Effects and dose-response relationship of core strength training on balance performance in adolescent athletes: a systematic review and meta-analysis

Abstract

Core strength training (CST) is widely prescribed to improve balance performance, yet its dose-response relationship in adolescent athletes has not been quantified. We conducted a systematic review and meta-analysis of parallel-group randomized controlled trials evaluating CST versus control on balance outcomes in adolescent athletes aged 10–19 years. Six databases were searched from inception to 30 April 2026. Hedges’ g values were pooled under random-effects models; six training parameters were examined by univariate meta-regression, and restricted cubic splines were used to model dose-response relationships. Thirteen RCTs (n = 337) were included. CST produced a moderate-to-large improvement in balance performance (g = 0.84, 95% CI 0.38–1.30, p < 0.001), with larger effects for dynamic (g = 1.01) than static (g = 0.39) balance. Session duration was the only parameter showing a significant non-linear dose-response relationship (p < 0.001), with effects peaking at 31–45 min per session. Certainty of evidence was low (dynamic) to very low (static) by GRADE. A trim-and-fill sensitivity analysis attenuated the pooled estimate (g = 0.60, 95% CI 0.10–1.10) but it remained statistically significant. CST was associated with improved balance in adolescent athletes, with session durations of 31–45 min yielding the largest effects; this dose-response finding is exploratory and requires prospective confirmation.