Brief Review

Complex and Contrast Training: Does Strength and

Power Training Sequence Affect Performance-
Based Adaptations in Team Sports? A Systematic
Review and Meta-analysis
Patrick Cormier,1 Tomás T. Freitas,1 Jacobo Á. Rubio-Arias,2 and Pedro E. Alcaraz1,2
1
UCAM Research Center for High Performance Sport—Catholic University of Murcia, UCAM, Spain; and 2Faculty of Sport
Sciences—Catholic University of Murcia, UCAM, Spain

Abstract
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Cormier, P, Freitas, TT, Rubio-Arias, JÁ, and Alcaraz, PE. Complex and contrast training: Does strength and power training
sequence affect performance-based adaptations in team sports? A systematic review and meta-analysis. J Strength Cond Res
34(5): 1461–1479, 2020—The aims of this meta-analysis were to examine the effects of 2 different strength and power training
sequences (complex: CPX; and contrast: CNT, training) on performance-based adaptations in team sports {lower-body strength (1
repetition maximum [1RM]), vertical jump (VJ), sprinting, and change of direction (COD) ability}, as well as identify factors potentially
affecting said adaptations (i.e., athlete level, type of sport, intensity, and duration). CPX is the combination training that alternates
biomechanically similar high load weight training exercises with lighter load power exercises, set for set (e.g., squats followed by
countermovement jumps). CNT is the combination training where all high load strength exercises are performed at the beginning of
the session and all lighter load power exercises at the end. After an electronic database search (PubMed, SPORTDiscus, and WoS),
a total of 27 articles were included in the meta-analysis. The effects on outcomes were expressed as standardized mean differences
(SMDs). Baseline to postintervention overall results for the studied variables: (a) 1RM: large effects for CPX (SMD 5 2.01, 95%
confidence interval [CI] 1.18–2.84) and CNT (SMD 5 1.29, 95% CI 0.61–1.98); (b) VJ: large effects for CPX (SMD 5 0.88, 95%
CI 0.42–1.34) and medium effects for CNT (SMD 5 0.55, 95% CI 0.29–0.81); (c) sprint: large effects for CPX (SMD 5 20.94,
95% CI 21.33 to 20.54) and small effects for CNT (SMD 5 20.27, 95% CI 20.92 to 0.39); and (d) COD: large effects for CPX
(SMD 5 21.17, 95% CI 21.43 to 20.90) and medium effects for CNT (SMD 5 20.68, 95% CI 21.20 to 20.15). Regarding the
studies that contained a control group: (a) 1RM: large effects for CPX (SMD 5 1.61, 95% CI 1.12–2.10) and CNT (SMD 5 1.38, 95%
CI 0.30–2.46); (b) VJ: large effects for CPX (SMD 5 0.85, 95% CI 0.45–1.25) and medium for CNT (SMD 5 0.50, 95% CI 0.19–0.81);
(c) sprint: medium effects for CPX (SMD 5 20.69, 95% CI 21.02 to 20.36) and CNT (SMD 5 20.51, 95% CI 20.90 to 20.11); and
(d) COD: large effects for CPX (SMD 5 20.83, 95% CI 21.08 to 20.59), and there were no control groups for CNT. In conclusion,
both training interventions may lead to positive performance-based adaptations in team-sports with CPX interventions potentially
leading to slightly greater effects.
Key Words: agility, postactivation potentiation, combination training, sport

Introduction a greater ability to produce mechanical force and power, high-

lighting the importance of such qualities in team-sport athletes.
In team sports, it is well established that factors such as strength,
Altogether, these studies support that the ability to produce high
power, sprinting, and change of direction (COD) ability are
levels of strength and power could differentiate players from
crucial in players’ match-play performance (4,11,44,75,79). In
different competition levels and reinforce the notion that such
fact, the ability to exert high forces (i.e., strength) (76) and power
ability is associated with enhanced athletic capabilities
outputs (13) plays a major role in overall athletic performance
(i.e., strength, jump, sprint, and COD ability) in team sports.
and has been proposed as the foundational basis for athlete de-
According to the literature, strength and power training programs
velopment (76). In support of this, relative strength and power
have been demonstrated to be effective in improving said athletic
have been demonstrated to be greater in faster players, suggesting
capabilities in team-sport players (3,14,41,71,73,75,75,84). Some of
that they could be predictors of superior performance in rugby
the neuromuscular aspects underlying these positive adaptations
(15). In addition, there is evidence that strength is closely corre-
may be related changes in physiological mechanisms (i.e., storage
lated with vertical jump (VJ) and sprint performance in elite
and utilization of elastic energy or stretch-shortening cycle function),
soccer players (84) and is essential in preventing injury in this
in morphological factors (muscle architecture or fiber type), and
sport (83). Silva et al. (74) reported that lower performance
neural factors (motor unit recruitment, synchronization, firing
decrements were observed in elite soccer players who had
frequency, intermuscular coordination) (13). Furthermore, the
Address correspondence to Patrick Cormier, pjgcormier@alu.ucam.edu. increased rate of force development (RFD) (i.e., maximal rate of
Journal of Strength and Conditioning Research 34(5)/1461–1479 rise in muscle force in the early phase of a muscle contraction)
ª 2020 National Strength and Conditioning Association (1,51) is another important aspect that helps explain the

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 Complex and Contrast Training in Team-Sports (2020) 34:5
athletic performance improvements following power training (14),
especially considering that in team sports, high magnitudes of force
need to be applied in short periods of time (0–200 ms) (1), due to the
characteristics of the competition.
Interestingly, both heavy-resistance (1) and plyometric (5)
training alone have been shown to improve power and RFD.
Therefore, it can be expected that training methodologies that
combine both heavy-load low-velocity exercises and light-load
high-velocity plyometric drills may also result in performance
increments in explosive tasks such as jumping, sprinting, and
changing direction. In fact, combination training targets the force
component of the power equation (mechanical power 5 force 3
velocity), when using the heavier loads, while also allowing the
achievement of velocity-specific and neural drive adaptations
when using the light-load high-velocity exercises (14). Taking this
into account, in the past decades, 2 combination training methods
have emerged: Complex (CPX) (8,28,29,52,55) and Contrast
(CNT) (25,46,65,67) training. Both protocols combine strength
and power/plyometric exercises in the same workout session, but,
although the terms complex and contrast training are sometimes
used interchangeably, there is a fundamental difference between
these methods: the exercise sequence within the session. Based
on the most recent literature, CPX is defined as the combination
training that alternates biomechanically similar high-load
weight training exercises with lighter-load power exercises, set
for set (e.g., squats followed by countermovement jumps)
(3,19,23,28,40,60); CNT is defined as the combination training
that involves the use of contrasting heavy and light loads, where
all high-load strength exercises are performed at the beginning
of the session and all lighter load power exercises at the end
(16,25,46,65,67).
Regarding CPX, it has been suggested that the heavy resistance
stimulus increases motoneuron excitability, possibly creating
optimal training conditions for subsequent explosive exercises
(23). In addition, postactivation potentiation (PAP) has been
proposed as a possible mechanism explaining the potential ben-
efits of this method (17,31). Theoretically, the use of a condi-
tioning activity (CA) potentiates the subsequent mechanically
similar power exercise (70) due to different physiological aspects
such as the phosphorylation of myosin light chains, greater ATP
activity and contractile ability and the utilization of higher-order
motor recruitment, and type II muscle fibers (66,80). According
to Seitz and Haff (70), PAP responses are greater in stronger
individuals and when long rest intervals (from 5 to .8 minutes)
are allowed. However, Suchomel et al. (77) reported that stronger
individuals can potentiate immediately and #2 minutes after the
use of a CA. This has important implications for strength and
conditioning professionals who use the principles of PAP using
strength-power potentiation complexes for long-term adap-
tations in team sports. Of note, the ergogenic effects of PAP are
highly individualized (12,61,78), and there are disparities in
the literature regarding its acute and chronic effects
(17,31,32,42,69). Concerning CNT, the abovementioned
benefits related to the targeting of the force and velocity
components of the power equation in the same session are
believed to be the main mechanisms of adaptation (13).
Despite the growing amount of literature on combination
training (using CPX and CNT), results are equivocal concerning
competitive team sports. Freitas et al. (28) completed a meta-
analysis on the effects of CPX and reported effect sizes of medium
magnitude on sprint and small on VJ performance in team-sports
when considering post-intervention results compared with base-
line; however, the aforementioned meta-analysis neither did
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investigate the effects of CPX on 1-repetition maximum (1RM)
and COD ability nor did it compare CXT with other training
methodologies. Bauer et al. (3) investigated the effects of CPX
training in 1RM, jumping, and sprinting; however, they included
untrained subjects and education students. Regarding CNT, to
the best of the authors’ knowledge, no systematic review or meta-
analysis has been conducted to date. Thus, more research on
combination training is warranted. Based on the previous litera-
ture (28,29,46,55,59,65), methods combining strength and
power training are effective to promote neuromuscular adapta-
tions in team sports, but the question becomes “what is the best
sequence to organize strength and power exercises in the same
session to achieve the greatest performance adaptations?“. Recent
studies have tried to shine some light on this issue by comparing
the effects of these methods on trained team-sport athletes (46),
but further research is still needed. Therefore, we conducted
a meta-analysis to examine the most effective sequence of com-
bined strength and power training to improve performance-based
adaptations in team sports. The main purposes were to [1] in-
vestigate the effects of 2 different combination training (CPX vs.
CNT) interventions on lower-body strength, VJ, sprinting, and
COD ability in team-sports and [2] identify possible variables that
could affect neuromuscular adaptations.
Methods
Experimental Approach to the Problem
Data Sources and Searches. Electronic search followed the Preferred
Reported Items for Systematic Reviews and Meta-Analysis (PRISMA)
(56) guidelines and was conducted on the following search databases:
PubMed, SPORTDiscus, and Web of Knowledge. It considered arti-
cles published up until August 15th, 2019. The following keywords,
combined in pairs (e.g., “contrast training” AND “post-activation
potentiation”), were introduced in the selected databases: “contrast
training,” “complex training,” “combination training,” “post-
activation potentiation,” “performance,” “power,” “strength,”
“sprint,” “jump,” “agility,” “change of direction,” “1RM,” “ath-
letes,” “players,” “team-sports,” “basketball,” “soccer,” “rugby,”
“volleyball.” Reference lists from relevant articles were examined to
find other possible research that fit the inclusion criteria.
Subjects
Inclusion and Exclusion Criteria. Studies published in English
were considered for inclusion with no age or sex restrictions.
Studies were included if they met the following criteria: (a) at least
one of the groups within the study participated in a CPX or CNT
intervention containing lower-body exercises. CPX
(3,19,23,28,40,60) and CNT (16,25,46,65,67) were defined
based on the definitions stated earlier in this article. If a study
defined the training intervention as CPX but it was in fact CNT by
the aforementioned definition, we coded the training method
using such criteria and not that of the selected article; (b) subjects
were athletes engaged in competitive team sports; (c) inter-
ventions were at least 4 weeks; and (d) at least one of the following
outcome variables were reported: lower-body 1RM (i.e., squat,
leg extension, and leg press), VJ height, sprint time, or COD
ability. Control groups consisted of team-sport athletes who did
not partake in any lower-body strength or power training (only
standard sport-specific training session).
Studies were excluded if they met any of the following exclu-
sion criteria: (a) articles were not published in English; (b) no CPX
 Complex and Contrast Training in Team-Sports (2020) 34:5
or CNT intervention group was present; (c) only acute effects
were examined; (d) no full-text or data were available; (e) subjects
were not team-sport athletes; and (f) lower-body 1RM (i.e., squat,
leg extension, or leg press), VJ height, sprint time, or COD ability
were not outcome variables. Note that the term COD is used
herein even if some studies describe it as agility. Agility is defined
as a rapid whole-body movement with change of velocity in re-
sponse to a stimulus (86), and all the tests included were pre-
planned without a reactive stimulus, hence the use of the term
“COD ability” in the present review. The ethics committee of the
Catholic University of Murcia declared that approval was
unnecessary.
Procedures
Study Selection and Data Extraction. Database searches were
performed independently by 2 authors (P.C., and T.T.F.). After
the removal of duplicates, abstracts were screened, and studies
not related to the review’s topic were excluded. The remaining
articles that were not initially discarded were read. Then, in-
dependently and blindly, 2 reviewers selected the studies for
inclusion (P.C. and T.T.F.), according to the inclusion and
exclusion criteria. If no agreement was achieved, a third party
intervened (P.E.A.). One reviewer (P.C.) extracted the fol-
lowing data from the included studies: sample level, sport, sex,
and age; training intervention, frequency, rest interval, dura-
tion, and intensity; and measurement tools and units. Baseline
and postintervention values were extracted for all outcomes,
and on occasion where graphs were included in an article with
no numerical description of data, the extraction software
GetData Graph Digitizer 2.26 (free software downloaded from
http://getdata-graph-digitizer.com) was used.
Risk of Bias Assessment (Study Quality). The methodological
quality of selected studies that contained a control group was
assessed with the Cochrane risk of bias tool (38). The quality of
the studies that did not include a control group was assessed
with the Study Quality Assessment Tool from the Nation
Heart, Lung, and Blood Institute (58). Study bias and quality
were assessed by 2 authors (P.C., and T.T.F.), with any dis-
agreements resolved by a third reviewer (J.A.R-.A.).
Statistical Analyses
The meta-analysis was conducted using the Review Manager
Software (RevMan 5.2; Cochrane Collaboration, Oxford, United
Kingdom). A random-effects meta-analysis was conducted to
determine summary effect of training interventions on the out-
comes: 1RM, VJ, sprint, and COD. Effects between CPX or CNT
training and control and differences between post- and pre-
training in experimental group were expressed as standardized
mean difference (SMD) and their 95% confidence intervals (CI).
Standardized mean differences were used because 1RM, VJ,
sprint, and COD were assessed using different methods. Stan-
dardized mean differences were calculated using the follow-
ing (10):
M1 2 M2
SMD ¼
SDpooled
where M1 2 M2 is the difference in the mean outcome between
groups, and SDpooled is the pooled standard deviation of outcome
among subjects, which was calculated with the following
equation:
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sffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
SD21 2 SD22
SDpooled ¼
SDpooled
Threshold values for effect sizes (SMD) were $0.2 (small),
$0.5 (medium), and $0.8 (large) (10). In addition, subgroup
analyses were performed to identify modulating factors for CPX
and CNT.
Subgroup analysis regarding population characteristics and
training was conducted through dichotomous (level: amateur or
elite & subelite; type of sport: jump predominance, or other) and
continuous (intensity: $85% 1RM or ,85% 1RM; .6 weeks or
#6 weeks) variables that could have an influence on the results
after CNT and CPX interventions. The cutoff was established in
an arbitrary way based on the previous literature (28). Subjects
were classified as amateurs (A) if they practiced their sport at an
amateur club, college, or university level and in elite and subelite
(B) if they practiced professionally or semiprofessionally as
reported in each included study. With reference to sport modality,
nonjump predominant team sports were considered sports such
as soccer, rugby, and baseball and jump predominant consisted of
team sports where jumping is more frequent (79) such as hand-
ball, basketball, and volleyball. Regarding intensity, if 2 different
intensities were used in a training intervention, the average was
taken for the subgroup analysis.
The heterogeneity between the studies was evaluated through
I2 statistics and the between-study variance using the tau-square
(Tau2) (37,39). A scale of magnitude was implemented for the
interpretation of heterogeneity of the results, where ,25% was
assessed as a low magnitude, 25–75% was medium magnitude,
and .75% was high magnitude (37). A p value of ,0.1 for the
chi-square was defined as indicating the presence of heterogene-
ity; a Tau2 .1 suggests the presence of substantial statistical
heterogeneity (37). Publication bias was evaluated through an
asymmetry test as estimated from a funnel plot (24). A p value of
less than 0.05 was considered statistically significant.
Results
Search Results
The initial search for CPX and CT yielded 6,430 articles from
databases and 9 from other sources. After duplicates removal,
544 remained and were screened by titles and abstracts. The
remaining articles were screened based on the inclusion and ex-
clusion criteria. After the study selection process, 27 studies were
included (17 CPX studies and 10 CNT) (Figure 1). Two articles
had experimental groups that were included in the CPX and CNT
analysis (16,46). Regarding pre-post data: 1RM was assessed on
a total of 150 (CPX) (6,16,26,29,33–36,46,54,82) and 93 (CNT)
(16,27,46,62–65) subjects; VJ was assessed on 204 (CPX)
(20,26,29,30,33,35,36,46–48,52,55,82) and 118 (CNT)
(25,27,46,62–65,67) subjects; sprint was assessed on 253 (CPX)
(6,8,20,26,29,30,33–36,46,48,52,54,57) and 93 (CNT)
(25,27,46,63–65,81) subjects; and COD was assessed on 213
(CPX) (8,20,26,29,30,33–36,46,48,52,57) and 30 (CNT)
(46,62) subjects.
General Characteristics of Studies
Subjects’ characteristics, training intervention programs, and
specific tests and measurement devices that were used to assess the
performance variables in each study are reported in Tables 1 and
2. Dynamic lower-body strength was directly measured (1RM) or
 Complex and Contrast Training in Team-Sports (2020) 34:5
Figure 1. Flow diagram of the study selection process.
estimated (based on multiple RM or velocity-based predictions) in
the squat or half-squat exercise. Of note, one study used knee
extension to measure lower-body strength (62). Vertical jump
height was measured with either a Vertec device, jump mat, force
platform, or using infrared timing lights. Sprint time was mea-
sured using different methods, and the distances ranged from 10
to 40 m. COD times came from various tests with skill-based
COD (agility with a ball) and traditional COD measurements
(e.g., t-test, 505 agility, etc).
Study Quality
The methodological quality of eligible studies is shown in Figure 2
and 3. Overall, the risk of publication bias was low. Heteroge-
neity of effects was high among studies with a broad range of I2.
However, this may be explained due to the variability between
characteristics of the subjects (age, sex, etc.)
Meta-Analyses
Maximal Strength (1RM). When comparing the overall effect of
CPX and CNT on lower-body strength (Figure 4A), both inter-
ventions showed large pre-post improvements in 1RM (CPX:
SMD 5 2.01, 95% CI 1.18–2.84 vs. CNT: SMD 5 1.29, 95% CI
0.61–1.98). Also, in studies that had a control group (Figure 4B),
there were large improvements in 1RM following CPX and CNT
in experimental groups when compared with control (CPX: SMD
5 1.61, 95% CI 1.12–2.10 vs. CNT: SMD 5 1.38, 95% CI
0.30–2.46). There were no statistically significant differences
between CPX and CNT when comparing SMDs (p . 0.05). The
average percent change from baseline to post-training values was
23.4 6 18.1% for CPX and 23.7 6 17.2% for CNT.
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Vertical jump. Large and medium pre-post improvements in VJ
height were found for CPX (SMD 5 0.88, 95% CI 0.42–1.34) and
CNT (SMD 5 0.55, 95% CI 0.29–0.81), respectively (Figure 5A).
Likewise, there were large and medium improvements in VJ in CPX
and CNT studies containing a control (Figure 5B) and an experi-
mental group (CPX: SMD 5 0.85, 95% CI 0.45–1.25 vs. CNT:
SMD 5 0.50, 95% CI 0.19–0.81). There were no statistically sig-
nificant differences between CPX and CNT when comparing SMDs
(p . 0.05). The average percent change from baseline to post-
training values was 9.3 6 8.5% for CPX and 8.0 6 3.7% for CNT.
Sprint. Large pre- to post-training improvements in sprint per-
formance (Figure 6A) were obtained following CPX (SMD 5
20.94, 95% CI 21.33 to 20.54), whereas small nonsignificant
improvements were found regarding CNT (SMD 5 20.27, 95%
CI 20.92 to 0.39). In addition, there were medium improvements
in sprint performance (Figure 6B) in CPX and CNT studies con-
taining a control and an experimental group (CPX: SMD 5
20.69, 95% CI 21.02 to 20.36 vs. CNT: SMD 5 20.51, 95%
CI 20.90 to 20.11). There were no significant differences in
sprint performance between CPX and CNT for any analysis (p .
0.05). The average percent change from baseline to post-training
values was 24.7 6 3.6% for CPX and 21.3 6 2.7% for CNT.
Change of Direction Ability. Large and medium pre-post
improvements in COD ability were found for CPX (SMD 5
21.17, 95% CI 21.43 to 20.90) and CNT (SMD 5 20.68, 95%
CI 21.20 to 20.15), respectively (Figure 7A). In addition, large
improvements in COD ability (Figure 7B) were obtained only in
CPX studies containing a control group and an experimental group
(SMD 5 20.83, 95% CI 21.08 to 20.59). Furthermore, there
were no significant differences between CPX and CNT for COD
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Complex and Contrast Training in Team-Sports (2020) 34:5

Table 1
Characteristics of complex training (CPX) interventions included in the meta-analysis.*†
Complex training
Strength
n Age Training intervention (kg) Jump (cm) Sprint (s) COD (s)
Intensity
Mean Freq ICRI Duration CA (% Measure Measure
Study, year Level Sport Group f (%) Subjects (6SD) (times·wk21) (min) (wk) 1RM) Training type (type) Measure (type) (distance) Measure (type)
Dodd and Alvar A Baseball EG 0 32 20.5 (2.5) 2 ,10 7 85 CPs: 3 ST (SQ 1 lunge — Vertec (Aba) Stopwatch Stopwatch (T-test)
(20) s 1 split SQ) 1 3 PT (box (18.3 m)
jumps 1 DJ 1 split SQ
jumps)
Mihalik et al. A Volleyball EG 65 15 20.3 (2.2) 4 2 4 60 CPs (1): SQ 1 DJ CPs (2): — Vertec (CMJ) — —
(55) SL lunge 1 split SQ jumps
CPs3: deadlift 1 bilateral
leg bounds
Dobbs et al. (16) A Rugby EG1 0 10 17 (0.7) 2 4 7 90 CPs: SQ 1 CMJ Indirect 1RM — — —
(squat)
Brito et al. (6) A Soccer EG 0 12 19.9 (0.5) 2 — 9 85 CPs (1): SQ 1 high Direct 1RM Jump mat (CMJ) Photoelectric Photoelectric cells (T-test)
skipping 1 sprint CPs (2): (Squat) cells (20 m)
Calf extension 1 VJ CPs
(3): Leg extension 1 VJ
CG 0 21 — — — —
CPs: Isometric SQ 1 DJ
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Latorre Roman A Basketball EG 17 30 8.72 (0.97) 2 1.5 10 40–70 (s) — Photoelectric Photoelectric Photoelectric cells (T-test)
et al. (48) 1 VJ cells (CMJ) cells (25 m)
CG 18 28 — — — —
Nikolic et al. (57) B Basketball EG 0 16 17.5 (0.5) 2 2 12 60–80 Day 1-CPs: SQ 1 lunges — — Photoelectric Photoelectric cells
1 leg extension 1 calf cells (15 m) (10 3 5 m shuttle test)
raise 1 VJ Day 2- CPs: SQ
1 adduction 1 VJ
CG 0 15 — — — —
Kukrić et al. (47) B Basketball EG 0 10 16.5 (0.5) 2 5 10 80 CPs (1): Standing on toes — Force platform — —
with load 1 jumps CPs (2): (aba)
Leg press 1 jump over
hurdle CPs (3): Step
forward 1 telemark jumps
CPs (4): SQ 1 jumps over
hurdle
CG 0 10 — — — —
Cavaco et al. (8) A Soccer EG1 0 5 13.8 (0.45) 1 — 6 85 CPs (1): SQ 1 sprint CPs2: — — Photoelectric Stopwatch (agility with
SQ 1 sprint with ball (EG1 cells (15 m) ball)
and EG2 did the same)
EG2 0 5 2 — 6 85
CG 0 6 14.2 (0.84) — — — —

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Hammami et al. B Soccer EG 0 16 16 (0.5) 2 — 8 70–90 CPs: SQ 1 CMJs 1 sprint Direct 1RM Force platform Photoelectric Photocells (S180, SBF,
(33) (half-Squats) (CMJ) cells (20 m) S4x5)
CG 0 12 16.8 (0.2) — — — —
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Complex and Contrast Training in Team-Sports (2020) 34:5

Table 1
Characteristics of complex training (CPX) interventions included in the meta-analysis.*† (Continued)
Complex training
Strength
n Age Training intervention (kg) Jump (cm) Sprint (s) COD (s)
Intensity
Mean Freq ICRI Duration CA (% Measure Measure
Study, year Level Sport Group f (%) Subjects (6SD) (times·wk21) (min) (wk) 1RM) Training type (type) Measure (type) (distance) Measure (type)
Hammami et al. B Handball EG 100 14 16.6 (0.3) 2 2 10 85–90/75 CPs (1): SQ 1 hurdle Direct 1RM Infrared timing Photoelectric Photoelectric cells
(35), 2018 (B) isometric jumps 1 sprint CPs (2): (half-squats) system (CMJ) cells (20 m) (modified T-test and Illinois
Thigh press 1 jumps 1 test)
sprint CPs (3): Isometric
SQ 1 hops CPs4: Calf
extensions 1 jumps
1 sprint
CG 100 14 — — — —
Hammami et al. B Soccer EG 0 17 16 (0.5) 2 — 8 70–90 CPs: SQ 1 CMJs 1 sprint Direct 1RM — Photoelectric Infrared sensors (S180,
(34), 2017 (C) (half-squats) cells (20 m) SBF, S4x5)
CG 0 12 16.8 (0.2) — — — —
Hamammi et al. B Soccer EG 0 14 16.1 (0.5) 2 — 8 70–90 CPs: SQ 1 CMJs 1 sprint Direct 1RM Force platform Photoelectric Photoelectric cells
(36), 2018 (D) (half-squats) (CMJ) cells (40 m) (S4X5m)
CG 0 12 15.8 (0.2) — — — —
Maio Alves et al. B Soccer EG1 0 9 17.4 (0.6) 1 — 6 85 CPs (1): SQ 1 skipping — Contact mat Photoelectric Photoelectric cells (505
1 sprint CPs (2): Calf
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(52), 2010 (CMJ) cells (15 m) agility)

extension 1 VJ 1 ball
headers CPs (3): Leg
extension 1 VJ 1 DJ (EG1
and EG2 did the same)
EG2 0 8 2 — 6 85
CG 0 6 — — — —
Faude et al. (26), A Soccer EG 0 8 22.5 (2.5) 2 ,10 7 90/50–60 Day 1-CPs: SQ 1 SL Direct 1RM Force platform Photoelectric Stopwatch (Shuttle sprint
2013 s hurdle jumps day 2-CPs (squat) (CMJ) cells (30 m) & dribble test)
(1): SQ 1 DJ 1 sprint CPs
(2): Calf raises 1 high
jumps 1 header CPs (3):
SQ 1 lateral jumps 1
zig-zag sprints CPs (4):
Step-ups 1 bounding
jumps
1 headers
CG 0 8 — — — —
Watts et al. (82), B Volleyball EG1 0 4 16.8 (0.6) 4 2 4 90 Day 1-CPs (1): Power snatch Direct 1RM Force platform — —
2012 (HRS) 1 MB throw CPs (2): SQ 1 (squat) (CMJ)
DJs 1 SQ Day 2-CPs (1):
Power clean 1 spike jump
CPs (2): SQ 1 long jumps 1
deadlifts (HRS and LRS did
the same)
EG2 0 5 17.9 (1.1) 4 2 4 90
(LRS)
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Complex and Contrast Training in Team-Sports (2020) 34:5

Table 1
Characteristics of complex training (CPX) interventions included in the meta-analysis.*† (Continued)
Complex training
Strength
n Age Training intervention (kg) Jump (cm) Sprint (s) COD (s)
Intensity
Mean Freq ICRI Duration CA (% Measure Measure
Study, year Level Sport Group f (%) Subjects (6SD) (times·wk21) (min) (wk) 1RM) Training type (type) Measure (type) (distance) Measure (type)
McMaster et al. B Rugby EG1 0 14 20.9 (1.6) 4 2 5 85–100/ Day1- CPs: CMJ 1 power Direct 1RM — Photoelectric —
(54), 2014 (SHB) 60–75 cleans Day2-Upper body (squat) cells (20 m)
Day 3-CPs (1): SQ 1 SQ
jumps CPs (2): Bulgarian
split SQ 1 speed lunge
day 4-CPs (1): Upper body
CPs (2): Hip thrusts 1 Calf
extensions
EG2 0 14 4 2 5 85–100/
(SLB) 15–30
Kobal et al. (46), B Soccer EG 0 13 18.9 (0.7) 2 3 8 60–80 CPs: SQ 1 DJ Direct 1RM Contact mat Photoelectric Photoelectric cells (505
2017 (half-squats) (CMJ) cells (20 m) agility)
Freitas et al. B Basketball EG 0 9 21.3 (4.3) 2 2.5 6 80/Optimal CPs (1): SQ 1 SQ (optimal Indirect 1RM Force platform Photoelectric Photoelectric cells (T-test)
(29), 2018 load load) CPs (2): Bench press (half-squats) (CMJ) cells (10 m)
1 bench press (optimal
load) CPs (3): Hip thrust 1
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hip thrust (optimal load)

Garcia-Pinillos B Soccer EG 0 17 16.38 (1.5) 2 — 12 40–80 (s) CPs: Isometric SQ 1 VJ 1 — FreePower jump 2D 2D photogrammetry
et al. (30), 2014 SL jumps Sensorize (CMJ) photogrammetry (Balsom agility test)
(20 m)
CG 0 13 15.47 (1.28) — — — —
*A 5 amateur; B 5 elite & subelite; f 5 female; CPs 5 complex sets; ICRI 5 intracomplex rest interval; RM 5 repetition maximum; EG 5 experimental group; CG 5 control group; HRS 5 high-reactive strength group; LRS 5 low-reactive strength group; SHB 5 strength & heavy
ballistic; SLB 5 strength & low ballistic; CA 5 conditioning activity; CMJ 5 countermovement jump; Aba 5 abalokov jump; VJ 5 vertical jump; SQ 5 squat; SL 5 single leg; DB 5 dumbbell; DJ 5 drop jumps; ST 5 strength exercises; PT 5 plyometric exercises; MB 5 medicine
ball; COD 5 change of direction; wk 5 wk; kg 5 kilograms; cm 5 centimeters; s 5 seconds; m 5 meters.
†Data is represented in mean (6SD), n, or range.

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Complex and Contrast Training in Team-Sports (2020) 34:5

Table 2
Characteristics of contrast training (CNT) interventions included in the meta-analysis.*†
Contrast training
n Age Training intervention Strength (kg) Jump (cm) Sprint (s) COD (s)
Mean Freq ISRI Duration Intensity CA Measure
Study, year Level Sport Group f (%) Subjects (6SD) (times·wk21) (min) (wk) (%1RM) Training type Measure (type) Measure (type) (distance) Measure (type)
Dobbs et al. (16), A Rugby EG2 0 10 17 (0.7) 2 4 7 90 CTs: SQ 1 CMJ Indirect 1RM — — —
2015 (squat)
Fathi et al. (25), B Volleyball EG — 20 14.7 (0.6) 2 1.5 16 40–70 CTs: ST 1 PT — Infrared timing Photoelectric —
2018 system (CMJ) cells (10 m)
CG — 20 — — — —
Ramirez-Campillo A Soccer EG 0 9 17.3 (1.1) 2 2 8 70 CTs: Knee extension/flexion Indirect 1RM Contact mat — Photoelectric cells
et al. (62), 2018 (UG) exercises 1 DJ 1 horizontal (knee extension) (CMJ) (T-test)
jumps (UG and TG did the
same)
EG 0 9 17.6 (0.5) 2 2 8 70
(TG)
Santos and Janeira A Basketball EG 0 15 14.7 (0.5) 2 1–3 10 70–75 CTs: (wk 1–10) leg extension — Contact mat — —
(67), 2008 1 leg curl 1 leg press (wk (CMJ)
1–2) jump 1 zigzag drill 1
ankle hop 1 SQ jump (wk
3–4) Lateral box jump 1 DJ
1 hurdle hops (wk 5–7)
Lateral box jump 1 DJ 1
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hurdle hops (wk 8–10) DJ 180

turn 1 hurdle hops 1 cone
hops with COD 1 5 m sprint
1 multiple box-to-box jumps
CG 0 10 14.2 (0.4) — — — —
Franco-Márquez A Soccer EG 0 20 14.7 (0.5) 2 3 6 45–60 CTs: SQ 1 CMJs 1 step Indirect 1RM Infrared timing Photoelectric —
et al. (27), 2015 phase triple jump 1 COD or (squat) system (CMJ) cells (20 m)
CMJ 1 step phase triple jump
1 sprint
CG 0 18 — — — —
Rodriguez-Rosell A Soccer EG 0 15 12.7 (0.5) 2 3 6 45–58 CTs: SQ 1 COD or CMJs Indirect 1RM Infrared timing Photoelectric —
et al. (63), 2016 1 sprint (squat) system (CMJ) cells (20 m)
CG 0 15 — — — —
Kobal et al. (46), B Soccer EG2 0 12 18.9 (0.7) 2 3 8 60–80 CTs: SQ 1 DJ Direct 1RM (half- Contact mat Photoelectric Photoelectric cells
2017 squats) (CMJ) cells (20 m) (505 agility)
Ronnestad et al. B Soccer EG 0 8 23 (2) 2 — 7 85–90 CTs: ST 1 alternate leg Direct 1RM (half- Force platform Photoelectric —
(65), 2008 bound 1 bilateral hurdle jump squats) (CMJ) cells (40 m)
1 SL forward hop
CG 0 7 24 (1.5) — — — —
Rodriguez-Rosell B Soccer EG 0 10 24.5 (3.4) 2 3 6 45–60 CTs: SQ 1 COD or CMJs Indirect 1RM Infrared timing Photoelectric —
et al. (64), 2017 1 sprint (squat) system (CMJ) cells (20 m)
CG 0 10 — — — —
Voelzke et al. (81), B Volleyball EG 0 8 20 (7) 2 — 5 85/35 CTs: SQ 1 calf raise 1 power — — Photoelectric —
2012 clean 1 PT cells (15 m)
*A 5 amateur; B 5 elite & subelite; f 5 female; CTs 5 contrast sets; ISRI 5 intraset rest interval; RM 5 repetition maximum; EG 5 experimental group; CG 5 control group; CA 5 conditioning activity; UG 5 unilateral group; TG 5 traditional bilateral group; CMJ 5
countermovement jump; ST 5 strength exercises; PT 5 plyometric exercises; DJ 5 drop jump; COD 5 change of direction.
†Data is represented in mean (6SD), n, or range.
 Complex and Contrast Training in Team-Sports (2020) 34:5 | www.nsca.com

Figure 2. A) Risk of bias graph: review of authors’ judgments about each risk of bias item
presented as percentages across all included studies (studies with control group). B) Risk of
bias summary: review of authors’ judgments about each risk of bias item for each included
study.

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 Complex and Contrast Training in Team-Sports (2020) 34:5

Figure 3. A) Risk of bias graph: review of authors’ judgments about each risk of bias item presented as
percentages across all included studies (studies without control group). B) Risk of bias summary: review of
authors’ judgments about each risk of bias item for each included study.

ability when examining the pre- to post-test results (p 5 0.10). No
analysis could be conducted for CNT because there were no control
groups present. The average percent change from baseline to post-
training values was 24.9 6 2.5% for CPX and 23.3 6 0.9% for
CNT. Note that CPX studies included had multiple measures of
COD for 1 experimental group.
Subgroup Analyses
Results from the subgroup analysis are presented in Table 3 and
4. Two CPX studies (30,48) were eliminated from the subgroup
analysis (regarding intensity) because they used isometric rather
than a dynamic CA. Nonjump predominant team sports (other)
included were soccer, rugby, and baseball, whereas jump pre-
dominant team sports consisted of handball, basketball, and
volleyball. Subgroup analyses were not performed for the variable
COD regarding CNT due to the low number of studies.
When comparing characteristics of CPX (Table 3) for 1RM, no
differences were found in the competitive level of the subjects, but
the results show that there were higher large improvements in
1RM in subjects who performed nonjump predominant (SMD 5
2.55, 95% CI 1.44–3.65) team sports when compared with jump

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Figure 4. Total effects of complex training and contrast training on squat 1RM (kg): (A) Each plotted point represents the SE and
standardized mean difference (SMD) between postintervention and preintervention. B) Each plotted point represents the SE and SMD
between increases of the control group and intervention group. CI 5 confidence interval; IV 5 inverse variance; Std. 5 standardized.

predominant (SMD 5 0.90, 95% CI 20.11 to 1.90) team sports.
Furthermore, CA with loads ,85% 1RM (SMD 5 3.40, 95% CI
1.83–4.98) resulted in larger increases when compared with in-
tensities $85% 1RM (SMD 5 0.98, 95% CI 0.46–1.50). In ad-
dition, performing CPX for .6 weeks (SMD 5 2.99, 95% CI
1.87–4.11) showed greater large improvements in 1RM com-
pared with medium improvements for durations #6 weeks (SMD
5 0.62, 95% CI 0.20–1.04). Regarding characteristics of CNT
(Table 4) for 1RM, no differences were found concerning type of
sport, intensity, and duration. However, elite and subelite (SMD
5 3.17, 95% CI 0.58–5.76) subjects showed higher large im-
provement in 1RM compared with amateurs (SMD 5 0.93, 95%
CI 0.56–1.30).
Considering VJ, in CPX (Table 3), no differences were
found regarding type of sport or intensity of CA, despite
nonjump predominant sports and CA with loads ,85% 1RM
displayed large magnitudes of change. Large improvements in
VJ were attained in subjects who performed CPX for .6
weeks (SMD 5 1.31, 95% CI 0.64–1.97) compared with
small improvements for #6 weeks (SMD 5 0.21, 95%
CI 20.19 to 0.60). In addition, elite and subelite (SMD 5
1.13, 95% CI 0.50–1.77) attained greater large improvements
in VJ compared with small improvements for subjects of the
amateur level (SMD 5 0.31, 95% CI 0.01–0.61). Concerning
CNT (Table 4), for VJ height, no differences were found re-
garding level, type of sport, intensity, or duration of
intervention.
Regarding sprint performance, for CPX (Table 3), no differ-
ences were found considering the level, type of sport of the sub-
jects, intensity of CA used, or duration. In addition, there were no
differences for moderating factors regarding sprint for CNT
(Table 4).

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 Complex and Contrast Training in Team-Sports (2020) 34:5

Figure 5. Total effects of complex training and contrast training on VJ height (cm): (A) Each plotted point represents the SE and
standardized mean difference (SMD) between postintervention and preintervention. B) Each plotted point represents the SE
and SMD between increases of the control group and intervention group. VJ 5 vertical jump; CI 5 confidence interval; IV 5
inverse variance; Std. 5 standardized.

Finally, for COD ability, CPX (Table 3) analysis displayed no
differences regarding type of sport played, but larger magnitudes
were obtained for nonpredominant jump sports. Elite and sub-
elite (SMD 5 21.28, 95% CI 21.60 to 20.96) subjects showed
greater large improvements in COD compared with amateurs
(SMD 5 20.82, 95% CI 21.14 to 20.49). Likewise, subjects
who performed CAs at intensities ,85% 1RM obtained higher
large improvements in COD ability (SMD 5 21.38, 95% CI 2
1.73 to 21.02) compared with medium for intensities $85%
1RM (SMD 5 20.79, 95% CI 21.24 to 20.35). In addition,
performing CPX for .6 weeks (SMD 5 21.33, 95% CI 21.60 to
21.05) showed greater large improvements in COD compared
with small improvements using durations #6 weeks (SMD 5
20.43, 95% CI 20.90 to 0.05). There were not enough studies to
perform a subgroup analysis for COD ability regarding CNT
(Table 4).
Discussion
The main objectives of this study were to examine the effects of
CPX and CNT training interventions on lower-body 1RM, VJ,
sprint time, and COD and determine which program may better
explain neuromuscular adaptations after the use of these methods
with team sports. In addition, we aimed to identify training

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Figure 6. Total effects of complex training and contrast training on sprint time (s): (A) Each plotted point represents the SE and
standardized mean difference (SMD) between postintervention and preintervention. B) Each plotted point represents the SE
and SMD between increases of the control group and intervention group. CI 5 confidence interval; IV 5 inverse variance; Std.
5 standardized.

characteristics that may have a greater moderating effect. The
main findings indicate that there were no statistically significant
differences between CPX and CNT and that both types of training
had positive large effects on 1RM, medium (CNT) to large (CPX)
effects in VJ and COD ability, and small (CNT) to large (CPX)
effects on sprint performance. This implies that the sequence of
strength and power exercises does not significantly affect
performance-based outcomes but that CPX seems to result in
changes of higher magnitude in team-sport athletes. Moreover, in
studies that contained a control group, the experimental groups
performed better in both CPX and CNT.
Previous researchers (17,23,28,80) have proposed the benefits
of CPX training as being related to PAP response. However, our
results do not indicate significantly higher performance benefits
accrued from a period of CPX training compared with CNT in
team-sport athletes, although the magnitude of the effects asso-
ciated with CPX was greater. It may simply be that the adapta-
tions following CPX are a result of the combination of loads that
stimulate different areas of the force-velocity relationship (high
load–low velocity and low load–high velocity zones) (13) as it also
occurs when using CNT. However, it is worth noting CPX ach-
ieved higher magnitudes of improvement for all outcomes

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 Complex and Contrast Training in Team-Sports (2020) 34:5

Figure 7. Total effects of complex training and contrast training on COD time (s): (A) Each plotted point represents the SE and
standardized mean difference (SMD) between postintervention and preintervention. B) Each plotted point represents the SE
and SMD between increases of the control group and intervention group. CI 5 confidence interval; IV 5 inverse variance; Std.
5 standardized.

measures, which indicates that this method may potentially be
slightly superior. Furthermore, both interventions significantly
improved neuromuscular performance in team-sport athletes
which, from an applied perspective, suggests that sport scientists
and strength and conditioning professionals may use either
combination method to achieve positive adaptations on neuro-
muscular performance variables in team sports.
Both CPX and CNT were found to be effective methods to in-
crease 1RM in team-sport athletes. Interestingly, greater
improvements in 1RM using CPX were obtained for elite-level
athletes, for intensities ,85%, and using durations .6 weeks. This
supports previous findings that using lower CA intensities (,85%
1RM) in CPX may be more effective in team sports (28) and that
higher level athletes, with greater relative strength, may exhibit
greater increments in performance in comparison with weaker
individuals (70). This was also observed for CNT, in which effects
were greater in elite and subelite subjects. A possibility is that high-
level athletes have a greater capability to sustain combination
training performed concurrently to their team sport practice.
Johnston et al. (43) reported that rugby players with higher lower-
body strength demonstrated a more rapid recovery from compe-
tition; hence, they can counteract the detrimental effects of fatigue

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 Complex and Contrast Training in Team-Sports (2020) 34:5 | www.nsca.com

Table 3
Subgroup analyses assessing potential moderating factors of CPX intervention on lower-body 1RM, VJ, sprint, and COD in studies
included in the meta-analysis.*
Complex Training
N Group Studies ref. SMD (95% CI) I2 (%) p pDifference
1RM
Level
Amateur 3 (6,16,26) 1.31 (0.74 to 1.89) 0 ,0.001 0.14
Elite & subelite 10 (29,33–36,46,54,82) 2.25 (1.15 to 3.36) 90 ,0.001
Type of sport
Jump predominance 4 (29,35,82) 0.90 (20.11 to 1.90) 68 0.08 0.03
Other 9 (6,16,26,33,34,36,46,54) 2.55 (1.44 to 3.65) 90 ,0.001
Intensity
$85% 1RM 7 (6,16,35,54,82) 0.98 (0.46 to 1.50) 51 0.0002 0.004
,85% 1RM 6 (26,29,33,34,36,46) 3.40 (1.83 to 4.98) 89 ,0.001
Duration
.6 weeks 8 (6,16,26,33–36,46) 2.99 (1.87 to 4.11) 86 ,0.001 0.0001
#6 weeks 5 (29,54,82) 0.62 (0.20 to 1.04) 0 0.004
Vertical jump
Level
Amateur 4 (20,26,48,55) 0.31 (0.01 to 0.61) 0 0.05 0.02
Elite & subelite 11 (29,30,33,35,36,46,47,52,82) 1.13 (0.50 to 1.77) 78 ,0.001
Type of sport
Jump predominance 7 (29,35,47,48,55,82) 0.89 (0.18 to 1.61) 76 0.01 0.97
Other 8 (20,26,30,33,36,46,52) 0.88 (0.22 to 1.53) 80 0.009
Intensity
$85% 1RM 7 (20,35,48,52,82) 0.64 (20.05 to 1.32) 78 0.07 0.29
,85% 1RM 7 (26,29,33,36,46,47,55) 1.17 (0.46 to 1.88) 77 0.001
Duration
.6 weeks 9 (20,26,30,33,35,36,46–48) 1.31 (0.64 to 1.97) 85 ,0.001 0.005
#6 weeks 6 (29,52,55,82) 0.21 (20.19 to 0.60) 0 0.30
Sprint
Level
Amateur 6 (6,8,20,26,48) 20.73 (21.37 to 20.09) 71 0.03 0.47
Elite & subelite 12 (29,30,33–36,46,52,54,57) 21.03 (21.55 to 20.52) 77 ,0.001
Type of sport
Jump predominance 4 (29,35,48,57) 20.81 (21.16 to 20.46) 0 ,0.001 0.56
Other 14 (6,8,20,26,30,33,34,36,46,52,54) 21.00 (21.53 to 20.47) 81 ,0.001
Intensity
$85%1RM 9 (6,8,20,35,52,54) 20.84 (21.33 to 20.36) 62 ,0.001 0.77
,85%1RM 7 (26,29,33,34,36,46,57) 21.00 (21.90 to 20.10) 87 0.03
Duration
.6 weeks 11 (6,20,26,30,33–36,46,48,57) 21.09 (21.65 to 20.52) 84 ,0.001 0.16
#6 weeks 7 (8,29,52,54) 20.61 (20.97 to 20.24) 1 0.001
COD
Level
Amateur 5 (8,20,26,48) 20.82 (21.14 to 20.49) 0 ,0.001 0.05
Elite & subelite 15 (29,30,33–36,46,52,57) 21.28 (21.60 to 20.96) 54 ,0.001
Type of sport
Jump predominance 5 (29,35,48,57) 20.99 (21.35 to 20.64) 0 ,0.001 0.36
Other 15 (8,20,26,30,33,34,36,46,52) 21.22 (21.55 to 20.89) 58 ,0.001
Intensity
$85% 1RM 7 (8,20,35,52) 20.79 (21.24 to 20.35) 42 ,0.001 0.05
,85% 1RM 11 (26,29,30,33,34,36,46,57) 21.38 (21.73 to 21.02) 49 ,0.001
Duration
.6 weeks 15 (20,26,30,33–36,46,48,57) 21.33 (21.60 to 21.05) 47 ,0.001 0.001
#6 weeks 5 (8,29,52) 20.43 (20.90 to 0.05) 0 0.08
*CI 5 confidence interval; VJ 5 vertical jump; I2 heterogeneity; pDifference test for subgroup differences; p Value test for overall effect; SMD 5 standardized mean difference.

and possibly sustain greater training loads and intensities (72,76).
Furthermore, Malone et al. (53) reported that stronger team-sport
athletes could tolerate larger week to week changes in workload
compared with weaker athletes when strength was considered the
moderator of injury risk. Their ability to counteract fatigue as well
as the possibility that the elite and subelite athletes could have
a greater proportion of type II fibers could have led to greater
training adaptations when compared with weaker amateur team-
sport athletes (PAP mechanism dominating over fatigue) (66).
Recent publications (29,50) have focused on explaining how
increases in strength can be achieved with submaximal loads. Briefly,
when using such loading, higher acceleration of the barbell may be
achieved, which results in the application of considerable amounts of
force (force equals mass multiplied by acceleration) and possibly

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 Complex and Contrast Training in Team-Sports (2020) 34:5

Table 4
Subgroup analyses assessing potential moderating factors of CNT intervention on lower-body 1RM, VJ, and sprint in studies included in
the meta-analysis.*†
Contrast Training
N Group Studies ref. SMD (95% CI) I2 (%) p pDifference
1RM
Level
Amateur 5 (16,27,62,63) 0.93 (0.56 to 1.30) 0 ,0.001 0.09
Elite & subelite 3 (46,64,65) 3.17 (0.58 to 5.76) 90 0.02
Type of sport
Jump predominance n — — — —
Other n — — —
Intensity
$85% 1RM 2 (16,65) 4.33 (22.82 to 11.48) 94 0.24 0.37
,85% 1RM 6 (27,46,62–64) 1.08 (0.55 to 1.60) 53 ,0.001
Duration
.6 weeks 5 (16,46,62,65) 1.75 (0.41 to 3.08) 85 ,0.001 0.37
#6 weeks 3 (27,63,64) 1.11 (0.66 to 1.56) 0 ,0.001
Vertical jump
Level
Amateur 6 (25,27,62,63,67) 0.52 (0.21 to 0.82) 0 ,0.001 0.67
Elite & subelite 3 (46,64,65) 0.65 (0.12 to 1.17) 0 0.02
Type of sport
Jump predominance 2 (25,67) 0.41 (20.07 to 0.88) 0 0.09 0.48
Other 7 (27,46,62–65) 0.61 (0.30 to 0.92) 0 ,0.001
Intensity
$85% 1RM 1 (65) 0.34 (20.65 to 1.33) 0.50 0.67
,85% 1RM 8 (25,27,46,62–64,67) 0.56 (0.29 to 0.84) ,0.001
Duration
.6 weeks 6 (25,46,62,65,67) 0.52 (0.18 to 0.85) 0 0.002 0.76
#6 weeks 3 (27,63,64) 0.60 (0.18 to 1.03) 0 0.005
Sprint
Level
Amateur 3 (25,27,63) 20.66 (21.10 to 20.23) 19 0.002 0.24
Elite & subelite 4 (46,64,65,81) 0.11 (21.12 to 1.33) 84 0.86
Type of sport
Jump predominance 2 (25,81) 20.55 (21.52 to 0.43) 64 0.27 0.56
Other 5 (27,46,63–65) 20.15 (21.04 to 0.73) 82 0.73
Intensity
$85% 1RM 1 (65) 20.87 (21.91 to 0.17) 0.10 0.28
,85% 1RM 6 (25,27,46,63,64,81) 20.17 (20.91 to 0.56) 81 0.65
Duration
.6 weeks 3 (25,46,65) 0.01 (21.78 to 1.79) 92 1.00 0.63
#6 weeks 4 (27,63,64,81) 20.44 (20.83 to 20.05) 0 0.03
*CI 5 confidence interval; VJ 5 vertical jump; I2 5 heterogeneity; 1RM 5 pDifference test for subgroup differences; p Value test for overall effect; SMD 5 standardized mean difference.
†Type of sport subgroup for 1RM in the CNT intervention was not included because there were not enough studies.

contributes to strength gains. Therefore, the use of submaximal loads
,85% 1RM (lifted with the intent to achieve maximal movement
velocities) may be recommended to maintain/improve strength-
related measures with elite team-sport athletes, especially in portions
of the season where maximal loads may increase the risk of injury
and fatigue. In addition, interventions .6 weeks when using CPX
could be a beneficial duration, as supported by recent meta-analysis
(28) on this type of training. This implies that longer adaptation
periods are needed to see meaningful improvements.
Regarding VJ height, improvements were observed after both
CPX and CNT interventions. No factors were shown to modulate
the results regarding CNT in this meta-analysis. However, regarding
CPX, elite and subelite teams-sport athletes had significantly greater
improvements in VJ height compared with amateurs, possibility due
to the reasons listed previously: the level of the athlete could affect his
or her ability to counteract fatigue and elicit PAP. Of note, short rest
intervals (,5 minutes) were used in CPX protocols in the studies
included in this review. Although a previous meta-analysis (70)
suggested that longer intervals (.5 minutes) lead to higher PAP
responses, our results coincide with reports that a shorter rest interval
can result in significant potentiation using strength-power complexes
(77). This has important implications in the practical use of CPX for
chronic adaptations, especially given that in team-sport settings,
intracomplex rest intervals .5 minutes are generally unrealistic to
use. Surprisingly, already well-trained athletes achieved greater
improvements than amateur athletes. As mentioned before, higher
level/stronger athletes cope better with fatigue when utilizing con-
current programs in team sports, which is why they may have ach-
ieved greater increments in power-oriented exercises. In addition,
there were similar adaptations in VJ height when using CPX in
nonjump predominant sports (i.e., baseball, soccer, and rugby) when
compared with the jump predominant. Sports such as handball,
basketball, and volleyball include individuals who are already highly
jump trained; therefore, it may be more difficult for them to acquire
additional gains in VJ height when compared with athletes from
other modalities. Nevertheless, significant adaptations of medium

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 Complex and Contrast Training in Team-Sports (2020) 34:5
magnitude were observed in this population, despite their proficiency
in VJ, suggesting this is a viable method.
Concerning sprint ability, there were no statistically significant dif-
ferences between CPX and CNT, and no moderating factors that could
have affected straight sprint time were identified. Interestingly, signif-
icant improvements in sprinting performance were observed after CPX
but not after CNT interventions. A possible rationale to the absence of
positive sprint adaptations may be related to the fact that team-sport
athletes are exposed to high physiological demands in their technical
and physical training (2,22,68), which could interfere with some of the
intended outcomes of strength-power training (in this particular case,
sprint performance) (49). This so-called “interference phenomenon” is
problematic for sport scientists (18) and highlights the need for training
variables to be manipulated to avoid detriments in team sports. Kobal
et al. (46) reported decrements in speed-related tests after CPX and
CNT in highly trained soccer players. The authors’ hypothesized that
the absence of adaptations could be explained by the interference effect,
the lack of a sprint stimulus in the training intervention, and the high
training experience of the soccer players in their study. Given this, it is
possible that higher volumes or variations of sprint stimulus are needed
to elicit adaptations in team-sport athletes. Interestingly, some of the
studies included used a CA paired with sprints (8,27,33–36,63,64,67),
which could have resulted in greater speed performance increases over
the studies that did not have a sprint stimulus.
Another aspect worth considering is that completing all heavy-
load strength exercises at the beginning of the training session and all
light-load exercises at the end can excessively task the neuromuscular
system and hinder the performance of the explosive actions executed
at the end, negatively affecting acute and chronic adaptation (45).
There is an existing balance between fatigue and potentiation when
using CPX (80), where performance in explosive exercises will be
enhanced after a CA if there is an appropriate amount of rest to
mitigate fatigue. However, when performing all the heavy mechan-
ical work at the beginning (CNT), the neuromuscular system may be
fatigued, which could theoretically lead to poorer movement me-
chanics and diminished explosive power production. Following this
logic, completing all the explosive movements at the beginning to
preserve movement quality and velocity would be a logical and in-
teresting intervention; however, there is insufficient literature on this
type of combination training.
Considering COD ability, there were no statistically significant
differences between CPX and CNT. Noteworthy, the studies in-
cluded in the meta-analysis conducted multiple COD tests with dif-
ferent angle of directional change or number of COD maneuvers,
which could have potentially affected the results. It is well established
in the literature that COD performance is task-specific (21) and that
there is no universal COD ability (86). This being said, COD
improvements were greater in CPX training when performed by elite
and subelite teams-sport athletes, using loads ,85% 1RM, for
durations greater than 6 weeks.
The magnitude of effect of CPX on COD was large, and the effect
of CNT on COD was medium. This supports findings that strength
and power training have an ergogenic effect on COD ability. Possible
aspects that could explain these findings are the relationship between
strength and COD. Notably, eccentric strength has been determined
an essential component of COD ability (9). Strength and power
training exercises have a concentric as well as an eccentric component
which could improve the ability to tolerate braking loads or capacity,
hence improving an athlete’s ability to change direction efficiently
(75). Previous studies have highlighted that straight sprinting speed
has a limited transfer to COD ability and vice-versa (7,85); hence,
when developing a CPX or CNT protocols, it is important to pre-
scribe a specific stimulus for the desired adaptations.
1477
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| www.nsca.com
Limitations and Future Research
In this systematic review with meta-analysis, some limitations
can be identified; therefore, readers must be critical when
interpreting the results. First, a high heterogeneity was ob-
served in the studies included in this analysis as they had dif-
ferent populations and training characteristics. Second, there
was a greater amount of CPX studies included compared with
CNT. Furthermore, seasonal periods (i.e., preseason, com-
petitive period, etc.) were not considered in this analysis, which
may be considered a factor potentially affecting the results.
Also, of note, most of the studies did not report the total
training load outside of the experimental protocol (frequency,
intensity, duration, etc.); hence, the influence of the sport-
specific training cannot be determined or discussed. In addi-
tion, the use of direct and indirect measurements of maximal
strength and various instruments and testing procedures used
to measure VJ, sprint, and COD cannot be counted out as
a possible factor that could have affected the outcome of
results. Finally, a lack of control groups is considered a limi-
tation in this meta-analysis. Accordingly, future research
should take these aforementioned variables into account when
designing a study that is focused on the combination of
strength-power exercises in different sequences.
CPX and CNT are both effective methods to increase lower-
body strength, VJ height, sprint performance, and COD ability
in team sports and may be used by strength and conditioning
professionals. Based on the results obtained, CPX may lead to
superior gains in the studied variables, although no statistically
significant differences were found. In large competitive seasons
(sometimes longer than 8 months), CPX and CNT may be
useful tools to offer variability in training, to minimize mo-
notony, and to keep athletes engaged while achieving similar
adaptations. In general, regarding the use of combination
training programs in team sports, higher adaptations seem to
occur with the use of CA at intensities ,85% 1RM, for
durations .6 weeks, and with higher level athletes. Finally,
CPX and CNT can be used concurrently with usual sport-
specific training sessions to improve various neuromuscular
performance measures in team sports.
Practical Applications
Based on present results, CPX and CNT are effective inter-
ventions for improving performance-based adaptations
(i.e., lower-body strength, VJ, sprint, and COD ability) in team-
sport athletes. The absence of significant differences between
the effect of CPX and CNT in this study encourages the use of
both methods, but it is worth noting that CPX had an overall
greater ergogenic effect on the outcome variables assessed. In
CNT, considering that all heavy lifting is performed in the be-
ginning of the training session, coaches should be careful and
avoid excessively tasking the neuromuscular system, possibly
hindering the performance of the explosive actions executed at
the end. Of note, CPX demonstrated to be most effective with
elite-level team-sport athletes, using submaximal CA intensities
(,85% 1RM), for .6 weeks duration. More research is needed
to determine whether other combination training methods (e.g.,
plyometric/power exercises performed before strength exer-
cises) could be optimal for performance-based adaptations or
injury prevention in team sports.
 Complex and Contrast Training in Team-Sports (2020) 34:5
Acknowledgments
The authors have no conflicts of interest to disclose.
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