Abstract
OBJECTIVE: This study investigates the impact of exercise training on athletes' cortical excitability, aiming to provide scientific evidence for optimizing training protocols and enhancing athletic performance. METHOD: Following PRISMA guidelines, a systematic search was conducted in databases including PubMed, Web of Science, Embase, and Cochrane Library up to May 1, 2025, including randomized controlled trials (RCTs) or quasi-experimental studies using transcranial magnetic stimulation (TMS) to assess cortical excitability in athletes. Study quality was evaluated using the Cochrane Risk of Bias tool. Meta-analysis was performed with RevMan 5.4 software, using standardized mean difference (SMD) as the effect size and a random-effects model to analyze heterogeneity. Sensitivity analysis was conducted using Stata 18.0. RESULTS: The meta-analysis included 8 studies (245 participants). Results showed that exercise training significantly enhanced cortical excitability (n = 8, SMD = -1.2, 95% CI = -1.75 to -1.65, p < 0.01), with high heterogeneity (I (2) = 71%). Subgroup analysis by exercise type indicated significant effects for combat sports and endurance sports (p < 0.05), but not for technical-tactical sports (p > 0.05). Subgroup analysis by training duration showed significant effects for long-, medium-, and short-term training (p < 0.05), with medium-term training exhibiting low heterogeneity (I (2) = 0%). Sensitivity analysis and funnel plots confirmed robust results with low risk of publication bias. CONCLUSION: Exercise training significantly enhances athletes' cortical excitability, particularly in combat and endurance sports and during medium-term training. Future research should further explore the specific effects of different training types and TMS metrics to reduce heterogeneity and optimize training design. SYSTEMATIC REVIEW REGISTRATION: The systematic review has been registered in PROSPERO under the ID CRD420251045271. The registration details are available at: https://www.crd.york.ac.uk/PROSPERO/recorddashboard.