Critical Appraisal of Studies Addressing the Impact of Vitamin D Supplementation on Muscle Strength, Balance, and Fall Prevention
Critical Appraisal of Studies Addressing the Impact of Vitamin D Supplementation on Muscle Strength, Balance, and Fall Prevention
Student
Professor
Course
Date
| Study | Level of Evidence | Purpose | Sample/Settings | Outcomes Measured | Findings | Does it Answer the PICOT Question? |
|---|---|---|---|---|---|---|
| Chou et al. (2025) | Randomized Controlled Trial (RCT) | To assess the vitamin D3 and omega-3 supplementation effect on physical performance in older adults. | 25,000 older adults (65+) across U.S. clinical and community settings. | Muscle strength, physical performance, fall risk, balance. | Combined vitamin D3 (2000 IU/day) and omega-3 improved muscle strength and reduced falls. | Yes. Directly demonstrates improvement in strength, balance, and fall prevention. |
| de Lima et al. (2024) | Literature Review/Editorial | Explores relationship between blood flow, brain function, and muscle health. | No direct sample; synthesis of existing studies. | Blood flow, muscle function, brain health. | Highlights importance of circulation for muscle performance. | Partially. Indirect relevance to vitamin D and fall prevention. |
| Eggimann et al. (2024) | Randomized Controlled Trial (RCT) | Examines combined vitamin D, omega-3, and exercise effects on sarcopenia. | 2,157 older adults (65+) in European clinical settings. | Muscle mass, strength, balance, fall prevention. | Significant improvement in muscle mass and strength with combined intervention. | Yes. Supports role of vitamin D with adjunct interventions. |
| Giustina & Giustina (2025) | Systematic Review | Evaluates vitamin D in preventing osteosarcopenia and fractures. | Multiple studies on older adults. | Bone health, muscle strength, fall risk. | Vitamin D reduces osteosarcopenia and fracture risk. | Partially. Indirect support via bone and fall outcomes. |
| Pludowski et al. (2024) | Meta-analysis | Assesses overall health effects of vitamin D supplementation. | 30+ studies involving older adults. | Muscle strength, balance, bone density. | ≥1000 IU daily improves strength and reduces falls. | Yes. Strong evidence supporting PICOT outcomes. |
| Wimalawansa (2025) | Systematic Review | Evaluates vitamin D’s role in disease and sarcopenia prevention. | Clinical trials on older adults. | Sarcopenia, muscle function, fall risk. | Vitamin D improves muscle health and reduces fall risk. | Yes. Direct relevance to PICOT question. |
| Xiong et al. (2024) | Meta-analysis | Examines vitamin D analogues on muscle strength and falls. | RCTs and cohort studies in older adults. | Muscle strength, falls, sarcopenia. | Calcitriol improves strength and reduces fall risk. | Yes. Strong direct evidence. |
| Yang et al. (2025) | Cohort Study | Examines testosterone influence on vitamin D effectiveness. | 500 older men (65–80) in U.S. clinical settings. | Muscle strength, hormone interaction. | Higher testosterone enhances vitamin D effectiveness. | Yes. Provides supporting insight on effectiveness variability. |
Summary of Evidence
The reviewed studies collectively provide strong evidence supporting the effectiveness of vitamin D supplementation in improving muscle strength, enhancing balance, and reducing fall risk among older adults. Randomized controlled trials and meta-analyses, such as Chou et al. (2025) and Pludowski et al. (2024), offer the highest level of evidence, consistently demonstrating positive outcomes associated with vitamin D intake.
Several studies indicate that combined interventions, including omega-3 supplementation and exercise, further enhance these benefits. Systematic reviews reinforce the role of vitamin D in preventing sarcopenia and improving musculoskeletal health, while cohort studies highlight moderating factors such as hormonal levels.
Although some studies provide indirect evidence, particularly those focusing on bone health or physiological mechanisms, the overall body of literature strongly supports the PICOT question. Vitamin D supplementation emerges as a critical intervention in promoting functional independence and reducing fall-related risks in ageing populations.
References
Chou, S. H., et al. (2025). Effects of supplemental vitamin D3 and Omega-3 fatty acids on physical performance measures. Journal of Clinical Endocrinology & Metabolism.
de Lima, E. P., et al. (2024). Bridging the gap: blood flow, muscle health, and brain function. Medicine and Pharmacology.
Eggimann, A. K., et al. (2024). DO-HEALTH trial on vitamin D and sarcopenia. Journal of the American Geriatrics Society.
Giustina, A., & Giustina, A. (2025). Vitamin D and osteosarcopenia. Reviews in Endocrine and Metabolic Disorders.
Pludowski, P., et al. (2024). Vitamin D supplementation evidence review. Nutrients.
Wimalawansa, S. J. (2025). Vitamin D clinical trials review. Nutrition Reviews.
Xiong, A., et al. (2024). Vitamin D analogues and muscle strength. Frontiers in Endocrinology.
Yang, A., et al. (2025). Testosterone and vitamin D interaction. Journal of Cachexia, Sarcopenia and Muscle.