The goal of this systematic review was to evaluate the effects of exercise programs using agility ladders and to assess the quality of available evidence. Search was conducted in October of 2019 using the following databases: Cochrane Library, PEDro, PubMed, Scopus and Web of Science. Study eligibility criteria included randomized trials or randomized controlled trials using agility ladders drills. Participants were healthy humans of any health status. The study appraisal and synthesis methods followed the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and a qualitative synthesis of the main results of each study were applied. Only five studies met our criteria, lasting between 4 and 8 weeks. Only two studies evaluated the effects of ladder drills on more than one dimension. Lack of description of the specific exercises that were used limits reproducibility of current studies. With one exception, the articles had low risk of bias for most domains. Despite the widespread popularity of agility ladder drills, research is scarce and problematic, with poorly described protocols and mostly unidimensional performance measures. Claims that agility ladders improve agility and other physical skills is premature, given the nature and quality of existing research.
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