McHugh · Scandinavian journal of medicine & science in sports 2003 · narrative review · n=?

Recent advances in the understanding of the repeated bout effect: the protective effect against muscle damage from a single bout of eccentric exercise.

Cited 622 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of proposed physiological mechanisms with no systematic search or primary data synthesis.

PubMed 12641640 · doi:10.1034/j.1600-0838.2003.02477.x · record verified 2026-08-30

What was done

This narrative review synthesized evidence on the proposed neural, mechanical, and cellular mechanisms underlying the repeated bout effect, where an initial bout of eccentric exercise protects against muscle damage from subsequent bouts.

What was found

The abstract reports no quantitative data or effect sizes. Qualitatively, it notes potential neural shifts toward slow-twitch motor unit recruitment (though electrically stimulated contractions show peripheral mechanisms predominate), increases in muscle stiffness with eccentric training, longitudinal addition of sarcomeres to reduce strain, and adaptations in the post-exercise inflammatory response. No unified mechanistic theory was established.

Why it matters

It organizes the mechanistic hypotheses for the repeated bout effect into neural, mechanical, and cellular domains, establishing a framework for subsequent research on muscle damage adaptation.

Limits

The abstract contains no quantitative metrics, sample sizes, or search criteria. As a narrative review, it summarizes mechanistic hypotheses rather than providing pooled empirical findings or risk-of-bias assessments.

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