Rest-pause (RP) and drop sets (DS) are widely used as intensification strategies during resistance training. However, their incorporation within a repetition-based progressive-overload (PO) model and their effects under supervised conditions are not well established. We compared progressive-overload rest-pause (PO-RP) with progressive-overload drop-set (PO-DS) training, assessing changes in body composition and maximal strength in resistance-trained adults. Twenty-three participants (20 men and 3 women; 29.1 [5.9] years; 25.0 [3.1] kg/m2) were randomized to either PO-RP (n = 12) or PO-DS (n = 11). After a 1-week familiarization phase, both groups trained twice weekly for 8 weeks under supervision while following a prescribed nutritional protocol. Pre/post measures of body composition were assessed by DXA, and maximal strength was evaluated by the one-repetition maximum (1-RM) bench press. Adiposity-related outcomes (total and upper-body fat mass, and total and upper-body fat-free adipose tissue) remained essentially unchanged in both protocols (all group × time p > 0.05). Lean soft tissue mass increased in PO-DS (delta = 1.4 kg; 95% CI, 0.8-2.2; p < 0.001; g = 0.1) and PO-RP (delta = 1.2 kg; 95% CI, 0.8-2.0; p < 0.001; g = 0.1), with no between-protocol difference in change (group × time p = 0.688). Bench press 1-RM increased in both protocols (PO-DS: delta = 12.3 kg; 95% CI, 9.6-14.0; p < 0.001; g = 0.7; PO-RP: delta = 9.5 kg; 95% CI, 7.3-11.2; p < 0.001; g = 0.4), without a statistically significant group × time effect (p = 0.086). Under supervised training and a standardized nutritional protocol, PO-RP and PO-DS produced comparable adaptations. Adiposity-related outcomes remained stable, fat-free compartment measures increased, and maximal strength improved, with no statistically significant between-protocol differences in change. Future research should determine whether these adaptations are maintained over longer interventions and whether responses differ across populations with different characteristics, including women, older adults, clinical populations, or individuals with different training experience. Further studies incorporating larger samples, direct assessments of muscle hypertrophy, additional strength outcomes, and mechanistic measures of fatigue and recovery may help refine the application of advanced resistance-training strategies in evidence-based exercise programs.
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