Age-Related Decline in Force, Power and Postural Control, and the Adjunct Modalities Studied
Reviews and trials on the neuromuscular changes of ageing and on adjunct training modalities: Granacher 2008 reports reduced maximal and explosive force and postural control with ageing, McKinnon 2017 reports that power deficits are more pronounced with aging than strength loss and may be a more sensitive marker, and trials report that strength and flexibility declined after three months of detraining (Carvalho 2008) and that older women were unable to maintain cardio-respiratory fitness, lipid, glycemic and hemodynamic profiles after three months of detraining (Leitão 2019).
Screen for cardiovascular and orthopedic limits before adding power/impact work.
- Two or more falls in the past 12 months, or any fall with injury
- Dizziness, lightheadedness, or fainting during standing or movement
- New or worsening unsteadiness, neurological symptoms, or numbness in the feet
- Fear of falling severe enough to restrict daily activity
What the evidence says
The sources on this entry are narrative reviews of how ageing changes the neuromuscular system, a cross-sectional study, and reviews and trials of adjunct modalities and of what happens when training stops. On the substrate, Granacher 2008 (narrative review) reports that ageing reduces maximal and explosive force and static and dynamic postural control, through type II fibre loss, denervation, satellite cell loss and muscle spindle changes, and that strength training has potential to delay or reverse these. Hurley 1998 (cross-sectional) reports increasing age associated with decreased quadriceps strength, joint position sense acuity and postural stability, and concludes that this deterioration may contribute to the increased fear and frequency of falls. Orssatto 2018 (narrative review) reports that several steps in the force-production pathway are negatively affected by ageing and that combined aerobic and strength training can lessen age-related force reductions. On power, McKinnon 2017 (narrative review) reports that deficits in muscle power are more pronounced with aging than strength loss and may be a more sensitive marker of neuromuscular degeneration, and that high-velocity power training may have advantages over conventional strength training; Byrne 2016 (systematic review, 44 studies) reports a positive association between muscle power and physical function, with power a “marginally superior predictor than strength”; Jiménez-Lupión 2023 (meta-analysis, 12 studies, 478 participants) reports that power training improves functional capacity related to fall risk in older adults; Schaun 2021 (narrative review) reports that high-velocity resistance training appears effective for improving muscle power, functional performance and mobility. On adjunct modalities, Howes 2017 (meta-analysis, 35 studies, 2,936 participants) reports a moderate significant effect of active computer gaming on balance (SMD 0.52) and on functional exercise capacity when delivered for more than 120 minutes per week (SMD 0.53), no significant effect on functional mobility or fear of falling, and concludes that “At present there is very little confidence that ACG improves physical and cognitive outcomes in older adults”; Gallou-Guyot 2020 (overview of 18 reviews) reports exergame effects on physical functions as controversial; Mollà-Casanova 2024 (meta-analysis) reports that mirror neuron activation therapy improved functionality, balance and gait velocity compared with control, while adding it to physical exercise did not improve functionality; Palop-Montoro 2015 (systematic review) reports an 18% increase in lower limb power after 2 months of whole-body vibration, with results similar to conventional resistance exercise. On stopping, Leitão 2019 (non-randomised trial) reports that after three months of detraining older women were unable to maintain the cardiorespiratory fitness, lipid, glycemic and hemodynamic profiles gained from nine months of multicomponent training; Carvalho 2008 (randomised trial) reports that strength and flexibility declined significantly after 3-month detraining; and Westlake 2007 (two randomised trials) reports that balance-exercise effects on proprioceptive reintegration and ankle velocity sense were not maintained at 8-week follow-up, while the Fullerton Advanced Balance Scale improvement was maintained.
- 'Declining balance is unavoidable with age' (training can partially reverse it)
- 'Older adults should only do gentle, slow exercise' (power declines faster than strength with age, which is why high-velocity power training is studied)
- Does not guarantee prevention of any fall or injury
- Not a substitute for medical evaluation of dizziness, syncope, or unexplained falls
- Cannot reverse all age-related change or guarantee independence
- Agreement
- Direction recorded for 0 of 15 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- A source states a certainty rating for 1 outcome.
- Authors
- Sources share authors: Kelly Westlake (first author of 2 sources); E. Culham (senior author of 2 sources).
- How the sources were read
- Some sources are based on abstracts, not full texts.
What each source measured and concluded (15)
- What it measured
- Strength, power and postural control changes with ageing and training/fall prevention
- How it was read
- screened only, not extracted
- What it measured
- Quadriceps strength, proprioceptive acuity (joint position sense), postural stability and functional performance
- How it was read
- screened only, not extracted
- What it measured
- Neuromuscular adaptations underlying age-related loss of muscle power and effect of high-velocity power training
- How it was read
- screened only, not extracted
- What it measured
- Neural and musculotendinous mechanisms of age-related force reduction; effects of training
- How it was read
- screened only, not extracted
- What it measured
- Relationship between muscle power and functional performance; effect of power training on function
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and scoping review
- Studies and participants, as stated
- 44 studies
- What it measured
- Functional capacity tests related to fall risk (30s Sit-to-Stand, Timed Up and Go)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs
- Studies and participants, as stated
- 12 studies, 478 subjects (meta-analysis subsets: 6 studies/217 for 30s-STS, 4 studies/142 for TUG)
- What it measured
- Effects of high-velocity resistance training on muscle power and functional performance
- How it was read
- screened only, not extracted
- What it measured
- Balance, functional exercise capacity, cognitive function, fear of falling.
- How it measured it
- Timed Up and Go test (validated), Six-Minute Walk Test (validated), tracking task (validated).
- How it was read
- read in full text
- What the review says it includes
- Meta-analysis of 35 studies within a systematic review
- Studies and participants, as stated
- N=2,936 participants across 35 studies
- What it measured
- Functionality, balance, gait velocity, risk of falls
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 13 RCTs qualitative, 11 quantitative
- What it measured
- Muscle strength.
- How it measured it
- 5-Chair Stands (objective), Timed Up and Go (objective), Tinetti test (objective).
- Its conclusion, in its own words
- “WBV training proves to be a healthy method, adequate and effective in the strength of the elderly population, but with similar results to conventional resistance exercise.”
- How it was read
- read in full text
- What it measured
- Cognitive, physical and dual-task functions
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Overview of systematic reviews/meta-analyses
- Studies and participants, as stated
- 18 reviews
- What it measured
- Cardiorespiratory fitness and health profiles (lipid, glycemic, hemodynamic).
- How it measured it
- Six-minute walk test (6MWT) with Cosmed K4b2.
- How it was read
- read in full text
- What it measured
- Functional fitness test battery after multicomponent training and detraining
- How it was read
- screened only, not extracted
- What it measured
- Center-of-pressure (COP) velocity change score after proprioceptive perturbation
- How it was read
- screened only, not extracted
- What it measured
- Ankle proprioception (threshold to passive movement, passive joint position sense, velocity discrimination)
- How it was read
- screened only, not extracted
Certainty ratings the sources state (1)
- Rating, as the source states it
- Low
- Framework
- not named by the source
- Applies to
- Low quality of evidence due to small sample sizes and limited methodological quality.
- Stated by
- Howes et al. (2017)
Every source below is shown with its study design and links to the original study. This is the audit trail.
“Abstract only” means the review read that paper’s abstract, not its full text; “screened only” means it was included at re-screening and not extracted. Both stay in the trail with their DOI, because how a source was read is part of the audit.