Therapeutic Exercise for Hospitalized Sarcopenic Patients: A Systematic Review and Meta-Analysis

Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an impairment of functional status, increasing dependency and mortality. The high prevalence among hospitalized patients has increased interest in active interventions such as exercise; however, the effectiveness of therapeutic exercise in this population remains unclear. This systematic review with a meta-analysis aims to evaluate the effectiveness of therapeutic exercises in hospitalized patients diagnosed with or at risk of sarcopenia. A systematic search was conducted in Medline, Web of Science, and Scopus databases following PRISMA guidelines. Randomized controlled trials assessing therapeutic exercises for sarcopenic or at-risk hospitalized patients were included. Methodological quality was evaluated using the TIDieR Checklist and the ROB2 tool. We performed a meta-analysis addressing muscle strength, physical performance and cognitive function. Six studies met the inclusion criteria, with a total of 1468 participants. Similar interventions were observed, including mainly resistance and balance exercises. Therapeutic exercises demonstrated significant improvements in physical performance (2.98 (1.13-4.83); p = 0.002; I² = 99%), muscle strength (2.11 (0.20-4.01); p = 0.03; I² = 99%) and cognitive function (0.77 (0.25-1.29); p = 0.004; I² = 98%) across several studies. Therapeutic exercises appear to improve sarcopenic outcomes in hospitalized patients, supporting their role as a non-pharmacological intervention to mitigate sarcopenia-related complications. However, due to the lack of reported muscle mass outcomes, as well as the limited number and methodological quality of the included studies, further well-designed trials are needed to confirm these findings.