Age-related muscle weakness is only partially related to muscle atrophy, due to neuromuscular changes including reduced voluntary muscle activation and antagonist muscle co-activation. The respective contribution of these mechanisms in exercise-induced strength gains at higher age is unclear. Here the literature was systematically reviewed for studies reporting exercise-induced effects on voluntary muscle activation and antagonist muscle co-activation in elderly persons. Seventeen relevant studies were identified, 4 investigated voluntary muscle activation, 8 antagonist muscle co-activation and 5 studies investigated both. Meta-analysis showed an exercise-induced improvement in voluntary activation in plantar flexors (weighted mean difference (WMD) +. 8.8%, p.
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