BACKGROUND: Physical exercise has been identified as a health promotion strategy for the oldest old. However, scientific evidence regarding the benefits of exercise on nonagenarians is scarce. This systematic review aimed to evaluate the characteristics and methodological quality of investigations that have examined the effects of physical exercise on nonagenarians. METHODS: A systematic review and evidence synthesis were conducted. The Medline/PubMed, CINAHL, Scopus, SPORTDiscus, and Cochrane Library were systematically searched up to November 2018. Investigations were included if they tested the effects of an exercise intervention on people 90 years or older. The methodological quality of the randomized controlled trials was evaluated using the PEDro scale. Quality appraisal tools developed by the National Heart, Lung and Blood Institute were used to evaluate the uncontrolled and observational investigations. RESULTS: Three randomized controlled trials, 1 retrospective study, 2 case reports, and 1 single-subject A-B design met the eligibility criteria. The methodological quality scores obtained from the scales ranged from poor to good. Most interventions were based on muscular strengthening, balance exercises, or a combination of both. No adverse effects were registered. In general, exercise showed a significant impact on muscular strength, while mixed effects were found regarding gait and balance. Pooled analyses indicated that interventions had significant improvements in global lower body functioning (standardized mean difference (SMD) 0.47; 95% confidence interval 0.04 to 0.90; p < 0.01). CONCLUSIONS: Exercise is a feasible therapy for nonagenarians, which can lead to improvements in physical functioning. Future research should focus on the effects of aerobic interventions, as well as the impact that exercise has on the cognitive functioning of nonagenarians.

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