The efficacy of complex training for enhancing change of direction ability: A systematic review and meta-analysis

While Complex Training (CT) is widely used to improve Change of Direction (COD) ability, its comparative efficacy against its constituent components—resistance training (RT) and plyometric training (PT)—remains contested. This systematic review and meta-analysis aimed to quantify the effects of CT on COD performance compared to active control groups (ACGs), RT alone, and PT alone. Methods Following PRISMA guidelines, six electronic databases were searched from their inception to July 15, 2025. Randomized and non-randomized controlled trials with a duration of at least four weeks were included if they compared a CT intervention to an ACG, RT, or PT group in healthy individuals. A random-effects model was used to calculate Hedges's g effect sizes (ES), and pre-specified moderator analyses were conducted. Results Forty-two studies involving 1385 participants met the inclusion criteria. CT demonstrated a moderate-to-large, significant superiority over ACGs (ES = 1.16, 95% CI [0.86, 1.45]) and a small-to-moderate but significant advantage over both RT (ES = 0.59, 95% CI [0.26, 0.93]) and PT (ES = 0.65, 95% CI [0.13, 1.16]). Subgroup analyses revealed that the benefits of CT were significantly moderated by competitive level ( p = 0.01), with trained/developmental (Tier 2) athletes showing greater improvements, and training duration ( p = 0.04), with interventions lasting seven weeks or longer yielding larger effects. Conclusion CT is a highly effective modality for enhancing COD performance, proving superior to its individual components and standard sport-specific training. For optimal results, practitioners should consider implementing CT programs for at least seven weeks, particularly with developmental-level athletes.