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Which ROMs Lead to Rome? A Systematic Review of the Effects of Range of

Motion on Muscle Hypertrophy

Article in The Journal of Strength and Conditioning Research · September 2022

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 Brief Review

Which ROMs Lead to Rome? A Systematic Review of

the Effects of Range of Motion on Muscle
Hypertrophy
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Witalo Kassiano,1 Bruna Costa,1 João Pedro Nunes,1 Alex S. Ribeiro,2 Brad J. Schoenfeld,3 and
Edilson S. Cyrino1
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1
Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR,
Brazil; 2Center for Research in Health Sciences, University Pitágoras UNOPAR, Londrina, PR, Brazil; 3Health Sciences Department,
CUNY Lehman College, Bronx, New York

Abstract
Kassiano, W, Costa, B, Nunes, JP, Ribeiro, AS, Schoenfeld, BJ, and Cyrino, ES. Which ROMs lead to Rome? a systematic review of
the effects of range of motion on muscle hypertrophy. J Strength Cond Res 37(5): 1135–1144, 2022—Resistance exercise range of
motion (ROM) influences muscular adaptations. However, there are no consistent practical guidelines about the optimal ROM for
maximizing muscle hypertrophy. The objective of this article was to systematically review the literature for studies that compared the
effects of full ROM (fROM) and partial ROM (pROM) on muscle hypertrophy. PubMed/MEDLINE, Scopus, and Web of Science
databases were searched to identify articles from the earliest record up to and including April 2022. We calculated the effect size
(ES) scores of the variables of interest. Eleven studies were included in the review. Full ROM and pROM performed in the initial part of
the ROM elicited greater muscle hypertrophy of the rectus femoris, vastus lateralis, biceps brachii, and brachialis distal sites
(between-groups ES: 0.20–0.90) than pROM performed in the final part of the ROM. fROM elicited greater muscle growth on the
gluteus maximus and adductors than pROM in the final part of the ROM (between-groups ES: 0.24–0.25). Initial pROM produced
more favorable proximal rectus femoris hypertrophy than fROM (between-groups ES: 0.35–0.38). pROM in the middle part of the
ROM elicited greater triceps brachii hypertrophy than fROM (between-group ES: 1.21). In conclusion, evidence suggests that when
training at a longer muscle length—through either pROM or fROM—some muscles, such as quadriceps femoris, biceps brachii,
and triceps brachii, tend to experience optimal growth. Thus, the use pROM in the initial part of the excursion in combination with
fROM training should be considered when prescribing hypertrophy-oriented resistance training programs.
Key Words: strength training, resistance training, excursion, regional hypertrophy, muscle length, length-tension relationship

Introduction A full ROM (fROM) has been described as dynamic resistance

exercise performed without movement restrictions (11). By con-
Range of motion (ROM) can be operationally defined as the de-
trast, training through a limited degree of excursion has been
gree of movement that occurs in a given joint during exercise
termed “partial ROM” (pROM) (25,26). Despite the widespread
performance (11). Range of motion plays a substantial role in the
belief that fROM training is superior to pROM to induce muscular
manifestations of muscular adaptations (e.g., muscle hypertrophy
adaptations (25,26), evidence remains equivocal on the topic
and increased strength) in response to resistance exercise (25,37),
(12,25,26). Traditionally, researchers have addressed the question
which can be attributed to the fact that the capacity of a muscle for
as to how ROM affects muscular adaptations by comparing fROM
producing force during dynamic actions changes across joint
with pROM, wherein pROM is a part of fROM (8,16,33). More
angles. That is, depending on the specific ROM, factors such as
recently, some studies have compared pROM training at different
muscle activation, internal moment arm length, and length-
parts of the complete excursion (e.g., initial versus final parts of the
tension relationship will be differentially affected (17,25), po-
ROM), which may or may not overlap (31,35). Based on the first
tentially influencing the magnitude of hypertrophy. For instance,
group of studies that exclusively compared fROM versus pROM, a
training with a greater ROM generally requires the muscle to
recent meta-analysis found consistently favorable results for fROM
produce force in a more elongated position (21). Depending on
compared with pROM for muscular strength gains (30). On the
the mechanical characteristics of a muscle (e.g., if its fibers work
other hand, the results were more inconclusive for lower-limb
on the ascending, plateau, or descending limb of the length-
muscle hypertrophy (12,30).
tension curve), it may experience differential degrees of mechan-
It is important to note that most studies investigating hyper-
ical tension from active and passive elements (10,15), which in
trophy outcomes involved performing the pROM only in the
turn may affect the hypertrophic stimulus (41).
final portion of the ROM, which hinders the ability to conclude
that fROM would necessarily be superior to other pROMs (e.g.,
Submitted for publication July 11, 2022; accepted September 23, 2022. training at the initial or middle portions) (12). For instance,
Address correspondence to Witalo Kassiano, acc.witalo@gmail.com. recent studies have found that pROM performed in the initial
Journal of Strength and Conditioning Research 37(5)/1135–1144 part of the ROM of the concentric muscle action (i.e., at longer
ª 2023 National Strength and Conditioning Association muscle lengths) elicits greater hypertrophy compared with

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 Range of Motion and Muscle Hypertrophy (2023) 37:5
pROM performed in the final part of the ROM (i.e., at shorter
muscle lengths) (35) and is comparable with or even more ef-
fective than training with fROM (31). These conflicting findings
impair the ability to draw practical conclusions regarding the
optimal ROM to maximize muscle hypertrophy. Consideration
of recent studies that compared different ROMs with fROM
may help to reconcile limitations of previous reviews and allow
for more insightful practical recommendations and isolating
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gaps in the current literature and thus helping to direct future
research on the topic. The aim of this article was to compre-
hensively review the literature and compare the effects of fROM
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and different pROMs on muscle hypertrophy.
Methods
Experimental Approach to the Problem
The current systematic review was performed according to the
guidelines set forth by PRISMA and Prisma in Exercise, Re-
habilitation, Sport Medicine, and Sports Science (PERSiST)
(1,29). The research questions were defined by population, in-
tervention, comparator, outcomes, and study design (PICOS)
model following the PRISMA guidelines, as follows.
Population. Adults (18 years or older) with or without RT ex-
perience, with no restrictions on sex. Investigations including
individuals with chronic diseases, musculoskeletal disorders, or
injuries were excluded.
Intervention. Studies implementing dynamic resistance training
programs lasting $4 weeks. Investigations involving isometric
actions were excluded because this form of training is restricted to
a specific point of the ROM.
Comparator. An experimental trial comparing resistance training
with fROM versus pROM or comparison between 2 pROMs
performed at different parts of the ROM—i.e., initial versus final
part of the ROM.
Outcomes. Changes in muscle size using a site-specific measure-
ment (muscle thickness, cross-sectional area, or volume [through
ultrasound, magnetic resonance imaging, or computed
tomography]).
Study Design. Longitudinal randomized control trials using either
parallel group(s) or within-subject designs comparing fROM and
pROM at different parts of the ROM.
Literature Search
To perform this review, we searched PubMed/MEDLINE, Sco-
pus, and Web of Science through December 2021 and updated the
search in April 2022. Only peer-reviewed articles in English were
selected for inclusion; citations from scientific conferences were
excluded from analysis. The search included the following syntax:
“range of motion” AND (“muscle thickness” OR “cross-
sectional area” OR “muscle volume” OR “muscle mass” OR
“hypertrophy” OR “muscle growth”). The title and abstract of
each study were inspected for relevance, and the full text was then
scrutinized for those initially appearing to meet inclusion criteria.
Studies in which the abstracts did not provide enough in-
formation according to our inclusion criteria were retrieved for
full-text evaluation. In the selected articles, the reference lists and
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Google Scholar citations were screened for additional manu-
scripts. In addition, the list of articles that cited the included
studies was screened. Two authors (W.K. and BC.) performed the
search independently. In the case of any disagreement as to in-
clusion, a third assessor (J.P.N.) resolved the dispute.
Study Coding, Data Extraction, and Analysis
The following data were extracted from the included studies: (a)
study characteristics (author, year, sample size, and study design),
(b) subject demographics (age, sex, and resistance training expe-
rience), (c) resistance training protocols and how the ROM was
measured, and (d) outcome measures (muscle hypertrophy). We
then coded data for the pretraining and posttraining means and
standard deviations of the included studies. We calculated aver-
age percentage changes (d%) and effect size (ES) scores of the
variables of interest. Values of d% were calculated as follows:
([posttraining mean/pretraining mean * 100] – 100). The ES of
each training group was calculated using the following formula:
([posttraining mean – pretraining mean]/[pooled pretraining
standard deviation]) (23). Values of ES regarding the pre-to-post
changes, as well as the differences between groups (e.g., group 1
ES minus group 2 ES), were considered as follows: ,0.20, trivial/
negligible; 0.20–0.49, small; 0.50–0.79, moderate; and $ 0.80,
large (5). In cases where studies did not provide sufficient in-
formation as to results, we contacted the authors to request the
missing data (2,8,21,31,33,40,42,43). In the case of no response
and where applicable, values were extracted from the studies’
figures using WebPlotDigitizer (2,8,33,43). We opted to interpret
the findings based on the calculated ES for each study (13).
Quality Assessment
The modified Physiotherapy Evidence Database (PEDro) scale
and Oxford’s level of evidence were used by 2 independent in-
vestigators (W.K. and B.C.) to assess the methodological quality
of the articles included in the review. Given that it is not possible
to blind the subjects and investigators in supervised resistance
exercise interventions, items 5–7 from the scale, which are specific
to blinding, were removed. This approach has been used in pre-
vious systematic reviews in the area of resistance training (13,37).
With the removal of these items, the maximum score on the
modified “PEDro 8-point” scale was 7 because the first item,
related to eligibility criteria, is not included in the total score.
Oxford’s level of evidence ranges from 1a to 5, with 1a being
systematic reviews of high-quality, randomized controlled trials,
and 5 being expert opinions.
Results
The search strategy initially yielded 2,532 studies. After removing
duplicates, 1,443 titles and abstracts were screened, resulting in
16 potentially eligible full texts, plus 5 articles found through
other sources (citations searching: 4 articles and accepted but not
indexed in a data base: 1 article). After the full-text screening, 11
investigations were considered for inclusion in the present sys-
tematic review. The PRISMA flow diagram is presented in
Figure 1.
Study Characteristics
Details of the 11 studies (n 5 297) included in the systematic review
are presented in Table 1. The average duration of studies was 10
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Figure 1. PRISMA flow diagram.
weeks (ranging from 5 to 15 weeks). Eight studies compared
fROM versus pROM (2,8,16,20,33,40,42,43), 2 compared
pROM at the initial part of the ROM versus at the final part of the
ROM (21,35), and 1 compared multiple groups and ROMs (31).
Three studies measured the excursed ROM with a goniometer
(8,20,21), 1 used a potentiometer (31), 1 used isokinetic dyna-
mometry (40), and 6 studies did not specify the type of measure-
ment assessment (2,16,33,35,42,43). Resistance training
interventions involved male-only samples in 5 studies
(2,8,16,33,40), female-only in 1 study (31), and mixed samples in 5
studies (20,21,35,42,43). Eight studies used lower-limb exercises, 3
of them used the squat (2,16,43), 2 used the knee extension (31,40),
2 used a combination of lower-limb exercises (20,21), and 1 used
the 45° leg press exercise (42). Three studies investigated upper-
limb exercises (8,33,35), 2 of them used the preacher curl exercise
(33,35) and the other used the lying elbow extension (8). Four
studies assessed changes in muscle size through muscle thickness
(33,35,42,43), 4 through CSA (8,20,21,31), 1 through both muscle
thickness and CSA (2), 1 through muscle volume (16), and 1
through CSA and volume (40).
Muscle Hypertrophy in Response to Different ROMs
Pedrosa et al. (31) compared the effects of performing knee ex-
tension with fROM versus initial and final pROM (i.e., initial and
final half of the angles of fROM, taking the concentric action as
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| www.nsca.com
reference) and a group that alternated between training in the
initial pROM and final pROM from session to session. The re-
sults showed greater increases in CSA of the proximal rectus
femoris for the initial pROM training performed at longer muscle
lengths (65–100° of knee flexion; 0° 5 knee fully extended)
compared with fROM (30–100° of knee flexion) and final pROM
training performed at shorter muscle lengths (30–65° of knee
flexion). Moreover, there was a greater CSA increase at the distal
sites of the rectus femoris and vastus lateralis in fROM and initial
pROM groups than the final pROM condition (31). Valamatos
et al. (40) also investigated the effects of performing knee exten-
sion at different ROMs; however, the training protocol was
performed using an isokinetic dynamometer. The authors com-
pared knee extension with fROM (0–100° of knee flexion; 0° 5
knee fully extended) versus final pROM training (0–60° of knee
flexion). The results showed similar increases in vastus lateralis
muscle volume and anatomic CSA at proximal, middle, and distal
sites in both groups (40).
Bloomquist et al. (2) compared the effects of performing the
back squat with fROM (0–120° of knee flexion; 0° 5 knee fully
extended) versus final pROM (0–60° of knee flexion). The au-
thors observed greater increases in CSA of the middle and distal
sites of the anterior thigh in the fROM group; only one of the
more proximal sites of the back of thigh increased, without dif-
ferences between groups. Moreover, vastus lateralis muscle
thickness increased to a small magnitude in both groups. Kubo
et al. (16) compared the effects of performing the back squat with
 Range of Motion and Muscle Hypertrophy (2023) 37:5

Table 1
Characteristics of included studies and main results.*
Study Sample Duration/Frequency Groups Exercises Outcomes Findings
21
Bloomquist Non–resistance-trained 12 wk, 3 d·wk Shallow squat (0–60˚ of Back squat (free weight) CSA by MRI of front and Deep squat induced
et al. (2)† young men (n 5 17) knee flexion); deep squat posterior thigh at greater increases in 5 of 6
(0–120˚ of knee flexion) proximo-distal femur sites of front thigh
lengths; MT of the vastus(4.3–6.1% vs. 2
lateralis by US measured 2.3–2.3%). The
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at 50% of femur length exception was the most

proximal site of front thigh
that grew in similar
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magnitude (7.1 vs. 4.6%)

Changes in back thigh did
not differ between groups
(21.2–3.0% vs. 2
1.3–2.7%).
The changes in vastus
lateralis MT were similar
for both groups
(2.8–3.6%, ES 5
0.22–0.29)
Goto et al. (8) Resistance-trained young 8 wk, 3 d·wk21 pROM (45–90˚ of elbow Lying elbow extension CSA triceps brachii at pROM induced greater
men (n 5 44) flexion); (free weight) 60% of humerus length increases in CSA triceps
fROM (0–120˚ of elbow by US and arm brachii than fROM
flexion) circumference (49.5%, ES 5 2.88 vs.
27.6%, ES 5 1.67)
Kubo et al. Physically active young 10 wk, 2 d·wk21 Half squat (0–90˚ of knee Back squat (free weight) Muscle volume by MRI of Full squat induced greater
(16) men (n 5 17) flexion); full squat rectus femoris, vastus increases than half squat
(0–140˚ of knee flexion); lateralis, vastus in size of gluteus
intermedius, vastus maximum (6.4%, ES 5
medialis, biceps femoris 0.38 vs. 2.1%, ES 5
short head, biceps 0.13) and adductors
femoris long head, (5.1%, ES 5 0.47 vs.
semitendinosus, 2.7%, ES 5 0.23); while
semimembranosus, the increases in vastii
adductor magnus, were similar (3.5–6.8%,
adductor longus, ES 5 0.24–0.52); rectus
adductor brevis, and femoris, biceps femoris
gluteus maximum short and long heads,
semitendinosus and
semimembranosus did
not change in both groups
(20.5–1.3%, ES 5 2
0.03–0.04)
McMahon Non–resistance-trained 8 wk, 3 d·wk21 (2 Shorter ROM (0–50˚ of Barbell back squat, knee CSA vastus lateralis by US Longer ROM induced
et al. (20) young men and women supervised, 1 home- knee flexion); longer ROM extension, Bulgarian split at 25, 50, and 75% of greater CSA increases
(n 5 26) based session) (0–90˚ of knee flexion); squat, double- and femur length than shorter ROM at
control (no exercise) single-legged Sampson proximal (33.8%, ES 5
chair, leg press, and 0.92 vs. 19.0%, ES 5
lunges 0.55) and distal sites
(40.1%, ES 5 0.78 vs.
7.5%, ES 5 0.15);
similar increases were
observed at middle site
(18.0%, ES 5 0.54 vs.
22.0%, ES 5 0.66,
longer and shorter ROM,
respectively)
McMahon Non–resistance-trained 8 wk, 3 d·wk21 (2 Final pROM (0–50˚ of Bilateral barbell squat, CSA vastus lateralis by US Middle pROM induced
et al. (21) young men and women supervised, 1 home- knee flexion); middle seated leg press, seated at 25, 50, and 75% of greater increases in CSA
(n 5 31) based session) pROM (40–90˚ of knee knee extension, Bulgarian femur length vastus lateralis than final
flexion); control (no split squat, and Sampson pROM at proximal
exercise) chair (30.5%, ES 5 1.23 vs.
17.4%, ES 5 0.75),
middle (35.8%, ES 5
1.33 vs. 21.6%, ES 5
0.89), and distal (50.7%,

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Table 1
Characteristics of included studies and main results.* (Continued)
Study Sample Duration/Frequency Groups Exercises Outcomes Findings
ES 5 1.27 vs. 13.5%, ES
5 0.36) sites
Pedrosa Non–resistance-trained 12 wk, 3 d·wk21 INITIALROM (65–100˚ of Knee extension in a CSA of the rectus femoris Rectus femoris:
et al. (31) young women (n 5 45) knee flexion); FINALROM weight-stack machine and vastus lateralis by US INITIALROM and VARROM
(30–65˚ of knee flexion); at 40, 50, 60, and 70% of induced greater
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FULLROM (30–100˚ of femur length increases at more

knee flexion); VARROM proximal sites than
(daily alternated between FINALROM and FULLROM
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30–65˚ and 65–100˚ of (16.9–24.9%, ES 5

knee flexion); control (no 0.57–0.73 vs.
exercise) 9.7–13.0%, ES 5
0.32–0.38); INITIALROM,
VARROM, and FULLROM
induced greater
increases at more distal
sites than FINALROM
(17.7–23.7%, ES 5
0.38–0.68 vs. 1.2–9.1%,
ES 5 0.02–0.24)
Vastus lateralis: VARROM
induced greater
increases at more
proximal site than
INITIALROM, FINALROM,
and FULLROM (18.4%, ES
5 0.96 vs. 12.2–15.4%,
ES 5 0.65–0.73);
INITIALROM and VARROM
induced greater
increases at middle site
than FINALROM and
FULLROM (15.5–16.0%,
ES 5 0.78–0.79 vs.
9.1–12.4%, ES 5
0.44–0.54); INITIALROM,
VARROM, and FULLROM
induced greater
increases at more distal
sites than FINALROM
(10.2–15.6%, ES 5
0.32–0.58 vs. 1.1–4.8%,
ES 5 0.04–0.19)
Pinto et al. Non–resistance-trained 10 wk, 2 d·wk21 pROM (50–100˚ of elbow Preacher curl using a MT of elbow flexors pROM and fROM induced
(33) young men (n 5 35) flexion); fROM (0–130˚ of curling bar (biceps brachii and similar increases in MT of
elbow flexion); control (no brachialis) by US elbow flexors (7.2–7.8%,
exercise) measured at 60% of ES 5 0.42–0.44)
humerus length
Sato et al. Non–resistance-trained 5 wk, 2 d·wk21 Final pROM (80–130˚ of Preacher curl using a MT of elbow flexors Initial pROM induced
(35) young men and women elbow flexion); initial dumbbell (biceps brachii and greater MT increases
(n 5 32) pROM (0–50˚ of elbow brachialis) by US than final pROM at distal
flexion); control (no measured at 50, 60, and site (12.7%, ES 5 0.68
exercise) 70% of humerus length vs. 2.1%, ES 5 0.11);
while the increases were
similar at proximal and
middle portions
(3.7–6.9%, ES 5
0.18–0.32) for both
training groups
Valamatos Untrained young men 15 wk, 3 d·wk21 pROM (0–60˚ of knee Isokinetic knee extension Vastus lateralis muscle Muscle volume and
et al. (40) (n 5 19) flexion); fROM (0–100˚ of volume by MRI and anatomical CSA at
knee flexion); control (no anatomic CSA by US at proximal, middle, and
exercise) 25, 50, and 75% of the distal portions increased
total muscle length similarly (3.0–7.6%, ES
5 0.25–0.58)

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 Range of Motion and Muscle Hypertrophy (2023) 37:5

Table 1
Characteristics of included studies and main results.* (Continued)
Study Sample Duration/Frequency Groups Exercises Outcomes Findings
21
Werkhausen Resistance-trained young 10 wk, 3 d·wk pROM (81–90˚ of knee 45˚ leg press MT of the vastus lateralis The groups did not differ
et al. (42) men and women (n 5 15) flexion); fROM (0–90˚ of by US measured at 60% in the magnitude of MT
knee flexion) of femur length changes (pROM: 21%,
ES 5 20.08 vs. fROM:
22%, ES 5 20.16)
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Yoshiko et al. Physically active older 12 wk, 3 d·wk21 (home- Shallow squat (not Weight-bearing squat MT of rectus femoris, Deep squat induced
(43) men and women (n 5 16) based sessions) specified); deep squat vastus intermedius higher increases in MT of
(not specified)‡ anterior and lateral, and rectus femoris (9.3%, ES
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vastus lateralis by US 5 0.41 vs. 1.3%, ES 5

0.06) and vastus
intermedius anterior
(20.3%, ES 5 0.81 vs.
1.4%, ES 5 0.06), but
not in vastus intermedius
lateral (1.7%, ES 5 0.07
vs. 26.0%, ES 5 2
0.24) and vastus lateralis
(6.7%, ES 5 0.29 vs.
3.1%, ES 5 0.14) than
shallow squat
*fROM 5 full range of motion; pROM 5 partial range of motion; CSA 5 cross-sectional area; MRI 5 magnetic resonance imaging; US 5 ultrasound; MT 5 muscle thickness. ES 5 effect size.
†We were unable to calculate the ES because we got no response from the authors, and the figures do not allow for data extraction of premean and postmean and standard deviation. In this sense, we obtained
the relative changes (%) using WebPlotDigitizer.
‡ROM was controlled by chair height of 40 cm and a cushion of 20 cm. The shallow group performed squat training with the cushion and deep group without this implement.

fROM (0–140° of knee flexion) versus pROM from the initial to
final part of the ROM (0–90° of knee flexion). The authors
reported similar increases in muscle volume of the vastus lateralis,
intermedius, and medialis. Importantly, muscle volume of the
gluteus maximus and adductors increased to a greater magnitude
in fROM than pROM; the size of the rectus femoris, semite-
ndinosus, semimembranosus, and biceps femoris short and long
heads did not significantly change pre-to-post study in either
group.
McMahon et al. (20) compared the effect of different lower-
limb exercises with pROM performed from the initial to final part
of the ROM (0–90° of knee flexion) versus pROM performed
exclusively at the final part of the ROM (0–50° of knee flexion).
The results showed that pROM from initial to final part of the
excursion induced greater CSA increases of the vastus lateralis at
the proximal and distal sites, but not at the middle site. In another
study from the same laboratory, McMahon et al. (21) compared a
pROM group that trained from the initial to final part of the
ROM, but without reaching terminal extension (40–90° of knee
flexion) versus another pROM group that trained in the final part
of the ROM (0–50° of knee flexion) using a combination of dif-
ferent lower-limb resistance exercises. The researchers found that
pROM focusing on the initial part of the excursion experienced
greater vastus lateralis CSA increases at proximal, middle, and
distal sites.
Yoshiko and Watanabe (43) compared the effects of per-
forming a deep squat versus a shallow squat (ROMs not specified)
on lower-limb muscle growth in older adults. The results in-
dicated superior rectus femoris and vastus intermedius (anterior
aspect) muscle thickness increases in deep squat training. Wer-
khausen et al. (42) compared the effects of performing power-
oriented training on the 45° leg press with a longer ROM (0–90°
of knee flexion) versus pROM performed in the initial part of the
ROM (81–90° of knee flexion) in resistance-trained men and
women. There were no observed differences in changes of vastus
lateralis muscle thickness between groups nor were there any
substantial changes from pre-to-post study in either condition.
Pinto et al. (33) compared the effects of performing the
preacher curl using fROM (0–130° of elbow flexion; 0° as elbow
fully extended) versus pROM at the middle part of the ROM
(50–100° of elbow flexion) on elbow flexors muscle size in
non–resistance-trained men. The results showed similar increases
in muscle thickness between ROMs. Sato et al. (35) compared the
effects of performing the preacher curl in pROM in the initial part
of the ROM (0–50° of elbow flexion; 0° as elbow fully extended)
versus pROM in the final part of the ROM (80130° of elbow
flexion) on regional (proximo-distal) elbow flexors muscle
thickness. The pROM performed in the initial part of the ROM
induced greater muscle growth at the distal site than the pROM
performed in the final part of the ROM; the increases at proximal
and middle sites were similar between conditions. Goto et al. (8)
compared the effects of performing the lying elbow extension in
fROM (0–120° of elbow flexion; 0° as elbow fully extended)
versus pROM performed in the middle part of the ROM (45–90°
of elbow flexion) on triceps brachii CSA in resistance-trained
men. The results showed a superior increase in CSA in the pROM
group compared with fROM.
Quality of Studies and Level of Evidence
The PEDro score for the studies in this review ranged from 5 to 7
(mean 5 6.3 6 0.9), indicating “good” to “excellent” method-
ological quality (Table 2). Of the 11 studies, 7 achieved a total
score of 7, 1 achieved a total score of 6, and 3 achieved a total
score of 5. According to Oxford’s level of evidence, 7 of the 11
studies had an evidence level 1b (high-quality randomized con-
trolled trials) and 4 of the 11 studies had an evidence level of 2b
(individual cohort study or low-quality randomized controlled
trials).

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 Range of Motion and Muscle Hypertrophy (2023) 37:5 | www.nsca.com

Discussion elbow flexors only in the middle site, thus precluding the ability to
draw inferences as to the potential effect of the studied ROM
The purpose of this study was to comprehensively review the
configurations on regional growth of the elbow flexors. Because
literature on the effects of fROM and different pROMs (e.g.,
hypertrophy during training at long muscle lengths often occurs
initial and final pROM) on muscle hypertrophy. The findings of
to a greater extent in the distal region of the muscle, this might
this systematic review point to a differential effect of the distinct
explain the null finding observed in Pinto et al. (33).
ROM configurations on muscle size. Specifically, some muscles
In the second study that investigated the effects of different
experience more favorable hypertrophy when trained at longer
ROM configurations in the elbow flexors, Sato et al. (35) found
muscle lengths, through fROM or initial pROM training
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greater distal increases in muscle thickness when performing the

(i.e., initial angles of fROM, taking the concentric action as ref-
preacher curl with pROM in the initial part of the ROM
erence); this seems to be the case for the quadriceps femoris and
(i.e., initial angles of fROM, taking the concentric action as ref-
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biceps brachii. In some cases, muscle hypertrophy was greater in

erence) than pROM in the final portion of the ROM (i.e., final
pROM compared with fROM. Conversely, training at short
angles of fROM, taking the concentric action as reference); sim-
muscle lengths through the final pROM often elicits less favorable
ilar gains were observed in proximo-middle sites. Based on find-
muscle hypertrophy, and no study to date shows a beneficial ef-
ings that the sarcomeres of biceps brachii and brachialis work on
fect when training at shorter muscle lengths in the muscles stud-
the ascending limb of the length-tension curve (24), it can be
ied. Potential mechanisms and practical applications for our
speculated that training this muscle at shortened lengths may
findings are discussed in the following sections.
decrease force production by the active elements (36), whereas at
Two studies compared the effects of different ROMs on hy-
longer muscle lengths, there is a greater active force production.
pertrophic adaptations of the elbow flexors (33,35). In the first
This aspect would explain the inferior gains in the distal region of
study, Pinto et al. (33) observed similar increases in muscle
the elbow flexors in the group that trained with pROM in the top
thickness at the middle site of the elbow flexors when performing
of the preacher curl exercise. Alternatively, evidence indicating
the preacher curl with fROM and pROM at the midrange of the
that the biceps brachii and brachialis operate primarily on the
ROM. Such findings conceivably can be explained at least in part
descending limb (4) might suggest that findings involved greater
by muscle mechanical properties (e.g., length-tension relation-
passive tension. When taken together, the findings of Pinto et al.
ship) (9,15,17). Some evidence indicates that the elbow flexors
(33) and Sato et al. (35) suggest that training at longer muscle
work mainly in the ascending limb and plateau region of the
lengths may preferentially hypertrophy the distal region of the
length-tension curve (24), suggesting their sarcomeres reach near
elbow flexors; whether this is due to active or passive factors
maximal active force generation at longer muscle lengths. Because
remains underdetermined. Considering that only 2 studies have
the passive elements (e.g., giant molecule titin) contribute more to
investigated the effects of different ROMs in the biceps brachii,
force generation in the descending limb of the length-tension
these conclusions should be considered preliminary; further re-
curve and less in the ascending and plateau portion (9,15), it is
search is need to draw stronger inferences on the topic.
possible that most fibers of the elbow flexors do not experience
Importantly, in the aforementioned studies (33,35), the
additional mechanical tension induced by passive elements on
preacher curl exercise was performed using free weights
reaching longer muscle lengths. However, other research indi-
(i.e., curling bar and dumbbell). Based on the horizontal distance
cates that the sarcomeres of the biceps brachii and brachialis re-
between the weight and the elbow joint axis, the greater external
side primarily on the descending limb (4), which seemingly would
moment arm imposed by the exercise in both studies seemingly
refute this hypothesis and raise the possibility that heightened
occurred at the middle to the bottom portions of the ROM (28).
passive force production might in fact be involved. It is important
This requires the muscles to produce higher forces at the initial
to note that Pinto et al. (33) measured the muscle thickness of the
part of the exercise than in the final part. Such factors
(i.e., external moment arm length and forces produced by the
elbow flexors) potentially influence the stimulus for trained
Table 2
muscles (14,22). Therefore, it remains to be determined whether
Physiotherapy Evidence Database (PEDro) ratings and Oxford
the modification of the exercise strength curve through, for ex-
evidence levels of the included studies.*
ample, the use of cables and machines could induce differential
Studies 1 2 3 4 8 9 10 11 Total Evidence level hypertrophic responses through the manipulation of different
Bloomquist et al. (2) Yes 1 1 1 1 1 1 1 7 1b ROMs.
Goto et al. (8) Yes 1 1 1 1 1 1 1 7 1b A single study directly compared the effects of different ROMs
Kubo et al. (16) No 0 0 1 1 1 1 1 5 2b
on triceps brachii muscle hypertrophy (8), thus providing only
McMahon et al. (20) Yes 1 1 1 1 1 1 1 7 1b
preliminary insights on the topic. Goto et al. (8) reported superior
McMahon et al. (21) Yes 1 1 1 1 1 1 1 7 1b
Pedrosa et al. (31) No 0 0 1 1 1 1 1 5 2b triceps brachii hypertrophy in response to performing the lying
Pinto et al. (33) Yes 0 0 1 1 1 1 1 5 1b elbow extension with pROM at the midrange of the ROM when
Sato et al. (35) No 1 1 1 1 1 1 1 7 1b compared with fROM. Given that the fROM overlapped the
Valamatos et al. (40) Yes 1 1 1 1 1 1 1 7 1b ROM performed in the pROM, one might expect that gains
Werkhausen et al. (42) Yes 1 1 1 1 1 1 1 7 2b would be similar between conditions, but this was not the case.
Yoshiko et al. (43) Yes 1 0 1 1 1 1 1 6 2b When examining the length-tension curve of the triceps brachii
*Items in the PEDro scale: 1 5 eligibility criteria were specified; 2 5 subjects were randomly from a cadaver study (24), the fibers of the long head seem to
allocated to groups; 3 5 allocation was concealed; 4 5 the groups were similar at baseline work almost exclusively on the plateau limb, whereas the lateral
regarding the most important prognostic indicators; 8 5 measures of one key outcome were head seems to work on the plateau and early part of the
obtained from 85% of subjects initially allocated to groups; 9 5 all subjects for whom outcome descending limb (24). Such characteristics contribute to explain,
measures were available received the treatment or control condition as allocated or, where this was
not the case, data for at least 1 key outcome were analyzed by “intention to treat”; 10 5 the results of
at least in part, the effectiveness of performing the lying elbow
between-group statistical comparisons are reported for at least 1 key outcome; 11 5 this study extension with pROM at a moderate muscle length. Importantly,
provides both point measures and measures of variability for at least 1 key outcome. the cadaver study referenced herein (24) was only concerned with

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 Range of Motion and Muscle Hypertrophy (2023) 37:5
muscles that cross the elbow without taking into account proxi-
mal attachments and thus discounting the fact that the long head
is biarticular. Moreover, the referenced study (24) made no
mention of shoulder position because they analyzed frozen upper
extremities. Although the length-tension of the long head may
work only on the plateau, this is probably not the case in an
overhead position in which the long head at stretched position.
Indeed, biomechanical models suggest that long head works on
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the descending limb in the overhead arm position (19); based on
this information, it is possible that triceps brachii long head may
experience additional mechanical tension from passive elements
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and potentially achieve a greater hypertrophic stimulus (27).
Although no other studies to date have directly compared the
effects of different ROMs on triceps brachii hypertrophy, it is
possible to contrast the study by Goto et al. (8) with other re-
search that investigated the hypertrophic effects of different ex-
ercises (3,19,39). For example, Maeo et al. (19) compared the
effects of performing elbow extension with the arm elevated
(shoulder joint fixed at 180° flexion) versus the neutral arm po-
sition (shoulder joint fixed at 0°; anatomical position) on changes
in CSA of the triceps brachii heads (long head and lateral plus
medial heads) in young adults; both exercises had the same total
ROM (90° of ROM). Because the long head is biarticular, per-
forming an overhead elbow extension exercise places the muscle
in a more stretched position, while the neutral arm position places
the muscle in a shortened position (19). After 12 weeks of train-
ing, the elevated arm position elicited superior hypertrophy in the
triceps brachii long head (28.5 vs. 19.6%) and lateral plus medial
heads (14.6 vs. 10.5%) than the neutral arm position (19). Taken
together, the findings of Goto et al. (8) and Maeo et al. (19)
support the hypothesis that the triceps brachii—especially the
long head—does appear to hypertrophy more when using exer-
cises that place this muscle in a moderate to stretched position,
conceivably because it works on the plateau and descending limb
of the length-tension curve (19,24).
It should be noted that the current evidence is not fully con-
sistent on the topic. For instance, Stasinaki et al. (39) compared
the effects of performing the cable overhead elbow extension
versus the cable push down on changes in muscle thickness of the
triceps brachii long head; both exercises had the same total ROM
(80° of ROM). After 6 weeks of training, both exercises induced
relatively similar hypertrophy of the triceps brachii long head in
the proximal and distal sites (13.7–19.4% vs. 10.7–15.5%,
overhead elbow extension and push down, respectively). Al-
though speculative, discrepancies between studies may be
explained, at least in part, by a shorter training period in Stasinaki
et al. (39) relative to Maeo et al. (19) study (6 vs. 12 weeks) and
likely an insufficient sample size in Stasinaki et al. (39) (n 5 9/
condition). Further investigations are needed to bring clarity to
the topic.
It is important to highlight that while the length-tension curve
explanation proposed in the present review seems plausible, other
mechanisms may be involved in the differential hypertrophic
adaptation to distinct ROM configurations. For example, Goto
et al. (8) observed greater muscle activation in the pROM and
greater hypoxia; this latter finding explained 49% of the observed
hypertrophy variance in results when performing the lying elbow
extension. Thus, physiological aspects (i.e., heightened muscle
hypoxia) may have been influential in addition to biomechanical
factors in mediating hypertrophy under the conditions studied.
Also, of note, the study by Goto et al. (8) measured total triceps
CSA at a single site, thus precluding the ability to draw specific
inferences regarding the effects of ROM on regional growth of the
1142
Copyright © 2023 National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
triceps brachii. As previously discussed, this limitation is relevant
when investigating the effects of different ROMs and needs fur-
ther scrutiny because performing the lying overhead elbow ex-
tension seems to be effective to inducing muscle hypertrophy of
triceps brachii long and medial heads, but not the lateral head (3).
Seven studies directly compared the effects of different ROMs
on quadriceps hypertrophy (2,16,20,21,31,40,42). When syn-
thesizing the body of evidence, it can be inferred that training this
muscle complex at more elongated muscle lengths, either through
pROM or fROM, elicited greater hypertrophy than pROM at
shorter muscle lengths, especially in the more distal region of the
quadriceps. For instance, Pedrosa et al. (31) reported greater in-
creases at more distal sites of the rectus femoris and vastus lat-
eralis in training groups that performed the knee extension
exercise at a longer muscle length (i.e., initial pROM, varied
ROM, and fROM) than in a shortened muscle position (i.e., final
pROM). Similarly, Bloomquist et al. (2) and Yoshiko and
Watanabe (43) observed that the deep back squat induced more
favorable quadriceps hypertrophy than the shallow back squat.
The same pattern of adaptive responses was observed by
McMahon et al. in 2 different studies (20,21). The authors
reported that achieving greater degrees of knee flexion, and
consequently a longer muscle length, in different lower-limb re-
sistance exercises through fROM (20) and pROM (21) induced
greater increases in distal CSA of vastus lateralis. Interestingly, the
vastus medialis, vastus lateralis, and rectus femoris seem to work
on the plateau and descending limb of the length-tension curve
(6,38), which suggests that these muscles indeed may experience
additional mechanical tension from passive elements when
reaching elongated muscle lengths (9,15). This conceivably helps
to explain the greater hypertrophy observed in the aforemen-
tioned studies.
Despite the convergent findings of different studies showing a
hypertrophic advantage to training the quadriceps at a longer
muscle length, these results are not universal (16,42). For exam-
ple, Kubo et al. (16) did not observe differences in quadriceps
muscle hypertrophy when training with half and full squats. A
possible explanation for this finding may be that the half squat
group in Kubo et al. (16) reached 90° of knee flexion, which may
achieve a sufficient muscle length to optimally stimulate the
vastus lateralis (12,38). Moreover, the findings of Werkhausen
et al. (42) did not observe hypertrophy of the vastus lateralis when
performing the 45° leg press either with pROM at a longer muscle
length or with fROM (42). A possible explanation for these
findings may lie in the fact that the training protocol composed
exclusively of concentric actions, which attenuates the contribu-
tion of passive forces that occur during eccentric muscle actions.
In addition, this study used a power-oriented protocol wherein
subjects performed repetitions in an explosive fashion. Based on
the force-velocity relationship (32), it is possible that muscular
actions performed at high velocities generate lower levels of me-
chanical tension, despite the high level of motor unit recruitment
(7,17,32).
In addition to the quadriceps, studies also investigated hyper-
trophy of the hamstrings (2), gluteus maximus, and adductors
(16) when performing squats in different ROMs. Regarding
gluteus maximum and adductors, Kubo et al. (16) observed
greater increases in these muscles in the deep squat than half
squat. Although speculative, it is possible that the gluteus max-
imus and adductor fibers experience greater mechanical tension
when reaching greater muscle lengths, as occurs in the deep squat.
Notably, to the best of our knowledge, there are no studies that
have investigated the sarcomere length ranges of the gluteus
 Range of Motion and Muscle Hypertrophy (2023) 37:5
maximus and adductors; therefore, the potential mechanistic
explanation for this finding remains to be determined. Further-
more, the assumptions that gluteus maximus and adductors re-
spond better to training at longer muscle lengths are made from a
single study that exclusively investigated the effects of different
ROMs on the squat (16). Thus, it is necessary to investigate other
exercises, especially those that impose greater torque at different
muscle lengths, such as the barbell hip thrust.
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Regarding the hamstrings, 2 studies compared the effects of
different ROMs on the hypertrophy of this muscle group; both
studies employed the squat (2,16). Multiple lines of evidence
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suggest that the squat is not an effective exercise for inducing
hamstring hypertrophy (34), which was essentially demonstrated
in the aforementioned studies (2,16). Hence, it is not possible to
evaluate the potential effect of different ROMs on hamstrings
hypertrophy from the available evidence. That said, it is possible
to make some indirect inferences from studies that measured or
estimated the fiber sarcomere length ranges of the hamstrings and
the effects of performing different exercises for this muscle group.
For example, it seems that the sarcomeres contained in the sem-
itendinosus, semimembranosus, and biceps femoris muscle fibers
seem to work on the descending limb of the length-tension curve
(6), which, in theory, could favor greater hypertrophy when
training these muscles with fROM or pROM at longer muscle
length. In fact, a recent study (18) that compared performing the
prone leg curl versus the seated leg curl (where the hamstrings
muscles were at shortened and longer lengths, respectively) sup-
ported this hypothesis. The authors (18) observed greater in-
creases in muscle volume in the seated leg curl than the prone leg
curl for the whole hamstrings and each individual biarticular
muscle (i.e., semitendinosus, semimembranosus, and biceps
femoris). Importantly, despite the plausibility of the hypotheses
presented above, studies that compare exercises specific to tar-
geting the hamstrings (e.g., stiff leg deadlift and seated leg curl) in
different ROM configurations are necessary to draw stronger
inferences.
Although this review provides relevant insights into the role of
ROM on hypertrophic adaptations, several limitations must be
acknowledged. First, most research on the topic has focused on
hypertrophy of the quadriceps femoris; findings for other muscle
groups are limited or nonexistent, and thus, the evidence on these
muscles should be considered preliminary. Future studies are
needed to advance our understanding of the effects of ROM on
the hypertrophic adaptations of muscles already investigated
(i.e., biceps brachii and triceps brachii) and on others that have
not yet been studied (e.g., pectoralis major, triceps surae, and
hamstrings). Second, given that there may be longitudinal fascicle
growth with ROMs reaching greater muscle lengths, it is con-
ceivable that this longitudinal growth in response to training may
reduce passive tension at long muscle lengths (10). Future re-
search should consider the measurement of fascicle length and
estimation of potential changes at ultrastructural levels (e.g.,
sarcomerogenesis or extension of existing sarcomeres) (10) in
response to ROMs that stimulate the muscle at different lengths.
Third, resistance exercises impose greater torque in different parts
of the ROM (14,22,28), and therefore, in different muscle
lengths, thus, it is necessary to conduct investigations on exercises
with different strength curves such as ascending, descending, and
bell-shaped. Fourth, because different ROMs seem to affect
muscle growth in an inhomogeneous manner (13,44), future
studies should consider measuring the muscle size along its length
(i.e., proximo-distal sites) and the different heads of each muscle
group. This approach will allow for more comprehensive
1143
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| www.nsca.com
conclusions about the potential effects of specific ROMs on
muscle hypertrophy. Fifth, our pooled sample displayed consid-
erable heterogeneity in characteristics (e.g., sex, age, and training
status) and the mode of resistance training incorporated across
the included studies. The extent to which this may influence re-
sults warrants further research. Finally, the absence of in-
formation on the ROM assessment method in several of the
studies should be considered a limitation of the current literature
because this can hamper the ability to make comparisons across
studies and thus potentially create threats to experimental val-
idity. To address this issue, future studies should clearly report the
method of ROM assessment.
The findings of this systematic review indicate that training in a
lengthened muscle position elicits more favorable muscle hyper-
trophy compared with training at shorter muscle lengths; such
results have been observed in several muscles (i.e., quadriceps,
biceps, and triceps brachii) using both fROM and initial pROM
training. These findings are relevant for healthy individuals who
seek to optimize muscle hypertrophy and indicating the need for
research focused on the effects of altering ROM in rehabilitation
populations. Moreover, given the paucity of studies in muscles
other than the limbs, further research is necessary to expand the
current knowledge and, consequently, practical generalizability.
Practical Applications
The current evidence suggests that ROM configuration can
affect muscle hypertrophy, and this influential effect seems to
be related to the muscle length in specific resistance exercise.
Specifically, the results of our systematic review generally
support the recommendation to perform resistance training
with fROM training to elicit optimal muscle growth. Impor-
tantly, we observed that when reaching a more stretched
length through traversing the initial pROM, some muscles,
such as the quadriceps and biceps brachii, seem to grow op-
timally, in some cases, to an even greater magnitude than
fROM. Limited research suggests that some muscles may ex-
perience favorable hypertrophic adaptations across a wider
spectrum of muscle lengths (e.g., moderate and lengthened
positions); this may be the case for the triceps brachii. On the
other hand, training at short muscle lengths through the final
pROM (i.e., final angles of fROM, taking the concentric ac-
tion as reference) seems to elicit less favorable muscle hyper-
trophy, with the caveat that research is limited on the topic to
the muscles of the upper arms and thighs. From a practical
perspective, strength and conditioning practitioners should
consider the selective use of pROM in the initial part of the
excursion in combination with fROM training when pre-
scribing hypertrophy-oriented training programs. Alterna-
tively, it remains questionable as to the benefit of training at
short muscle lengths because this can impair the force pro-
duction by the active contractile elements (i.e., active in-
sufficiency), especially in biarticular muscles, and thus
potentially hinder the hypertrophic stimulus. Research on a
broader array of muscles, particularly those of the trunk, is
warranted to determine whether certain muscles may respond
more favorably to training at shorter muscle lengths.
Acknowledgments
The authors thank the Coordination of Improvement of Higher
Education Personnel (CAPES/Brazil) for the scholarship
 Range of Motion and Muscle Hypertrophy (2023) 37:5
conferred to WK and JPN (master), BC (doctoral), and the
National Council of Technological and Scientific Development
(CNPq/Brazil) for the grants conceded to ESC. B.J. Schoenfeld
serves on the scientific advisory board for Tonal Corporation, a
manufacturer of exercise equipment. The other authors declare
that they have no conflict of interest regarding the publication of
this article. The authors report no conflicts of interests. This
research did not receive any specific grant from funding agencies
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in the public, commercial, or not-for-profit sectors.
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