Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs

Chen, Yu Chang; Chen, Wang-Chun; Liu, Chia-Wei; Huang, Wei-Yu; Lu, ICheng; Lin, Chi Wei; Huang, Ru Yi; Chen, Jung Sheng; Huang, Chi Hsien

doi:10.1186/s11556-023-00333-4

Cited by 35Nutrition and Health in AgingFrailty in Older AdultsMuscle metabolism and nutrition

Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs

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Chen, Yu Chang, Chen, Wang-Chun, Liu, Chia-Wei, Huang, Wei-Yu, Lu, ICheng, Lin, Chi Wei, Huang, Ru Yi, Chen, Jung Sheng +1 more·2023·European Review of Aging and Physical Activity

DOI 10.1186/s11556-023-00333-4PMC PMC10687931

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Abstract

Background: Resistance training (RT) and nutritional supplementation are recommended for the management of sarcopenia in older adults. However, optimal RT intensity for the treatment of sarcopenia has not been well investigated. Methods: This network meta-analysis aims to determine the comparative effectiveness of interventions for sarcopenia, taking RT intensity into consideration. RT intensity was classified into light-to-moderate intensity RT(LMRT), moderate intensity RT(MRT), and moderate-to-vigorous intensity RT(MVRT) based on percentage of one repetition maximum (%1RM) and/or rating of perceived exertion. Results: A total of 50 RCTs ( N = 4,085) were included after screening 3,485 articles. The results confirmed that RT with or without nutrition was positively associated with improved measures of muscle strength and physical performance. Regarding RT intensity, LMRT only demonstrated positive effects on hand grip (aerobic training + LMRT + nutrition: mean difference [MD] = 2.88; 95% credential intervals [CrI] = 0.43,5.32). MRT provided benefits on improvement in the 30-s chair stand test (repetitions) (MRT: MD = 2.98, 95% CrI = 0.35,5.59), timed up and go test (MRT: MD = -1.74, 95% CrI: = -3.34,-0.56), hand grip (MRT: MD = 2.44; 95% CrI = 0.03,5.70), and leg press (MRT: MD = 8.36; 95% CrI = 1.87,13.4). MVRT also improved chair stand test repetitions (MVRT: MD = 5.64, 95% CrI = 0.14,11.4), gait speed (MVRT + nutrition: MD = 0.21, 95% CrI = 0.003,0.48), appendicular skeletal muscle index (MVRT + nutrition: MD = 0.25, 95% CrI = 0.01,0.5), and leg press (MVRT: MD = 14.7, 95% CrI: 5.96,22.4; MVRT + nutrition: MD = 17.8, 95% CrI: 7.55,28.6). Conclusion: MVRT had greater benefits on muscle mass, lower extremity strength, and physical performance compared to MRT. Increasing RT intensity may be recommended for sarcopenic older adults.

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Resistance training improves gait speed compared with no exercise (CTRL) in healthy adults.
“Compared with CTRL, gait speed was impacted by standard RT (17,30,32,33,36–38,47,53,152–155).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [30]
The Results of network meta-analysis (Physical performance, Gait speed; page unavailable) report improved gait speed for RT combined with nutrition, but no significant difference for low- or moderate-intensity RT alone. The Methods (Search strategy and selection process; page unavailable) specify participants with sarcopenia or dynapenia, not healthy adults. (LLM, conf=0.88)
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Compared with control, standard resistance training improves muscle hypertrophy.
“Compared with CTRL, muscle hypertrophy was positively affected by standard RT (17,24,30,32,33,37,38,40,42–47,50,127), circuit RT (57,58), and elastic band RT (60,62).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [30]
The Results (Muscle mass) report that resistance training significantly increased skeletal muscle mass compared with placebo in older adults with sarcopenia. This supports a positive effect on muscle mass, but the paper does not specifically identify the intervention as “standard RT” or establish a hypertrophy effect beyond that population. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Resistance training improves timed up-and-go performance compared with no exercise (CTRL) in healthy adults.
“Compared with CTRL, TUG was impacted by standard RT (30,32,33,36,38,47,50,152,154,156).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [30]
The Results of network meta-analysis (Physical performance, ‘Timed up and go test’; page unavailable) report improved TUG performance with resistance training, mainly moderate-intensity training, relative to a placebo group. But the Methods (Search strategy and selection process; page unavailable) specify participants with sarcopenia or dynapenia, not healthy adults; the claim also describes the comparator more narrowly as no exercise. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Resistance training improves chair stand test performance compared with no exercise (CTRL) in healthy adults.
“Compared with CTRL, chair stand performance was impacted by standard RT (30,32,33,36,50,152).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [30]
The Results (Physical performance; page not supplied) report that resistance training improved 30-second chair stand repetitions relative to the comparison group. But the Methods restrict included participants to people with sarcopenia or dynapenia, so the finding does not establish the claim for healthy adults. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Resistance training does not improve Short Physical Performance Battery (SPPB) compared with no exercise (CTRL) in healthy adults.
“Compared with CTRL, SPPB was not affected by standard RT (30).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [30]
The Results of network meta-analysis (Physical performance, SPPB; page unavailable) report no significant differences among interventions, including RT, compared with placebo. However, the Methods (Search strategy and selection process; page unavailable) specify participants with sarcopenia or dynapenia, not healthy adults. The source supports a finding of no statistically significant SPPB difference in its studied population, not proof that RT has no effect in healthy adults. (LLM, conf=0.87)
Experimental — accuracy not yet measured

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Effects of different exercise types and intensities in older adults with sarcopenia: a systematic review and network meta-analysis
Jin-Hao, H., Si-Yuan, G., Lu, D., & Guo-Hui, X. (2026) · European Geriatric Medicine · doi:10.1007/s41999-026-01570-3
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Tan, Z., Jiang, Y., Candow, D. G., Castagna, C., Wang, X., & Zheng, H. (2026) · European Review of Aging and Physical Activity · doi:10.1186/s11556-025-00399-2 · Cited by 7 · see citing works
Additional file 1 of Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs
Chen, Y. C., Chen, W.-C., Liu, C.-W., Huang, W.-Y., Lu, I., Lin, C. W., Huang, R. Y., Chen, J. S., & Huang, C. H. (2023) · Figshare · doi:10.6084/m9.figshare.24669893
Self-citation
Effects of Resistance Training on Body Composition, Muscle Strength, and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis with Dose-Response and Moderator AnalysesPreprint
Tan, Z., & Jiang, Y. (2025) · OSF Preprints (OSF Preprints)
Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials.
Chen, N., He, X., Feng, Y., Ainsworth, B. E., & Liu, Y. (2021) · European Review of Aging and Physical Activity · doi:10.1186/s11556-021-00277-7 · Cited by 178 · see citing works

Authors: Chen, Y. C., Chen, W.-C., Liu, C.-W., Huang, W.-Y., Lu, I., Lin, C. W., Huang, R. Y., Chen, J. S., & Huang, C. H.
Affiliations: E-Da Hospital (TW)
National Taiwan University (TW)
Corresponding author: Huang, Chi Hsien
ORCID: Chen, Wang-Chun
Liu, Chia-Wei
Chen, Jung Sheng
Huang, Chi Hsien
Venue: European Review of Aging and Physical Activity
Publisher: Springer Science and Business Media LLC
Published: 2023-11-29
Volume: 20
Issue: 1
Pages: 22-22
ISSN: 1813-7253 (ISSN-L)
1861-6909
DOI: 10.1186/s11556-023-00333-4
PMC: PMC10687931
OpenAlex: W4389138260
Cited by: 34
References: 102
Citations by year: 2026: 14 · 2025: 16 · 2024: 4
FWCI: 1.21
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: European Review of Aging and Physical Activity (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: National Science and Technology Council
Topics: Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Keywords: sarcopenia, older adults, resistance training, exercise intensity, one-repetition maximum, dietary supplementation, muscle strength, physical performance, walking speed, grip strength, appendicular skeletal muscle mass index, chair stand test, Timed Up and Go test, leg press, aerobic exercise, comparative effectiveness, sarcopenic obesity, sarcopenic frailty

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Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs

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