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Table 3 Methodological quality and risk of bias assessment of the included studies

From: Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults

Study Methodological quality Risk of bias
Internal validity Statistical validity External validity Total score [%] Sequence Allocation Blinding Outcome Report Other
1.1 a 1.2 a 1.3 a 1.4 a 2.1A b 2.1B b 2.1C b 2.1D b 2.1E b 2.1F b 2.1G b 2.2A b 2.2B b 3A b 3B b Score [%] 4 a 5 a Score [%] 6.1 a 6.2 a 7A b 7B b 7C b 7D b 7E b 7F b 8A b 8B b 8C b 8D b 8E b Score [%]       
Albracht et al., 2013 [15] + - - + - + + + - + - / / - + 51 + - 50 + + + + + + + + - + + + + 95 65 Unclear Unclear Unclear Yes Yes Yes
Arampatzis et al., 2007 [29] + + + + - + + + - + - + + + - 87 + - 50 + + + + + + + + + + + + - 95 77 Unclear Unclear Unclear Yes Yes Yes
Arampatzis et al., 2010 [28] + + + - - + + + - + - + + + - 72 + - 50 + + + + + + + + + + + + - 95 72 Unclear’ Unclear’ Unclear Yes Yes Yes
Bohm et al. [31] + + + + - + + + + + + + + + + 98 + + 100 + + + + + + + + + + + + + 100 99 Unclear Unclear Unclear Yes Yes Yes
Carroll et al., 2011 [61] + + + - + - - - - + + + + - + 70 + - 50 + + + - + + + + + + + + + 96 72 Unclear’ Unclear’ Yes Yes Yes Yes
Fletcher et al., 2010 [17] + - - + - + + - + + - / / + + 60 + - 50 + + + + + + + + + + + + + 100 70 Unclear Unclear Unclear Yes Yes Yes
Fouré et al., 2009 [71] + - - + - + - - - - - / / + + 46 + - 50 + + - - + - + + + + + + + 88 61 Unclear Unclear Unclear Unclear Yes Yes
Foure et al., 2010a,b, 2011 [38,56,57] + - + + - + - - - + - - + + + 63 + - 50 + + - - + - + + + + + + + 88 67 Unclear Unclear Unclear Yes Yes Yes
Foure et al., 2013 [43] + - + + - + - - - + - - + + + 63 + - 50 + + - - + - + + + + + + + 88 67 Unclear Unclear Unclear Yes Yes Yes
Hansen et al., 2003 [62] + - + - - - - + + + - + + - + 56 + - 50 + + - + + + + + + + + + + 96 67 Unclear’ Unclear’ Unclear Yes Yes Yes
Hougthon et al., 2013 [39] + + + + - + + + + + - - + + + 84 + + 100 + + - - + + + + + + + + + 92 92 Unclear Unclear Unclear Yes Yes Unclear+
Kongsgaard et al., 2007 [24] + + + - + + - + - + - + + + + 74 + - 50 + + + - + + + + + + + + + 96 73 Unclear’ Unclear’ Yes Yes Yes Yes
Kubo et al., 2001a,b [37,42] + + + - - - - - - - + + - + + 66 + - 50 + + + + + + + + + + + + + 100 72 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2002 [25] + - + - - - - - - - + + - + + 52 + - 50 + + + - + + + + + + + + + 96 66 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2003 [63] + + + + - - - - - - + / / + + 86 + - 50 + + + - + + + + + + + + + 96 77 Unclear Unclear Unclear Yes Yes Yes
Kubo et al., 2006a [40] + - + - - - - + - + + + - + - 49 + - 50 + + + + + + + + + + + + - 95 65 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2006b [87] + - + + + - - + - + + + + + + 80 + - 50 + + + + + + + + + + + + + 100 77 Unclear Unclear Unclear Yes Yes Yes
Kubo et al., 2006c [88] + - + - + - - + - + - + + + - 56 + - 50 + + + + + + + + + + + + - 95 67 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2007 [59] + - + - - - - + - + + + - + + 56 + - 50 + + + + + + + + + + + + + 100 69 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2009 [60] + - + - + - - + - + - + + + - 56 + - 50 + + + + + + + + + + + + - 95 67 Unclear’ Unclear’ Unclear Yes Yes Yes
Kubo et al., 2010 [52] + - + + - - - + - + + + + + + 78 + - 50 + + + + + + + + + + + + + 100 76 Unclear Unclear Unclear Yes Yes Yes
Kubo et al., 2012 [72] + - + + - - - + - + + + + + - 70 + - 50 + + + + + + + + + + + + + 100 73 Unclear Unclear Unclear Yes Yes Yes
Malliaras et al., 2013 [41] + + + + + - - + - + + - - + + 80 + - 50 + + + + + + + + + + + + + 100 77 Unclear Yes Yes Yes Yes Yes
Seynnes et al., 2009 [30] + + + - + - - + + - - + + + + 78 + - 50 + + + - + + + + + + + + + 96 74 Unclear’ Unclear’ Unclear Yes Yes Yes
  1. Methodological quality: 1 Study design (1.1 Mechanical properties, 1.2 Material properties, 1.3 Morphological properties, 1.4 Control group), 2 Methods (2.1 Mechanical properties, 2.1A Object of investigation, 2.1B Gravitational forces, 2.1C Axes misalignment, 2.1D Antagonistic muscle activation, 2.1E Lever arm measured, 2.1F Joint angle change, 2.1G Used multiple trials, 2.2 Morphological properties, 2.2A MRI, 2.2B different positions), 3 Cofactors (3A Gender, 3B Activity level), 4 Statistical tests, 5 Power analysis, 6 Eligibility (6.1 Participants, 6.2 Variables), 7 Description exercise protocol (7A Intensity, 7B Duration single stimulus, 7C Repetitions, 7D Sets, 7E Weeks, 7F Times per week), 8 Description participants (8A Gender, 8B Age, 8C Body height, 8D Body weight, 8E Activity level). The single criteria were rated (+, point; -, no point; /, not included) and used to calculate the quality score for each category (i.e., internal, statistical, and external validity). The average of the three scores gives the total score. aA full point was assigned to each sub-category for the calculation of the score in the respective validity section (assigned points/possible points * 100). bThe sub-categories of the respective block were pooled to a single point (assigned points/possible points). Risk of bias [46]: Sequence, adequate sequence generation; Allocation, allocation concealment; Blinding, blinding outcome assessor; Outcome, incomplete outcome data; Report, selective outcome reporting; Other, other sources of bias. Judgments: Yes, low risk of bias; Unclear, insufficient information reported (’, only one group; +, significant difference of baseline tendon cross-sectional area values between the control and training group). The three studies of Foure et al. [38,56,57] and the two studies of Kubo et al. [37,42] were merged as one, since the results of one intervention were reported in different publications.