# Resistance training in older women with sarcopenia: function gains, muscle mass uncertain

> A 2025 meta-analysis of 12 randomized trials in 518 older women with sarcopenia found gains in strength and physical function with resistance training, but no significant effect on skeletal muscle mass index.

AthleticsMD Clinical Desk · 2026-10-11 · https://blog.athleticsmd.org/resistance-training-in-older-women-with-sarcopenia-function-gains-muscle-mass-un

Sarcopenia is the age-related, progressive loss of muscle mass, strength and physical function, and it raises the risk of falls, fractures and loss of independence [4]. Resistance training is widely recommended for the condition, yet the authors of a 2025 systematic review in Frontiers in Public Health note that evidence specific to older women remains limited [1]. Their meta-analysis pooled randomized controlled trials in that population to estimate effects on muscle mass, strength and physical function [1].

## What was studied

Four databases were searched through February 2025: PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials [1]. The protocol was registered in PROSPERO (CRD420251066233) [1]. Twelve randomized controlled trials, together enrolling 518 older women with sarcopenia, were included [1]. Pooling used a random-effects model fitted by restricted maximum likelihood with the "meta" package in R [1]. Risk of bias was judged with RoB 2 and certainty of evidence with GRADE [1].

## How the outcomes are measured

Clinicians generally define sarcopenia by one or more of three features: low muscle mass, low muscle strength and low physical performance [4]. The review's outcomes correspond to these features [1, 4]:

- Handgrip strength is the force of a hand squeeze and serves as a marker of overall muscle weakness [4].
- Gait speed is assessed by timing a 4-meter walk at a usual pace [4].
- The Timed Up and Go (TUG) test times rising from a chair, walking 3 meters away and back, and sitting down again [4].
- The 30-Second Chair Stand counts sit-to-stand repetitions completed without arm use in 30 seconds [4].
- Muscle mass is commonly estimated with dual-energy X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) [4].

## What was found

Effects were reported as standardized mean differences (SMD) with 95% confidence intervals (CI) [1]. Relative to control conditions, resistance training improved two strength measures and three functional measures to a statistically significant degree [1]:

- Knee extension strength showed the largest pooled effect, an SMD of 0.85 (95% CI, 0.37 to 1.33) [1].
- For handgrip strength the pooled SMD was 0.43 (95% CI, 0.11 to 0.74) [1].
- On the 30-Second Chair Stand, the estimate was 0.52 (95% CI, 0.19 to 0.86) [1].
- Gait speed had the smallest significant effect, 0.37 (95% CI, 0.09 to 0.64) [1].
- TUG improved with an SMD of −0.68 (95% CI, −0.95 to −0.41); because TUG is a timed test, the negative sign corresponds to faster completion [1, 4].

No significant effect on skeletal muscle mass index was found, and the abstract gives no pooled estimate for that outcome [1]. Of the reported outcomes, knee extension strength had the widest confidence interval [1]. The authors conclude that resistance training improves strength and physical function in older women with sarcopenia, but that its effect on muscle mass is still uncertain [1].

## Subgroup findings

Sarcopenic obesity refers to sarcopenia occurring together with a higher body mass index [4]. In the subgroup analyses, knee extension strength rose more among women with sarcopenic obesity, whereas gait speed rose more among women with sarcopenia only [1]. Mixed resistance training was reported to have a significant advantage for gait speed, though the abstract neither defines the term nor gives subgroup effect sizes [1].

## Context from other studies

A 12-week randomized trial in older adults with type 2 diabetes and sarcopenia compared combined aerobic and resistance exercise with health education, and reported increases in grip strength and appendicular skeletal muscle mass index in the exercise group; its abstract does not state the sample size [2]. A separate meta-analysis of 9 randomized trials in 513 hemodialysis patients with sarcopenia found that exercise combined with nutritional intervention, compared with either alone, improved skeletal muscle index (weighted mean difference 0.82, 95% CI 0.62 to 1.03) [3]. Those populations and interventions differ from the women-only resistance training trials in the 2025 review, so the findings are not directly comparable [1, 2, 3].

## Limitations

- The evidence base is small, at 12 trials and 518 participants, and the authors call for large-scale, long-term studies to confirm the findings and refine intervention protocols [1].
- The abstract does not report the GRADE certainty ratings, the RoB 2 judgments, between-trial heterogeneity, or the duration, frequency and intensity of the training programs [1].
- The authors describe the effect on muscle mass as uncertain, and the abstract provides no pooled estimate for skeletal muscle mass index [1].
- Results are reported as SMDs, and the abstract does not convert them into clinical units such as seconds, kilograms or repetitions [1].
- The abstract does not specify which diagnostic criteria the included trials used, and published estimates of sarcopenia vary partly because definitions and diagnostic methods differ [1, 5].
- The review was restricted to older women with sarcopenia, so its pooled estimates describe that population only [1].

## References

1. Zhou Y, Wen K, Zhang X, Sun Y. Effects of resistance training on muscle mass, strength, and physical function in older women with sarcopenia: a systematic review and meta-analysis. Front Public Health. 2025;13:1735899. doi:10.3389/fpubh.2025.1735899. PMID: 41668861. https://pubmed.ncbi.nlm.nih.gov/41668861/
2. Ma Y, Zheng J, Yu M, Zheng Z, Yang F, Liu Y. Effects of combined aerobic and resistance exercise on sarcopenia in elderly patients with type 2 diabetes mellitus. J Endocrinol. 2025;267(3). doi:10.1530/JOE-25-0275. PMID: 41342363. https://pubmed.ncbi.nlm.nih.gov/41342363/
3. Zhang L, Yang L, Wang X, Zhang D. Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis. Ren Fail. 2025;47(1):2492365. doi:10.1080/0886022X.2025.2492365. PMID: 40456518. https://pubmed.ncbi.nlm.nih.gov/40456518/
4. Cleveland Clinic. Sarcopenia (Muscle Loss): Symptoms & Causes. Accessed October 11, 2026. https://my.clevelandclinic.org/health/diseases/23167-sarcopenia
5. WebMD. Sarcopenia (Muscle Loss With Aging): Causes, and Treatments. Accessed October 11, 2026. https://www.webmd.com/healthy-aging/sarcopenia-with-aging