Training methods for maximal static apnea performance: a systematic review and meta-analysis.

INTRODUCTION:Currently, there is an increase in people practicing freediving (FD) both in competition and leisure. As a sports practice, its modalities are grouped into static, dynamic, and constant weight apnea. The aim of this systematic review and meta-analysis (PROSPERO-CRD42021230322) was to identify the training methods used to improve the static apnea time (AT) performance. EVIDENCE ACQUISITION:Ten training protocols were analyzed from eight studies published until March 09, 2022. The effect size (Hedge's g) and its confidence interval (CI95%) were calculated from the AT measured pre- and post-training. EVIDENCE SYNTHESIS:Three different apnea training methods were verified, the breath-hold (BH) that uses BH exercises, physical training with strength and cardiorespiratory exercises, and cross training that combines BH exercises with physical training. These training methods were applied to 138 participants of both sexes with or without experience in apnea episode or diving practice. In general, the AT improvement showed a large effect after the interventions (g=1.30, CI95%=0.85-1.76, P<0.01). CONCLUSIONS:All three methods were effective in improving static AT, however from the existing protocols is not possible to recommend an ideal to improve AT and therefore FD performance.