The Effect of Intensity, Frequency, Duration and Volume of Physical Activity in Children and Adolescents on Skeletal Muscle Fitness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Physical activity could improve the muscle fitness of youth, but the systematic analysis of physical activity elements and muscle fitness was limited. This systematic review and meta-analysis aim to explore the influence of physical activity elements on muscle fitness in children and adolescents. We analyzed literature in Embase, EBSCO, Web of Science, and PubMed databases from January 2000 to September 2020. Only randomized controlled studies with an active control group, which examined at least 1 muscle fitness evaluation index in individuals aged 5-18 years were included. Articles were evaluated using the Jaded scale. Weighted-mean standardized mean differences (SMDs) were calculated using random-effects models. Twenty-one studies and 2267 subjects were included. Physical activity had moderate effects on improving muscle fitness (SMD: 0.58-0.96, p < 0.05). Physical activity element subgroup analysis showed that high-intensity (SMD 0.68-0.99, p < 0.05) physical activity <3 times/week (SMD 0.68-0.99, p < 0.05), and <60 min/session (SMD 0.66-0.76, p < 0.01) effectively improved muscle fitness. Resistance training of >= 3 sets/session (SMD 0.93-2.90, p < 0.01) and <10 repetitions/set (SMD 0.93-1.29, p < 0.05) significantly improved muscle fitness. Low-frequency, high-intensity, and short-duration physical activity more effectively improves muscle fitness in children and adolescents. The major limitation of this meta-analysis was the low quality of included studies. The study was registered in PROSPERO with the registration number CRD42020206963 and was funded mainly by the Ministry of Education of Humanities and Social Science project, China.