Systematic Review of Single-Set Versus Multiple-Set Resistance-Training Randomized Controlled Trials: Implications for Rehabilitation

Purpose: This systematic review of randomized controlled trials (RCTs) comparing strength gains following single-set (SS) and multiple-set (MS) resistance-training protocols was performed to formulate therapeutic exercise recommendations. Methods: Systematic search of Cumulative Nursing and Allied Health Index (CINAHL) and MEDLINE databases for RCTs published between January 1980 and January 2003. Main Outcome Measures: Methodological quality scores based on 10 predetermined criteria, with 100% (10/10) indicating highest quality. Results: Quality scores of the 12 reviewed studies ranged from 50% (moderate quality) to 100% (high quality). Seven studies suggest that MS protocols are superior (MS > SS), and 5 suggest there is no difference in strength gains between SS and MS designs (MS = SS). Mean quality scores were 80.0% (high quality) for the pooled MS > SS studies and 70.0% (high quality) for the pooled MS = SS studies. Conclusions: The higher number of MS > SS studies and slightly higher quality of these pooled studies suggests that MS protocols are more effective for healthy individuals. None of these studies involved patients undergoing rehabilitation; thus, it remains to be seen if the inherently greater time, cost, and presumed injury risk with MS protocols is justified for therapeutic exercise.