The Effects of Different Exercise Training Types on Body Composition and Physical Performance in Older Adults with Sarcopenic Obesity: A Systematic Review and Meta-Analysis - 10/12/24

Doi : 10.1007/s12603-023-2018-6 
L. da Silva Gonçalves 1, Leonardo Santos Lopes da Silva 1, 7 , C.J. Rodrigues Benjamim 2, M.F. Tasinafo 1, L. Bohn 3, 4, 5, G. Ferreira Abud 6, G.U. Ortiz 6, E.C. de Freitas 1, 6
1 School of Physical Education and Sport of Ribeirão Preto (EEFERP/USP), University of São Paulo, Ribeirão Preto, Brazil 
2 Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil 
3 Lusofona University, Faculty of Psychology, Education and Sport, Porto, Portugal 
4 Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal 
5 Faculty of Sports, University of Porto, Porto, Portugal 
6 Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo - FMRP USP, Ribeirao Preto, Sao Paulo, Brazil 
7 Bandeirantes Avenue n° 3900, University Campus - Monte Alegre, Ribeirao Preto, SP, Brazil 

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Abstract

Objectives

To carry out a systematic review and meta-analysis to verify the effects of different exercise training types on body composition and physical performance in older adults with sarcopenic obesity (SO).

Design

Systematic review and meta-analysis.

Setting and Participants

Older adults (≥60 years).

Methods

Database searches were performed in MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, and LILACS on January 10th, 2023. We included: randomized and/or controlled clinical trials; physical exercise as an intervention; analysis of body composition and/or muscle function; and sarcopenic obesity diagnosis. We used the Risk of Bias 2 tool and PEDro scale. The GRADE certainty of evidence was also performed.

Results

Fourteen studies were included in the systematic review and nine studies in the meta-analysis. A decrease in body fat (%) favoring the exercise group was identified (SMD: −0.34 [95% CI: −0.53 to −0.16]; p=0.0003) (GRADE: ⊕⊕⊕○ Moderate). Only resistance training showed fat reduction (SMD: −0.27 [95% CI: −0.48 to −0.06]; p=0.01). Increases in upper (SMD: 0.41 [95% CI: 0.04 to 0.78]; p=0.03) (GRADE: ⊕⊕○○ Low) and lower (SMD: 0.80 [95% CI: 0.22 to 1.39]; p=0.007) (GRADE: ⊕⊕⊕⊕ High) limb strength was identified with exercise. Chair stand test showed increases with exercise (SMD: 0.73 [95% CI: 0.40 to 1.07]; p<0.0001) (GRADE ⊕⊕⊕⊕ High), especially for resistance training (SMD: 0.62 [95% CI: 0.21 to 1.02]; p=0.003) and combined training (SMD: 0.99 [95% CI: 0.40 to 1.57]; p=0.0005). The PEDro scale for the studies in our review ranged from 3 to 8 (mean = 5.8 (1.6)), meaning fair methodological quality, and most studies were overall judged with at least low/some concerns in terms of risk of bias.

Conclusion and Implications

Overall, moderate to high certainty of evidence was found for body fat, lower limb strength, and chair stand test. On the other hand, low certainty of evidence was found for upper limb strength. Resistance, combined, and aerobic training evoked divergent results between the variables analyzed. Although promising, our results should be considered sparingly, but may guide additional exercise recommendations to improve specific health parameters in older adults with SO.

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Key words : Exercise therapy, sarcopenia, noncommunicable diseases, physical fitness, aging


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Vol 27 - N° 11

P. 1076-1090 - novembre 2023 Retour au numéro
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