Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 34763651 · doi:10.1186/s11556-021-00277-7
What was done
Researchers conducted a systematic review and meta-analysis of randomized controlled trials published between January 2010 and October 2020 across PubMed, Embase, Cochrane Library, CNKI, and Wanfang. The review evaluated the effects of resistance training on body composition, muscle strength, and functional performance in healthy older adults (aged 65.8 to 82.8 years) diagnosed with sarcopenia. Data were independently extracted and assessed for quality by two reviewers, and pooled pre-post changes were calculated as standardized mean differences (SMD) with 95% confidence intervals.
What was found
Fourteen RCTs comprising 561 participants were included. Compared to controls, resistance training significantly improved: - Body fat mass (SMD = -0.53, 95% CI -0.81 to -0.25, p = 0.0002, I² = 0%) - Handgrip strength (SMD = 0.81, 95% CI 0.35 to 1.27, p = 0.0005, I² = 81%) - Knee extension strength (SMD = 1.26, 95% CI 0.72 to 1.80, p < 0.0001, I² = 67%) - Gait speed (SMD = 1.28, 95% CI 0.36 to 2.19, p = 0.006, I² = 89%) - Timed Up and Go test (SMD = -0.93, 95% CI -1.30 to -0.56, p < 0.0001, I² = 23%) Resistance training had no statistically significant effect on muscle mass outcomes: - Appendicular skeletal muscle mass (SMD = 0.25, 95% CI -0.27 to 0.78, p = 0.35, I² = 68%) - Skeletal muscle mass (SMD = 0.27, 95% CI -0.02 to 0.56, p = 0.07, I² = 0%) - Leg lean mass (SMD = 0.12, 95% CI -0.25 to 0.50, p = 0.52, I² = 0%)
Why it matters
This review shows that resistance training yields clinically meaningful gains in physical function and muscle strength in sarcopenic older adults, even in the absence of statistically significant increases in lean muscle mass.
Limits
The total sample size was modest (561 participants across 14 trials, averaging roughly 40 participants per study). There was substantial heterogeneity across several primary functional outcomes, including gait speed (I² = 89%) and handgrip strength (I² = 81%), reflecting differences in participant demographics, sarcopenia diagnostic criteria, and resistance training variables (intensity, duration, frequency, and exercise modality).
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