# Effects of resistance training on muscle mass, strength, and physical function in older women with sarcopenia: a systematic review and meta-analysis

## TL;DR

Resistance training improves strength and physical function in older women with sarcopenia, but not muscle mass, according to a review of 12 studies.

## Contribution

This is the first systematic review and meta-analysis focusing specifically on older women with sarcopenia.

## Key findings

- Resistance training significantly improved handgrip strength, gait speed, and knee extension strength.
- No significant effect on skeletal muscle mass index was observed.
- Mixed resistance training showed a significant advantage in enhancing gait speed.

## Abstract

Resistance training is widely recommended for sarcopenia, yet evidence in older women remains limited. This study systematically evaluated its effects on muscle mass, strength, and physical function in this population.

PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched up to February 2025; the protocol was registered in PROSPERO (CRD420251066233). Meta-analyses were performed using the “meta” package in R under a random-effects model with restricted maximum likelihood estimation. Study quality was assessed using RoB 2, and evidence certainty via GRADE.

Twelve randomized controlled trials involving 518 older women with sarcopenia were included. Resistance training significantly improved handgrip strength (SMD = 0.43, 95% CI: 0.11–0.74), gait speed (SMD = 0.37, 95% CI: 0.09 to 0.64), knee extension strength (SMD = 0.85, 95% CI: 0.37 to 1.33), Timed Up and Go (SMD = −0.68, 95% CI: −0.95 to −0.41), and 30-Second Chair Stand (SMD = 0.52, 95% CI: 0.19 to 0.86), but had no significant effect on skeletal muscle mass index. Subgroup analyses showed that women with sarcopenic obesity achieved greater gains in knee extension strength, while those with sarcopenia alone improved more in gait speed. Mixed resistance training demonstrated a significant advantage in enhancing gait speed.

Resistance training effectively enhances muscle strength and physical function in older women with sarcopenia, though improvements in muscle mass remain uncertain. Further large-scale, long-term studies are needed to confirm these findings and optimize intervention protocols.

Visual abstract summarizing a systematic review and meta-analysis on resistance training for older women with sarcopenia. The top section provides the study's title and objectives, which evaluate effects on muscle mass, strength, and function. Methods include data searches in several databases with risk of bias assessed. The results section features a forest plot showing standardized mean differences and confidence intervals for various outcomes such as gait speed and muscle strength. Each outcome has an associated funnel plot and grade of evidence. The conclusion states resistance training is beneficial, but larger, long-term studies are needed.