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The Effect of Resistance Training in Women on Dynamic Strength and Muscular Hypertrophy: A Systematic Review with Meta-analysis

  • Amanda D. HagstromEmail author
  • Paul W. Marshall
  • Mark Halaki
  • Daniel A. Hackett
Systematic Review

Abstract

Background

The effect of resistance training (RT) on adaptations in muscular strength and hypertrophy has never been examined in an exclusively female synthesis of the literature.

Objective

The objectives of this study were threefold: (1) to systematically review the literature on female adaptations to RT, characterising the effect in terms of muscular strength and hypertrophy; (2) to distinguish the individual effects of intervention duration, frequency, and intensity on these adaptations via sub-analysis; (3) to draw evidence-based conclusions regarding training expectations in female populations.

Methods

Three electronic databases were searched using terms related to RT combined with females or women. Random-effects meta-analyses were undertaken to estimate the effect of RT on muscular strength and hypertrophy in females. Possible predictors that may have influenced training-related effects (e.g., training intensity and volume) were explored using univariate analyses.

Results

The systematic search identified 14,067 articles of which a total of 24 studies met the inclusion criteria and were eligible. Upper body strength was assessed in 15 studies, lower body strength in 19 studies, and muscular hypertrophy in 15 studies. Study duration lasted between 4 weeks and 12 months. Large-effect sizes were found for upper body strength (Hedges’ g = 1.70; p < 0.001) and lower body strength (Hedges’ g = 1.40; p < 0.001). Following use of the Trim and Fill method (due to presence of publication bias), a large effect still remained for upper body strength (Hedges’ g = 1.07), although a medium effect was found for lower body strength (Hedges’ g = 0.52). A medium effect was found for muscular hypertrophy (g = 0.52, p = 0.002). Sub-analyses revealed that the moderating variables “training frequency” and “training volume” significantly influenced lower body muscular strength (p < 0.001). “Training frequency” and “sets per exercise” moderated the RT effects on upper body strength (p < 0.01). No moderating variables were found to significantly influence muscular hypertrophy. A trend for a moderating effect on upper body strength was found for “age of participants” (p = 0.08), whereby younger participants experienced a greater effect. A moderating effect was also observed where supervised training had a larger influence on the adaptation of lower body strength (p = 0.05) compared with unsupervised training. Methodological quality for the studies included in the review was found to be moderate.

Conclusions

RT elicits large improvements in muscular strength and hypertrophy in healthy adult females. Training volume and frequency appear to be important variables that influence muscular strength.

Notes

Compliance with Ethical Standards

Funding

No external sources of funding were used in the preparation of this manuscript

Conflict of interest

Amanda D. Hagstrom, Paul W Marshall, Mark Halaki, and Daniel A. Hackett declare that they have no conflicts of interest related to the content of this review.

Data availability

All data sets generated and analysed during the current study are available as supplementary material. See Electronic Supplementary Material Appendix S1.

Supplementary material

40279_2019_1247_MOESM1_ESM.xlsx (25 kb)
Supplementary material 1 (XLSX 25 kb)

References

  1. 1.
    Schoenfeld BJ. The mechanisms of muscle hypertrophy and their application to resistance training. J Strength Cond Res. 2010;24(10):2857–72.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Nelson ME, Fiatarone MA, Morganti CM, et al. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures: a randomized controlled trial. JAMA. 1994;272(24):1909–14.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Aagaard P, Suetta C, Caserotti P, et al. Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scand J Med Sci Sports. 2010;20(1):49–64.  https://doi.org/10.1111/j.1600-0838.2009.01084.x.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Doherty TJ. Invited review: aging and sarcopenia. J Appl Physiol. 2003;95(4):1717–27.  https://doi.org/10.1152/japplphysiol.00347.2003.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Fagard R. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol. 2006;33(9):853–6.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Seguin R, Nelson ME. The benefits of strength training for older adults. Am J Prev Med. 2003;25(3):141–9.  https://doi.org/10.1016/S0749-3797(03)00177-6.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hurley BF, Hanson ED, Sheaff AK. Strength training as a countermeasure to aging muscle and chronic disease. Sports Med. 2011;41(4):289–306.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Fleck SJ, Kraemer W. Designing resistance training programs, 4E. Champaign: Human Kinetics; 2014.Google Scholar
  9. 9.
    Hunter SK. Sex differences in fatigability of dynamic contractions. Exp Physiol. 2016;101(2):250–5.  https://doi.org/10.1113/EP085370.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Metcalf E, Hagstrom AD, Marshall PW. Trained females exhibit less fatigability than trained males after a heavy knee extensor resistance exercise session. Eur J Appl Physiol. 2019;119(1):181–90.  https://doi.org/10.1007/s00421-018-4013-x.CrossRefPubMedGoogle Scholar
  11. 11.
    Hunter SK. Sex differences in human fatigability: mechanisms and insight to physiological responses. Acta Physiol. 2014;210(4):768–89.  https://doi.org/10.1111/apha.12234.CrossRefGoogle Scholar
  12. 12.
    Flores DF, Gentil P, Brown LE, et al. Dissociated time course of recovery between genders after resistance exercise. J Strength Cond Res. 2011;25(11):3039–44.  https://doi.org/10.1519/JSC.0b013e318212dea4.CrossRefPubMedGoogle Scholar
  13. 13.
    Staron RS, Hagerman FC, Hikida RS, et al. Fiber type composition of the vastus lateralis muscle of young men and women. J Histochem Cytochem. 2000;48(5):623–9.  https://doi.org/10.1177/002215540004800506.CrossRefPubMedGoogle Scholar
  14. 14.
    Haizlip KM, Harrison BC, Leinwand LA. Sex-based differences in skeletal muscle kinetics and fiber-type composition. Physiology. 2015;30(1):30–9.  https://doi.org/10.1152/physiol.00024.2014.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Schoenfeld BJ, Ogborn D, Krieger JW. Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Med. 2016;46(11):1689–97.PubMedCrossRefGoogle Scholar
  16. 16.
    Ralston GW, Kilgore L, Wyatt FB, et al. The effect of weekly set volume on strength gain: a meta-analysis. Sports Med. 2017;47(12):2585–601.  https://doi.org/10.1007/s40279-017-0762-7.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Grgic J, Schoenfeld BJ, Davies TB, et al. Effect of resistance training frequency on gains in muscular strength: a systematic review and meta-analysis. Sports Med. 2018;48(5):1207–20.PubMedCrossRefGoogle Scholar
  18. 18.
    Grgic J, Lazinica B, Mikulic P, et al. The effects of short versus long inter-set rest intervals in resistance training on measures of muscle hypertrophy: a systematic review. Eur J Sport Sci. 2017;17(8):983–93.PubMedCrossRefGoogle Scholar
  19. 19.
    Zhao R, Zhao M, Xu Z. The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Osteoporosis Int. 2015;26(5):1605–18.CrossRefGoogle Scholar
  20. 20.
    Moran J, Sandercock G, Ramirez-Campillo R, et al. A meta-analysis of resistance training in female youth: its effect on muscular strength, and shortcomings in the literature. Sports Med. 2018;48(7):1661–71.  https://doi.org/10.1007/s40279-018-0914-4.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Moran J, Sandercock GR, Ramirez-Campillo R, et al. A meta-analysis of maturation-related variation in adolescent boy athletes’ adaptations to short-term resistance training. J Sports Sci. 2017;35(11):1041–51.  https://doi.org/10.1080/02640414.2016.1209306.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Costello JT, Bieuzen F, Bleakley CM. Where are all the female participants in sports and exercise medicine research? Eur J Sports Exerc Sci. 2014;14(8):847–51.CrossRefGoogle Scholar
  23. 23.
    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.  https://doi.org/10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Davies TB, Kuang K, Orr R, et al. Effect of movement velocity during resistance training on dynamic muscular strength: a systematic review and meta-analysis. Sports Med. 2017;47(8):1603–17.  https://doi.org/10.1007/s40279-017-0676-4.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–84.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Laframboise MA, Degraauw C. The effects of aerobic physical activity on adiposity in school-aged children and youth: a systematic review of randomized controlled trials. J Can Chiropr Assoc. 2011;55(4):256–68.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Borenstein M, Hedges L, Higgins J, et al. Introduction to meta-analysis. Chichester: Wiley; 2009.CrossRefGoogle Scholar
  28. 28.
    Morris SB. Estimating effect sizes from pretest-posttest-control group designs. Organ Res Methods. 2008;11(2):364–86.  https://doi.org/10.1177/1094428106291059.CrossRefGoogle Scholar
  29. 29.
    Warren M, Petit MA, Hannan PJ, et al. Strength training effects on bone mineral content and density in premenopausal women. Med Sci Sports Exerc. 2008;40(7):1282–8.  https://doi.org/10.1249/MSS.0b013e31816bce8a.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. New York: Wiley; 2011.Google Scholar
  31. 31.
    Cohen J. Statistical power analysis for the behavioral sciences. New York: Academic Press; 1977.Google Scholar
  32. 32.
    Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60.  https://doi.org/10.1136/bmj.327.7414.557.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Schoenfeld BJ, Ogborn D, Krieger JW. Dose-response relationship between weekly resistance training volume and increases in muscle mass: a systematic review and meta-analysis. J Sports Sci. 2017;35(11):1073–82.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Ratamess NA, Alvar BA, Evetoch TE, et al. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687.CrossRefGoogle Scholar
  37. 37.
    Baechle TR, Earle RW, Wathen D. Essentials of strength training and conditioning. 2nd ed. Champaign: Human Kinetics; 2000.Google Scholar
  38. 38.
    Abe T, DeHoyos DV, Pollock ML, et al. Time course for strength and muscle thickness changes following upper and lower body resistance training in men and women. Eur J Appl Physiol. 2000;81(3):174–80.  https://doi.org/10.1007/s004210050027.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Bell GJ, Syrotuik D, Martin TP, et al. Effect of concurrent strength and endurance training on skeletal muscle properties and hormone concentrations in humans. Eur J Appl Physiol. 2000;81(5):418–27.  https://doi.org/10.1007/s004210050063.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Botton CE, Radaelli R, Wilhelm EN, et al. Neuromuscular adaptations to unilateral vs. bilateral strength training in women. J Strength Cond Res. 2016;30(7):1924–32.  https://doi.org/10.1519/jsc.0000000000001125.CrossRefPubMedGoogle Scholar
  41. 41.
    Brown RD, Harrison JM. The effects of a strength training program on the strength and self-concept of two female age groups. Res Q Exerc Sport. 1986;57(4):315–20.CrossRefGoogle Scholar
  42. 42.
    de Castro Cesar M, Borin JP, Gonelli PRG, et al. The effect of local muscle endurance training on cardiorespiratory capacity in young women. J Strength Cond Res. 2009;23(6):1637–43.CrossRefGoogle Scholar
  43. 43.
    De Lima C, Boullosa DA, Frollini AB, et al. Linear and daily undulating resistance training periodizations have differential beneficial effects in young sedentary women. Int J Sports Med. 2012;33(9):723–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Hendrickson NR, Sharp MA, Alemany JA, et al. Combined resistance and endurance training improves physical capacity and performance on tactical occupational tasks. Eur J Appl Physiol. 2010;109(6):1197–208.  https://doi.org/10.1007/s00421-010-1462-2.CrossRefPubMedGoogle Scholar
  45. 45.
    Kim E, Dear A, Ferguson SL, et al. Effects of 4 weeks of traditional resistance training vs. superslow strength training on early phase adaptations in strength, flexibility, and aerobic capacity in college-aged women. J Strength Cond Res. 2011;25(11):3006–13.  https://doi.org/10.1519/jsc.0b013e318212e3a2.CrossRefPubMedGoogle Scholar
  46. 46.
    LeMura LM, von Duvillard SP, Andreacci J, et al. Lipid and lipoprotein profiles, cardiovascular fitness, body composition, and diet during and after resistance, aerobic and combination training in young women. Eur J Appl Physiol. 2000;82(5–6):451–8.  https://doi.org/10.1007/s004210000234.CrossRefPubMedGoogle Scholar
  47. 47.
    Malin SK, Hinnerichs KR, Echtenkamp BG, et al. Effect of adiposity on insulin action after acute and chronic resistance exercise in non-diabetic women. Eur J Appl Physiol. 2013;113(12):2933–41.  https://doi.org/10.1007/s00421-013-2725-5.CrossRefPubMedGoogle Scholar
  48. 48.
    Marx JO, Ratamess NA, Nindl BC, et al. Low-volume circuit versus high-volume periodized resistance training in women. Med Sci Sports Exerc. 2001;33(4):635–43.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Moghadasi M, Siavashpour S. The effect of 12 weeks of resistance training on hormones of bone formation in young sedentary women. Eur J Appl Physiol. 2013;113(1):25–32.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Mosti MP, Carlsen T, Aas E, et al. Maximal strength training improves bone mineral density and neuromuscular performance in young adult women. J Strength Cond Res. 2014;28(10):2935–45.  https://doi.org/10.1519/jsc.0000000000000493.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Olson TP, Dengel DR, Leon AS, et al. Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. Int J Obes. 2007;31(6):996–1003.  https://doi.org/10.1038/sj.ijo.0803534.CrossRefGoogle Scholar
  52. 52.
    Poehlman ET, Denino WF, Beckett T, et al. Effects of endurance and resistance training on total daily energy expenditure in young women: a controlled randomized trial. J Clin Endocrinol Metab. 2002;87(3):1004–9.  https://doi.org/10.1210/jcem.87.3.8282.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Rana SR, Chleboun GS, Gilders RM, et al. Comparison of early phase adaptations for traditional strength and endurance, and low velocity resistance training programs in college-aged women. J Strength Cond Res. 2008;22(1):119–27.  https://doi.org/10.1519/JSC.0b013e31815f30e7.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Santos E, Rhea MR, Simão R, et al. Influence of moderately intense strength training on flexibility in sedentary young women. J Strength Cond Res. 2010;24(11):3144–9.  https://doi.org/10.1519/JSC.0b013e3181e38027.CrossRefPubMedGoogle Scholar
  55. 55.
    Sarsan A, Ardiç F, Özgen M, et al. The effects of aerobic and resistance exercises in obese women. Clin Rehabil. 2006;20(9):773–82.PubMedCrossRefGoogle Scholar
  56. 56.
    Schlumberger A, Stec J, Schmidtbleicher D. Single-vs. multiple-set strength training in women. J Strength Cond Res. 2001;15(3):284–9.PubMedGoogle Scholar
  57. 57.
    Singh JA, Schmitz KH, Petit MA, et al. Effect of resistance exercise on bone mineral density in premenopausal women. Jt Bone Spine. 2009;76(3):273–80.  https://doi.org/10.1016/j.jbspin.2008.07.016.CrossRefGoogle Scholar
  58. 58.
    Stock MS, Olinghouse KD, Drusch AS, et al. Evidence of muscular adaptations within four weeks of barbell training in women. Hum Mov Sci. 2016;45:7–22.  https://doi.org/10.1016/j.humov.2015.11.004.CrossRefPubMedGoogle Scholar
  59. 59.
    Uçan Y. Effects of whole body resistance training on bone status and body composition in young females. J Phys Educ Sports Sci. 2014;8(3):261–9.Google Scholar
  60. 60.
    Weiss LW, Clark FC, Howard DG. Effects of heavy-resistance triceps surae muscle training on strength and muscularity of men and women. Phys Ther. 1988;68(2):208–13.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Cannon J, Marino FE. Early-phase neuromuscular adaptations to high-and low-volume resistance training in untrained young and older women. J Sports Sci. 2010;28(14):1505–14.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Radaelli R, Wilhelm EN, Botton CE, et al. Effects of single vs. multiple-set short-term strength training in elderly women. Age. 2014;36(6):9720.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Hisaeda H, Miyagawa K, Kuno S, et al. Influence of two different modes of resistance training in female subjects. Ergonomics. 1996;39(6):842–52.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Kerr D, Morton A, Dick I, et al. Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res. 1996;11(2):218–25.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Benton MJ, Kasper MJ, Raab SA, et al. Short-term effects of resistance training frequency on body composition and strength in middle-aged women. J Strength Cond Res. 2011;25(11):3142–9.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Calder AW, Chilibeck PD, Webber CE, et al. Comparison of whole and split weight training routines in young women. Can J Appl Physiol. 1994;19(2):185–99.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Damas F, Angleri V, Phillips SM, et al. Myofibrillar protein synthesis and muscle hypertrophy individualized responses to systematically changing resistance training variables in trained young men. J Appl Physiol. 2019;127(3):806–15.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Schoenfeld BJ, Grgic J, Ogborn D, et al. Strength and hypertrophy adaptations between low- vs. high-load resistance training: a systematic review and meta-analysis. J Strength Cond Res. 2017;31(12):3508–23.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Burd NA, Holwerda AM, Selby KC, et al. Resistance exercise volume affects myofibrillar protein synthesis and anabolic signalling molecule phosphorylation in young men. J Physiol. 2010;588(16):3119–30.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Terzis G, Spengos K, Mascher H, et al. The degree of p70 S6k and S6 phosphorylation in human skeletal muscle in response to resistance exercise depends on the training volume. Eur J Appl Physiol. 2010;110(4):835–43.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Burd NA, West DW, Staples AW, et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PloS One. 2010;5(8):e12033.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Mitchell CJ, Churchward-Venne TA, West DW, et al. Resistance exercise load does not determine training-mediated hypertrophic gains in young men. J Appl Physiol. 2012;113(1):71–7.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Davies T, Orr R, Halaki M, et al. Effect of training leading to repetition failure on muscular strength: a systematic review and meta-analysis. Sports Med. 2016;46(4):487–502.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Burd NA, Andrews RJ, West DW, et al. Muscle time under tension during resistance exercise stimulates differential muscle protein sub-fractional synthetic responses in men. J Physiol. 2012;590(2):351–62.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    de Salles BF, Simao R, Miranda F, et al. Rest interval between sets in strength training. Sports Med. 2009;39(9):765–77.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Maltais M, Desroches J, Dionne I. Changes in muscle mass and strength after menopause. Musculoskelet Neuronal Interact. 2009;9(4):186–97.Google Scholar
  77. 77.
    Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol. 2006;61(10):1059–64.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Medical SciencesUniversity of New South WalesSydneyAustralia
  2. 2.School of Science and HealthWestern Sydney UniversitySydneyAustralia
  3. 3.Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health SciencesThe University of SydneyLidcombeAustralia

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