Effects of Exercise on Balance-Related Functional Mobility in Older Adults With Sarcopenia: A Systematic Review and Meta-Analysis.

OBJECTIVES

This study aimed to evaluate the effects of exercise on balance in older adults with sarcopenia.

DESIGN

Systematic review and meta-analysis.

SETTING AND

PARTICIPANTS

Older adults diagnosed with sarcopenia.

METHODS

A comprehensive search was conducted across PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases from their inception to October 05, 2025 to identify eligible randomized controlled trials. Pooled effect sizes were calculated using weighted mean difference (WMD) with 95% CI. Methodological quality of included studies was assessed using the Cochrane Risk of Bias 2 tool. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of evidence.

RESULTS

Twenty randomized controlled trials met the inclusion criteria. Exercise significantly improved balance-related functional mobility in older adults with sarcopenia (WMD, -1.47; 95% CI, -1.87 to -1.07; P < .00001; I2 = 69%). Subgroup analyses indicated relatively larger pooled effects for resistance training (WMD, -1.75; 95% CI, -2.40 to -1.10; P < .00001; I2 = 75%), light intensity (WMD, -1.62; 95% CI, -2.74 to -0.49; P = .005; I2 = 0%), ≤3 times per week (WMD, -1.59; 95% CI, -2.04 to -1.15; P < .00001; I2 = 67%), <60 minutes per session (WMD, -1.56; 95% CI, -2.22 to -0.90; P < .00001; I2 = 69%), a weekly time of ≤180 minutes (WMD, -1.60; 95% CI, -2.08 to -1.13; P < .00001; I2 = 69%), unsupervised interventions (WMD, -1.55; 95% CI, -2.22 to -0.87; P < .00001; I2 = 71%), participants aged ≥75 years (WMD, -2.01; 95% CI -2.58 to -1.43; P < .00001; I2 = 16%), and participants with comorbidities (WMD, -1.51; 95% CI, -2.08 to -0.94; P < .00001; I2 = 73%).

CONCLUSIONS AND IMPLICATIONS: Exercise significantly improved balance-related functional mobility, as assessed by the Timed Up and Go Test, in older adults with sarcopenia, thereby supporting its implementation in clinical practice. In terms of pooled effect sizes, several prescription- and participant-related subgroups demonstrated relatively larger improvements in Timed Up and Go Test-based functional mobility, including light-intensity exercise, lower training frequency (≤3 sessions per week), lower exercise volume (<60 minutes per session and ≤180 minutes per week), unsupervised interventions, resistance training, older age (≥75 years), and the presence of comorbidities.