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Attention to principles of training and exercise prescription in systematic reviews of exercise for functional performance in older adults: an umbrella review
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Date
2026-01-16
Abstract
Background Exercise interventions are essential for maintaining functional independence in older adults, with systematic reviews guiding evidence-based practice. However, implementing these interventions requires detailed information about exercise parameters, progression strategies, and contextual adaptations that extend beyond basic intervention descriptions. The adequacy of systematic reviews in providing this practice-essential information remains unevaluated. We examined systematic reviews’ attention to exercise training principles, FITT-VP components, and implementation context in interventions for functional performance in community-dwelling older adults. Methods Six databases were searched for systematic reviews of exercise interventions published 2014–2024. Two reviewers independently screened studies and extracted data on FITT-VP components (Frequency, Intensity, Time, Type, Volume, Progression), fundamental exercise principles (specificity, overload, individualisation, reversibility, variation), and implementation context (setting adaptability, equipment, supervision, safety, adherence). Quality was assessed using the JBI critical appraisal tool. Results Twenty five systematic reviews met inclusion criteria. While reporting of frequency (23/25, 92%) and type (19/25, 76%) were well-reported, critical parameters showed deficiencies in terms of complete reporting: intensity (6/25, 24%), time (11/25, 44%), volume (9/25, 36%), and progression (0/25 0%). Exercise principles received minimal attention in terms of specificity (2/25, 8% complete), individualisation (1/25, 4%), and overload (1/25, 4%). Diminishing returns were not discussed. Implementation context showed poorest reporting with equipment requirements (11/25, 44% complete), supervision protocols (2/25, 8%), and safety considerations (0/25, 0% complete). No review (25/25) considered the alignment of component-based interventions with integrated functional assessments. Temporal analysis revealed no improvement between pre-2020 reviews (n = 6, mean 4.2 complete items, 23%) and post-2020 reviews (n = 19, mean 3.4 complete items, 19%). Methodological quality (JBI scores) inversely correlated with reporting completeness (ρ = − 0.379, p = 0.062). Sensitivity analysis excluding four partially eligible reviews confirmed all findings were robust (largest change 5.9%). Conclusions Systematic reviews of exercise interventions for older adults demonstrate incomplete reporting of information necessary for implementation. Substantial gaps exist in progression protocols, training principles, and implementation context. Limited discussion of relationships between intervention approaches and functional assessments may contribute to challenges in translating research to practice. Enhanced reporting standards would
benefit the field.
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Description
Publisher
Springer Nature
Citation
Systematic Reviews 15(72)
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Funding Information
Sustainable Development Goals
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License
Attribution-NonCommercial-ShareAlike 4.0 International