2025, Vol. 12, Issue 6, Part H

This systematic review was conducted to comprehensively examine the literature concerning various Resistance Training (RT) modalities and programming variables, aiming to identify effective approaches for older adults. The primary purpose was to counteract age-related skeletal muscle loss, medically termed sarcopenia, and enhance crucial physical performance metrics necessary for functional independence and quality of life. The review also sought to delineate which specific types of RT are most effective in mitigating sarcopenia and maximizing performance outcomes, while providing practical guidelines for prescribing exercise in older adults, especially those with pre-existing chronic conditions.

The subject content synthesized evidence on how RT protocols induce adaptive changes at molecular, neural, and functional levels, relying on the core principle of progressive overload to stimulate adaptation. RT was shown to promote muscle growth (hypertrophy) across all fiber types, with particular efficacy in reversing the atrophy of fast-twitch fibers preferentially lost during aging. Initial strength gains are significantly driven by neural adaptations, such as increased activation of agonist muscles, rather than structural hypertrophy alone, demonstrating that the capacity for improvement remains substantial even in advanced old age.

Regarding programming, maximizing adaptive gains typically requires intensities above 60% of the one-repetition maximum, and multiple sets generally yield superior gains in strength and size compared to single-set programs. Power training, characterized by high-velocity, low-load execution, proved critically important, demonstrating greater benefits for improving functional ability, such as performing activities of daily living and reducing fall risk, than traditional heavy strength training alone. Alternative modalities, such as low-load resistance combined with blood flow restriction, were shown to effectively elicit muscle hypertrophy comparable to heavier lifting. Crucial safety protocols were outlined for chronic conditions, including the use of weight-bearing, high-intensity exercises to enhance bone mineral density against osteoporosis, and the mandatory avoidance of high-intensity isometric actions for individuals with cardiovascular limitations.

The conclusion affirms that resistance training is a crucial and scientifically verified method for older adults to combat sarcopenia and enhance performance. Optimal outcomes require personalized, progressively challenging training programs that integrate varied modalities, with a strong emphasis on power development and meticulous management of underlying health conditions to maximize functional benefits and prolong independent living.