Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and Bayesian network meta-analysis of randomised controlled trials
PubMed 37414459 · doi:10.1136/bjsports-2023-106807
What was done
A systematic review and Bayesian network meta-analysis of randomised controlled trials in healthy adults was conducted across six databases (MEDLINE, Embase, Emcare, SPORTDiscus, CINAHL, Web of Science) through February 2022. The review compared non-exercise control to 12 distinct resistance training prescriptions varying by load, sets, and weekly frequency. Interventions were ranked using surface under the cumulative ranking curve (SUCRA) metrics, and confidence was assessed with threshold analysis.
What was found
For muscle strength (178 studies, n = 5,097; 45% women), all resistance training prescriptions exceeded control, with loads >80% of 1-repetition maximum maximizing gains. Higher-load, multiset, thrice-weekly training was the highest-ranked prescription (standardised mean difference [SMD] 1.60, 95% credible interval [CrI] 1.38 to 1.82 vs control). For muscle hypertrophy (119 studies, n = 3,364; 47% women), all prescriptions comparably stimulated muscle growth, though multiset configurations ranked highest. Higher-load, multiset, twice-weekly training was the top-ranked hypertrophy condition (SMD 0.66, 95% CrI 0.47 to 0.85 vs control).
Why it matters
This large-scale comparative analysis confirms that heavy loads are necessary to maximize strength adaptations, whereas muscle hypertrophy is more flexible and can be similarly stimulated across different loading ranges as long as multiple sets are performed.
Limits
The analysis is restricted to healthy adults, so findings may not directly translate to clinical, frail, or rehabilitation populations. The abstract does not provide subgroup analyses regarding training status (untrained vs trained), individual exercise selection, proximity to muscular failure, or adherence and injury rates.
Cited by
- supports Performing whole-body resistance training 2 days per week is sufficient to achieve musculoskeletal maintenance and benefits.