Effectiveness of home-based exercise interventions in the management of Sarcopenia in older adults: a systematic review of randomized controlled trials

Background Sarcopenia involves the age-related loss of skeletal muscle mass, strength, and function, severely reducing independence in older adults. While exercise is the primary management strategy, home-based exercise interventions offer a highly accessible, cost-effective, and sustainable alternative for long-term rehabilitation. This review evaluates how effectively home-based exercise programs combat sarcopenia and improve physical performance in older adults. Methods This review follows the PRISMA guidelines and was registered in PROSPERO. A comprehensive search was performed in PubMed, ScienceDirect, PEDro and Cochrane databases for randomized controlled trials (RCTs), published in English language between January 2016 to 28 February 2026. Eligible studies focused on older adults diagnosed with sarcopenia who received home-based exercise interventions, either alone or combined with other treatments. Extracted data were quality-assessed using the Cochrane risk-of-bias tool and the PEDro scale. Results A total of 12 RCTs involving 928 participants (513 in the intervention group and 415 in the control group) were included. The included studies demonstrated moderate-to-good methodological quality. While selection, attrition, and reporting biases were generally low across trials, performance bias was high due to the unfeasibility of participant blinding in exercise interventions, and minor concerns were present regarding allocation concealment. Home- based exercise interventions, particularly multicomponent programs predominantly incorporating resistance training and typically delivered for approximately 12 weeks, were generally associated with improvements in muscle strength,, physical performance including balance, and quality of life. Findings related to muscle mass and body composition were inconsistent across studies. However, substantial variation in sarcopenia diagnostic criteria, intervention protocols, outcome measures and follow- up periods limited direct comparison of findings and quantitative synthesis. Conclusion The available evidence suggests that home-based exercise, particularly resistance-focused and multicomponent programs, may improve physical and functional outcomes in older adults with sarcopenia. However, the heterogeneity of existing evidence and lack of standardized intervention protocols limit definitive conclusions regarding treatment effectiveness. Well- designed, adequately powered studies using standardized diagnostic criteria, intervention protocols and outcome measures are still needed to establish definitive clinical recommendations.