The Effects of Exercise Intervention in Older Adults With and Without Sarcopenia: A Systematic Review.

This systematic review, conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024619693), aimed to evaluate the effects of physical exercise interventions on muscle function and fall risk in older adults with and without sarcopenia. Methods: A comprehensive search of PubMed and Web of Science databases identified 11 randomized controlled trials (RCTs) published between 2015 and 2025. A total of 792 participants (mean age 75.13 ± 4.71 years; 65.53% women, 34.47% men) were included. Interventions varied in type-strength, balance, aerobic, and multi-component programs-with a minimum duration of 8 weeks. Results: The reviewed studies showed that physical exercise interventions significantly improved neuromuscular function, physical performance, and postural control in older adults. Positive effects were observed in gait speed, stair-climbing ability, grip strength, muscle mass, and bone density. Specific modalities such as Tai Chi improved postural control and neuromuscular response; dynamic resistance and functional training increased muscle strength and improved posture; Nordic walking reduced postural sway; and multi-component and combined walking-resistance training enhanced mobility and force efficiency. Programs integrating strength and balance components yielded the most consistent benefits. However, reporting on FITT (Frequency, Intensity, Time, Type) principles was limited across studies. Conclusions: Exercise interventions are effective in improving neuromuscular outcomes and reducing fall risk in older adults, both with and without sarcopenia. The findings support the need for tailored, well-structured programs and greater methodological standardization in future research to facilitate broader clinical application and maximize health outcomes.