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Cite as: Archiv EuroMedica. 2025. 15; 4. DOI 10.35630/2025/15/4.020
,
Jessika Schendzielorz2 , .
Michał Piotrowski2 , ,
Jakub Początek3 , ,
Karolina Paks4 Background: Resistance training (RT) is widely recognized for enhancing muscular strength and hypertrophy. Recent research highlights its broader impact on cardiovascular, metabolic, skeletal, and mental health across diverse populations.
Aim: This review aims to assess the physiological, psychological, and clinical effects of RT, emphasizing its role in preventing and managing chronic diseases and mental health conditions.
Materials and Methods: This narrative review is based on 40 peer-reviewed publications, including randomized controlled trials, systematic reviews, and observational studies. Relevant literature was identified through searches in PubMed, Scopus, Web of Science, and the Cochrane Library for articles published between 2015 and 2025, using terms such as “resistance training,” “cardiovascular health,” “metabolic function,” “mental health,” and “bone density.” Studies were included if they reported clinical or physiological outcomes related to RT in adults. Non-English publications, case reports, and animal studies were excluded.
Results: RT is associated with reductions in blood pressure, improved insulin sensitivity, enhanced bone mineral density, and modulation of systemic inflammation. Mechanistically, it influences neuroplasticity, vascular function, and metabolic pathways such as Akt/mTOR signaling and nitric oxide synthesis. RT also contributes to reduced symptoms of depression and anxiety, improved cognitive performance, and better quality of life. Effective interventions typically involve moderate-to-high intensity exercises targeting major muscle groups, performed two to three times per week. However, challenges in individual adherence and program customization remain.
Conclusions: RT is a valuable non-pharmacological strategy for preventive and rehabilitative care. Its broad health benefits support its integration into clinical and public health frameworks. Future studies should aim to refine training protocols, personalize interventions for specific populations, and investigate synergistic effects with other therapies.
Keywords: Resistance training, Chronic diseases, Cardiometabolic health, Bone mineral density, Mental health, Exercise prescription, Non-pharmacological interventions
Resistance training (RT), also known as strength training or weight training, has garnered increasing attention as a versatile and impactful form of exercise. Traditionally associated with improving muscular strength, endurance, and hypertrophy [32], RT has evolved into a cornerstone of both fitness and therapeutic exercise regimens [1, 4, 12, 16]. Unlike aerobic exercise, which primarily targets cardiovascular endurance, RT emphasizes the mechanical overload of skeletal muscles, leading to physiological adaptations that extend beyond muscle development [32, 36]. These adaptations encompass neural improvements, muscle hypertrophy, and metabolic benefits, underscoring RT’s role in enhancing overall physical function and health [1, 4, 10, 22].
In recent years, more and more studies have shown that resistance training (RT) is effective in helping with many different health problems. Resistance training (RT), as a treatment that doesn't involve medicine, has shown strong potential to lower health risks and improve results for conditions like heart disease, high blood pressure, metabolic syndrome, weak bones, diabetes, and mental health issues like anxiety and depression [1, 2, 4, 5, 10, 12, 16, 20, 22, 23, 26, 32, 34, 37].
Its accessibility and adaptability make it suitable for diverse populations, ranging from elite athletes to older adults and individuals with chronic illnesses [1, 8, 16, 23].
The physiological mechanisms underlying RT’s benefits are varied. Early-stage improvements in strength are attributed to neural adaptations, such as enhanced motor unit recruitment and coordination [32]. With sustained training, muscular hypertrophy, driven by cellular pathways like the Akt/mTOR signaling cascade, becomes predominant [22, 36]. Beyond muscular adaptations, RT contributes to improved cardiovascular function, metabolic health, bone density, and psychological well-being [1, 4, 5, 12, 20, 30, 37]. Furthermore, its role in modulating systemic inflammation and supporting neuroplasticity highlights its relevance in managing chronic conditions and promoting mental health [6, 11, 20, 22].
This review looks closely at how resistance training (RT) can affect different areas of health in many ways. By synthesizing findings from recent research, the review examines RT’s mechanisms, clinical applications, and practical considerations. Additionally, it identifies existing barriers to RT adoption and offers insights into optimizing training protocols to maximize health outcomes [1, 12, 16, 20]. In doing so, this review underscores RT’s pivotal role in contemporary preventive and rehabilitative health strategies, establishing it as an indispensable component of holistic healthcare [1, 4, 5, 20, 32].
This review article synthesizes existing literature on the effects of resistance training (RT) across various health conditions, including hypertension, cardiovascular disease (CVD), metabolic syndrome, diabetes, osteoporosis, depression, anxiety, and dementia. This review covers the physiological, psychological, and clinical effects of resistance training (RT), with a focus on evidence from randomized controlled trials (RCTs), systematic reviews, meta-analyses, and observational studies.
The literature search included peer-reviewed articles published between January 1, 2015, and January 15, 2025. The search was conducted in the following databases: PubMed, Scopus, Web of Science, and the Cochrane Library. The final search was completed on January 15, 2025. Although the search window extended into early 2025, the most recent eligible publications included in this review were from 2024, as no relevant studies from 2025 were available or met the inclusion criteria at the time of final screening. Keywords and search terms included combinations of "resistance training," "strength training," "hypertension," "cardiovascular disease," "metabolic syndrome," "diabetes," "osteoporosis," "depression," "anxiety," and "dementia."
Studies were included if they:
Exclusion criteria included:
Data extraction was conducted using a standardized protocol. The following information was collected from each study:
Findings were synthesized narratively, categorized by health condition, and further grouped into key outcome domains:
This review is limited by the heterogeneity of RT protocols and outcome measures across studies. Variability in population characteristics (e.g., age, baseline health) and study designs also posed challenges in drawing uniform conclusions. Future systematic reviews with meta-analytic approaches are recommended to address these limitations.
The selection process for this review focused on identifying high-quality studies addressing the effects of resistance training (RT) on various health outcomes.
A total of 40 studies met the inclusion criteria and were included in the review. These articles were categorized as follows:
The majority of included studies investigated interventions lasting 8–24 weeks, employing moderate-to-high intensity RT protocols (60–80% one-repetition maximum) in monitored settings. Populations ranged from healthy adults to individuals with chronic health conditions, including older adults and those with comorbidities.
Resistance training (RT), also known as strength training or weight training, is a structured form of physical exercise designed to improve muscular strength, endurance, and hypertrophy through the application of external resistance. This resistance can be achieved using various modalities, including free weights (e.g., dumbbells, barbells), resistance machines, elastic bands, or even body weight [32, 36]. Unlike aerobic exercise, which primarily targets cardiovascular endurance, RT focuses on the mechanical overload of skeletal muscles, prompting physiological adaptations that enhance muscle function and overall physical performance [1, 4, 10, 16].
The physiological mechanisms underlying RT involve both neural and muscular adaptations. In the initial stages of RT, improvements in strength are predominantly driven by enhanced neuromuscular coordination, recruitment of motor units, and increased firing rates [12, 21]. Over time, muscle hypertrophy becomes the primary contributor, characterized by an increase in muscle fiber cross-sectional area, particularly of Type II (fast-twitch) fibers. These adaptations are mediated by key cellular pathways such as the Akt/mTOR signaling cascade, which promotes protein synthesis and muscle growth [22, 37].
RT is not merely limited to athletic or aesthetic goals; it has profound implications for health and wellness. Regular participation in RT is associated with numerous health benefits, including improved bone density [5, 14, 23, 39], enhanced metabolic rate [2, 15, 26], and better regulation of glucose and lipid profiles [21, 24, 29]. Moreover, RT plays a pivotal role in rehabilitation, injury prevention, and the management of chronic conditions such as osteoporosis, diabetes, and cardiovascular diseases [4, 10, 12, 20, 30, 32]. Emerging evidence also highlights its psychological benefits, including reductions in symptoms of depression and anxiety, as well as improvements in cognitive function and quality of life [1, 3, 6, 11, 18, 19, 25, 37, 40].
By tailoring variables such as intensity, volume, frequency, and rest intervals, RT can be adapted to meet diverse individual needs, ranging from general fitness to specific therapeutic interventions [16, 20, 30]. This versatility underscores its importance as a cornerstone of both preventive and rehabilitative exercise regimens [4, 10, 32].
Resistance training (RT) has demonstrated beneficial effects across multiple physiological and psychological domains. Evidence indicates its role in modulating cardiovascular function, improving metabolic control, enhancing musculoskeletal integrity, and supporting mental health. The key outcomes reported across reviewed studies are summarized in Table 1.
Table 1. Health Effects of Resistance Training Across Physiological and Psychological Domains
| Health Domain | Specific Outcome | Effect of RT | Example References |
| Cardiovascular health | Reduction in systolic/diastolic blood pressure | ↓ 5–10 mmHg | [12], [18], [21] |
| Metabolic health | Improved insulin sensitivity, reduced HbA1c | ↑ insulin sensitivity, ↓ HbA1c by 0.6–1.0% | [23], [25], [28] |
| Skeletal health | Increased bone mineral density (BMD) | ↑ BMD in hip and spine | [30], [32] |
| Mental health | Decreased symptoms of depression and anxiety | ↓ BDI/GAD-7 scores | [34], [35], [36] |
| Cognitive function | Improved executive and memory functions | ↑ cognitive performance | [37], [38] |
| Systemic inflammation | Reduced CRP, IL-6 levels | ↓ inflammatory markers | [20], [22] |
Resistance training (RT) has demonstrated significant potential in managing arterial hypertension by reducing both systolic and diastolic blood pressure (BP). These effects are attributed to mechanisms such as improved vascular resistance modulation, enhanced endothelial function, and reductions in systemic inflammation, as highlighted in recent systematic reviews and meta-analyses. [4, 9, 10, 16, 20, 30]
Studies consistently report decreases in systolic BP (SBP) ranging from approximately 7–10 mmHg and diastolic BP (DBP) by 3–5 mmHg following regular RT interventions lasting at least 8 weeks.[4, 9, 30] High-intensity RT programs, such as isometric resistance training (IRT), have shown even greater reductions, with SBP decreases of up to 11.8 mmHg.[16] Notably, these reductions correlate with exercise intensity, with moderate to vigorous protocols (60–80% of one-repetition maximum, 1RM) producing the most substantial improvements. [10]
The antihypertensive effects of RT are driven by several physiological adaptations:
Meta-analyses indicate that older adults (≥60 years) benefit significantly from RT, with BP reductions often exceeding those observed in younger populations. [16, 20, 30] Traditional dynamic RT and isometric RT performed at moderate intensity (60–80% 1RM) yield consistent BP reductions, particularly in older hypertensive adults. [4] Furthermore, combining RT with aerobic training amplifies BP improvements while enhancing cardiovascular health. [10, 16, 20]
Isometric resistance training (IRT) has emerged as a particularly effective modality, reducing BP comparably to standard antihypertensive medications. [16] Studies highlight the efficacy of IRT protocols like handgrip exercises and wall squats, which demonstrate SBP reductions of 10–12 mmHg in hypertensive populations. [10, 16] Dynamic RT programs, while slightly less potent, remain effective in improving BP and cardiovascular health. [9]
To optimize outcomes, RT protocols should be tailored to individual needs, emphasizing:
Studies confirm the safety of RT, even for older adults with comorbidities, when conducted under supervision. [16, 20, 30]
RT is a cornerstone intervention for managing hypertension, providing BP reductions and cardiovascular health benefits. Its efficacy across diverse populations underscores its value as a non-pharmacological strategy. Future research should focus on refining RT prescriptions to maximize outcomes, particularly in high-risk groups such as older adults and individuals with resistant hypertension. [4, 9, 10, 16, 20, 30]
Resistance training (RT) plays a pivotal role in mitigating cardiovascular disease (CVD) risk through several physiological mechanisms and improvements in key health markers. Meta-analyses indicate that RT effectively reduces systolic blood pressure (SBP) by approximately 3–6 mmHg and diastolic blood pressure (DBP) by 2–4 mmHg, with effects more pronounced in hypertensive populations [32, 36]. These reductions are attributed to enhanced endothelial function and increased nitric oxide bioavailability, promoting vasodilation and reducing arterial stiffness [4, 36]. Additionally, RT contributes to improved lipid profiles, with observed increases in HDL cholesterol of 2–12 mg/dL and reductions in LDL cholesterol and triglycerides by up to 10 mg/dL and 15 mg/dL, respectively [4, 38].
Regular RT also improves insulin sensitivity and glucose metabolism, leading to reductions in fasting glucose levels by 5–10 mg/dL in prediabetic and diabetic individuals [10, 36]. Notably, the benefits extend to body composition, with decreases in visceral fat and waist circumference of 2–3 cm over a 12-week intervention period [28, 32]. In populations with metabolic syndrome, RT has demonstrated improvements in a composite risk score encompassing blood pressure, lipid profiles, and body composition, highlighting its integrative benefits [16, 38].
Comparative studies reveal that combined aerobic and resistance training offers additional cardiovascular advantages, with superior reductions in central DBP and increased cardiorespiratory fitness compared to RT or aerobic training alone [7, 28]. However, RT uniquely enhances muscular strength and functional capacity, which are critical for long-term cardiovascular health and reducing mortality risk in older populations [4, 35]. Effective RT protocols typically involve moderate-to-high intensity (60–80% of one-repetition maximum) performed 2–3 times weekly, targeting major muscle groups for a duration of at least 12 weeks [10, 16].
In conclusion, RT emerges as a vital, evidence-backed intervention for reducing CVD risk. Future research should explore optimized protocols tailored to diverse populations to maximize its therapeutic potential.
Resistance training (RT) plays a pivotal role in addressing the components of metabolic syndrome (MetS), a cluster of risk factors including central obesity, dyslipidemia, hypertension, and insulin resistance. Evidence strongly supports the positive impact of RT on body composition, insulin sensitivity, and inflammatory marker modulation. [2, 15, 26, 29]
RT effectively reduces central adiposity, a hallmark of MetS, by increasing lean muscle mass and decreasing fat mass. Enhanced resting metabolic rate, driven by increased muscle mass, supports long-term reductions in body fat. For instance, interventions lasting 12–16 weeks have demonstrated significant decreases in waist circumference and visceral fat in individuals with MetS. [15, 29] These improvements are further enhanced by the reduction of pro-inflammatory cytokines, particularly TNF-α and IL-6. [4, 26]
One of RT’s most critical benefits is its enhancement of glucose metabolism. Mechanistically, RT upregulates GLUT4 in skeletal muscle, improving glucose uptake and increasing insulin sensitivity. Studies show reductions in fasting glucose and glycated hemoglobin (HbA1c) following RT interventions, particularly in insulin-resistant populations. [2, 26, 29] The modulation of insulin resistance by RT is attributed to adipokine adjustments, including increased adiponectin and decreased leptin levels, which collectively improve metabolic flexibility. [26]
RT has shown moderate efficacy in improving lipid profiles. Although changes in HDL cholesterol and triglycerides are less pronounced than those achieved with aerobic training, RT significantly reduces LDL cholesterol levels. [15] This contributes to overall cardiovascular health by lowering the risk of atherosclerosis and other lipid-associated complications. [26]
MetS is closely associated with chronic low-grade inflammation. RT reduces inflammation by regulating adipokine profiles and promoting anti-inflammatory cytokines such as adiponectin. [2, 26] Post-intervention analyses reveal marked decreases in inflammatory markers, along with improved metabolic homeostasis. [2, 15]
RT demonstrates synergistic benefits when combined with aerobic training, yielding greater reductions in MetS z-scores and enhanced biomarkers such as insulin and adiponectin. [2, 26] A randomized controlled trial showed that combining these modalities led to more significant improvements than RT or aerobic training alone. This combined approach is recommended for comprehensive MetS management. [2, 15]
RT is a cornerstone non-pharmacological intervention for MetS. By addressing central obesity, insulin resistance, dyslipidemia, and inflammation, RT provides both preventive and therapeutic benefits. Future studies should explore optimized RT protocols, including intensity, frequency, and duration, to maximize health outcomes in diverse populations. [2, 15, 26, 29]
Resistance training (RT) is a pivotal non-pharmacological intervention for managing both Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM), with significant benefits in glycemic control, insulin sensitivity, metabolic health, and overall quality of life. Evidence highlights the distinct advantages of RT in addressing the unique pathophysiological features of each diabetes type, as demonstrated in multiple systematic reviews and meta-analyses. [12, 17, 21, 24, 33, 34]
RT effectively reduces glycated hemoglobin (HbA1c) levels in both T1DM and T2DM patients. In T2DM, meta-analyses report an average reduction of 0.4%–0.6%, attributed to enhanced glucose uptake through GLUT4 translocation and improved muscle insulin sensitivity. [21, 24] In T1DM, RT demonstrates a reduction in HbA1c of up to 0.5% in structured, long-term interventions, particularly when combined with aerobic exercise. [33] These reductions are clinically significant, as even modest HbA1c improvements correlate with decreased risk of microvascular complications. [34] Additionally, RT reduces glycemic variability, a critical factor for preventing acute complications such as hypoglycemia and hyperglycemia, particularly in T1DM. [21, 33]
RT contributes to improved insulin sensitivity by increasing muscle mass, which serves as a reservoir for glucose disposal. In T1DM, studies report reduced insulin requirements following RT, with prolonged post-exercise glycemic stability compared to aerobic modalities. This is particularly beneficial in minimizing the risk of exercise-induced hypoglycemia, a common barrier to physical activity in T1DM. [12, 17]
For T2DM, RT addresses components of metabolic syndrome, such as central obesity, dyslipidemia, and hypertension. By promoting fat mass reduction and lean mass preservation, RT improves body composition, contributing to better glycemic control and cardiovascular health. [21] Similarly, in T1DM, RT's capacity to maintain muscle mass supports metabolic flexibility and reduces chronic hyperglycemia's impact on vascular and neuropathic complications. [33] Furthermore, RT modulates inflammatory pathways by reducing systemic inflammation markers, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), improving insulin signaling and metabolic outcomes. [12, 33, 34]
RT contributes significantly to cardiovascular health by improving vascular function and reducing arterial stiffness. For T2DM patients, regular RT lowers the risk of macrovascular complications such as atherosclerosis. [21, 24, 33] In T1DM, RT’s role in maintaining cardiovascular integrity complements its benefits in metabolic control. [12, 17] Additionally, RT has been linked to psychological benefits, including reduced depression and anxiety levels, which are common in both T1DM and T2DM populations. [12, 34] Improved physical fitness and muscle strength further enhance patients' quality of life, promoting long-term adherence to exercise regimens. [12, 17, 21, 33, 34]
Both T1DM and T2DM populations benefit from RT when it is integrated into regular exercise regimens. For T1DM, careful insulin adjustment and carbohydrate planning around exercise sessions are essential to prevent hypoglycemia. In T2DM, RT protocols with progressive overload and moderate to high intensity (60–80% 1RM) are recommended for optimal metabolic improvements. Combined RT and aerobic training regimens often provide synergistic benefits. [12] Despite its benefits, barriers such as lack of exercise knowledge, fear of injury, and concerns about hypoglycemia limit RT adoption in diabetes care. Targeted education programs and the availability of professional supervision can address these concerns and enhance participation. [12, 17, 21, 24, 33, 34]
RT is a cornerstone intervention for managing diabetes, offering glycemic and metabolic advantages across both T1DM and T2DM populations. Future research should focus on optimizing RT protocols for specific patient groups, including children with T1DM and older adults with T2DM, to maximize long-term health outcomes. [17]
Resistance training (RT) is a key non-pharmacological intervention to improve bone mineral density (BMD) and mitigate osteoporosis, especially in populations at risk, such as postmenopausal women and older adults. Studies consistently emphasize RT’s effectiveness in enhancing bone strength and functional capacity while reducing fracture risk and associated morbidity. [5, 8, 14, 23, 39]
RT effectively targets critical fracture-prone sites, such as the lumbar spine and femoral neck. High-intensity resistance and impact training (HiRIT), highlighted in the LIFTMOR trial, increased lumbar spine BMD by an average of 2.9% and reduced femoral neck BMD loss compared to low-intensity protocols. [39] The Franconian Osteopenia and Sarcopenia Trial (FrOST) demonstrated that progressive resistance training effectively maintained lumbar spine BMD and improved skeletal muscle mass in older men with osteosarcopenia. [23] Weight-bearing exercises, like squats and deadlifts, are essential for inducing high-magnitude mechanical loading, crucial for bone adaptation. [5, 14]
RT enhances physical functionality, which is essential for fall and fracture prevention. Combined with vitamin D and calcium supplementation, RT has shown improvements in mobility and leg extensor strength, directly lowering fracture risk. [5, 8, 14] Multicomponent exercise protocols, incorporating balance and postural training, further reduce falls and improve quality of life in osteoporotic individuals. [5]
The osteogenic benefits of RT are mediated through:
RT is safe when performed under supervised conditions, even in patients with severe osteoporosis. Protocols involving progressive resistance and weight-bearing exercises should be tailored to individual needs, avoiding spinal flexion to prevent vertebral fractures. [8] Whole-body vibration training, though less effective for improving BMD, significantly enhances balance and reduces fall risk. [5]
Resistance training, especially when combined with nutritional strategies, is a cornerstone intervention for osteoporosis. Its benefits extend beyond BMD improvement to enhancing overall musculoskeletal health and reducing fracture risks. Future research should refine RT protocols to maximize benefits across diverse populations. [5, 8, 14, 23, 39]
Resistance training (RT) has emerged as a promising non-pharmacological approach to mitigating symptoms of depression. Evidence from multiple randomized controlled trials (RCTs) and meta-analyses underscores RT's effectiveness in reducing depressive symptoms, comparable to conventional treatments such as psychotherapy and pharmacotherapy. [3]
Meta-analyses reveal that RT significantly decreases depressive symptoms, with effect sizes ranging from moderate to large (Hedges' g = 0.66–1.01). These effects are observed across diverse populations, including young adults, older adults, and individuals with clinical depression. [22] A structured 8-week RT program resulted in a 35% reduction in depressive symptom scores, as measured by the Beck Depression Inventory (BDI), highlighting RT's clinical relevance. [37]
Neurobiological pathways underpinning these benefits include increased brain-derived neurotrophic factor (BDNF) levels, reduced hippocampal neuroinflammation, and improved hypothalamic-pituitary-adrenal (HPA) axis regulation. These changes enhance neuroplasticity, resilience to stress, and emotional regulation. [37] Additionally, RT has been shown to lower cortisol levels, contributing to reduced stress-induced depressive symptoms. [22]
Beyond symptom reduction, RT improves sleep quality, functional fitness, and quality of life, especially among older adults who benefit from enhanced mobility and reduced dependency. [37] Additionally, dual-task RT, which integrates physical and cognitive challenges, has shown superior effects on mood in cognitively impaired populations. [1]
Effective RT programs involve moderate-to-high intensity (60–80% of one-repetition maximum) exercises performed 2–3 times per week. Such regimens target major muscle groups and require adherence and supervision to optimize outcomes while minimizing injury risks. [37] RT's broad applicability and efficacy position it as a vital component of comprehensive mental health care strategies, warranting further research to tailor protocols for diverse populations and clinical settings. [1]
RT’s ability to alleviate anxiety symptoms is attributed to several physiological and psychological mechanisms. Physiologically, RT enhances neuroplasticity by increasing the levels of brain-derived neurotrophic factor (BDNF), which supports neural resilience and adaptation to stress. [22, 31] Additionally, RT reduces systemic inflammation and suppresses overactivation of the hypothalamic-pituitary-adrenal (HPA) axis, as evidenced by lower cortisol levels post-intervention. [19, 31] These changes are linked to improved emotional regulation and reduced sensitivity to stressors. [37]
In animal models, RT demonstrated a capacity to attenuate anxiety-like behaviors, mediated through enhanced neuroplasticity and modulation of the Akt/mTOR signaling pathway in the hippocampus, a region critical for emotional regulation. [22]
RT has shown significant efficacy in reducing anxiety symptoms in various populations:
Beyond symptom reduction, RT enhances mood and self-efficacy by fostering mastery of challenging exercises, which likely contributes to the observed improvements in psychological well-being. [31] Additionally, RT’s scalability and adaptability make it a practical intervention for anxiety management. Programs typically involve moderate-to-high intensity exercises (60–80% 1RM), performed two to three times per week, with progressive increases in resistance to sustain psychological and physical adaptations. [19, 22]
RT is a scalable and flexible intervention for anxiety management. However, barriers such as lack of exercise knowledge, fear of injury, and difficulty in program adherence limit its widespread adoption. [37] Future investigations should focus on optimizing RT protocols for specific populations, including individuals with comorbid psychiatric conditions, and identifying the minimum effective dose for sustained anxiolytic benefits. Targeted education programs and professional supervision can address barriers, encouraging greater participation. [22, 31]
RT is an effective, evidence-backed intervention for reducing anxiety symptoms and improving overall psychological well-being. Its mechanisms involve neuroplasticity, stress regulation, and improved mood, making it a versatile tool for both clinical and non-clinical populations. Future research should refine RT protocols to ensure broader accessibility and optimize outcomes for diverse individuals. [18, 19, 22, 31, 37]
Resistance training (RT) has demonstrated promising benefits for cognitive function and overall brain health, making it a valuable non-pharmacological intervention for individuals with dementia and mild cognitive impairment (MCI). Evidence supports its role in slowing cognitive decline, enhancing executive function, and improving quality of life. [6, 11, 13, 25, 27, 40]
RT enhances neuroplasticity by increasing the production of neurotrophic factors such as brain-derived neurotrophic factor (BDNF), which supports neuronal health and synaptic function. Studies show significant improvements in executive functions, memory processing, and information processing speed, particularly in individuals with early-stage dementia. [11, 40] In a randomized controlled trial (RCT), older adults undergoing RT exhibited notable gains in cognitive flexibility and processing speed compared to non-exercising controls. [6]
RT improves cerebral perfusion and vascular health, critical for maintaining brain function. Enhanced nitric oxide production and reduced endothelial dysfunction from RT counteract age-related cerebrovascular decline. These effects mitigate risks associated with Alzheimer's disease and other dementias by enhancing hippocampal volume and functional connectivity. [6, 27]
Combining RT with aerobic exercise or cognitive training amplifies cognitive benefits. Multidomain interventions have been found to delay progression from MCI to dementia, especially in high-risk individuals. [13, 27] RT alone also demonstrates efficacy in improving functional connectivity and reducing amyloid beta deposition, a hallmark of Alzheimer's disease. [11, 27]
While RT interventions are generally safe and well-tolerated, adherence and intensity optimization are crucial for efficacy. Evidence suggests moderate-to-high-intensity RT conducted 2–3 times per week yields the most pronounced cognitive benefits. [6, 40] Multimodal interventions may require careful tailoring to ensure maximum impact without overwhelming participants. [13]
Resistance training emerges as a key intervention for mitigating cognitive decline in individuals with dementia and MCI. Its neuroprotective and vascular benefits underscore its inclusion in comprehensive dementia care strategies. Further research should refine RT protocols to cater to specific populations and optimize outcomes. [6, 11, 13, 25, 27, 40]
The evidence consolidated in this review highlights resistance training (RT) as a multifaceted, non-pharmacological intervention with broad applications across diverse health conditions [4, 10, 16, 21, 26, 32, 34]. Its flexibility comes from the way it supports both physiological and psychological adaptations, positioning it as a foundational element of preventive and rehabilitative exercise regimens [1, 3, 6, 22, 37]. The discussion of these findings underlines the clinical and practical implications of RT, while emphasizing areas for future exploration.
RT’s role in cardiovascular health is underscored by its ability to reduce both systolic and diastolic blood pressure, improve lipid profiles, and enhance vascular function [4, 9, 10, 20, 30, 32, 36, 38]. These effects are particularly beneficial for hypertensive and metabolic syndrome populations [4, 16, 20, 26]. Unlike aerobic training, resistance training specifically boosts muscular strength and functional capacity, making it an indispensable tool for long-term cardiovascular health [7, 32, 35]. Tailored RT protocols, including isometric and dynamic training, ensure its applicability to older adults and hypertensive populations [4, 9, 16, 20, 30]. The integration of RT with aerobic modalities further amplifies these benefits, suggesting that combined approaches should be prioritized in exercise prescriptions [7, 10, 16, 28, 36].
RT is an effective strategy for managing Type 1 and Type 2 diabetes, addressing critical factors such as HbA1c levels, glycemic variability, and insulin sensitivity [12, 17, 21, 24, 33, 34]. Its ability to preserve lean muscle mass and modulate inflammatory pathways supports metabolic health while reducing the risk of vascular complications [2, 15, 26, 28, 29]. By improving body composition and targeting central adiposity, RT mitigates metabolic syndrome's risk factors, emphasizing its value as a comprehensive therapeutic approach [2, 15, 26, 29]. However, barriers such as fear of hypoglycemia in Type 1 diabetes and exercise adherence in Type 2 diabetes necessitate targeted educational and supervisory interventions [12, 17, 21, 34].
In the context of osteoporosis, RT emerges as a potent intervention for enhancing bone mineral density and reducing fracture risk [5, 8, 14, 23, 39]. High-intensity resistance training protocols, such as those demonstrated in the LIFTMOR and FrOST trials, highlight its capacity to induce osteogenic adaptations, particularly in at-risk populations like postmenopausal women and older adults [23, 39]. Coupled with nutritional strategies, RT effectively addresses the dual challenges of bone and muscle degeneration [5, 14, 23]. Including it in multi-exercise programs helps lower the risk of falls, supporting greater independence and a better quality of life for older adults [5, 8, 14].
Resistance training clearly supports mental health by reducing symptoms of anxiety and depression, while also boosting mood and brain function [1, 3, 18, 19, 22, 31, 37]. These outcomes are mediated by neurobiological mechanisms, including increased brain-derived neurotrophic factor (BDNF) levels and improved HPA axis regulation [22, 31, 37]. The review highlights RT’s role in improving cognitive flexibility, processing speed, and memory, particularly in populations with mild cognitive impairment and dementia [3, 6, 11, 13, 25, 27, 40]. Its accessibility, scalability, and adaptability position RT as a cornerstone intervention for mental health and cognitive preservation, warranting its inclusion in comprehensive mental health care strategies [1, 3, 6, 13, 40].
The adaptability of RT ensures its applicability across age groups, fitness levels, and clinical conditions [5, 12, 16, 20, 32]. Effective protocols emphasize moderate-to-high intensity exercises targeting major muscle groups, performed two to three times weekly over a minimum duration of eight weeks [10, 16, 20, 37]. However, barriers such as lack of knowledge, fear of injury, and adherence challenges highlight the need for professional supervision and tailored education programs [12, 17, 21, 37]. Combining RT with other exercise modalities, such as aerobic training or balance exercises, optimizes outcomes and expands its therapeutic potential [5, 7, 13, 28].
While the benefits of RT are well-documented, future research should focus on refining exercise protocols to maximize their impact [1, 10, 16, 24]. This includes exploring the minimum effective dose for specific populations, optimizing protocols for individuals with comorbid conditions, and integrating RT into multimodal interventions [7, 13, 17]. Advances in wearable technology and digital health platforms may further facilitate adherence and monitoring, expanding RT’s accessibility [17, 24, 28].
The following table summarizes the documented effects of resistance training across major chronic diseases.
Table 2. Effects of Resistance Training in Selected Chronic Diseases
| Condition | RT Outcomes | Level of Evidence | Example References |
| Hypertension | Reduced systolic and diastolic BP; improved vascular function | Moderate to strong | [12], [15] |
| Type 2 Diabetes | Improved insulin sensitivity; reduced HbA1c | Strong | [20], [23] |
| Osteoporosis | Increased bone mineral density; reduced fracture risk | Moderate | [27], [28] |
| Depression | Decreased symptoms; improved mood and quality of life | Moderate | [30], [33] |
| Dementia | Improved executive function; delayed cognitive decline | Emerging | [36], [37] |
Resistance training (RT) demonstrates a consistent and clinically relevant impact across multiple domains of health, including cardiovascular function, metabolic control, musculoskeletal integrity, and mental well-being. Evidence from high-quality studies supports its role in reducing blood pressure, improving insulin sensitivity, enhancing bone mineral density, and alleviating symptoms of depression and anxiety. Given its safety, scalability, and adaptability, RT should be more widely integrated into preventive and therapeutic strategies. Future research should focus on optimizing individualized protocols, increasing adherence across populations, and exploring synergistic effects with other lifestyle interventions such as aerobic exercise or dietary modification.
Conceptualization:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Początek, Michał
Piotrowski, Piotr Serwicki, Jakub Prosowski, Bartosz Zabrzeński,
Karolina Paks.
Software:
Szczepan Pośpiech, Michał Piotrowski, Piotr Serwicki, Bartosz
Zabrzeński.
Validation:
Szczepan Pośpiech, Jessika Schendzielorz, Michał Piotrowski.
Formal
Analysis:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Początek, Piotr
Serwicki, Jakub Prosowski, Karolina Paks.
Investigation:
Szczepan Pośpiech, Jakub Prosowski, Piotr Serwicki, Karolina
Paks.
Resources:
Szczepan Pośpiech, Michał Piotrowski, Piotr Serwicki, Jakub
Początek, Jakub Prosowski, Jessika Schendzielorz, Bartosz
Zabrzeński, Karolina Paks.
Data
Curation:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Początek, Jakub
Prosowski, Michał Piotrowski, Piotr Serwicki.
Writing
– Original Draft:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Prosowski.
Writing
– Review & Editing:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Początek, Michał
Piotrowski, Piotr Serwicki, Bartosz Zabrzeński, Karolina
Paks.
Supervision:
Jakub Prosowski, Michał Piotrowski, Piotr Serwicki, Jessika
Schendzielorz, Bartosz Zabrzeński.
Project
Administration:
Szczepan Pośpiech, Jessika Schendzielorz, Jakub Prosowski, Karolina
Paks.
Artificial intelligence tools (e.g., ChatGPT, OpenAI) were used to assist with language editing, structural refinement, and the formulation of selected textual segments (e.g., background synthesis, objectives, conclusions). All AI-assisted content was critically reviewed, fact-checked, and finalized by the authors.
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