Proposal of a Training Protocol for Muscle Strength and Postural Balance in Older Adults: An Integrative Review

Guidelines promote high-quality care for older adults. Exercise training recommendations have not been fully characterized. Objective: To propose a training protocol for functional muscle strength and postural balance in older adults, based on main literature findings. Methods: A systematic review, including studies for individuals aged 65 years or older, providing recommendations for strength and balance training between 2017 and March 2025. Results: A total of 1979 articles were initially identified. After removing duplicates and applying filters, 1880 articles were screened, and 11 studies met the inclusion criteria. These studies assessed multicomponent, concurrent, and strength training, and their effects on muscle strength, physical performance, balance, quality of life, and fall-related outcomes. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Significant improvements were observed in muscle strength, physical performance, and balance in the intervention groups. Training protocols typically included exercises targeting both upper and lower limbs, with variations in intensity, frequency, and progression. Recommendations from the American College of Sports Medicine emphasized gradual progression and balance across muscle groups. The findings highlight studies that recommend exercise training for diverse older adult populations and various health outcomes, establishing exercise as a recognized component of care. These findings contrast with clinical reports indicating low implementation rates of exercise training, suggesting guideline recommendations may often be overlooked. Conclusions: Improving adherence to guideline-concordant exercise training could enhance function and quality of life in older adults. The presence of qualified fitness professionals during training sessions is essential to ensure safety and efficacy.