Exercise selection can significantly impact training adaptations and subsequent sport performance. Hence, understanding the utility of certain exercises is crucial in the design of comprehensive strength and conditioning programs. The purpose of this review was to investigate the effects that unilateral and bilateral exercises have on physical and athletic performance. A search of the PubMed and Google Scholar databases was conducted for all time periods up to May 2020. Fifteen original investigations met the search criteria and were included in this review. It was found that bilateral and unilateral exercises are both capable of improving physical and athletic performance. Isotonic strength, power and jumping ability seem to increase similarly in response to bilateral and unilateral training, however, adaptations tend to comply with the principle of specificity such that bilateral exercises increase bilateral performance to a greater extent than unilateral exercises, and vice versa. Bilateral isometric strength also increases similarly in response to unilateral and bilateral exercises, although unilateral training likely induces greater unilateral isometric strength gains. Likewise, bilateral exercises have less of a transference effect to unilateral jumping ability than unilateral exercises have to bilateral jumping. Furthermore, hypertrophy and sprinting performance increase similarly in response to bilateral and unilateral exercises. Finally, while change of direction performance has been demonstrated to increase with both training modalities, the differential effects of unilateral and bilateral exercises are uncertain due to methodological limitations. For most athletes, coaches should consider incorporating a combination of bilateral and unilateral exercises in the training program. Moreover, specific consideration should be given to how these exercises target the underlying neuromuscular requirements of athletic skills, as opposed to their superficial resemblance to athletic movements.
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