Table 1 Characteristics of Included Reviews

Antoniak 2017 [25]

To assess effectiveness of RT + vitamin D3 on musculoskeletal health in older adults.

ScienceDirect, MEDLINE, PubMed, Google Scholar, Cochrane CENTRAL to Mar 2016

2003–2015

I: RT and vitamin D3 supplementation with or without calcium

C: inactive, usual care without vitamin D3 supplementation

7 RCTs

Inclusion: ≥65

Mean: 72.8

792

82

RT + vitamin D: moderate

RT + vitamin D + calcium: moderate-high

(GRADE)

Borde 2015 [26]

To determine effects of RT on muscle strength and morphology and explore any dose–response relationships.

PubMed, Web of Science, Cochrane Library to May 2015

1991–2014

I: Machine-based RT of low, moderate, or high intensity

C: inactive

25 RCTs

Inclusion: ≥60

Mean: 70.4

Range: 60–90

819

NR; 16% F only, 16% M only

Low

(PEDro)

Bouaziz 2016 [27]

To evaluate the evidence of the health benefits of MCT training in adults > 65.

CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, PubMed, MEDLINE, ScienceDirect, Jan 2000-Apr 2015

2000–2015

I: MCT including AT, RT, balance, stability, flexibility, and/or coordination training

C: NR

27 total; 19 RCTs

Inclusion: ≥65

Range: 65–83

NR

NR

Low quality studies excluded

(Tool NR)

Bouaziz 2017 [28]

To review effect of AT in adults > 70 on cardiovascular, metabolic, functional, cognitive, and QoL outcomes.

CINAHL Plus, Embase, MEDLINE, PubMed, Scopus, Web of Science, SPORTDiscus, ScienceDirect, to Jan 31, 2016

1984–2013

I: Supervised (class or small group) AT

C: NR

53 total; 36 RCTs

Inclusion: ≥70

Range: 70.0–87

2051

NR

Low-moderate (Cochrane)

Bouaziz 2018 [29]

To determine the benefits of AT on VO₂peak among those ≥70.

MEDLINE, PubMed Central, Scopus ScienceDirect, Embase to Mar 31, 2017

1989–2013

I: AT, any activity that uses large muscle groups, can be maintained continuously, and is rhythmic

C: usual care or other exercise

10 RCTs

Inclusion: ≥70

Range: 70–79

348

NR; 20% F only, 10% M only

Moderate (Cochrane)

Bruderer-Hofstetter 2018 [30]

To identify effective MCT interventions for physical capacity and/or cognitive function.

MEDLINE, CENTRAL, CINAHL, PsycINFO, Scopus, Date NR

2002–2017

I: Combined cognitive training (exergames, dancing or Tai Chi) and physical exercise (planned, structured)

C: attention controls or no intervention

17 RCTs

Inclusion ≥55

Mean: 71.37 ± 4.89

1758

Range: 32–555

67

Very low certainty

(GRADE)

Bueno de Souza 2018 [31]

To determine the effects of mat Pilates on physical function in older persons.

MEDLINE, Scopus, Scielo, PEDro, Jan 2011-Mar 2017

2011–2017

I: Mat Pilates with or without accessories

C: inactive control

9 RCTs

Inclusion ≥60

Mean: 68.5 ± 5.1

Range: 45–88

NR; 56% F only

56% high

44% low

(PEDro)

Bullo 2015 [32]

To summarize the benefits of Pilates on physical fitness and QoL in the elderly.

MEDLINE, Embase, SPORTDiscus, PubMed, Scopus, PsycINFO, Date NR

2009–2014

I: Pilates-identified exercise training intervention

C: inactive control

10; 6 RCTs

Inclusion: ≥60

Range: 60–80

349

Range: 9–60

NR; 50% F only

40% high

60% low (Cochrane)

Bullo 2018 [33]

To determine the effects of Nordic walking on physical fitness, QoL and body composition in the elderly.

MEDLINE, Embase, PubMed, Scopus, SPORTDiscus, PsycINFO, Date NR

2012–2017

I: Supervised or unsupervised Nordic walking

C: sedentary, walking, or resistance exercise

15; 8 RCTs

Inclusion ≥60

Range: 60–92

Range: 18–95

“Majority female”

27% high

73% low

(Cochrane)

Chase 2017 [34]

To determine the effects of supervised RT and/or AT on physical function among community-dwelling older adults

MEDLINE, PubMed, CINAHL, Cochrane Library, Proquest, SPORTDiscus, PEDro, Ageline, Dissertation Abstracts International, 1960–2015

1999–2015

I: Supervised intervention involving RT and/or AT. 18 studies used RT only, the remainder employed combination RT and AT

C: NR

28 (designs NR)

Inclusion: > 65

Mean: 70

Range: 65–85

2608

71

NR; lower quality studies had stronger findings (PEDro)

da Rosa Orssatto 2019 [35]

To compare change in functional capacity following fast- vs. moderate-velocity lower limb RT in older adults

PubMed, Scopus, Web of Science to Jan 2019

2003–2019

I: Fast-velocity lower limb RT

C: moderate-velocity lower limb RT

15 RCTs

Inclusion: ≥60

Range: 64.4–81.6

593

NR

Fair

(PEDro)

Devries 2014 [36]

To determine whether the addition of creatine to RT increased gains in muscle mass, strength, and function in older adults over RT alone.

MEDLINE, HealthStar to June 2013

1998–2013

I: RT and Creatine supplementation

C: RT and placebo

10 RCTs

Inclusion: > 45

Range: 55–71

357

NR; 20% F only, 40% M only

Low-moderate (Jadad)

Ebner 2021 [37]

To determine the effects of mind-body interventions on physical fitness in healthy community dwelling older adults.

Web of Knowledge, PubMed, SPORTDiscus to Nov 2019

2005–2019

I: Yoga, Qi Gong, Tai Chi, Pilates

C: Active and inactive controls

30 RCTs

Inclusion: ≥65

Mean: 71.2

2792

37

3% poor

17% fair

63% good

17% excellent

(PEDro)

Elboim-Gabyzon 2021 [38]

To explore the effectiveness of high-intensity interval training for reducing fall risk factors in older adults.

PubMed, CINAHL, Cochrane, APA PsycInfo, Web of Science, Scopus, PEDro, AgeLine, ClinicalTrials.gov, Google Scholar to July 2021

2015–2020

I: High-intensity exercise (90–95% peak heart rate, 90% maximal oxygen uptake, at least 75% peak work rate) separated by periods of low to moderate-intensity or rest (e.g., walking/running, cycling).

C: No treatment or other exercise

11 (8 RCTs)

Inclusion: Average ≥ 60

Range: 50–81

328

9% F only, 36% M only

45% high

36% moderate

9% low

1 not assessed

(PEDro)

Fernandez-Arguelles 2015 [39]

To know the effects of dancing as a physical exercise modality on balance, flexibility, gait and muscle strength in older adults.

PubMed, Cochrane Library Plus, PEDro, ScienceDirect, Dialnet, Academic Search Complete, Jan 2000-Jan 2013

2002–2012

I: Dance-based AT, dance and foot tapping or squatting, Turkish folk dance, low impact aerobic dance, Greek traditional dance, ballroom dance, and salsa dancing

C: other types of exercise

7 RCTs

Inclusion: > 60

Range: 63.1–82.2

354

Range: 26–97

NR; 43% F only

29% good

71% fair

(PEDro)

Fernández-Rodríguez 2021 [40]

To estimate the effectiveness of Pilates on physical performance and risk of falls in older adults.

MEDLINE, Scopus, Web of Science, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials to April 2021

2010–2021

I: At least one exercise intervention described as “Pilates” (Mat, machine, or both)

C: Habitual or non-exercise

39 RCTs

Inclusion: ≥60

Range: 60–80

1650

62

64% high

36% unclear

(Cochrane)

Finger 2015 [41]

To determine whether protein supplements can optimize the effects of RT on muscle mass and strength in an aged population.

MEDLINE, Cochrane Central, EMBASE, LILACS to January 2014

1995–2013

I: RT and protein for ≥6 weeks. Protein supplements ranged from 0.3 to 0.8 g/kg/day (mean 0.46 g/kg/day) or 6 to 40 g/day (mean = 20.7 g/day) or high protein diet

C: RT with placebo or no supplement

9 RCTs

Inclusion: ≥60

Range: 61.2–79.2

462

Range: 12–87

NR; 11% F only, 33% M only

Low-moderate risk of bias (PRISMA statement)

Frost 2017 [42]

To evaluate effectiveness of home- and community-based health promotion interventions on functioning and frailty in older people with mild or pre-frailty.

MEDLINE, EMBASE, Scopus, Social Science Citation Index, Science Citation Index Expanded, Cochrane (library, CENTRAL, EPOC), NHS Health Economic Evaluations, DARE, PsycINFO, CINAHL, Bibliomap, Social Care Online, Sociological Abstracts, Applied Social Sciences Index, Jan 1990-May 2016

2000–2015

I: Home- or community-based health promotion interventions (i.e., interventions that enable people to improve or increase control over their health)

C: usual care or health education or flexibility training

10 (7 RCTs)

Inclusion: > 60

Range: 72–83

485

NR

Low or unclear risk of bias (Cochrane)

Gade 2018 [43]

To determine the effect of protein or essential amino acid supplementation during RT in older adults.

PubMed, SCOPUS, EMBASE, Cochrane databases to 2017

1994–2016

I: RT plus protein or essential amino acid supplementation or a modified diet with increased protein content for > 5 weeks

C: RT with/without non-protein placebo

16 RCTs

Inclusion: > 60

Range: 61–85

1107

Range: 16–179

NR; 13% F only, 25% M only

Good to excellent

(PEDro)

Garcia-Hermoso 2020 [44]

To analyze the safety and effectiveness of long-term exercise interventions in older adults.

PubMed, Cochrane CENTRAL, SPORTDiscus to Sept 16, 2019

1991–2019

I: MCT (n =45), RT (n=24), AT (n=19), and Tai Chi (n=4). Most used group-based supervised exercise alone (n=46) or combined with home-based unsupervised training (n=21)

C: usual care with or without non-exercise intervention

99 (93 RCTs; 90 RCTs in meta-analysis)

Inclusion: ≥65

Mean: 74.2

28,523

NR; 19% F only, 4% M only

Good

(PEDro)

Grässler 2021 [45]

To summarize the effects of endurance, resistance, coordinative, and multimodal exercise interventions on resting heart rate variability and secondary health factors in healthy older adults.

PubMed, Scopus, SPORTDiscus, Ovid, Cochrane Jan 2005-Sept 2020

2005–2020

I: Physical training intervention (endurance, resistance, coordinative, or multimodal training) with a minimum of 4 weeks and 8 training sessions

C: NR

13 RCTs and non-RCTs (designs NR)

Inclusion: ≥60

Mean: 67.8

422

31% F only, 8% M only

Mean: 8.88 (SD 2.47)/15 (Tool for the Assessment of Study Quality and reporting in Exercise)

Mean: 20 (SD 1.56)/25 (STARDHRV)

Hanach 2019 [46]

To evaluate the effectiveness of dairy proteins on functions associated with sarcopenia in middle-aged and older adults.

PubMed, CINAHL, Web of Science to May 10, 2017

2009–2016

I: Dairy protein supplementation (e.g., whey protein, milk-protein concentrate, casein) or a protein-based dairy product (e.g., ricotta cheese) for ≥12 weeks with/out RT

C: usual care, placebo, or regular dairy

14 RCTs

Inclusion: 45–65

Range: 61–81

1424

NR; 7% F only

Moderate-High (Cochrane)

Hortobagyi 2015 [47]

To determine the effects of strength, power, coordination, and MCT on healthy older adults’ gait speed.

PubMed, Web of Knowledge, Cochrane, Jan 1984 to Dec 2014

1993–2014

I: RT or interventions that included 2+ types of exercise in any combination or functional or coordination training

C: no exercise

42 (designs NR)

Inclusion ≥65

Mean: 74.2

Range: 64.4–82.7

2495

63

Low (PEDro)

Hou 2019 [48]

To explore whether a combination of protein supplementation with RT is effective in enhancing muscle mass, strength and function in the elderly.

PubMed, MEDLINE, Embase, Jan 2004-May 2018

2004–2018

I: Protein supplements containing leucine, whey protein, casein, lean meat, low-fat milk or related mixture and RT 1–4 times/week

C: RT alone

21 RCTs

Inclusion: > 50

Range: 50–91

1249

NR; 38% F only, 14% M only

Moderate certainty (Cochrane)

Howe 2011 [49]

To examine the effects of exercise interventions on balance in older people, ≥60 y, living in the community or institutional care.

Cochrane Specialized Register, CENTRAL, MEDLINE, EMBASE, PEDro, CINAHL, AMED to Feb 2011

1989–2010

I: Interventions designed to improve balance, or RT or MCT or Tai Chi, qi gong, dance and yoga or gait, coordination, and functional exercises

C: attention control

94 RCTs and quasi-experimental

Inclusion: ≥60

Range: 60–75

9821

NR; 27% F only, 5% M only

Most unclear risk of bias (Cochrane)

Hurst 2019 [50]

To assess the effects of same session combined exercise on measures of fitness in adults ≥50 y.

PubMed, MEDLINE, Scopus, BIOSIS, Web of Science to July 2018

1991–2018

I: At least one AT and RT group

C: no exercise, AT only, or RT only

27 (22 RCTs)

Inclusion: > 50

Mean: 68.8

Range: 54–85

1346

NR; 44% F only, 18% M only

Low or unclear risk of bias (Cochrane)

Hwang 2015 [51]

To examine the benefits to physical health of dance among older adults.

PubMed, Date NR

2004–2013

I: Dance defined as a form of artistic expression through rhythmic movement to music, not including aerobic fitness classes taught to music

C: other activity or no activity

18 (10 RCTs)

Inclusion: NR

Range: 52–87

Range: 13–97

NR; 44 > 50% F, 28% F only

Moderate

(Sackett, Megens and Harris)

Katsoulis 2019 [52]

To investigate the effect of high- vs. low-intensity RT on muscular power in older, healthy, untrained adults.

MEDLINE, Embase, CINAHL, AgeLine, SPORTDiscus, Scopus to Apr 2017

2001–2017

I: Low (≤50% 1RM), moderate or high (≥70% 1RM) intensity power training

C: post-intervention vs. pre-intervention

27 RCTs

Inclusion: > 60

Mean: 74.5

Range: 62.7–81.8

549

Range: 5–59

NR; 22% F only, 7% M only

52% high (> 6); remaining fair-good (PEDro)

King 2016 [53]

To synthesize research that tests the effects of aquatic exercise in healthy older adults on functional balance.

Academic Search Complete, AMED, CINHAL, MEDLINE, SPORTDiscus, Date NR

1996–2013

I: Exercise programs in water, with no restriction on depth or temperature of the aquatic environment. Swimming programs were not included

C: land exercise or no exercise

13 (6 RCTs)

Inclusion > 60

Mean: 71

Range: 68–80

545

Range: 20–79

NR; 31% F only, 8% M only

46% good; 54% poor-fair

(Downs and Black)

Labott 2019 [54]

To examine the effects of exercise training on handgrip strength in healthy community-dwelling older adults ≥60 y.

PubMed, Web of Science, SPORTDiscus to Nov 25, 2018

1995–2018

I: aquatic exercise, walking, flexibility, TRX-training, home-trainer exercise, RT, vibration platform, dance, Tai Chi, exergames, balance training, calisthenics, and MCT

C: NR

24 RCTs

Inclusion: ≥60

Mean: 73.3 ± 6.0

3018

Range: 22–1635

NR; 50% F only 4% M only

Fair (PEDro)

Lesinski 2015 [55]

To quantify effects of balance training on balance outcomes and to characterize dose–response in healthy community-dwelling older adults.

PubMed, Web of Science, Jan 1985 to Jan 2015

1994–2014

I: Balance training protocol comprising static/dynamic postural stabilization exercises (combined training was excluded)

C: no intervention

23 RCTs

Inclusion: ≥65

Range: 66–83

1220

Range: 11–75

NR; 9% F only

74% weak (PEDro)

Leung 2011 [56]

To assess the usefulness of tai chi to improve balance reduce falls in older adults.

CINAHL, Science citation index, social science citation index, MEDLINE, Cochrane Central, ScienceDirect, PubMed, Allied & Complementary medicine, China journals, eCAM, Jan 1, 1998-Jan 31, 2008

2000–2007

I: Various styles of Tai Chi

C: no treatment or other exercise

13 RCTs

Inclusion: ≥60

Range: 45–98

2151

NR; 23% mostly F, 8% mostly M, 8% M only

Good to excellent

(PEDro)

Levin 2017 [57]

To examine the dual effects of different types of physical training on cognitive and motor tasks in older adults with no known cognitive or motor disabilities or disease

PubMed, Jan 2007-Dec 2016

2008–2016

I: physical training (e.g., balance training, AT, strength training, group sports, etc.) or combined physical and cognitive intervention (dual-task)

C: passive control or health education classes and lesser training

19 (17 RCTs)

Inclusion: > 65

Range: 65.5 ± 6.3–81.9 ± 6.3

1226

52

Mostly low

(Jadad)

Liberman 2017 [58]

To assess the effects of exercise on muscle strength, body composition, physical function and inflammatory profile in older adults.

PubMed, 2015–2016

2015–2016

I: Any exercise; included RT (n=16), AT (n=8), AT/RT (n=6) and other types (n=10)

C: no intervention

34 RCTs

Inclusion: > 65

Range: 54.5–92.3

1747

NR

Unclear risk of bias across domains (NICE)

Liu 2010 [59]

To determine whether Tai Chi has an effect on static and dynamic balance, functional performance, muscle strength and flexibility, and subjective measures.

MEDLINE, PubMed; Jan 2000-July 2007

2000–2007

I: Tai Chi

C: NR

18 (15 RCTs)

Inclusion: ≥60

Mean: NR

3741

Range: 17–1200

NR

NR; lower-quality studies screened out

Liu 2017 [60]

To compare RT or MCT to no intervention or attentional controls, on muscle strength, physical functioning, ADL, and falls in community- dwelling older adults with reduced physical capacity.

MEDLINE, Embase, Cochrane Library Central, Date NR

1996–2015

I: Progressive RT, strength training in which one exerts an effort against an external resistance or MCT combines > 2 types of exercise RT, balance, stretching, and AT

C: no intervention or attention control

23 RCTs

Inclusion: ≥60

Mean: 75

Range: 69–84

2018

NR; 22% F only, 4% M only

Low risk of bias (Cochrane)

Liu 2020 [61]

To evaluate the effects of dance on physical function performance in healthy older adults.

Cochrane Library, PsycINFO, PubMed, Scopus, Web of Science to June 2018

2008–2017

I: Dance interventions of at least 6 weeks duration

C: usual care with no intervention or other exercise

13 RCTs

Inclusion: ≥65

Mean: NR

1029

Range: 23–510

85

Low-moderate risk of bias (Cochrane)

Loureiro 2021 [62]

To determine the effects of multifactorial programs including physical activity based on individual assessment of fall risk factors on rate of falls and physical performance in older adults.

PubMed, Cochrane Plus, Web of Science, SCOPUS, 2009–2020

2009–2017

I: Multi-component interventions including strength and balance training, flexibility, endurance, gait, and/or functional exercises, treatment of sensory impairments, health education, medical management and/or in home falls risk assessment

C: Usual care, delayed intervention, health education

6 RCTs

Inclusion: ≥60 years

Mean: 77.62

2012

Range: 19–616

54.4

50% good

50% fair

(PEDro)

Martin 2013 [63]

To compare physical therapist–administered group-based exercise with individual or no exercise control.

PubMed, CINAHL, Dec 1, 2001-June 7, 2012

2002–2010

I: Physical therapist led or supervised group exercise

C: individual physical therapy or no exercise control

10 RCTs

Inclusion: ≥65

Mean: 76.21

Range: 72–81

2293

Range: 32–1090

NR

Good

(PEDro)

Martins 2018 [64]

To identify modified Otago Exercise Program delivering methods and analyze their effects on balance, functional ability and self-reported falls.

PubMed, PEDro, ScienceDirect, Scopus, Date NR

2011–2016

I: Modified Otago Exercise program (RT, balance and walking)

C: original Otago program, non-intervention, or other exercise

8 (5 RCTs)

Inclusion: NR

Mean: 76.75 ± 5.5

604

NR; 13% F only

Fair-Good

(PEDro)

Meereis-Lemos 2019 [65]

To determine the effectiveness of RT and MCT on functionality of healthy older patients.

PubMed, Web of Science, PEDro, Cochrane, Lilacs databases, Date NR

2007–2016

I: Supervised RT or RT combined with another modality at least twice a week for a minimum of 8 weeks

C: no exercise

28 RCTs

Inclusion: ≥60

Range: 62.2 ± 4.3–83.4 ± 2.8

NR

NR; 36% F only, 14% M only

Good

(PEDro)

Montero 2016 [66]

To explore the effects of AT on VO₂max, Qmax and Ca-VO₂max in healthy middle-aged and older subjects.

MEDLINE, Scopus and Web of Science to May 2015

1989–2014

I: Dynamic exercise involving a large muscle mass (e.g., running, cycling), 3 weeks or more

C: post-intervention vs. pre-intervention

16 (designs NR)

Inclusion: > 40

Range: 42–71

153

NR; 19% F only, 63% M only

Moderate-high

(SAQOR)

Moore 2016 [67]

To assess the effectiveness of community-based interventions to increase physical activity in older people (≥ 65 y) living rural or regional areas.

CINHAL, Ageline, ProQuest Central, PubMed, Informit Complete, Google Scholar to Aug 2014

1997–2014

I: Community-based PA intervention of six weeks or more (from start to follow-up)

C: NR

7 (3 RCTs)

Inclusion: ≥65

Mean: NR

Range: 37–1200

NR; 14% F only

High risk of bias

(Cochrane)

Moran 2018 [68]

To determine the effect of jump training on muscular power in older adults (≥ 50 y).

Google Scholar, PubMed, Microsoft Academic, Date NR

1998–2018

I: Jump training, defined as lower body unilateral and bilateral bounds, jumps and hops

C: NR

9 (designs NR)

Inclusion: ≥50

Range: 53.0–72.4

467

NR; 56% F only, 11% M only

Good

(PEDro)

Nicolson 2021 [69]

To evaluate the effects of therapeutic exercise interventions on physical function, health-related quality of life and psychosocial outcomes in community-dwelling adults.

MEDLINE, EMBASE, CINAHL to July 2020

1997–2020

I: Therapeutic exercise including AT, RT, functional training, balance training, gait training, flexibility, or 3D (constant movement in a controlled, fluid, repetitive way through all three spatial dimensions, e.g., Tai Chi)

C: Usual care, no treatment, other exercise, pharmacotherapy, or health education

16 RCTs

Inclusion: ≥80

Median: 84.2 (interquartile range: 83.4–86.1)

1660

19% F only, 6% M only

6% low

63% moderate

31% high

(Cochrane)

Plummer 2015 [70]

To examine the effects of physical exercise on dual-task performance during walking in older adults.

PubMed, CINAHL, EMBASE, Web of Science, PsycINFO up to Sept 19, 2014

2006–2014

I: Any physical exercise intervention

C: active, education, or inactive no treatment/delayed treatment

21 (15 RCTs)

Inclusion: ≥60

Range: 71.1–91.1

Range: 10–134

≥70% in all but 2 studies

Good

(Downs and Black)

Qi 2020 [71]

To evaluate the effects of Tai Chi with RT on health outcomes in adults ≥50 y.

PubMed, Scopus, Web of Science, CINAHL, MEDLINE, PEDro, Cochrane library to Jan 2018

2005–2016

I: Tai Chi combined with RT

C: any control or comparison

7 (6 RCTs)

Inclusion: ≥50

Range: 58.5–74.0

703

NR; 14% F only

Fair

(PEDro)

Raymond 2013 [72]

To examine the effect of high intensity RT on strength, function, mood, QoL, and adverse events in older adults.

Cochrane Central, MEDLINE, Embase, CINAHL, AMED, AgeLine, PEDro to July 2012

1995–2007

I: Lower limb high intensity progressive RT with or without upper limb or trunk strengthening

C: other intensity RT

21 RCTs

Inclusion: ≥65

Range: 60–95

724

NR; 14% F only, 24% M only

Poor to fair (PEDro)

Rodrigues-Krause 2019 [73]

To review the literature on the use of dance to promote functional and metabolic health in older adults.

MEDLINE, Cochrane Wiley, ClinicalTrials.gov; PEDRO, LILACS, Nov 1980 to Mar 2016

1984–2016

I: Regular dance classes of any style for at least 2 weeks. Dance environments included dance studios and stage and/or dance ballrooms

C: inactive control or other exercise

50 (31 RCTs)

Inclusion: > 55

Range: 50–94

Range: 10–700

NR; 34% F only, 4% M only

Majority high risk of bias

(PRISMA)

Roland 2011 [74]

To investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults.

PubMed, Scholars Portal, AgeLine, CINAHL, EBSCO, MEDLINE, SPORTDiscus, PsycINFO, EMBASE, 1970–2009

1989–2009

I: Yoga

C: other exercise, no exercise, or pre/post yoga groups

10 (5 RCTs)

Inclusion: ≥65 or 55–64

Mean: 69.6 ± 6.3

544

Range: 13–176

71

Moderate-high

(Modified Downs and Black)

Sivaramakrishnan 2019 [75]

To synthesize existing evidence on the effects of yoga on physical function and QoL in older adults not characterized by any specific clinical condition.

MEDLINE, PsycINFO, CINAHL Plus, Scopus, Web of Science, Cochrane Library, Embase, SPORTDiscus, AMED, ProQuest Dissertations & Theses Global to Sept 2017

1983–2017

I: Yoga

C: inactive or active controls

22 RCTs

Inclusion: ≥60

Range: 61.0–83.8

Range: 18–410

> 70

Moderate risk of bias (Cochrane)

Stares 2020 [76]

To assess whether creatine combined with exercise results improves indices of skeletal muscle, bone, and mental health over exercise alone in healthy older adults.

PubMed, CINAHL, Web of Science, 1998–2018

1998–2016

I: A physical training program and creatine supplementation

C: placebo

17 RCTs

Inclusion: ≥48

Mean age: NR

Range: 48–84

583

39

Overall good

(PEDro)

Stathokostas 2012 [77]

To assess the effects of flexibility training on functional outcomes in healthy older adults > 65 y.

PubMed, Embase, CINAHL, Scopus, and SPORTDiscus to Jan 2011

1988–2011

I: Flexibility training (excluding Tai Chi or yoga)

C: NR

22 (13 RCTs)

Inclusion: ≥65

Mean: 74.1

Range: 64–88.8

1127

Range: 7–132

75

RCTs: good

Non-RCTs: low-moderate

(Modified Downs and Black)

Straight 2016 [78]

To estimate the effect of RT on lower-extremity muscle power in middle-aged and older adults.

Google Scholar to Nov 1, 2014

1995–2013

I: RT, defined as muscle-strengthening activities that use major muscle groups and could include free weights, machines, and resistance bands

C: usual care or sham exercise

12 RCTs

Inclusion: ≥50

Range: 56.3–93 (intervention), 56.7–93 (control)

810

NR; 17% F only, 8% M only

NR

Ten Haaf 2018 [79]

To assess the effect of protein on lean body mass, muscle strength, and/or physical performance, in non-frail community-dwelling older adults.

PubMed, Embase, Web of Science to May 15, 2018

1992–2018

I: Multi-nutrient protein or essential amino acid supplementation added to or replacing normal diet with or without RT. Supplements were consumed ≥3 times/week for at least 4 weeks

C: placebo control or RT

36 RCTs

Inclusion: ≥50

Range: 55–85

1682

NR; 19% F only, 31% M only

50% Moderate, 42% Good, 8% Excellent

(Downs and Black)

Tschopp 2011 [80]

To determine the effects of power training with high movement velocity for older community-dwelling people.

PubMed (MEDLINE), EMBASE, CINAHL, PEDro, Cochrane Central and Google Scholar to April 2010

2002–2009

I: Power training (training with moderate resistance and an ‘as fast as possible’ movement speed for at least the concentric phase of an exercise)

C: Conventional RT (high or moderate resistance and slow concentric movement)

11 RCTs

Inclusion: > 60

377

NR

Moderate risk of bias (Tool NR)

Van Abbema 2015 [81]

To determine the effects of different types or combinations of exercise to improve preferred gait speed.

PubMed, EMBASE, AMED, CINAHL, ERIC, MEDLINE, PsycINFO, SocINDEX, and Cochrane Library 1990 -Dec 9, 2013

1994–2013

I: Progressive RT or RT, balance and AT with or without additional training components, exercise interventions with a dance/rhythmic component or stretching exercises

C: usual care or attention control

25 RCTs

Inclusion: ≥65

Mean: 75.8

Range: 61.4 ± 5.5–87.1 ± 0.6

2389

NR; 32% F only

Low-quality studies excluded

Moderate-high (PEDro)

Vetrovsky 2019 [82]

To evaluate the safety and efficacy of plyometric training in older adults regarding various performance, functional, and health related outcomes.

PubMed, SPORTDiscus, Scopus, and EMBASE to 2017

2007–2017

I: Plyometric training (eccentric loading followed by a concentric contraction, e.g., repetitive jumping, hopping, bounding, and skipping) or MCT with plyometrics

C: non-exercising control or other exercise

12 RCTs

Inclusion: ≥60

Range: 58.4–79.4

289

Range: 8–36

61

75% high

(PEDro)

Waller 2016 [83]

To investigate the effect of aquatic exercise on physical functioning in healthy older adults.

MEDLINE, Embase, CINAHL, PEDro, SPORTDiscus, Web of Science, Cochrane Library to Dec 31, 2015

1994–2015

I: Exercise in an aquatic environment with no limitation on the type of exercise

C: land exercise or no exercise

28 RCTs

Inclusion: ≥55

Mean: 66.4

Range: 55.4–82.0

1456

89

High risk of bias (Cochrane)

Wang 2021 [84]

To examine the impact of Traditional Chinese medicine-based exercises on physical performance, balance, and muscle strength in the elderly.

PubMed, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wan Fang, manual search of Soochow University and Nanjing University of Chinese Medicine libraries to March 2021

2003–2020

I: Traditional Chinese medicine-based exercises including but not limited to Tai Chi, Ba Duan Jin, and Qigong

C: Placebo, AT, routine care, or educational programs

27 RCTs

Inclusion: ≥55

Range: 59.7–88.8

2580

68

Moderate

(Cochrane)

Wirth 2020 [85]

To investigate the effect of protein supplementation on body composition and muscle function in healthy adults.

PubMed, Web of Science, CINAHL, Embase to March 2019

2001–2019

I: Oral protein intake, 2wk minimal duration, including energy-restriction or not, and including exercise or not

C: Low-protein diet, no protein supplementation, or non-protein placebo

23 RCTs

Inclusion: > 55

Range: 55–81

1290

62

Moderate certainty

(GRADE)

Yang 2019 [86]

To determine intensity and interval of effective interventions in improving physical function in community-dwelling older adults.

PubMed, EBSCO, and Cochrane Trials, Jan 1, 2013-Dec 31, 2017.

2013–2017

I: Any types of MCT interventions that were conducted in the community, delivered by any kinds of providers

C: no exercise control

5 RCTs

Inclusion: > 60

Mean: 70 (intervention)

69 (control)

272

“Majority female”

Moderate (Cochrane)