Residual effects of physical exercise after periods of training cessation in older adults: a systematic review with meta-analysis and meta-regression

We aimed to determine the persisting effects of various exercise modalities and intensities on functional capacity after periods of training cessation in older adults. A comprehensive search was conducted across the Cochrane Library, PubMed/MEDLINE, Scopus, and Web of Science Core Collection up to March 2024 for randomized controlled trials examining residual effects of physical exercise on functional capacity in older adults ≥ 60 years. The analysis encompassed 15 studies and 21 intervention arms, involving 787 participants. The exercise and training cessation periods ranged from 8 to 43 weeks and 4 to 36 weeks, respectively. Meta-analyses were performed using change scores from before the physical exercise to after the training cessation. The effect sizes (ES) were calculated as the standardized mean differences between the intervention and control groups' change scores. Subgroup analyses and meta-regressions explored the influence of participant characteristics, the magnitude of the effect produced by the initial training program, various exercise modalities (resistance and multicomponent training) and intensities (high and low), and subdomains of functional capacity (agility, balance, standing ability, walking ability, and stair walking). The findings revealed that exercise interventions had a significant effect on preserving functional capacity after training cessation (ES = 0.87; p < 0.01). This protective effect was consistent across various exercise modalities and intensities (ES ≥ 0.67; p ≤ 0.04). The benefits obtained during the training program were positively associated with the residual effects observed after training cessation (β = 0.73; p < 0.01), while age negatively influenced the persisting adaptations (β = −0.07; p < 0.01). Current evidence suggests that exercise-based interventions, irrespective of modality and intensity, are highly effective in preventing functional declines after training cessation among older adults.