The Effectiveness of Exercise on Lower Extremity Muscle Strength, Balance and Functional Mobility Among Older Adults: A Systematic Review and Meta-analysis
Keywords:
Balance and functional mobility, Exercise in older adults, Lower extremity muscle strength, Systematic reviewAbstract
Exercise in older adults is an important strategy for promoting muscle strength and physical performance. This systematic review and meta-analysis aimed to examine the effectiveness of exercise on lower extremity muscle strength, balance, and functional mobility among older adults. The PICO framework was applied to define the study components. A total of 65 quantitative research articles published between 2015 and 2024 were identified; 14 studies met the quality appraisal criteria and were included in the analysis which was conducted in accordance with the PRISMA 2020 guidelines. Data were analyzed using a random-effects model.
The systematic review revealed that exercise interventions were classified into two categories: single-component exercise programs (42.86%) and multicomponent exercise programs (57.14%). The majority of interventions were implemented 2–5 times per week, with each session lasting 30–60 minutes, over a duration ranging from 2 to 12 weeks. The primary outcomes consistently demonstrated statistically significant improvements in lower extremity muscle strength, balance, and functional mobility. In addition, secondary outcomes indicated reductions in fear of falling and enhancements in cardiovascular endurance. The meta-analysis demonstrated that exercise interventions had the greatest effect on mobility (Hedges’ g = 1.01, 95% CI = 0.63–1.39), followed by balance (Hedges’ g = 0.91, 95% CI = 0.48–1.34) and lower extremity muscle strength (Hedges’ g = 0.84, 95% CI = 0.36–1.32), with all outcomes reaching statistical significance (p < .001). Programs that were culturally congruent with the Thai context, particularly traditional Thai Ramwong dance, and the nine-square grid exercise combined with resistance band training demonstrated positive effects across all three outcomes.
The results provide empirical support for the adaptation and implementation of exercise programs available in Thai communities, emphasizing the importance of selecting modalities that are contextually relevant and aligned with the lifestyle patterns of older adults.
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