Effect of exercise interventions on hand grip and TUG in older adults: A network meta-analysis of randomized controlled trials.

BACKGROUND

Increasing life expectancy has led to a growing older population and a higher prevalence of age-related declines in muscle mass, strength, and functional capacity, increasing the risk of frailty and sarcopenia. Although resistance and multicomponent exercise programs, particularly when combined with adequate protein and vitamin D intake, have demonstrated benefits, comparative evidence across exercise modalities remains limited.

OBJECTIVE

To compare the effects of different exercise modalities on muscle strength and functional mobility in older adults through a network meta-analysis (NMA).

METHODS

A systematic search was conducted from database inception to May 2026. Randomized controlled trials evaluating exercise interventions in older adults and reporting outcomes on Hand Grip strength (dynamometry) and Timed Up and Go (TUG) performance were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated with GRADE. Pairwise and network meta-analyses were performed to integrate direct and indirect comparisons.

RESULTS

Forty-seven studies were included. For Hand Grip strength, the largest improvement was observed in multicomponent exercise combined with nutritional support versus control (effect size [ES]: 6.39; 95% CI: 0.48 to 12.30), followed by resistance training plus nutritional support (ES: 3.63; 95% CI: 0.44 to 6.82). For functional mobility, the greatest reduction in TUG completion time was found in multicomponent plus interventions versus control (ES: -1.88; 95% CI: -2.73 to -1.02), with superiority also demonstrated over conventional combined exercise (ES: -1.68; 95% CI: -3.25 to -0.11).

CONCLUSIONS

Multicomponent exercise programs combined with nutritional support appear to provide the greatest improvements in muscle strength and functional mobility in healthy older adults. These findings support integrated exercise-nutrition strategies to preserve physical function with aging. High-quality trials are needed to refine optimal intervention components and dosing.

REGISTRATION: The protocol for this review was registered in PROSPERO (CRD420251253057).