@misc{LacroixHortobagyiBeurskensetal.2017, author = {Lacroix, Andre and Hortobagyi, Tibor and Beurskens, Rainer and Granacher, Urs}, title = {Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis}, series = {Sports medicine}, volume = {47}, journal = {Sports medicine}, publisher = {Springer}, address = {Northcote}, issn = {0112-1642}, doi = {10.1007/s40279-017-0747-6}, pages = {2341 -- 2361}, year = {2017}, abstract = {Objectives The objective of this systematic review and meta-analysis was to quantify the effectiveness of supervised vs. unsupervised balance and/or resistance training programs on measures of balance and muscle strength/ power in healthy older adults. In addition, the impact of supervision on training-induced adaptive processes was evaluated in the form of dose-response relationships by analyzing randomized controlled trials that compared supervised with unsupervised trials. Data Sources A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SportDiscus to detect articles examining the role of supervision in balance and/or resistance training in older adults. Study Eligibility Criteria The initially identified 6041 articles were systematically screened. Studies were included if they examined balance and/or resistance training in adults aged >= 65 years with no relevant diseases and registered at least one behavioral balance (e.g., time during single leg stance) and/or muscle strength/ power outcome (e.g., time for 5-Times-Chair-Rise-Test). Finally, 11 studies were eligible for inclusion in this meta-analysis. Study Appraisal Weighted mean standardized mean differences between subjects (SMDbs) of supervised vs. unsupervised balance/resistance training studies were calculated. The included studies were coded for the following variables: number of participants, sex, age, number and type of interventions, type of balance/strength tests, and change (\%) from pre- to post-intervention values. Additionally, we coded training according to the following modalities: period, frequency, volume, modalities of supervision (i.e., number of supervised/unsupervised sessions within the supervised or unsupervised training groups, respectively). Heterogeneity was computed using I 2 and chi(2) statistics. The methodological quality of the included studies was evaluated using the Physiotherapy Evidence Database scale. Results Our analyses revealed that in older adults, supervised balance/resistance training was superior compared with unsupervised balance/resistance training in improving measures of static steady-state balance (mean SMDbs = 0.28, p = 0.39), dynamic steady-state balance (mean SMDbs = 0.35, p = 0.02), proactive balance (mean SMDbs = 0.24, p = 0.05), balance test batteries (mean SMDbs = 0.53, p = 0.02), and measures of muscle strength/power (mean SMDbs = 0.51, p = 0.04). Regarding the examined dose-response relationships, our analyses showed that a number of 10-29 additional supervised sessions in the supervised training groups compared with the unsupervised training groups resulted in the largest effects for static steady-state balance (mean SMDbs = 0.35), dynamic steady-state balance (mean SMDbs = 0.37), and muscle strength/power (mean SMDbs = 1.12). Further, >= 30 additional supervised sessions in the supervised training groups were needed to produce the largest effects on proactive balance (mean SMDbs = 0.30) and balance test batteries (mean SMDbs = 0.77). Effects in favor of supervised programs were larger for studies that did not include any supervised sessions in their unsupervised programs (mean SMDbs: 0.28-1.24) compared with studies that implemented a few supervised sessions in their unsupervised programs (e.g., three supervised sessions throughout the entire intervention program; SMDbs: -0.06 to 0.41). Limitations The present findings have to be interpreted with caution because of the low number of eligible studies and the moderate methodological quality of the included studies, which is indicated by a median Physiotherapy Evidence Database scale score of 5. Furthermore, we indirectly compared dose-response relationships across studies and not from single controlled studies. Conclusions Our analyses suggest that supervised balance and/or resistance training improved measures of balance and muscle strength/power to a greater extent than unsupervised programs in older adults. Owing to the small number of available studies, we were unable to establish a clear dose-response relationship with regard to the impact of supervision. However, the positive effects of supervised training are particularly prominent when compared with completely unsupervised training programs. It is therefore recommended to include supervised sessions (i.e., two out of three sessions/week) in balance/resistance training programs to effectively improve balance and muscle strength/power in older adults.}, language = {en} } @article{PrieskeDalagerHerzetal.2019, author = {Prieske, Olaf and Dalager, Tina and Herz, Michael and Hortobagyi, Tibor and Sjogaard, Gisela and Sogaard, Karen and Granacher, Urs}, title = {Effects of Physical Exercise Training in the Workplace on Physical Fitness: A Systematic Review and Meta-analysis}, series = {Sports medicine}, volume = {49}, journal = {Sports medicine}, number = {12}, publisher = {Springer}, address = {Northcote}, issn = {0112-1642}, doi = {10.1007/s40279-019-01179-6}, pages = {1903 -- 1921}, year = {2019}, abstract = {Background There is evidence that physical exercise training (PET) conducted at the workplace is effective in improving physical fitness and thus health. However, there is no current systematic review available that provides high-level evidence regarding the effects of PET on physical fitness in the workforce. Objectives To quantify sex-, age-, and occupation type-specific effects of PET on physical fitness and to characterize dose-response relationships of PET modalities that could maximize gains in physical fitness in the working population. Data Sources A computerized systematic literature search was conducted in the databases PubMed and Cochrane Library (2000-2019) to identify articles related to PET in workers. Study Eligibility Criteria Only randomized controlled trials with a passive control group were included if they investigated the effects of PET programs in workers and tested at least one fitness measure. Study Appraisal and Synthesis Methods Weighted mean standardised mean differences (SMDwm) were calculated using random effects models. A multivariate random effects meta-regression was computed to explain the influence of key training modalities (e.g., training frequency, session duration, intensity) on the effectiveness of PET on measures of physical fitness. Further, subgroup univariate analyses were computed for each training modality. Additionally, methodological quality of the included studies was rated with the help of the Physiotherapy Evidence Database (PEDro) Scale. Results Overall, 3423 workers aged 30-56 years participated in 17 studies (19 articles) that were eligible for inclusion. Methodological quality of the included studies was moderate with a median PEDro score of 6. Our analyses revealed significant, small-sized effects of PET on cardiorespiratory fitness (CRF), muscular endurance, and muscle power (0.29 <= SMDwm <= 0.48). Medium effects were found for CRF and muscular endurance in younger workers (<= 45 years) (SMDwm = 0.71) and white-collar workers (SMDwm = 0.60), respectively. Multivariate random effects meta-regression for CRF revealed that none of the examined training modalities predicted the effects of PET on CRF (R-2 = 0). Independently computed subgroup analyses showed significant PET effects on CRF when conducted for 9-12 weeks (SMDwm = 0.31) and for 17-20 weeks (SMDwm = 0.74). Conclusions PET effects on physical fitness in healthy workers are moderated by age (CRF) and occupation type (muscular endurance). Further, independently computed subgroup analyses indicated that the training period of the PET programs may play an important role in improving CRF in workers.}, language = {en} } @misc{HortobagyiLesinskiFernandezdelOlmoetal.2015, author = {Hortobagyi, Tibor and Lesinski, Melanie and Fernandez-del-Olmo, Miguel and Granacher, Urs}, title = {Small and inconsistent effects of whole body vibration on athletic performance: a systematic review and meta-analysis}, series = {European journal of applied physiology}, volume = {115}, journal = {European journal of applied physiology}, number = {8}, publisher = {Springer}, address = {New York}, issn = {1439-6319}, doi = {10.1007/s00421-015-3194-9}, pages = {1605 -- 1625}, year = {2015}, abstract = {We quantified the acute and chronic effects of whole body vibration on athletic performance or its proxy measures in competitive and/or elite athletes. Systematic literature review and meta-analysis. Whole body vibration combined with exercise had an overall 0.3 \% acute effect on maximal voluntary leg force (-6.4 \%, effect size = -0.43, 1 study), leg power (4.7 \%, weighted mean effect size = 0.30, 6 studies), flexibility (4.6 \%, effect size = -0.12 to 0.22, 2 studies), and athletic performance (-1.9 \%, weighted mean effect size = 0.26, 6 studies) in 191 (103 male, 88 female) athletes representing eight sports (overall effect size = 0.28). Whole body vibration combined with exercise had an overall 10.2 \% chronic effect on maximal voluntary leg force (14.6 \%, weighted mean effect size = 0.44, 5 studies), leg power (10.7 \%, weighted mean effect size = 0.42, 9 studies), flexibility (16.5 \%, effect size = 0.57 to 0.61, 2 studies), and athletic performance (-1.2 \%, weighted mean effect size = 0.45, 5 studies) in 437 (169 male, 268 female) athletes (overall effect size = 0.44). Whole body vibration has small and inconsistent acute and chronic effects on athletic performance in competitive and/or elite athletes. These findings lead to the hypothesis that neuromuscular adaptive processes following whole body vibration are not specific enough to enhance athletic performance. Thus, other types of exercise programs (e.g., resistance training) are recommended if the goal is to improve athletic performance.}, language = {en} } @article{JararnezhadgeroMamashliGranacher2021, author = {Jararnezhadgero, AmirAli and Mamashli, Elaheh and Granacher, Urs}, title = {An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy}, series = {Frontiers in physiology / Frontiers Research Foundation}, volume = {12}, journal = {Frontiers in physiology / Frontiers Research Foundation}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-042X}, doi = {10.3389/fphys.2021.654755}, pages = {1 -- 15}, year = {2021}, abstract = {Background: The prevalence of diabetes worldwide is predicted to increase from 2.8\% in 2000 to 4.4\% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility. Objective: We aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN. Methods: Sixty male and female individuals aged 45-65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40-55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s. Results: No statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p < 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p < 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001-0.037; d = 0.56-1.53). For IG, post-hoc analyses showed decreases in peak lateral (p < 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p < 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001-0.044; d = 0.54-0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p < 0.001; d = 1.28). Conclusions: This study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics.}, language = {en} } @article{PrieskeMuehlbauerMuelleretal.2013, author = {Prieske, Olaf and M{\"u}hlbauer, Thomas and M{\"u}ller, Steffen and Kr{\"u}ger, Tom and Kibele, Armin and Behm, David George and Granacher, Urs}, title = {Effects of surface instability on neuromuscular performance during drop jumps and landings}, series = {European journal of applied physiology}, volume = {113}, journal = {European journal of applied physiology}, number = {12}, publisher = {Springer}, address = {New York}, issn = {1439-6319}, doi = {10.1007/s00421-013-2724-6}, pages = {2943 -- 2951}, year = {2013}, abstract = {The purpose of this study was to investigate the effects of surface instability on measures of performance and activity of leg and trunk muscles during drop jumps and landings. Drop jumps and landings were assessed on a force plate under stable and unstable (balance pad on top of the force plate) conditions. Performance measures (contact time, jump height, peak ground reaction force) and electromyographic (EMG) activity of leg and trunk muscles were tested in 27 subjects (age 23 +/- A 3 years) during different time intervals (preactivation phase, braking phase, push-off phase). The performance of drop jumps under unstable compared to stable conditions produced a decrease in jump height (9 \%, p < 0.001, f = 0.92) and an increase in peak ground reaction force (5 \%, p = 0.022, f = 0.72), and time for braking phase (12 \%, p < 0.001, f = 1.25). When performing drop jumps on unstable compared to stable surfaces, muscle activity was reduced in the lower extremities during the preactivation, braking and push-off phases (11-25 \%, p < 0.05, 0.48 a parts per thousand currency sign f a parts per thousand currency sign 1.23). Additionally, when landing on unstable compared to stable conditions, reduced lower limb muscle activities were observed during the preactivation phase (7-60 \%, p < 0.05, 0.50 a parts per thousand currency sign f a parts per thousand currency sign 3.62). Trunk muscle activity did not significantly differ between the test conditions for both jumping and landing tasks. The present findings indicate that modified feedforward mechanisms in terms of lower leg muscle activities during the preactivation phase and/or possible alterations in leg muscle activity shortly after ground contact (i.e., braking phase) are responsible for performance decrements during jumping on unstable surfaces.}, language = {en} } @article{AraziAsadiKhalkhalietal.2020, author = {Arazi, Hamid and Asadi, Abbas and Khalkhali, Farhood and Boullosa, Daniel and Hackney, Anthony C. and Granacher, Urs and Zouhal, Hassane}, title = {Association Between the Acute to Chronic Workload Ratio and Injury Occurrence in Young Male Team Soccer Players}, volume = {11}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2020.00608}, pages = {7}, year = {2020}, abstract = {This study aimed to investigate the relationship between the acute to chronic workload ratio (ACWR), based upon participant session rating of perceived exertion (sRPE), using two models [(1) rolling averages (ACWRRA); and (2) exponentially weighted moving averages (ACWREWMA)] and the injury rate in young male team soccer players aged 17.1 ± 0.7 years during a competitive mesocycle. Twenty-two players were enrolled in this study and performed four training sessions per week with 2 days of recovery and 1 match day per week. During each training session and each weekly match, training time and sRPE were recorded. In addition, training impulse (TRIMP), monotony, and strain were subsequently calculated. The rate of injury was recorded for each soccer player over a period of 4 weeks (i.e., 28 days) using a daily questionnaire. The results showed that over the course of the study, the number of non-contact injuries was significantly higher than that for contact injuries (2.5 vs. 0.5, p = 0.01). There were also significant positive correlations between sRPE and training time (r = 0.411, p = 0.039), ACWRRA (r = 0.47, p = 0.049), and ACWREWMA (r = 0.51, p = 0.038). In addition, small-to-medium correlations were detected between ACWR and non-contact injury occurrence (ACWRRA, r = 0.31, p = 0.05; ACWREWMA, r = 0.53, p = 0.03). Explained variance (r²) for non-contact injury was significantly greater using the ACWREWMA model (ranging between 21 and 52\%) compared with ACWRRA (ranging between 17 and 39\%). In conclusion, the results of this study showed that the ACWREWMA model is more sensitive than ACWRRA to identify non-contact injury occurrence in male team soccer players during a short period in the competitive season.}, language = {en} } @article{AhmadiHeratAlizadehetal.2021, author = {Ahmadi, Hamid and Herat, Nehara and Alizadeh, Shahab and Button, Duane C. and Granacher, Urs and Behm, David G.}, title = {Effect of an inverted seated position with upper arm blood flow restriction on measures of elbow flexors neuromuscular performance}, series = {PLOS ONE / Public Library of Science}, volume = {16}, journal = {PLOS ONE / Public Library of Science}, number = {5}, publisher = {PLoS}, address = {San Fransisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0245311}, pages = {19}, year = {2021}, abstract = {Purpose The objective of the investigation was to determine the concomitant effects of upper arm blood flow restriction (BFR) and inversion on elbow flexors neuromuscular responses. Methods Randomly allocated, 13 volunteers performed four conditions in a within-subject design: rest (control, 1-min upright position without BFR), control (1-min upright with BFR), 1-min inverted (without BFR), and 1-min inverted with BFR. Evoked and voluntary contractile properties, before, during and after a 30-s maximum voluntary contraction (MVC) exercise intervention were examined as well as pain scale. Results Inversion induced significant pre-exercise intervention decreases in elbow flexors MVC (21.1\%, Z2p = 0.48, p = 0.02) and resting evoked twitch forces (29.4\%, Z2p = 0.34, p = 0.03). The 30-s MVC induced significantly greater pre- to post-test decreases in potentiated twitch force (Z2p = 0.61, p = 0.0009) during inversion (75\%) than upright (65.3\%) conditions. Overall, BFR decreased MVC force 4.8\% (Z2p = 0.37, p = 0.05). For upright position, BFR induced 21.0\% reductions in M-wave amplitude (Z2p = 0.44, p = 0.04). There were no significant differences for electromyographic activity or voluntary activation as measured with the interpolated twitch technique. For all conditions, there was a significant increase in pain scale between the 40-60 s intervals and post-30-s MVC (upright< inversion, and without BFR< BFR). Conclusion The concomitant application of inversion with elbow flexors BFR only amplified neuromuscular performance impairments to a small degree. Individuals who execute forceful contractions when inverted or with BFR should be cognizant that force output may be impaired.}, language = {en} } @article{LesinskiHerzSchmelcheretal.2020, author = {Lesinski, Melanie and Herz, Michael and Schmelcher, Alina and Granacher, Urs}, title = {Effects of resistance training on physical fitness in healthy children and adolescents}, series = {Sports medicine}, volume = {50}, journal = {Sports medicine}, number = {11}, publisher = {Springer}, address = {Northcote}, issn = {0112-1642}, doi = {10.1007/s40279-020-01327-3}, pages = {1901 -- 1928}, year = {2020}, abstract = {Background Over the past decades, an exponential growth has occurred with regards to the number of scientific publications including meta-analyses on youth resistance training (RT). Accordingly, it is timely to summarize findings from meta-analyses in the form of an umbrella review. Objectives To systematically review and summarise the findings of published meta-analyses that investigated the effects of RT on physical fitness in children and adolescents. Design Systematic umbrella review of meta-analyses. Data Sources Meta-analyses were identified using systematic literature searches in the databases PubMed, Web of Science, and Cochrane Library. Eligibility Criteria for Selecting Meta-analyses Meta-analyses that examined the effects of RT on physical fitness (e.g., muscle strength, muscle power) in healthy youth (<= 18 years). Results Fourteen meta-analyses were included in this umbrella review. Eleven of these meta-analyses reported between-subject effect sizes which are important to eliminate bias due to growth and maturation. RT produced medium-to-large effects on muscle strength, small-to-large effects on muscle power, small-to-medium effects on linear sprint, a medium effect on agility/change-of-direction speed, small-to-large effects on throwing performance, and a medium effect on sport-specific enhancement. There were few consistent moderating effects of maturation, age, sex, expertise level, or RT type on muscle strength and muscle power across the included meta-analyses. The analysed meta-analyses showed low-to-moderate methodological quality (AMSTAR2) as well as presented evidence of low-to-very low quality (GRADE). Conclusion This umbrella review proved the effectiveness of RT in youth on a high evidence level. The magnitude of effects varies according to the respective outcome measure and it appears to follow the principle of training specificity. Larger effect sizes were found for strength-related outcome measures. Future studies should consistently report data on participants' maturational status. More research is needed with prepubertal children and girls, irrespective of their maturational status.}, language = {en} } @article{JafarnezhadgeroMadadiShadAlaviMehretal.2018, author = {Jafarnezhadgero, Amir Ali and Madadi-Shad, Morteza and Alavi-Mehr, Seyed Majid and Granacher, Urs}, title = {The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet}, series = {PLoS ONE}, volume = {13}, journal = {PLoS ONE}, number = {10}, publisher = {Public Library of Science}, address = {San Francisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0205187}, pages = {1 -- 19}, year = {2018}, abstract = {Background Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet. Methods Thirty boys aged 8-12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected. Results Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group. Conclusions The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.}, language = {en} } @article{MakhloufChaouachiChaouachietal.2018, author = {Makhlouf, Issam and Chaouachi, Anis and Chaouachi, Mehdi and Othman, Aymen Ben and Granacher, Urs}, title = {Combination of Agility and Plyometric Training Provides Similar Training Benefits as Combined Balance and Plyometric Training in Young Soccer Players}, series = {Frontiers in Physiology}, volume = {9}, journal = {Frontiers in Physiology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2018.01611}, pages = {1 -- 17}, year = {2018}, abstract = {Introduction: Studies that combined balance and resistance training induced larger performance improvements compared with single mode training. Agility exercises contain more dynamic and sport-specific movements compared with balance training. Thus, the purpose of this study was to contrast the effects of combined balance and plyometric training with combined agility and plyometric training and an active control on physical fitness in youth. Methods: Fifty-seven male soccer players aged 10-12 years participated in an 8-week training program (2 × week). They were randomly assigned to a balance-plyometric (BPT: n = 21), agility-plyometric (APT: n = 20) or control group (n = 16). Measures included proxies of muscle power [countermovement jump (CMJ), triple-hop-test (THT)], muscle strength [reactive strength index (RSI), maximum voluntary isometric contraction (MVIC) of handgrip, back extensors, knee extensors], agility [4-m × 9-m shuttle run, Illinois change of direction test (ICODT) with and without the ball], balance (Standing Stork, Y-Balance), and speed (10-30 m sprints). Results: Significant time × group interactions were found for CMJ, hand grip MVIC force, ICODT without a ball, agility (4 m × 9 m), standing stork balance, Y-balance, 10 and 30-m sprint. The APT pre- to post-test measures displayed large ES improvements for hand grip MVIC force, ICODT without a ball, agility test, CMJ, standing stork balance test, Y-balance test but only moderate ES improvements with the 10 and 30 m sprints. The BPT group showed small (30 m sprint), moderate (hand grip MVIC, ICODTwithout a ball) and large ES [agility (4 m × 9 m) test, CMJ, standing stork balance test, Y-balance] improvements, respectively. Conclusion: In conclusion, both training groups provided significant improvements in all measures. It is recommended that youth incorporate balance exercises into their training and progress to agility with their strength and power training.}, language = {en} }