7 95 Janetzki Rev

Assessing athlete readiness using physical, physiological, and
perceptual markers: A systematic review and meta-analysis

Samuel J. Janetzki 1 . Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
University of South Australia. Adelaide, Australia.
High Performance Department. Adelaide Football Club. Adelaide, Australia.
Pitre C. Bourdon. Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
Netball South Australia / Adelaide Thunderbirds. Adelaide, Australia.
Darren J. Burgess. Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
High Performance Department. Adelaide Football Club. Adelaide, Australia.
Georgina K. Barratt. Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
South Australian Sports Institute. Adelaide, Australia.
Clint R. Bellenger. Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
ABSTRACT
This systematic review and meta-analysis evaluated the validity of tests / markers of athletic readiness to predict physical
performance in elite team and individual sport athletes. Ovid MEDLINE, Embase, Emcare, Scopus and SPORT Discus
databases were searched from inception until 15 March 2023. Included articles examined physiological and psychological
tests / markers of athletic readiness prior to a physical performance measure. 165 studies were included in the systematic
review and 27 studies included in the meta-analysis. 20 markers / tests of athletic readiness were identified, of which five
were meta-analysed. Countermovement jump (CMJ) jump height had a large correlation with improved 10m sprint speed /
time (r = 0.69; p = .00), but not maximal velocity (r = 0.46; p = .57). Non-significant correlations were observed for peak
power (r = 0.13; p = .87) and jump height (r = 0.70; p = .17) from squat jump, and 10m sprint speed / time. CMJ jump height
(r = 0.38; p = .41) and salivary cortisol (r = -0.01; p = .99) did not correlate with total distance. Sub-maximal exercise heart
rate (r = -0.65; p = .47) and heart rate variability (r = 0.66; p = .31) did not correlate with Yo-Yo Intermittent Recovery Test 1
performance. No correlation was observed between blood C-reactive protein and competition load (r = 0.33; p = .89). CMJ
jump height can predict sprint and acceleration qualities in elite athletes. The validity of the other readiness tests / markers
meta-analysed warrants further investigation.
Keywords: Elite athletes, Athlete readiness, Physical performance, Athlete monitoring.
Cite this article as:

Janetzki, S. J., Bourdon, P. C., Burgess, D. J., Barratt, G. K., & Bellenger, C. R. (2023). Assessing athlete readiness using physical, physiological, and
perceptual markers: A systematic review and meta-analysis. Scientific Journal of Sport and Performance, 2(3), 339-380.
https://doi.org/10.55860/AGRH6754
1
Corresponding author. Alliance for Research in Exercise, Nutrition and Activity (ARENA). UniSA Allied Health and Human Performance.
E-mail: [email protected]
Submitted for publication May 12, 2023.
Accepted for publication June 05, 2023.
Published June 20, 2023.
Scientific Journal of Sport and Performance. ISSN 2794-0586.
©Asociación Española de Análisis del Rendimiento Deportivo. Alicante. Spain.
doi: https://doi.org/10.55860/AGRH6754
VOLUME 2 | ISSUE 3 | 2023 | 339

Janetzki, et al. / Assessing athlete readiness using physical, physiological & perceptual markers Scientific Journal of Sport and Performance
INTRODUCTION
The demands and nature of modern day professional sport has caused an increase in not only the
physiological demands on athletes but psychological stress from commercial obligations, sponsors, media,
education and family (Ryan et al., 2020). Therefore, it is of critical importance performance coaches have a
comprehensive understanding of the competing demands on their athletes, their fatigue and recovery status,
and ultimately their “readiness” to perform in training and competition (Ryan et al., 2020). Athlete monitoring
is now standard practice in professional sport (Taylor et al., 2012), with the information collected used to
inform performance staff of an athlete’s injury risk and readiness to perform (Taylor et al., 2012; Thorpe et
al., 2017). The primary goal of athlete monitoring systems is to monitor training load and the athletes’
responses to training and competition stress to inform decision making on recovery and availability for
subsequent training and competition (Bourdon et al., 2017). Importantly, an intricate understanding of the
stress on athletes is fundamental to the subtle manipulation of training load to maximise favourable and
functional adaptations to maximise performance (Impellizzeri et al., 2019).
Often the difficulties with monitoring team sport athletes in particular, is the individual variability between
athletes in their response to modifiable (health, sleep and training status) and non-modifiable (genetics,
weather, and pressure and expectation from media and supporters) factors (Impellizzeri et al., 2019). Indeed,
the prescription of the identical training load for one athlete may evoke a completely different internal,
psychophysiological response in other athletes from the same team (Bouchard et al., 2011; Mann et al.,
2014; Smith, 2003).
With improvements in technologies used to monitor athletes, the current practice in professional sport is to
assess athlete readiness for training and competition, and tolerance to training load, at the individual level.
Typically, this is comprised of neuromuscular assessments including countermovement jump (CMJ) and
squat jump (SJ) (Cormack et al., 2013), fitness tests (i.e., Yo-Yo Intermittent Recovery Test 1 (Yo-Yo IR1))
(Veugelers et al., 2016), and autonomic nervous system assessment using heart rate parameters (i.e., heart
rate variability (HRV) and heart rate recovery (HRR) (Plews, Laursen, Stanley, et al., 2013). More invasive
measures such as testing biological markers are also commonly used, with inflammatory markers such as
creatine kinase (CK) suggested to be a valid and reliable indicator of fatigue in team sport athletes
(Hecksteden et al., 2016; Nédélec et al., 2012). Furthermore, whilst the importance of physiological recovery
is fundamental to athlete readiness for training and competition, there is well-established literature supporting
the use of psychological markers of training status to monitor individual athlete response (Borresen &
Lambert, 2009; Raglin, 2001). These psychological recovery markers, commonly assessed through a range
of psychological wellness questionnaires (Saw et al., 2015), provide an athlete’s individual perception of
readiness and comprise a critical component of the recovery-fatigue monitoring process (Kellmann et al.,
2018; Saw et al., 2016).
Previous studies that have established changes in readiness tests and markers, particularly HRV, suggest a
stronger correlation with measures of performance as opposed to other isolated measures (Bellenger et al.,
2016; Plews, Laursen, Kilding, et al., 2013). Importantly, a distinguishing feature of the current review was
the investigation of tests and markers of readiness in the context of gold standard measures of athletic
performance using correlation analysis. Furthermore, despite the volume of studies which, in isolation, have
investigated the use of various tests and markers of athletic readiness as an indicative measure of
performance, no study has conducted a holistic investigation and analysis of the various readiness tests and
markers used to assess fitness and fatigue in elite team and individual sport athletes.
340 | 2023 | ISSUE 3 | VOLUME 2 © 2023 ARD Asociación Española

Given the rise in the reliance and application of these markers and tests for practitioners in sport and exercise
science, the aim of this review was to identify the most valid tests and measures of athletic readiness to
predict physical performance in elite athletes.
MATERIAL AND METHODS
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
statement for improved reporting of systematic reviews (Moher et al., 2009).
Literature search
A systematic search of the literature was conducted on 3 November 2021 in the following databases: Ovid
MEDLINE, Embase, Emcare, SPORT Discus and Scopus. Database update alerts were monitored until 15
March 2023 for any additional studies that met the inclusion criteria. Database searches were complemented
with pearling of reference lists for relevant studies which satisfied the inclusion criteria.
Title, abstract and keyword searches were conducted in the aforementioned databases using the following
search strategy (see Supplementary Table 1 for the master search strategy) developed in MEDLINE and
Emcare, which was revised and amended for the remaining databases:
1. Elite athletes
AND
2. Tests and / or markers of athletic readiness
AND
3. Physical measures of athletic performance
Eligibility criteria
To be eligible for inclusion in this review, study participants must have been elite, professional able-bodied
athletes of any gender competing in team or individual sports. Study participants were considered to have
met the inclusion criteria if they satisfied tiers four and five of the classification frameworks developed by
McKay et al. (McKay et al., 2022), with the exception of NCAA and elite junior or underage athletes who were
excluded as they were not considered professional for the purpose of this review. Studies needed to assess
more than one participant using a relevant test and marker of athletic readiness, prior to a subsequent
measure of athletic performance. Only studies which analysed participants using a test and marker of
readiness in a rested or sub-maximal state were included, due to the disruption of physiological homeostasis
following near, or maximal physical exertion (Bellenger et al., 2016). Studies which investigated markers and
tests of readiness in the context of other interventions which disrupted a homeostatic state (i.e., caffeine
ingestion or heat exposure) were eligible for inclusion provided a placebo / control group’s data could be
extracted independently of the intervention group, and there was no cross-over of participants to control and
/ or intervention groups during the study. Studies’ intervention period could not exceed 12 months or one
season. Studies measuring HRR were only included if heart rate was measured following sub-maximal
exercise, in line with previously established sub-maximal heart rate assessment protocols (Buchheit et al.,
2009). Studies using session rating of perceived exertion (sRPE) as a performance measure were only
included if the subjective measure of load was calculated from a competition or match setting. Studies which
VOLUME 2 | ISSUE 3 | 2023 | 341

analysed sport-specific readiness and performance (i.e., 7-stroke max and repeated sprint ability) tests were
not eligible for inclusion as their application was not generalisable, as were unpublished, non-English, or
qualitative studies.
Studies were eligible for inclusion in the meta-analysis if the relationship between the marker and test of
performance readiness and the subsequent performance measure were analysed using Pearson product-
moment correlation coefficient or Spearman’s rank correlation coefficient. To improve the generalisability of
the findings, studies were only meta-analysed if three or more studies analysed an identical, standardised
readiness test and marker in the context of an analogous performance outcome. Where necessary, the
direction of relationships was transformed to a positive value to indicate an improvement or decrement in
performance. For example, the time to complete a time trial and the average speed in a time trial provide
different directions. Therefore, studies included in the meta-analysis were amended to ensure consistency in
the direction of the reported relationship between analogous readiness markers and tests, study designs,
and performance outcomes.
Studies analysing sub-maximal exercise heart rate were eligible for inclusion if exercise heart rate was
measured following a period of at least three minutes of sub-maximal exercise intensity, so a steady state
heart rate was established (Buchheit, 2014; Cerretelli & Di Prampero, 1971). For HRV, meta-analyses were
only conducted on studies which reported indices of standard deviation of instantaneous beat-to-beat R–R
interval variability from Poincare plots (SD1), root-mean-square difference of successive normal R–R
intervals from time-domain analysis (RMSSD) and high frequency power (HFP) as measures of pure
parasympathetic modulation based on the findings and recommendations of Bellenger et al. (Bellenger et al.,
2016).
Study selection
Studies identified in the systematic search were exported into a reference management software program
(Endnote version X8.2, Thomson Reuters, 2012). All articles were subsequently imported into Covidence
(Covidence Systematic Review Software, Veritas Health Innovation, 2013) where all duplicates were
removed. Studies were initially assessed for eligibility by title and abstract screening against the eligibility
criteria in Covidence, where irrelevant studies were excluded. The remaining studies were assessed for full-
text eligibility using the eligibility criteria. Screening was conducted independently by two investigations (SJJ
and GKB), with conflicts resolved by consensus.
Data extraction was conducted by the lead author (SJJ) and confirmed by a second investigator (GKB). The
following information was obtained from the included studies: publication details (year, author(s), country),
participant characteristics, study design (longitudinal (pre-post test(s) and marker(s) of readiness) or cross-
sectional), results (athletic readiness test(s) / marker(s), performance measure(s)), duration of time between
the fatiguing exposure and test of readiness and performance, and the relationship between the readiness
test and performance measure (acute (<48 hours) or chronic (>48 hours)), based on the passage of time
between the assessment of the readiness test and / or marker and the subsequent performance measure.
Risk of bias assessment

The Cochrane Collaboration tool was used by the lead author (SJJ) and confirmed by a second investigator
(GKB) to assess risk of bias (Higgins et al., 2011). The tool was used to assess selection, performance,
detection, attrition and reporting bias from the studies identified from the systematic search.

Statistical analysis
Random effects meta-analyses were performed in Stata 16.1 (College Station, Texas) to assess the
relationship between homogenous markers and tests of performance readiness, and performance measures.
All correlation coefficient data from the included studies were normally distributed using the Fisher Z-
Transformation to calculate the standard error, before being transferred back into Pearson product-moment
correlation coefficients for reporting and presentation. Data were presented as Pearson product-moment
correlation coefficient (r) ± 95% confidence interval (CI) with statistical significance set at p < .05. Qualitative
interpretations of the correlation coefficients were applied based on the following framework: 0.00-0.09, trivial;
0.10-0.29, small; 0.30-0.49, moderate; 0.50-0.69, large; 0.70-0.89, very large; 0.90-1.00, nearly perfect
(Hopkins, 2000). The presence of statistical heterogeneity was determined by the I2 statistic and interpreted
using the framework developed by Higgins et al. (Higgins et al., 2019).
Meta-analyses were conducted on indices of the following markers and tests of performance readiness: CMJ,
biomarkers, SJ, sub-maximal exercise heart rate, and HRV which were sub-grouped into acute (<48 hours)
and chronic (>48 hours). These markers were further grouped into cross-sectional and / or longitudinal study
designs for analysis, as well as whether the performance measure(s) assessed the marker and test of
readiness in a training or competition setting. Identical markers and tests of readiness were eligible to be
analysed with different performance measures provided the performance measures assessed different
psychophysiological qualities. To ensure uniformity in the analyses and reporting, and where appropriate to
do so, data were presented with a positive correlation.
RESULTS
Note. n number of studies.
Figure 1. Literature search flow chart.

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The initial search identified 24698 studies, with 28 studies identified through other sources. Once 14513
studies were removed as duplicates, a further 9454 studies were identified as irrelevant by title and abstract
screening. 759 studies were reviewed by full text for inclusion. A summary of the search, including the number
of studies included in the qualitative synthesis and meta-analysis, is shown in Figure 1. A summary of the
165 studies included in the qualitative synthesis is provided in Table 1.
Table 1. Summary of studies included in the qualitative synthesis.

Study n Athletes Study Readiness marker(s) / Performance Relationship
design test(s) measure context
Costa et al., M: 11 Beach Longitudinal Wellness Questionnaire Training Acute
2022 Soccer (HI)
Gaviglio & M: 22 Rugby Union Longitudinal Biomarker (salivary T, T:C) Competition Acute
Cook, 2014
Loturco et al., M: 9 Athletics Cross- CMJ (jump height) Training Acute
2018 F: 7 sectional Squat Jump (jump height)
Balthazar et al., M: 8 Triathlon Cross- Biomarker (salivary T, C) Competition Acute
2012 sectional
Morris et al., M: 14 ARF Cross- CMJ (PCF, PEF, eccentric Training Acute
2022 sectional time, concentric time, FT,
eccentric: concentric time,
PEP, PCP, peak eccentric
velocity, peak concentric
velocity, jump height, peak
eccentric RFD, peak
concentric RFD)
McLellan et al., M: 17 Rugby Longitudinal Biomarker (blood CK, and Competition Chronic
2010 League salivary T, C)
Crewther et al., M: 64 Rugby Union Cross- Biomarker (salivary T) Training Acute
2012 sectional
Gaviglio et al., M: 22 Rugby Union Longitudinal Biomarker (salivary T, C, Competition Acute
2014 T:C)
Loturco et al., M: 9 Karate Cross- CMJ (jump height) Training Acute
2014 F: 10 sectional Squat Jump (jump height,
relative mean propulsive
power)
Webster et al., M: 15 Cricket Cross- CMJ (jump height) Competition Chronic
2022 sectional
Henderson et M: 20 Rugby Longitudinal Wellness Questionnaire Competition Chronic
al., 2019 Sevens (soreness, sleep, stress,
fatigue, recovery)
Groin Squeeze
Assessment (00)
Le Panse et al., M: 13 Powerlifting Cross- Biomarker (salivary T, C, Competition Acute
2010 F:13 sectional DHEA)
Loturco, M: 14 Athletics Cross- CMJ (jump height) Competition Chronic
Pereira, et al., sectional Squat Jump (jump height)
2015 Horizontal Jump
Knöpfli et al., M: 4 Cross- Longitudinal Biomarker (dopamine, Competition Acute
2001 F: 5 country epinephrine,
skiing norepinephrine)
Krustrup et al., M: 17 Soccer Longitudinal Biomarker (blood lactate, Training Acute
2003 plasma K+)
Staunton et al., F: 12 Basketball Longitudinal Sleep (time, efficiency) Competition Acute
2017

Hansen et al., M: 12 Gymnastics Cross- CMJ (jump height, peak Competition Acute
2019 sectional power)
Drop Jump (jump height)
McMahon et al., M: 15 Hockey Longitudinal Biomarker (CK) Competition Chronic
2021 Wellness Questionnaire
(soreness)
Loturco, M: 13 Athletics Cross- CMJ (jump height, peak Training Acute
D'Angelo, et al., F: 9 sectional force)
2015 Squat Jump (jump height,
peak force)
Horizontal Jump (distance
(m))
Pojskic et al., M: 38 Basketball Cross- CMJ (jump height) Training Chronic
2018 sectional Squat Jump (jump height)
Secomb, Farley, M: 18 Surfing Cross- CMJ (peak force, peak Training and Acute
et al., 2015 sectional velocity, jump height, Competition
stiffness)
Squat Jump (peak force,
peak velocity, jump height)
IMTP (peak force, relative
force)
Nakamura et M: 11 Futsal Longitudinal HRV (RMSSD) Training Acute
al., 2020
Hooper et al., M: 5 Swimming Longitudinal Biomarker (blood cortisol, Training Acute
1993 F: 8 epinephrine,
norepinephrine)
Thorpe et al., M: 10 Soccer Longitudinal Wellness Questionnaire Training Acute
2015 (fatigue, sleep, soreness)
CMJ (jump height)
HRV (lnRMSSD)
HRR
Turner et al., M: 17 Rugby Union Cross- CMJ (jump height) Training Chronic
2015 sectional
Rabbani et al., M: 14 Soccer Longitudinal Sub-maximal exercise HR Training Chronic
2018 HRR
Colyer et al., M: 8 Skeleton Longitudinal CMJ (max centre of mass Training Acute
2017 F: 5 displacement, peak power,
mean power, RFD)
Lombard et al., M: 23 Hockey Longitudinal CMJ (jump height) Competition Chronic
2021
Peñailillo et al., M: 9 Soccer Longitudinal Biomarker (salivary T, C, Competition Acute
2015 IgA)
Selmi, Levitt, et M: 16 Soccer Longitudinal Wellness Questionnaire Training Acute
al., 2022 (physical freshness)
Hills & M: 37 Rugby Union Longitudinal Wellness Questionnaire Training Acute
Rogerson, 2018
Loures et al., M: 21 Kayaking Longitudinal Biomarker (blood lactate) Competition Acute
2014 F: 7 (K1)
Balsalobre- M: 12 Athletics Longitudinal CMJ (jump height) Training Acute
Fernández et F: 3 Biomarker (salivary C)
al., 2014
Spiteri et al., F: 12 Basketball Cross- CMJ (jump height) Training Acute
2014 sectional IMTP (peak force)
Stojanovic et M: 24 Basketball Cross- CMJ (jump height) Training Acute
al., 2012 sectional
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Maior et al., M: 20 Soccer Longitudinal Biomarker (blood CK) Competition Acute

2018
Saidi et al., M: 14 Soccer Longitudinal Biomarker (blood CRP, Training and Acute and
2022 CK, creatinine) Competition Chronic
CMJ (jump height)
Squat Jump (jump height)
Wellness Questionnaire
(HI)
Shearer et al., M: 12 Rugby Union Cross- Wellness Questionnaire Training Acute
2015 sectional (BAM)
Malone et al., M: 22 Gaelic Longitudinal HRV (lnSD1) Training Acute
2017 Football HRR
Sub-maximal exercise HR
Gastin et al., M: 27 ARF Longitudinal Wellness Questionnaire Competition Acute
2013 (general muscle strain,
hamstring strain,
quadriceps strain, stress)
R. Gathercole et F: 12 Rugby Longitudinal CMJ (RFD, time to peak Training Acute
al., 2015 Sevens power, time to peak force,
velocity at peak power,
peak displacement, flight
time, FT:CT)
(HI)
Requena et al., M: 25 Soccer Longitudinal CMJ (flight time, velocity at Training Acute
2014 take-off)
Drop Jump (flight time,
contact time, velocity at
take-off)
Silva et al., M: 14 Soccer Longitudinal CMJ (jump height) Competition Chronic
2014 Biomarker (blood C, T:C,
antioxidant, gluthione
peroxidase, superoxide
dismutase gluthione
peroxidase ratio)
Guilhem et al., M: 9 Athletics Longitudinal Wellness Questionnaire Training Chronic
2015 F: 15 (POMS)
Biomarker (salivary T, C,
AA, IgA, chromogranin A,
and blood CK)
Díaz Gómez et M: 8 Swimming Longitudinal Biomarker (salivary AA, Training Chronic
al., 2013 F: 3 chromogranin, nitrate, and
blood adrenaline,
noradrenaline, dopamine)
Hulin et al., M: 32 Rugby Longitudinal Sub-maximal exercise HR Training Acute
2019 League
Calleja- M: 8 Basketball Longitudinal Biomarker (blood T, C, Competition Chronic
Gonzalez & T:C, CK)
Terrados, 2014
Clarke et al., F: 12 Rugby Longitudinal Biomarker (blood CK) Competition Acute
2015 Sevens
Moncef et al., M: 40 Handball Cross- CMJ (jump height) Training Chronic
Vertical Jump (jump
height)

Silva & Paiva, F: 67 Rhythmic Longitudinal Sleep (duration) Competition Not reported
2016 Gymnastics Wellness Questionnaire
(SCAT-A, PSQI, ESS)
Bonifazi et al., M: 8 Swimming Longitudinal Biomarker (blood C) Competition Chronic
2000
Doeven et al., F: 12 Rugby Cross- Wellness Questionnaire Competition Acute
2019 Sevens sectional (fatigue, soreness)
Bok & Jukić, M: 11 Soccer Longitudinal Biomarker (blood CK) Competition Acute
2019
Emmonds et al., F: 10 Soccer Cross- CMJ (jump height, RFD) Training Acute
2019 sectional Squat Jump (jump height,
RFD)
Drop Jump (jump height)
Atlaoui et al., M: 9 Swimming Longitudinal Biomarker (urinary Competition Chronic
2006 F: 5 adrenaline,
adrenaline:noradrenaline
ratio)
Chamari et al., M: 9 Windsurfing Longitudinal Heart rate reserve Competition Acute
2003 F: 1
Hunkin et al., M: 29 ARF Longitudinal Biomarker (blood CK) Competition Acute
2014
Selmi et al., M: 20 Soccer Longitudinal Wellness Questionnaire Training Acute
2021 (HI)
Enes et al., M: 23 Soccer Cross- CMJ (jump height) Training Chronic
2021 sectional Sit and Reach Test
Mielgo-Ayuso et F: 40 Volleyball Cross- Biomarker (blood T, Training Acute
al., 2017 sectional ACTH, C, free T, T:C, free
T:C)
(SCAT, STAI, CSAI 2-7,
OSQ, GHQ, Psychological
Characteristics Related to
Sport Performance
Questionnaire)
Messias et al., M: 10 Kayaking Cross- Wellness Questionnaire Training Acute
2018 (K1, C1, C2) sectional (POMS, SCAT, PSQI,
ESS)
Mäestu et al. M: 11 Rowing Longitudinal Biomarker (blood T, C) Training Chronic
2005
Haller et al., M: 26 Soccer Longitudinal Biomarker (blood cell-free Training and Acute
2019 DNA) Competition
(VAS)
Cullen et al., M: 37 Gaelic Longitudinal Wellness Questionnaire Training and Acute
2021 Football (mood, sleep (quality and Competition
duration), energy,
soreness, nutrition, stress,
health)
Saidi et al., M: 18 Soccer Longitudinal Squat Jump (jump height) Training Chronic
2019
Lum & Joseph, M: 18 Floorball Longitudinal CMJ (jump height) Training Acute
2020 F: 6
Nunes et al., F: 12 Basketball Longitudinal Biomarker (salivary T) Training Chronic
2011
McEwan et al., M: 12 Cricket Longitudinal Wellness Questionnaire Competition Acute
2020 (Core-CSD)
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Solana-Tramunt F: 12 Synchronised Longitudinal HRV (lnRMSSD) Training Acute

et al., 2019 Swimming
Purge et al., M: 11 Rowing Longitudinal Biomarker (blood T, C) Training Chronic
2006
Costa et al., F: 20 Soccer Longitudinal HRV (lnRMSSD) Training and Acute
2019 Sleep (time, efficiency) Competition
Tiernan et al., M: 19 Rugby Union Longitudinal Biomarker (salivary C) Training Chronic
2020
Rodríguez- M: 14 Basketball Cross- CMJ (jump height) Training Chronic
Fernández et sectional
al., 2021
Hauer et al., M: 12 Lacrosse Longitudinal Wellness Questionnaire Competition Acute
2020 (TQR, SRSS)
HRV (RMSSD)
Costa et al., F: 34 Soccer Longitudinal HRV (lnRMSSD, lnHFP) Training and Acute
2021 Sleep (duration, efficiency) Competition
Iizuka et al., M: 4 Badminton Longitudinal HRV (RMSSD, HFP) Training Acute
2020 F: 4
Bouaziz et al., M: 16 Rugby Longitudinal Biomarker (urinary C, Training Chronic
2016 Sevens cortisone, cortisol:
cortisone ratio, adrenaline,
adrenaline:noradrenaline
ratio)
Cormack et al., M: 22 ARF Longitudinal CMJ (FT:CT) Competition Acute and
2008 Biomarker (salivary T, C, Chronic
T:C)
Crewther et al., M: 24 Rugby Union Cross- Biomarker (salivary T, C, Training Acute
2009 sectional T:C)
Russell et al., F: 9 Netball Longitudinal Biomarker (salivary C, AA) Competition Acute and
2021 Wellness Questionnaire Chronic
(SRSS)
Morales et al., F: 10 Soccer Longitudinal Wellness Questionnaire Training Acute and
2019 (RESTQ-Sport) Chronic
HRV (RMSSD, HFP)
Crewther et al., M: 29 Rugby Union Longitudinal Biomarker (salivary C) Competition Acute
Moalla et al., M: 14 Soccer Longitudinal Wellness Questionnaire Training and Acute
2016 (HI) Competition
Watanabe et al., F: 57 Baseball Cross- CMJ (jump height) Competition Chronic
2019 sectional Vertical Jump (jump
height)
Coppalle et al., M: 26 Soccer Longitudinal Biomarker (blood LDH, Competition and Chronic
2019 CK, CRP) Training
Bosco et al., M: 32 Soccer Cross- CMJ (jump height) Training Acute
1996 sectional Biomarker (blood T, C)
Ingebrigtsen et M: 34 Soccer Cross- Sub-maximal exercise HR Training Acute
al., 2014 sectional
West et al., M: 39 Rugby Cross- CMJ (jump height) Training Acute
2011) League sectional IMTP (peak force, RFD,
force 110 ms)
Secomb, M: 15 Surfing Cross- CMJ (jump height, peak Training Acute
Lundgren, et al., sectional force)
2015) Squat Jump (jump height,
peak force)
IMTP (peak force)

Boraczyński et M: 25 Soccer Cross- CMJ (jump height, peak Training Acute and
al., 2020 sectional power) Chronic
Cunningham et M: 15 Rugby Union Cross- CMJ (jump height, peak Competition Chronic
al., 2018 sectional power)
IMTP (peak force, force at
250 ms)
Drop Jump (jump height,
RSI)
Cook & Beaven, F: 12 Netball Longitudinal Biomarker (salivary T) Training Acute
2013
Bishop et al., F: 14 Hockey Longitudinal Biomarker (blood lactate, Training Acute
2003 hydrogen ion,
hypoxanthine)
Teece et al., M: 29 Rugby Union Longitudinal Wellness Questionnaire Training Acute
2021 (HI)
Sleep (total, efficiency,
latency, wake episodes)
Stepinski et al., F: 18 Soccer Longitudinal CMJ (peak power) Training Acute
2020
de Freitas et al., M: 11 Futsal Longitudinal HRV (lnRMSSD) Training Acute
2015 Sub-maximal exercise HR
HRR
Peacock et al., M: 8 Martial Arts Longitudinal Sleep (time, latency, Training Acute
2018 efficiency, onset
variances)
Wisløff et al., M: 17 Soccer Cross- CMJ (jump height) Training Acute and
2004 sectional Chronic
Lim et al., 2021 M: Basketball Cross- Wellness Questionnaire Training Acute
261 sectional (PSQI)
F: 79
Dumortier et al., F: 7 Artistic Longitudinal Sleep (time) Competition Acute
2018 Gymnastics
Cunningham et M: 20 Rugby Union Cross- CMJ (jump height) Training Acute
al., 2016 sectional Drop Jump (contact time,
RSI)
Berriel et al., M: 13 Volleyball Longitudinal Wellness Questionnaire Training Acute
2020 (RESTQ-Sport)
Smart et al., M: 23 Rugby Union Longitudinal Biomarker (blood CK) Competition Acute
2008
Ravé et al., M: 14 Soccer Longitudinal HRV (RMSSD) Competition Acute
2020
Landolsi et al., M: 23 Shot Put Cross- CMJ (jump height) Training Chronic
2014 sectional
Brown et al., M: 21 Hockey Cross- Biomarker (salivary C, Competition Acute
2021 sectional DHEA, C:DHEA)
João R Silva et M: 13 Soccer Longitudinal CMJ (FT:CT) Competition Chronic
al., 2013
Carlsson et al., M: 12 Cross- Cross- CMJ (jump height) Competition Chronic
2012 Country sectional Squat Jump (jump height)
Skiing
Young et al., M: 23 ARF Cross- CMJ (jump height, peak Training Acute
2011 sectional force, peak velocity, peak
power)
Silva et al., M: 24 Soccer Longitudinal CMJ (jump height) Training and Acute and
2021 Competition Chronic
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Loturco et al., M& Athletics, Cross- CMJ (jump height) Training Acute
2019 F: 61 Soccer, sectional Squat jump (jump height)
Rugby
Sevens,
Bobsled
Jürimäe et al., M: 11 Rowing Longitudinal Biomarker (T, C, insulin, Training Chronic
2006 GH)
Casanova et al., F: 18 Soccer Longitudinal Biomarker (salivary C, T, Competition Acute and
2020 T:C) Chronic
Crewther, Potts, M: 24 Rugby Union Longitudinal Biomarker (T, C) Competition Chronic
et al., 2018
Boullosa et al., M: 8 Soccer Longitudinal HRV (CV RMSSD, Training Acute
2013 RMSSD, SD1)
Mancha- F: 10 Basketball Cross- Abalakov Test (time, Competition Chronic
Triguero et al., sectional height, impulse)
2021 Multi-Jump Test (average
time)
Rowell et al., M: 23 Soccer Longitudinal CMJ (FT:CT) Competition Acute
2018 Biomarker (salivary C, T,
T:C)
Chrismas et al., M: 16 Soccer Longitudinal HRV (lnRMSSD) Training Acute
2019
Araújo et al., M: 16 Soccer Cross- Sub-maximal exercise HR Training Acute
2019 F: 16 sectional
Ganzevles et M: 5 Swimming Longitudinal HRR Training Acute
al., 2017 F: 8
Dubois et al., M: 14 Rugby Union Longitudinal Biomarker (blood CK, Training and Acute and
2020 CRP, T, T:C, RBC, Competition Chronic
lymphocytes, insulin
growth factor, alanine,
aspartate
aminotransferase)
CMJ (jump height)
(RESTQ-Sport)
Elloumi et al., M: 16 Rugby Longitudinal Wellness Questionnaire Training Acute
2012 Sevens (fatigue)
Ihsan et al., M: 12 Hockey Longitudinal Wellness Questionnaire Competition Acute
2017 (fatigue, soreness, mood,
sleep)
Northeast et al., M: 26 Soccer Cross- CMJ (jump height, peak Training Acute
2019 sectional power, unilateral
asymmetry score)
IMTP (peak force, RFD,
force at 100 ms)
Drop Jump (contact time,
jump height, stiffness, RSI)
Vervoorn et al., F: 6 Rowing Longitudinal Biomarker (blood C, T, Training Acute
1992 free T, free T:C)
Siart et al., 2017 M: 8 Athletics Longitudinal Biomarker (salivary T, C) Competition Acute
F: 10
Malone, M: 30 Soccer Longitudinal Biomarker (blood CK) Training Acute
Mendes, et al., CMJ (jump height)
2018
Oliveira et al., M: 24 Soccer Longitudinal Wellness Questionnaire Competition Acute
2020 (HI)

Marcote- F: 19 Soccer Cross- Squat Jump (jump height) Training Acute

Pequeño et al., sectional
2019
Shalfawi et al., M: 33 Basketball Cross- CMJ (jump height, peak Training Acute
2011 sectional power)
Squat Jump (jump height,
peak power)
Rago et al., M: 15 Soccer Longitudinal Biomarker (blood T, C, Training Chronic
2021 T:C, CK, ferritin, iron,
RBC, haemoglobin,
haematocrit)
Beattie et al., M: 18 Soccer Longitudinal Biomarker (blood CK) Competition Acute
2021 CMJ (jump height, FT:CT,
CT, FT, peak power, max
force, take-off velocity,
mean power, mean force)
Bootes, 2017 M: 8 Rowing Longitudinal CMJ (peak force, mean Training Acute
power, take-off peak force,
peak power, eccentric /
concentric duration)
Squat Jump (peak power,
concentric mean force)
Mangine et al., M: 12 Basketball Cross- Visual Reaction Time Competition Chronic
2014 sectional Motor Reaction Time
Physical Reaction Time
Variable Region Choice
Reaction
Malone, Owen, M: 48 Soccer Longitudinal Wellness Questionnaire Training Acute
et al., 2018 (soreness, sleep, fatigue,
stress, energy)
Troester et al., M: 27 Rugby Union Longitudinal CMJ (jump height, Training Acute
2019 eccentric RFD)
Díaz et al., 2013 M: 13 Swimming Cross- Biomarker (salivary C) Competition Acute
sectional
and
Longitudinal
Buchheit et al., M: 18 ARF Longitudinal Biomarker (salivary C) Training Acute
(fatigue, sleep, soreness,
stress, mood)
Sub-maximal exercise HR
Clemente et al., M: 13 Volleyball Cross- Wellness Questionnaire Training Chronic
2018 sectional (HI)
Crewther et al., M: 13 Rugby Longitudinal Biomarker (salivary free T, Competition Chronic
2013 League free C)
Springham et M: 18 Soccer Longitudinal Biomarker (salivary T, C, Training and Chronic
al., 2022 T:C) Competition
Redman et al., M: 14 Rugby Cross- CMJ (jump height, Training Chronic
2021 League sectional concentric impulse, peak
force, peak power)
Gonçalves et F: 22 Soccer Cross- CMJ (jump height) Competition Chronic
al., 2021 sectional Squat Jump (jump height)
Hip / Groin Adduction and
Abduction Test
Saidi et al., M: 16 Soccer Longitudinal Biomarker (blood T, C, Training Acute
2020 T:C)
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(POMS)
Merati et al., M: 13 Swimming Cross- HRV (SD1, HFP) Competition Chronic
2015 sectional
Veugelers et al., M: 38 ARF Cross- HRR Training Acute
2016 sectional Sub-maximal exercise HR
Rago et al., M: 17 Soccer Longitudinal Sub-maximal exercise HR Training and Chronic
2020 Competition
Rodríguez- M: 15 Cycling Longitudinal Sub-maximal exercise HR Training Acute
Marroyo et al.,
2017
Ryan et al., M: 37 ARF Longitudinal Wellness Questionnaire Competition Acute and
2021 (soreness, sleep, fatigue, Chronic
stress, motivation)
Hip / Groin Adduction and
Abduction Test
Scott et al., M: 19 Rugby Longitudinal Sub-maximal exercise HR Training Acute and
2022 League HRR Chronic
Berriel et al., M: 13 Volleyball Cross- CMJ (jump height) Competition Chronic
Stanković et al., F: 16 Soccer Cross- CMJ (jump height) Training Acute
Glassbrook et M: 16 Rugby Cross- CMJ (peak power, peak Competition Chronic
al., 2022 League sectional force)
Selmi, Ouergui, M: 15 Soccer Longitudinal Wellness Questionnaire Training Chronic
et al., 2022 (HI)
Silva et al., M: 25 Soccer Longitudinal Biomarker (CRP, albumin, Training Acute
2022 haemoglobin, HDL,
lymphocytes, RBC,
basophils, eosinophil,
potassium)
Lu et al., 2022 M: 13 Shooting Longitudinal Wellness Questionnaire Competition Acute
F: 10 (PSQI, POMS, CSAI-2)
Dobbin et al., M: 21 Touch Longitudinal CMJ (jump height, peak Competition Acute
2020 F: 20 Football power, peak force)
(fatigue, mood, soreness,
sleep, stress)
Lalor et al., M: 38 ARF Longitudinal Sleep (wake bouts, wake Training Acute
2020 time, efficiency, latency)
Salhi et al., M: 22 Soccer Longitudinal CMJ (jump height) Training Acute
2022
Lourenço et al., M: 32 Soccer Longitudinal Wellness questionnaire Training Acute
2023 (HI)
Eastburn et al., M: 34 ARF Longitudinal Wellness questionnaire Competition Chronic
2022 (sleep, fatigue, soreness,
stress, mood)
Barreira et al., F: 16 Soccer Longitudinal Sleep (efficiency, duration) Training Acute
2022
Crewther, F: 23 Hockey Longitudinal Biomarker (salivary T) Competition Acute
Hamilton, et al.,
2018
Rebelo et al., M:15 Volleyball Longitudinal CMJ (jump height, peak Training Acute
2023 power)

Wellness questionnaire
(fatigue, recovery, stress,
soreness, sleep)
Haksever et al., F: 39 Handball Cross- Hip abduction test Training Acute
2022 sectional
Note. AA alpha-amylase, ACTH adrenocorticotropic hormone, ARF Australian Rules Football, BAM Brief Assessment of Mood
Questionnaire, C:DHEA cortisol to dehydroepiandrosterone ratio, CK creatine kinase, CMJ countermovement jump, C cortisol,
Core-CSD Core Consensus Sleep Diary, CRP C-reactive protein, CSAI 2-7 Competitive State Anxiety Inventory (2-7), CT
contraction time, CV RMSSD coefficient of variation of root-mean-square difference of successive normal R–R intervals from time-
domain analysis, DHEA dehydroepiandrosterone, ESS Epworth Sleepiness Scale, F female, FT flight time, FT:CT flight time to
contact time ratio, GH growth hormone, GHQ General Health Questionnaire, HDL high-density lipoprotein, HFP high-frequency
power, HI Hooper Index, HR heart rate, HRR heart rate recovery, HRV heart rate variability, IgA immunoglobulin A, IMTP isometric
mid-thigh pull, K+ potassium, LDH lactate dehydrogenase, LDL low-density lipoprotein, lnHF logarithmic high frequency power,
lnRMSSD log-transformed root-mean-square difference of successive normal R–R intervals from time-domain analysis, lnSD1 log-
transformed standard deviation of instantaneous beat-to-beat R–R interval variability from Poincare plots, M male, ms milliseconds,
n sample size, OSQ Oviedo Sleep Questionnaire, PCF peak concentric force, PCP peak concentric power, PEF peak eccentric
force, PEP peak eccentric power, POMS Profile of Mood States Questionnaire, PSQI Pittsburgh Sleep Quality Index, RBC red
blood cells, RESTQ-Sport Recovery-Stress Questionnaire-Sport, RFD rate of force development, RMSSD root-mean-square
difference of successive normal R–R intervals from time-domain analysis, RSI reactive strength index, SCAT-A Sport Competition
Anxiety Test from A, SD1 standard deviation of instantaneous beat-to-beat R–R interval variability from Poincare plots, SFMS
French Society for Sport Medicine Questionnaire, SRSS Short Recovery and Stress Scale for Sports, STAI State-Trait Anxiety
Inventory, T testosterone, T:C testosterone cortisol ratio, TQR Total Quality Recovery Questionnaire, VAS Visual Analogue Scale,
WBC white blood cells.
Reason for exclusion

Of the 759 studies for which the full text was reviewed, 594 were excluded from the qualitative synthesis
(Figure 1). The two primary reasons for study exclusion were attributable to the failure to identify or analyse
a relevant test and / or marker of athletic readiness (n = 109) or analyse a readiness test and / or marker with
an appropriate performance measure (n = 202). Several studies analysed data from participants who failed
this review’s definition of an elite athlete and were excluded (n = 82). Studies which assessed the readiness
marker and test following the performance measure (n = 43) were excluded, as were studies which applied
a sport-specific test to assess athlete readiness (n = 27). Studies which reported elite and sub-elite athlete
data concomitantly were excluded if the data from the elite athletic population could not be extrapolated
independently (n = 24). Some studies analysed markers or tests of readiness across more than one season
or 12-month period and were excluded (n = 24).
Risk of bias
Selection bias (in the form of random sequence generation and allocation concealment bias) was assessed
as unclear or low risk for all included studies due to the nature of the study interventions. All studies were
assessed as unclear or low risk of performance and detection bias, as the study designs did not require or
address participant blinding.
Risk of attrition bias was assessed as unclear or low for all studies as they either did not address the
wholeness of data, failed to report reasons for missing data or excluded participants, or the missing data from
excluded participants were unlikely to relate to the true outcome. However, one study was assessed as
potentially having a high risk of attrition bias with 26% of the original participants not included in the final
analysis (Hooper et al., 1993).
Thirteen studies were assessed at high risk of reporting bias as they either reported only some of the
correlations between the marker(s) or test(s) of readiness and the performance measure(s), or only the
statistically significant correlations (Berriel et al., 2020; Bok & Jukić, 2019; Cormack et al., 2008; Doeven et
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al., 2019; R. Gathercole et al., 2015; Guilhem et al., 2015; Jürimäe et al., 2006; Mangine et al., 2014; Merati
et al., 2015; Morales et al., 2019; Purge et al., 2006; Russell et al., 2021; Silva et al., 2014).
Participants
The studies included in this review reported on 3564 athletes, of which 2779 were male and 785 females,
who submitted to a marker of athletic readiness prior to a subsequent measure of athletic performance. Of
these studies, 115 investigated male athletes only, 28 investigated female athletes only, while 22 investigated
a mixed sex cohort.
Study outcomes
From the 165 studies included in this review, a total of 20 different markers or tests of athletic readiness were
identified across 46 sports (Table 1). The most common readiness markers and tests identified across the
included studies were biomarkers (n = 58), CMJ (n = 58), wellness questionnaires (n = 42), SJ (n = 20), HRV
(n = 14), sub-maximal exercise heart rate (n = 11), and sleep measures (n = 10).
73 studies implemented a longitudinal study design to assess the readiness measure and performance
outcome relationship in an acute setting, 27 in a chronic setting, and 9 in a combined acute and chronic
setting. 33 studies analysed the relationship between markers and tests of readiness and performance
outcomes using a cross-sectional study design in an acute setting, 19 in a chronic setting, and two in a
combined acute and chronic setting. One study used a combined longitudinal and cross-sectional study
design to assess the readiness marker, performance outcome relationship in an acute setting, while one
study implemented a longitudinal study design but failed to report the strength of the relationship between
the performance measure and readiness marker (Silva & Paiva, 2016).
Meta-analysis
Table 1. Summary of acute markers and tests of athletic readiness included in the meta-analysis.
Summary
Readiness test / Performance Studies 95% Significance Heterogeneity
Correlation
marker measure (n) CI (p) (I2)
(r)
Cross-sectional studies
Jump 10 m sprint speed / 0.47 to
6 0.69 .00 71.4%
Height time 0.83
CMJ
-0.10 to
Peak Power 10 m sprint time 3 0.13 .87 0.0%
0.35
Jump 10 m sprint speed / 0.48 to
Squat Jump 3 0.70 .17 45.0%
Height time 0.84
Longitudinal studies
Jump Total distance 0.12 to
CMJ 3 0.38 .41 0.0%
Height covered 0.59
Salivary Total distance -0.33 to
Biomarker 3 -0.01 .99 0.0%
Cortisol covered 0.32
Exercise Heart Sub- -0.78 to -
Yo-Yo IR1 distance 3 -0.65 .47 0.0%
Rate maximal 0.47
RMSSD + 0.44 to
Yo-Yo IR1 distance 5 0.66 .31 14.5%
SD1 0.80
HRV
Competition load -0.15 to
RMSSD 3 0.10 .91 0.0%
(sRPE) 0.35
Note. CI confidence interval, CMJ countermovement jump, HRV heart rate variability, I2 proportion of variance in observed effect due to
variance in true effects, m metre, n sample size, r Pearson product-moment correlation coefficient, RMSSD root-mean-square difference
of successive normal R–R intervals from time-domain analysis, SD1 standard deviation of instantaneous beat-to-beat R–R interval
variability from Poincare plots, sRPE session rating of perceived exertion, Yo-Yo IR1, Yo-Yo Intermittent Recovery Test Level 1.

From the 27 studies which satisfied the inclusion criteria (Balsalobre-Fernández et al., 2014; Beattie et al.,
2021; Boraczyński et al., 2020; Boullosa et al., 2013; Buchheit et al., 2013; Coppalle et al., 2019; Costa et
al., 2019; Costa et al., 2021; Cunningham et al., 2016; de Freitas et al., 2015; Dubois et al., 2020; Gonçalves
et al., 2021; Hauer et al., 2020; Hulin et al., 2019; Loturco et al., 2018; Loturco, D'Angelo, et al., 2015; Malone
et al., 2017; Moncef et al., 2012; Morales et al., 2019; Nakamura et al., 2020; Northeast et al., 2019; Peñailillo
et al., 2015; Saidi et al., 2022; Shalfawi et al., 2011; Silva et al., 2021; Webster et al., 2022; Young et al.,
2011), five markers and tests of athletic readiness were identified and meta-analysed: CMJ, biomarkers, SJ,
sub-maximal exercise heart rate, and HRV. A summary of the acute and chronic, and longitudinal and cross-
sectional study correlations of the readiness markers and tests with the relevant performance measures, are
outlined in Tables 2 and 3.
Table 2. Summary of chronic markers and tests of athletic readiness included in the meta-analysis.
Summary
Readiness test / Performance Studies 95% Significance Heterogeneity
Correlation
marker measure (n) CI (p) (I2)
(r)
Cross-sectional studies
Jump 0.25 to
CMJ Maximal velocity 3 0.46 .57 0.0%
Height 0.62
Longitudinal studies
Competition load -0.04 to
Biomarker Blood CRP 3 0.33 .89 0.0%
(sRPE) 0.56
Note. CI confidence interval, CMJ countermovement jump, CRP C-reactive protein, HRV heart rate variability, I 2 proportion of
variance in observed effect due to variance in true effects, n sample size, r Pearson product-moment correlation coefficient, sRPE
session rating of perceived exertion.
Countermovement jump
Figure 2 shows the association between various indices of CMJ and athletic performance. Acute, cross-
sectional assessment revealed a large, statistically significant correlation between CMJ jump height and
faster 10 m sprint speed and time (r = 0.69; p = .00), which was affected by substantial statistical
heterogeneity (I2 = 71%). A small, non-significant correlation existed between CMJ peak power and 10 m
sprint time (r = 0.13; p = .87). Acute and longitudinal assessment of CMJ jump height found a non-significant,
moderate association with total distance covered (r = 0.38; p = .41). Chronic, and cross-sectional CMJ jump
height had a moderate, non-significant correlation with maximal speed (r = 0.46; p = .57).
Biomarkers
An acute, longitudinal assessment of salivary cortisol revealed a statistically non-significant, negative, and
trivial association with total distance (Figure 3; r = -0.01; p = .99). When assessed over a chronic timeframe,
blood C-reactive protein (CRP) exhibited a moderate but non-significant correlation with competition load
quantified by sRPE (Figure 3; r = 0.33; p = .89).
Squat jump
Cross-sectional and acute assessment of jump height from SJ provided a very large, but statistically non-
significant correlation with 10 m sprint speed and time (Figure 4; r = 0.70; p = .17), which was affected by
moderate statistical heterogeneity (I2 = 45%).
Sub-Maximal Exercise Heart Rate

Acute and longitudinal assessment of sub-maximal exercise heart rate revealed a negative and large, but
statistically non-significant, correlation with Yo-Yo IR1 distance (Figure 5; r = -0.65; p = .47).
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Heart Rate Variability

Figure 6 provides the correlation of acute and longitudinal assessment of RMSSD and SD1 indices of HRV
and subsequent athletic performance. Pooled RMSSD and SD1 exhibited a large, but statistically non-
significant, correlation with Yo-Yo IR1 distance (r = 0.66; p = .31), while a small, non-significant correlation
was found between RMSSD and competition sRPE load (r = 0.10; p = .91).
Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient.
Figure 2. Correlation of CMJ indices (using static arm position) and athletic performance measures.

Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient, sRPE session rating of
perceived exertion derived from competition.
Figure 3. Correlation of salivary cortisol and blood C-reactive protein biomarkers and athletic performance
measures.
Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient.
Figure 4. Correlation of squat jump height (with hands on hips) and 10 m sprint speed and time.
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Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient, Sub-Maximal HR, Sub-
Maximal Exercise Heart Rate, Yo-Yo IR1, Yo-Yo Intermittent Recovery Test Level 1.
Figure 5. Correlation of sub-maximal exercise heart rate and yo-yo IR1 distance.
Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient, sRPE session rating of
perceived exertion derived from competition, Yo-Yo IR1 Yo-Yo Intermittent Recovery Test Level 1.
Figure 6. Correlation of heart rate variability indices RMSSD and SD1, and athletic performance measures.
DISCUSSION
This systematic literature review explored the relationship between tests and markers of athletic readiness
and subsequent performance in elite athletes. To the knowledge of the authors, no review has provided a
combined, holistic assessment of the psychological and physiological readiness markers and tests to assess
training status in elite team and individual sport athletes, while using correlation analysis to assess athletic

performance (to best evaluate the sensitivity of the readiness measures). The 165 studies included in this
review identified 20 markers and tests of athletic readiness, of which five measures were meta-analysed
across 27 studies. The most common measures of athletic readiness were biomarkers, CMJ and wellness
questionnaires. The most significant finding from this review was the validation of jump height from CMJ
(without arm swing) to predict explosive leg muscle function, expressed as acceleration and speed qualities,
in elite athletes. The five markers and tests of readiness included in the meta-analysis are discussed
independently below.
Countermovement jump
This review found a large, positive correlation between an acute and cross-sectional assessment of jump
height from CMJ (without arm swing) and superior 10 m sprint speed and time (Figure 2), which may have
been impacted by substantial statistical heterogeneity. Interestingly, an increase in jump height when
assessed in different contexts (i.e., chronic and cross-sectional, and acute and longitudinal designs), did not
correlate to greater maximal speed or total distance in training and competition (Figure 2). Similarly, the acute
and cross-sectional assessment of peak power from CMJ did not correlate with 10 m sprint time (Figure 2).
As a monitoring tool for leg muscle function, the CMJ remains the most utilised vertical jump test for
practitioners to provide a practical measure of neuromuscular fatigue and recovery time from training and
competition demands (Alba-Jiménez et al., 2022). As a measure of physical performance, the CMJ provides
an assessment of the explosive qualities of the leg muscles (Young et al., 2011). Whilst modern technologies
assessing CMJ provide numerous variables of interest, jump height is still the most commonly assessed
variable (Taylor et al., 2012), which is in keeping with the findings of this review (Table 1). Yet standardisation
of the CMJ is influenced by a number of factors including the depth of countermovement, use of arm swing,
as well as the number and frequency of jumps used for analysis (Alba-Jiménez et al., 2022). However,
comparison of the “highest” and “average” CMJ results found the use of an “average”, in comparison to the
“best” jump, to be more sensitive in identifying fatigue or the positive effects of supercompensation (Claudino
et al., 2017).
Whilst the studies meta-analysed in this review were controlled for the use (or not) of arm swing, the depth
of countermovement and varying number and frequency of jumps used in the analysis could not be controlled.
These methodological variances may explain the substantial statistical heterogeneity found for jump height,
and potentially the non-significant findings found for all CMJ variables other than jump height. Interestingly,
acute and longitudinal, and chronic and cross-sectional, assessment of CMJ jump height was not correlated
with increases in total distance and maximal speed respectively (Figure 2). These findings potentially suggest
jump height is sensitive to various study designs, as well as assessment in the context of different physical
performance measures.
In keeping with the significant finding from this review, previous studies with an identical study design also
found statistically significant correlations between jump height from CMJ as a predictor of various speed and
power qualities in elite soccer (Bosco et al., 1996), rugby league (West et al., 2011), athletics (Loturco et al.,
2019), and surfing (Secomb, Lundgren, et al., 2015) athletes. Interestingly, a number of studies which
implemented an identical acute and cross-sectional study design to this review, found a statistically significant
correlation between CMJ jump height and 5 m sprint time (Boraczyński et al., 2020), 20 m sprint time
(Northeast et al., 2019; Shalfawi et al., 2011), and 40 m sprint time (Shalfawi et al., 2011), but not for peak
power. These previous findings are in keeping with the results from this review and supports the notion of a
potential inverse relationship between jump height and peak power from CMJ, as a predictor of acceleration
and power qualities in elite athletes.
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Whilst this review validates the acute, cross-sectional assessment of jump height from CMJ (without arm
swing) to predict acceleration and power qualities in elite athletes, caution should be used in the application
of other CMJ variables and study designs to predict similar athletic qualities. In particular, the use of peak
power from CMJ to predict 10 m sprint time, as well as the application of acute and longitudinal, and chronic
and cross-sectional assessments of jump height to predict total distance and maximal speed, respectively.
Biomarkers
Despite finding biomarkers to be the most extensively investigated readiness measure in elite athletes (Table
1), neither of the biomarkers meta-analysed in this review were found to have a significant relationship with
their respective performance measure. Specifically, a longitudinal assessment of acute, salivary cortisol and
chronic, blood derived CRP, were not correlated with subsequent distance covered or competition load
quantified by sRPE, respectively (Figure 3).
Cortisol is one of the most commonly used biochemical stress hormones to evaluate athlete response to
recovery, workload, and training and competition stress (Edwards et al., 2018a). Whilst previous studies have
established an association between salivary cortisol and subsequent competition performance variables in
netball (Russell et al., 2021), triathlon (Balthazar et al., 2012), rugby union (Crewther, Potts, et al., 2018),
soccer (Springham et al., 2022) and athletics (Balsalobre-Fernández et al., 2014; Siart et al., 2017), the
application of cortisol as a marker to ascertain a change in performance remains ambiguous (Greenham et
al., 2018). Similarly, and in keeping with the findings from this review, the majority of research in ARF
(Buchheit et al., 2013; Cormack et al., 2008), soccer (Casanova et al., 2020; Peñailillo et al., 2015), rugby
league (Crewther et al., 2013; McLellan et al., 2010), rugby union (Crewther et al., 2009; Gaviglio et al., 2014;
Tiernan et al., 2020), track and field (Balsalobre-Fernández et al., 2014; Guilhem et al., 2015), swimming
(Díaz et al., 2013), hockey (Brown et al., 2021), and powerlifting (Le Panse et al., 2010) athletes, found no
association between salivary cortisol and various measures of athletic performance.
It has been postulated salivary cortisol is not sensitive to total volume and lower intensity performance
measures (i.e., total distance) in professional soccer (Peñailillo et al., 2015), offering a potential explanation
for the non-significant correlation found in this review. This suggests the use of salivary cortisol may be best
utilised as a readiness marker to predict higher intensity performance measures which evoke a greater stress
response. Whilst this relationship requires further investigation to be validated, this hypothesis is supported
by studies in elite netball (Russell et al., 2021) and soccer (Springham et al., 2022) athletes which found pre-
competition salivary cortisol to be significantly, positively associated with subsequent “higher intensity”
change of direction and high-speed running measures, respectively.
A consequence of intense training and competition stress commonly induces an inflammatory response in
the body, often presenting as swelling and muscle soreness, and results in decreased muscle function and
the leakage of muscle protein such as CRP (Chatzinikolaou et al., 2010; Hirose et al., 2004). Given its link to
acute inflammation, CRP is considered an important measure to provide information regarding the severity
of the trauma or injury precipitating the inflammatory processes (Coppalle et al., 2019; Joao R Silva et al.,
2013). Yet the validity of pre-training or competition CRP as an indicator of performance in elite athletes has
not been widely investigated outside of soccer and rugby union, with few significant correlations between
blood CRP and ensuing athletic performance (Coppalle et al., 2019; Dubois et al., 2020; Saidi et al., 2022;
Silva et al., 2022).
The non-significant correlation found in this review between blood CRP and chronic, competition load is
potentially explained by the passage of time between the assessment of CRP relative to the competition load.

It has been established that CRP returns to baseline levels in elite team-sport athletes within two days
following competition (37 hours) (Souglis et al., 2015). Therefore, unless the recovery period between the
preceding competition / training stimulus and the subsequent activity is appropriate (i.e., less than 37 hours),
then it is conceivable a pre-competition measure of CRP has no relationship to competition load. Whilst future
research should look to investigate this relationship further, practitioners should apply caution when using
CRP as a marker of readiness more generally, but particularly in circumstances when the duration of recovery
between training or competition is insufficient to allow the homeostatic restoration of inflammation (less than
37 hours).
Squat jump
This review highlights the relative lack of research in the application of squat jump variables to homogenous
performance measures. Whilst 20 studies evaluated squat jump variables in the context of a subsequent
measure of athletic performance (Table 1), only three studies assessed jump height from squat jump using
an analogous study design and performance measure. These studies were meta-analysed using a
standardised, acute, and cross-sectional squat jump protocol, in which participants kept their hands on their
hips throughout the jump. Despite the level of standardisation, no significant correlation was observed
between jump height and 10 m sprint speed and time (Figure 4).
This finding provides mixed support for previous studies assessing the relationship between jump height from
SJ and subsequent athletic performance. The current finding complements an existing body of literature
which found no association between SJ jump height and various training and competition performance
outcomes in elite karate (Loturco et al., 2014), basketball (Pojskic et al., 2018), surfing (Secomb, Farley, et
al., 2015), soccer (Gonçalves et al., 2021; Saidi et al., 2020; Saidi et al., 2022; Saidi et al., 2019; Stanković
et al., 2022), cross-country skiing (Carlsson et al., 2012), and track and field (Loturco et al., 2019) athletes.
Conversely, studies have found a positive correlation between jump height from squat jump and performance
outcomes in elite track and field (Loturco, Pereira, et al., 2015; Loturco et al., 2019), basketball (Pojskic et
al., 2018), handball (Moncef et al., 2012), soccer (Emmonds et al., 2019; Gonçalves et al., 2021; Marcote-
Pequeño et al., 2019; Stanković et al., 2022), surfing (Secomb, Lundgren, et al., 2015), and volleyball (Berriel
et al., 2021) athletes. Clearly, the current finding contributes to the ambiguity around the sensitivity of SJ
jump height to predict athletic performance, whilst also inadvertently supporting the suggestion alternate SJ
variables of mean force, mean power and relative mean power should be preferred, as they exhibit
acceptable reliability and sensitivity (Edwards et al., 2018b).
Interestingly, the current finding is also in contrast with an earlier finding of this review for CMJ jump height,
despite an identical, standardised testing protocol and performance measure. Whilst both findings were
affected by statistical heterogeneity, the contrasting findings are possibly explained by several other factors.
Firstly, the use of different technologies to measure jump height (i.e., contact mat or force platform), as well
as the sensitivity of the inherent physiological and biomechanical differences of each jump (Van Hooren &
Zolotarjova, 2017), particularly the performance enhancing effect of the stretch-shortening cycle from the
countermovement (McGuigan et al., 2006). Further, the smaller sample of studies used to meta-analyse the
association between jump height from SJ and the performance outcome, is also a likely contributing factor.
While squat jump assessment more broadly is considered a simple, practical, valid and reliable tool for
measuring neuromuscular function (R. J. Gathercole et al., 2015) and explosive power output from the lower
limbs (Markovic et al., 2004), the current finding suggests practitioners should exhibit caution when using SJ
jump height as a monitoring tool of the lower limbs to predict acceleration and power performance in elite
athletes.
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Sub-Maximal Exercise Heart Rate

This review found 11 studies which evaluated the use of sub-maximal exercise heart rate to forecast athletic
performance (Table 1). Three studies were meta-analysed, which found no association between the acute,
longitudinal assessment of sub-maximal exercise heart rate and greater Yo-Yo IR1 performance (Figure 5).
This finding is inconsistent with previous cross-sectional assessments in studies investigating sub-maximal
heart rate, which found significant correlations with Yo-Yo IR1 (Ingebrigtsen et al., 2014) and Yo-Yo IR2
performance (Ingebrigtsen et al., 2014; Veugelers et al., 2016). This inconsistency in findings may be
attributable to the sensitivity of sub-maximal heart rate assessment to the type of study design (longitudinal
or cross-sectional assessment). This explanation would appear consistent with the likelihood of longitudinal
assessment of sub-maximal exercise heart rate being accentuated and influenced by day-to-day variability
in heart rate and environmental factors (Juul & Jeukendrup, 2003). Previous studies have also found the
assessment of other maximal aerobic performance measures such as total competition and training distance,
to have small to large correlations with sub-maximal heart rate (Buchheit et al., 2013; Rago et al., 2020).
Ultimately, this suggests sub-maximal heart rate may also be sensitive to various measures of athletic
performance.
Heart rate assessment at a fixed, sub-maximal intensity is commonly used as an indicator of training status
in elite athletic populations and is a valid and reliable tool to assess Yo-Yo IR2 performance in elite Australian
rules football players (Veugelers et al., 2016). This review’s non-significant finding emphasises the need for
practitioners to ensure their sub-maximal exercise heart rate assessment protocol is sensitive to their specific
performance outcome. The contrasting finding from this review with previous studies (Ingebrigtsen et al.,
2014; Veugelers et al., 2016), cautions the use of a longitudinal assessment of sub-maximal heart rate to
predict an elite athlete’s capacity to perform intense, intermittent exercise assessed by Yo-Yo IR1
performance (Bangsbo et al., 2008). This adds further support to the existing literature that a cross-sectional
assessment of sub-maximal heart should perhaps be preferred as a measure of training status in elite
athletes to predict maximal aerobic capacity.
Heart Rate Variability

Of the 14 studies which assessed pre-training and competition HRV, eight studies implementing a longitudinal
study design were meta-analysed across two different performance outcomes (Table 1; Figure 6). This review
found an acute, pre-training and competition HRV assessment of pooled RMSSD and SD1, and RMSSD
measures separately, were not correlated with subsequent Yo-Yo IR1 distance and competition load
quantified by sRPE (Figure 6).
The use of HRV assessment as a non-invasive measure of autonomic nervous system status in response to
training and competition stress is common practice in elite sport (Plews et al., 2014). The current application
and interpretation in the literature of HRV assessment as a readiness marker offers mixed support for the
findings of this review, particularly in studies with an acute, longitudinal study design. In support of this
review’s findings, a previous study in elite male futsal players using a similar performance measure in Yo-Yo
IR2 distance, also failed to find a statistically significant correlation with resting HRV (de Freitas et al., 2015).
Similarly, other studies assessing the correlation between HRV, and training and match derived physical
output data in elite male Gaelic football and female soccer players, were unable to find significant
associations (Costa et al., 2019; Malone et al., 2017). However, some studies found statistically significant
correlations between resting HRV assessment and physical output data from training (Thorpe et al., 2015)
and Cooper 12-minute run test performance (Morales et al., 2019) in elite soccer athletes. It has been
suggested such ambiguous findings in the literature may be attributable to methodological inaccuracies due

to the large variation in day-to-day HRV measurements (Plews et al., 2014), offering a potential explanation
for the contrast in findings between this review and existing research.
The assessment of HRV can be influenced by a myriad of complex environmental, lifestyle, physiological,
neuropsychological and non-modifiable (i.e., gender and age) factors (Fatisson et al., 2016). The confounding
influences on HRV assessment potentially explains the non-significant findings from this review and
highlights the importance of ensuring standardised HRV measurements, despite the inherent difficulties of
doing so in a team sport setting. However, the findings from a previous review found vagal-related HRV
indices increased in response to positive training adaptations which is suggestive of HRV being a sensitive
marker of readiness, albeit in the absence of a standardised performance outcome (Bellenger et al., 2016).
Therefore, the application of this review’s findings for practitioners cautions the use of resting, pre-training
HRV assessment as a sensitive marker of readiness in predicting aerobic capacity in elite athletes,
specifically for Yo-Yo IR1 performance and subjective competition load.
Limitations
Evidenced by the volume of studies included in this review and summarised in Table 1, this review is limited
by the amount of data which could be extracted from eligible studies, particularly those included in the meta-
analysis. The lack of standardisation in the application of markers and tests of athletic readiness, and the
outcome correlation, to common and consistent performance measures in the included studies, limited the
depth of findings and analysis in this review. However, it is acknowledged the application of markers and
tests of readiness to assess athletic performance is largely determined by the contextual physiological and
psychological requirements of the sport. As such, the assessment and application of various readiness
markers and tests with consistent and standardised performance measures may not be appropriate in
practice.
This review acknowledged the methodological differences and variations in the application of various
measures of readiness, particularly the assessment of HRV and sub-maximal exercise heart rate (Plews et
al., 2014). These inconsistencies potentially limit the generalisability of this review’s findings, particularly
given the known sensitivities associated with the markers and tests of readiness identified in this review.
Whilst the strict standardisation of studies eligible for inclusion in the meta-analysis intended to account for
this limitation, this confounder ultimately reduced the number of studies eligible to be meta-analysed.
CONCLUSIONS
This review sought to investigate the validity of tests and markers of athletic readiness to predict subsequent
athletic performance in elite athletes. In examining this relationship, 20 athletic readiness markers and tests
were identified, with the requisite level of data from five readiness measures meta-analysed. The most
common measures employed to assess athletic readiness in elite athletes includes the assessment of
biomarkers, CMJ testing and the use of subjective wellness questionnaires.
The most significant finding from this review is the validation of the use of jump height from CMJ (without arm
swing) to predict power and acceleration qualities in elite team and individual sport athletes, where explosive
leg muscle function is an integral physical requirement of the sport. However, there was no significant
relationship between additional measures of readiness, in the form of salivary cortisol and blood CRP
biomarkers, SJ, sub-maximal exercise heart rate, indices of HRV, and subsequent athletic performance. It is
suggested, when implementing these readiness measures as part of an athlete monitoring system, that
practitioners ensure their validity with the relevant performance outcome(s).
VOLUME 2 | ISSUE 3 | 2023 | 363

It is postulated this review’s non-significant findings are explained by the sensitivity of different study designs,
the application of different performance measures, and the methodological differences in the assessment of
the various tests and markers used to assess athletic readiness. Whilst this review has somewhat contributed
to the ambiguity in the literature, and uncovered conflicting findings in the current evidence, the findings
highlight the sensitivities of the inter and intra-individual variations between athletes which likely influences
the validity of some measures identified in this review. However, further research into, and standardisation
of, these markers and tests of readiness is required to ensure their sensitivity and validity to contextualised
measures of subsequent athletic performance in elite team and individual sport athletes.
AUTHOR CONTRIBUTIONS
SJJ designed and conceptualised the research question and method of analysis, conducted the systematic
search, screened all articles, extracted and analysed the data, and prepared the manuscript. PCB designed
and conceptualised the research question and method of analysis, assisted with the analysis and
interpretation of data, and substantively revised the manuscript. DJB designed and conceptualised the
research question and method of analysis, assisted with the analysis and interpretation of data, and
substantively revised the manuscript. GKB screened all articles and confirmed the data extraction and risk of
bias assessment of the lead author. CRB designed and conceptualised the research question and method
of analysis, assisted with the analysis and interpretation of data, and substantively revised the manuscript.
All authors read and approved the final manuscript.
SUPPORTING AGENCIES
No funding agencies were reported by the authors.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the authors.
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APPENDIX
Supplementary Table 1. Systematic review master search strategy.
1. Athletes/ and (high perform* or professional* or olympic or Olympian* or competit* or elite) OR ((high
perform* or professional* or olympic or Olympian* or competit* or elite) and (sportspe* or sportswo* or
sportsm* or athlete* or player*))
AND
2. gait/ OR gait analysis/ OR gait OR Biomarkers/ OR Lactic Acid/ OR Urea/ OR Creatine Kinase/ OR
Norepinephrine/ OR Catecholamines/ OR Epinephrine/ OR Cytokines/ OR Immunoglobulin/ OR alpha-
Amylases/ OR Glutamine/ OR Testosterone/ OR Hydrocortisone/ OR lymphocyte count/ OR Neutrophils/ OR
Hormones/ OR (biomarker* or bio marker* or cortisol hormone* or endocrine* or lactic acid or creatine kinase
or CK or urea or norepinephrine or catecholamine* or epinephrine or cytokine* or biological marker* or
biochemical marker* or immunoglobulin or IgA or alpha-Amylase* or alpha Amylase* or physiological marker*
or immunoendocrine marker* or glutamine or glutamate or physiological measure* or testosterone or
hydrocortisone or lymphocyte count* or neutrophil* or hormone*) OR (countermovement jump or counter
movement jump or CMJ or vertical jump or run* pattern* or isometric midthigh pull or isometric mid-thigh pull
or isometric mid-thigh pull or ISMTP or flight time to contraction time or flight time to contraction ratio or FT:CT
or adductor strength assessment or eccentric hamstring strength assessment or adductor strength test or
hamstring strength test or hamstring strength assessment or groin squeeze strength test or groin squeeze
strength assessment) OR Heart Rate/ OR Sleep/ OR sleep hygiene/ OR (heart rate or heartrate or HR or
HRV or HRR or sleep or yo-yo intermittent recovery or yoyo intermittent recovery or submaximal heart rate
assessment or sub-maximal heart rate assessment or submaximal heart rate test or sub-maximal heart rate
test) OR Reaction Time/ OR ((reaction or response) adj (speed* or tim* or laten*)) OR (choice response or
rating of perceived exertion or RPE or perceptual wellness questionnaire* or perceived wellness or recovery
stress questionnaire* or recovery cue or athlete burnout questionnaire or athlete distress questionnaire or
daily analysis of life demands for athletes) OR Exercise Test/ OR (exercise test* or fitness test*)
AND
3. Fatigue/ OR Muscle Fatigue/ OR fatigue* OR Athletic Performance/ OR Psychomotor Performance/

OR (((athlete* or psychomotor or physical or fitness or competit*) adj2 Perform*) or training status) OR
recove* OR Physical Endurance/ OR Endurance Training/ OR Resistance Training/ OR Muscle Strength/ OR
(endurance or stamina or overtraining or over training or over reach* or overreach* or prepare* or readiness
or endurance training or resistance training or power training or strength training or motor learning training or
muscle strength).

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Assessing athlete readiness using physical, physiological, and

perceptual markers: A systematic review and meta-analysis

Cite this article as:

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MATERIAL AND METHODS

2. Tests and / or markers of athletic readiness

3. Physical measures of athletic performance

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Risk of bias assessment

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Note. n number of studies.

Figure 1. Literature search flow chart.

Table 1. Summary of studies included in the qualitative synthesis.

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Maior et al., M: 20 Soccer Longitudinal Biomarker (blood CK) Competition Acute

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Solana-Tramunt F: 12 Synchronised Longitudinal HRV (lnRMSSD) Training Acute

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Marcote- F: 19 Soccer Cross- Squat Jump (jump height) Training Acute

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Reason for exclusion

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Sub-Maximal Exercise Heart Rate

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Heart Rate Variability

Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient.

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Note. CI confidence interval, n number of studies, r Pearson product-moment correlation coefficient.

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Sub-Maximal Exercise Heart Rate

Heart Rate Variability

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No funding agencies were reported by the authors.

No potential conflict of interest was reported by the authors.

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International Journal of Environmental Research and Public Health, 20(2), 1539.

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level competitive match. European journal of applied physiology, 113(9), 2193-2201.

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