Effects of Resistance Training on Academic Outcomes in School-Aged Youth: A Systematic Review and Meta-Analysis

Abstract

Background
The primary aim of our systematic review and meta-analysis was to investigate the effect of resistance training on academic outcomes in school-aged youth.

Methods
We conducted a systematic search of six electronic databases (CINAHL Complete, PsycINFO, SCOPUS, Ovid MEDLINE, SPORTDiscus and EMBASE) with no date restrictions. Studies were eligible if they: (a) included school-aged youth (5–18 years), and (b) examined the effect of resistance training on academic outcomes (i.e., cognitive function, academic achievement, and/or on-task behaviour in the classroom). Risk of bias was assessed using the appropriate Cochrane Risk of Bias Tools, funnel plots and Egger’s regression asymmetry tests. A structural equation modelling approach was used to conduct the meta-analysis.

Results
Fifty-three studies were included in our systematic review. Participation in resistance training (ten studies with 53 effect sizes) had a small positive effect on the overall cognitive, academic and on-task behaviours in school-aged youth (standardized mean difference (SMD) 0.19, 95% confidence interval (CI) 0.05–0.32). Resistance training was more effective (SMD 0.26, 95% CI 0.10–0.42) than concurrent training, i.e., the combination of resistance training and aerobic training (SMD 0.11, 95% CI − 0.05–0.28). An additional 43 studies (including 211 effect sizes) examined the association between muscular fitness and cognition or academic achievement, also yielding a positive relationship (SMD 0.13, 95% CI 0.10–0.16).

Conclusion
This review provides preliminary evidence that resistance training may improve cognitive function, academic performance, and on-task behaviours in school-aged youth.

PROSPERO Registration
CRD42020175695.

Full text

Vol.:(0123456789)
Sports Medicine (2023) 53:2095–2109
https://doi.org/10.1007/s40279-023-01881-6
SYSTEMATIC REVIEW
Effects ofResistance Training onAcademic Outcomes inSchool‑Aged
Youth: ASystematic Review andMeta‑Analysis
KatieRobinson1,2· NicholasRiley1,2· KatherineOwen3· RyanDrew1,4· MyrtoF.Mavilidi5,6· CharlesH.Hillman7,8·
AveryD.Faigenbaum9· AntonioGarcia‑Hermoso10· DavidRevaldsLubans1,11
Accepted: 19 June 2023 / Published online: 19 July 2023
© The Author(s) 2023
Abstract
Background The primary aim of our systematic review and meta-analysis was to investigate the effect of resistance training
on academic outcomes in school-aged youth.
Methods We conducted a systematic search of six electronic databases (CINAHL Complete, PsycINFO, SCOPUS, Ovid
MEDLINE, SPORTDiscus and EMBASE) with no date restrictions. Studies were eligible if they: (a) included school-aged
youth (5–18years), and (b) examined the effect of resistance training on academic outcomes (i.e., cognitive function, aca-
demic achievement, and/or on-task behaviour in the classroom). Risk of bias was assessed using the appropriate Cochrane
Risk of Bias Tools, funnel plots and Egger’s regression asymmetry tests. A structural equation modelling approach was used
to conduct the meta-analysis.
Results Fifty-three studies were included in our systematic review. Participation in resistance training (ten studies with
53 effect sizes) had a small positive effect on the overall cognitive, academic and on-task behaviours in school-aged youth
(standardized mean difference (SMD) 0.19, 95% confidence interval (CI) 0.05–0.32). Resistance training was more effective
(SMD 0.26, 95% CI 0.10–0.42) than concurrent training, i.e., the combination of resistance training and aerobic training
(SMD 0.11, 95% CI − 0.05–0.28). An additional 43 studies (including 211 effect sizes) examined the association between
muscular fitness and cognition or academic achievement, also yielding a positive relationship (SMD 0.13, 95% CI 0.10–0.16).
Conclusion This review provides preliminary evidence that resistance training may improve cognitive function, academic
performance, and on-task behaviours in school-aged youth.
PROSPERO Registration CRD42020175695.
Key Points
Resistance training interventions had a small positive
effect on the combined outcomes of cognition, academic
achievement, and on-task behaviour in school-aged
youth.
Resistance training was more effective than concurrent
training.
Higher levels of muscular fitness were associated with
greater performance in tests of cognition and academic
achievement in school-aged youth.
1 Introduction
International guidelines recommend children and adoles-
cents participate in an average of 60min of moderate to
vigorous physical activity each day [1]. Further, it is advised
that young people engage in muscle-strengthening activities
at least 3days per week [1, 2]. Resistance training is a spe-
cialized form of muscle strengthening activity designed to
enhance muscular strength, local muscular endurance, and
muscular power (hereafter the combined terms are referred
to as muscular fitness) [3]. It involves the use of different
modes of training with a variety of resistance loads, includ-
ing but not limited to body weight, free weights, elastic
bands, medicine balls, and kettlebells.
The benefits of resistance training for young people’s
health and sport performance are well established: for exam-
ple, resistance training can enhance performance through
increased muscular fitness and positively contribute to
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2096 K.Robinson et al.
improvements in motor skill performance, speed and power
[3]. Adequate muscular fitness can also reduce the risk of
injury and assist in rehabilitation [3]. In addition, health
benefits such as improved cardiovascular fitness and body
composition provide strong evidence for the promotion of
resistance training for school-aged youth [3]. Global self-
esteem and physical self-worth are two further psychological
health outcomes positively impacted by resistance training
[4]. While the benefits of resistance training are numerous,
a significant proportion of youth are not meeting current
guidelines for muscle-strengthening activity [5].
Cognitive abilities, defined as the set of mental processes
that contribute to perception, memory, intellect and action
[6, 7], are strongly associated with academic skills and are
critical for children's development [8]. The impact of resist-
ance training on cognitive outcomes and academic achieve-
ment for youth has not been established; however, recent sys-
tematic reviews have shown positive findings in adults and
older adults [9–12]. A recent meta-analysis conducted by
Wilke and colleagues revealed that resistance training had a
positive effect on global cognition (standardized mean differ-
ence (SMD) 0.56, 95% confidence interval (CI) 0.22–0.90,
p = 0.004), with selectively varied effects for inhibitory con-
trol (SMD 0.73, 95% CI 0.21–1.26, p = 0.01) and cognitive
flexibility (SMD 0.36, 95% CI 0.17–0.55, p = 0.004) [12].
There are a range of potential behavioural, psychosocial and
neurobiological mechanisms that may explain the effects of
physical activity, including resistance training, on cognitive
function and academic outcomes in youth [7, 13, 14]. There
is a growing body of evidence suggesting that participa-
tion in physical activity leads to changes in brain structure
and function [15]. To our knowledge, no previous study
has examined the mechanisms responsible for the effects
of resistance training in youth. However, the self-regulation
skills that are inherent in resistance training (e.g., the moni-
toring of load) is one plausible mechanism that warrants
further investigation [14]. While there is emerging evidence
for the benefits of resistance training for children and adoles-
cents’ cognitive function [16, 17], no systematic review of
the literature has been conducted. Similarly, there is increas-
ing interest in examining the associations between muscu-
lar fitness, cognition, and academic achievement in young
people. For example, a study by Cancela etal. [18] found
that academic achievement was moderately associated with
strength, and the work of Syvaoja etal. [19] offers further
support, with a longitudinal study that positively associates
muscular fitness and overall academic achievement.
Despite growing evidence for the benefits of resistance
training and positive associations between muscular fitness,
cognitive and academic outcomes in youth, the existing evi-
dence has not been quantitatively synthesized. Therefore, the
primary aim of our systematic review and meta-analysis was
to investigate the effect of resistance training on academic
outcomes (i.e., cognitive function, academic achievement,
and on-task behaviors) in school-aged youth, and our sec-
ondary aim was to examine muscular fitness and its relation-
ship with cognition and academic achievement in the same
population.
2 Methods
Our systematic review and meta-analysis protocol was reg-
istered with the Preferred Reporting Items for Systematic
Review and Meta-Analysis Protocols (PROSPERO) on 28
April 2020 (CRD42020175695). The conduct and reporting
of this review adhere to the PRISMA (Preferred Reporting
Items for Systematic Reviews and Meta Analyses) and PER-
SiST (implementing PRISMA in Exercise, Rehabilitation,
Sport medicine and SporTs science) guidelines [20, 21].
2.1 Eligibility Criteria
To be included in this review, all studies were required to
meet the following criteria (using PICOS/PECOS criteria
[22]): (1) Participants: school-aged children and adolescents
(mean age 5–18years) who were attending a primary or
secondary school, but not university or tertiary education.
Studies needed to assess the whole population, not be lim-
ited to a subgroup. Some special populations were eligible
for inclusion. For example, participants with physical dis-
abilities, overweight and obesity, and those with diagnosed
mental health disorders. (2) Intervention/exposure character-
istics: studies that assessed the relationship between resist-
ance training or muscular fitness and cognition and academic
outcomes. We use the phrase academic outcomes to refer to
academic grades, performance on standardized tests, and on-
task behaviour in the classroom. Our review includes acute
studies (i.e., single bout) designed to examine the immedi-
ate effect of resistance training on cognitive function, and
chronic studies (i.e., long-term intervention); and classify
the intervention as either resistance training only or concur-
rent training (e.g., the combined training of strength and
aerobic activities) [23]. (3) Comparison: non-exercise con-
trol group. (4) Outcome: cognition outcomes (i.e., attention,
inhibitory control, cognitive flexibility, working memory,
planning, fluid intelligence) and/or academic achievement
(e.g., maths, languages and combined scores) and/or on-task
behaviour. (5) Study design: use an experimental, quasi-
experimental, parallel group, cluster, single-group study
design, cross-sectional or longitudinal study design.
2.2 Search Strategy
Structured electronic searches were conducted in the follow-
ing databases: CINAHL Complete, PsycINFO, SCOPUS,
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2097
Resistance Training and Academic Outcomes in Youth
Ovid MEDLINE, SPORTDiscus and EMBASE. The final
search was carried out by the first author on 24 October 2022
and included all years prior to the search date. The selected
search terms encompassed a combination of keywords relat-
ing to (i) resistance training, muscular fitness, (ii) cognition,
executive function, on-task behaviour, and (iii) age limits.
The full search strategy is presented in Online Supplemental
Material (OSM) Resource 1. Only peer-reviewed publica-
tions that were published in English were considered, and
no additional filters were applied during the search. Finally,
a manual search of full-text articles’ reference lists was con-
ducted to identify any additional publications.
2.3 Selection Processes
First, two researchers independently screened titles and
abstracts retrieved from databases and other sources for eli-
gibility (Fig.1). Next, relevant full texts were retrieved and
independently screened by two researchers. All discrepan-
cies regarding inclusion criteria fulfilment were resolved by
a third researcher.
2.4 Data Extraction
Two researchers independently extracted data from the eligi-
ble studies using a standardized extraction form. Key study
characteristics were extracted and included: first author
name, year of publication, study location (country), study
design, sample size, sex and age of participants. Further
characteristics were collected when investigating the pri-
mary outcome (resistance training studies) and included:
assessment period (acute/chronic), study duration, inter-
vention type, measure of cognition and academic outcomes
(post-test mean scores of control and intervention groups).
Regarding the secondary outcome, when cross-sectional
and longitudinal studies reported the correlation between
muscular fitness and cognition and academic outcomes, we
also recorded if the result was adjusted for cardiorespiratory
fitness.
Across all studies, when the relevant data were not
reported in the study, we contacted the corresponding author
and requested the additional information.
2.5 Study Risk ofBias Assessment
An independent assessment of the risk of bias was conducted
by two reviewers. Reviewers worked independently and
met weekly to discuss score allocation. Discrepancies were
discussed and were able to be resolved. A third reviewer
although available was not required. The appropriate version
of the Cochrane Risk of Bias Tool (RoB 2.0) was used to
assess individually randomized and parallel trials or cluster
randomized trials [24]. This tool assesses the risk of bias
in the following domains: randomization process, deviation
from intended intervention, missing data, measurement
of outcome, and reporting [25]. The same two reviewers
independently assessed the methodological quality of non-
randomized studies by applying the 14 items of the National
Institutes of Health (NIH) Quality Assessment Tool for
Observational Cohort and Cross-Sectional Studies [26].
2.6 Effect Measures
Summary measures included standardized mean differences,
correlation coefficients, log odds ratios, and F values. For
experimental studies, the effect size was calculated using
post-test mean values and standard deviations from control
and intervention groups [27]. Where multiple tests of cog-
nition were conducted, each test score was extracted and
treated individually. Where results were not reported ade-
quately, we contacted the corresponding authors (one study
was not included). All scores were converted to Cohen's
d effect size (hereafter referred to as the SMD) and were
defined as small (SMD: 0.20), medium (SMD: 0.50), and
large (SMD: 0.80) [28]. We corrected Cohen’s d for sample
size so that effect sizes for smaller studies were reduced to
control for different sample sizes across studies [29].
We combined effect sizes using a structural equation
modelling approach to multilevel meta-analysis. The main
advantage of this approach is that it is not limited by the
assumption of independence (i.e., effect sizes are nested
within studies), and multiple effect sizes can be included
from each study [30]. Unconditional mixed-effects models
using maximum likelihood estimation were conducted to
calculate the overall pooled effect size. For each pooled
effect size, 95% likelihood-based CIs were calculated. All
analyses were conducted using the metaSEM package [30]
in R Version 4.0.2 [31].
The I2 statistic measures variability in the effect sizes
(i.e., heterogeneity) [32]. An I2 statistic between 0 and 40%
might not be important, 30–60% might represent moder-
ate heterogeneity, 50–90% might represent substantial het-
erogeneity, and 75–100% considerable heterogeneity [33].
Heterogeneity was explored and explained using moderator
analyses.
2.6.1 Primary Outcome: Moderators Examining theEffect
ofResistance Training onCognitive andAcademic
Outcomes
To provide future direction for how resistance training inter-
ventions can affect cognition, academic achievement, and
on-task behaviour, we moderated by aspects of cognition. A
broad approach was adopted to include all aspects of cogni-
tion and is presented in Table1. Each outcome was broadly
classified as:
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2098 K.Robinson et al.
Cognition: The set of mental processes that contribute
to perception, memory, intellect and action [7].
Academic achievement:The extent to which a student
has achieved their educational goals, commonly meas-
Fig. 1 PRISMA flow diagram for study inclusion
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2099
Resistance Training and Academic Outcomes in Youth
ured by examinations or continuous assessment (i.e.,
standardized tests, school grades) [7].
On-task behaviour:On-task behaviour (follows the class
rules and is appropriate to the learning situation). Off-
task behaviour (any behaviour that was not on-task and
could be categorized as either motor off-task, noise off-
task or passive off-task) [34].
As there is some evidence that the effects of resistance
training may differ by age and maturity status [3], we com-
pared children (mean age 5–9years) and adolescents (mean
age 10–18years). Next, we examined study characteristics
to support future researchers in the decision making for the
design of resistance-training interventions. Acute (single-ses-
sion studies with immediate cognitive testing), compared to
chronic interventions (studies
≥
4weeks with cognitive tests
performed a minimum of 1h post exercise), have previously
been shown to effectively improve cognition, and comparing
these results may direct future approaches for study duration
and timing of cognitive tests [35]. Finally, we also compared
the effects of resistance training and concurrent training pro-
grams [36].
2.6.2 Secondary Outcome: Moderators Examining
theAssociation Between Muscular Fitness
andCognition andAcademic Outcomes
The larger number of studies allowed for aspects of cogni-
tion to be analyzed by outcome: attention, inhibitory con-
trol, cognitive flexibility, working memory, planning, fluid
intelligence (see Table1). Also, we compared mathemat-
ics, languages and overall academic achievement based
on current indications in this field [37]. School grades and
standardized test results, although subject to methodologi-
cal artifact, were combined in the analysis. Data that had
been adjusted for cardiorespiratory fitness were compared.
In many cases, additional adjustment for cardiorespiratory
fitness weakens the association between muscular fitness
and cognitive outcomes [38]. Consideration of participant
characteristics analyzed age and study design moderators
analyzed cross-sectional and longitudinal studies indepen-
dently. Finally, to examine risk of bias within studies, we
compared studies with high risk, some concerns and low
risk of bias.
Table 1 List of the measures used by the studies included in this review, organized by outcomes
Note that many cognitive tests span multiple aspects of cognition, as indicated below
Outcome Measure
Cognition
Attention Simple Reaction Time, 4-Choice Reaction Time, d2 Test of Attention, Rapid Visual Information Processing (RVP) test,
Finger tapping tests, modified Attention Network Test (ANT)
Cognitive flexibility Trail making test (TMT), Dimensional Change Card Sort Test, Design Fluency Test, Digit symbol coding, verbal flu-
ency test
Inhibition Stroop test, modified Flanker task, Eriksen Flanker, Simon-task, Go/ no-go test, modified Attention Network Test
(ANT)
Working memory Serial n-back task, Spatial working memory test, Visual Memory-Wechsler Memory Scale, Modified delayed non‐
matched‐to‐sample Task (DNMS), Forward memory span, Reverse memory span, Grid test, Forward and Backward
digit span task
Planning Zoo Map Test, modified Hanoi towers
Fluid intelligence Woodcock-Muñoz test battery, D48 and Raven’s Progressive Matrices, Balance scale, Progressive matrices
Academic achievement
Languages School grades (assessed by teachers), Illinois Standardized Achievement Test (ISAT), Standardized test scores, Adapted
standardized tests, Battery of General and Differential Aptitudes (BADyG E1)
Mathematics School grades (assessed by teachers), 10-question math tests, Illinois Standardized Achievement Test (ISAT), Standard-
ized test scores, Adapted standardized tests, Battery of General and Differential Aptitudes (BADyG E1)
Combined School grades (assessed by teachers), academic questionnaires, Grade Point Average (GPA)
On-task behaviour
On-task behaviour Adapted momentary time sampling procedure
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2100 K.Robinson et al.
2.7 Reporting Bias Across Studies
We assessed risk of bias across studies (publication bias)
using funnel plots [39] and Egger’s regression asymmetry
tests [40]. Effect sizes were plotted against the standard
errors and then the symmetry was inspected. Next, we con-
ducted Egger’s regression asymmetry tests by regressing the
normalized effect estimate (effect size divided by its stand-
ard error) against precision (reciprocal of the standard error
of the effect size). The regression line will pass through the
origin when the funnel plot is symmetrical (i.e., no bias).
2.8 Certainty Assessment
The results of the meta-analysis and risk of bias assess-
ment were used to complete a Grading of Recommenda-
tions, Assessment, Development, and Evaluation (GRADE)
certainty assessment [41]. Two researchers qualitatively
assessed risk of bias, consistency and precision, and gave
a summary rating – high, moderate or low certainty of
evidence.
3 Results
3.1 Study Selection
Study selection results are presented in Fig.1 (flow dia-
gram). The search yielded a total of 2330 potentially relevant
articles after the removal of duplicates. After reviewing titles
and abstracts, we obtained and reviewed 212 full-text arti-
cles. Of these articles, 55 met the inclusion criteria. How-
ever, after contacting authors, two of these articles [42, 43]
did not provide enough information to be included in the
meta-analyses (k = 53).
3.2 Study Characteristics
Articles were grouped by study design to align with the
primary and secondary aims of the review. Study charac-
teristics are detailed in OSM Resources 2 and 3. Publica-
tion dates ranged from 2009 to 2022. Most studies were
published in Spain (k = 14), followed by the USA (k = 8),
Australia (k = 6), Chile (k = 5), Taiwan (k = 3) and Finland
(k = 3). Study designs were cross-sectional (k = 36), longi-
tudinal (k = 8) and experimental (k = 11).
There was a total of 1,917,659 participants. The primary
meta-analysis of resistance training studies included 1,235
participants, with a mean age ranging from 8.8 to 16.4years.
The secondary meta-analysis of cross-sectional and lon-
gitudinal studies included 1,916,424 participants, with a
mean age ranging from 5.8 to 18years. Most participants
were adolescents (10–18years, k = 33), followed by both
adolescents and children (5–18years, k = 14) and children
(5–9years, k = 6).
Cognition was measured using tests of attention (k = 7),
cognitive flexibility (k = 7), inhibitory control (k = 19), work-
ing memory (k = 11), planning (k = 2) and fluid intelligence
(k = 9). Academic achievement was measured in mathemat-
ics (k = 20), languages (k = 16) and combined scores (k = 15).
Only one measure of on-task behaviour was included (k = 1).
3.3 Risk ofBias
The risk of bias within studies for resistance training is pre-
sented in OSM Resource 4. Studies were defined as having
low (k = 5), some (k = 3) or high (k = 2) concerns. The risk
of bias within studies for muscular fitness is presented in
OSM Resource 5. All studies clearly defined their research
questions, and only one study failed to clearly define the
study population. Studies were categorized as poor (k = 1),
fair (k = 21) or good (k = 23).
(a) (b)
Cohen's d
Standard error
0.52 0.39 0.26 0.13 0
-1 -0.5 00.5 11.5
Cohen's d
Standard error
0.609 0.4570.305 0.15
20
-1 -0.5 00.5 11.5
Fig. 2 Funnel plots depicting publication bias: (a) resistance training studies; (b) muscular fitness studies
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2101
Resistance Training and Academic Outcomes in Youth
To determine if there was publication bias, funnel plots
were created for the primary and secondary objectives
(Fig.2). For resistance training, some asymmetry of effect
sizes in the funnel plot and a significant Egger’s regres-
sion test (z = 3.72, P < 0.001) indicated that there was some
evidence of publication bias. Regarding muscular fitness,
relative symmetry of effect sizes in the funnel plot and a
non-significant Egger’s regression test (z = 1.21, P = 0.25)
indicated that publication bias was not a major concern.
3.4 Synthesis ofResults
Resistance training had a small positive effect on overall
cognition, academic performance and on-task behaviour
(SMD 0.19, 95% CI 0.05–0.32) (Table2). A minimal pro-
portion of the variation within this pooled effect was attrib-
utable to differences within studies (
I2
= 7%); however, dif-
ferences between studies (
I2
= 43%) may represent moderate
heterogeneity.
The association between muscular fitness and cognition
and academic achievement combined was positive but very
small (SMD 0.13, 95% CI 0.10–0.16) (Table3). Within
this pooled effect size, heterogeneity within (
I2
= 17%) and
between (
I2
= 5%) studies was negligible.
3.5 Primary Outcome Moderator Analyses:
Effect ofResistance Training onCognitive
andAcademic Outcomes
3.5.1 Cognition andAcademic Outcomes
Aspects of cognition moderated the effect of resistance train-
ing on overall cognitive, academic and on-task behaviour
performance (
R2
= 0.36). Resistance training had a small
positive effect on cognition (SMD 0.17, 95% CI 0.06–0.30),
academic achievement (SMD 0.24, 95% CI − 0.03 to 0.51),
and on-task behaviour (SMD 0.39, 95% CI − 0.14 to 0.88);
however, the confidence intervals for academic achievement
and on-task behaviour crossed zero.
3.5.2 Participant Characteristics
Age did not moderate the effect of resistance training on
academic outcomes (
R2
= 0.01).
3.5.3 Study Characteristics
Study design (i.e., acute vs. chronic studies) did not have a
moderating effect. However, intervention type moderated
the effect of resistance training on overall cognition and
academic outcomes (
R2
= 0.40). Resistance training sig-
nificantly improved cognition and academic outcomes (SMD
0.26, 95% CI 0.10–0.42), while the result for concurrent
training was less effective (SMD 0.11, 95% CI − 0.05 to
0.28).
3.5.4 Risk ofBias
Risk of bias did not moderate the effect of resistance training
on cognition and academic outcomes (
R2
= 0.00).
3.6 Secondary Outcome Moderator Analyses:
Association Between Muscular Fitness
andCognition andAcademic Outcomes
3.6.1 Cognition andAcademic Outcomes
Aspects of cognition moderated the association between
muscular fitness and overall cognition and academic out-
comes (
R2
= 0.42). Cognitive flexibility, working memory
and fluid intelligence showed very small positive associa-
tions (SMD 0.18, 95% CI 0.03–0.32; SMD 0.14, 95% CI
0.02–0.26; SMD 0.11, 95% CI 0.01–0.21). The other aspects
of cognitive function were not significantly associated with
muscular fitness. In addition, we found a small positive
association for studies that included mathematics (SMD
0.17, 95% CI 0.08–0.25), languages (SMD 0.10, 95% CI
0.01–0.18) and combined academic results (SMD 0.12, 95%
CI 0.02–0.22).
3.6.2 Fitness
Adjustment for cardiorespiratory fitness did not moderate
the association between muscular fitness and overall cogni-
tion and academic outcomes (
R2
= 0.00).
3.6.3 Participant Characteristics
Age did not moderate the association between muscular
fitness and overall academic and cognitive performance
combined (
R2
= 0.00). However, a small association was
evident for studies across both age ranges (SMD 0.19, 95%
CI 0.12–0.26) and negligible for adolescents (SMD 0.10,
95% CI 0.03–0.16).
3.6.4 Study Characteristics
Study design moderated the association between muscular
fitness and cognition and academic outcomes (
R2
= 0.41).
The very small positive effect was marginally stronger for
cross-sectional studies (SMD 0.14, 95% CI 0.10–0.17) than
longitudinal studies (SMD 0.09, 95% CI 0.02–0.16).
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2102 K.Robinson et al.
Table 2 The effect of resistance training on cognitive and academic outcomes in school-aged youth
The summary measures for resistance training and its effect on cognition and academic outcomes are in Cohen’s d. A Cohen’s d of 0.2 is interpreted as small, 0.5 represents medium, and 0.8 a
large effect size
I2_2 = heterogeneity at Level 2 (i.e., between effect sizes from the same study); I2_3 = heterogeneity at Level 3 (i.e., between studies).
𝜏
2_2 = within study variance;
𝜏
2_3 = between study vari-
ance; R2_2 = variance explained at Level 2 (i.e., between effect sizes from the same study); R2_3 = variance explained at Level 3 (i.e., between studies).
Figures in bold represent effect sizes with confidence intervals that did not cross zero
Variable kNumber of
effect sizes
Effect size
(Cohen's d) Lower 95% CI Upper 95% CI
I2_2
I2_3
𝜏2_2
𝜏2_3
R2_2
R2_3
Overall academic, cognitive, and on-task
behaviour performance
10 53 0.19 0.05 0.32 0.07 0.43 0.003 0.018
Moderator analyses
Cognitive and academic outcomes 0.003 0.012 0.000 0.361
Academic achievement—mathematics 2 2 0.24 − 0.03 0.51
On− task behaviour 1 2 0.39 − 0.14 0.88
Cognition 10 49 0.17 0.06 0.30
Aspects of cognition 0.003 0.033 0.000 0.000
Working memory 3 15 0.13 − 0.07 0.29
Inhibition 7 20 0.14 − 0.05 0.28
Cognitive flexibility 3 7 0.06 − 0.20 0.30
Attention 2 7 0.11 − 0.22 0.44
Participant characteristics
Age 0.003 0.018 0.003 0.010
 Children 5–9 y 1 1 − 0.01 − 1.03 0.82
 Adolescents 10–18 y 9 52 0.19 0.06 0.32
Study characteristics
Study design 0.003 0.018 0.000 0.000
 Acute 5 26 0.16 − 0.04 0.33
 Chronic 5 27 0.22 0.03 0.41
Intervention type 0.003 0.011 0.000 0.403
 Resistance training 5 20 0.26 0.10 0.42
 Concurrent training 5 33 0.11 − 0.05 0.28
Risk of bias 0.003 0.019 0.005 0.000
 Poor (high risk of bias) 2 13 0.21 0.04 0.40
 Fair (some concerns) 3 10 0.20 − 0.06 0.44
 Good (low risk of bias) 5 30 0.06 − 0.35 0.38
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2103
Resistance Training and Academic Outcomes in Youth
Table 3 The associations between muscular fitness and cognitive and academic outcomes in school aged youth
The summary measures for muscular fitness and its relationship with cognition and academic outcomes are in Cohen’s d. A Cohen’s d of 0.2 is interpreted as small, 0.5 represents medium and
0.8 a large effect size
I2_2 = heterogeneity at Level 2 (i.e., between effect sizes from the same study); I2_3 = heterogeneity at Level 3 (i.e., between studies).
𝜏
2_2 = within study variance;
𝜏
2_3 = between study vari-
ance; R2_2 = variance explained at Level 2 (i.e., between effect sizes from the same study); R2_3 = variance explained at Level 3 (i.e., between studies)
Figures in bold represent effect sizes with confidence intervals that did not cross zero
Variable kNumber of effect
sizes
Effect size
(Cohen's d) Lower 95% CI Upper 95% CI I
2_2
I2_3
𝜏2_2
𝜏2_3
R
2_2
R2_3
Overall academic and cognitive performance combined 43 211 0.13 0.10 0.16 0.17 0.05 0.003 0.001
Moderator analyses
Cognitive and academic outcomes 0.003 0.001 0.000 0.422
Overall cognition 24 113 0.12 0.07 0.17
Overall academic achievement 28 98 0.15 0.09 0.18
Aspects of cognition 0.003 0.007 0.000 0.000
 Attention 5 10 0.08 − 0.10 0.26
 Inhibition 12 26 0.09 − 0.03 0.21
 Cognitive flexibility 4 18 0.18 0.03 0.32
 Working memory 8 26 0.14 0.02 0.26
 Planning 2 5 0.26 − 0.05 0.57
Fluid intelligence 9 28 0.11 0.01 0.21
School subject 0.002 0.007 0.213 0.000
 Mathematics 18 39 0.17 0.08 0.25
 Languages 16 32 0.10 0.01 0.18
 Combined academics 15 27 0.12 0.02 0.22
Fitness
Data adjusted for cardiorespiratory fitness 0.003 0.000 0.039 0.000
 No 36 172 0.12 0.07 0.16
Yes 8 39 0.15 0.08 0.19
Participant characteristics
Age 0.003 0.011 0.005 0.00
 Children 5–9 y 5 14 0.14 − 0.04 0.32
 Adolescents 10–18 y 24 115 0.10 0.03 0.16
 Both 5–18 y 14 82 0.19 0.12 0.26
Study characteristics
Study design 0.003 0.001 0.013 0.407
Cross-sectional 35 174 0.14 0.10 0.17
 Longitudinal 8 37 0.09 0.02 0.16
Risk of bias 0.003 0.001 0.000 0.272
Poor (high risk of bias) 1 2 0.27 − 0.31 0.86
Fair (some concerns) 19 90 0.12 0.07 0.18
Good (low risk of bias) 23 119 0.13 0.09 0.17
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2104 K.Robinson et al.
3.6.5 Risk ofBias
Risk of bias within studies moderated the association
between muscular fitness and cognition and academic out-
comes (
R2
= 0.27). Studies rated as fair or good reported
very small positive results (SMD 0.12, 95% CI 0.07–0.18;
SMD 0.13, 95% CI 0.09–0.17).
3.7 Certainty Assessment
The certainty of evidence for the primary and secondary
outcomes are displayed in Table4.
4 Discussion
To our knowledge, this is the first systematic review and
meta-analysis designed to investigate the effects of resistance
training and muscular fitness on cognitive and academic out-
comes in school− aged youth. Our primary outcome find-
ings suggest that resistance training has a small positive
effect on cognition and academic outcomes (low certainty
evidence). Our meta-analysis of cross− sectional and longi-
tudinal studies for our secondary outcome identified a small
positive association between muscular fitness and cognition
and academic achievement (moderate certainty evidence).
Academic achievement, particularly in mathematics, was
more strongly associated with muscular fitness than cog-
nitive function. However, the inclusion of cross− sectional
studies limited the heterogeneity so our findings should be
interpreted with caution.
Evidence for the benefits of physical activity for young
people’s cognition has been accumulating in recent years;
however, most research has focused on aerobic exercise [7,
44–46]. Systematic reviews provide support for the use of
aerobic training to improve cognitive and academic out-
comes in children and adolescents [47–49], though other
qualitative approaches including mindfulness practices or
cognitive training are favored by some researchers [50].
Until now, information regarding the cognitive benefits of
resistance training for youth has not been quantitatively
synthesized.
Our moderator analyses revealed that resistance train-
ing interventions produced improvements in the combined
aspects of cognition (SMD 0.17, 95% CI 0.06–0.30). Cogni-
tive tasks of varying complexity were included in the analy-
sis and our findings are consistent with those observed in a
recent review, where overall exercise had a positive effect
on all three core executive functions: working memory,
inhibition, and cognitive flexibility [35]. The analysis of
our included constructs (attention, cognitive flexibility,
inhibition, working memory, planning, and fluid intelli-
gence) revealed no specific construct of cognition, showed
greater sensitivity to resistance training. Unfortunately, we
were unable to analyze the effect of resistance training on
academic achievement and on− task behaviour due to the
limited number of studies. More research is warranted in
this area so that future reviews can explore these factors in
greater detail.
When comparing study characteristics, we found
that acute and chronic studies produced similar effects.
Long− standing evidence exists for the benefits of acute
physical activity on cognition [35, 51], while, in contrast to
our findings, chronic outcomes can be inconsistent [52, 53].
It is important to acknowledge that while the consequences
of resistance training on overall cognition may be similar,
the mechanisms involved are different. Despite the positive
results shown for resistance training, further quantitative and
qualitative factors should be considered. For example, the
intensity, frequency [54] and demand of cognition [55] could
also be taken into consideration, as well as the significant
positive effect sometimes observed when interventions are
led by highly qualified practitioners [54]. Nevertheless, this
finding highlights the need for subsequent studies to deliver
resistance training programs to youth that provide opportu-
nities for acute and chronic responses through delivery in
educational settings.
We found that resistance training resulted in larger
improvements in cognition and academic outcomes than
concurrent training. A moderate amount of variance was evi-
dent in this finding, which could possibly be attributed to the
Table 4 Certainty of evidence for the impacts of resistance training and associations of muscular fitness
SMD standardized mean difference
Variable #No. of stud-
ies
n Findings Certainty of evidence
Resistance training
Overall academic, cognitive, and on− task behav-
iour performance
10 1235 SMD, 0.19 (0.05 to 0.32) Low certainty
Muscular fitness
Overall academic and cognitive performance 43 1,916,424 SMD, 0.12 (0.08 to 0.16) Moderate certainty
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2105
Resistance Training and Academic Outcomes in Youth
scope of the interventions delivered. Interestingly, most of
the resistance training interventions included in our review
were delivered in schools. Educational settings can be prac-
tical for targeting school− aged youth to increase physical
activity, as students are required to spend most of the day in a
classroom, where sedentary behaviours are prevalent. In this
context, the inclusion of resistance training into active learn-
ing (e.g., classroom activity breaks, cognitively challeng-
ing physical activity) may therefore be warranted. Reviews
have found positive effects for active learning on academic
achievement but not executive function [56, 57]. Donnelly
and Lambourne [58] discuss the challenges of designing
classroom active breaks that require minimal disruption to
the learning environment while providing adequate intensity
and energy expenditure. Bodyweight exercises (e.g., squats)
could be a feasible solution as they are a scalable form of
resistance training that does not require equipment and is
suitable for children and adolescents [3, 59, 60].
Although not examined in our review, it is interesting to
consider the potential mechanisms responsible for the effect
of resistance training on cognition. Lubans etal. [13] suggest
three broad categories of mechanisms (i.e., neurobiological,
psychosocial and behavioural) responsible for the effects of
physical activity on cognition. Of relevance to our current
review is the behavioural mechanism, as changes in cop-
ing and self− regulation skills may lead to improvements in
executive function. In the school setting, on− task behaviour
is seen as synonymous with self− regulation and, although
limited by available studies, the results of our meta-analysis
align with the evidence of behavioural mechanisms. The
allocation of mental resources during exercise may also
contribute to cognitive improvements [61]. Alternatively,
resistance training is a motor coordinative task requiring
focus and attention to safely execute each movement. The
increased cognitive demand of resistance training may facili-
tate improvements in cognition and academic outcomes via
neurogenesis [61]. Identifying the mechanisms that underlie
the link between resistance training and improved cognition
and academic outcomes for adolescents holds extraordinary
promise for future research.
Despite limited evidence showing a link between mus-
cular fitness and cognitive and academic outcomes, avail-
able data suggest there is an uncertain association for both
cross− sectional and longitudinal studies [37]. In that regard,
the large number of studies included in our meta-analysis
offers a unique opportunity to further investigate the asso-
ciation between muscular fitness and cognitive function. It
is important to note that studies assessing the association
between muscular fitness and cognitive function were rela-
tively consistent, with negligible heterogeneity. However, we
acknowledge that there is considerable heterogeneity in the
methods for assessing cognition and academic performance
in the included studies.
The analysis of aspects of cognition was unable to explain
any of the observed variance of the overall association of
muscular fitness and cognition. Working memory, which
allows for temporary storage and manipulation of informa-
tion necessary for complex cognitive tasks, showed a strong
association with muscular fitness [62]. Considered one of the
core domains of executive function, improvements in work-
ing memory may benefit learning outcomes, and further,
improvements in working memory may also benefit other
higher level executive functions such as planning, reasoning
and problem solving, leading to additional learning gains
[63]. Comparative studies are not available for youth, but
in a systematic review conducted in adults, Landrigan etal.
[9] found that resistance training had little effect on working
memory. This could suggest developmental changes due to
age and maturity may make working memory more suscep-
tible to resistance training effects. Cognitive flexibility (i.e.,
adjusting to new demands, rules or priorities) [63] and fluid
intelligence (the ability to reason, problem solve, and to see
patterns or relations among items) [64] had very small posi-
tive effects. All other constructs of cognition were not signif-
icantly associated with muscular fitness in our meta-analysis.
Mathematics showed the strongest relationship with
muscular fitness, while languages and combined scores pro-
vided less evidence. This result is not unexpected given that
complex mathematical concepts such as algebraic fractions
have been shown to associate with working memory [65].
These results are supported by a recent systematic review
from Santana etal. [37], which found positive associa-
tions between physical fitness and academic achievement.
Of interest, the only study that was unable to be included
in our meta-analysis also aligned with our findings, with
Van Dunsen etal. [42] reporting that core strength (meas-
ured by curl− ups) was positively associated with overall
academic performance. The practical application of these
findings could inform future directions for the inclusion of
muscle− strengthening activities to support student learning
as mathematics/languages is embedded within most subjects
in the school curriculum.
Participant age did not moderate the association between
muscular fitness and cognition or academic achievement.
Studies involving adolescents (10–18years) and both age
groups (5–18years) provided the greatest indication of a
positive association. The increased association for the wider
age range may be attributed to the large number (92%) of
included cross− sectional studies. Cross− sectional studies
compared to longitudinal studies often report stronger evi-
dence for a positive association between physical fitness and
academic performance [37]. Our analysis of study design
supports the findings of Santana etal. [37], with cross− sec-
tional studies showing a stronger relationship between mus-
cular fitness and cognition and academic achievement than
longitudinal studies.
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2106 K.Robinson et al.
The meta-analysis for the benefits of resistance train-
ing and associations between muscular fitness and aca-
demic outcomes in youth provides further evidence for
the benefits of muscle− strengthening activity, consistent
with international guidelines. More specifically, our find-
ings may assist researchers, policy makers and practition-
ers regarding the implementation of resistance training
and muscular fitness. Where studies are currently having
difficulty scaling up resistance training interventions in
schools, our findings may offer support for their inclusion
due to the benefits for young people’s cognitive and aca-
demic outcomes [66].
4.1 Limitations
We identified only ten studies that had examined the impact
of resistance training on cognitive and academic outcomes.
Further, our meta-analysis consisted mostly of cross− sec-
tional and longitudinal studies (k = 43). Some additional
limitations include the following: first, cognition and aca-
demic performance were measured using a wide range of
instruments that vary substantially in validity and reliabil-
ity. Second, we combined standardized tests and school
grades (evaluated by teachers) to assess academic achieve-
ment. Third, it is important to note the variability in resist-
ance− training protocols included in our review. Due to the
small number of studies, we were unable to compare the
effects of different resistance− training protocols in terms
of volume, intensity and type of training (e.g., free weights,
body weight). Finally, there was some publication bias in
the meta-analysis of resistance training and cognitive and
academic outcomes due to inclusion of only published lit-
erature [67].
5 Conclusions
Based on a limited number of studies we found select evi-
dence that participation in resistance training has a small
positive effect on cognition and academic outcomes in
school− aged youth. Consistent with our findings from
experimental studies, we found evidence for the benefit
of muscular fitness for young people’s cognition and aca-
demic achievement. Our results suggest that including resist-
ance training may help to improve cognition and academic
achievement in school− aged youth.
Supplementary Information The online version contains supplemen-
tary material available at https:// doi. org/ 10. 1007/ s40279- 023- 01881-6.
Acknowledgements We would like to acknowledge the work of Colin
Sanctuary during the early stages of data collection.
Declarations
Funding Open Access funding enabled and organized by CAUL and
its Member Institutions. Funding was generously provided by HMRI
philanthropic donations. Grant number: G19011491.
Conflict of Interest The authors declare that they have no competing
interests.
Availability of Data and Material All data relevant to the study are
included in the article or uploaded as supplementary information.
Ethics Approval Not required.
Consent to Participate Not required.
Consent for Publication Not required.
Code Availability Code used during the meta-analysis is available on
request from the corresponding author.
Author Contributions KR conceptualized and designed the study, col-
lected data, carried out the analyses, drafted the initial manuscript and
reviewed and revised the manuscript. NR, CH, AF, AG− H and MM
conceptualized and designed the study and reviewed and revised the
manuscript. KO designed the data collection instruments, supervised
the analyses, and reviewed and revised the manuscript. RD supervised
data extraction and reviewed and revised the manuscript. DRL concep-
tualized and designed the study, supervised data collection and analy-
ses, and critically reviewed the manuscript for important intellectual
content. All authors approved the final manuscript as submitted and
agree to be accountable for all aspects of the work.
Open Access This article is licensed under a Creative Commons Attri-
bution 4.0 International License, which permits use, sharing, adapta-
tion, distribution and reproduction in any medium or format, as long
as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes
were made. The images or other third party material in this article are
included in the article's Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in
the article's Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a
copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/.
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Authors and Aliations
KatieRobinson1,2· NicholasRiley1,2· KatherineOwen3· RyanDrew1,4· MyrtoF.Mavilidi5,6· CharlesH.Hillman7,8·
AveryD.Faigenbaum9· AntonioGarcia‑Hermoso10· DavidRevaldsLubans1,11
* David Revalds Lubans
david.lubans@newcastle.edu.au
1 Centre forActive Living andLearning, College ofHuman
andSocial Futures, University ofNewcastle, Callaghan
Campus, Callaghan, NSW2308, Australia
2 Hunter Medical Research Institute (HMRI), NewLambton,
NSW, Australia
3 Prevention Research Collaboration, Sydney School ofPublic
Health, The University ofSydney, Sydney, NSW, Australia
4 School ofEnvironmental andLife Sciences, College
ofEngineering, Science andEnvironment, Newcastle, NSW,
Australia
5 School ofEducation/Early Start, University ofWollongong,
Wollongong, NSW, Australia
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

2109
Resistance Training and Academic Outcomes in Youth
6 Illawarra Health andMedical Research Institute (IHMRI),
Keiraville, Australia
7 Department ofPsychology, Northeastern University, Boston,
MA, USA
8 Department ofPhysical Therapy, Movement
andRehabilitation Sciences, Northeastern University,
Boston, MA, USA
9 Department ofKinesiology andHealth Sciences, The
College ofNew Jersey, Ewing, NJ08628, USA
10 Navarrabiomed, Hospital Universitario de Navarra (HUN),
Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona,
Navarra, Spain
11 Faculty ofSport andHealth Sciences, University
ofJyväskylä, Jyväskylä, Finland
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

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