Corticospinal effects and motor performance changes following resistance training in healthy adults: a systematic review and meta-analysis of transcranial magnetic stimulation.

BACKGROUND

Resistance training is widely utilized to enhance motor performance in healthy populations. Its effects arise not only from peripheral muscular adaptations but also from neuroplastic changes within the central nervous system. Transcranial magnetic stimulation enables noninvasive quantification of corticospinal excitability; however, existing evidence in apparently healthy adults lacks systematic synthesis.

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the effects of resistance training on corticospinal excitability and motor performance in healthy adults.

METHODS

Following the PRISMA 2020 guidelines, a comprehensive search was performed in Web of Science, PubMed, Embase, Cochrane Library, SPORTDiscus, Scopus, and China National Knowledge Infrastructure databases, with the cutoff date of February 27, 2026. Randomized trials were included if they involved healthy adults, with the experimental group receiving resistance training and the control group receiving sedentary activity or no exercise intervention. Data extraction and risk-of-bias assessment using the Cochrane tool were conducted independently by two researchers. Statistical analyses were performed using R software with a random-effects model to compute standardized mean differences (SMDs) with 95% confidence intervals (95% CI), accompanied by heterogeneity testing and publication bias evaluation.

RESULTS

Eleven studies encompassing 244 healthy adults were included. Meta-analysis demonstrated that resistance training significantly increased corticospinal excitability (SMD = 0.59, 95% CI [0.10, 1.08], p = 0.003; I² = 69.3%) and significantly improved motor performance (SMD = 0.40, 95% CI [0.02, 0.79], p = 0.04; I² = 64.8%). The included studies were of high methodological quality (mean Cochrane score 6.4), and funnel plots indicated a low risk of publication bias.

CONCLUSION

Resistance training significantly enhances corticospinal excitability and improves motor performance in healthy adults. These findings affirm resistance training as an effective modality for inducing central neural plasticity and furnish an evidence-based foundation for the development of precision training prescriptions. Future research should further elucidate the dose-response relationships between specific training parameters and neural adaptations.