From efficacy verification to precision intervention: a dual-database bibliometric and clinical mapping analysis of therapeutic exercise for adolescent obesity (2016–2025)

Objective This study aimed to systematically map the research landscape, knowledge structure, collaboration patterns, and evolutionary frontiers of therapeutic exercise for adolescent obesity from 2016 to 2025, and to identify translational gaps between basic research and clinical practice. Methods Publications were retrieved from the Web of Science Core Collection (WoSCC) and PubMed. The WoSCC dataset, comprising original articles and reviews, was analyzed using CiteSpace 7.0.1 for co-citation, keyword co-occurrence, thematic clustering, and burst detection, and VOSviewer 1.6.19 for collaboration networks at the country, institution, and author levels. The PubMed dataset, restricted to clinical research, was analyzed using CiteSpace to identify clinical intervention hotspots and evolutionary trends. Results A total of 2,953 records from WoSCC and 1,295 clinical studies from PubMed were included. Annual publications showed a fluctuating upward trend, peaking at 349 articles in 2022. The United States and China led publication output, but international cross-regional collaboration remained limited, with high-output countries functioning primarily as production cores rather than collaboration hubs. Ten research clusters were identified in the WoSCC dataset, with insulin resistance, cardiorespiratory fitness, and body mass index as core themes. Research evolved through three distinct phases: basic efficacy evaluation (2016–2018), mechanism and benefit expansion (2019–2021), and precision intervention for special populations (2022–2025). Clinical research in PubMed emphasized intervention efficacy and patient-oriented outcomes, with high-intensity interval training and health-related quality of life emerging as the latest frontiers since 2024. A clear thematic divergence was observed between basic research, which focused on mechanistic targets and population characteristics, and clinical practice, which prioritized intervention protocols and practical outcomes. Conclusion Therapeutic exercise research for adolescent obesity has developed steadily from 2016 to 2025, with prominent multidisciplinary integration but insufficient international cross-regional collaboration. A potential translational gap, reflected by thematic divergence, persists between basic mechanistic research and clinical practice. Future efforts should prioritize multi-factor synergistic interventions combining exercise with sleep, nutrition, and psychological support; precision exercise prescriptions tailored to special populations such as adolescents with Down syndrome or severe obesity; and high-quality multicenter clinical trials to accelerate the translation of basic findings into standardized clinical protocols.