The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans

Strength training is an important component in sports training and rehabilitation. Quantification of the dose-response relationships between training variables and the outcome is fundamental for the proper prescription of resistance training. The purpose of this comprehensive review was to identify dose-response relationships for the development of muscle hypertrophy by calculating the magnitudes and rates of increases in muscle cross-sectional area induced by varying levels of frequency, intensity and volume, as well as by different modes of strength training. Computer searches in the databases MEDLINE, SportDiscus (R) and CINAHL (R) were performed as well as hand searches of relevant journals, books and reference lists. The analysis was limited to the quadriceps femoris and the elbow flexors, since these were the only muscle groups that allowed for evaluations of dose-response trends. The modes of strength training were classified as dynamic external resistance (including free weights and weight machines), accommodating resistance (e.g. isokinetic and semi-isokinetic devices) and isometric resistance. The subcategories related to the types of muscle actions used. The results demonstrate that given sufficient frequency, intensity and volume of work, all three types of muscle actions can induce significant hypertrophy at an impressive rate and that, at present, there is insufficient evidence for the superiority of any mode and/or type of muscle action over other modes and types of training. Tentative dose-response relationships for each variable are outlined, based on the available evidence, and interactions between variables are discussed. In addition, recommendations for training and suggestions for further research are given.