Elastic band resistance training improves physical function, gait, cardiac indices, and corticomuscular coherence in older women at risk of sarcopenia: a randomized controlled trial

Abstract The risk of sarcopenia is associated with dysregulation of the heart‑brain‑muscle network. This study investigated whether elastic band resistance training (RT) modulates these integrative pathways. Forty older women (mean age 76.4 ± 5.8 years, Ishii score ≥ 120) were randomly assigned to a control group (CON; health education) or an RT group (health education plus 12 weeks of RT). Muscle mass, muscle strength, physical function, gait parameters, skeletal muscle and cardiac morphology, and corticomuscular coherence (CMC) were assessed at baseline and after 12 weeks. RT significantly improved muscle strength and physical function ( p < 0.05) and reduced the Ishii score ( p < 0.01). Gait analysis showed increased stride length ( p < 0.01) and reduced double‑support time ( p < 0.01). Ultrasound examination revealed significant increases in biceps brachii thickness, rectus femoris cross‑sectional area, rectus femoris pennation angle, interventricular septal thickness ( p < 0.05), as well as in LVEF and E/A ratio ( p < 0.01). After correction for multiple comparisons, the β‑band coherence areas for the vastus lateralis and biceps femoris increased (adjusted p < 0.05). RT reduced sarcopenia risk and was associated with improvements in physical function, gait stability, and corticomuscular coherence, as well as changes in selected cardiac indices. These findings suggest parallel adaptations rather than directly demonstrating integrated regulation of the heart‑brain‑muscle network.