Design: Systematic review and meta-analysis of randomised trials
Population: 15 RCTs, 438 older adults
Primary outcome: Lower-limb muscle strength
Effect: SMD 0.50 (95% CI 0.12 to 0.87); explosive power SMD 0.39

A meta-analysis pooled 15 randomised trials with 438 older adults testing eccentric overload training, in which muscles work hardest while lengthening, often on flywheel devices, published in August.

Training improved lower-limb strength (standardised mean difference 0.50, 95% CI 0.12 to 0.87) and explosive power (SMD 0.39, 0.07 to 0.71). Against conventional resistance training it was at least comparable. Exploratory analyses suggested flywheel devices did best, programmes of eight weeks or more gave larger gains, and more frequent sessions favoured strength while fewer favoured power. The abstract does not report results for gait or balance.

The trials were small, and the subgroup findings are exploratory.

For older adults who find conventional heavy lifting difficult, eccentric work such as slow lowering into a chair or controlled stair descent is a practical way to build leg strength, and can be done without equipment.

Include eccentric exercises, such as slow sit-to-stand lowering, in strength programmes for older adults.
Plan programmes of at least eight weeks for meaningful gains.
Use more frequent sessions when strength is the goal.
Combine strength work with balance training for falls prevention.

Why it matters

Leg strength and power are what keep older adults rising from chairs and catching themselves before a fall.

The statistics, in plain English

A standardised mean difference of 0.50 is a moderate effect. Trials with 438 participants in total are small, so the subgroup comparisons on device, frequency and duration are hypothesis-generating.