Effectiveness of functional tasks exercise on functional ability and health-related quality of life in community-dwelling older adults: A systematic review and meta-analysis

Background: Functional Task Exercise (FTE) aims to improve functional ability by training tasks that resemble activities of daily living. However, its effectiveness compared with strength training (ST) or control interventions in older adults remains unclear. Objectives: To evaluate the effects of FTE on functional ability and health-related quality of life (HRQoL) in community-dwelling older adults. Data sources: MEDLINE, Embase, CINAHL, CENTRAL, PEDro, Web of Science, PsycINFO, and Google Scholar were searched from inception to 22 January 2026. Study selection: Randomized controlled trials and controlled clinical trials comparing FTE with ST or control and reporting functional ability or HRQoL. Study appraisal and synthesis methods: Methodological quality was assessed using the PEDro scale. Random-effects meta-analyses were conducted when ≥2 studies reported the same outcome domain; heterogeneity was quantified with I². Results: Fourteen articles (10 studies; n = 583) were included. Compared with control conditions, FTE demonstrated large effects on activities of daily living (ADL) and mobility. Compared with ST, FTE showed a medium effect on ADL but no statistically significant effect on mobility. No significant effects were found for HRQoL. Certainty of evidence was high for ADL and mobility outcomes versus control, moderate for ADL versus ST, and low or very low for mobility and HRQoL outcomes. Limitations: The number of studies per outcome domain was limited, outcome measures varied across studies, and heterogeneity in several analyses. Conclusion: FTE improves ADL and mobility versus control and appears superior to strength training for ADL; effects on mobility versus strength training and on HRQoL remain inconclusive. Systematic review registration: PROSPERO: CRD42018090080. Contribution of paper: • This systematic review and meta-analysis provides the first synthesis of the effects of Functional Task Exercise (FTE) on functional ability and health-related quality of life specifically in community-dwelling older adults, using a predefined task-specific definition of FTE. • The findings demonstrate that FTE yields clinically meaningful improvements in activities of daily living, and improves mobility compared with control interventions, while its added value over strength training appears domain-specific. • By integrating heterogeneous outcome measures into clinically meaningful functional domains, this review clarifies inconsistencies in the literature and highlights the importance of distinguishing task-specific FTE from biomechanically defined functional training in both research and practice.