Effects of sprint interval training versus moderate-intensity continuous training on physiological adaptations and exercise performance in healthy adults: a systematic review and meta-analysis

Although various forms of high-intensity interval training (HIIT) have been shown to improve cardiorespiratory fitness and metabolic health, physiological adaptations may vary across different exercise modalities. Sprint interval training (SIT) is an interval training modality characterized by repeated bouts of brief all-out or supramaximal-intensity sprint efforts interspersed with recovery periods. However, whether SIT produces greater improvements in physiological adaptations and exercise performance than moderate-intensity continuous training (MICT) remains unclear. Therefore, this systematic review and meta-analysis aimed to compare the effects of SIT and MICT on physiological adaptations and exercise performance in healthy adults. Additionally, potential moderating effects of participant characteristics (sex, age, and training status) and training prescription variables (training frequency, intervention duration, recovery interval, sprint duration, session volume, and total training time) were investigated. This study followed the PRISMA statement and systematically searched the PubMed, Web of Science, Embase and CNKI databases up to November 14, 2025. Randomized controlled trials comparing the long-term effects of SIT and MICT were included. Standardized mean differences (SMD; Hedges’ g ) were calculated using a three-level meta-analysis, and subgroup analyses and meta-regression were conducted to explore potential moderating factors. A total of 44 studies involving 1,034 participants were included. Compared with MICT, statistically significant between-group differences were observed for relative maximal oxygen uptake (VO 2max ; g = 0.23, 95% CI [0.07, 0.38]), maximal heart rate (HR max ; g = 0.46, 95% CI [0.11, 0.80]), and total cholesterol (TC; g = − 0.59, 95% CI [− 1.12, − 0.05]). No statistically significant between-group differences were identified for the other measured outcomes. Exploratory subgroup analyses suggested that sex, training status, exercise modality, and per-session volume may influence effect sizes for specific outcomes; however, these findings should be interpreted cautiously given the limited number of studies in some analyses. SIT may produce comparable or modestly greater effects than MICT for selected outcomes, particularly relative VO 2max , HR max , and total cholesterol. However, the magnitude of these effects is generally small, and the wide prediction intervals indicate uncertainty in their generalizability. Exploratory analyses suggest that the effects may vary according to participant characteristics and training protocol variables, although these findings should be interpreted cautiously. Overall, SIT may be a time-efficient training option for improving selected physiological outcomes, but current evidence does not support considering it universally superior to MICT, and its application should be tailored to individual characteristics and training objectives. CRD420251231005.