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Table 3 Characteristics of Included Studies Mixed Training as an Exercise Training Mode

From: Effects of different exercise training modes on muscle strength and physical performance in older people with sarcopenia: a systematic review and meta-analysis

MT Study Sample size (ETG/CG) M/F Age Sarcopenia diagnostics Intervention Control group Outcome
Mode Training movement Intensity DurationDays/week (weeks)
1 Bagheri et al. (2020) [56] 10/10 20/0 63.8 ± 3.6/65 ± 3.9 HGS < 26–30 kg, GS < 0.8 m/s, BMI at least two standard deviations below the average young population (EWGSOP-2010) Resistance machine 1.RT: leg extension, leg curl, bench press, lat pulldown, lateral raise, abdominal crunch. Beginning: 8–16 reps, 40% 1RM; Progressed to: 75% 1RM 3(8) Non-exercise SMM; KES
Fixed-speed bike 2.ET Beginning: 55% maxHR, 15 min;Progressed to: 70% maxHR, 30 min
2 Chen et al. (2017) [42] 15/15 5/25 68.5 ± 2.7/68.6 ± 3.1 ASMI by BIA, M:
≤32.5%, F: ≤25.7% (Chung)
Weight machine 1.RT: shoulder presses, bicep curls, triceps curls, bench presses, deadlifts, leg swings, squats, standing rows, unilateral rows, and split front squats 3 sets/8–12 reps;60–70% 1RM 1(8) Non-exercise; SMM; HGS, KES
/ 2.AT: a combination of dance steps such as stepping on the spot, knee lifts, high knee running, rowing arm swings, arm swings, twist steps, arm raises, squats, V steps, mambo steps, diamond steps, and point step jumps; /    
3 Hassan et al. (2015) [57] 20/21 Not identified 85.9 ± 7.5 SMI by BIA, M: < 8.87 kg/m2, F: < 6.42 kg/m2
HGS, M: < 30 kg, F: < 20 kg; GS, < 0.8 m/s (EWGSOP2010)
Air-pneumatic equipment 1.RT: elbow and shoulder extension, leg press, knee extension and flexion, hip abduction and adduction, abdominal curl and back extension 2–3 sets/10–15 times;Intensity: Borg RPE 12–14 2(24) Non-exercise SMI; HGS; GS
2.Balance exercises: heel and toe raise, varied directional quick stepping, reaching, single leg standing, static balance, heel to toe walking and complex cross over stepping activities. 3 sets/10 reps
→3 sets/15 reps
4 Kim et al. (2012) [58] 39/39 0/78 79.0 ± 2.9/78.7 ± 2.8 1) ASMI by BIA < 6.42 kg/m2 and KES < 1.01 Nm/kg;
2) ASMI by BIA < 6.42 kg/m2
and GS < 1.22 m/s;
3) BMI < 22.0 kg/m, KES < 1.01 Nm/kg;
4) BMI < 22.0 kg/m2 and GS < 1.22 m/s (Kim 2012/2013)
Resistance band or ankle weight 1.RT: (1) Chair exercise: Repetitions of toe raises, heel raises, knee lifts, knee extensions, and others were performed while seated on a chair; Hip flexions, lateral leg raises, and repetitions of other exercises while standing upright behind the chair and holding the back of the chair for stability. (2) Ankle-weight exercise: seated knee flexion, extension, standing knee flexion extensions 1 set/8 reps; Intensity: Borg RPE 12–14 2(12) Education (1 month/time, 3 times) MM, AMM; KES; GS
2.Balance and gait training: raising the toes during the forward swing of the leg, kicking off the floor with the ball of the foot, walking with directional changes, gait pattern variations. Weights of 0.50, 0.75, 1.00, and 1.50 kg
5 Kim et al. (2013) [59] 32/32 0/64 79.6 ± 4.2/80.2 ± 5.6 1) ASMI < 6.42 kg/m2 and KES < 1.01 Nm/kg;
2) ASMI < 6.42 kg/m2
and GS < 1.22 m/s;
3) BMI < 22.0 kg/m, KES < 1.01 Nm/kg;
4) BMI < 22.0 kg/m2 and GS < 1.22 m/s.
(Kim 2012/2013)
Resistance band and ankle weight 1.RT: focused on hip extensors and adductors, knee flexors and extensors, ankle dorsi, plantar flexors. 1 set/8 reps→ gradually increased to 2 sets/10 reps 2(12) Non-exercise MM, ASM; HGS, KES; GS, TUG
/ 2.Gait and balance training: toe elevation of the forward leg, heel elevation of the rear limb; one-leg stands, tandem stand, tandem walking /
6 Kim et al. (2016) [60] 35/34 0/69 81.4 ± 4.3/81.1 ± 5.1 SMI by DXA: < 5.67 kg/m2;
HGS < 17.0 kg;
GS < 1.0 m/s
(Kim 2016)
Weight machine; Resistance band; Hydraulic exercise machine 1.RT: (1) Chair exercise: toe raise, heel raises, knee lifts, knee extensions; hip flexions, lateral leg raises, standing upright behind the chair and holding the back;
(2) Resistance band exercise: double-arm pulldowns, bicep curls, leg extensions, hip flexions; (3) Machine: seated row, leg press, abduction, leg extension, abdominal crunch machines
1–3 sets/10 reps 2(12) Education (2 weeks/time, 6 times) MM, AMM, ASM; HGS, KES; GS
/ 2.AT 1 set/10 reps→3 sets/10 reps
7 Makizako et al. (2020) [33] 36/36 21/51 74.1 ± 6.6/75.8 ± 7.3 ASMI by BIA, M: < 7.0 kg/m2, F: < 5.7 kg/m2 (AWGS) Resistance band 1.RT: knee extension, hip flexion (knee raises), hip internal rotation, elbow flexion and shoulder abduction, elbow flexion and trunk rotation, hip extension, knee flexion, hip abduction, and squat. 5 resistance levels/10 reps; Intensity: Borg RPE 12–14 12 weeks Education (60 min, 1 time) ASMI; HGS; GS, CS, TUG
/ 2.Balance and AT: tandem stand, heel-up stand, one-leg stand, weight shifts, and stepping; anterior-posterior or lateral stepping repetitions for 6 min. /
8 Maruya et al. (2016) [50] 26/14 23/29 69.2 ± 5.6/68.5 ± 6.2 SMI by BIA, M: < 7.0 kg/m2, F: < 5.7 kg/m2 (AWGS) Weight 1.RT: (1) Squats: a 6-s movement time, and then to slowly return to their standing position; (2) Single-leg standing: a single-leg standing posture for 1 min, using light touch on stable desk or chair; (3) Heel raises 3 sets/6 reps; 3 sets; 3 sets/20 reps 6 months Non-exercise SMI; HGS, KES; GS, SPPB
/ 2.AT: walking 20–30 min/day
9 Moghadam et al. (2020) [61] 10/10 20/0 64.1 ± 3.3/65 ± 3.9 HGS < 26–30 kg, GS < 0.8 m/s, SMI at least two standard deviations below the average young population (EWGSOP-2010) Resistance machine 1.RT: leg extension, leg curl, bench press, lat pulldown, lateral raise, and abdominal crunch Beginning: 2 sets/16–18 reps, 40% 1RM; Progressed to: 3 sets/8–10 reps, 75% 1RM 3(8) Non-exercise KES
fixed-speed cycle ergometer 2.ET Beginning: 55% of maxHR, 15 min; Progressed to: 70% maxHR, 30 min
10 Park et al. (2017) [62] 25/25 0/50 73.5 ± 7.1/74.7 ± 5.1 ASM/weight <25.1% (Park) / 1.AT: sideways, backward, and forward walking, slow and fast indoor walking; W1–12:
13–15 RPE; W13–24:
≤15 RPE
5(24) Education (2 times) ASM; HGS; CS, GS
Thera-Band 2.RT: elbow flexion, wrist flexion, shoulder flexion, lateral raise, front raise, chest press, reverse flies, side band, dead lift, squat, leg press, ankle plantar flexion. W1–12:
8–11 reps/set; W13–24:
12–15 reps/set
3(24)
11 Shahar et al. (2013) [63] 19/16 Not identified 69.74 ± 5.46/67.25 ± 5.48 SMI by BIA, M: < 10.75 kg/m2, F: < 6.75 kg/m2 (NHANES III)   1.AT: walking and jogging on the spot; walking forwards, backwards, sideways; arm movements; raising the head, moving it in circularly; moving the trunk in four directions; and pushing knee forwards and backwards. / 2(12) Relaxation (2 weeks/ time, 6 times) MM; HGS; CS, TUG, 6MWT
Elastic band 2.RT: shoulder abduction; shoulder flexion; triceps extension; overhead press, side lateral extension; a standing double biceps curl; leg extension; foot extension; plantar flexion.
/ 3.Balance exercises: stand on their heels; stand on one leg with the other leg on the ground or lifted behind or aside; stand on one leg while lifting up the opposite hand; and to walk foot by foot with fingers touching the foot from the back.
12 Tsekoura et al. (2018) [23] 18/18 4/32 74.56 ± 6.04/72.89 ± 8.31 SMI by BIA, M: < 7.23 kg/m2, F: < 5.67 kg/m2 (EWGSOP-2010) Weight 1.AT: walking 30–35 min/time 3(12) Education SMI; HGS, KES; GS, TUG, CS
2.RT: knee extensor-flexor, hip abductor-extension, ankle plantar flexors- dorsi flexors, wall push up, seated bicep curl, seated triceps extension, seated lateral shoulder raises, seated abdominal crunches W1–4:
1 set/8 reps; Intensity: Borg RPE 10–11 (Easy)
W5–8:
2 sets/10 reps; Intensity: Borg RPE 10–12 (Easy)
W9–12:
2 sets/12reps; Intensity: Borg RPE 12 (Medium)
2(12)
3.Balance and gait training: walking and turning around, walking- backward tandem-heel-toe- heel to toe-sideways, one leg stand, tandem stance /
13 Vasconcelos et al. (2016) [64] 14/14 0/28 72 ± 4.6/72 ± 3.6 BMI ≥30 kg/m2, HGS ≤21 kg (Fried) / 1. stretching exercise: remained the same, 60 s in each leg for posterior, anterior, lateral, and medial muscles of hips and knees Using the modified Borg Scale 2(10) Non-exercise KES; GS, SPPB
Weight 2.RT: (1) W1–4: a low speed concentric and eccentric movements) → the high-speed (focusing on muscle power); (2) W5–6: perform the concentric movements of exercises “as fast as possible”; (3)W7–10: concentric and eccentric movements in high speeds W1–2: (1) Knee exercise: 2 sets/12 reps, 50% 1RM; (2) Hip exercises: 2 sets/8 reps; (3) Mini-squats, against the wall: 2 sets/10 reps
W3–4: (1) Knee exercise: 2 sets/12 reps, 75% 1RM; (2) Hip exercises: 2 sets/8 reps, 2 kg; (3) Mini-squats: 2 sets/10 reps
W5–6: (1) Knee exercise: 2 sets/12 reps, 40% 1RM; (2) Hip exercises: 2 sets/8 reps, 2 kg; (3) Mini-squats: 2 sets/10 reps
W7–8: (1) Knee exercise: 2 sets/12 reps, 60% 1RM; (2) Hip exercises: 2 sets/8 reps, 3 kg; (3) Mini-squats: 2 sets/10 reps W9–10: (1) Knee exercise: 3 sets/12 reps, 60% 1RM; (2) Hip exercises: 3 sets/8 reps, 3 kg; (3) Mini-squats: 3sets/10 reps
14 Zhu et al. (2019) [65] 40/37 19/58 74.5 ± 7.1/72.2 ± 6.6 SMI by BIA, M: < 7.0 kg/m2, F: < 5.7 kg/m2 (AWGS) Thera-Band 1.RT: chest, back, biceps, triceps; knee extension/flexion, heel raises, side leg lifts) 6 sets/6–8 reps; 40% 1RM 2(12) Non-exercise ASMI, AMM; HGS; GS, CS
/ 2.AT /
  1. MT mixed training, ETG exercise training group, CG control group, M male, F female, reps repetitions, 1RM one repetition maximum, RPE rated perceived exertion, maxHR maximum Heart Rate, W week, DXA Dual energy X-ray absorptiometry, BIA Bioelectrical impedance analysis, BMI body mass index, MM muscle mass, SMM skeletal muscle mass, SMI skeletal muscle mass index (SMI = skeletal muscle mass/ height2 [SMI/m2]), AMM appendicular muscle mass, ASM appendicular skeletal muscle mass, ASMI appendicular skeletal muscle mass index (ASMI = appendicular skeletal muscle mass/height2 [ASM/m2]), AWGS Asian Working Group for Sarcopenia, EWGSOP European Working Group on Sarcopenia in Older People, HGS hand grip strength, KES knee extension strength, GS gait speed, TUG Timed Up and Go, CS Chair stand, SPPB Short Physical Performance Battery, 6MWT 6-m walk test, RT resistance training; AT aerobic training, ET endurance training