Effectiveness of tele-exercise on muscle function and physical performance in older adults for preventing sarcopenia: A protocol for systematic review
Authors: Shi Ya , Stanmore Emma , McGarrigle Lisa , Todd Chris 
Published: March 2024

ABSTRACTIntroductionSarcopenia is characterized by the progressive weakening of muscle function that occurs with age. This condition frequently leads to frailty, disability, and even death. Research on sarcopenia prevention is growing. Tele-exercise intervention is increasingly gaining attention in this field, with the rapid advancement of the Internet and the influence of the COVID-19. However, there is a lack of empirical support for its effectiveness. Our study aims to assess the effect of tele-exercise on sarcopenia in older persons, specifically focusing on its ability to improve muscle strength, muscle mass and physical performance.Methods and analysisSearching will be performed in the following eleven databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, WOS, Scopus, CBM, CNKI, WANFANG, VIP) for published trials and two trial registries (Clinicaltrials.govand the WHO International Clinical Trials Registry Platform) for unpublished trials. Google Scholar will be utilized to find grey literatures. The criterion of inclusion will be clinical trials involving tele-exercise interventions in older adults (≥ 60y) diagnosed with sarcopenia (possible, confirmed, or severe sarcopenia). For data synthesis, we will utilize a summary table to show the major characteristics of selected trials and a summary graph to demonstrate the risk of bias using RoB 2 in each trial, which will be further discussed in a narrative synthesis. The possibility of meta-analysis for quantitative data will be assessed according to the homogeneity analysis of the trials, using the methods of fixed or random effects model. If meta-analysis is possible, subgroup analysis and sensitivity analysis will be performed as well. Publication bias will be assessed through the use of the funnel plot and Egger’s linear regression test when an adequate number of trials are available. Finally, the GRADE approach will be used to classify the certainty of evidence body into four categories (high, moderate, low, and very low).Ethics and disseminationThe findings of the systematic review will be shared through publishing in a peer-reviewed journal and presentation at appropriate conferences. Since we will not be utilizing specific patient data, ethical approval is unnecessary.PROSPERO registration numberCRD42024516930Strengths and limitations of this study-This will be the first systematic review on tele-exercise for sarcopenia prevention in older adults.-This review will seek to determine the duration, frequency, intensity and type of tele-exercise that is most appropriate for preventing and treating sarcopenia.-The results may fill the gap pertaining to accurate tele-exercise prescription in older adults with sarcopenia.-This review will adhere to the PRISMA standards for conducting and reporting systematic reviews and meta-analyses in order to reduce bias.-High heterogeneity may exist due to the different diagnostic criteria and thresholds for sarcopenia.