The Effects of Combined Training on Functionality, Balance, and Gait Speed of the Elderly: A Systematic Review and Meta-analysis

Background: Ensuring the safety and functional independence of older people is becoming increasingly important. Fall-prevention guidelines emphasize the use of highly challenging training modalities to reduce fall risk. Therefore, this systematic review and meta-analysis examined the effects of combined training (CT) on functionality, balance, and gait speed in older adults.Methods: A systematic search was conducted in four electronic databases—PubMed, SCOPUS, Cochrane Central, and Web of Science—from inception to June 2, 2024. Standardized mean differences (SMDs), weighted mean differences (WMDs), and 95% confidence intervals (CIs) were calculated using fixed- or random-effects models, depending on heterogeneity.Results: Twelve studies involving 570 participants met the inclusion criteria. Meta-analysis indicated that CT significantly improved functionality (SMD = 0.64; 95% CI: 0.34–0.93; p = 0.003), balance (SMD = 0.65; 95% CI: 0.39–0.90; p = 0.001), and gait speed (SMD = 1.18; 95% CI: 0.76–1.59; p = 0.001). Furthermore, CT was superior to traditional training (TT) in enhancing functionality (SMD = 0.50; 95% CI: 0.28–0.73; p = 0.001).Conclusion: This meta-analysis demonstrates that combined training has a significant positive effect on functionality, balance, and gait speed in older adults. Compared with traditional training, CT yields greater improvements in functional performance. Therefore, CT is an effective and practical method for enhancing physical function and mobility in older people.