The effects of creatine supplementation combined with resistance training on regional measures of muscle hypertrophy: a systematic review with meta-analysis.
The purpose of this paper was to carry out a systematic review with meta-analysis of randomized controlled trials that examined the combined effects of resistance training (RT) and creatine supplementation on regional changes in muscle mass with direct imaging measures of hypertrophy. Moreover, we performed regression analyses to determine the potential influence of covariates. We included trials of at least 6 weeks in duration that examined the combined effects of creatine supplementation and RT on site-specific direct measures of hypertrophy (magnetic resonance imaging [MRI], computed tomography [CT] or ultrasound) in healthy adults. A total of 44 outcomes were analyzed across 10 studies that met inclusion criteria. Univariate analysis of all standardized outcomes showed a pooled mean estimate of 0.11 (95% Credible Interval [CrI]: -0.02 to 0.25) providing evidence of a very small effect favoring creatine supplementation when combined with RT, compared to RT and placebo. Multivariate analyses found similar small benefits for the combination of creatine supplementation and RT on changes in upper and lower body muscle thickness (0.10-0.16 cm). Analyses of moderating effects indicated a small superior benefit for creatine supplementation on younger compared to older adults (0.17 [95% CrI: -0.09 to 0.45]). In conclusion, results suggest that creatine supplementation combined with RT promotes a small increase in direct measures of skeletal muscle hypertrophy in both the upper and lower body
