REF-1635 · Meigh et al., 2019 · BMC Sports Science, Medicine and Rehabilitation, · Paper · PubMed

The kettlebell evidence is thin: a scoping review of 99 publications up to February 2019 found effects typically trivial to small, few longitudinal studies and most of them underpowered and of low methodological quality, confidence in the reported effects low to very low, and only a weak recommendation that kettlebell training improves physical function

Main caveat: A scoping review: no pooled estimate, and single-reviewer screening and extraction can miss studies or misread data.
limited, mixed evidenceMeasured on non-athletes to trained athletesRead from the abstract only

Meigh and colleagues mapped the scientific literature on kettlebell training to see what evidence exists to guide its use in primary care, where no guidelines exist.

Following the PRISMA-ScR checklist they searched 10 databases from inception to 1 February 2019; one reviewer screened and extracted, studies were charted by theme and synthesised narratively, effect sizes from longitudinal studies were taken or calculated, and two reviewers appraised the randomised trials with a modified Downs & Black checklist.

Of 829 records, 99 publications were included. Effect sizes were typically trivial to small. Only one trial used a pragmatic hardstyle programme in healthy college-age people and two tested kettlebell training in clinical conditions.

The authors conclude that the few longitudinal studies, mostly underpowered and of low methodological quality, give therapists little guidance; confidence in the reported effects is low to very low, and the recommendation that kettlebell training improves physical function is weak.

Participants

Not pooled; the abstract gives no participant totals or training status.
Of the 99 publications: one pragmatic hardstyle trial in healthy college-age participants; two trials in clinical conditions; 33 studies that explicitly used hardstyle technique; 4 on kettlebell sport; 6 reviews; 22 clinical or expert opinions; 3 case reports of injury.

Methods

PRISMA-ScR; 10 electronic databases from inception to 1 February 2019, with no exclusions in the search.
One reviewer screened records and extracted data; publications were grouped and charted by concepts relevant to primary care and synthesised narratively.
Effect sizes from longitudinal studies were identified or calculated; randomised trials were appraised independently by two reviewers with a modified Downs & Black checklist.
Flow: 829 records identified, 496 screened, 170 assessed for eligibility, 99 included.

Key Results

Effect sizes in the longitudinal studies were typically trivial to small.
The longitudinal studies were few, largely underpowered and of low methodological quality.
Confidence in reported effects: low to very low.
Strength of recommendation that kettlebell training improves measures of physical function: weak.
Gaps named by the authors: clinical populations, musculoskeletal conditions common in primary care, and a standardised, externally valid way to train and test kettlebell interventions.
Competing interest (PubMed record): the first author is a physiotherapist and hardstyle kettlebell instructor who has promoted kettlebells in clinical practice and runs an online presence as a kettlebell physiotherapist; the conclusions are cautious despite that interest (our reading).

Practical Application

Treat kettlebells as a practical tool, not as proven equal to barbell training. Up to 2019 the effects measured were typically trivial to small and came from a few small, low-quality studies; the authors rate the recommendation that kettlebell training improves physical function as weak.
Inference, not tested here: with only kettlebells at home, the general strength rules (enough load, sets near failure, steady progression) are what carry results; when the bell is light, more reps per set or a heavier bell are the levers (SYNTH-105, SYNTH-101).
One head-to-head trial in the base points the same way: over 6 weeks, barbell lifting raised back-squat strength more than kettlebell training, with jump height similar (REF-1636).
Not settled by this review: whether kettlebell work transfers to running or cycling performance, how it compares with other home options, and its injury risk (only three case reports of injury).

Limitations

A scoping review: no pooled estimate, and single-reviewer screening and extraction can miss studies or misread data.
The search ends in February 2019; later trials are not covered.
Participant numbers, populations and outcomes per study are not in the abstract.
Mixed inclusions (trials, reviews, expert opinions, case reports) are counted together in the 99.
Written from the abstract and the PubMed record; full text not read.
How this entry was checked and changed
Why this level

a scoping review with a systematic search but no pooled estimate, screened and charted by a single reviewer; by its own appraisal the longitudinal studies it maps are largely underpowered and of low quality, with confidence in their effects low to very low

Content correction 2026-11-07
2026-11-07: added from the abstract and the PubMed record; level B- (scoping review without pooling, single-reviewer screening, low-quality underlying studies by its own appraisal).