The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis

Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown. Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults....

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Sports medicine (Auckland) 2022-02, Vol.52 (2), p.287-300
Hauptverfasser: Wewege, Michael A., Desai, Imtiaz, Honey, Cameron, Coorie, Brandon, Jones, Matthew D., Clifford, Briana K., Leake, Hayley B., Hagstrom, Amanda D.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 300
container_issue 2
container_start_page 287
container_title Sports medicine (Auckland)
container_volume 52
creator Wewege, Michael A.
Desai, Imtiaz
Honey, Cameron
Coorie, Brandon
Jones, Matthew D.
Clifford, Briana K.
Leake, Hayley B.
Hagstrom, Amanda D.
description Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown. Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults. Our primary outcome was body fat percentage; secondary outcomes were body fat mass and visceral fat. Design Systematic review with meta-analysis. Data Sources We searched five electronic databases up to January 2021. Eligibility Criteria We included randomised trials that compared full-body resistance training for at least 4 weeks to no-exercise control in healthy adults. Analysis We assessed study quality with the TESTEX tool and conducted a random-effects meta-analysis, with a subgroup analysis based on measurement type (scan or non-scan) and sex (male or female), and a meta-regression for volume of resistance training and training components. Results From 11,981 records, we included 58 studies in the review, with 54 providing data for a meta-analysis. Mean study quality was 9/15 (range 6–15). Compared to the control, resistance training reduced body fat percentage by − 1.46% (95% confidence interval − 1.78 to − 1.14, p  
doi_str_mv 10.1007/s40279-021-01562-2
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2574398005</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2574398005</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-2fab67c547899841866baf34f13cd1be2afbd58a2feda05b320b2ea89dd7c2c03</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS0EIkPgB1ggS2yySBM_-8FuiBKClAgEA9tWtV2edNTjDrY7Uf8DH41nJoCUBatSlU_dW_Il5DVn7zhj1UlUTFRNwQQvGNelKMQTsuA8jwST-ilZMM5FwUslDsiLGG8YY7pW4jk5kErLkjfNgvxaXSM9cw5NoqOjXzH2MYE3SFcBet_7Ne09vUAY0vVMl3YaUqSjpx9GO9NzSPQLBoM-wRqPd_0VxEjBW_qjjwYDDNvpe7qk3-aYcAOpN9nlrsf7HXWFCYqlh2HOxi_JMwdDxFcP9ZB8Pz9bnV4Ul58_fjpdXhZGVjoVwkFXVkarqm6aWvG6LDtwUjkujeUdCnCd1TUIhxaY7qRgnUCoG2srIwyTh-Ror3sbxp8TxtRutscOA3gcp9gKXSnZ1Pm7Mvr2EXozTiHfm6lSaMakYlWmxJ4yYYwxoGtvQ7-BMLectdus2n1Wbc6q3WXVirz05kF66jZo_678CScDcg_E_OTXGP55_0f2N-T6np4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2625003407</pqid></control><display><type>article</type><title>The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wewege, Michael A. ; Desai, Imtiaz ; Honey, Cameron ; Coorie, Brandon ; Jones, Matthew D. ; Clifford, Briana K. ; Leake, Hayley B. ; Hagstrom, Amanda D.</creator><creatorcontrib>Wewege, Michael A. ; Desai, Imtiaz ; Honey, Cameron ; Coorie, Brandon ; Jones, Matthew D. ; Clifford, Briana K. ; Leake, Hayley B. ; Hagstrom, Amanda D.</creatorcontrib><description>Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown. Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults. Our primary outcome was body fat percentage; secondary outcomes were body fat mass and visceral fat. Design Systematic review with meta-analysis. Data Sources We searched five electronic databases up to January 2021. Eligibility Criteria We included randomised trials that compared full-body resistance training for at least 4 weeks to no-exercise control in healthy adults. Analysis We assessed study quality with the TESTEX tool and conducted a random-effects meta-analysis, with a subgroup analysis based on measurement type (scan or non-scan) and sex (male or female), and a meta-regression for volume of resistance training and training components. Results From 11,981 records, we included 58 studies in the review, with 54 providing data for a meta-analysis. Mean study quality was 9/15 (range 6–15). Compared to the control, resistance training reduced body fat percentage by − 1.46% (95% confidence interval − 1.78 to − 1.14, p  &lt; 0.0001), body fat mass by − 0.55 kg (95% confidence interval − 0.75 to − 0.34, p  &lt; 0.0001) and visceral fat by a standardised mean difference of − 0.49 (95% confidence interval − 0.87 to − 0.11, p  = 0.0114). Measurement type was a significant moderator in body fat percentage and body fat mass, but sex was not. Training volume and training components were not associated with effect size. Summary/Conclusions Resistance training reduces body fat percentage, body fat mass and visceral fat in healthy adults. Study Registration osf.io/hsk32.</description><identifier>ISSN: 0112-1642</identifier><identifier>EISSN: 1179-2035</identifier><identifier>DOI: 10.1007/s40279-021-01562-2</identifier><identifier>PMID: 34536199</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Aerobics ; Body Composition ; Body fat ; Chronic illnesses ; Confidence intervals ; Exercise ; Exercise - physiology ; Female ; Handbooks ; Humans ; Intervention ; Intra-Abdominal Fat ; Magnetic resonance imaging ; Male ; Medicine ; Medicine &amp; Public Health ; Meta-analysis ; Obesity ; Overweight ; Physical fitness ; Physical training ; Resistance Training ; Reviews ; Sports Medicine ; Strength training ; Systematic Review ; Weightlifting</subject><ispartof>Sports medicine (Auckland), 2022-02, Vol.52 (2), p.287-300</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. Feb 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-2fab67c547899841866baf34f13cd1be2afbd58a2feda05b320b2ea89dd7c2c03</citedby><cites>FETCH-LOGICAL-c375t-2fab67c547899841866baf34f13cd1be2afbd58a2feda05b320b2ea89dd7c2c03</cites><orcidid>0000-0002-5534-755X ; 0000-0002-3283-2149 ; 0000-0002-6133-2186 ; 0000-0002-8036-9216 ; 0000-0003-4392-795X ; 0000-0002-6972-4440</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40279-021-01562-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40279-021-01562-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34536199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wewege, Michael A.</creatorcontrib><creatorcontrib>Desai, Imtiaz</creatorcontrib><creatorcontrib>Honey, Cameron</creatorcontrib><creatorcontrib>Coorie, Brandon</creatorcontrib><creatorcontrib>Jones, Matthew D.</creatorcontrib><creatorcontrib>Clifford, Briana K.</creatorcontrib><creatorcontrib>Leake, Hayley B.</creatorcontrib><creatorcontrib>Hagstrom, Amanda D.</creatorcontrib><title>The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis</title><title>Sports medicine (Auckland)</title><addtitle>Sports Med</addtitle><addtitle>Sports Med</addtitle><description>Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown. Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults. Our primary outcome was body fat percentage; secondary outcomes were body fat mass and visceral fat. Design Systematic review with meta-analysis. Data Sources We searched five electronic databases up to January 2021. Eligibility Criteria We included randomised trials that compared full-body resistance training for at least 4 weeks to no-exercise control in healthy adults. Analysis We assessed study quality with the TESTEX tool and conducted a random-effects meta-analysis, with a subgroup analysis based on measurement type (scan or non-scan) and sex (male or female), and a meta-regression for volume of resistance training and training components. Results From 11,981 records, we included 58 studies in the review, with 54 providing data for a meta-analysis. Mean study quality was 9/15 (range 6–15). Compared to the control, resistance training reduced body fat percentage by − 1.46% (95% confidence interval − 1.78 to − 1.14, p  &lt; 0.0001), body fat mass by − 0.55 kg (95% confidence interval − 0.75 to − 0.34, p  &lt; 0.0001) and visceral fat by a standardised mean difference of − 0.49 (95% confidence interval − 0.87 to − 0.11, p  = 0.0114). Measurement type was a significant moderator in body fat percentage and body fat mass, but sex was not. Training volume and training components were not associated with effect size. Summary/Conclusions Resistance training reduces body fat percentage, body fat mass and visceral fat in healthy adults. Study Registration osf.io/hsk32.</description><subject>Adult</subject><subject>Aerobics</subject><subject>Body Composition</subject><subject>Body fat</subject><subject>Chronic illnesses</subject><subject>Confidence intervals</subject><subject>Exercise</subject><subject>Exercise - physiology</subject><subject>Female</subject><subject>Handbooks</subject><subject>Humans</subject><subject>Intervention</subject><subject>Intra-Abdominal Fat</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Meta-analysis</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Physical fitness</subject><subject>Physical training</subject><subject>Resistance Training</subject><subject>Reviews</subject><subject>Sports Medicine</subject><subject>Strength training</subject><subject>Systematic Review</subject><subject>Weightlifting</subject><issn>0112-1642</issn><issn>1179-2035</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kctuFDEQRS0EIkPgB1ggS2yySBM_-8FuiBKClAgEA9tWtV2edNTjDrY7Uf8DH41nJoCUBatSlU_dW_Il5DVn7zhj1UlUTFRNwQQvGNelKMQTsuA8jwST-ilZMM5FwUslDsiLGG8YY7pW4jk5kErLkjfNgvxaXSM9cw5NoqOjXzH2MYE3SFcBet_7Ne09vUAY0vVMl3YaUqSjpx9GO9NzSPQLBoM-wRqPd_0VxEjBW_qjjwYDDNvpe7qk3-aYcAOpN9nlrsf7HXWFCYqlh2HOxi_JMwdDxFcP9ZB8Pz9bnV4Ul58_fjpdXhZGVjoVwkFXVkarqm6aWvG6LDtwUjkujeUdCnCd1TUIhxaY7qRgnUCoG2srIwyTh-Ror3sbxp8TxtRutscOA3gcp9gKXSnZ1Pm7Mvr2EXozTiHfm6lSaMakYlWmxJ4yYYwxoGtvQ7-BMLectdus2n1Wbc6q3WXVirz05kF66jZo_678CScDcg_E_OTXGP55_0f2N-T6np4</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Wewege, Michael A.</creator><creator>Desai, Imtiaz</creator><creator>Honey, Cameron</creator><creator>Coorie, Brandon</creator><creator>Jones, Matthew D.</creator><creator>Clifford, Briana K.</creator><creator>Leake, Hayley B.</creator><creator>Hagstrom, Amanda D.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5534-755X</orcidid><orcidid>https://orcid.org/0000-0002-3283-2149</orcidid><orcidid>https://orcid.org/0000-0002-6133-2186</orcidid><orcidid>https://orcid.org/0000-0002-8036-9216</orcidid><orcidid>https://orcid.org/0000-0003-4392-795X</orcidid><orcidid>https://orcid.org/0000-0002-6972-4440</orcidid></search><sort><creationdate>20220201</creationdate><title>The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis</title><author>Wewege, Michael A. ; Desai, Imtiaz ; Honey, Cameron ; Coorie, Brandon ; Jones, Matthew D. ; Clifford, Briana K. ; Leake, Hayley B. ; Hagstrom, Amanda D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-2fab67c547899841866baf34f13cd1be2afbd58a2feda05b320b2ea89dd7c2c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Aerobics</topic><topic>Body Composition</topic><topic>Body fat</topic><topic>Chronic illnesses</topic><topic>Confidence intervals</topic><topic>Exercise</topic><topic>Exercise - physiology</topic><topic>Female</topic><topic>Handbooks</topic><topic>Humans</topic><topic>Intervention</topic><topic>Intra-Abdominal Fat</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Meta-analysis</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Physical fitness</topic><topic>Physical training</topic><topic>Resistance Training</topic><topic>Reviews</topic><topic>Sports Medicine</topic><topic>Strength training</topic><topic>Systematic Review</topic><topic>Weightlifting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wewege, Michael A.</creatorcontrib><creatorcontrib>Desai, Imtiaz</creatorcontrib><creatorcontrib>Honey, Cameron</creatorcontrib><creatorcontrib>Coorie, Brandon</creatorcontrib><creatorcontrib>Jones, Matthew D.</creatorcontrib><creatorcontrib>Clifford, Briana K.</creatorcontrib><creatorcontrib>Leake, Hayley B.</creatorcontrib><creatorcontrib>Hagstrom, Amanda D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Sports medicine (Auckland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wewege, Michael A.</au><au>Desai, Imtiaz</au><au>Honey, Cameron</au><au>Coorie, Brandon</au><au>Jones, Matthew D.</au><au>Clifford, Briana K.</au><au>Leake, Hayley B.</au><au>Hagstrom, Amanda D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis</atitle><jtitle>Sports medicine (Auckland)</jtitle><stitle>Sports Med</stitle><addtitle>Sports Med</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>52</volume><issue>2</issue><spage>287</spage><epage>300</epage><pages>287-300</pages><issn>0112-1642</issn><eissn>1179-2035</eissn><abstract>Background Resistance training is the gold standard exercise mode for accrual of lean muscle mass, but the isolated effect of resistance training on body fat is unknown. Objectives This systematic review and meta-analysis evaluated resistance training for body composition outcomes in healthy adults. Our primary outcome was body fat percentage; secondary outcomes were body fat mass and visceral fat. Design Systematic review with meta-analysis. Data Sources We searched five electronic databases up to January 2021. Eligibility Criteria We included randomised trials that compared full-body resistance training for at least 4 weeks to no-exercise control in healthy adults. Analysis We assessed study quality with the TESTEX tool and conducted a random-effects meta-analysis, with a subgroup analysis based on measurement type (scan or non-scan) and sex (male or female), and a meta-regression for volume of resistance training and training components. Results From 11,981 records, we included 58 studies in the review, with 54 providing data for a meta-analysis. Mean study quality was 9/15 (range 6–15). Compared to the control, resistance training reduced body fat percentage by − 1.46% (95% confidence interval − 1.78 to − 1.14, p  &lt; 0.0001), body fat mass by − 0.55 kg (95% confidence interval − 0.75 to − 0.34, p  &lt; 0.0001) and visceral fat by a standardised mean difference of − 0.49 (95% confidence interval − 0.87 to − 0.11, p  = 0.0114). Measurement type was a significant moderator in body fat percentage and body fat mass, but sex was not. Training volume and training components were not associated with effect size. Summary/Conclusions Resistance training reduces body fat percentage, body fat mass and visceral fat in healthy adults. Study Registration osf.io/hsk32.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34536199</pmid><doi>10.1007/s40279-021-01562-2</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-5534-755X</orcidid><orcidid>https://orcid.org/0000-0002-3283-2149</orcidid><orcidid>https://orcid.org/0000-0002-6133-2186</orcidid><orcidid>https://orcid.org/0000-0002-8036-9216</orcidid><orcidid>https://orcid.org/0000-0003-4392-795X</orcidid><orcidid>https://orcid.org/0000-0002-6972-4440</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0112-1642
ispartof Sports medicine (Auckland), 2022-02, Vol.52 (2), p.287-300
issn 0112-1642
1179-2035
language eng
recordid cdi_proquest_miscellaneous_2574398005
source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Adult
Aerobics
Body Composition
Body fat
Chronic illnesses
Confidence intervals
Exercise
Exercise - physiology
Female
Handbooks
Humans
Intervention
Intra-Abdominal Fat
Magnetic resonance imaging
Male
Medicine
Medicine & Public Health
Meta-analysis
Obesity
Overweight
Physical fitness
Physical training
Resistance Training
Reviews
Sports Medicine
Strength training
Systematic Review
Weightlifting
title The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T19%3A09%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Effect%20of%20Resistance%20Training%20in%20Healthy%20Adults%20on%20Body%20Fat%20Percentage,%20Fat%20Mass%20and%20Visceral%20Fat:%20A%20Systematic%20Review%20and%20Meta-Analysis&rft.jtitle=Sports%20medicine%20(Auckland)&rft.au=Wewege,%20Michael%20A.&rft.date=2022-02-01&rft.volume=52&rft.issue=2&rft.spage=287&rft.epage=300&rft.pages=287-300&rft.issn=0112-1642&rft.eissn=1179-2035&rft_id=info:doi/10.1007/s40279-021-01562-2&rft_dat=%3Cproquest_cross%3E2574398005%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2625003407&rft_id=info:pmid/34536199&rfr_iscdi=true