Sports Medicine

, Volume 45, Issue 9, pp 1285–1294 | Cite as

Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses

  • Charlotte Lanhers
  • Bruno Pereira
  • Geraldine Naughton
  • Marion Trousselard
  • François-Xavier Lesage
  • Frédéric DutheilEmail author
Systematic Review



Creatine is the most widely used supplementation to increase strength performance. However, the few meta-analyses are more than 10 years old and suffer from inclusion bias such as the absence of randomization and placebo, the diversity of the inclusion criteria (aerobic/endurance, anaerobic/strength), no evaluation on specific muscles or group of muscles, and the considerable amount of conflicting results within the last decade.


The objective of this systematic review was to evaluate meta-analyzed effects of creatine supplementation on lower limb strength performance.


We conducted a systematic review and meta-analyses of all randomized controlled trials comparing creatine supplementation with a placebo, with strength performance of the lower limbs measured in exercises lasting less than 3 min. The search strategy used the keywords “creatine supplementation” and “performance”. Dependent variables were creatine loading, total dose, duration, the time-intervals between baseline (T0) and the end of the supplementation (T1), as well as any training during supplementation. Independent variables were age, sex, and level of physical activity at baseline. We conducted meta-analyses at T1, and on changes between T0 and T1. Each meta-analysis was stratified within lower limb muscle groups and exercise tests.


We included 60 studies (646 individuals in the creatine supplementation group and 651 controls). At T1, the effect size (ES) among stratification for squat and leg press were, respectively, 0.336 (95 % CI 0.047–0.625, p = 0.023) and 0.297 (95 % CI 0.098–0.496, p = 0.003). Overall quadriceps ES was 0.266 (95 % CI 0.150–0.381, p < 0.001). Global lower limb ES was 0.235 (95 % CI 0.125–0.346, p < 0.001). Meta-analysis on changes between T0 and T1 gave similar results. The meta-regression showed no links with characteristics of population or of supplementation, demonstrating the creatine efficacy effects, independent of all listed conditions.


Creatine supplementation is effective in lower limb strength performance for exercise with a duration of less than 3 min, independent of population characteristic, training protocols, and supplementary doses and duration.


Creatine Resistance Training Creatine Supplementation Strength Performance Creatine Monohydrate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Frédéric Dutheil contributed to the conception and design. Charlotte Lanhers conducted all literature searches and collated the abstracts. Charlotte Lanhers and Frédéric Dutheil separately reviewed the abstracts and, based on the selection criteria, decided the suitability of the articles for inclusion. All authors then reviewed the eligible articles. Bruno Pereira performed the statistical analysis. Charlotte Lanhers drafted the manuscript. Frédéric Dutheil and Geraldine Naughton revised the manuscript. All authors read and approved the final manuscript. The authors declare no conflict of interest. No sources of funding were used to assist in the preparation of this systematic review.

Supplementary material

40279_2015_337_MOESM1_ESM.docx (4.6 mb)
Supplementary material 1 (DOCX 4745 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Charlotte Lanhers
    • 2
  • Bruno Pereira
    • 3
  • Geraldine Naughton
    • 1
  • Marion Trousselard
    • 4
  • François-Xavier Lesage
    • 5
  • Frédéric Dutheil
    • 1
    • 2
    • 6
    • 7
    Email author
  1. 1.School of Exercise Science, Australian Catholic UniversityMelbourneAustralia
  2. 2.Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU)Clermont-FerrandFrance
  3. 3.Clinical research and innovation direction, University Hospital of Clermont-Ferrand (CHU)Clermont-FerrandFrance
  4. 4.Neurophysiology of stress, Armies’ Biomedical Research Institute, Armies’ Health ServiceBretigny sur OrgeFrance
  5. 5.Occupational Medicine, University Hospital CHUMontpellierFrance
  6. 6.Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533Blaise Pascal UniversityClermont-FerrandFrance
  7. 7.Research Centre in Human Nutrition (CRNH) AuvergneClermont-FerrandFrance

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