BACKGROUND: Maintaining physical fitness in older adults is crucial for preventing functional decline. This study aimed to examine the effects of a 6-month medium-intensity training (MIT) programme on physical fitness components in older adults. METHODS: In this randomized controlled trial, 72 older adults aged 60 to 70 years in Indonesia were randomly assigned to either an exercise group (EG; n = 36) or a control group (CG; n = 36). The EG participated in MIT sessions (60 minutes, 3 times per week). Each session consisted of a warm-up with joint mobility and flexibility exercises, followed by 15 to 20 minutes of moderate-intensity walking performed at 55 to 70% of maximum heart rate, a strength training phase targeting major muscle groups with 8 to 10 repetitions per movement using bodyweight or light resistance, and a cooldown phase incorporating stretching for major muscle groups. Physical fitness was assessed using the Senior Fitness Test at baseline and post-intervention. Group x time interaction effects were analyzed using repeated measures ANOVA. Effect sizes were calculated using partial eta squared (partial eta2), with 95% confidence intervals (CI) reported. RESULTS: Significant group x time interaction effects were observed for lower-limb strength (post-intervention: EG 13.40 +/- 3.22 versus CG 10.55 +/- 2.20 reps; partial eta2 0.167, 95% CI 0.041 to 0.296, p = 0.02, upper-body strength (15.55 +/- 2.88 versus 11.37 +/- 1.71 reps; partial eta2 0.223, 95% CI 0.085 to 0.352, p = 0.00), lower-body flexibility (3.69 +/- 2.93 versus 2.50 +/- 4.04 cm; partial eta2 0.101, 95% CI 0.013 to 0.229, p = 0.01), and aerobic endurance (468.26 +/- 88.49 versus 417.50 +/- 33.72 m; partial eta2 0.325, 95% CI 0.172 to 0.460, p < 0.001). No significant interactions were found for upper-body flexibility or agility (p > 0.05). All values in parentheses represent post-intervention means +/- standard deviations. CONCLUSIONS: A structured 6-month MIT programme significantly improved key physical fitness domains in older adults, particularly muscular strength and aerobic capacity. These findings underscore the importance of implementing regular, moderate-intensity exercise as a practical strategy to support healthy aging and reduce functional limitations. TRIAL REGISTRATION: The trial was registered at Thai Clinical Trials Registry no TCTR20250407006 (date of registration on April 7, 2025).

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