Abstract

Introduction: Frailty in older adults is a clinical syndrome that significantly affects independence and quality of life. Resistance training with elastic bands has been proposed as a low-cost intervention to improve physical function in this population. Objective: To evaluate the best available evidence on the effectiveness of elastic band training in frail older adults for improving muscle strength, physical performance, and overall functionality. Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD42024582352). Four randomized controlled trials were included, comprising 148 frail participants aged 65 years or older. The interventions lasted between 12 and 28 weeks and included exercises with elastic bands, with or without nutritional education. The outcomes assessed included functionality, frailty status, muscle strength, physical fitness, cognition, quality of life, and endurance. Results: Significant improvements were observed in functionality, handgrip strength, and lower-limb strength, particularly in programs with progressive intensity and longer duration. Combined interventions (exercise plus nutritional education) showed a greater impact in reducing frailty levels. However, no significant changes were observed in autonomy. The risk of bias was high in three studies, mainly due to insufficient reporting of randomization procedures and missing outcome data. Conclusions: Elastic band training appears to be a safe, affordable, and feasible intervention to improve physical outcomes in frail older adults. These findings support its implementation in community and institutional settings, although further research with long-term follow-up and improved methodological quality is needed.