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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Public Health</journal-id>
<journal-title>Frontiers in Public Health</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Public Health</abbrev-journal-title>
<issn pub-type="epub">2296-2565</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fpubh.2022.840490</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Public Health</subject>
<subj-group>
<subject>Systematic Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Effect of Resistance Training Methods and Intensity on the Adolescent Swimmer&#x00027;s Performance: A Systematic Review</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Guo</surname> <given-names>Wei</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1607393/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Soh</surname> <given-names>Kim Geok</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/587751/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zakaria</surname> <given-names>Noor Syamilah</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Hidayat Baharuldin</surname> <given-names>Mohamad Taufik</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Gao</surname> <given-names>Yongqi</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia</institution>, <addr-line>Seri Kembanga</addr-line>, <country>Malaysia</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Sports Studies, Faculty of Physical Educations, Ningxia Normal University</institution>, <addr-line>Guyuan</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Department of Counselor Education and Counseling Psychology, Faculty of Educational Studies, Universiti Putra Malaysia</institution>, <addr-line>Seri Kembanga</addr-line>, <country>Malaysia</country></aff>
<aff id="aff4"><sup>4</sup><institution>Department of Preclinical, Faculty of Medicine and Defence Health, Defence University of Malaysia</institution>, <addr-line>Kuala Lumpur</addr-line>, <country>Malaysia</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Pedro Morou&#x000E7;o, Polytechnic Institute of Leiria, Portugal</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Pedro Forte, Douro Higher Institute of Educational Sciences, Portugal; Athanasios A. Dalamitros, Aristotle University, Greece; Fl&#x000E1;vio De Souza Castro, Federal University of Rio Grande do Sul, Brazil; Alfonso Trinidad Morales, European University of Madrid, Spain</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Kim Geok Soh <email>kims&#x00040;upm.edu.my</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Children and Health, a section of the journal Frontiers in Public Health</p></fn></author-notes>
<pub-date pub-type="epub">
<day>04</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>10</volume>
<elocation-id>840490</elocation-id>
<history>
<date date-type="received">
<day>21</day>
<month>12</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>07</day>
<month>02</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2022 Guo, Soh, Zakaria, Hidayat Baharuldin and Gao.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Guo, Soh, Zakaria, Hidayat Baharuldin and Gao</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license> </permissions>
<abstract>
<sec>
<title>Background</title>
<p>Resistance training has been widely used in various sports and improves competition performance, especially in swimming. Swimming performance is highly dependent on muscle strength, especially short distances. For adolescent athletes, the existing literature has bound to prove that resistance training is undoubtedly bound to improve swimmers&#x00027; performance.</p></sec>
<sec>
<title>Objectives</title>
<p>This study adopts a systematic literature review to (1) examine the effects of resistance training on the performance of adolescent swimmers, and (2) summarize their training methods and intensity.</p></sec>
<sec>
<title>Methods</title>
<p>The literature search was undertaken in five international databases: the SCOUPS, PubMed, EBSCOhost (SPORTDiscus), CNKL, Web of Science. The searches covered documents in English and Chinese published until 30th December 2020. Electronic databases using various keywords related to &#x0201C;strength training&#x0201D; and &#x0201C;adolescent swimmers&#x0201D; were searched. Sixteen studies met the inclusion and exclusion criteria where the data was then systematically reviewed using the PRISMA guideline. Furthermore, the physical therapy evidence database (PEDro) scale was used to measure each study&#x00027;s scientific rigor.</p></sec>
<sec>
<title>Results</title>
<p>This review found that to improve the swimming performance of adolescents, two types of resistance training were used, specifically in water and on land, where both types of training can improve swimming performance. In addition, training with two types of resistance machines were better in the water than with one equipment. Resistance training can improve the swimming performance of adolescent swimmers at 50 m, 100 m, 200 m and 400 m distances. However, most studies only focused on the swimming performance at 50 m and 100 m lengths. A low-intensity, high-speed resistance training programme is recommended for adolescent swimmers to obtain the best training results.</p></sec>
<sec>
<title>Conclusion</title>
<p>Water or land resistance training can improve the swimming performance. Given that both types of exercises have their strengths and weaknesses, combining these methods may enhance the swimmers&#x00027; performance. In addition, despite the starting and turning phases consuming up to one-third of the total swimming time for short distances, literature in this area is limited.</p></sec>
<sec>
<title>Systematic Review Registration</title>
<p><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero">https://www.crd.york.ac.uk/prospero</ext-link>, identifier: CRD42021231510.</p></sec></abstract>
<kwd-group>
<kwd>physical activity</kwd>
<kwd>speed</kwd>
<kwd>combination</kwd>
<kwd>distance</kwd>
<kwd>strength</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="66"/>
<page-count count="10"/>
<word-count count="7101"/>
</counts>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>Swimming differs from other sports as it requires a particular environment involving water. Swimming is a systemic exercise that necessitates the coordination of the upper and lower limbs to ensure that the body performs its best in water (<xref ref-type="bibr" rid="B1">1</xref>). Building their support platform in water is, hence, essential among swimmers. The core to a solid and stable swimming movement is connecting the upper and lower limb movements in water while producing a stable support foundation (<xref ref-type="bibr" rid="B2">2</xref>, <xref ref-type="bibr" rid="B3">3</xref>). Studies have found that swimming speed is the product of stroke rate and stroke length, where increasing either one of these would improve a swimmer&#x00027;s performance (<xref ref-type="bibr" rid="B4">4</xref>&#x02013;<xref ref-type="bibr" rid="B6">6</xref>). It has also been suggested that improving swimming speed requires high frequency, duration and intensity, where a high total training volume may be expected (<xref ref-type="bibr" rid="B7">7</xref>).</p>
<p>Resistance training is defined as the ability of a given muscle, or group of muscles, to generate muscle strength under specific conditions (<xref ref-type="bibr" rid="B8">8</xref>, <xref ref-type="bibr" rid="B9">9</xref>). Furthermore, resistance training has been found to increase the maximum muscle strength, thereby increasing the speed of strength development (<xref ref-type="bibr" rid="B10">10</xref>). It is generally believed that swimming performance is highly dependent on the muscle strength (<xref ref-type="bibr" rid="B11">11</xref>&#x02013;<xref ref-type="bibr" rid="B15">15</xref>). The purpose of resistance training is to overload the muscles used in swimming and increase the maximum strength output. Resistance training has many physiological benefits including increased phosphate stores, contractile proteins, anaerobic power output, muscle structure, fiber bundles, protein synthesis, tissue remodeling and fast-twitch muscle fiber hypertrophy (<xref ref-type="bibr" rid="B16">16</xref>&#x02013;<xref ref-type="bibr" rid="B19">19</xref>).</p>
<p>Furthermore, swimming performance is highly dependent on muscle strength (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B20">20</xref>&#x02013;<xref ref-type="bibr" rid="B22">22</xref>). The ability to exert force in water is the decisive factor, especially for short distances (<xref ref-type="bibr" rid="B23">23</xref>, <xref ref-type="bibr" rid="B24">24</xref>) as many studies have described the importance of muscle strength of arms and legs and its generated force in swimming performance (<xref ref-type="bibr" rid="B25">25</xref>, <xref ref-type="bibr" rid="B26">26</xref>). As compared to traditional resistance training (e.g. barbells, dumbbells, pull-ups, leapfrogs), elastic bands, Swiss balls, drag parachutes and resistance gloves are currently more commonly used to build strength. Research has shown that resistance training in either water or land is superior to traditional strength training (<xref ref-type="bibr" rid="B27">27</xref>&#x02013;<xref ref-type="bibr" rid="B31">31</xref>). Where muscle strength is considered the primary determinant of competitive swimming success (<xref ref-type="bibr" rid="B32">32</xref>). In order to move freely in water, swimmers are required to overcome these resistance by continuously improving their strength (<xref ref-type="bibr" rid="B33">33</xref>).</p>
<p>Youth sports coaches tend to implement structured training methods based on college or professional models for adult athletes (<xref ref-type="bibr" rid="B34">34</xref>). This is due to the assumption that these methods would be similarly effective and applicable among adolescent athletes. However, the intensive training model among adults usually include year-round arrangements, professional training and daily physical exertion. Given that physical recovery during intense training is limited regardless of age and development (<xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B36">36</xref>), most studies have shown that the response of prepubertal children to training is similar to that of mature athletes, but with a different degree (<xref ref-type="bibr" rid="B37">37</xref>&#x02013;<xref ref-type="bibr" rid="B40">40</xref>). Hence, while resistance training can be used with adolescents, it should be conducted at a smaller intensity.</p>
<p>The present study is to specify a set of descriptions of swimming training methods, intensity, number of groups, repetitions or practice times for teenagers suitable for different research objects. Some studies have prescribed a set of suitable training methods for their subjects. The purpose of this paper is to find the law of resistance training for teenagers and sum up a set of principles and methods suitable for all teenagers swimming training. Therefore, the purpose of this systematic literature review is to (1) examine the effect of resistance training on the performance of adolescent swimmers and (2) summarize the training methods and intensity of adolescent swimmers.</p></sec>
<sec sec-type="methods" id="s2">
<title>Methods</title>
<sec>
<title>Literature Search Strategy</title>
<p>The literature search was undertaken in five international databases: the SCOUPS, PubMed, EBSCOhost (SPORTDiscus), CNKL, Web of Science. The searches covered documents in English and Chinese published until 30th December 2020. Only articles in journals were accepted. The following electronic sources were searched: Science and China National Knowledge Infrastructure (CNKI). The key terms used were: (&#x0201C;weight exercise&#x0201D; OR &#x0201C;strength training&#x0201D; OR &#x0201C;strength exercise&#x0201D; OR &#x0201C;weight training&#x0201D;) AND (&#x0201C;adolescent swimmer&#x0201D; OR &#x0201C;juvenile swimmer&#x0201D; OR &#x0201C;teenager swimmer&#x0201D; OR &#x0201C;youth swimmer&#x0201D; OR &#x0201C;young swimmer&#x0201D; OR &#x0201C;junior swimmer&#x0201D; OR &#x0201C;children swimmer&#x0201D;). In addition, age (children and adolescents of 6&#x02013;20 years in age) was used as the limiter.</p></sec>
<sec>
<title>Inclusion and Exclusion Criteria</title>
<p>Used the PICOS (population, intervention, comparison, outcome, study designs) criteria as the inclusion criteria, is presented in <xref ref-type="table" rid="T1">Table 1</xref>. Only records presenting resistance training on aspect of performance of adolescent swimmer were included. Thus, studies were included if they met the following criteria: (1) A full text, peer-reviewed study published in English, describing the use of athletes (male and female) to explore the effects of resistance training interventions on swimming performance., randomized controlled trial (RCT), non-randomized controlled trial (Non-RCT) with two or more groups, and single-group trials with pretest and post-test design; (2) In this study, only included studies on planned and organized resistance training intervention to improve swimming performance; (3) Investigate the effects of resistance training on swimming performance athletes and assess at least one swimming performance, component outcome; (4) There were no restrictions on the sample size, study location, and intervention time for the included studies.</p>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption><p>Inclusion criteria according to the PICOS conditions.</p></caption>
<table frame="hsides" rules="groups">
<thead><tr>
<th valign="top" align="left"><bold>Items</bold></th>
<th valign="top" align="left"><bold>Detailed inclusion criteria</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Population</td>
<td valign="top" align="left">Athletes</td>
</tr>
<tr>
<td valign="top" align="left">Intervention</td>
<td valign="top" align="left">Resistance training</td>
</tr>
<tr>
<td valign="top" align="left">Comparison</td>
<td valign="top" align="left">Two or more groups</td>
</tr>
<tr>
<td valign="top" align="left">Outcome</td>
<td valign="top" align="left">Swimming performance</td>
</tr>
<tr>
<td valign="top" align="left">Study designs</td>
<td valign="top" align="left">RCT or Non-RCT</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>The inclusion criteria were (1) swimming performance as an outcome measure, (2) swimmers had undergone structured swimming training programmes, and (3) participants were 20 years old and below. On the other hand, the exclusion criteria were (1) untrained, novice, masters, and paraplegic swimmers, (2) triathlon and water polo athletes, and (3) injured swimmers.</p></sec>
<sec>
<title>Study Selection</title>
<p>This study used projects for systematic reviews and meta-analysis (PRISMA) guidelines to conduct this systematic review (<xref ref-type="bibr" rid="B41">41</xref>). The retrieval process, as shown in <xref ref-type="fig" rid="F1">Figure 1</xref>, included an evaluation hierarchy that evaluated studies first by journal title, second by abstract, and third by full-text review where journal articles were selected according to the inclusion and exclusion criteria. An initial search yielded 439 published papers and after deletion of duplicates, 320 papers remained. In total 264 papers were further excluded as they were published in different disciplines while another 20 papers were deleted as the full text was unavailable. The remaining 33 papers were on the influence of resistance training on adolescent swimming performance. In total 17 papers were further excluded as they were neither in English nor Chinese, non-experimental studies, did not have a control group and included water polo, disability and triathlon athletes. As a result, 16 papers were included in this systematic review.</p>
<fig id="F1" position="float">
<label>Figure 1</label>
<caption><p>PRISMA flow chart of the study selection process.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fpubh-10-840490-g0001.tif"/>
</fig></sec>
<sec>
<title>Data Extraction and Quality Assessment</title>
<p>After the data search was complete, data were obtained from eligible studies in a predetermined extraction form [Including, (1) Author, title, publication year; (2) Research design; (3) Sample size, control group; (4) Participant characteristics (age, gender,etc.); (5) Intervention features (type, length, and frequency); (6) Measures index; and (7) Research outcomes]. One author abstracted information into the standard form and the other author checked it.</p>
<p>The Physiotherapy Evidence Database (PEDro) scale was subsequently used to assess the quality of the final 16 records (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>&#x02013;<xref ref-type="bibr" rid="B55">55</xref>). The PEDro scale was used to score the literature quality based on 15 items related to scientific rigor, which includes eligibility criteria, random allocation strategy, type of intervention, main exercises, training arrangements, test items, inter-group analysis, and results (<xref ref-type="bibr" rid="B56">56</xref>). If the study meets the criteria, the scale is scored with 1 point, but zero points were awarded if a criterion is not met. Research with a score of either 9 or 10 on the PEDro scale is considered methodologically excellent while a score of between 6 and 8 is good. Research with a 4 or 5 score is considered average, with scores lower than 4 suggesting that the research was methodologically poor. The authors rated all studies based on this scale as reported in <xref ref-type="table" rid="T2">Table 2</xref>.</p>
<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption><p>Population, study design and PEDro scale.</p></caption>
<table frame="hsides" rules="groups">
<thead><tr>
<th valign="top" align="left"><bold>Study</bold></th>
<th valign="top" align="left"><bold>Population</bold></th>
<th valign="top" align="center" colspan="7" style="border-bottom: thin solid #000000;"><bold>Study design</bold></th>
<th valign="top" align="left"><bold>Score</bold></th>
</tr>
<tr>
<th/>
<th/>
<th valign="top" align="center"><bold>Duration</bold><break/><bold>(weeks)</bold></th>
<th valign="top" align="left"><bold>Frequency</bold></th>
<th valign="top" align="left"><bold>Randomized</bold></th>
<th valign="top" align="left"><bold>Intervention type</bold></th>
<th valign="top" align="left"><bold>Main exercises</bold></th>
<th valign="top" align="left"><bold>The training arrangement</bold></th>
<th valign="top" align="left"><bold>Test project</bold></th>
<th/>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Huang (<xref ref-type="bibr" rid="B42">42</xref>)</td>
<td valign="top" align="left">Young swimmers (13)</td>
<td valign="top" align="center">4</td>
<td valign="top" align="left">6 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">Five meters of rubber tension band</td>
<td valign="top" align="left">8&#x0002A;30 s</td>
<td valign="top" align="left">50 m freestyle<break/>400 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Zhao (<xref ref-type="bibr" rid="B33">33</xref>)</td>
<td valign="top" align="left">Young male swimmers (11&#x02013;15)</td>
<td valign="top" align="center">8</td>
<td valign="top" align="left">3 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Land resistance training</td>
<td valign="top" align="left">Prone Swiss ball, pull-up, Isodynamic tension. resistance sprints.</td>
<td valign="top" align="left">3&#x0002A;30 times<break/>5&#x0002A;60 times<break/>3&#x0002A;30 m</td>
<td valign="top" align="left">100 m freestyle<break/>100 m breaststroke,<break/>100 m butterfly,<break/>100 m backstroke</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Batalha et al. (<xref ref-type="bibr" rid="B43">43</xref>)</td>
<td valign="top" align="left">Young swimmers (12-15)</td>
<td valign="top" align="center">10</td>
<td valign="top" align="left">8h of per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water and land</td>
<td valign="top" align="left">Elastic resistance bands.</td>
<td valign="top" align="left">3&#x0002A;30 s<break/> 4&#x0002A;30 s<break/> 5&#x0002A;30 s</td>
<td valign="top" align="left">Shoulder Rotator Cuff Strength and Balance</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Dalamitros et al. (<xref ref-type="bibr" rid="B44">44</xref>)</td>
<td valign="top" align="left">Young swimmers (14.82 &#x000B1; 0.45)</td>
<td valign="top" align="center">24</td>
<td valign="top" align="left">6 per week</td>
<td valign="top" align="left">NO</td>
<td valign="top" align="left">Land resistance training</td>
<td valign="top" align="left">Swim resistance machines</td>
<td valign="top" align="left">5 to 7 km</td>
<td valign="top" align="left">Concentric knee extension and flexion peak torque</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Amaro et al. (<xref ref-type="bibr" rid="B45">45</xref>)</td>
<td valign="top" align="left">Young Swimmer (12.7 &#x000B1; 0.7)</td>
<td valign="top" align="center">10</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Land resistance training</td>
<td valign="top" align="left">Dumbbell 1.5 kg Russian twist 3 kg Push-up</td>
<td valign="top" align="left">2&#x0002A;30 times<break/> 2&#x0002A;40 times<break/> 2&#x0002A;90 times</td>
<td valign="top" align="left">Vertical jump, ball throwing<break/> 50 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Naczk et al. (<xref ref-type="bibr" rid="B46">46</xref>)</td>
<td valign="top" align="left">Young swimmers (15.8 &#x000B1; 0.4)</td>
<td valign="top" align="center">4</td>
<td valign="top" align="left">3 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Land inertial training</td>
<td valign="top" align="left">ITMS inertial training measurement system</td>
<td valign="top" align="left">2&#x0002A;60 times</td>
<td valign="top" align="left">100 m butterfly<break/> 50 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Marques et al. (<xref ref-type="bibr" rid="B47">47</xref>)</td>
<td valign="top" align="left">Young swimmers (16.6 &#x000B1; 0.7)</td>
<td valign="top" align="center">20</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">NO</td>
<td valign="top" align="left">Land strength training</td>
<td valign="top" align="left">Full squat<break/> bench press<break/> jump height</td>
<td valign="top" align="left">30&#x02013;40% 1RM</td>
<td valign="top" align="left">50 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr style="border-bottom: thin solid #000000;">
<td valign="top" align="left">Girold et al. (<xref ref-type="bibr" rid="B15">15</xref>)</td>
<td valign="top" align="left">Young swimmers (16.5)</td>
<td valign="top" align="center">12</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Land strength training</td>
<td valign="top" align="left">Assisted-sprint exercises</td>
<td valign="top" align="left">80&#x02013;90% 1RM</td>
<td valign="top" align="left">50 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left"><bold>Study</bold></td>
<td valign="top" align="left"><bold>Population</bold></td>
<td valign="top" align="center" colspan="7" style="border-bottom: thin solid #000000;"><bold>Study Design</bold></td>
<td valign="top" align="left"><bold>Score</bold></td>
</tr>
<tr style="border-bottom: thin solid #000000;">
<td/>
<td/>
<td valign="top" align="center"><bold>Duration</bold><break/> <bold>(weeks)</bold></td>
<td valign="top" align="left"><bold>Frequency</bold></td>
<td valign="top" align="left"><bold>Randomized</bold></td>
<td valign="top" align="left"><bold>Intervention type</bold></td>
<td valign="top" align="left"><bold>Main exercises</bold></td>
<td valign="top" align="left"><bold>Frequency</bold></td>
<td valign="top" align="left"><bold>Test project</bold></td>
<td/>
</tr> <tr>
<td valign="top" align="left">Toussaint et al. (<xref ref-type="bibr" rid="B48">48</xref>)</td>
<td valign="top" align="left">Young swimmers (18.50 &#x000B1; 3.30)</td>
<td valign="top" align="center">10</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resisted training</td>
<td valign="top" align="left">System to measure active drag</td>
<td valign="top" align="left">2&#x0002A;20 m<break/> 6&#x0002A;6 m</td>
<td valign="top" align="left">50 m, 100 m and 200 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Dragunas et al. (<xref ref-type="bibr" rid="B49">49</xref>)</td>
<td valign="top" align="left">Young swimmers (19.36)</td>
<td valign="top" align="center">5</td>
<td valign="top" align="left">9 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resisted training</td>
<td valign="top" align="left">Drag suit&#x02013;trained</td>
<td valign="top" align="left">3&#x0002A;50 m<break/> 4&#x0002A;25 m</td>
<td valign="top" align="left">50 m freestyle</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Rav&#x000E9; et al. (<xref ref-type="bibr" rid="B50">50</xref>)</td>
<td valign="top" align="left">Young male swimmers (16.22 &#x000B1; 2.63)</td>
<td valign="top" align="center">6</td>
<td valign="top" align="left">5 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">Power rack</td>
<td valign="top" align="left">50&#x02013;70% 1RM</td>
<td valign="top" align="left">50 m crawl<break/> 50 m competition-style time trials</td>
<td valign="top" align="center">5</td>
</tr>
<tr>
<td valign="top" align="left">Gourgoulis et al. (<xref ref-type="bibr" rid="B51">51</xref>)</td>
<td valign="top" align="left">Young female swimmers (13.08 &#x000B1; 0.9)</td>
<td valign="top" align="center">11</td>
<td valign="top" align="left">6 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">Water parachute</td>
<td valign="top" align="left">6&#x0002A;15 m<break/> 4&#x0002A;25 m</td>
<td valign="top" align="left">50 m crawl<break/> 100 m crawl<break/> 200 m crawl</td>
<td valign="top" align="center">5</td>
</tr>
<tr>
<td valign="top" align="left">Kojima et al. (<xref ref-type="bibr" rid="B52">52</xref>)</td>
<td valign="top" align="left">Young Swimmers (13.6 &#x000B1; 1.1)</td>
<td valign="top" align="center">10</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">10 m sprints with progressively increasing resistance</td>
<td valign="top" align="left">70&#x02013;80% 1RM</td>
<td valign="top" align="left">50 m freestyle</td>
<td valign="top" align="center">5</td>
</tr>
<tr>
<td valign="top" align="left">Papoti et al. (<xref ref-type="bibr" rid="B53">53</xref>)</td>
<td valign="top" align="left">Young swimmers (16.0 &#x000B1; 2.1)</td>
<td valign="top" align="center">11</td>
<td valign="top" align="left">6 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">A 6 m elastic cord was connected to a load cell</td>
<td valign="top" align="left">70&#x02013;90% 1RM</td>
<td valign="top" align="left">Free-swimming 200 m, 100 m, and 400 m</td>
<td valign="top" align="center">5</td>
</tr>
<tr>
<td valign="top" align="left">Keiner et al. (<xref ref-type="bibr" rid="B54">54</xref>)</td>
<td valign="top" align="left">Young swimmers (17.5 &#x000B1; 2)</td>
<td valign="top" align="center">2</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Land strength training</td>
<td valign="top" align="left">Back squat<break/> dead lift started<break/> both arms<break/> sit-up</td>
<td valign="top" align="left">1RM</td>
<td valign="top" align="left">15&#x02013;100 meters in freestyle, breaststroke and backstroke</td>
<td valign="top" align="center">5</td>
</tr>
<tr>
<td valign="top" align="left">Salman et al. (<xref ref-type="bibr" rid="B55">55</xref>)</td>
<td valign="top" align="left">Young swimmers</td>
<td valign="top" align="center">8</td>
<td valign="top" align="left">2 per week</td>
<td valign="top" align="left">YES</td>
<td valign="top" align="left">Water resistance exercises</td>
<td valign="top" align="left">Parachute gloves</td>
<td valign="top" align="left">Did not show</td>
<td valign="top" align="left">100 m freestyle</td>
<td valign="top" align="center">4</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p><italic>1RM, 1 Repetition maximum</italic>.</p>
</table-wrap-foot>
</table-wrap></sec></sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec>
<title>Participant Characteristics</title>
<p><xref ref-type="table" rid="T2">Table 2</xref> summarizes the characteristics of the participants from the 16 papers who meet the criteria for inclusion in this review. In total 338 participants, of which 224 were males and 91 were females, were collected where participants had an age range of between 11 and 20 years old (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>&#x02013;<xref ref-type="bibr" rid="B55">55</xref>). The pre-test difference between the control and experimental groups was minimal, in which 15 studies involved swimmers who were trained for national or international competitions (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>&#x02013;<xref ref-type="bibr" rid="B54">54</xref>). One study, however, did not mention the swimming capabilities of the athletes (<xref ref-type="bibr" rid="B55">55</xref>).</p></sec>
<sec>
<title>Study Design and PEDro Score</title>
<p>The research design and PEDro scores were also summarized in <xref ref-type="table" rid="T2">Table 2</xref>. In total 10 studies reported an intervention duration of 8 to 12 weeks (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B45">45</xref>, <xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B51">51</xref>&#x02013;<xref ref-type="bibr" rid="B55">55</xref>) with the longest duration reported at 24 weeks (<xref ref-type="bibr" rid="B44">44</xref>) There were 14 studies that used randomization (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B45">45</xref>) in their design while the remaining 2 studies did not randomly assign the participants into intervention conditions (<xref ref-type="bibr" rid="B44">44</xref>, <xref ref-type="bibr" rid="B47">47</xref>). The PEDro scores for all studies were 4 (<xref ref-type="bibr" rid="B55">55</xref>), 5 (<xref ref-type="bibr" rid="B50">50</xref>&#x02013;<xref ref-type="bibr" rid="B54">54</xref>) and 6 (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>&#x02013;<xref ref-type="bibr" rid="B49">49</xref>). All studies were deducted points for items related to blindness in participants, therapists, and evaluators. The differences in scores were mainly based on whether the study involved random assignment.</p></sec>
<sec>
<title>Resistance Training and Strength Training</title>
<p>Through these 16 papers, it was found that some articles adopted the term &#x0201C;resistance training&#x0201D; while others used the term &#x0201C;strength training.&#x0201D; Resistance training emphasized the way that muscle tissues resisted force, generally including combined equipment, free-weight training and self-weight training. The equipment necessary were: isokinetic dynamometer, Swiss ball, solid ball, bungee rope, drag parachute and drag hand webs (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B48">48</xref>&#x02013;<xref ref-type="bibr" rid="B53">53</xref>, <xref ref-type="bibr" rid="B55">55</xref>). The other articles used &#x0201C;strength training&#x0201D; that highlighted the purpose of training, which is to increase muscle strength. The equipment required include resistance parachute, elastic rope, resistance suit, isokinetic dynamometer, barbell and dumbbells (<xref ref-type="bibr" rid="B44">44</xref>, <xref ref-type="bibr" rid="B45">45</xref>, <xref ref-type="bibr" rid="B47">47</xref>, <xref ref-type="bibr" rid="B54">54</xref>). While there were no noticeable differences in concept and training equipment for these terms, their primary focuses were different.</p></sec>
<sec>
<title>Training Programmes</title>
<p><xref ref-type="table" rid="T2">Table 2</xref> summarizes training types, content, arrangements and test items related to strength training intervention and training used by swimmers during the study period. Resistance training was mainly divided into water resistance training (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B48">48</xref>&#x02013;<xref ref-type="bibr" rid="B53">53</xref>, <xref ref-type="bibr" rid="B55">55</xref>) and land resistance training (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B44">44</xref>&#x02013;<xref ref-type="bibr" rid="B47">47</xref>, <xref ref-type="bibr" rid="B54">54</xref>). Water training mainly included resistance parachutes, gloves, tie ropes and resistance clothes, whereas land training comprised of rubber bands, Swiss balls, solid balls, sit-ups, dumbbells, push-ups, and large resistance equipment. However, the resistance training was mainly at low intensities, and the outcome measures were primarily either through freestyle or short distances. All research used only one type of resistance training, which were found to be superior to traditional strength training. Interestingly, none of the studies examined the effect of water resistance training in combination with land resistance training on swimming performance (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>&#x02013;<xref ref-type="bibr" rid="B55">55</xref>).</p>
<p>The intensity of training was also summarized in <xref ref-type="table" rid="T2">Table 2</xref>. Six articles showed the strength of movement in percentage, with the passion ranging from 30&#x02013;40% 1RM (<xref ref-type="bibr" rid="B47">47</xref>) to 80&#x02013;90% 1RM (<xref ref-type="bibr" rid="B15">15</xref>), while the intensity of other training programmes ranged from 50&#x02013;80% 1RM (<xref ref-type="bibr" rid="B50">50</xref>, <xref ref-type="bibr" rid="B52">52</xref>&#x02013;<xref ref-type="bibr" rid="B54">54</xref>). The training intensity did not reach 100% 1RM. Resistance training in water had a specific resistance, covered a short swimming distance of 20&#x02013;30m (<xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B49">49</xref>, <xref ref-type="bibr" rid="B51">51</xref>) and lasted less than 30 seconds (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>). Therefore, these resistance training were low-intensity and high-speed. Each resistance training conducted on land was performed more than 30 times (<xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B45">45</xref>, <xref ref-type="bibr" rid="B46">46</xref>) and only low-intensity resistance was possible with more repetitions and faster natural speed.</p></sec>
<sec>
<title>Strength Outcomes</title>
<p>In the 16 studies in <xref ref-type="table" rid="T3">Table 3</xref>, the improvement in swimming performance were significant in both water and land resistance training (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B45">45</xref>, <xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B48">48</xref>&#x02013;<xref ref-type="bibr" rid="B54">54</xref>). One study showed that muscle strength and swimming performance were highly correlated (<xref ref-type="bibr" rid="B44">44</xref>). Another study demonstrated that two types of water resistance training were more effective in improving swimming performance than one type of training (<xref ref-type="bibr" rid="B55">55</xref>). In addition, research showed that water resistance training improved swimmers&#x00027; performance more than traditional land strength training, but land resistance training was more effective than conventional land strength training. Furthermore, strength training on land also improved the performance of swimmers. With the swimming performance of adolescents improving especially at 50 m and 100 m distances, programme should use the low-intensity, high-speed force approach to engender results among youths (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B45">45</xref>&#x02013;<xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B52">52</xref>, <xref ref-type="bibr" rid="B54">54</xref>, <xref ref-type="bibr" rid="B55">55</xref>).</p>
<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption><p>Group, main outcomes and participant characteristics.</p></caption>
<table frame="hsides" rules="groups">
<thead><tr>
<th valign="top" align="left"><bold>Study</bold></th>
<th valign="top" align="left"><bold>Group</bold></th>
<th valign="top" align="left"><bold>Main outcomes</bold></th>
<th valign="top" align="center" colspan="4" style="border-bottom: thin solid #000000;"><bold>Participant characteristics</bold></th>
</tr>
<tr>
<th/>
<th/>
<th/>
<th valign="top" align="center"><bold>(I/C)</bold></th>
<th valign="top" align="center"><bold>Sex</bold></th>
<th valign="top" align="center"><bold>Age (years)</bold></th>
<th valign="top" align="left"><bold>Training background</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Huang (<xref ref-type="bibr" rid="B42">42</xref>)</td>
<td valign="top" align="left">1. Water resistance traction.<break/>2. Conventional training regimen.</td>
<td valign="top" align="left">Underwater resistance training can effectively improve swimming performance</td>
<td valign="top" align="center">16</td>
<td valign="top" align="center">8 =F<break/>8 = M</td>
<td valign="top" align="center">13</td>
<td valign="top" align="left">National<break/>level 2</td>
</tr>
<tr>
<td valign="top" align="left">Zhao (<xref ref-type="bibr" rid="B33">33</xref>)</td>
<td valign="top" align="left">1. On shore resistance training.<break/>2. Traditional strength exercise.</td>
<td valign="top" align="left">The training effect of the land resistance training is higher than conventional strength training.</td>
<td valign="top" align="center">20</td>
<td valign="top" align="center">M</td>
<td valign="top" align="center">11&#x02013;12</td>
<td valign="top" align="left">National<break/>level 2</td>
</tr>
<tr>
<td valign="top" align="left">Batalha et al. (<xref ref-type="bibr" rid="B43">43</xref>)</td>
<td valign="top" align="left">1. The water group. (WG).<break/>2. The land group. (LG)</td>
<td valign="top" align="left">Dry-land training is more effective than water training.</td>
<td valign="top" align="center">25</td>
<td valign="top" align="center">M</td>
<td valign="top" align="center">12&#x02013;15</td>
<td valign="top" align="left">Three years of experience</td>
</tr>
<tr>
<td valign="top" align="left">Dalamitros et al. (<xref ref-type="bibr" rid="B44">44</xref>)</td>
<td valign="top" align="left">1. Dr&#x02014;land strength training.<break/><break/>2. Swimming training.</td>
<td valign="top" align="left">Bilateral muscle strength deficit and knee F/E peak torque ratio only reported small changes</td>
<td valign="top" align="center">11</td>
<td valign="top" align="center">M</td>
<td valign="top" align="center">14.82 &#x000B1; 0.45</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Amaro et al. (<xref ref-type="bibr" rid="B45">45</xref>)</td>
<td valign="top" align="left">1. Swim training alone.<break/>2. Dry-land programme based on sets. 3. Dry-land focused on explosiveness.</td>
<td valign="top" align="left">Dry-land S&#x00026;C training may lead to an improvement in dry-land strength.</td>
<td valign="top" align="center">21</td>
<td valign="top" align="center">M</td>
<td valign="top" align="center">12.7 &#x000B1; 0.7</td>
<td valign="top" align="left">Competitive<break/>swimmers</td>
</tr>
<tr>
<td valign="top" align="left">Naczk et al. (<xref ref-type="bibr" rid="B46">46</xref>)</td>
<td valign="top" align="left">1. Dry-land strength training.<break/>2. Swimming training.</td>
<td valign="top" align="left">There is a marked improvement in swimmers&#x00027; performance in dry-land.</td>
<td valign="top" align="center">14</td>
<td valign="top" align="center">12 = M<break/>14 = F</td>
<td valign="top" align="center">15.8 &#x000B1; 0.4</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Marques et al. (<xref ref-type="bibr" rid="B47">47</xref>)</td>
<td valign="top" align="left">1. Male athletes.<break/>2. Female athletes.</td>
<td valign="top" align="left">Improved swimming performance, with no significant difference between the two sexes.</td>
<td valign="top" align="center">10</td>
<td valign="top" align="center">5 = M<break/>5 = F</td>
<td valign="top" align="center">16.6 &#x000B1; 0.7</td>
<td valign="top" align="left">International<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Girold et al. (<xref ref-type="bibr" rid="B15">15</xref>)</td>
<td valign="top" align="left">1. Dry-land strength.<break/>2. Water resistance. 3.Traditional swimming training.</td>
<td valign="top" align="left">Dry-land strength or water resistance is more effective than using traditional swimming training methods alone.</td>
<td valign="top" align="center">21</td>
<td valign="top" align="center">10 = M <break/>11 = F</td>
<td valign="top" align="center">16.5</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Toussaint et al. (<xref ref-type="bibr" rid="B48">48</xref>)</td>
<td valign="top" align="left">1. A training group<break/>2. A control group</td>
<td valign="top" align="left">The POP is a specific training device especially suitable for increasing maximal power output during swimming.</td>
<td valign="top" align="center">22</td>
<td valign="top" align="center">16 = M<break/>6 = F</td>
<td valign="top" align="center">18.50 &#x000B1; 3.30</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Dragunas et al. (<xref ref-type="bibr" rid="B49">49</xref>)</td>
<td valign="top" align="left">1. Control group<break/>2. Drag suit&#x02013;trained group</td>
<td valign="top" align="left">The stroke speed of the resistance suit training group was significantly improved.</td>
<td valign="top" align="center">18</td>
<td valign="top" align="center">10 = M<break/>8 = F</td>
<td valign="top" align="center">19.36</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Rav&#x000E9; et al. (<xref ref-type="bibr" rid="B50">50</xref>)</td>
<td valign="top" align="left">1. A standard training group (GS)<break/>2. A pattern group (GP)</td>
<td valign="top" align="left">In the GP events, the 50m freestyle improved.</td>
<td valign="top" align="center">16</td>
<td valign="top" align="center">M</td>
<td valign="top" align="center">16.22 &#x000B1;<break/>2. 63</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Gourgoulis et al. (<xref ref-type="bibr" rid="B51">51</xref>)</td>
<td valign="top" align="left">1. Water parachute resistance training<break/>2. Resistance training was not increased</td>
<td valign="top" align="left">Improvements were only significant in the experimental group.</td>
<td valign="top" align="center">12</td>
<td valign="top" align="center">F</td>
<td valign="top" align="center">13.08 &#x000B1; 0.9</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Kojima et al. (<xref ref-type="bibr" rid="B52">52</xref>)</td>
<td valign="top" align="left">1. Resisted sprint swim training<break/>2. Non-resisted sprint swim training</td>
<td valign="top" align="left">A boycott of sprint training is no more effective than a boycott of sprint training.</td>
<td valign="top" align="center">24</td>
<td valign="top" align="center">12 = M<break/>12 = F</td>
<td valign="top" align="center">13.6 &#x000B1; 1.1</td>
<td valign="top" align="left">Well-trained</td>
</tr>
<tr>
<td valign="top" align="left">Papoti et al. (<xref ref-type="bibr" rid="B53">53</xref>)</td>
<td valign="top" align="left">1. Tethered Resistance Training<break/>2. Traditional freestyle training</td>
<td valign="top" align="left">The tethered resistance training method helps to improve the performance of swimmers.</td>
<td valign="top" align="center">34</td>
<td valign="top" align="center">22 = M<break/>12 = F</td>
<td valign="top" align="center">16.0 &#x000B1;<break/>2. 1</td>
<td valign="top" align="left">Least 2 years</td>
</tr>
<tr>
<td valign="top" align="left">Keiner et al. (<xref ref-type="bibr" rid="B54">54</xref>)</td>
<td valign="top" align="left">5 groups (each with 4 or 5 subjects)</td>
<td valign="top" align="left">The maximal strength parameters of the upper and lower extremities and maximal trunk strength are good predictors of performance in sprint swimming in trained adolescent swimmers in different disciplines.</td>
<td valign="top" align="center">21</td>
<td valign="top" align="center">12 = M<break/>9 = F</td>
<td valign="top" align="center">17.5 &#x000B1; 2</td>
<td valign="top" align="left">National<break/>level</td>
</tr>
<tr>
<td valign="top" align="left">Salman et al. (<xref ref-type="bibr" rid="B55">55</xref>)</td>
<td valign="top" align="left">1. Trained using the umbrella resistance.<break/><break/>2. Trained using paw resistance. 3.Two types of resistance.</td>
<td valign="top" align="left">Two kinds of resistance combined training, improve swimming performance is more effective.</td>
<td valign="top" align="center">9</td>
<td valign="top" align="center">NO</td>
<td valign="top" align="center">NO</td>
<td valign="top" align="left">NO</td>
</tr>
</tbody>
</table>
</table-wrap></sec></sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>This systematic review aimed to examine the influence of resistance training on the performance of adolescent swimmers and summarize resistance training methods for these swimmers. According to the data collected, resistance training can directly impact performance with proper training being beneficial to adolescent growth and development. Appropriate resistance training can help increase muscle strength, promote body growth and prevent injuries (<xref ref-type="bibr" rid="B57">57</xref>). To achieve the best training effect in adolescent swimmers, a low-intensity, high-speed force resistance training programme is recommended for optimal training results. However, there were inconsistencies in the literature, which can be attributed to differences in methodology and participant demographics; hence, practitioners should apply the recommendation in this study to their athletes with caution. The most significant concern with resistance training in children and adolescents was the risk of injury due to the excessive use of soft tissues, especially for the lower back, back and shoulders (<xref ref-type="bibr" rid="B58">58</xref>). If a resistance exercise programme was designed to exceed a child&#x00027;s capacity, the pleasure in exercising may be diminished through the increase of acute or overtraining injuries (<xref ref-type="bibr" rid="B59">59</xref>). Moreover, although the PEDro scores were moderate (i.e. 4, 5 or 6), the quality of the work reviewed in this article were generally acceptable considering the inevitable restrictions imposed by training intervention studies related to blindness.</p>
<sec>
<title>Dry-Land Resistance Training Modalities</title>
<p>Some studies confirmed that dry-land strength training can improve swimming performance (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B44">44</xref>&#x02013;<xref ref-type="bibr" rid="B47">47</xref>, <xref ref-type="bibr" rid="B54">54</xref>). Therefore, widespread dry-land strength training procedures were reported by swimming athletes to improve performance in competitions. In addition, studies showed the auxiliary effect of kicking in improving swimming speed (<xref ref-type="bibr" rid="B60">60</xref>&#x02013;<xref ref-type="bibr" rid="B62">62</xref>). In general, dry-land resistance training includes two types of strength training which were basic and special. Basic strength training comprised of (1) bench press barbell, which was to develop the maximum muscle strength of the pectoralis major, triceps and forearm muscles, (2) dumbbell exercise to develop the strength of pectoralis major and latissimus dorsi, and (3) Swiss ball and medicine ball to build local muscles. The Swiss ball can improve the control ability of the whole body muscles, help to develop stability and maintain a good body posture during swimming (<xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B44">44</xref>, <xref ref-type="bibr" rid="B45">45</xref>). The techniques for special strength training included isokinetic tension, pulley tension and isokinetic dynamometer. The isokinetic pulling force is divided into three positions: prone, supine and standing. This exercise mirrors one&#x00027;s posture in water, introduces force on one or both arms and imitates the movement and resistance in water to a great extent (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B44">44</xref>&#x02013;<xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B54">54</xref>).</p></sec>
<sec>
<title>Underwater Resistance Training Modalities</title>
<p>Some studies confirmed that underwater resistance training can improve swimming performance (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B48">48</xref>&#x02013;<xref ref-type="bibr" rid="B53">53</xref>, <xref ref-type="bibr" rid="B55">55</xref>). &#x0201C;Underwater&#x0201D; Resistant Sprint Swimming Training (RST) was developed to increase the possibility of effective transfer of mature swimmers (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B63">63</xref>). Generally, water resistance training included the usage of a variety of equipment to increase the swimming resistance of athletes, namely (1) power frame, (2) rubber tension, (3) Increase water resistance, elastic rope, and (4) parachutes, gloves and resistance clothes (<xref ref-type="bibr" rid="B49">49</xref>, <xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B55">55</xref>). Power frame is a traditional method used to improve swimming intensity (<xref ref-type="bibr" rid="B52">52</xref>). On the other hand, rubber tension involves tying the two ends to the waists of each athlete during two-person resistance training Another variation of rubber tension involves one end of the rubber tension being tied to the waist of two athletes, while the other end being tied to the athlete on the pool wall (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>). Furthermore, with an elastic rope, one end is connected to a load cell while the other end is connected to the swimmer&#x00027;s waist (<xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B50">50</xref>, <xref ref-type="bibr" rid="B55">55</xref>).</p></sec>
<sec>
<title>Swimming Performance</title>
<p><xref ref-type="table" rid="T2">Table 2</xref> summarized the main outcomes of the 16 studies selected. Multiple studies found that adolescent swimmers who underwent dry-land resistance training (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B45">45</xref>, <xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B52">52</xref>) and water-resistance training (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B49">49</xref>, <xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B53">53</xref>, <xref ref-type="bibr" rid="B54">54</xref>) reported significant improvements in their swimming performance as compared to traditional swimming training. The swimming performances studied in most studies were mainly freestyle, specifically 50 m freestyle (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B45">45</xref>&#x02013;<xref ref-type="bibr" rid="B52">52</xref>, <xref ref-type="bibr" rid="B54">54</xref>), 100 m freestyle (<xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B53">53</xref>&#x02013;<xref ref-type="bibr" rid="B55">55</xref>), 200 m freestyle (<xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B51">51</xref>, <xref ref-type="bibr" rid="B53">53</xref>), and 400 m freestyle (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B53">53</xref>). Other strokes that were measured as swimming performance were 100 m breaststroke (<xref ref-type="bibr" rid="B33">33</xref>), 100 m backstroke (<xref ref-type="bibr" rid="B33">33</xref>), and 100 m butterfly (<xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B46">46</xref>). One study, however, found that resistance training showed little change in bilateral muscle strength and F/E peak torque ratio of the knee (<xref ref-type="bibr" rid="B44">44</xref>). Moreover, competitive swimming races consist of four different segments: start, clean, turn and finish (<xref ref-type="bibr" rid="B64">64</xref>, <xref ref-type="bibr" rid="B65">65</xref>). As the race distance becomes longer (e.g. from 50 m to 1,500 m), different phases during the swim had different contributions to the final race time. For example, in short 100 m events, the start and turn accounted for nearly one-third of the final race time (<xref ref-type="bibr" rid="B66">66</xref>). Therefore, these phases are crucial for the impact of swimming performance. More concerning is the limited studies that have investigated the effect of resistance training specifically on the start and turn skills of adolescent swimmers especially for a 50 m event.</p></sec></sec>
<sec id="s5">
<title>Limitations</title>
<p>Overall, this review provides substantial evidence of considerable quality and the beneficial effects of different resistance training programs on swimming performance. However, this review has several limitations. However, there are several limitations to this review. First, most of the studies involved unequal numbers of male or female, either only male or only female. If present, it could be important because there are differences in assessing swimming performance based on sex, which could affect the final study results. Second, none of the studies in this review stated sample size calculation methods. Determining the sample size is influenced by several factors, including the purpose of the study, the size of the population, the risk of selecting the sample, and the allowable sampling error. Therefore, inappropriate, insufficient, or excessive sample size can affect quality and accuracy. Errors in the calculation of sample size in included studies may affect study results. Third, most studies did not record or control for the exercises that participants performed outside of the research setting. Therefore, it is difficult to predict the effect of resistance on swimming performance of athletes.</p></sec>
<sec id="s6">
<title>Conclusion and Future Research</title>
<p>Maglischo&#x00027;s theory of resistance training in swimming posited that there are two types of resistance training that can improve swimming performance, which are training conducted in water and on land (<xref ref-type="bibr" rid="B1">1</xref>). Existing literature also showed that underwater resistance training (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B48">48</xref>&#x02013;<xref ref-type="bibr" rid="B53">53</xref>, <xref ref-type="bibr" rid="B55">55</xref>) and terrestrial resistance training (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B44">44</xref>&#x02013;<xref ref-type="bibr" rid="B47">47</xref>, <xref ref-type="bibr" rid="B54">54</xref>) can improve the swimming performance of adolescents. At present, no study on the effects of combined land and water resistance training on swimming performance has been reported. Furthermore, while the improvements in the overall performance of teenage swimmers undergoing resistance training were noticeable, no research detailing the impact of specific techniques on performance were conducted.</p>
<p>This review is the most comprehensive review to date relating to the effects of resistance training on the performance of young swimmers. Numerous studies found that resistance training can improve swimming performance in response to all resistance training programmes. Based on this review, the strength training programme recommended for young swimmers is a low-intensity, high-speed programme. Furthermore, resistance training interventions were mainly short distances of between 50&#x02013;100 meters. Future research may consider investigating the effects of resistance training on adolescents&#x00027; start and turn skills. In addition, the impact of combining land and water resistance training on teenage swimmers warrants further study.</p></sec>
<sec sec-type="data-availability" id="s7">
<title>Data Availability Statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/supplementary material.</p></sec>
<sec id="s8">
<title>Author Contributions</title>
<p>KS and WG contributed to the design, acquisition, analysis, interpretation of the data for the systematic review, drafted the work, revised it critically for important intellectual content, approved the version to be published, and agreed to be account-able for all aspects of the work ensuring that the questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors contributed to the article and approved the submitted version.</p></sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p></sec>
<sec sec-type="disclaimer" id="s9">
<title>Publisher&#x00027;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p></sec>
</body>
<back>
<ack><p>The review was registered with PROSPERO (Effect of Resistance Training Methods and Intensity on the Adolescent Swimmers Performance: A Systematic Review&#x02014;CRD42021231510) at the University of York, United Kingdom.</p>
</ack>
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