Effects of integrating self-efficacy strategies into multi-joint resistance exercise for overweight and obese older adults: A randomized controlled trial.
Kanlayawut O, Maphong R, Wongpipit W, Kritpet T • PloS one • 2026
Multi-joint resistance training improves physical function in overweight and obese older adults, and embedding self-efficacy strategies within training may provide additional psychological benefits and selected physiological benefits beyond exercise alone.
Key Findings
Results
Both groups significantly improved physical function outcomes including muscle strength, endurance, balance, and mobility over 12 weeks, with no significant group×time interactions between conditions.
Both the multi-joint exercise group (MJ; n=16) and the multi-joint exercise plus self-efficacy group (MJS; n=18) completed a 12-week progressive resistance training program.
Sessions were 60 minutes, three times per week.
No significant group×time interactions were found for physical function measures.
Participants were aged 60-75 years and were overweight or obese.
Results
The MJS group showed a significantly smaller increase in resting heart rate compared to the MJ group over the intervention period.
The MJS group showed minimal change in resting heart rate (Δ = 0.8 beats·min⁻¹), whereas the MJ group increased (Δ = 7.8 beats·min⁻¹).
The between-group difference in change was -7.0 beats·min⁻¹ (95% CI -12.5 to -1.9; p = 0.009).
This was one of the significant group×time interactions detected in the study.
Data were analyzed using linear mixed-effects models with intention-to-treat analysis.
Results
A significant group×time interaction was observed for HbA1c, though Bonferroni-adjusted pairwise comparisons did not demonstrate statistically significant within-group changes.
The group×time interaction for HbA1c reached statistical significance (p = 0.014).
Bonferroni-adjusted pairwise comparisons did not confirm statistically significant within-group changes for HbA1c.
HbA1c was assessed as a blood biomarker secondary outcome.
Outcomes were assessed pre- and post-intervention using linear mixed-effects models with estimated marginal means and 95% confidence intervals.
Results
Psychological outcomes improved more in the MJS group compared to the MJ group, including knowledge, self-efficacy, and outcome expectations.
The MJS group received integrated self-efficacy strategies embedded within each training session in addition to the resistance training program.
Greater improvements were observed in knowledge, self-efficacy, and outcome expectations in the MJS group.
Psychological measures were classified as secondary outcomes in the study.
The study used a randomized controlled trial design with intention-to-treat analysis (n=34 in final analysis).
Methods
The study used a randomized controlled trial design with 34 overweight and obese older adults aged 60-75 years completing a 12-week progressive multi-joint resistance training program.
Participants were randomly assigned to MJ (n=16; age 67.63 ± 5.28 years) or MJS (n=18; age 67.35 ± 3.69 years).
The final intention-to-treat analysis included 34 adults.
The primary outcome was body composition; secondary outcomes included blood biomarkers, physical function, and psychological measures.
Data were analyzed using linear mixed-effects models testing group×time interactions with estimated marginal means and 95% confidence intervals.
What This Means
This research suggests that a 12-week progressive resistance exercise program involving multiple muscle groups can improve physical fitness in older adults who are overweight or obese, regardless of whether or not the program included additional psychological support strategies. Both groups—one doing resistance training alone and one doing resistance training with added self-efficacy strategies (techniques designed to build confidence and motivation)—showed improvements in muscle strength, endurance, balance, and mobility. This finding supports the value of structured resistance exercise for older adults managing excess weight.
However, adding self-efficacy strategies to the exercise program appeared to offer some extra benefits. Participants who received these integrated psychological strategies showed greater improvements in exercise-related knowledge, confidence in their ability to exercise, and expectations about the benefits of exercise. They also showed a notably smaller rise in resting heart rate compared to the exercise-only group, and there was a statistically significant interaction for blood sugar control (HbA1c), though individual within-group changes were not confirmed after statistical correction.
This research suggests that combining psychological support strategies with resistance training may offer advantages beyond physical training alone, particularly for mental and motivational aspects of exercise participation and possibly for certain cardiovascular and metabolic markers. These findings could be relevant for designing exercise programs for older adults who face both physical and psychological barriers to staying active, though the modest sample size (34 participants) means further research with larger groups is needed to confirm these effects.
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Kanlayawut O, Maphong R, Wongpipit W, Kritpet T. (2026). Effects of integrating self-efficacy strategies into multi-joint resistance exercise for overweight and obese older adults: A randomized controlled trial.. PloS one. https://doi.org/10.1371/journal.pone.0335830