions. Participants’ age range was 10–18 years (mean 15 years). Ten studies examined young male and female athletes from different sports (i.e., basketball, handball, soccer) and one study physical education students. Metastable resistance training compared with plyometric training performed on stable surfaces showed no extra effect on measures of balance and muscular fitness. Stable plyometric training appears to be even more effective to improve jump performance. Sequenced balance and resistance training in the form of a mesocycle of balance followed by plyometric training seems to be particularly effective to improve measures of balance and muscular fitness in young athletes. This scoping review identified knowledge gaps that may indicate future research avenues: (i) comparative studies should be designed to examine how sex, age, maturity status, and expertise level impact on the adaptive potential following metastable resistance training or sequenced balance and resistance training in youth and youth athletes, (ii) at least one established measure of balance and muscular fitness should always be included in study designs to allow future comparison between studies and to aggregate (meta-analyze) findings across studies and (iii) studies are needed that examine neuromuscular and tendomuscular adaptations following these exercise types as well as dosage effects.

Conclusions

According to the results of this scoping review, balance training should be an essential training component for youth that is incorporated with the resistance training exercises or introduced at least a month before resistance and plyometric training within a periodized training program. More research is needed to examine the moderating roles of age, maturity status, and sex.

中文翻译：

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结合阻力和平衡训练以改善健康青年和青年运动员的平衡和肌肉健康的相关性和有效性：范围界定审查

背景

作为单一模式干预应用的平衡和阻力训练已被证明可以提高青少年和青少年运动员的平衡和/或肌肉健康水平。对青年和青年运动员联合或顺序平衡和阻力训练的有效性知之甚少。

客观的

本范围审查的目的是描述同时进行的平衡和阻力训练（即亚稳态阻力训练）以及平衡和阻力训练的不同顺序方案对健康青年和青年运动员的平衡和/或肌肉健康测量的影响。我们还旨在确定文献中的知识差距。

方法

根据范围界定审查的原则，我们遵循了一个广泛的研究问题，确定了文献中的差距，并报告了单个研究水平的发现，但没有汇总和荟萃分析跨研究的结果。为此，从电子数据库 PubMed（包括 MEDLINE）、Web of Science 和 SPORTDiscus 开始到 2022 年 8 月，我们进行了系统的文献检索。我们纳入了亚稳态阻力训练以及健康青年和青年运动员的有序平衡和阻力训练研究6-18 岁调查了训练对平衡（例如，鹳平衡测试）和肌肉健康（例如，反向运动跳跃测试）测量的影响，与主动/被动控制相比。物理治疗证据数据库 (PEDro) 量表用于评估偏倚风险。

结果

基于不一致或质量有限的证据，范围界定审查的推荐强度为 B 级。11 项随机对照试验有资格纳入本范围界定审查，每项研究都被评为“有限质量证据”。在纳入的研究中计算出的 PEDro 评分中位数为 6。四项研究检查了亚稳态阻力训练（例如，在不稳定表面上的增强式训练）对青年运动员平衡和/或肌肉健康测量的影响。其余七项研究调查了顺序平衡和阻力训练（例如，块状平衡训练之后是块状阻力训练）对青少年和青年运动员的平衡和/或肌肉健康测量的影响。干预计划的持续时间从 6 到 10 周不等，每周进行 2 到 3 周的锻炼。参与者的年龄范围为 10-18 岁（平均 15 岁）。十项研究调查了来自不同运动项目（即篮球、手球、足球）的年轻男女运动员，一项研究调查了体育专业的学生。与在稳定表面上进行的增强式训练相比，亚稳态阻力训练对平衡和肌肉健康的测量没有额外的影响。稳定的增强式训练似乎对提高跳跃性能更有效。以平衡中循环形式继以增强式训练的顺序平衡和阻力训练似乎对改善年轻运动员的平衡和肌肉健康措施特别有效。

结论

根据本次范围界定审查的结果，平衡训练应该是青少年必不可少的训练组成部分，它与阻力训练相结合，或者至少在周期性训练计划中的阻力和增强式训练前一个月引入。需要更多的研究来检验年龄、成熟状态和性别的调节作用。