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

Abstract

Sarcopenia is an age-related condition characterized by gradual loss of muscle mass and strength, leading to reduced physical function, often observed among older adults. This review aimed to evaluate the effects of resistance, aerobic, and balance exercises on muscle strength, functional ability, gait speed, balance, and quality of life (QoL) in adults with sarcopenia. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. A comprehensive search of Web of Science, CAB-Abstract, CENTRAL, Embase, Global Health, Scopus, PEDro, and PubMed databases was performed between 2010 and July 31, 2025. Eligible RCTs were those that evaluated the effects of resistance, aerobic, and balance exercises on the most common outcomes in adults with sarcopenia. The outcomes included strength (handgrip strength and knee extension strength), mobility (gait speed), balance (timed up and go test (TUG)), functional ability, and QoL. Our search identified 12 RCTs involving 652 participants with sarcopenia (mean age: 74.1 ± 7.6 years; female: 82.7%). The results of the analysis indicated that exercise interventions resulted in significant improvement of handgrip strength (standardized mean difference (SMD) = 0.39), knee extension strength (SMD = 0.62), gait speed (SMD = 0.66), and TUG (SMD = -0.73) compared with the control groups. Functional ability and QoL did not exhibit any significant differences between the groups. The results suggest that incorporating resistance training, either alone or in combination with aerobic and balance training, may improve muscle strength, mobility, and balance in adults with sarcopenia.