Table 1_A systematic review and meta-analysis of the effects of different exercise modalities on frailty in older adults.docx

Prespecified subgroup analyses examined exercise modality and intervention characteristics. Leave-one-comparison-out sensitivity analysis was used to assess influence. Funnel-plot findings were considered exploratory because few comparisons were available.</p>Results<p>Ten articles contributed 13 eligible exercise-control comparisons comprising 1,361 participant observations (682 intervention and 679 control).

The overall random-effects estimate favored exercise (SMD = −0.57, 95% CI −0.91 to −0.24), but heterogeneity was substantial (I² = 88%) and the approximate 95% prediction interval crossed the null (−1.73 to 0.57). Resistance-exercise comparisons showed a significant pooled association with lower frailty scores (SMD = −0.78, 95% CI −1.22 to −0.35), whereas walking and Tai Chi estimates were imprecise and not statistically significant.

Leave-one-comparison-out estimates remained in the same direction (SMD range, −0.65 to −0.46), although heterogeneity remained high. Dose-characteristic subgroup findings were based on small numbers of comparisons and should be regarded as exploratory rather than as evidence of an optimal prescription.</p>Conclusion<p>Resistance-exercise trials showed a significant pooled reduction in frailty scores, but the available evidence does not establish superiority over walking or Tai Chi because no direct head-to-head or network comparison was performed.

High heterogeneity, imprecise modality subgroups, and sparse dose strata limit certainty. The dose-related findings should be used to generate hypotheses for adequately powered comparative trials rather than to prescribe an optimal regimen.</p>