BACKGROUND/OBJECTIVES: Exercise is a key nonpharmacological strategy for the management of sarcopenic obesity (SO), characterized by low muscle mass and excess fat. However, long-term interventions and specific modalities, such as power training (PT), remain unexplored in this population. METHODS: In this 32-week randomized controlled trial, 40 community-dwelling women (mean age 77.0 +/- 6.8 years) with sarcopenic obesity (per the EWGSOP2 and ESPEN criteria) were assigned to power training (PT), multicomponent training (MT), or a non-exercise control group (CG). Body composition, strength, and function were assessed pre- and post-intervention using within- and between-group analyses with effect size estimation. Nutritional intake was evaluated at baseline. RESULTS: Significant pre-post intervention between-group differences were observed in appendicular skeletal muscle mass index (ASMI; p = 0.039), body fat percentage (BF%; p = 0.002), visceral fat (VF; p = 0.044), appendicular muscle mass (ASM; p = 0.021), gait speed (GS; p = 0.018), timed up and go test (TUG; p = 0.005), five-times sit-to-stand test (5STS; p < 0.001), and Short Physical Performance Battery (SPPB; p = 0.002). Large effect sizes (Cohen's d > 0.8) were found in the PT group for all these variables. Post hoc analyses indicated that PT was significantly superior to MT in improving 5STS (p = 0.005) and TUG (p = 0.025). Notably, 35.7% of the PT participants no longer met diagnostic criteria for SO after the intervention. CONCLUSIONS: PT was more effective than MT and the CG in improving muscle mass, reducing fat, and enhancing functional performance in older women with SO. These findings support PT as a feasible and promising intervention.

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