Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial

<b>Background/Objectives:</b> Exercise is a key nonpharmacological strategy for the management of sarcopenic obesity (SO), characterized by low muscle mass and excess fat. However, long-term interventions and specific modalities, such as power training (PT), remain unexplored in this population. <b>Methods</b>: In this 32-week randomized controlled trial, 40 community-dwelling women (mean age: 77.0 ± 6.8 years) with sarcopenic obesity (per the EWGSOP2 and ESPEN criteria) were assigned to power training (PT), multicomponent training (MT), or a non-exercise control group (CG). Body composition, strength, and function were assessed pre- and post-intervention using within- and between-group analyses with effect size estimation. Nutritional intake was evaluated at baseline. <b>Results</b>: Significant pre-post intervention between-group differences were observed in appendicular skeletal muscle mass index (ASMI; <i>p</i> = 0.039), body fat percentage (BF%; <i>p</i> = 0.002), visceral fat (VF; <i>p</i> = 0.044), appendicular muscle mass (ASM; <i>p</i> = 0.021), gait speed (GS; <i>p</i> = 0.018), timed up and go test (TUG; <i>p</i> = 0.005), five-times sit-to-stand test (5STS; <i>p</i> < 0.001), and Short Physical Performance Battery (SPPB; <i>p</i> = 0.002). Large effect sizes (Cohen's d > 0.8) were found in the PT group for all these variables. Post hoc analyses indicated that PT was significantly superior to MT in improving 5STS (<i>p</i> = 0.005) and TUG (<i>p</i> = 0.025). Notably, 35.7% of the PT participants no longer met diagnostic criteria for SO after the intervention. <b>Conclusions</b>: PT was more effective than MT and the CG in improving muscle mass, reducing fat, and enhancing functional performance in older women with SO. These findings support PT as a feasible and promising intervention.