Resistance Training for Activity Limitations in Older Adults with Skeletal Muscle Function Deficits: A Systematic Review

Objective: Resistance training (RT) is defined as any strength training program in which participants exercise a muscle against an external force that is set to a specific intensity. RT is a critical component of rehabilitation programs for preserving functional activity in older adults. Skeletal muscle function deficits, such as sarcopenia, can be improved with RT. The purpose of this systematic review was to provide an overview of the current knowledge on RT for older adults with sarcopenia and offer recommendations for clinical practice to improve functional mobility for patients. Methods: This study was conducted according to the Methodology to Develop Systematic Reviews of Treatment Interventions developed by the American Academy for Cerebral Palsy and Developmental Medicine. A search was performed in PubMed with the following inclusion criteria: average age 60+, RT as the only intervention, and functional mobility as the primary outcome measure. Exclusion criteria included absence of supplementary training measures, absence of chronic neurological conditions, any article that was published prior to 2008. Articles were limited to publications in the English language. Articles were summarized and effect sizes were calculated using Cohen’s d for each intervention. Results: Eleven articles were included in this systematic review. There was a general consensus that one-hour training sessions on alternate days of the week, 2-3 times per week was enough time to make significant improvements in function. The articles with the highest effect sizes were an average of 10.5 weeks; the shortest being 6 weeks and longest being 13 weeks. Two studies examined core strengthening which showed an average effect size of 1.13 on the Functional Reach Test (FRT). Seven studies focused on the strengthening the large muscle groups in the lower extremities. These articles described notable effect sizes in functional outcomes such as eyes closed single leg balance (0.81), Timed Up and Go (1.45), 10-meter walk test (0.85), timed chair rise (2.42), FRT (5.28), and maximal lateral lean (0.88). Conclusions: Resistance training can attenuate age-related changes in muscle function. To improve functional outcomes in older adults with sarcopenia we recommend a 60-minute RT exercise program to be performed 2-3 times per week. RT sessions should be dosed at 2-3 sets of 8-12 reps, with a 2-minute rest between sets.