# Concurrent HIIT and Resistance Training for Musculoskeletal Function: A Systematic Review of Neuromuscular, Morphological, and Performance Adaptations

## TL;DR

This review examines how combining high-intensity interval training and resistance training affects musculoskeletal health in adults of different ages and activity levels.

## Contribution

The study provides a musculoskeletal-focused synthesis of concurrent training effects, extending beyond prior cardiorespiratory or interference-focused reviews.

## Key findings

- Concurrent HIIT and resistance training can improve or maintain maximal strength and explosive performance in both older and younger adults.
- Neuromuscular activation and muscle architecture may improve with progressive loading, though tendon adaptations are less clear due to limited imaging.
- Adherence to these programs is generally high, with few adverse events reported across diverse populations.

## Abstract

This systematic review focuses on the effect of concurrent high-intensity interval training (HIIT) and resistance training on musculoskeletal function in adult individuals. Four electronic databases (PubMed, Web of Science Core Collection, Scopus, and PsycINFO) were searched for controlled trials in older or middle-aged adults, in recreationally exercising adults, and in athletic or tactical populations, which completed parallel HIIT and resistance training and described musculoskeletal responses to the intervention up to 30 November 2025. A total of 18 trials fulfilled the eligibility criterion and were synthesized narratively across the domains of maximal strength, explosive performance, neuromuscular activity, muscle morphology and architecture, tendon-related outcomes, and adherence and safety. Most 8- to 12-week interventions maintained two to three weekly resistance sessions and were designed in time-effective HIIT formats, increasing or preserving maximal strength in older subjects as well as younger ones that were trained. Explosive performance metrics, including both jump and sprint tasks, were usually preserved or even improved by the maintenance of the power-oriented component in resistance-based exercise sessions. The limited electromyography data indicated improved neuromuscular activation during submaximal tasks, particularly in older subjects, whereas some studies reported subtle increases or maintenance of muscle size and selective architectural patterns during application of progressive loading. Tendon-specific adaptations are difficult to measure, as imaging was seldom available, but functional tasks influenced by the muscle–tendon unit have been studied in multiple studies. Adherence was good, and adverse events were rare in all studies. Overall, the evidence suggests that well-designed concurrent HIIT and resistance training programs can improve or maintain musculoskeletal performance, although the magnitude and expression of these adaptations vary according to population characteristics and intervention design. Importantly, by integrating neuromuscular, morphological, and performance-related outcomes across diverse adult populations, this review provides a musculoskeletal-centered synthesis that extends prior concurrent training reviews beyond cardiorespiratory or interference-focused perspectives.