Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians
Open accessAbstract
This randomized controlled trial examined the effects of multicomponent training on muscle power output, muscle mass, and muscle tissue attenuation; the risk of falls; and functional outcomes in frail nonagenarians. Twenty-four elderly (91.9 ± 4.1 years old) were randomized into intervention or control group. The intervention group performed a twice-weekly, 12-week multicomponent exercise program composed of muscle power training (8-10 repetitions, 40-60 % of the one-repetition maximum) combined with balance and gait retraining. Strength and power tests were performed on the upper and lower limbs. Gait velocity was assessed using the 5-m habitual gait and the time-up-and-go (TUG) tests with and without dual-task performance. Balance was assessed using the FICSIT-4 tests. The ability to rise from a chair test was assessed, and data on the incidence and risk of falls were assessed using questionnaires. Functional status was assessed before measurements with the Barthel Index. Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography. The intervention group showed significantly improved TUG with single and dual tasks, rise from a chair and balance performance (P < 0.01), and a reduced incidence of falls. In addition, the intervention group showed enhanced muscle power and strength (P < 0.01). Moreover, there were significant increases in the total and high-density muscle cross-sectional area in the intervention group. The control group significantly reduced strength and functional outcomes. Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population.
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Older adults with advanced frailty and multiple comorbidities remain very capable of undertaking high intensity progressive resistance training, even in the tenth decade of life.
“such individuals remain very capable of undertaking high intensity PRT, even in the tenth decade of life [35,84]”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Multicomponent exercise programs incorporating PRT, balance, and functional exercises effectively reduce the incidence of falls in older adults compared to control groups.
“multicomponent exercise programs that incorporate PRT, balance, and functional exercises [84,123,130,131], have been demonstrated to effectively reduce the incidence of falls in older adults compared to control groups”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Exercise interventions on gait stability in older adults with frailty have yielded conflicting results, with some studies reporting gait improvements after physical training and others finding no benefits.
“Several studies have investigated the effects of exercise interventions on gait stability in older adults with frailty, yielding conflicting results. Some studies reported gait improvements after physical training [84,145,146], while others found no benefits [84].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Moderate-intensity power training (60% of 1RM) can lead to superior functional capacity adaptations.
“However, moderate-intensity power training (60% of 1RM) [84,212,213] can lead to superior functional capacity adaptations.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Free weights and specialized PRT machines show similar improvements in neuromuscular, functional, and overall fitness outcomes for power training.
“Both free weights and specialized PRT machines are used for power training, showing similar improvements in neuromuscular [84,204,205], functional, and overall fitness [84,204,205].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
In a 12-week multicomponent exercise intervention involving institutionalized frail nonagenarians, explosive resistance training improved muscle cross-sectional area, muscle fat infiltration, maximal strength and power, balance, gait, and sit-to-stand ability, and reduced fall incidence.
“In a 12-week multicomponent exercise intervention involving institutionalized frail nonagenarians, explosive resistance training improved the muscle cross-sectional area, muscle fat infiltration, maximal strength and power, balance, gait, and sit-to-stand ability, and reduced fall incidence [84,109].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Resistance training programs or multicomponent exercise interventions with robust PRT have enhanced muscle strength in older adults with frailty and sarcopenia.
“Resistance training programs or multicomponent exercise interventions with robust PRT have enhanced muscle strength in older adults with frailty and sarcopenia [35,84,241,[456], [457], [458], [459]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Multicomponent exercise programs that combine PRT, balance plus functional exercises, programs involving balance and functional exercises, or Tai Chi have been shown to reduce falls compared with control in older adults by 20−40%.
“Multicomponent exercise programs that combine PRT, balance plus functional exercises such as transferring from a chair and using steps [84,123,130,131], programs involving balance and functional exercises [123], or an alternative exercise intervention such as Tai Chi [[127], [128], [129]] have been shown to reduce falls compared with control in older adults by 20−40%.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Both multicomponent exercise and PRT could effectively enhance the physical performance of institutionalized older adults, as measured by the Short Physical Performance Battery, 30-second Chair-Stand, Timed Up and Go tests, and gait ability.
“The studies provided evidence that both multicomponent exercise and PRT could effectively enhance the physical performance of institutionalized older adults, as measured by the Short Physical Performance Battery, 30-second Chair-Stand, Timed Up and Go tests, and gait ability [84,109,493], and potentially ameliorate frailty and reduce falls [84,109,240].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Multicomponent exercise and PRT potentially ameliorate frailty and reduce falls in institutionalized older adults.
“and potentially ameliorate frailty and reduce falls [84,109,240].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Such individuals remain very capable of undertaking high intensity PRT, even in the tenth decade of life.
“However, such individuals remain very capable of undertaking high intensity PRT, even in the tenth decade of life [35,84].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Multicomponent exercise programs that incorporate PRT, balance, and functional exercises effectively reduce the incidence of falls in older adults compared to control groups.
“On the other hand, multicomponent exercise programs that incorporate PRT, balance, and functional exercises [84,123,130,131], have been demonstrated to effectively reduce the incidence of falls in older adults compared to control groups”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Both free weights and specialized PRT machines are used for power training, showing similar improvements in neuromuscular, functional, and overall fitness.
“Both free weights and specialized PRT machines are used for power training, showing similar improvements in neuromuscular [84,204,205], functional, and overall fitness [84,204,205].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Strategies to develop skeletal muscle power are essential to prevent or delay functional limitations and subsequent disability in older adults with frailty, diabetes, and functional decline.
“Strategies to develop skeletal muscle power in this population are essential to prevent or delay functional limitations and subsequent disability [84,397].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Multicomponent exercise programs combining PRT, balance plus functional exercises, programs involving balance and functional exercises, or Tai Chi have been shown to reduce falls compared with control in older adults by 20−40%.
“Multicomponent exercise programs that combine PRT, balance plus functional exercises such as transferring from a chair and using steps [84,123,130,131], programs involving balance and functional exercises [123], or an alternative exercise intervention such as Tai Chi [[127], [128], [129]] have been shown to reduce falls compared with control in older adults by 20−40%.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
Both multicomponent exercise and PRT can effectively enhance physical performance of institutionalized older adults, as measured by SPPB, 30-second Chair-Stand, Timed Up and Go tests, and gait ability, and potentially ameliorate frailty and reduce falls.
“The studies provided evidence that both multicomponent exercise and PRT could effectively enhance the physical performance of institutionalized older adults, as measured by the Short Physical Performance Battery, 30-second Chair-Stand, Timed Up and Go tests, and gait ability [84,109,493], and potentially ameliorate frailty and reduce falls [84,109,240].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [84]
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Multicomponent exercise with power training: A vital intervention for frail older adults
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- Authors
- Cadore, E. L., Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., Gómez, M., Rodriguez-Mañas, L., & Izquierdo, M.
- Affiliations
- Universidad Pública de Navarra (UPNA) (ES)
- Venue
- AGE
- Published
- 2013-09-13
- Volume
- 36
- Issue
- 2
- Pages
- 773-785
- ISSN
- 0161-9152 (ISSN-L)
- 1574-4647
- PMC
- PMC4039263
- OpenAlex
- W2170739529
- Cited by
- 526
- References
- 42
- Citations by year
- 2026: 20 · 2025: 40 · 2024: 48 · 2023: 57 · 2022: 64 · 2021: 65 · 2020: 52 · 2019: 46 · 2018: 44 · 2017: 38 · 2016: 25 · 2015: 14 · 2014: 11 · 2012: 1
- FWCI
- 11.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- AGE (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission (278803)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- multicomponent exercise, muscle power training, frail elderly, nonagenarians, muscle mass, muscle power output, muscle strength, muscle fat infiltration, fall risk, balance, gait, dual-task performance, functional status, institutionalized elderly
- MeSH terms
- Accidental Falls, Aged, 80 and over, Postural Balance, Female, Follow-Up Studies, Gait, Humans, Institutionalization, Male, Motor Activity, Frail Elderly, Treatment Outcome, Muscle, Skeletal, Resistance Training, Sarcopenia
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