Effectiveness of different types of exercise based-interventions in sarcopenia: A systematic review and meta-analysis

Sarcopenia is one of the most prevalent and disabling health conditions in older adults associated with muscle mass loss and a reduced ability to perform daily-living activities. Although evidence supports the use of exercise interventions to reduce the impact of sarcopenia, the most effective type of physical exercise remains unknown. The objectives of this review were (1) to determine the effectiveness of physical exercise at overall and type-specific levels on the physical performance and muscular strength of older adults with sarcopenia, and (2) to detect potential effect modifiers such as age and sex. Three databases (i.e., PubMed, Web of Science, and Scopus) were used to conduct the searches. We included randomised controlled trials where exercise-based interventions were applied to participants aged 65 and over diagnosed with sarcopenia using the EWGSOP2 or AWGSOP2 criteria. Bayesian meta-analyses were performed to pool the evidence using standardised mean changes from baseline [SCFB] for physical performance and mean changes from baseline for muscle strength as effect measures. The risk of bias was assessed using the revised Cochrane risk-of-bias tool. Evidence from 28 studies (2582 participants) showed that physical exercise was effective to improve the physical performance (SCFB = 0.21; 95 % CrI 0.08 to 0.33) and muscular strength (Kg grip strength gain = 2.50; 95 % CrI 0.32 to 4.63) of older adults with sarcopenia. Resistance-based interventions presented a meaningful treatment effect on physical performance (SCFB = 0.23; 95 % CrI 0.10 to 0.36). Age and sex modified the effects of physical exercise on both outcomes. This meta-analysis supported the use of physical exercise to improve the physical performance and muscular strength of people with sarcopenia. Resistance-based interventions were the most effective type of activities in both outcomes. Physical exercise effects may vary between males and females older adults. These findings should inform policymakers and healthcare providers in developing more targeted and efficient physical exercise programs (resistance based interventions) to enhance functional independence and reduce the risk of falls in older adults with sarcopenia.