Benefits of Resistance Training in Early and Late Stages of Frailty and Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

Karolina Talar; Alejandro Hernández-Belmonte; Tomas Vetrovsky; Michal Steffl; Ewa Kałamacka; Javier Courel-Ibáñez

Journal of clinical medicine, 2021

Narrative reviewCC BYData current as of 25 Oct 2026

Abstract

Sarcopenia and frailty are age-related syndromes with negative effects on the quality of life of older people and on public health costs. Although extensive research has been carried out on the effects of physical exercise and physical syndromes, there is a knowledge gap when it comes to the effect of resistance training on muscular strength, physical performance, and body composition at early (prevention) and late (treatment) stages in both syndromes combined. We conducted this systematic review and meta-analysis (CRD42019138253) to gather the evidence of randomized controlled trials examining the effects of resistance training programs lasting ≥8 weeks on strength, physical function, and body composition of adults ≥65 years old diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. A search from the earliest record up to and including December 2020 was carried out using the PubMed, Scopus, Web of Science, and Cochrane Library databases. A total of 25 studies (n = 2267 participants) were included. Meta-analysis showed significant changes in favour of resistance training for handgrip (ES = 0.51, p = 0.001) and lower-limb strength (ES = 0.93, p < 0.001), agility (ES = 0.78, p = 0.003), gait speed (ES = 0.75, p < 0.001), postural stability (ES = 0.68, p = 0.007), functional performance (ES = 0.76, p < 0.001), fat mass (ES = 0.41, p = 0.001), and muscle mass (ES = 0.29, p = 0.002). Resistance training during early stages had positive effects in all variables during early stages (ES > 0.12), being particularly effective in improving gait speed (ES = 0.63, p = 0.016) and functional strength (ES = 0.53, p = 0.011). Based on these results, resistance training should be considered as a highly effective preventive strategy to delay and attenuate the negative effects of sarcopenia and frailty in both early and late stages.

Source: PubMed. Shown under the article’s CC BY licence.

Where this study is used

Progressive resistance training in older adults: Fat mass (Older adults with frailty or sarcopenia (≥ 65 y)) — High. Counted in the grade.
Progressive resistance training in older adults: Functional performance (Older adults with frailty or sarcopenia (≥ 65 y)) — Moderate. Counted in the grade.
Progressive resistance training in older adults: Lean / fat-free mass (Older adults with frailty or sarcopenia (≥ 65 y)) — Moderate. Counted in the grade.
Progressive resistance training in older adults: Lower-body strength (Older adults with frailty or sarcopenia (≥ 65 y)) — Moderate. Counted in the grade.

Extracted values

AI-assisted extraction: each number comes with the sentence it was read from.

Studies pooled: 25
Participants pooled: 2267
Funding: This research was supported by the research grants of Charles University, Czech Republic (PRIMUS/19/HUM/012 and the project Q41).

Study-level values with their source sentences
Field	Value	Source sentence
Review question	This research aimed to systematically review the scientific evidence examining the effect of resistance training on muscular strength, physical function, and body composition of older adults diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. Moreover, to address this issue comprehensively, a meta-analysis was conducted to synthesize the outcomes of comparative studies.	Show quote for Review question This research aimed to systematically review the scientific evidence examining the effect of resistance training on muscular strength, physical function, and body composition of older adults diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. Moreover, to address this issue comprehensively, a meta-analysis was conducted to synthesize the outcomes of comparative studies. Located at `sec:1/p:2`
Population	older individuals (≥65 years of age) with pre-frailty, frailty, pre-sarcopenia or sarcopenia but without comorbid conditions	Show quote for Population participants included older individuals (≥65 years of age) with pre-frailty, frailty, pre-sarcopenia or sarcopenia but without comorbid conditions

Abstract

Source: PubMed. Shown under the article’s CC BY licence.

Extracted values

AI-assisted extraction: each number comes with the sentence it was read from.

Studies pooled: 25
Participants pooled: 2267
Funding: This research was supported by the research grants of Charles University, Czech Republic (PRIMUS/19/HUM/012 and the project Q41).

Study-level values with their source sentences
Field	Value	Source sentence
Review question	This research aimed to systematically review the scientific evidence examining the effect of resistance training on muscular strength, physical function, and body composition of older adults diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. Moreover, to address this issue comprehensively, a meta-analysis was conducted to synthesize the outcomes of comparative studies.	Show quote for Review question This research aimed to systematically review the scientific evidence examining the effect of resistance training on muscular strength, physical function, and body composition of older adults diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. Moreover, to address this issue comprehensively, a meta-analysis was conducted to synthesize the outcomes of comparative studies. Located at `sec:1/p:2`
Population	older individuals (≥65 years of age) with pre-frailty, frailty, pre-sarcopenia or sarcopenia but without comorbid conditions	Show quote for Population participants included older individuals (≥65 years of age) with pre-frailty, frailty, pre-sarcopenia or sarcopenia but without comorbid conditions

Field	Value	Source sentence
Outcome name	handgrip	Show quote for Outcome name Meta-analysis showed significant changes in handgrip Located at `sec:3.4/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.51 [95% CI: 0.23 to 0.78] Located at `sec:3.4/p:0`
Point estimate	0.51	Show quote for Point estimate ES = 0.51 [95% CI: 0.23 to 0.78] Located at `sec:3.4/p:0`
Ci low	0.23	Show quote for Ci low ES = 0.51 [95% CI: 0.23 to 0.78] Located at `sec:3.4/p:0`
Ci high	0.78	Show quote for Ci high ES = 0.51 [95% CI: 0.23 to 0.78] Located at `sec:3.4/p:0`
Ci level	95	Show quote for Ci level ES = 0.51 [95% CI: 0.23 to 0.78] Located at `sec:3.4/p:0`
P value	0.001	Show quote for P value p = 0.001, Figure 2 Located at `sec:3.4/p:0`
I2	68	Show quote for I2 handgrip (I^2 = 68%) Located at `sec:3.4/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in handgrip Located at `sec:3.4/p:0`

Field	Value	Source sentence
Outcome name	lower-limb strength	Show quote for Outcome name and lower-limb strength (ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
Point estimate	0.93	Show quote for Point estimate ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
Ci low	0.64	Show quote for Ci low ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
Ci high	1.22	Show quote for Ci high ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
Ci level	95	Show quote for Ci level ES = 0.93 [95% CI: 0.64 to 1.22] Located at `sec:3.4/p:0`
P value	0.001	Show quote for P value p < 0.001, Figure 3 Located at `sec:3.4/p:0`
I2	77	Show quote for I2 lower-limb strength (I^2 = 77%) Located at `sec:3.4/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in handgrip Located at `sec:3.4/p:0`

Field	Value	Source sentence
Outcome name	handgrip	Show quote for Outcome name Sub-group analyses for early stages yielded positive but non-significant effects in handgrip Located at `sec:3.4/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.12 [95% CI: -0.13 to 0.36] Located at `sec:3.4/p:0`
Point estimate	0.12	Show quote for Point estimate ES = 0.12 [95% CI: -0.13 to 0.36] Located at `sec:3.4/p:0`
Ci low	−0.13	Show quote for Ci low ES = 0.12 [95% CI: -0.13 to 0.36] Located at `sec:3.4/p:0`
Ci high	0.36	Show quote for Ci high ES = 0.12 [95% CI: -0.13 to 0.36] Located at `sec:3.4/p:0`
Ci level	95	Show quote for Ci level ES = 0.12 [95% CI: -0.13 to 0.36] Located at `sec:3.4/p:0`
P value	0.146	Show quote for P value p = 0.146, Figure 4 Located at `sec:3.4/p:0`
I2	0	Show quote for I2 I^2 = 0%, p = 0.146 Located at `sec:3.4/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Subgroup	early stages	Show quote for Subgroup Sub-group analyses for early stages Located at `sec:3.4/p:0`
Analysis kind	subgroup	Show quote for Analysis kind Sub-group analyses for early stages Located at `sec:3.4/p:0`

Field	Value	Source sentence
Outcome name	lower-limb strength	Show quote for Outcome name and lower-limb strength (ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
Point estimate	0.35	Show quote for Point estimate ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
Ci low	−0.97	Show quote for Ci low ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
Ci high	1.67	Show quote for Ci high ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
Ci level	95	Show quote for Ci level ES = 0.35 [95% CI: −0.97 to 1.67] Located at `sec:3.4/p:0`
P value	0.372	Show quote for P value p = 0.372 Located at `sec:3.4/p:0`
I2	52	Show quote for I2 I^2 = 52%, p = 0.372 Located at `sec:3.4/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Subgroup	early stages	Show quote for Subgroup Sub-group analyses for early stages Located at `sec:3.4/p:0`
Analysis kind	subgroup	Show quote for Analysis kind Sub-group analyses for early stages Located at `sec:3.4/p:0`

Field	Value	Source sentence
Outcome name	agility	Show quote for Outcome name for the agility (ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
Point estimate	0.78	Show quote for Point estimate ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
Ci low	0.34	Show quote for Ci low ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
Ci high	1.22	Show quote for Ci high ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.78 [95% CI: 0.34 to 1.22] Located at `sec:3.5/p:0`
P value	0.003	Show quote for P value p = 0.003, Figure 6 Located at `sec:3.5/p:0`
I2	78	Show quote for I2 agility (I^2 = 78%) Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in favor of the resistance training group for the agility Located at `sec:3.5/p:0`

Benefits of Resistance Training in Early and Late Stages of Frailty and Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

Abstract

Where this study is used

Extracted values

Benefits of Resistance Training in Early and Late Stages of Frailty and Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

Abstract

Where this study is used

Extracted values

handgrip

lower-limb strength

handgrip · early stages

lower-limb strength · early stages

agility

balance

gait speed

functional strength

agility · early stages

balance · early stages

gait speed · early stages

functional strength · early stages

fat mass

muscle mass

fat mass · early stages

muscle mass · early stages

How these values were extracted

Field	Value	Source sentence
Outcome name	balance	Show quote for Outcome name balance (ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
Point estimate	0.68	Show quote for Point estimate ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
Ci low	0.23	Show quote for Ci low ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
Ci high	1.13	Show quote for Ci high ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.68 [95% CI: 0.23 to 1.13] Located at `sec:3.5/p:0`
P value	0.007	Show quote for P value p = 0.007, Figure 7 Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in favor of the resistance training group for the agility Located at `sec:3.5/p:0`

Field	Value	Source sentence
Outcome name	gait speed	Show quote for Outcome name gait speed (ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
Point estimate	0.75	Show quote for Point estimate ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
Ci low	0.49	Show quote for Ci low ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
Ci high	1.02	Show quote for Ci high ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.75 [95% CI: 0.49 to 1.02] Located at `sec:3.5/p:0`
P value	0.001	Show quote for P value p < 0.001, Figure 8 Located at `sec:3.5/p:0`
I2	76	Show quote for I2 gait speed (I^2 = 76%) Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in favor of the resistance training group for the agility Located at `sec:3.5/p:0`

Field	Value	Source sentence
Outcome name	functional strength	Show quote for Outcome name functional strength (ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
Point estimate	0.76	Show quote for Point estimate ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
Ci low	0.52	Show quote for Ci low ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
Ci high	1	Show quote for Ci high ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.76 [95% CI: 0.52 to 1.00] Located at `sec:3.5/p:0`
P value	0.001	Show quote for P value p < 0.001, Figure 9 Located at `sec:3.5/p:0`
I2	48	Show quote for I2 functional strength (I^2 = 48%) Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in favor of the resistance training group for the agility Located at `sec:3.5/p:0`

Field	Value	Source sentence
Outcome name	agility	Show quote for Outcome name effects in agility (ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
Point estimate	0.28	Show quote for Point estimate ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
Ci low	−0.47	Show quote for Ci low ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
Ci high	1.03	Show quote for Ci high ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.28 [95% CI: −0.47 to 1.03] Located at `sec:3.5/p:0`
P value	0.244	Show quote for P value p = 0.244, Figure 10 Located at `sec:3.5/p:0`
I2	58	Show quote for I2 I^2 = 58%, p = 0.244 Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Subgroup	early stages	Show quote for Subgroup Sub-group analyses for early stages Located at `sec:3.5/p:0`
Analysis kind	subgroup	Show quote for Analysis kind Sub-group analyses for early stages Located at `sec:3.5/p:0`

Field	Value	Source sentence
Outcome name	gait speed	Show quote for Outcome name benefits in gait speed (ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
Point estimate	0.63	Show quote for Point estimate ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
Ci low	0.22	Show quote for Ci low ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
Ci high	1.04	Show quote for Ci high ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
Ci level	95	Show quote for Ci level ES = 0.63 [95% CI: 0.22 to 1.04] Located at `sec:3.5/p:0`
P value	0.016	Show quote for P value p = 0.016, Figure 12 Located at `sec:3.5/p:0`
I2	18	Show quote for I2 I^2 = 18%, p = 0.016 Located at `sec:3.5/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Subgroup	early stages	Show quote for Subgroup Sub-group analyses for early stages Located at `sec:3.5/p:0`
Analysis kind	subgroup	Show quote for Analysis kind Sub-group analyses for early stages Located at `sec:3.5/p:0`

Field	Value	Source sentence
Outcome name	fat mass	Show quote for Outcome name fat mass (ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
Point estimate	0.41	Show quote for Point estimate ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
Ci low	0.23	Show quote for Ci low ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
Ci high	0.59	Show quote for Ci high ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
Ci level	95	Show quote for Ci level ES = 0.41 [95% CI: 0.23 to 0.59] Located at `sec:3.6/p:0`
P value	0.001	Show quote for P value p = 0.001, Figure 14 Located at `sec:3.6/p:0`
I2	18	Show quote for I2 fat mass (I^2 = 18%) Located at `sec:3.6/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in fat mass Located at `sec:3.6/p:0`

Field	Value	Source sentence
Outcome name	muscle mass	Show quote for Outcome name muscle mass (ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
Effect measure	SMD	Show quote for Effect measure The effect sizes (ES) were calculated as the standardized mean differences Located at `sec:2.6/p:0`
Effect measure as written	ES	Show quote for Effect measure as written ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
Point estimate	0.29	Show quote for Point estimate ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
Ci low	0.12	Show quote for Ci low ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
Ci high	0.46	Show quote for Ci high ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
Ci level	95	Show quote for Ci level ES = 0.29 [95% CI: 0.12 to 0.46] Located at `sec:3.6/p:0`
P value	0.002	Show quote for P value p = 0.002, Figure 15 Located at `sec:3.6/p:0`
I2	54	Show quote for I2 muscle mass (I^2 = 54%) Located at `sec:3.6/p:0`
Pooling model	random	Show quote for Pooling model RVE is a form of random-effects meta-regression Located at `sec:2.6/p:0`
Analysis kind	primary	Show quote for Analysis kind Meta-analysis showed significant changes in fat mass Located at `sec:3.6/p:0`