Effect of Chair-Based Exercise on Lower Limb Strength and Dynamic Balance in Older Adults: A Systematic Review

Abstract

Background: Aging is associated with declines in muscle mass, strength, postural control, and dynamic balance, increasing fall risk and reducing functional independence in older adults. Chair-based exercise (CBE) is a safe and accessible intervention for individuals with limited mobility.

Objective: To evaluate the effects of chair-based exercise on lower limb muscle strength and dynamic balance in older adults.

Methods: This systematic review followed PRISMA 2020 guidelines. Literature searches were conducted in PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2021 and 2025. Keywords included chair-based exercise, older adults, lower limb strength, dynamic balance, Timed Up and Go, and the 30-second chair stand test. Studies were selected using PICOS criteria. Risk of bias was assessed using the PEDro scale. Due to heterogeneity in study design, interventions, and outcomes, a narrative synthesis was performed.

Results: Eight studies were included. Chair-based and sit-to-stand exercises consistently improved lower limb muscle strength, particularly in the 30-second chair stand test. Improvements in dynamic balance were also reported, commonly measured using the Timed Up and Go test and Berg Balance Scale. However, the evidence strength was limited by small sample sizes, heterogeneous protocols, and variable methodological quality.

Conclusion: Chair-based exercise is a safe and feasible intervention with the potential to improve lower limb strength and dynamic balance in older adults. However, findings should be interpreted cautiously due to the moderate-to-high risk of bias.