BACKGROUND: Functional sarcopenia is characterized by decreased physical performance and grip strength despite preserved muscle mass. The effectiveness of a program combining exercise and nutritional support-known interventions for individuals with low muscle mass-was evaluated for its impact on older adults with functional sarcopenia. METHODS: An unblinded, parallel-group randomized controlled trial was conducted in a public medical center in a rural Korean community. Eligible older adults with functional sarcopenia were randomized into either the intervention group, receiving a 12-week program of group exercises and nutritional support, or the control group, receiving education on lifestyle management. Outcomes measured included changes in gait speed, grip strength, physical performance, and quality of life indices. RESULTS: The study enrolled 42 participants, with 21 allocated to each group. Compared with the control group, the intervention group showed significant improvements in the primary outcome of gait speed (mean change (m/s) 0.24 vs 0.00, p<
0.001) and secondary outcomes, such as Short Physical Performance Battery scores, grip strength, and quality of life. No significant adverse events were reported. CONCLUSION: The 12-week exercise and nutritional intervention significantly enhanced physical performance, grip strength, and quality of life among community-dwelling older adults with functional sarcopenia. This suggests that strategies commonly recommended for sarcopenia, including exercise and nutritional support, are also beneficial for individuals with functional sarcopenia, indicating the potential for broader application of such interventions.