The effects of resistance training on muscular strength and hypertrophy in elderly cancer patients: A systematic review and meta-analysis

Abstract

Background: One of the most life-threatening comorbidities in elderly cancer patients is cancer cachexia, which is characterized by the ongoing loss of skeletal muscular strength and mass and is also associated with aging. There is a lack of recommendations for optimal resistance training (RT) for those patients. The purpose of this study was to systematically review and quantify the effects of RT on muscular strength and hypertrophy in elderly cancer patients.

Methods: Five electronic databases were searched (until January 2020) for studies that met the following criteria: (i) cancer patients aged ≥60 years; (ii) structured and supervised RT intervention for ≥6 weeks; and (iii) measured muscular strength and/or hypertrophy.

Results: Thirteen studies (717 participants, average age = 66 years) met the inclusion criteria. RT significantly increased muscular strength (mean effect size = 0.87, 95% confidence interval (95%CI): 0.43-1.32, p < 0.001) and did not significantly induce muscle hypertrophy (mean effect size = 0.09, 95%CI: -0.14 to 0.31, p = 0.45). In subgroup analyses for muscle strength, higher weekly frequency was significantly associated with larger effect size. Egger's test showed no significant publication bias for the 2 outcomes.

Conclusion: The results suggest that RT improves muscular strength but does not significantly induce muscle hypertrophy in elderly cancer patients.

Keywords: Cancer cachexia; Muscle synthesis; Sarcopenia; Skeletal muscle.

Graphical abstract

Fig. 1

Study search and selection process.

Fig. 2

Funnel plots of publication bias in 2 outcomes: (A) muscular strength and (B) muscular hypertrophy. SE = standard error; SMD = standardized mean difference.

Fig. 3

Forest plot of ES and 95%CIs for 12 cohorts representing muscular strength, based on the random effects meta-analysis results. 95%CI = 95% confidence interval; ES = effect size.

Fig. 4

Forest plot of ES and 95%CIs for 7 cohorts representing muscular hypertrophy, based on the fixed effects meta-analysis results. 95%CI = 95% confidence interval; ES = effect size.