Search Results (139)

Background: The timing of perceived exertion assessment within a resistance training set may influence physiological adaptation; this study aimed to directly compare first-repetition (RPE-1) and last-repetition (RPE-last) monitoring strategies applied to functional, neuromuscular, body composition, and cardiometabolic adaptations during elastic band resistance training in older adults. Methods: Forty sedentary older adults (n = twenty per group, sex-balanced) were randomly assigned to RPE-1 or RPE-last using the OMNI-RES elastic band scale during a 16-week, open-label high-intensity elastic band resistance training program, with blinded outcome assessment and data analysis; three withdrew during the intervention (RPE-1, n = 2; RPE-last, n = 1), and all forty randomized participants were retained in the intention-to-treat analysis via baseline carry-forward. Functional capacity, isokinetic knee and elbow strength (60 and 180°/s), DXA-assessed body composition, and fasting cardiometabolic biomarkers were evaluated pre- and post-intervention. Between-group effects were analyzed using ANCOVA with Benjamini–Hochberg false discovery rate (FDR) correction, whereas functional equivalence was assessed using Welch-corrected two one-sided tests (TOST) with percentile bootstrap against published minimum clinically important difference (MCID) margins. Results: Both groups improved significantly across most outcomes. For the primary outcomes, RPE-1 was associated with greater improvements across all eight isokinetic strength conditions after FDR correction, with adjusted between-group differences ranging from +7.86 to +18.38 Nm in favor of RPE-1, and all 95% CIs excluding zero (ηp² = 0.14–0.37). The Welch-corrected TOST demonstrated functional equivalence between monitoring strategies for all four functional outcomes in the primary intention-to-treat analysis. However, the pre-specified complete-case sensitivity did not confirm equivalence in the 30-Second Chair Stand Test, indicating that this outcome was sensitive to the handling of missing data. Among secondary exploratory outcomes, RPE-1 also was associated with greater improvements in DXA-assessed fat mass (adjusted difference—−1.33 kg; 95% CI—−2.02 to −0.63; ηp² = 0.29) and lean mass (+0.42 kg; 95% CI—0.02 to 0.83; ηp² = 0.11), high-density lipoprotein cholesterol (+5.11 mg/dL; 95% CI—1.52 to 8.69; ηp² = 0.18), and low-density lipoprotein cholesterol (−16.99 mg/dL; 95% CI—−23.22 to −10.76; ηp² = 0.45). Conclusion: RPE-1 appeared to confer greater benefits for maximizing neuromuscular strength, whereas RPE-last provides an equally valid alternative when preserving physical independence is the primary objective. Full article

Background: Hematologic malignancies (HMs) represent a growing global health burden, and HSCT remains a cornerstone of treatment for many HMs. Despite improvements in survival, transplantation-related physical deconditioning is a persistent clinical challenge, and evidence supporting structured inpatient exercise interventions is scarce. Objectives: To evaluate the effects of a self-directed aerobic exercise program on a cycle ergometer in inpatients under isolation precautions related to HSCT. Methods: In this single-center prospective, non-randomized controlled interventional study, 73 patients were enrolled in an intervention group (n = 43) performing daily aerobic exercise on a cycle ergometer, or a control group (n = 30) receiving standard care. Physical performance was assessed at baseline and at discharge using the 6-min walk test (6 MWT), Timed Up and Go test (TUG), and 30-s chair stand test (30 s-CST). Results: Significant group-by-time interactions were observed for the TUG (F(1,71) = 10.35; p = 0.001; ηp² = 0.13) and the 30 s-CST (F(1,71) = 21.61; p < 0.0001; ηp² = 0.23). No significant interaction was detected for the 6 MWT (F(1,71) = 2.01; p = 0.16; ηp² = 0.03), although the decline in walking distance was smaller in the intervention group than in the control group (−4.1% vs. −10.5%). Post hoc analyses demonstrated significant within-group deterioration only in the control group. Conclusions: Self-directed aerobic exercise during inpatient isolation may mitigate physical deconditioning in HSCT recipients, supporting its integration into routine care. Full article

This study investigated the effects of an 8-week Square-Stepping Exercise (SSE) program on lower-extremity muscle function and cognitive function in pre-frail older women. Sixty pre-frail older women aged 65 years and older were assigned to either an exercise group (n = 30) or a control group (n = 30). The SSE program was performed twice weekly for 60 min over 8 weeks. Functional mobility was assessed using the Time Up and Go (TUG) test, balance using the Berg Balance Scale (BBS), lower-extremity muscle strength using the 30 s Chair Stand Test, and cognitive function using the Mini-Mental State Examination (MMSE). Measurements were obtained at baseline, week 4, and week 8. Significant group × time interactions were observed for TUG (p < 0.001), lower-extremity muscle strength (p < 0.05), and MMSE (p < 0.001). The exercise group showed significant improvements in TUG, BBS, muscle strength, and MMSE values, whereas the control group showed no significant changes except for a slight change in TUG. TUG was significantly correlated with balance, muscle strength, and cognitive function. These findings suggest that an 8-week SSE program may improve selected physical function measures and global cognitive status, as assessed by the MMSE, in pre-frail older women. Full article

Background: The objective of this study was to compare the effects of bisphosphonates and denosumab on sarcopenia-related parameters, contributing to a better understanding of osteosarcopenia management. Methods: This cross-sectional, comparative study assessed physical performance, muscle strength, muscle mass, and sarcopenia category in postmenopausal women aged 65 to 80 years with osteoporosis who were receiving either bisphosphonates or denosumab. Additional groups consisted of untreated osteoporotic patients and controls without osteoporosis (n = 50 per group). Muscle mass was assessed using bioelectrical impedance analysis, and the classification of sarcopenia was assessed according to the EWGSOP2 criteria. Results: Among the osteoporotic groups, the 4 m walking speed, 5-chair stand test, and timed up-and-go performance did not differ significantly, although denosumab-treated patients had numerically shorter completion times. Nondominant handgrip strength was the only grip parameter showing a significant between-group difference (p = 0.026), mainly due to higher values in denosumab-treated patients than in untreated osteoporotic patients; dominant and maximum handgrip strength were comparable. Skeletal muscle mass was higher in the denosumab group than in both the bisphosphonate-treated and untreated osteoporosis groups (p = 0.045), whereas ALM, ASM, and the ASMI did not differ significantly. No statistically significant between-group differences were observed in SARC-F scores or sarcopenia classifications. Controls had significantly higher odds of sarcopenia absence compared with untreated osteoporotic patients, and treatment duration was not correlated with sarcopenia-related parameters. Conclusions: These findings suggest a favorable but limited association between denosumab treatment and selected muscle-related parameters. Prospective longitudinal studies are needed to determine whether anti-osteoporotic therapies influence osteosarcopenia. Full article

This study investigated whether baseline sleep quality influences the effects of a 12-week multicomponent exercise program on sleep quality and physical function in community-dwelling older adults. Twenty-five older adults were classified according to baseline sleep quality using the Pittsburgh Sleep Quality Index into a Good Sleep (GS, n = 8) group and a Poor Sleep (PS, n = 17) group. The exercise program was performed three times per week for 12 weeks, with each 60 min session consisting of warm-up, multicomponent exercise, and cool-down. Outcome measures included sleep quality (PSQI), physical performance assessed by the Short Physical Performance Battery, and health-related fitness tests. A significant group × time interaction was observed for PSQI total score (p = 0.035). The PS group showed a significant reduction in PSQI score (−1.71 points, p < 0.01), indicating improved sleep quality, with favorable changes in subjective sleep quality, sleep latency, use of sleeping medication, and daytime dysfunction. However, the PS group demonstrated significant improvements in gait speed, grip strength, and 2 min walking performance. A significant group × time interaction was observed for the 30 s chair stand test (p = 0.011), with the GS group showing greater improvements in lower-extremity muscular endurance. Baseline sleep quality was associated with the pattern of adaptation to multicomponent exercise. Older adults with poor sleep quality experienced meaningful improvements in sleep, whereas those with good sleep quality showed greater gains in muscular endurance. These findings support the inclusion of sleep assessment when designing individualized exercise interventions for older adults. Full article

Individuals with type 2 diabetes mellitus (T2D) are at increased cardiovascular risk. Although exercise is an important strategy for reducing cardiometabolic risk, accessible and scalable intervention delivery strategies, such as synchronous telehealth programs, remain underexplored. This randomized clinical trial (RED Study; NCT05362071) investigated the effects of a 12-week synchronous telehealth exercise program on clinical, functional, and psychosocial outcomes in adults with T2D. Thirty-three participants (55.8 ± 10.1 years) were randomized to an intervention group (INT; n = 17), which performed supervised combined aerobic and resistance exercise via video calls (2–3 sessions/week), or a control group (CON; n = 16). Glycated hemoglobin (HbA1c) was the primary outcome. Secondary outcomes included capillary blood glucose, blood pressure, functional performance, and psychosocial parameters. Assessments were conducted at baseline and post-intervention by blinded evaluators, and analyses were conducted using linear mixed-effects models in an intention-to-treat analysis. No significant interaction effect was observed for HbA1c (p > 0.05). However, significant group × time interactions favored the INT for functional performance outcomes, including the 30 s Chair Stand (p = 0.02), Arm Curl (p < 0.001), Timed Up and Go (p = 0.01), and 2-Minute Step Test (p = 0.01), as well as sleep quality (p < 0.001). Depressive symptoms decreased over time (p = 0.03) in both groups. Additionally, the INT showed reductions in post-session capillary blood glucose across mesocycles 1, 2, and 4 (p = 0.03). The synchronous telehealth exercise program was not superior to the control condition in reducing HbA1c; however, it improved functional performance, enhanced sleep quality, and promoted acute reductions in glycemic levels in individuals with T2D. Full article

Background/Objectives: Determination of baseline predictors of longer-term quality of life (QOL) after autologous hematopoietic stem cell transplantation (Auto-HSCT) may identify patients with the greatest supportive care needs. We hypothesized that baseline older age, weight loss, and worse functional performance would negatively predict QOL over two years post-HSCT. Methods: Physical function, body composition, and QOL were assessed before (PRE) and one month (1MO) after Auto-HSCT in U.S. Veterans (N = 23). QOL and survival were also assessed approximately every six months for two years after Auto-HSCT (5MO, 1YR, 1.5YR, and 2YR). Changes over time were tested via Generalized Estimating Equation regression analyses (p < 0.05 = significant). The impact of PRE variables on QOL at each follow-up was tested via Spearman’s correlations (p < 0.01 = significant). Results: Relative to PRE, depression and anxiety significantly improved (p ≤ 0.039) at 1MO while fatigue and vitality significantly worsened (p ≤ 0.024) 1MO to 5MO post-HSCT. Vitality, depression, and anxiety returned to PRE levels thereafter, while fatigue trajectory varied depending on the survey used. Bone-Marrow-Transplant-related QOL significantly improved at 5MO (p = 0.014) while self-reported function (p ≤ 0.021) and physical activity (p ≤ 0.045) significantly improved 1-2YR post-HSCT. Greater PRE 30 s chair stand test performance consistently correlated with better self-reported function 1-2YR (r = 0.76–0.91, p ≤ 0.007) post-HSCT. Greater PRE 6 min walk test performance consistently correlated with better symptom burden 1-2YR (r = 0.71–0.81, p ≤ 0.01) post-HSCT. Conclusions: In support of our hypothesis, baseline functional performance was associated with QOL during two years of recovery after Auto-HSCT; older age and recent weight loss at baseline only predicted worse baseline QOL. Our data indicates that evaluation of the 30 s chair stand and 6 min walk tests as rehabilitation targets and/or predictors of QOL, fitness, or mortality after Auto-HSCT are warranted. Larger, controlled studies are needed to confirm the findings from this exploratory analysis. Full article

Background: Maximal isometric co-contraction (MICC) of upper-limb muscles enhances strength and size, but its effects on lower-limb function are unknown. The aim of this study was to examine whether MICC training targeting the lower limbs can improve muscular strength and functional performance in sedentary adults. Methods: Twenty sedentary individuals (10 men, 10 women; 48.5 ± 7.5 years; BMI = 24.8 ± 4.2 kg/m²) were randomly assigned to either an experimental (EXP) or control (CON) group. The EXP group performed MICC of the knee flexors and extensors three times per week for four weeks, completing three sets of 5–10 maximal effort 3 s contractions per session. Assessments conducted pre- and post-intervention included the isometric mid-thigh pull (IMTP), 3-m timed up and go (TUG), and 30 s chair stand (CS) tests. Results: Significant time (p < 0.001) and time × group (p < 0.001) effects were found for all outcomes. Compared with CON, the EXP group showed greater improvements in IMTP peak force (p < 0.001, g = 1.80), faster TUG times (p < 0.001, g = 2.73), and more CS repetitions (p < 0.001, g = 3.90). Conclusions: Twelve sessions of MICC training improved maximal strength and functional performance in sedentary adults. This simple, equipment-free method may be particularly useful for individuals with limited access to conventional exercise facilities or supervision. Full article

Background: Persistent pain, neuropathic symptoms, dyspnea, and impaired quality of life are common components of post-COVID syndrome. However, the long-term trajectory of these symptoms and the factors associated with persistent pain remain incompletely understood. Methods: This longitudinal cohort study included 80 patients previously hospitalized with COVID-19. Participants were evaluated at approximately 1, 4, and 8 months after discharge. Pain severity was assessed using the Visual Analog Scale (VAS), neuropathic symptoms using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, dyspnea using the modified Medical Research Council (mMRC) scale, functional limitation using the Post-CO9VID Functional Status (PCFS) scale, and health-related quality of life using the EQ-5D-5L and EQ-VAS scales. Functional performance was additionally assessed using the 30 s chair stand test and the Modified Borg Scale. Multivariable linear regression and logistic regression analyses were performed to identify predictors of reduced quality of life and persistent pain at 8 months. Results: A total of 80 patients were included in the study. Median VAS score decreased from 3.0 (0–6) at 1 month to 0 (0–0) at 4 months and 1 (0–1) at 8 months (p < 0.001). Median LANSS score decreased from 0 (0–2) at 1 month to 0 (0–0) at 4 and 8 months (p < 0.001), while the proportion of patients with LANSS ≥ 12 declined from 11.3% to 2.5%. EQ-5D index scores improved from 0.81 (0.72–0.91) to 0.93 (0.88–0.96) during follow-up (p < 0.001). Dyspnea severity, exertional symptoms, and functional limitation also improved significantly over time. Most of the clinical recovery occurred between the 1-month and 4-month evaluations, although smaller but significant improvements continued until 8 months for pain severity, functional performance, and quality-of-life measures. Older age, baseline dyspnea, anxiety, and higher baseline LANSS scores were independently associated with lower EQ-VAS scores at 8 months, whereas only higher baseline LANSS scores remained independently associated with persistent pain. Conclusions: Patients hospitalized with COVID-19 experience persistent pain, dyspnea, neuropathic symptoms, and reduced quality of life during follow-up, although most symptoms improve substantially over time. Early neuropathic symptom burden and baseline dyspnea may help identify patients at risk of poorer long-term recovery, although the associations should be interpreted cautiously. Full article

Background: Fibromyalgia is a chronic condition characterized by a complex array of symptoms that impact multiple domains, including physical, psychological, and social aspects of an individual’s well-being. Although home-based adapted physical activity (HAP) interventions represent a promising strategy to improve health-related physical fitness (PF), studies on the topic are still lacking and further research is required. The objective of the present study was to evaluate the impact of participation in a 12-week HAP intervention on health-related PF in adult women with fibromyalgia syndrome (FS). Methods: Participants were women with fibromyalgia (n = 29; 47.1 ± 9.5 yrs) assigned to the 12-week HAP program (n = 17) or wait-list control group (n = 12). Participants completed two weekly circuit-training sessions delivered through an online platform. PF components were assessed through a standardized test battery: 30-s chair stand (lower-body strength), arm curl (upper-body strength), 2-min step (cardiorespiratory fitness), back scratch (flexibility) and 8-foot up-and-go test (agility and balance). Three time-point evaluations were planned: at baseline (T0), after 6 weeks (T1), and after 12 weeks (T2). Linear mixed models were used, and partial eta-squared (η²p) effect sizes were calculated. Results: A significant time × group interaction emerged for upper body strength (p = 0.001; η²p = 0.404), agility (p < 0.001; η²p = 0.569) and cardiorespiratory fitness (p = 0.009, η²p = 0.292). Specifically, from baseline to 12 weeks, the experimental group improved in the arm-curl test (from 15.8 ± 4.5 to 18.9 ± 5.0 repetitions), agility (from 6.6 ± 1.5 to 5.2 ± 1.1 s), and cardiorespiratory fitness (from 69.1 ± 18.8 to 77.2 ± 21.1 repetitions), while the control group showed no meaningful changes. Conclusions: The participation in a 12-week HAP intervention had a positive impact on different components of PF in women with FS, which may have implications for greater physical autonomy and well-being. Full article

Japan is a super-aged society where community group multicomponent exercise is widely implemented, yet the age at which a fixed, low-frequency exercise dose no longer offsets functional decline is unclear. We examined 6-year trainability and explored “zero-change” ages in frail older women. Twenty community-dwelling frail women (80–86 years) participated in a once-weekly 90 min multicomponent exercise program for 6 years. Nine physical tests were assessed at baseline (Pre), 6 months, and annually. Overall time effects were tested using repeated-measures ANOVA and generalized estimating equations, with planned paired t-tests versus Pre. Age-specific annual percent changes (%/year) from Pre to each follow-up were annualized, grouped by age at follow-up (81–91 years), and tested against 0%/year. Separately, regression analyses related age to annual percent change across seven consecutive intervals to estimate “zero-change age” (predicted change = 0%). Time effects were significant for all nine measures (all p ≤ 0.032). Chair stand, 10 m fast/zigzag walk, supine-to-stand, maximal 5-step length, and 10-times knee lift generally improved in the early follow-up, whereas handgrip strength and sit-and-reach declined over time. In 6/9 tests, annual percent change diminished with advancing age; estimated zero-change ages ranged from ≈82 years (maximal 5-step length) to ≈88 years (chair stand and one-leg stance). Attendance remained high (≈90%). In this single-arm community program, several mobility-related functions improved or were maintained in frail women in their early 80s, whereas reduced trainability beyond the mid-80s may limit further protection. Threshold ages are exploratory statistical estimates; controlled trials are warranted. Full article

Background: Sarcopenia is defined by decreased muscle strength along with low muscle quantity or quality. The assessment of muscle strength may be performed by grip strength test or chair stand test (CST) and both of these tests are treated as equivalent tools for assessing muscle strength. Heart failure with preserved ejection fraction (HFpEF) contributes to the progression of sarcopenia, and it is left ventricular diastolic dysfunction (LVDd) which primarily leads to the development of HFpEF. The aim of this study was to examine the relationship of muscle strength with echocardiographic parameters of LVDd in patients with CKD and eGFR ≤ 29 mL/min/1.73 m² not treated with dialysis. Methods: The study samples consisted of 46 men with CKD stages G4–G5 not treated with dialysis: 23 participants with HGS < 27 kg and 23 individuals with HGS ≥ 27 kg. The assessment of muscle strength was provided by the hand grip strength (HGS) test and the five-times sit-to-stand test (FTSST). Transthoracic echocardiography was performed with the use of a convex probe in conjunction with a Logiq P6 ultrasound system. Results: In G4–G5 CKD patients, upper limb muscle strength did not correspond to lower limb muscle strength. Participants with prolonged FTSST had a lower mean value of septal e’ and higher mean E/e’ compared to individuals with correct both HGS and FTSST. Participants with correct HGS and prolonged FTSST had the lowest mean left ventricular ejection fraction (LVEF), as well as the lowest mean tricuspid annular plane systolic excursion (TAPSE). Conclusions: In G4–G5 CKD patients not treated with dialysis, HGS and FTSST are not equivalent and should not be used interchangeably. In this population, decreased muscle strength is associated with LVDd and FTSST is more sensitive than HGS in the prediction of LVDd. Low muscle strength is also associated with systolic function of the left and right ventricle in G4–G5 CKD patients not treated with dialysis. Full article

The current study investigated proximal femur bone shape asymmetry and its associations with cartilage composition and functional performance in individuals with hip osteoarthritis (OA). Forty-seven participants with hip OA (mean age: 53.77 ± 12.47 years; 22 females; BMI: 24.49 ± 4.0 kg/m²) were included in this study. Bilateral hip MRI was performed using a 3.0 T MR scanner with 3D proton density fat-saturated CUBE and MAPSS sequences. Automatic segmentation of the proximal femur was achieved using a U-Net framework refined through a human-in-the-loop annotation strategy, followed by three-dimensional bone shape analysis to quantify asymmetry. Cartilage relaxation times were assessed using atlas-based segmentation and quantification, while functional activity was evaluated according to OARSI-recommended criteria. The proposed proximal femur bone segmentation showed a DSC of 96.48% (95%-CI: 96.33–96.64) and Hausdorff Distance of 4.66 mm (95%-CI: 3.80–5.51). Increased bone shape asymmetry in the posterior–lateral–superior region of the proximal femur was associated with functional activity in the chair stand test (rho = −0.41; p = 0.006), and the anterior–lateral–inferior region demonstrated a comparatively higher significant positive correlation ($\mathrm{rho}=0.37$; p = 0.006) with the ${\mathrm{T}}_{1\mathrm{rho}}$values of the acetabular cartilage region. Overall, the findings indicate that region-specific proximal femoral bone shape asymmetry in hip OA is associated with cartilage characteristics and functional impairment, highlighting the potential value of bone shape features as imaging biomarkers relevant to clinical function. Full article

Background/Objectives: Specific pharmacological osteoporosis therapy (SPOT) is regarded as a key intervention to reduce fracture risk and improve musculoskeletal function. Real-life data, particularly regarding functional muscular outcomes and pain trajectories, remain limited. This study aimed to longitudinally analyze bone mineral density, laboratory parameters, handgrip strength, functional performance, and pain symptoms under guideline-based SPOT. Methods: In this monocentric prospective real-life observational study, 178 patients (80.9% women; median age 82 years) with confirmed osteoporosis were followed for a median of four years. All patients received guideline-recommended antiresorptive or osteoanabolic therapy. Analyses included T-scores, 25(OH)D, calcium, handgrip strength, Chair Rise Test (CRT), tandem stance (TS), pain parameters, alkaline phosphatase (AP), HbA1c, fractures, comorbidities, and body mass index (BMI). Time-dependent changes were evaluated using linear mixed-effects models. Results: Bone mineral density improved highly significantly (ΔT-score ≈ +0.45 SD; p < 0.001), with no differences between therapy groups (antiresorptive vs. osteoanabolic) or BMI categories. Serum 25(OH)D levels increased markedly (Δ ≈ +20 nmol/L; p < 0.001), while calcium levels showed a small but highly significant decrease (Δ ≈ −0.047 mmol/L; p < 0.001), particularly under antiresorptive treatment. Dominant (Δ ≈ −1.95 kg; p < 0.001) and non-dominant handgrip strength (Δ ≈ −0.83 kg; p = 0.046) decreased significantly. In contrast, functional performance improved significantly: CRT time decreased by ~1 s (p = 0.004), and TS time increased by ~1 s (p = 0.007). Back pain decreased highly significantly (Δ ≈ −1.5 NRS; p < 0.001), while pain-free walking time (Δ ≈ +38 min; p = 0.031) and pain-free standing time (Δ ≈ +31 min; p = 0.038) both increased significantly. AP levels decreased significantly (p = 0.003), particularly among normal-weight patients. HbA1c changes were not significant. Overall, 73% of patients had at least one major osteoporotic fracture. Conclusions: In this real-life cohort, guideline-based specific pharmacological osteoporosis therapy was associated with significant improvements in bone mineral density, vitamin D status, functional performance, and pain-related outcomes. Despite a moderate decline in handgrip strength, balance- and mobility-related functional parameters improved, suggesting preserved or even enhanced functional capacity in daily life. These findings provide real-world evidence on the associations between SPOT, laboratory parameters, functional performance, and pain outcomes in a very elderly and multimorbid population. Full article

Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual reality (VR)-based training has recently emerged as a promising tool to promote physical activity; however, its application among the oldest-old individuals remains underexplored. This is a randomized controlled pilot study to evaluate the effects of VR-based intervention using the game “Beat Saber” on muscle strength and selected physical performance indicators related to sarcopenia risk in older adults. Methods: Thirty-eight residents (mean age: 87.2) of a long-term care facility were randomly assigned to either a VR group or a control group. The VR group participated in 12 supervised VR-based training sessions of 20 min per session, three times per week for four weeks. Handgrip strength, the arm curl test, 30-s chair stand, a 2-min step-in-place test, and an 8-foot up-and-go test were assessed before and after the intervention. Results: Linear mixed-model analyses revealed significant group-by-time interactions for upper- and lower-limb strength (handgrip, arm curl, chair stand; p < 0.05), favoring the VR group. Agility and endurance (8-foot up-and-go, 2-min step-in-place) showed no significant interactions. In the VR group, the 30-s chair stand performance correlated positively with the arm curl and the 2-min step-in-place tests results, while handgrip strength correlated with the arm curl performance. In the control group, the 30-s chair stand test results correlated strongly with the 8-foot up-and-go and 2-min step-in-place tests, but no significant correlations were found for handgrip strength. Conclusions: The findings indicate short-term functional benefits of VR exercise among the oldest-old adults. VR-based training appears to be an effective and well-tolerated method to enhance physical performance in individuals aged 80 and older and may represent a valuable strategy for improving functional performance indicators associated with sarcopenia risk in adults aged 80 years and older. Full article