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Value-Based Performance in Physical Fitness and Exercise Training: A Systematic Review and Conceptual Framework
Hussein H Khachfe1, Aly Diab1, Bassel H Abdel Sater2
1Division of Value-Based Performance, Taqa Fitness, Beirut, Lebanon.
Sports Health
|July 20, 2026
Summary
This review suggests that exercise efficiency, not just volume, is key for fitness gains. A new "value-based performance" (VBP) framework prioritizes outcomes relative to the effort invested.
Area of Science:
- Exercise physiology and sports science research.
- Biomedical and health sciences.
Background:
- Traditional exercise interventions focus on volume metrics (sets, reps, duration), neglecting outcome performance and patient-reported outcomes (PROs).
- Existing metrics do not capture the benefits of exercise in relation to the effort required, such as improvements in function, health, and quality of life.
- Emerging evidence indicates significant benefits can be achieved with lower training doses, highlighting a need for a new framework.
Purpose of the Study:
- To systematically review literature on exercise dosing, volume, and time efficiency concerning function, performance, and PROs.
- To propose a novel conceptual framework termed "value-based performance" (VBP) to redefine exercise efficiency.
Main Methods:
- Systematic review with qualitative thematic analysis of 9 eligible studies.
- Searches conducted in PubMed, Web of Science, and Scopus databases following PRISMA 2020 guidelines.
- Data extraction focused on exercise dose, volume, time, performance, function, and PROs.
Main Results:
- Time-efficient, reduced-dose training (resistance, aerobic, HIIT) yielded small-to-moderate improvements in performance, functional capacity, and PROs.
- Strong evidence supports benefit maintenance, favorable outcome-to-burden ratios, minimum effective dose thresholds, and quicker time to benefit.
- Reduced training doses demonstrate clinically meaningful changes with less time investment.
Conclusions:
- The conventional volume-focused definition of exercise performance is challenged, advocating for the inclusion of efficiency.
- A new framework, value-based performance (VBP), is proposed, defining performance as the ratio of outcome gains to the cost of achieving them.
- VBP offers a more comprehensive approach to evaluating exercise effectiveness and efficiency.
Keywords:
exercise dosehigh-intensity interval trainingperformance metricsresistance trainingtraining efficiencyvalue-based performanceMore Related Videos
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