Effects of resistance training, endurance training and whole-body vibration on lean body mass, muscle strength and physical performance in older people: a systematic review and network meta-analysis

Background: A variety of different types of exercise are promoted to improve muscle strength and physical performance in older people. Objective: We aimed to determine the relative effects of resistance training, endurance training and whole-body vibration on lean body mass, muscle strength and physical performance in older people. Design: A systematic review and network meta-analysis. Subjects: Adults aged 60 and over. Methods: Evidence from randomised controlled trials of resistance training, endurance training and whole-body vibration were combined. The effects of exercise interventions on lean body mass, muscle strength and physical performance were evaluated by conducting a network meta-analysis to compare multiple interventions and usual care. Risk of bias of included studies was assessed using the Cochrane Collaboration's tool. A meta-regression was performed to assess potential effect modifiers. Results: Data were obtained from 30 trials involving 1,405 participants (age range: 60-92 years). No significant differences were found between the effects of exercise or usual care on lean body mass. Resistance training (minimum 6 weeks duration) achieved greater muscle strength improvement than did usual care (12.8 kg; 95% confidence interval [CI]: 8.5-17.0 kg). Resistance training and whole-body vibration were associated with greater physical performance improvement compared with usual care (2.6 times greater [95% CI: 1.3-3.9] and 2.1 times greater [95% CI: 0.5-3.7], respectively). Conclusions: Resistance training is the most effect intervention to improve muscle strength and physical performance in older people. Our findings also suggest that whole-body vibration is beneficial for physical performance. However, none of the three exercise interventions examined had a significant effect on lean body mass.