Real-world fatigue testing in professional rugby union: A systematic review and meta-analysis

Document Type

Journal Article

Publication Title

Sports Medicine




School of Medical and Health Sciences




Grainger, A., Comfort, P., Twist, C., Heffernan, S. M., & Tarantino, G. (2023). Real-world fatigue testing in professional rugby union: A systematic review and meta-analysis. Sports Medicine. Advance online publication.


Background: Professional rugby union is a high-intensity contact sport with position-specific high training and match volumes across a season that may lead to periods of fatigue if above a typically experienced threshold. This study assesses the influence of match play and/or training on fatigue levels in rugby union players. Objective: We aimed to perform a systematic review and meta-analysis of measures used to assess fatigue status in male professional rugby union players. Methods: Using electronic databases (PubMed, SPORTDiscus, Web of Science, Cochrane Library, EMBASE, and MEDLINE), a systematic review of fatigue testing in rugby union was conducted on (1) neuromuscular, (2) subjective self-report, (3) biochemical, and (4) heart rate-derived measures. Results: Thirty-seven articles were included in this systematic review, of which 14 were further included in a meta-analysis. The results of the meta-analysis revealed small, yet not significant, decreases in countermovement jump height immediately after (effect size [ES] = − 0.29; 95% confidence interval [CI] − 0.64 to 0.06), 24 h (ES = − 0.43; 95% CI − 3.99 to 3.21), and 48 h (ES = − 0.22; 95% CI − 0.47 to 0.02) after exposure to rugby union match play or training. Reported wellness (ES = − 0.33; 95% CI − 1.70 to 1.04) and tiredness (ES = − 0.14; 95% CI − 1.30 to 1.03) declined over a period of a few weeks (however, the results were not-statistically significant), meanwhile muscle soreness increased (ES = 0.91; 95% CI 0.06 to 1.75) within the 96 h after the exposure to rugby union match play or training. Finally, while cortisol levels (ES = 1.87; 95% CI − 1.54 to 5.29) increased, testosterone declined (ES = − 1.54; 95% CI − 7.16 to 4.08) within the 24 h after the exposure. However, these results were not statistically significant. Conclusions: Subjective measures of muscle soreness can be used to assess fatigue after match play and training in rugby union players. Within-study and between-study variability for countermovement jump height, biochemical markers, and heart rate-derived measures means the utility (practical application) of these measures to assess fatigue in professional rugby union players after matches and training is unclear. Clinical Trial Registration: PROSPERO ID: CRD42020216706.



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