The impact of exercise intervention on physical self-esteem of Chinese college students: a systematic review and...

This study systematically synthesized relevant empirical research through meta-analysis to quantify the intervention effects of different exercise modalities on college students' physical self-esteem, identify key moderating variables driving between-study heterogeneity, and provide an evidence-based basis for colleges and universities to develop precise exercise intervention programs.

In accordance with the PRISMA 2020 guidelines, we systematically searched six electronic databases (CNKI, Wanfang Data, Embase, PubMed, Web of Science, and the Cochrane Library) from their inception to September 7, 2025 to identify eligible randomized controlled trials. The Cochrane Risk of Bias 2 (Rob 2) tool was adopted to evaluate the risk of bias of the included studies, the GRADE system was used to rate the quality of evidence for all core physical self-esteem-related outcomes, and effect size pooling, predefined subgroup analysis, and meta-regression were performed to explore sources of between-study heterogeneity. The study protocol was retrospectively registered with PROSPERO (Registration No. CRD420261356511).

A total of 12 studies involving 2,128 participants were included. Meta-analysis using a random-effects model showed that exercise intervention had a significant large positive effect on the overall level of college students' physical self-esteem (SMD = 0.95, 95% CI [0.70, 1.20], p < 0.001), with substantial between-study heterogeneity (I ² = 79, 95% prediction interval [0.12, 1.78]). Exercise interventions also exerted significant moderate positive impacts on all core dimensions of physical self-esteem: physical self-worth (SMD = 0.55, 95% CI [0.39, 0.71], p < 0.001), sport competence (SMD = 0.68, 95% CI [0.54, 0.83], p < 0.001), physical condition (SMD = 0.67, 95% CI [0.55, 0.78], p < 0.001), physical attractiveness (SMD = 0.68, 95% CI [0.50, 0.85], p < 0.001), and physical fitness (SMD = 0.64, 95% CI [0.47, 0.81], p < 0.001). Predefined subgroup analyses identified preliminary indications that intervention effects may be greater in males, those receiving combined aerobic-resistance training, and healthy individuals. Sensitivity analysis confirmed the robustness of the core qualitative conclusion, but publication bias was detected for most outcomes, and the certainty of evidence ranged from low to moderate according to the GRADE system.

Current available evidence suggests that exercise interventions may improve overall physical self-esteem and all its dimensions in Chinese college students. The subgroup analyses provide preliminary indications that greater benefits may be observed in males, those receiving combined aerobic and resistance training, and healthy individuals. However, these subgroup findings are hypothesis-generating rather than definitive, and the pooled effect estimate should be interpreted with caution due to substantial between-study heterogeneity and low-to-moderate evidence quality. Future research should expand sample sizes, standardize exercise intervention parameters, and conduct head-to-head trials to verify these preliminary subgroup effects.