Influence of strength training and multicomponent training on the functionality of older adults: systematic review and meta-analysis

Abstract Physical exercise is an important option to maintain functional independence in older adults, however, it is not clear which type of exercise is the most benefic: strength or multicomponent. The objective was to verify the effectiveness of strength training and multicomponent training on functionality of healthy older patients through a systematic review with meta-analysis. Registration number: CRD42017071887. Two independent evaluators searched Pubmed, Web of Science, PEDro, Cochrane and Lilacs databases. Of the 1434 studies found, 32 clinical trials that investigated the effects of strength training only and/or combined with other modalities (multicomponent) in older adults and evaluated the Timed up and Go (TUG), sit-to-stand (STS) and/or Berg Balance Scale (BBS were included. The methodological quality was evaluated with the Downs & Black scale. Data analysis was performed with the Software Review Manager. It was verified improvement in all the investigated outcomes when performing multicomponent training in comparison to control groups. Strength training, compared to control groups, showed benefit only for sit to stand test. Studies comparing the two trainings found no difference between them. The not high average score in the methodological quality assessment of the included studies is a limitation of the present study. In conclusion, both types of training were effective to improve functionality and are good strategies of training for older individuals. However, as the comparison between the two types of training was performed in few studies, it is not possible to infer which is more effective for the functionality, suggesting the realization of new clinical trials.

摘要 身体锻炼是维持老年人群功能独立性的重要手段，但目前尚不清楚哪种锻炼类型的获益更优：力量训练抑或多组分训练。本研究旨在通过一篇结合荟萃分析的系统综述，验证力量训练与多组分训练对健康老年患者功能状态的改善效果。研究注册编号：CRD42017071887。两名独立评价员检索了PubMed、Web of Science、PEDro、Cochrane及Lilacs数据库。在检索获得的1434项研究中，最终纳入32项临床试验，这些研究针对老年人群探究了单纯力量训练或联合其他训练形式（即多组分训练）的干预效果，并对计时起身行走测试（Timed up and Go, TUG）、坐站测试（sit-to-stand, STS）以及伯格平衡量表（Berg Balance Scale, BBS）进行了评估。采用Downs & Black量表对纳入研究的方法学质量进行评价，数据分析使用Review Manager软件完成。结果显示，与对照组相比，实施多组分训练可使所有被考察的结局指标均得到显著改善；而力量训练仅在坐站测试中相较对照组展现出正向获益。直接对比两类训练的相关研究未发现二者存在显著差异。本研究的局限性在于，纳入研究的方法学质量平均评分偏低。综上，两类训练均能有效改善老年人群的功能状态，均为适合老年人的优质训练策略。但由于直接对比两类训练的研究数量较少，目前无法推断哪种训练对功能改善更具优势，因此建议开展更多相关临床试验。