Physical therapy for hospitalized older adults with sarcopenia or at risk of sarcopenia: A systematic review with meta-analysis

Abstract

Introduction: Sarcopenia, characterized by the loss of muscle mass, strength, and physical performance, is prevalent among the elderly and is associated with disability, hospitalization, poorer quality of life, and mortality. Objective: To evaluate the efficacy of physical therapy interventions on the functional prognosis of hospitalized elderly patients with sarcopenia or at risk of developing sarcopenia. Methods: A systematic review with meta-analysis was conducted following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with searches performed in the PubMed/MEDLINE, Cochrane Library, Embase, PEDro (Physiotherapy Evidence Database), and Scopus databases between 2020 and 2026. Hospitalized elderly patients with sarcopenia or at risk of sarcopenia who underwent physical therapy were included. Of 909 records, three studies involving 311 participants were eligible. Only two studies, comprising 251 participants, provided comparable data for quantitative synthesis. Results: Early physical therapy did not result in significant improvement in functional performance (mean difference = 0.55; 95% confidence interval: -0.21 to 1.31; p = 0.16; I² = 68%), but it did favor gait speed (mean difference = 0.07; 95% confidence interval: 0.03–0.11; p = 0.0005) and handgrip strength (mean difference = 0.84; 95% confidence interval: 0.08–1.61; p = 0.03). Conclusion: The findings suggest a potential benefit of early physical therapy regarding gait speed and handgrip strength, but not functional performance.  The limited number of studies and the inclusion of only two in the quantitative syntheses limit the precision of the estimates and preclude definitive conclusions.