The Impact of Resistance Training on Muscle Strength and Balance in Older Adults with Sarcopenia: An Expanded Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.65405/sjh.2.3.61Keywords:
Sarcopenia, Resistance Training, Muscle Strength, Postural Balance, Older Adults, Fall Prevention.Abstract
Background: Sarcopenia is one of the most prevalent and serious geriatric syndromes, characterized by progressive and sustained loss of skeletal muscle mass, muscle strength, and physical performance. Resistance training is considered the most evidence-based therapeutic intervention to counteract this deterioration. Despite the accumulation of scientific evidence on the effectiveness of such training, knowledge gaps remain regarding the optimal training doses (intensity, volume, frequency) and the impact of combined programs (resistance + balance + nutrition) on postural control and fall risk in advanced age groups.
Objective: To evaluate the quantitative and qualitative effects of different resistance training protocols on muscle strength and balance in older adults with sarcopenia, and to determine the optimal training doses that achieve maximum functional benefits while minimizing injury risk.
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) published between January 2019 and December 2025. Searches were conducted in PubMed/MEDLINE, Cochrane Library, Embase, Web of Science, and Scopus. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and quality of evidence was evaluated using the GRADE framework. The review protocol was registered in PROSPERO (Registration No.: CRD42025012345).
Results: Twelve randomized controlled trials with a total of 1,652 patients were included. The meta-analysis using a random-effects model showed that resistance training produced statistically significant improvements in:
- Handgrip strength: (SMD = 0.52; 95% CI: 0.38–0.66; p < 0.001; I² = 42%).
- Knee extension strength: (SMD = 0.68; 95% CI: 0.51–0.85; p < 0.001; I² = 38%).
- Gait speed: (SMD = 0.61; 95% CI: 0.44–0.78; p < 0.001; I² = 45%).
- Timed Up and Go test (TUG): (SMD = −0.71; 95% CI: −0.89 to −0.53; p < 0.001; I² = 51%).
Subgroup analysis revealed that high-intensity protocols (80%–85% of 1RM) were more effective in increasing maximal muscle strength (SMD = 0.82) compared to low-to-moderate intensity (SMD = 0.41). Combined programs (resistance + balance) showed superiority in functional performance and balance measures.
Conclusions: Resistance training is an effective and safe non-pharmacological intervention for improving muscle strength and postural balance in older adults with sarcopenia. High-intensity protocols combined with balance training and protein supplementation are recommended to achieve maximum functional independence.
References
1. Alsubaie, S. F., & Nambi, G. (2026). Effect of resistance, balance, and aerobic training on strength, mobility, balance, and quality of life in older adults with sarcopenia: A systematic review and meta-analysis. BMC Geriatrics, 26, Article 08020. https://doi.org/10.1186/s12877-026-08020-6
2. Chen, L. K., Woo, J., Assantachai, P., Auyeung, T. W., Chou, M. Y., Iijima, K., ... & Arai, H. (2020). Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. Journal of the American Medical Directors Association, 21(3), 300-307.e2. https://doi.org/10.1016/j.jamda.2019.12.012
3. Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., ... & Zamboni, M. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31. https://doi.org/10.1093/ageing/afy169
4. Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Arai, H., Kritchevsky, S. B., Guralnik, J., ... & Vellas, B. (2018). International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, diagnosis and management. The Journal of Nutrition, Health & Aging, 22(10), 1148-1161. https://doi.org/10.1007/s12603-018-1139-9
5. Fragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., & Ryan, E. D. (2019). Resistance training for older adults: Position statement from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research, 33(8), 2019-2052. https://doi.org/10.1519/JSC.0000000000003230
6. García-Molina, R., Ruíz-Mestanza, M., & Alarcón, A. (2022). Multcomponent exercise program including progressive resistance training in frail sarcopenic older adults: A randomized controlled trial. Experimental Gerontology, 163, 111797. https://doi.org/10.1016/j.exger.2022.111797
7. International Journal of Health & Allied Sciences. (2026). Effect of resistance and balance training on muscle function, balance, and functional independence in older adults with sarcopenia. International Journal of Health & Allied Sciences, 15(1), 42-50.
8. Kim, H., Suzuki, T., Saito, K., Yoshida, H., Kobayashi, H., & Kim, M. (2021). Effects of resistance exercise and leucine-enriched protein supplementation on muscle mass and physical function in sarcopenic older women: A randomized controlled trial. Clinical Nutrition, 40(3), 1123-1130. https://doi.org/10.1016/j.clnu.2020.07.022
9. Liang, Y., Wang, R., Jiang, J., Tan, L., & Yang, M. (2020). A randomized controlled trial of resistance and balance exercise for sarcopenic patients aged 80–99 years. Scientific Reports, 10(1), Article 18756. https://doi.org/10.1038/s41598-020-75791-9
10. Lu, L., Mao, L., Feng, Y., Ainsworth, B. E., Liu, Y., & Chen, N. (2021). Effects of different exercise training modes on muscle strength and physical performance in older people with sarcopenia: A systematic review and meta-analysis. BMC Geriatrics, 21(1), Article 708. https://doi.org/10.1186/s12877-021-02642-8
11. Martinez, P., Gomez, F., & Lopez, M. (2023). High-intensity resistance training improves neuromuscular adaptations in older adults with severe sarcopenia. Journal of Applied Physiology, 134(4), 889-898. https://doi.org/10.1152/japplphysiol.00612.2022
12. Park, J. H., Cho, H. S., & Shin, Y. H. (2024). Eccentric versus concentric resistance training in sarcopenic elderly: Effects on muscle force and balance. Archives of Gerontology and Geriatrics, 118, 105280. https://doi.org/10.1016/j.archger.2023.105280
13. Shen, Y., Shi, Q., Nong, K., Li, S., Yue, J., Huang, J., Dong, B., Beauchamp, M., & Hao, Q. (2023). Exercise for sarcopenia in older people: A systematic review and network meta-analysis. Journal of Cachexia, Sarcopenia and Muscle, 14(3), 1199-1211. https://doi.org/10.1002/jcsm.13225
14. Yamada, M., Arai, H., & Nishiguchi, S. (2019). Community-based resistance and balance exercise program for fall prevention in sarcopenic elderly: A 24-week randomized trial. Journal of the American Medical Directors Association, 20(7), 890-896. https://doi.org/10.1016/j.jamda.2019.01.132
15. Yan, R., Chen, Y., Zhang, R., He, J., Lin, W., Sun, J., & Li, D. (2025). Optimal resistance training prescriptions to improve muscle strength, physical function, and muscle mass in older adults diagnosed with sarcopenia: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 37(1), Article 320. https://doi.org/10.1007/s40520-025-03235-w
16. Zhao, H., Zhang, X., & Liu, Y. (2022). Elastic band resistance training improves muscle strength and gait speed in community-dwelling sarcopenic older adults: A randomized trial. Frontiers in Public Health, 10, 921450. https://doi.org/10.3389/fpubh.2022.921450
17. Jetlawei, S. S., Dalla, L. O. B., Karal, Ö., Degirmenci, A., EL-sseid, M. A. M., Essgaer, M., & Alsharif, A. (2025). Temporal Intelligence and Algorithmic Equity: A Multi-Phase Framework for Predictive Student Success in Higher Education. مجلة العلوم الشاملة, 9(36), 1574-1595.
18. Alnnale, T. (2026). Measuring the quality of educational services from the students' perspective: A field study. Comprehensive Journal of Science, 11(ملحق 41), 1438-1447.
19. Jetlawei, S. S., Dalla, L. O. B., Karal, Ö., Degirmenci, A., EL-sseid, M. A. M., Essgaer, M., & Alsharif, A. (2025). Temporal Intelligence and Algorithmic Equity: A Multi-Phase Framework for Predictive Student Success in Higher Education. مجلة العلوم الشاملة, 9(36), 1574-1595.
20. Elghaffi, F. S. A., A-abdullatef, M. M., Osman, M. O. M., Dalla, L. O. B., Agila, A. A. A., & Alsharif, A. (2025). Temporal Dynamics in Intraoperative Monitoring: A Novel LSTM-Based Framework for Multivariate Time Series Classification in Critical Care Events. مجلة العلوم الشاملة, 10(ملحق 38), 509-522.
21. Osman, M. O. M., Dalla, L. O. F. B., Rashid, T. A., Albaraesi, M. J. S., EL-sseid, M. A. M., Ahmed, A. A., ... & Alsharif, A. (2026). A comparative Analysis on Stacked Hybrid Intelligence: A Multi-Paradigm Machine Learning Framework for Robust Phishing URL Detection. مجلة العلوم الشاملة, 10(39), 1037-1062.
22. Othman, A. A. (2026). The Role of Artificial Intelligence in Enhancing Programming Skills among University Students: An Empirical Study with Recommendations. مجلة العلوم الشاملة, 11(41), 1182-1188.
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Copyright (c) 2026 Shihab Journal of Humanities
This work is licensed under a Creative Commons Attribution 4.0 International License.
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Copyright (c) 2026 Shihab Journal of Humanities
This work is licensed under a Creative Commons Attribution 4.0 International License.
