Impact of Physical Exercise Interventions on Functional Fitness in Older Adults

Cheng Chen^1*Cristiana Freire²Zhiyang Fu¹Inês Teixeira²Matilde Adegas²Rafael Gomes²Ricardo Rabaçal²Sara Silva²Alexandra Malheiro²Luciano Bernardes Leite³António Reis^2,4,5António Miguel Monteiro^2,4,5Yao Xiaolin⁶Pedro Forte^2,4,5

• ¹Graduate School, Harbin Sport University, Harbin, China
• ²Departmento of Sports, Higher Institute of Educational Sciences of Douro, Douro, Portugal
• ³Department of Physical Education,, Universidade Federal de Vicosa, Viçosa, Brazil
• ⁴Department of Sports Sciences, Instituto Politecnico de Braganca, Bragança, Portugal
• ⁵Research Center for Active Living and Wellbeing, Instituto Politécnico de Bragança, Bragança, Portugal, Bragança, Portugal
• ⁶Institute of Sports Humanities and Society, Harbin Sport University, Harbin, China

Aging is associated with a progressive decline in functional fitness—the physiological capacity for performing everyday activities safely and independently—which compromises autonomy in older adults. This systematic review synthesized evidence from randomized and controlled clinical trials published from 2015 to 2024 to evaluate the effects of physical exercise on functional fitness in people aged ≥65 years. Three major databases (MEDLINE, PMC, and PubMed Central Canada) were systematically searched using comprehensive sets of keywords and MeSH terms related to "older adults" and specific exercise modalities (e.g., endurance, strength, resistance training). After duplicate removal and application of eligibility criteria, 95 studies were included. A meta-analysis was not performed due to substantial methodological heterogeneity among the included studies. The synthesized evidence indicates that most exercise interventions, particularly multicomponent programs, resistance training, and supervised protocols, improved functional fitness outcomes. Significant benefits were observed in muscular strength (e.g., ~20-40% improvement in 30-second chair stand test), mobility (e.g., ~1.0-2.5 seconds reduction in Timed Up and Go test time), balance, and gait speed (e.g., ~0.08-0.15 m/s increase), alongside positive effects on body composition (e.g., increased lean mass); however, effects on cognitive function were inconsistent. Interventions lasting more than 12 weeks and demonstrating high adherence were associated with more favorable outcomes. In conclusion, structured, well-designed exercise programs tailored to the needs and capacities of older adults represent effective, non-pharmacological strategies to enhance functional independence and promote healthy aging. These conclusions should be interpreted considering the heterogeneity of the interventions and the limitations in the quality appraisal of all included studies.