Effects of strength exercises combined with other training on physical performance in frail older adults: A systematic review and meta-analysis

Objectives: Strength training is one of the most important protocols for frailty prevention in the older population. However, effects of adding other types of exercise to strength training in frail older adults remain unknown. Therefore, this review and meta-analysis determined the effects of strength exercise combined with other types of training on physical performance in frail older adults. Methods: MEDLINE, PubMed, CINAHL, and Cochrane databases were searched through October 2021. In our study, we included both pre-frailty and frailty as frail older adults. The intervention was strength training combined with other exercise training, whereas the control group received usual care or light-intensity exercises. The included studies included at least one of the following outcomes: handgrip strength, knee extensor strength, gait speed, Timed Up and Go, and short physical performance battery. Results: Ten articles met the inclusion criteria and were included. The results indicated that handgrip strength (SMD = 0.86, 95% CI= 0.01–1.70, p = 0.05), knee extensor strength (SMD = 0.61, 95%CI = 0.12–1.10, p = 0.01), TUG (SMD = -1.79, 95%CI = -3.16– -0.43, p=0.01), and SPPB (SMD = 0.53, 95%CI = 0.12–0.94, p = 0.01) improved significantly in the experimental group. Conclusions: Strength exercise combined with other exercise training improved muscle strength, TUG, and SPPB, but not gait velocity, in frail older adults.