Introduction: Declines in physical fitness can notably affect healthy aging of older adults. Multimodal exercise training regimen such as mind-body interventions (MBIs) has been reported to mitigate these aging-related declines of physical function. This meta-analytical review aimed at pooling the effects of MBIs on physical fitness indices compared to active control (AC) and inactive control (IC) conditions in healthy older adults. Methods: The literature search was conducted in 3 databases using search terms with Boolean conjunctions. Randomized controlled trials applying MBIs focusing on improving physical fitness parameters in healthy seniors over 65 years of age were screened for eligibility. Eligibility and study quality were assessed by 2 researchers using the PEDro scale. Standardized mean differences (SMD) adjusted for small sample sizes (Hedges’ g) served as main outcomes for the comparisons of MBIs versus IC and MBIs versus AC. Results: Thirty trials with 2,792 healthy community dwellers (mean age: 71.2 ± 4.7 years) were included. Large overall effects were found for strength (p < 0.001, SMD: 0.87 [90% CI: 0.43, 1.30], I2 = 94%), medium effects were observed for functional mobility (p = 0.009, SMD: 0.55 [90% CI: 0.20, 0.89], I2 = 83%), and small overall effects were found for static balance (p = 0.02, SMD: 0.35 [90% CI: 0.10, 0.60], I2 = 77%), endurance (p = 0.0001, SMD: 0.44 [90% CI: 0.25, 0.62], I2 = 0%), and flexibility (p = 0.003, SMD: 0.46 [90% CI: 0.21, 0.72], I2 = 54%) in favor of MBIs compared to IC. Small effects of strength slightly favoring AC (p = 0.08, SMD: −0.22 [90% CI: −0.43, −0.01], I2 = 52%) were found, whereas static balance moderately improved in favor of MBIs (p < 0.001, SMD: 0.46 [90% CI: 0.16, 0.76], I2 = 73%). Discussion/Conclusion: MBIs induce small to moderate effects in relevant domains of physical fitness in healthy older adults. Strength should be better targeted with traditional resistance training routines, whereas balance seems to sufficiently benefit from MBIs. However, large variability between the studies was observed due to differences in methodology, intervention content, and outcomes that affect conclusive evidence.

1.
Lutz
W
,
Sanderson
W
,
Scherbov
S
.
The coming acceleration of global population ageing
.
Nature
.
2008
;
451
(
7179
):
716
9
. .
2.
Spirduso
WW
,
Francis
KL
,
MacRae
PG
.
Physical dimensions of aging
. 2nd ed.
Champaign, IL
:
Human Kinetics
;
2005
.
3.
Katigbak
C
,
Maglalang
DD
,
Nguyen
T
,
Wang
M
,
Lo
L-C
.
Older Chinese Americans’ perspectives on physical activity: a mixed methods study
.
J Appl Gerontol
.
2020 May
;
39
(
5
):
472
80
. .
4.
Cancela
JM
,
de Oliveira
IM
,
Rodríguez-Fuentes
G
.
Effects of Pilates method in physical fitness on older adults. A systematic review
.
Eur Rev Aging Phys Act
.
2014
;
11
(
2
):
81
94
. .
5.
Lee
E-KO
,
Yoon
H
,
Lee
J
,
Yoon
J
,
Chang
E
.
Body-mind-spirit practice for healthy aging
.
Educ Gerontol
.
2012
;
38
(
7
):
473
85
. .
6.
Hall
DL
,
Luberto
CM
,
Philpotts
LL
,
Song
R
,
Park
ER
,
Yeh
GY
.
Mind-body interventions for fear of cancer recurrence: a systematic review and meta-analysis
.
Psychooncology
.
2018
;
27
(
11
):
2546
58
. .
7.
Farhang
M
,
Miranda-Castillo
C
,
Rubio
M
,
Furtado
G
.
Impact of mind-body interventions in older adults with mild cognitive impairment: a systematic review
.
Int Psychogeriatr
.
2019
;
31
(
5
):
643
66
. .
8.
Suárez-Iglesias
D
,
Miller
KJ
,
Seijo-Martínez
M
,
Ayán
C
.
Benefits of Pilates in Parkinson’s disease: a systematic review and meta-analysis
.
Medicina
.
2019
;
55
:
476
. .
9.
Taylor-Piliae
RE
,
Newell
KA
,
Cherin
R
,
Lee
MJ
,
King
AC
,
Haskell
WL
.
Effects of Tai Chi and Western exercise on physical and cognitive functioning in healthy community-dwelling older adults
.
J Aging Phys Act
.
2010
;
18
(
3
):
261
79
. .
10.
Jahnke
R
,
Larkey
L
,
Rogers
C
,
Etnier
J
,
Lin
F
.
A comprehensive review of health benefits of qigong and tai chi
.
Am J Health Promot
.
2010
;
24
(
6
):
e1
25
. .
11.
Chen
KM
,
Tseng
WS
,
Ting
LF
,
Huang
GF
.
Development and evaluation of a yoga exercise programme for older adults
.
J Adv Nurs
.
2007
;
57
(
4
):
432
41
. .
12.
Pucci
GCMF
,
Neves
EB
,
Saavedra
FJF
.
Effect of Pilates method on physical fitness related to health in the elderly: a systematic review
.
Rev Bras Med Esporte
.
2019
;
25
(
1
):
76
87
. .
13.
Wells
C
,
Kolt
GS
,
Bialocerkowski
A
.
Defining Pilates exercise: a systematic review
.
Complement Ther Med
.
2012
;
20
(
4
):
253
62
. .
14.
Sekendiz
B
,
Altun
Ö
,
Korkusuz
F
,
Akın
S
.
Effects of Pilates exercise on trunk strength, endurance and flexibility in sedentary adult females
.
J Bodyw Mov Ther
.
2007
;
11
(
4
):
318
26
. .
15.
Hutton
B
,
Salanti
G
,
Caldwell
DM
,
Chaimani
A
,
Schmid
CH
,
Cameron
C
, et al.
The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations
.
Ann Intern Med
.
2015
;
162
(
11
):
777
. .
16.
Maher
CG
,
Sherrington
C
,
Herbert
RD
,
Moseley
AM
,
Elkins
M
.
Reliability of the PEDro scale for rating quality of randomized controlled trials
.
Phys Ther
.
2003
;
83
(
8
):
713
21
. .
17.
Aibar-Almazán
A
,
Martínez-Amat
A
,
Cruz-Díaz
D
,
De la Torre-Cruz
MJ
,
Jiménez-García
JD
,
Zagalaz-Anula
N
, et al.
Effects of Pilates on fall risk factors in community-dwelling elderly women: a randomized, controlled trial
.
Eur J Sport Sci
.
2019
;
19
(
10
):
1386
94
. .
18.
Alvarenga
G
,
Charkovski
S
,
Santos
L
,
da Silva
M
,
Tomaz
G
,
Gamba
H
, et al.
The influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women: a randomized controlled trial
.
Clinics
.
2018
;
73
:
e356
. .
19.
Fourie
M
,
Gildenhuys
GM
,
Shaw
I
,
Shaw
BS
,
Toriola
AL
,
Goon
DT
.
Effects of a mat Pilates programme on muscular strength and endurance in elderly women
.
Afr J Phys Health Educ Recreat Dance
.
2012
;
18
:
296
304
.
20.
Fourie
M
,
Gildenhuys
GM
,
Shaw
I
,
Shaw
BS
,
Toriola
AL
,
Goon
DT
.
Effects of a mat Pilates program on flexibility in elderly woman
.
Med Sport Riv Fisiopatol Sport
.
2013
;
66
:
545
53
.
21.
Hyun
J
,
Hwangbo
K
,
Lee
CW
.
The effects of Pilates mat exercise on the balance ability of elderly females
.
J Phys Ther Sci
.
2014
;
26
(
2
):
291
3
. .
22.
Markovic
G
,
Sarabon
N
,
Greblo
Z
,
Krizanic
V
.
Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: a randomized-controlled trial
.
Arch Gerontol Geriatr
.
2015
;
61
(
2
):
117
23
. .
23.
Pereira
MD
,
Oliveira
R
,
Silva
M
,
Souza
L
,
Vianna
L
.
Effects of Tai Chi Chuan on knee extensor muscle strength and balance in elderly women
.
Braz J Phys Ther
.
2008
;
12
:
121
6
.
24.
de Siqueira Rodrigues
BG
,
Ali Cader
S
,
Bento Torres
NVO
,
de Oliveira
EM
,
Martin Dantas
EH
.
Pilates method in personal autonomy, static balance and quality of life of elderly females
.
J Bodyw Mov Ther
.
2010
;
14
:
195
202
.
25.
Tozim
BM
,
Navega
MT
.
Efeito do método pilates na força dos músculos inspiratórios e expiratórios em idosos
.
Rev Bras Cineantropom Desempenho Hum
.
2018
;
20
(
1
):
1
9
. .
26.
Zou
L
,
Wang
C
,
Tian
Z
,
Wang
H
,
Shu
Y
.
Effect of Yang-style Tai Chi on gait parameters and musculoskeletal flexibility in healthy Chinese older women
.
Sports
.
2017
;
5
(
3
):
52
. .
27.
Josephs
S
,
Pratt
ML
,
Calk Meadows
E
,
Thurmond
S
,
Wagner
A
.
The effectiveness of Pilates on balance and falls in community dwelling older adults
.
J Bodyw Mov Ther
.
2016
;
20
(
4
):
815
23
. .
28.
Taylor
D
,
Hale
L
,
Schluter
P
,
Waters
DL
,
Binns
EE
,
McCracken
H
, et al.
Effectiveness of Tai Chi as a community-based falls prevention intervention: a randomized controlled trial
.
J Am Geriatr Soc
.
2012
;
60
(
5
):
841
8
. .
29.
Donath
L
,
Roth
R
,
Hürlimann
C
,
Zahner
L
,
Faude
O
.
Pilates vs. balance training in health community-dwelling seniors: a 3-arm, randomized controlled trial
.
Int J Sports Med
.
2015
;
37
(
3
):
202
10
. .
30.
Frye
B
,
Scheinthal
S
,
Kemarskaya
T
,
Pruchno
R
.
Tai Chi and low impact exercise: effects on the physical functioning and psychological well-being of older people
.
J Appl Gerontol
.
2007
;
26
(
5
):
433
53
. .
31.
Ni
M
,
Mooney
K
,
Richards
L
,
Balachandran
A
,
Sun
M
,
Harriell
K
, et al.
Comparative impacts of Tai Chi, balance training, and a specially-designed yoga program on balance in older fallers
.
Arch Phys Med Rehabil
.
2014
;
95
(
9
):
1620
e30
. .
32.
Noradechanunt
C
,
Worsley
A
,
Groeller
H
.
Thai yoga improves physical function and well-being in older adults: a randomised controlled trial
.
J Sci Med Sport
.
2017
;
20
(
5
):
494
501
. .
33.
Hosseini
L
,
Kargozar
E
,
Sharifi
F
,
Negarandeh
R
,
Memari
AH
,
Navab
E
.
Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial
.
J Exerc Rehabil
.
2018
;
14
(
6
):
1024
31
. .
34.
Li
F
,
Harmer
P
,
Fisher
KJ
,
McAuley
E
,
Chaumeton
N
,
Eckstrom
E
, et al.
Tai chi and fall reductions in older adults: a randomized controlled trial
.
J Gerontol A Biol Sci Med Sci
.
2005
;
60
:
187
94
.
35.
Wolf
SL
,
O’Grady
M
,
Easley
KA
,
Guo
Y
,
Kressig
RW
,
Kutner
M
.
The influence of intense Tai chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults
.
J Gerontol A Biol Sci Med Sci
.
2006
;
61
:
184
9
.
36.
Gabizon
H
,
Press
Y
,
Volkov
I
,
Melzer
I
.
The effects of Pilates training on balance control and self-reported health status in community-dwelling older adults: a randomized controlled trial
.
J Aging Phys Act
.
2016
;
24
(
3
):
376
83
. .
37.
Lin
SF
,
Sung
HC
,
Li
TL
,
Hsieh
TC
,
Lan
HC
,
Perng
SJ
, et al.
The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people
.
J Clin Nurs
.
2015
;
24
(
9–10
):
1357
66
. .
38.
Takeshima
N
,
Islam
M
,
Kato
Y
,
Koizumi
D
,
Narita
M
,
Rogers
N
, et al.
Effects of 12 weeks of Tai Chi Chuan training on balance and functional fitness in older Japanese adults
.
Sports
.
2017
;
5
(
2
):
32
. .
39.
Zhang
JG
,
Ishikawa-Takata
K
,
Yamazaki
H
,
Morita
T
,
Ohta
T
.
The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: an intervention study for preventing falls
.
Arch Gerontol Geriatr
.
2006
;
42
(
2
):
107
16
. .
40.
Manor
B
,
Lough
M
,
Gagnon
MM
,
Cupples
A
,
Wayne
PM
,
Lipsitz
LA
.
Functional benefits of Tai Chi training in senior housing facilities
.
J Am Geriatr Soc
.
2014
;
62
(
8
):
1484
9
. .
41.
Lelard
T
,
Doutrellot
PL
,
David
P
,
Ahmaidi
S
.
Effects of a 12-week Tai Chi Chuan program versus a balance training program on postural control and walking ability in older people
.
Arch Phys Med Rehabil
.
2010
;
91
(
1
):
9
14
. .
42.
Okuyan
C
,
Bilgili
N
.
Effect of tai chi chuan on fear of falling, balance and physical self-perception in elderly: a randomised controlled trial
.
Turk Geriatri Dergisi
.
2017
;
20
:
232
41
.
43.
Song
R
,
Ahn
S
,
So
H
,
Lee
E-H
,
Chung
Y
,
Park
M
.
Effects of T’ai Chi on balance: a population-based meta-analysis
.
J Altern Complement Med
.
2015
;
21
:
141
51
.
44.
Nguyen
MH
,
Kruse
A
.
The effects of Tai Chi training on physical fitness, perceived health, and blood pressure in elderly Vietnamese
.
Open Access J Sports Med
.
2012
;
3
:
7
16
. .
45.
Sun
J
,
Kanagawa
K
,
Sasaki
J
,
Ooki
S
,
Xu
H
,
Wang
L
.
Tai chi improves cognitive and physical function in the elderly: a randomized controlled trial
.
J Phys Ther Sci
.
2015
;
27
(
5
):
1467
71
. .
46.
Deeks
J
,
Higgins
J
.
Statistical algorithms in review manager 5
.
Statistical Algorithms in Review Manager 5
.
2007
.
47.
Borenstein
M
,
Hedges
LV
,
Higgins
JP
,
Rothstein
HR
.
A basic introduction to fixed-effect and random-effects models for meta-analysis
.
Res Synth Methods
.
2010
;
1
(
2
):
97
111
. .
48.
Cohen
J
.
Statistical power analysis for the behavioral sciences
. 2nd ed. reprint.
New York, NY
:
Psychology Press
;
2009
.
49.
Son
NK
,
Ryu
YU
,
Jeong
HW
,
Jang
YH
,
Kim
HD
.
Comparison of 2 different exercise approaches: Tai Chi versus Otago, in community-dwelling older women
.
J Geriatr Phys Ther
.
2016
;
39
(
2
):
51
7
. .
50.
Weber
M
,
Schnorr
T
,
Morat
M
,
Morat
T
,
Donath
L
.
Effects of mind-body interventions involving meditative movements on quality of life, depressive symptoms, fear of falling and sleep quality in older adults: a systematic review with meta-analysis
.
Int J Environ Res Public Health
.
2020
;
17
(
18
):
6556
.
51.
Sañudo
B
,
de Hoyo
M
,
McVeigh
JG
.
Improved muscle strength, muscle power, and physical function after flywheel resistance training in healthy older adults: a randomized controlled trial
.
J Strength Cond Res
.
2020 Feb 7
;
1
.
52.
Vikberg
S
,
Sörlén
N
,
Brandén
L
,
Johansson
J
,
Nordström
A
,
Hult
A
, et al.
Effects of resistance training on functional strength and muscle mass in 70-year-old individuals with pre-sarcopenia: a randomized controlled trial
.
J Am Med Dir Assoc
.
2019
;
20
(
1
):
28
34
. .
53.
Giboin
LS
,
Gruber
M
,
Kramer
A
.
Task-specificity of balance training
.
Hum Mov Sci
.
2015
;
44
:
22
31
. .
54.
Franco
MR
,
Grande
GHD
,
Padulla
SAT
.
Effect of Pilates exercise for improving balance in older adults (PEDro synthesis)
.
Br J Sports Med
.
2018
;
52
(
3
):
199
200
. .
55.
Liu
H
,
Frank
A
.
Tai chi as a balance improvement exercise for older adults: a systematic review
.
J Geriatr Phys Ther
.
2010
;
33
(
3
):
103
9
.
56.
Chen
PY
,
Wei
SH
,
Hsieh
WL
,
Cheen
JR
,
Chen
LK
,
Kao
CL
.
Lower limb power rehabilitation (LLPR) using interactive video game for improvement of balance function in older people
.
Arch Gerontol Geriatr
.
2012
;
55
(
3
):
677
82
. .
57.
Hopkins
DR
,
Murrah
B
,
Hoeger
WW
,
Rhodes
RC
.
Effect of low-impact aerobic dance on the functional fitness of elderly women
.
Gerontologist
.
1990
;
30
(
2
):
189
92
. .
58.
Geweniger
V
,
Bohlander
A
.
Pilates in der Prävention: Grundlagen
. In:
Das Pilates-Lehrbuch
.
Berlin, Heidelberg
:
Springer
;
2016
. p.
19
60
.
59.
Bueno de Souza
RO
,
Marconde
LF
,
ASF de
A
,
Luciano Pontes Junior
F
,
de Melo
RC
.
Effects of mat Pilates on physical functional performance of older adults: a meta-analysis of randomized controlled trials
.
Am J Phys Med Rehabil
.
2018
;
97
:
414
25
.
60.
Gatts
S
.
A Tai Chi Chuan training model to improve balance control in older adults
.
Curr Aging Sci
.
2008
;
1
(
1
):
68
70
. .
61.
Chen
S
.
Effect of Tai Chi exercises on the balance, functional gait, and flexibility of elderly Filipino males
.
Proceedings of the 2nd symposium on health and education 2019 (SOHE 2019)
.
Wuhan, China
:
Atlantis Press
;
2019
.
62.
Villarreal
DJ
,
Poonawala
HA
,
Gregg
RD
.
A robust parameterization of human gait patterns across phase-shifting perturbations
.
IEEE Trans Neural Syst Rehabil Eng
.
2017
;
25
(
3
):
265
78
. .
63.
Sanchis-Sanchis
R
,
Blasco-Lafarga
C
,
Encarnación-Martínez
A
,
Pérez-Soriano
P
.
Changes in plantar pressure and spatiotemporal parameters during gait in older adults after two different training programs
.
Gait Posture
.
2020
;
77
:
250
6
. .
64.
Giboin
LS
,
Gruber
M
,
Kramer
A
.
Task-specificity of balance training
.
Hum Mov Sci
.
2015
;
44
:
22
31
. .
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