Sports Medicine

, Volume 46, Issue 3, pp 353–364 | Cite as

Effects of Resistance Training on Lower-Extremity Muscle Power in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Chad R. StraightEmail author
  • Jacob B. Lindheimer
  • Anne O. Brady
  • Rodney K. Dishman
  • Ellen M. Evans
Systematic Review



Resistance training (RT) has been investigated as a potential intervention strategy for improving muscle function, but the effects on lower-extremity muscle power in middle-aged and older adults have not been systematically reviewed.


The aim of this meta-analysis is to provide a quantitative estimate of the effect of RT on lower-extremity muscle power in middle-aged and older adults and to examine independent moderators of this relationship.


Randomized controlled trials that examined the effects of RT on either leg press (LP) or knee extension (KE) muscle power in adults aged ≥50 years were included. Data were aggregated with meta-analytic techniques, and multi-level modeling was used to adjust for nesting effects. A total of 52 effects from 12 randomized controlled trials were analyzed with a random-effects model to estimate the effect of RT on lower-extremity muscle power. A multiple-regression analysis was conducted to examine independent moderators of the mean effect.


The adjusted aggregated results from all studies indicate that RT has a small-to-moderate effect on lower-extremity muscle power (Hedges’ d = 0.34, 95 % confidence interval [CI] 0.25–0.43), which translated to 54.90 watts (95 % CI 40.37–69.43). Meta-regression analyses indicated that high-velocity RT was superior to traditional RT (Δ = 0.62 vs. 0.20, respectively) for increasing lower-extremity muscle power. In addition, training volume significantly moderated the effect of RT on muscle power.


The findings from this meta-analysis indicate that RT is an efficacious intervention strategy for improving LP and KE muscle power in adults aged ≥50 years. Training mode and volume independently moderate the effect of RT on lower-extremity muscle power, and should be considered when prescribing RT exercise for middle-aged and older adults.


Resistance Training Knee Extension Training Intensity Muscle Power Resistance Training Exercise 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards


No sources of funding were used to assist in the preparation of this review.

Conflict of interest

Chad Straight, Jacob Lindheimer, Anne Brady, Rodney Dishman, and Ellen Evans declare that they have no conflicts of interest relevant to the content of this review.


  1. 1.
    Administration on Aging. A profile of older Americans: 2013. Washington, DC: US Department of Health and Human Services; 2013.Google Scholar
  2. 2.
    Martin LG, Freedman VA, Schoeni RF, et al. Trends in disability and related chronic conditions among people ages fifty to sixty-four. Health Aff (Millwood). 2010;29:725–31.PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Holmes J, Powell-Griner E, Lethbridge-Cejku M, et al. Aging differently: physical limitations among adults aged 50 years and over: United States, 2001–2007. NCHS Data Brief. 2009:1–8.Google Scholar
  4. 4.
    National Center for Health Statistics. Health, United States, 1996–97 and Injury chartbook. Hyattsville: US Department of Health and Human Services; 1997.Google Scholar
  5. 5.
    Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12:249–56.CrossRefPubMedGoogle Scholar
  6. 6.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Barbat-Artigas S, Rolland Y, Zamboni M, et al. How to assess functional status: a new muscle quality index. J Nutr Health Aging. 2012;16:67–77.CrossRefPubMedGoogle Scholar
  8. 8.
    Metter EJ, Conwit R, Tobin J, et al. Age-associated loss of power and strength in the upper extremities in women and men. J Gerontol A Biol Sci Med Sci. 1997;52:B267–76.CrossRefPubMedGoogle Scholar
  9. 9.
    Skelton DA, Greig CA, Davies JM, et al. Strength, power and related functional ability of healthy people aged 65–89 years. Age Ageing. 1994;23:371–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Clark DJ, Pojednic RM, Reid KF, et al. Longitudinal decline of neuromuscular activation and power in healthy older adults. J Gerontol A Biol Sci Med Sci. 2013;68:1419–25.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Knuttgen HG, Kraemer WJ. Terminology and measurement in exercise performance. J Strength Cond Res. 1987;1:1–10.Google Scholar
  12. 12.
    Foldvari M, Clark M, Laviolette LC, et al. Association of muscle power with functional status in community-dwelling elderly women. J Gerontol A Biol Sci Med Sci. 2000;55:M192–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Suzuki T, Bean JF, Fielding RA. Muscle power of the ankle flexors predicts functional performance in community-dwelling older women. J Am Geriatr Soc. 2001;49:1161–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Bean JF, Kiely DK, Herman S, et al. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002;50:461–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Cuoco A, Callahan DM, Sayers S, et al. Impact of muscle power and force on gait speed in disabled older men and women. J Gerontol A Biol Sci Med Sci. 2004;59:1200–6.CrossRefPubMedGoogle Scholar
  16. 16.
    Rantanen T, Avela J. Leg extension power and walking speed in very old people living independently. J Gerontol A Biol Sci Med Sci. 1997;52:M225–31.CrossRefPubMedGoogle Scholar
  17. 17.
    Bean JF, Leveille SG, Kiely DK, et al. A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more? J Gerontol A Biol Sci Med Sci. 2003;58:728–33.CrossRefPubMedGoogle Scholar
  18. 18.
    Kuo HK, Leveille SG, Yen CJ, et al. Exploring how peak leg power and usual gait speed are linked to late-life disability: data from the National Health and Nutrition Examination Survey (NHANES), 1999–2002. Am J Phys Med Rehabil. 2006;85:650–8.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing. 2002;31:119–25.CrossRefPubMedGoogle Scholar
  20. 20.
    Bassey EJ, Fiatarone MA, O’Neill EF, et al. Leg extensor power and functional performance in very old men and women. Clin Sci (Lond). 1992;82:321–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Ward-Ritacco CL, Adrian AL, Johnson MA, et al. Adiposity, physical activity, and muscle quality are independently related to physical function performance in middle-aged postmenopausal women. Menopause. 2014;21:1114–21.CrossRefPubMedGoogle Scholar
  22. 22.
    Straight CR, Brady AO, Evans EM. Muscle quality and relative adiposity are the strongest predictors of lower-extremity physical function in older women. Maturitas. 2015;80:95–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Reid KF, Fielding RA. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev. 2012;40:4–12.PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Verbrugge LM, Jette AM. The disablement process. Soc Sci Med. 1994;38:1–14.CrossRefPubMedGoogle Scholar
  25. 25.
    Evans WJ, Campbell WW. Sarcopenia and age-related changes in body composition and functional capacity. J Nutr. 1993;123:465–8.PubMedGoogle Scholar
  26. 26.
    Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1094–105.CrossRefPubMedGoogle Scholar
  27. 27.
    Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.CrossRefPubMedGoogle Scholar
  28. 28.
    Kraemer WJ, Adams K, Cafarelli E, et al. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34:364–80.CrossRefPubMedGoogle Scholar
  29. 29.
    American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41:687–708.CrossRefGoogle Scholar
  30. 30.
    Peterson MD, Rhea MR, Sen A, et al. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9:226–37.PubMedCentralCrossRefPubMedGoogle Scholar
  31. 31.
    Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc. 2011;43:249–58.PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    Hruda KV, Hicks AL, McCartney N. Training for muscle power in older adults: effects on functional abilities. Can J Appl Physiol. 2003;28:178–89.CrossRefPubMedGoogle Scholar
  33. 33.
    Henwood TR, Riek S, Taaffe DR. Strength versus muscle power-specific resistance training in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2008;63:83–91.CrossRefPubMedGoogle Scholar
  34. 34.
    Skelton DA, Young A, Greig CA, et al. Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. J Am Geriatr Soc. 1995;43:1081–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Marsh AP, Miller ME, Rejeski WJ, et al. Lower extremity muscle function after strength or power training in older adults. J Aging Phys Act. 2009;17:416–43.PubMedCentralPubMedGoogle Scholar
  36. 36.
    Reid KF, Martin KI, Doros G, et al. Comparative effects of light or heavy resistance power training for improving lower extremity power and physical performance in mobility-limited older adults. J Gerontol A Biol Sci Med Sci. 2014;70:374–80.CrossRefPubMedGoogle Scholar
  37. 37.
    Fielding RA, LeBrasseur NK, Cuoco A, et al. High-velocity resistance training increases skeletal muscle peak power in older women. J Am Geriatr Soc. 2002;50:655–62.CrossRefPubMedGoogle Scholar
  38. 38.
    de Vos NJ, Singh NA, Ross DA, et al. Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol A Biol Sci Med Sci. 2005;60:638–47.CrossRefPubMedGoogle Scholar
  39. 39.
    Evans WJ. Exercise strategies should be designed to increase muscle power. J Gerontol A Biol Sci Med Sci. 2000;55:M309–10.CrossRefPubMedGoogle Scholar
  40. 40.
    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.PubMedCentralCrossRefPubMedGoogle Scholar
  41. 41.
    Delmonico MJ, Lofgren IE. Resistance training during weight loss in overweight and obese older adults: what are the benefits? Am J Lifestyle Med. 2010;4:309–13.CrossRefGoogle Scholar
  42. 42.
    Straight CR, Brady AO, Evans EM. Muscle quality in older adults: what are the health implications? Am J Lifestyle Med. 2015;9:130–6.CrossRefGoogle Scholar
  43. 43.
    Henwood TR, Taaffe DR. Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training. Gerontology. 2005;51:108–15.CrossRefPubMedGoogle Scholar
  44. 44.
    Reid KF, Callahan DM, Carabello RJ, et al. Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial. Aging Clin Exp Res. 2008;20:337–43.PubMedCentralCrossRefPubMedGoogle Scholar
  45. 45.
    Hedges L, Olkin I. Statistical methods for meta-analysis. New York: Academic Press; 1985.Google Scholar
  46. 46.
    Lipsey M, Wilson D. Practical meta-analysis. Thousand Oaks: Sage Publications; 2001.Google Scholar
  47. 47.
    Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10:101–29.CrossRefGoogle Scholar
  48. 48.
    Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconstency in meta-analyses. BMJ. 2003;327:557–60.PubMedCentralCrossRefPubMedGoogle Scholar
  49. 49.
    Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.PubMedCentralCrossRefPubMedGoogle Scholar
  50. 50.
    Rosenberg MS. The file-drawer problem revisited: a general weighted method for calculating fail-safe numbers in meta-analysis. Evolution. 2005;59:464–8.CrossRefPubMedGoogle Scholar
  51. 51.
    Muthén L, Muthén B. Mplus user’s guide. Los Angeles: Muthen & Muthen; 1998–2012.Google Scholar
  52. 52.
    Cheung M. A model for integrating fixed-, random-, and mixed-effects meta-analyses into structural equation modeling. Psychol Methods. 2008;13:182–202.CrossRefPubMedGoogle Scholar
  53. 53.
    Hox J, editor. Multilevel analysis: techniques and applications. 2nd ed. New York; 2010.Google Scholar
  54. 54.
    Froot K. Consistent covariance matrix estimation with cross-sectional dependence and heteroskedasticity in financial data. J Financ Quant Anal. 1989;24:333–55.CrossRefGoogle Scholar
  55. 55.
    White H. A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica. 1980;48:817–38.CrossRefGoogle Scholar
  56. 56.
    Williams R. A note on robust variance estimation for cluster-correlated data. Biometrics. 2000;56:645–6.CrossRefPubMedGoogle Scholar
  57. 57.
    Holviala J, Kraemer WJ, Sillanpaa E, et al. Effects of strength, endurance and combined training on muscle strength, walking speed and dynamic balance in aging men. Eur J Appl Physiol. 2012;112:1335–47.CrossRefPubMedGoogle Scholar
  58. 58.
    Liu-Ambrose T, Nagamatsu LS, Graf P, et al. Resistance training and executive functions: a 12-month randomized controlled trial. Arch Intern Med. 2010;170:170–8.PubMedCentralCrossRefPubMedGoogle Scholar
  59. 59.
    Lohne-Seiler H, Torstveit MK, Anderssen SA. Traditional versus functional strength training: effects on muscle strength and power in the elderly. J Aging Phys Act. 2013;21:51–70.PubMedGoogle Scholar
  60. 60.
    Ramsbottom R, Ambler A, Potter J, et al. The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old. J Aging Phys Act. 2004;12:497–510.PubMedGoogle Scholar
  61. 61.
    Sayers SP, Gibson K. A comparison of high-speed power training and traditional slow-speed resistance training in older men and women. J Strength Cond Res. 2010;24:3369–80.CrossRefPubMedGoogle Scholar
  62. 62.
    Latham NK, Bennett DA, Stretton CM, et al. Systematic review of progressive resistance strength training in older adults. J Gerontol A Biol Sci Med Sci. 2004;59:48–61.CrossRefPubMedGoogle Scholar
  63. 63.
    Steib S, Schoene D, Pfeifer K. Dose-response relationship of resistance training in older adults: a meta-analysis. Med Sci Sports Exerc. 2010;42:902–14.CrossRefPubMedGoogle Scholar
  64. 64.
    Hazell T, Kenno K, Jakobi J. Functional benefit of power training for older adults. J Aging Phys Act. 2007;15:349–59.PubMedGoogle Scholar
  65. 65.
    Porter MM. Power training for older adults. Appl Physiol Nutr Metab. 2006;31:87–94.CrossRefPubMedGoogle Scholar
  66. 66.
    McComas AJ. Skeletal muscle: form and function. Champaign: Human Kinetics; 1996.Google Scholar
  67. 67.
    Straight CR, Brady AO, Evans E. Sex-specific relationships of physical activity, body composition, and muscle quality with lower-extremity physical function in older men and women. Menopause. 2015;22:297–303.CrossRefPubMedGoogle Scholar
  68. 68.
    Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Chad R. Straight
    • 1
    Email author
  • Jacob B. Lindheimer
    • 1
  • Anne O. Brady
    • 2
  • Rodney K. Dishman
    • 1
  • Ellen M. Evans
    • 1
  1. 1.Department of KinesiologyUniversity of GeorgiaAthensUSA
  2. 2.Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroUSA

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