Effects of Movement-Based Mind-Body Interventions on Physical Fitness in Healthy Older Adults: A Meta-Analytical Review

Abstract

<b><i>Introduction:</i></b> Declines in physical fitness can notably affect healthy aging of older adults. Multimodal exercise training regimen such as mind-body interventions (MBIs) has been reported to mitigate these aging-related declines of physical function. This meta-analytical review aimed at pooling the effects of MBIs on physical fitness indices compared to active control (AC) and inactive control (IC) conditions in healthy older adults. <b><i>Methods:</i></b> The literature search was conducted in 3 databases using search terms with Boolean conjunctions. Randomized controlled trials applying MBIs focusing on improving physical fitness parameters in healthy seniors over 65 years of age were screened for eligibility. Eligibility and study quality were assessed by 2 researchers using the PEDro scale. Standardized mean differences (SMD) adjusted for small sample sizes (Hedges’ <i>g</i>) served as main outcomes for the comparisons of MBIs versus IC and MBIs versus AC. <b><i>Results:</i></b> Thirty trials with 2,792 healthy community dwellers (mean age: 71.2 ± 4.7 years) were included. Large overall effects were found for strength (<i>p</i> < 0.001, SMD: 0.87 [90% CI: 0.43, 1.30], <i>I</i><sup>2</sup> = 94%), medium effects were observed for functional mobility (<i>p</i> = 0.009, SMD: 0.55 [90% CI: 0.20, 0.89], <i>I</i><sup>2</sup> = 83%), and small overall effects were found for static balance (<i>p</i> = 0.02, SMD: 0.35 [90% CI: 0.10, 0.60], <i>I</i><sup>2</sup> = 77%), endurance (<i>p</i> = 0.0001, SMD: 0.44 [90% CI: 0.25, 0.62], <i>I</i><sup>2</sup> = 0%), and flexibility (<i>p</i> = 0.003, SMD: 0.46 [90% CI: 0.21, 0.72], <i>I</i><sup>2</sup> = 54%) in favor of MBIs compared to IC. Small effects of strength slightly favoring AC (<i>p</i> = 0.08, SMD: −0.22 [90% CI: −0.43, −0.01], <i>I</i><sup>2</sup> = 52%) were found, whereas static balance moderately improved in favor of MBIs (<i>p</i> < 0.001, SMD: 0.46 [90% CI: 0.16, 0.76], <i>I</i><sup>2</sup> = 73%). <b><i>Discussion/Conclusion:</i></b> MBIs induce small to moderate effects in relevant domains of physical fitness in healthy older adults. Strength should be better targeted with traditional resistance training routines, whereas balance seems to sufficiently benefit from MBIs. However, large variability between the studies was observed due to differences in methodology, intervention content, and outcomes that affect conclusive evidence.

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review

“…18 studies used RT only, the remainder employed combination RT and AT C: NR 28 (designs NR) Inclusion: > 65 Mean: 70 Range: 65–85 2608 71 NR; lower quality studies had stronger findings (PEDro) da Rosa Orssatto 2019 [ 35 ] To compare change in functional capacity following fast- vs. moderate-velocity lower limb RT in older adults PubMed, Scopus, Web of Science to Jan 2019 2003–2019 I: Fast-velocity lower limb RT C: moderate-velocity lower limb RT 15 RCTs Inclusion: ≥60 Range: 64.4–81.6 593 NR Fair (PEDro) Devries 2014 [ 36 ] To determine whether the addition of creatine to RT increased gains in muscle mass, strength, and function in older adults over RT alone. MEDLINE, HealthStar to June 2013 1998–2013 I: RT and Creatine supplementation C: RT and placebo 10 RCTs Inclusion: > 45 Range: 55–71 357 NR; 20% F only, 40% M only Low-moderate (Jadad) Ebner 2021 [ 37 ] To determine the effects of mind-body interventions on physical fitness in healthy community dwelling older adults. Web of Knowledge, PubMed, SPORTDiscus to Nov 2019 2005–2019 I: Yoga, Qi Gong, Tai Chi, Pilates C: Active and inactive controls 30 RCTs Inclusion: ≥65 Mean: 71.2 2792 37 3% poor 17% fair 63% good 17% excellent (PEDro) Elboim-Gabyzon 2021 [ 38 ] To explore the effectiveness of high-intensity interval training for reducing fall risk factors in older adults.…”

“…Included reviews reported on several types of interventions, with some reporting separate results for more than one intervention type. Most reviews focused on exercise or PA only ( n = 53) [ 26 – 35 , 37 – 40 , 42 , 44 , 45 , 47 , 49 – 75 , 77 , 78 , 80 – 84 , 86 ], while others included exercise with nutritional supplements ( n = 9) [ 25 , 36 , 41 , 43 , 46 , 48 , 76 , 79 , 85 ]. No reviews included group-based nutrition interventions alone.…”

“…No reviews included group-based nutrition interventions alone. Exercise or PA interventions were categorized as resistance exercise ( n = 12) [ 26 , 35 , 47 , 49 , 52 , 60 , 65 , 69 , 72 , 78 , 80 , 81 ], aerobic exercise ( n = 5) [ 28 , 29 , 33 , 38 , 66 ], combined aerobic and resistance exercise ( n = 9) [ 27 , 34 , 47 , 50 , 57 , 60 , 64 , 65 , 81 ], general PA ( n = 12) [ 42 , 44 , 45 , 49 , 54 , 58 , 62 , 63 , 67 , 69 , 70 , 86 ], mind-body exercise (e.g., Tai Chi, yoga, Pilates) ( n = 11) [ 31 , 32 , 37 , 40 , 49 , 56 , 59 , 71 , 74 , 75 , 84 ], dance ( n = 5) [ 39 , 51 , 61 , 73 , 81 ], and other (e.g., aquatics, stretching) ( n = 10) [ 30 , 47 , 49 , 53 , 55 , 68 , 77 , 81 – 83 ]. Nutritional supplements included protein ( n = 5) [ 41 , 43 , 48 ...…”

“…Nutritional supplements included protein ( n = 5) [ 41 , 43 , 48 , 79 , 85 ], creatine ( n = 2) [ 36 , 76 ], vitamin D ( n = 1) [ 25 ], or dairy ( n = 1) [ 46 ]. Meta-analyses were undertaken in 39 reviews [ 25 , 26 , 29 , 31 – 37 , 40 – 42 , 44 , 46 – 50 , 54 – 56 , 60 , 61 , 65 , 66 , 68 – 70 , 72 , 75 , 78 – 81 , 83 – 86 ], 22 reviews presented findings narratively [ 27 , 28 , 38 , 39 , 43 , 45 , 51 – 53 , 57 – 59 , 62 – 64 , 67 , 71 , 73 , 74 , 76 , 77 , 82 ], and one performed a network meta-analysis [ 30 ]. Total sample sizes ranged from 153 to 28,523 when reported.…”

Skeletal muscle weakness in older adults home-restricted due to COVID-19 pandemic: a role for full-body in-bed gym and functional electrical stimulation

“…The resulting disuse muscle atrophy further limits their independence, eventually forcing them to bed and hospitalization for long periods [2][3][4]. In addition to nutritional and pharmacological treatments, physical exercise at home is useful to counteract muscle atrophy in these persons [5][6][7][8][9].…”