Structured Horticultural Therapy Enhances Muscle Strength and Mass in Aging Women at Risk of Sarcopenia

Abstract Background Sarcopenia, characterized by the progressive decline of skeletal muscle mass, strength, and physical performance, is commonly observed among older people and significantly impairs quality of life. Horticultural therapy can maintain muscle mass and reduce waist circumference in healthy participants but remains underutilized in the aging women of sarcopenia. Aim To investigate the effects of a structured horticultural therapy program on muscle strength and mass in aging women at risk of sarcopenia, an age-related condition characterized by progressive skeletal muscle loss and weakness. Design A 12-week, assessor-blinded, non-randomized controlled trial. Methods The study was conducted with 20 women aged ≥50 years with SARC-CalF scores ≥11. Participants were assigned to either a treatment group (n = 11) or a control group (n = 9). The intervention consisted of 100-minute sessions twice a week, involving gardening tasks with a progressive workload adapted based on resistance training principles. The primary outcome was peak quadriceps electromyographic (EMG) activity; secondary outcomes included handgrip strength and skeletal muscle mass. Results The median participant age was 64.5 years. In the treatment group, left leg EMG activity increased by 93.1% (p < 0.001, Δ = 80.4) post-intervention, with 56.9% (p = 0.037, Δ = 49.2) retained at follow-up. Right leg EMG improved by 39.3% (p = 0.008, Δ = 39.0), rising to 56.4% (p = 0.018, Δ = 56.2) at follow-up. No significant changes were observed in the control group. Between-group comparisons revealed a significantly greater improvement in the treatment group (38% difference, p = 0.010). Improvements were also noted in handgrip strength, total body, upper, and lower limb muscle mass. Adherence was 100%, with no adverse events reported. Conclusion Structured horticultural therapy may serve as a safe and effective intervention to enhance muscle health in older adults at risk of sarcopenia.