Dose-Response Relationship for Strength Gains From Nordic Hamstring Exercise: A Systematic Review, Meta-Analysis, and...

Franke, RA, Rodrigues, R, Lopez, P, Nakamura, FY, and Baroni, BM. Dose-response relationship for strength gains from Nordic hamstring exercise: a systematic review, meta-analysis, and meta-regression. J Strength Cond Res 39(10): 1088-1104, 2025-This systematic review aimed to (a) evaluate the effects of Nordic hamstring exercise (NHE) training on eccentric, concentric, and isometric strength; (b) examine the potential dose-response relationship between NHE training volume and strength gains; and (c) provide updated recommendations on NHE training volume. A systematic search across 6 databases identified 42 eligible studies. Nordic hamstring exercise training was prescribed with 3-103 weekly repetitions (median: 50) across 1-3 sessions per week (median: 2) for 3-39 weeks (median: 6). Training programs led to significant improvements in primary outcomes: eccentric NHE strength (p < 0.01; effect size [ES] = 0.98) and eccentric isokinetic strength (p < 0.01; ES = 0.52). Nordic hamstring exercise training also increased concentric isokinetic strength (p < 0.01; ES = 0.42), but not isometric strength (p = 0.47; ES = 0.12). Subgroup analyses considering study design, inclusion of additional exercises, and subjects' conditioning status yielded similar results. Meta-regressions showed no association between strength gains and training volume-related variables (duration, frequency, number of sets or repetitions). These results should be interpreted with caution because of the low to very low certainty of the evidence and confounding factors discussed in this review. From a practical standpoint, prescribing high training volumes is unnecessary during the first 6-8 weeks for both nonathletes and athletes inexperienced with NHE. Based on the interquartile range of the reviewed studies, a weekly volume of approximately 29-64 NHE repetitions is likely to elicit meaningful strength gains. This target volume should be preceded by a progressive introduction and is typically distributed across 2-3 weekly sessions. Increased training volumes may enhance strength gains in individuals proficient in NHE, though further investigation is needed.