Table 1.
Characteristics of Included Reviews
| Study | Objectives | Search | Years included | Description of intervention and comparator | Number and type of studies | Age (years) | N | % F | Study Quality (Tool) |
|---|---|---|---|---|---|---|---|---|---|
| Antoniak 2017 [25] | To assess effectiveness of RT + vitamin D3 on musculoskeletal health in older adults. | ScienceDirect, MEDLINE, PubMed, Google Scholar, Cochrane CENTRAL to Mar 2016 | 2003–2015 |
I: RT and vitamin D3 supplementation with or without calcium C: inactive, usual care without vitamin D3 supplementation |
7 RCTs |
Inclusion: ≥65 Mean: 72.8 |
792 | 82 |
RT + vitamin D: moderate RT + vitamin D + calcium: moderate-high (GRADE) |
| Borde 2015 [26] | To determine effects of RT on muscle strength and morphology and explore any dose–response relationships. | PubMed, Web of Science, Cochrane Library to May 2015 | 1991–2014 |
I: Machine-based RT of low, moderate, or high intensity C: inactive |
25 RCTs |
Inclusion: ≥60 Mean: 70.4 Range: 60–90 |
819 | NR; 16% F only, 16% M only |
Low (PEDro) |
| Bouaziz 2016 [27] | To evaluate the evidence of the health benefits of MCT training in adults > 65. | CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, PubMed, MEDLINE, ScienceDirect, Jan 2000-Apr 2015 | 2000–2015 |
I: MCT including AT, RT, balance, stability, flexibility, and/or coordination training C: NR |
27 total; 19 RCTs |
Inclusion: ≥65 Range: 65–83 |
NR | NR |
Low quality studies excluded (Tool NR) |
| Bouaziz 2017 [28] | To review effect of AT in adults > 70 on cardiovascular, metabolic, functional, cognitive, and QoL outcomes. | CINAHL Plus, Embase, MEDLINE, PubMed, Scopus, Web of Science, SPORTDiscus, ScienceDirect, to Jan 31, 2016 | 1984–2013 |
I: Supervised (class or small group) AT C: NR |
53 total; 36 RCTs |
Inclusion: ≥70 Range: 70.0–87 |
2051 | NR | Low-moderate (Cochrane) |
| Bouaziz 2018 [29] | To determine the benefits of AT on VO2peak among those ≥70. | MEDLINE, PubMed Central, Scopus ScienceDirect, Embase to Mar 31, 2017 | 1989–2013 |
I: AT, any activity that uses large muscle groups, can be maintained continuously, and is rhythmic C: usual care or other exercise |
10 RCTs |
Inclusion: ≥70 Range: 70–79 |
348 | NR; 20% F only, 10% M only | Moderate (Cochrane) |
| Bruderer-Hofstetter 2018 [30] | To identify effective MCT interventions for physical capacity and/or cognitive function. | MEDLINE, CENTRAL, CINAHL, PsycINFO, Scopus, Date NR | 2002–2017 |
I: Combined cognitive training (exergames, dancing or Tai Chi) and physical exercise (planned, structured) C: attention controls or no intervention |
17 RCTs |
Inclusion ≥55 Mean: 71.37 ± 4.89 |
1758 Range: 32–555 |
67 |
Very low certainty (GRADE) |
| Bueno de Souza 2018 [31] | To determine the effects of mat Pilates on physical function in older persons. | MEDLINE, Scopus, Scielo, PEDro, Jan 2011-Mar 2017 | 2011–2017 |
I: Mat Pilates with or without accessories C: inactive control |
9 RCTs |
Inclusion ≥60 Mean: 68.5 ± 5.1 |
Range: 45–88 | NR; 56% F only |
56% high 44% low (PEDro) |
| Bullo 2015 [32] | To summarize the benefits of Pilates on physical fitness and QoL in the elderly. | MEDLINE, Embase, SPORTDiscus, PubMed, Scopus, PsycINFO, Date NR | 2009–2014 |
I: Pilates-identified exercise training intervention C: inactive control |
10; 6 RCTs |
Inclusion: ≥60 Range: 60–80 |
349 Range: 9–60 |
NR; 50% F only |
40% high 60% low (Cochrane) |
| Bullo 2018 [33] | To determine the effects of Nordic walking on physical fitness, QoL and body composition in the elderly. | MEDLINE, Embase, PubMed, Scopus, SPORTDiscus, PsycINFO, Date NR | 2012–2017 |
I: Supervised or unsupervised Nordic walking C: sedentary, walking, or resistance exercise |
15; 8 RCTs |
Inclusion ≥60 Range: 60–92 |
Range: 18–95 | “Majority female” |
27% high 73% low (Cochrane) |
| Chase 2017 [34] | To determine the effects of supervised RT and/or AT on physical function among community-dwelling older adults | MEDLINE, PubMed, CINAHL, Cochrane Library, Proquest, SPORTDiscus, PEDro, Ageline, Dissertation Abstracts International, 1960–2015 | 1999–2015 |
I: Supervised intervention involving RT and/or AT. 18 studies used RT only, the remainder employed combination RT and AT C: NR |
28 (designs NR) |
Inclusion: > 65 Mean: 70 Range: 65–85 |
2608 | 71 | NR; lower quality studies had stronger findings (PEDro) |
| da Rosa Orssatto 2019 [35] | To compare change in functional capacity following fast- vs. moderate-velocity lower limb RT in older adults | PubMed, Scopus, Web of Science to Jan 2019 | 2003–2019 |
I: Fast-velocity lower limb RT C: moderate-velocity lower limb RT |
15 RCTs |
Inclusion: ≥60 Range: 64.4–81.6 |
593 | NR |
Fair (PEDro) |
| Devries 2014 [36] | To determine whether the addition of creatine to RT increased gains in muscle mass, strength, and function in older adults over RT alone. | MEDLINE, HealthStar to June 2013 | 1998–2013 |
I: RT and Creatine supplementation C: RT and placebo |
10 RCTs |
Inclusion: > 45 Range: 55–71 |
357 | NR; 20% F only, 40% M only | Low-moderate (Jadad) |
| Ebner 2021 [37] | To determine the effects of mind-body interventions on physical fitness in healthy community dwelling older adults. | Web of Knowledge, PubMed, SPORTDiscus to Nov 2019 | 2005–2019 |
I: Yoga, Qi Gong, Tai Chi, Pilates C: Active and inactive controls |
30 RCTs |
Inclusion: ≥65 Mean: 71.2 |
2792 | 37 |
3% poor 17% fair 63% good 17% excellent (PEDro) |
| Elboim-Gabyzon 2021 [38] | To explore the effectiveness of high-intensity interval training for reducing fall risk factors in older adults. | PubMed, CINAHL, Cochrane, APA PsycInfo, Web of Science, Scopus, PEDro, AgeLine, ClinicalTrials.gov, Google Scholar to July 2021 | 2015–2020 |
I: High-intensity exercise (90–95% peak heart rate, 90% maximal oxygen uptake, at least 75% peak work rate) separated by periods of low to moderate-intensity or rest (e.g., walking/running, cycling). C: No treatment or other exercise |
11 (8 RCTs) |
Inclusion: Average ≥ 60 Range: 50–81 |
328 | 9% F only, 36% M only |
45% high 36% moderate 9% low 1 not assessed (PEDro) |
| Fernandez-Arguelles 2015 [39] | To know the effects of dancing as a physical exercise modality on balance, flexibility, gait and muscle strength in older adults. | PubMed, Cochrane Library Plus, PEDro, ScienceDirect, Dialnet, Academic Search Complete, Jan 2000-Jan 2013 | 2002–2012 |
I: Dance-based AT, dance and foot tapping or squatting, Turkish folk dance, low impact aerobic dance, Greek traditional dance, ballroom dance, and salsa dancing C: other types of exercise |
7 RCTs |
Inclusion: > 60 Range: 63.1–82.2 |
354 Range: 26–97 |
NR; 43% F only |
29% good 71% fair (PEDro) |
| Fernández-Rodríguez 2021 [40] | To estimate the effectiveness of Pilates on physical performance and risk of falls in older adults. | MEDLINE, Scopus, Web of Science, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials to April 2021 | 2010–2021 |
I: At least one exercise intervention described as “Pilates” (Mat, machine, or both) C: Habitual or non-exercise |
39 RCTs |
Inclusion: ≥60 Range: 60–80 |
1650 | 62 |
64% high 36% unclear (Cochrane) |
| Finger 2015 [41] | To determine whether protein supplements can optimize the effects of RT on muscle mass and strength in an aged population. | MEDLINE, Cochrane Central, EMBASE, LILACS to January 2014 | 1995–2013 |
I: RT and protein for ≥6 weeks. Protein supplements ranged from 0.3 to 0.8 g/kg/day (mean 0.46 g/kg/day) or 6 to 40 g/day (mean = 20.7 g/day) or high protein diet C: RT with placebo or no supplement |
9 RCTs |
Inclusion: ≥60 Range: 61.2–79.2 |
462 Range: 12–87 |
NR; 11% F only, 33% M only | Low-moderate risk of bias (PRISMA statement) |
| Frost 2017 [42] | To evaluate effectiveness of home- and community-based health promotion interventions on functioning and frailty in older people with mild or pre-frailty. | MEDLINE, EMBASE, Scopus, Social Science Citation Index, Science Citation Index Expanded, Cochrane (library, CENTRAL, EPOC), NHS Health Economic Evaluations, DARE, PsycINFO, CINAHL, Bibliomap, Social Care Online, Sociological Abstracts, Applied Social Sciences Index, Jan 1990-May 2016 | 2000–2015 |
I: Home- or community-based health promotion interventions (i.e., interventions that enable people to improve or increase control over their health) C: usual care or health education or flexibility training |
10 (7 RCTs) |
Inclusion: > 60 Range: 72–83 |
485 | NR | Low or unclear risk of bias (Cochrane) |
| Gade 2018 [43] | To determine the effect of protein or essential amino acid supplementation during RT in older adults. | PubMed, SCOPUS, EMBASE, Cochrane databases to 2017 | 1994–2016 |
I: RT plus protein or essential amino acid supplementation or a modified diet with increased protein content for > 5 weeks C: RT with/without non-protein placebo |
16 RCTs |
Inclusion: > 60 Range: 61–85 |
1107 Range: 16–179 |
NR; 13% F only, 25% M only |
Good to excellent (PEDro) |
| Garcia-Hermoso 2020 [44] | To analyze the safety and effectiveness of long-term exercise interventions in older adults. | PubMed, Cochrane CENTRAL, SPORTDiscus to Sept 16, 2019 | 1991–2019 |
I: MCT (n =45), RT (n=24), AT (n=19), and Tai Chi (n=4). Most used group-based supervised exercise alone (n=46) or combined with home-based unsupervised training (n=21) C: usual care with or without non-exercise intervention |
99 (93 RCTs; 90 RCTs in meta-analysis) |
Inclusion: ≥65 Mean: 74.2 |
28,523 | NR; 19% F only, 4% M only |
Good (PEDro) |
| Grässler 2021 [45] | To summarize the effects of endurance, resistance, coordinative, and multimodal exercise interventions on resting heart rate variability and secondary health factors in healthy older adults. | PubMed, Scopus, SPORTDiscus, Ovid, Cochrane Jan 2005-Sept 2020 | 2005–2020 |
I: Physical training intervention (endurance, resistance, coordinative, or multimodal training) with a minimum of 4 weeks and 8 training sessions C: NR |
13 RCTs and non-RCTs (designs NR) |
Inclusion: ≥60 Mean: 67.8 |
422 | 31% F only, 8% M only |
Mean: 8.88 (SD 2.47)/15 (Tool for the Assessment of Study Quality and reporting in Exercise) Mean: 20 (SD 1.56)/25 (STARDHRV) |
| Hanach 2019 [46] | To evaluate the effectiveness of dairy proteins on functions associated with sarcopenia in middle-aged and older adults. | PubMed, CINAHL, Web of Science to May 10, 2017 | 2009–2016 |
I: Dairy protein supplementation (e.g., whey protein, milk-protein concentrate, casein) or a protein-based dairy product (e.g., ricotta cheese) for ≥12 weeks with/out RT C: usual care, placebo, or regular dairy |
14 RCTs |
Inclusion: 45–65 Range: 61–81 |
1424 | NR; 7% F only | Moderate-High (Cochrane) |
| Hortobagyi 2015 [47] | To determine the effects of strength, power, coordination, and MCT on healthy older adults’ gait speed. | PubMed, Web of Knowledge, Cochrane, Jan 1984 to Dec 2014 | 1993–2014 |
I: RT or interventions that included 2+ types of exercise in any combination or functional or coordination training C: no exercise |
42 (designs NR) |
Inclusion ≥65 Mean: 74.2 Range: 64.4–82.7 |
2495 | 63 | Low (PEDro) |
| Hou 2019 [48] | To explore whether a combination of protein supplementation with RT is effective in enhancing muscle mass, strength and function in the elderly. | PubMed, MEDLINE, Embase, Jan 2004-May 2018 | 2004–2018 |
I: Protein supplements containing leucine, whey protein, casein, lean meat, low-fat milk or related mixture and RT 1–4 times/week C: RT alone |
21 RCTs |
Inclusion: > 50 Range: 50–91 |
1249 | NR; 38% F only, 14% M only | Moderate certainty (Cochrane) |
| Howe 2011 [49] | To examine the effects of exercise interventions on balance in older people, ≥60 y, living in the community or institutional care. | Cochrane Specialized Register, CENTRAL, MEDLINE, EMBASE, PEDro, CINAHL, AMED to Feb 2011 | 1989–2010 |
I: Interventions designed to improve balance, or RT or MCT or Tai Chi, qi gong, dance and yoga or gait, coordination, and functional exercises C: attention control |
94 RCTs and quasi-experimental |
Inclusion: ≥60 Range: 60–75 |
9821 | NR; 27% F only, 5% M only | Most unclear risk of bias (Cochrane) |
| Hurst 2019 [50] | To assess the effects of same session combined exercise on measures of fitness in adults ≥50 y. | PubMed, MEDLINE, Scopus, BIOSIS, Web of Science to July 2018 | 1991–2018 |
I: At least one AT and RT group C: no exercise, AT only, or RT only |
27 (22 RCTs) |
Inclusion: > 50 Mean: 68.8 Range: 54–85 |
1346 | NR; 44% F only, 18% M only | Low or unclear risk of bias (Cochrane) |
| Hwang 2015 [51] | To examine the benefits to physical health of dance among older adults. | PubMed, Date NR | 2004–2013 |
I: Dance defined as a form of artistic expression through rhythmic movement to music, not including aerobic fitness classes taught to music C: other activity or no activity |
18 (10 RCTs) |
Inclusion: NR Range: 52–87 |
Range: 13–97 | NR; 44 > 50% F, 28% F only |
Moderate (Sackett, Megens and Harris) |
| Katsoulis 2019 [52] | To investigate the effect of high- vs. low-intensity RT on muscular power in older, healthy, untrained adults. | MEDLINE, Embase, CINAHL, AgeLine, SPORTDiscus, Scopus to Apr 2017 | 2001–2017 |
I: Low (≤50% 1RM), moderate or high (≥70% 1RM) intensity power training C: post-intervention vs. pre-intervention |
27 RCTs |
Inclusion: > 60 Mean: 74.5 Range: 62.7–81.8 |
549 Range: 5–59 |
NR; 22% F only, 7% M only | 52% high (> 6); remaining fair-good (PEDro) |
| King 2016 [53] | To synthesize research that tests the effects of aquatic exercise in healthy older adults on functional balance. | Academic Search Complete, AMED, CINHAL, MEDLINE, SPORTDiscus, Date NR | 1996–2013 |
I: Exercise programs in water, with no restriction on depth or temperature of the aquatic environment. Swimming programs were not included C: land exercise or no exercise |
13 (6 RCTs) |
Inclusion > 60 Mean: 71 Range: 68–80 |
545 Range: 20–79 |
NR; 31% F only, 8% M only |
46% good; 54% poor-fair (Downs and Black) |
| Labott 2019 [54] | To examine the effects of exercise training on handgrip strength in healthy community-dwelling older adults ≥60 y. | PubMed, Web of Science, SPORTDiscus to Nov 25, 2018 | 1995–2018 |
I: aquatic exercise, walking, flexibility, TRX-training, home-trainer exercise, RT, vibration platform, dance, Tai Chi, exergames, balance training, calisthenics, and MCT C: NR |
24 RCTs |
Inclusion: ≥60 Mean: 73.3 ± 6.0 |
3018 Range: 22–1635 |
NR; 50% F only 4% M only | Fair (PEDro) |
| Lesinski 2015 [55] | To quantify effects of balance training on balance outcomes and to characterize dose–response in healthy community-dwelling older adults. | PubMed, Web of Science, Jan 1985 to Jan 2015 | 1994–2014 |
I: Balance training protocol comprising static/dynamic postural stabilization exercises (combined training was excluded) C: no intervention |
23 RCTs |
Inclusion: ≥65 Range: 66–83 |
1220 Range: 11–75 |
NR; 9% F only | 74% weak (PEDro) |
| Leung 2011 [56] | To assess the usefulness of tai chi to improve balance reduce falls in older adults. | CINAHL, Science citation index, social science citation index, MEDLINE, Cochrane Central, ScienceDirect, PubMed, Allied & Complementary medicine, China journals, eCAM, Jan 1, 1998-Jan 31, 2008 | 2000–2007 |
I: Various styles of Tai Chi C: no treatment or other exercise |
13 RCTs |
Inclusion: ≥60 Range: 45–98 |
2151 | NR; 23% mostly F, 8% mostly M, 8% M only |
Good to excellent (PEDro) |
| Levin 2017 [57] | To examine the dual effects of different types of physical training on cognitive and motor tasks in older adults with no known cognitive or motor disabilities or disease | PubMed, Jan 2007-Dec 2016 | 2008–2016 |
I: physical training (e.g., balance training, AT, strength training, group sports, etc.) or combined physical and cognitive intervention (dual-task) C: passive control or health education classes and lesser training |
19 (17 RCTs) |
Inclusion: > 65 Range: 65.5 ± 6.3–81.9 ± 6.3 |
1226 | 52 |
Mostly low (Jadad) |
| Liberman 2017 [58] | To assess the effects of exercise on muscle strength, body composition, physical function and inflammatory profile in older adults. | PubMed, 2015–2016 | 2015–2016 |
I: Any exercise; included RT (n=16), AT (n=8), AT/RT (n=6) and other types (n=10) C: no intervention |
34 RCTs |
Inclusion: > 65 Range: 54.5–92.3 |
1747 | NR | Unclear risk of bias across domains (NICE) |
| Liu 2010 [59] | To determine whether Tai Chi has an effect on static and dynamic balance, functional performance, muscle strength and flexibility, and subjective measures. | MEDLINE, PubMed; Jan 2000-July 2007 | 2000–2007 |
I: Tai Chi C: NR |
18 (15 RCTs) |
Inclusion: ≥60 Mean: NR |
3741 Range: 17–1200 |
NR | NR; lower-quality studies screened out |
| Liu 2017 [60] | To compare RT or MCT to no intervention or attentional controls, on muscle strength, physical functioning, ADL, and falls in community- dwelling older adults with reduced physical capacity. | MEDLINE, Embase, Cochrane Library Central, Date NR | 1996–2015 |
I: Progressive RT, strength training in which one exerts an effort against an external resistance or MCT combines > 2 types of exercise RT, balance, stretching, and AT C: no intervention or attention control |
23 RCTs |
Inclusion: ≥60 Mean: 75 Range: 69–84 |
2018 | NR; 22% F only, 4% M only | Low risk of bias (Cochrane) |
| Liu 2020 [61] | To evaluate the effects of dance on physical function performance in healthy older adults. | Cochrane Library, PsycINFO, PubMed, Scopus, Web of Science to June 2018 | 2008–2017 |
I: Dance interventions of at least 6 weeks duration C: usual care with no intervention or other exercise |
13 RCTs |
Inclusion: ≥65 Mean: NR |
1029 Range: 23–510 |
85 | Low-moderate risk of bias (Cochrane) |
| Loureiro 2021 [62] | To determine the effects of multifactorial programs including physical activity based on individual assessment of fall risk factors on rate of falls and physical performance in older adults. | PubMed, Cochrane Plus, Web of Science, SCOPUS, 2009–2020 | 2009–2017 |
I: Multi-component interventions including strength and balance training, flexibility, endurance, gait, and/or functional exercises, treatment of sensory impairments, health education, medical management and/or in home falls risk assessment C: Usual care, delayed intervention, health education |
6 RCTs |
Inclusion: ≥60 years Mean: 77.62 |
2012 Range: 19–616 |
54.4 |
50% good 50% fair (PEDro) |
| Martin 2013 [63] | To compare physical therapist–administered group-based exercise with individual or no exercise control. | PubMed, CINAHL, Dec 1, 2001-June 7, 2012 | 2002–2010 |
I: Physical therapist led or supervised group exercise C: individual physical therapy or no exercise control |
10 RCTs |
Inclusion: ≥65 Mean: 76.21 Range: 72–81 |
2293 Range: 32–1090 |
NR |
Good (PEDro) |
| Martins 2018 [64] | To identify modified Otago Exercise Program delivering methods and analyze their effects on balance, functional ability and self-reported falls. | PubMed, PEDro, ScienceDirect, Scopus, Date NR | 2011–2016 |
I: Modified Otago Exercise program (RT, balance and walking) C: original Otago program, non-intervention, or other exercise |
8 (5 RCTs) |
Inclusion: NR Mean: 76.75 ± 5.5 |
604 | NR; 13% F only |
Fair-Good (PEDro) |
| Meereis-Lemos 2019 [65] | To determine the effectiveness of RT and MCT on functionality of healthy older patients. | PubMed, Web of Science, PEDro, Cochrane, Lilacs databases, Date NR | 2007–2016 |
I: Supervised RT or RT combined with another modality at least twice a week for a minimum of 8 weeks C: no exercise |
28 RCTs |
Inclusion: ≥60 Range: 62.2 ± 4.3–83.4 ± 2.8 |
NR | NR; 36% F only, 14% M only |
Good (PEDro) |
| Montero 2016 [66] | To explore the effects of AT on VO2max, Qmax and Ca-VO2max in healthy middle-aged and older subjects. | MEDLINE, Scopus and Web of Science to May 2015 | 1989–2014 |
I: Dynamic exercise involving a large muscle mass (e.g., running, cycling), 3 weeks or more C: post-intervention vs. pre-intervention |
16 (designs NR) |
Inclusion: > 40 Range: 42–71 |
153 | NR; 19% F only, 63% M only |
Moderate-high (SAQOR) |
| Moore 2016 [67] | To assess the effectiveness of community-based interventions to increase physical activity in older people (≥ 65 y) living rural or regional areas. | CINHAL, Ageline, ProQuest Central, PubMed, Informit Complete, Google Scholar to Aug 2014 | 1997–2014 |
I: Community-based PA intervention of six weeks or more (from start to follow-up) C: NR |
7 (3 RCTs) |
Inclusion: ≥65 Mean: NR |
Range: 37–1200 | NR; 14% F only |
High risk of bias (Cochrane) |
| Moran 2018 [68] | To determine the effect of jump training on muscular power in older adults (≥ 50 y). | Google Scholar, PubMed, Microsoft Academic, Date NR | 1998–2018 |
I: Jump training, defined as lower body unilateral and bilateral bounds, jumps and hops C: NR |
9 (designs NR) |
Inclusion: ≥50 Range: 53.0–72.4 |
467 | NR; 56% F only, 11% M only |
Good (PEDro) |
| Nicolson 2021 [69] | To evaluate the effects of therapeutic exercise interventions on physical function, health-related quality of life and psychosocial outcomes in community-dwelling adults. | MEDLINE, EMBASE, CINAHL to July 2020 | 1997–2020 |
I: Therapeutic exercise including AT, RT, functional training, balance training, gait training, flexibility, or 3D (constant movement in a controlled, fluid, repetitive way through all three spatial dimensions, e.g., Tai Chi) C: Usual care, no treatment, other exercise, pharmacotherapy, or health education |
16 RCTs |
Inclusion: ≥80 Median: 84.2 (interquartile range: 83.4–86.1) |
1660 | 19% F only, 6% M only |
6% low 63% moderate 31% high (Cochrane) |
| Plummer 2015 [70] | To examine the effects of physical exercise on dual-task performance during walking in older adults. | PubMed, CINAHL, EMBASE, Web of Science, PsycINFO up to Sept 19, 2014 | 2006–2014 |
I: Any physical exercise intervention C: active, education, or inactive no treatment/delayed treatment |
21 (15 RCTs) |
Inclusion: ≥60 Range: 71.1–91.1 |
Range: 10–134 | ≥70% in all but 2 studies |
Good (Downs and Black) |
| Qi 2020 [71] | To evaluate the effects of Tai Chi with RT on health outcomes in adults ≥50 y. | PubMed, Scopus, Web of Science, CINAHL, MEDLINE, PEDro, Cochrane library to Jan 2018 | 2005–2016 |
I: Tai Chi combined with RT C: any control or comparison |
7 (6 RCTs) |
Inclusion: ≥50 Range: 58.5–74.0 |
703 | NR; 14% F only |
Fair (PEDro) |
| Raymond 2013 [72] | To examine the effect of high intensity RT on strength, function, mood, QoL, and adverse events in older adults. | Cochrane Central, MEDLINE, Embase, CINAHL, AMED, AgeLine, PEDro to July 2012 | 1995–2007 |
I: Lower limb high intensity progressive RT with or without upper limb or trunk strengthening C: other intensity RT |
21 RCTs |
Inclusion: ≥65 Range: 60–95 |
724 | NR; 14% F only, 24% M only | Poor to fair (PEDro) |
| Rodrigues-Krause 2019 [73] | To review the literature on the use of dance to promote functional and metabolic health in older adults. | MEDLINE, Cochrane Wiley, ClinicalTrials.gov; PEDRO, LILACS, Nov 1980 to Mar 2016 | 1984–2016 |
I: Regular dance classes of any style for at least 2 weeks. Dance environments included dance studios and stage and/or dance ballrooms C: inactive control or other exercise |
50 (31 RCTs) |
Inclusion: > 55 Range: 50–94 |
Range: 10–700 | NR; 34% F only, 4% M only |
Majority high risk of bias (PRISMA) |
| Roland 2011 [74] | To investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults. | PubMed, Scholars Portal, AgeLine, CINAHL, EBSCO, MEDLINE, SPORTDiscus, PsycINFO, EMBASE, 1970–2009 | 1989–2009 |
I: Yoga C: other exercise, no exercise, or pre/post yoga groups |
10 (5 RCTs) |
Inclusion: ≥65 or 55–64 Mean: 69.6 ± 6.3 |
544 Range: 13–176 |
71 |
Moderate-high (Modified Downs and Black) |
| Sivaramakrishnan 2019 [75] | To synthesize existing evidence on the effects of yoga on physical function and QoL in older adults not characterized by any specific clinical condition. | MEDLINE, PsycINFO, CINAHL Plus, Scopus, Web of Science, Cochrane Library, Embase, SPORTDiscus, AMED, ProQuest Dissertations & Theses Global to Sept 2017 | 1983–2017 |
I: Yoga C: inactive or active controls |
22 RCTs |
Inclusion: ≥60 Range: 61.0–83.8 |
Range: 18–410 | > 70 | Moderate risk of bias (Cochrane) |
| Stares 2020 [76] | To assess whether creatine combined with exercise results improves indices of skeletal muscle, bone, and mental health over exercise alone in healthy older adults. | PubMed, CINAHL, Web of Science, 1998–2018 | 1998–2016 |
I: A physical training program and creatine supplementation C: placebo |
17 RCTs |
Inclusion: ≥48 Mean age: NR Range: 48–84 |
583 | 39 |
Overall good (PEDro) |
| Stathokostas 2012 [77] | To assess the effects of flexibility training on functional outcomes in healthy older adults > 65 y. | PubMed, Embase, CINAHL, Scopus, and SPORTDiscus to Jan 2011 | 1988–2011 |
I: Flexibility training (excluding Tai Chi or yoga) C: NR |
22 (13 RCTs) |
Inclusion: ≥65 Mean: 74.1 Range: 64–88.8 |
1127 Range: 7–132 |
75 |
RCTs: good Non-RCTs: low-moderate (Modified Downs and Black) |
| Straight 2016 [78] | To estimate the effect of RT on lower-extremity muscle power in middle-aged and older adults. | Google Scholar to Nov 1, 2014 | 1995–2013 |
I: RT, defined as muscle-strengthening activities that use major muscle groups and could include free weights, machines, and resistance bands C: usual care or sham exercise |
12 RCTs |
Inclusion: ≥50 Range: 56.3–93 (intervention), 56.7–93 (control) |
810 | NR; 17% F only, 8% M only | NR |
| Ten Haaf 2018 [79] | To assess the effect of protein on lean body mass, muscle strength, and/or physical performance, in non-frail community-dwelling older adults. | PubMed, Embase, Web of Science to May 15, 2018 | 1992–2018 |
I: Multi-nutrient protein or essential amino acid supplementation added to or replacing normal diet with or without RT. Supplements were consumed ≥3 times/week for at least 4 weeks C: placebo control or RT |
36 RCTs |
Inclusion: ≥50 Range: 55–85 |
1682 | NR; 19% F only, 31% M only |
50% Moderate, 42% Good, 8% Excellent (Downs and Black) |
| Tschopp 2011 [80] | To determine the effects of power training with high movement velocity for older community-dwelling people. | PubMed (MEDLINE), EMBASE, CINAHL, PEDro, Cochrane Central and Google Scholar to April 2010 | 2002–2009 |
I: Power training (training with moderate resistance and an ‘as fast as possible’ movement speed for at least the concentric phase of an exercise) C: Conventional RT (high or moderate resistance and slow concentric movement) |
11 RCTs | Inclusion: > 60 | 377 | NR | Moderate risk of bias (Tool NR) |
| Van Abbema 2015 [81] | To determine the effects of different types or combinations of exercise to improve preferred gait speed. | PubMed, EMBASE, AMED, CINAHL, ERIC, MEDLINE, PsycINFO, SocINDEX, and Cochrane Library 1990 -Dec 9, 2013 | 1994–2013 |
I: Progressive RT or RT, balance and AT with or without additional training components, exercise interventions with a dance/rhythmic component or stretching exercises C: usual care or attention control |
25 RCTs |
Inclusion: ≥65 Mean: 75.8 Range: 61.4 ± 5.5–87.1 ± 0.6 |
2389 | NR; 32% F only |
Low-quality studies excluded Moderate-high (PEDro) |
| Vetrovsky 2019 [82] | To evaluate the safety and efficacy of plyometric training in older adults regarding various performance, functional, and health related outcomes. | PubMed, SPORTDiscus, Scopus, and EMBASE to 2017 | 2007–2017 |
I: Plyometric training (eccentric loading followed by a concentric contraction, e.g., repetitive jumping, hopping, bounding, and skipping) or MCT with plyometrics C: non-exercising control or other exercise |
12 RCTs |
Inclusion: ≥60 Range: 58.4–79.4 |
289 Range: 8–36 |
61 |
75% high (PEDro) |
| Waller 2016 [83] | To investigate the effect of aquatic exercise on physical functioning in healthy older adults. | MEDLINE, Embase, CINAHL, PEDro, SPORTDiscus, Web of Science, Cochrane Library to Dec 31, 2015 | 1994–2015 |
I: Exercise in an aquatic environment with no limitation on the type of exercise C: land exercise or no exercise |
28 RCTs |
Inclusion: ≥55 Mean: 66.4 Range: 55.4–82.0 |
1456 | 89 | High risk of bias (Cochrane) |
| Wang 2021 [84] | To examine the impact of Traditional Chinese medicine-based exercises on physical performance, balance, and muscle strength in the elderly. | PubMed, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wan Fang, manual search of Soochow University and Nanjing University of Chinese Medicine libraries to March 2021 | 2003–2020 |
I: Traditional Chinese medicine-based exercises including but not limited to Tai Chi, Ba Duan Jin, and Qigong C: Placebo, AT, routine care, or educational programs |
27 RCTs |
Inclusion: ≥55 Range: 59.7–88.8 |
2580 | 68 |
Moderate (Cochrane) |
| Wirth 2020 [85] | To investigate the effect of protein supplementation on body composition and muscle function in healthy adults. | PubMed, Web of Science, CINAHL, Embase to March 2019 | 2001–2019 |
I: Oral protein intake, 2wk minimal duration, including energy-restriction or not, and including exercise or not C: Low-protein diet, no protein supplementation, or non-protein placebo |
23 RCTs |
Inclusion: > 55 Range: 55–81 |
1290 | 62 |
Moderate certainty (GRADE) |
| Yang 2019 [86] | To determine intensity and interval of effective interventions in improving physical function in community-dwelling older adults. | PubMed, EBSCO, and Cochrane Trials, Jan 1, 2013-Dec 31, 2017. | 2013–2017 |
I: Any types of MCT interventions that were conducted in the community, delivered by any kinds of providers C: no exercise control |
5 RCTs |
Inclusion: > 60 Mean: 70 (intervention) 69 (control) |
272 | “Majority female” | Moderate (Cochrane) |
F Female, M Male, NR Not reported, RCT Randomized controlled trial, PEDro Physiotherapy Evidence Database, GRADE Grading of Recommendations, Assessment, Development and Evaluations, MCT Multicomponent interventions, AT Aerobic exercise training, RT Resistance training, QoL Quality of life, ADL Activities of daily living, VO2 max Maximal oxygen consumption, Qmax Maximal cardiac output, Ca-VO2max Arteriovenous oxygen difference at maximal exercise