Author(s): SUHRKAMP, J., WIEDENMANN, T., RAPPELT, L., MORAT, T., HELD, S., ISENMANN, E., DONATH, L., Institution: EXERCISE TRAINING AND SPORT INFORMATICS, Country: GERMANY, Abstract-ID: 1305

INTRODUCTION:
Resistance training is widely recognized as a valuable method to enhance physical function, reduce the risk of falls and improve overall health, independence and well-being in older adults [1,2]. The training can be performed through various modalities of which the comparative effects have not yet been thoroughly elucidated. This network meta-analysis (NMA) therefore aims at comparing and ranking different resistance training modalities regarding their effects on strength outcomes in older adults.
METHODS:
The NMA was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for NMAs (PRISMA-NMA) [3]. The studies included in this NMA were identified through a comprehensive search across three health-related, biomedical databases (PubMed, Web of Science and SPORTDiscus). Relevant search terms were combined with Boolean operators (OR/AND) and applied on three search levels, including the targeted training modalities, strength outcomes and population. We included (randomized) controlled trials that assessed the effect of resistance training modes (including: free weight training, machine-based training, body weight training, elastic band training and mixed training) in comparison to each other or to a control condition, focusing on traditional maximal strength outcomes in older individuals.
RESULTS:
This NMA includes 29 trials involving 1347 community-dwelling seniors with a mean age of 72 ± 6 years (range 66 to 87 years of age). The average study quality was rated as high, indicated by a mean PEDro score of 6 ± 1.2. and the funnel plot evaluation revealed no considerable risk of bias. All of the included resistance training modalities yield moderate to large positive effects on strength when compared to a “no intervention” control condition. Machine based training (SMD = 1.08 [95%-CI: 0.64; 1.52]) elicits the largest effect, followed by free weight (SMD = 0.96 [95%-CI: -0.05; 1.98]), mixed (SMD = 0.96 [95%-CI: 0.46; 1.45]), elastic band (SMD = 0.89 [95%-CI: 0.33; 1.46]) and bodyweight training (SMD = 0.49 [95%-CI: -0.32; 1.29]).
CONCLUSION:
Machine-based training elicits the largest effect with the smallest variance and is therefore most likely to be effective. However, our findings demonstrate that various different resistance training modalities can have large positive effects on the strength development in older adults. We suggest that, with adequately chosen load criteria such as training intensity, volume and duration of the training period, the selection of the appropriate resistance training type might depend on individual preference, enjoyability and practicability.

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3. Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. Ann Intern Med. 2015;162:777–84.