Resistance Exercise Training for Skeletal Muscle Health in Adults Living With Multiple Long‐Term Conditions: A Scoping Review

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ABSTRACT Background Low muscle strength is prevalent in individuals living with multiple long‐term conditions (MLTC). Resistance exercise (RE) training is the most effective treatment for improving strength and physical performance across the life course, but little is known about RE in people living with MLTC. This scoping review aimed to identify published evidence on RE as a treatment for improving muscle mass, strength and physical performance in adults living with MLTC. Methods Six electronic databases were searched to identify studies published up to May 2025 that included adults aged ≥ 18 years who were living with two or more long‐term conditions and undertaking a RE intervention. Results Sixty‐eight papers representing 66 unique studies met the inclusion criteria. A range of methods for characterising MLTC were reported; almost half of the papers (30/68) that included people living with ≥ 2 LTC focused on comorbidity (i.e., participants selected based on the presence of an index condition plus one or more coexisting conditions). There were only seven papers that specifically described their population as living with MLTC. Importantly, only 11 of the included studies involved interventions that were RE only with most including RE performed as part of a multicomponent exercise programme (RE‐MCT). None of the RE interventions reported increases in muscle mass, although improvements in muscle strength were observed in four of seven papers and physical performance in five of eight papers. In studies involving RE‐MCT, one paper reported a postintervention increase in muscle mass, whereas muscle strength improved in 44% (12/27) of papers where it was measured. Improvements in physical performance were reported across most RE‐MCT studies (85%). Exercise session attendance was generally good with few reported adverse events across both RE and RE‐MCT interventions. Conclusions RE training may be effective for improving strength and physical performance in adults living with MLTC. However, only a small number of studies have evaluated the effects of RE alone in this population, with RE typically incorporated within a broader multicomponent exercise programme. Consequently, more research is needed to understand the effects of interventions, which involve RE alone, but also in comparison with RE‐MCT programmes, in individuals living with MLTC across the adult life course.

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