Efficacy of resistance training in hypoxia on muscle hypertrophy and strength development: a systematic review with meta‑analysis Benavente Bardera, Cristina Padial Puche, Paulino Feriche Fernández-Castanys, María Belén Metabolic stress Performance Mechanisms Intensity Responses Exercise We would like to thank contacted authors for taking the time to respond to data requests in such a kind and prompt manner. The online version contains supplementary material available at https://doi.org/10.1038/s41598-023-30808-4 www.nature.com/scientificreports A systematic review and meta-analysis was conducted to determine the effects of resistance training under hypoxic conditions (RTH) on muscle hypertrophy and strength development. Searches of PubMed-Medline, Web of Science, Sport Discus and the Cochrane Library were conducted comparing the effect of RTH versus normoxia (RTN) on muscle hypertrophy (cross sectional area (CSA), lean mass and muscle thickness) and strength development [1-repetition maximum (1RM)]. An overall meta-analysis and subanalyses of training load (low, moderate or high), inter-set rest interval (short, moderate or long) and severity of hypoxia (moderate or high) were conducted to explore the effects on RTH outcomes. Seventeen studies met inclusion criteria. The overall analyses showed similar improvements in CSA (SMD [CIs] = 0.17 [- 0.07; 0.42]) and 1RM (SMD = 0.13 [0.0; 0.27]) between RTH and RTN. Subanalyses indicated a medium effect on CSA for longer inter-set rest intervals and a small effect for moderate hypoxia and moderate loads favoring RTH. Moreover, a moderate effect for longer inter-set rest intervals and a trivial effect for severe hypoxia and moderate loads favoring RTH was found on 1RM. Evidence suggests that RTH employed with moderate loads (60-80% 1RM) and longer inter-set rest intervals (>= 120 s) enhances muscle hypertrophy and strength compared to normoxia. The use of moderate hypoxia (14.3-16% FiO(2)) seems to be somewhat beneficial to hypertrophy but not strength. Further research is required with greater standardization of protocols to draw stronger conclusions on the topic. 2023-05-12T07:05:01Z 2023-05-12T07:05:01Z 2023-03-04 info:eu-repo/semantics/article Cristina Benavente et al. Efficacy of resistance training in hypoxia on muscle hypertrophy and strength development: a systematic review with meta‑analysis. Scientific Reports (2023) 13:3676 nature portfolio. [https://doi.org/10.1038/s41598-023-30808-4] https://hdl.handle.net/10481/81473 10.1038/s41598-023-30808-4 eng http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Atribución 4.0 Internacional Springer Nature