Occupational Impacts of Compound Resistance Training in Community-Dwelling Older Adults
Phase: NA
Conditions: Resistance Training, Older Adults (65 Years and Older)
Sponsor: University of Arkansas

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 1 
 
 
 
Study Title: 
Occupational Impacts of Compound Resistance Training in 
Community-Dwelling Older Adults 
 
Principal Investigator:  
Alexis Skalberg (neé Viering) 
University of Arkansas for Medical Sciences 
Northwest Regional Campus 
1125 N College Ave 
Fayetteville, AR 72703 
Telephone:  469.525.2213 
Email:  aviering@uark.edu 
 
 
Sub-Investigator (s): 
Dr. Jennifer Muriithi, OTD, OTR/L, CNS 
University of Arkansas for Medical Sciences 
Northwest Regional Campus 
1125 N College Ave 
Fayetteville, AR 72703 
Telephone:  480.215.4122 
Email:  jm249@uark.edu 
 
 
Study location: 
Washington Regional Center for Exercise 
12 E Appleby Rd 
Fayetteville, AR 72703 
Telephone: 479.463.3488 
Email: centerforexercise@wregional.com 
 
 
 
 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 2 
Table of Contents 
 
Table of Contents ............................................................................................................... 2 
Background and Rationale ................................................................................................. 3 
Specific Aims ...................................................................................................................... 3 
Study Design and Procedures ........................................................................................... 3 
Study Population ................................................................................................................ 4 
Inclusion Criteria ............................................................................................................. 4 
Exclusion Criteria ............................................................................................................ 4 
Risks and Benefits .............................................................................................................. 5 
Data Handling and Recordkeeping .................................................................................... 5 
Multisite Research .............................................................................................................. 5 
Data Analysis ...................................................................................................................... 6 
Ethical Considerations ........................................................................................................ 6 
Dissemination of Data ........................................................................................................ 7 
References.......................................................................................................................... 7 
 
 
 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 3 
Background and Rationale 
Resistance training offers many benefits for community-dwelling elderly adults, 
impacting physiological, cognitive, psychological, and functional domains. Existing 
research highlights the importance of utilizing resistance training as an intervention to 
counteract age-related declines such as loss of muscle mass, decreased strength, and 
diminished cognitive function. The evidence indicates significant improvements in 
muscle mass, strength, sleep, fluid cognition, and overall quality of life, all of which 
contribute to enhanced functional performance and reduced risk of injury. Despite the 
robust findings supporting resistance training in older adults, its integration into 
occupational therapy practices remains underexplored. This study will aim to bridge this 
gap, emphasizing the occupational therapy perspective and its potential to provide 
holistic, person-centered resistance training interventions to improve functional 
performance. The utilization of compound movement resistance training within this 
project will establish new pathways for occupational therapy professionals to support 
the health and independence of community-dwelling elderly adults (Coelho-Júnior et al., 
2021; Cranmer & Walston, 2022; Gupta et al., 2022; Lai et al., 2023; Macaulay et al., 
2021; Marzuca-Nassr et al., 2024; Syed-Abdul et al., 2022; Voulgaridou et al., 2023). 
 
Specific Aims 
This study aims to assess the impact of compound resistance training on the ability of 
adults age 65 and older to participate in desired daily activities, their satisfaction with 
their level of participation, and their overall mental health. 
Study Design and Procedures 
This is a quasi-experimental pre-test post-test study. Following initial screening for 
eligibility via inclusion and exclusion criteria, and completion of informed consent 
discussion and signed form, subjects will complete an initial assessment. This 
assessment will consist of a semi-structured interview, completion of the Patient Health 
Questionnaire (PHQ-9) and Perceived Stress Scale (PSS), and completion of the 
Canadian Occupational Performance Measure (COPM) with guidance from principal 
investigator, who has been trained in administration of this occupational therapy field-
specific assessment.  
Intervention will take place over the course of 10 weeks, with individual sessions 
occurring twice weekly for one hour per session with each participant. Each session will 
consist of personalized strength training sessions, utilizing programming with a focus on 
compound, multi-joint movements, in keeping with existing literature on the subject. The 
nature of the exercises will be submitted for IRB review in a separate document 
(Intervention Guide). Each session will be designed based upon the PI’s evaluation of 
each individual participant with customized interventions. The PI will record specific 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 4 
exercises prescribed and completed, including volume, load, and Rate of Perceived 
Exertion (RPE) from subject report. Ongoing reassessment will be conducted from 
session to session with changes made in intervention throughout. At completion of the 
10-week study, subjects will complete a reassessment with the same measures from 
the initial assessment, the PHQ-9, the PSS, and the COPM. Subjects will also be asked 
to re-answer the questions from the semi-structured interview.  
Study Population 
20 participants will be enrolled in this study. Up to 60 individuals may engage in the 
consent process to obtain 20 participants in the research activities. 
Inclusion Criteria 
• Adult age 65 or older 
• Living independently in a community dwelling, such as a house or apartment 
• Able to complete basic daily tasks (i.e. dressing, toileting, transfers) without 
assistance from another person 
• Access to transportation to and from sessions for this study 
• Able to attend two, one-hour sessions per week for the duration of the study 
• Has a membership to Silver Sneakers, Silver and Fit, and/or Renew Active, or 
are willing to obtain a paid membership to Washington Regional Center for 
Exercise 
Exclusion Criteria 
• Personal history of stroke or heart attack 
• Limb amputation 
• Heart failure or arrythmias  
• Presence of brain or aortic aneurism 
• Active cancer 
• Major illness 
• Physical activity contraindicated as instructed by a physician 
• Active drug abuse 
• Moderate to severe cognitive impairment 
Potential subjects will be located in the following ways: 
• Handing out and/or posting fliers in community settings such as churches, local 
senior centers, and/or other public places such as grocery stores or shopping 
malls 
• Advertising on social media platforms (Instagram and Facebook) 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 5 
In some cases, potential subjects will respond to posted fliers. In these cases, initial 
contact with the study team will be made by the subject via phone or email. 
Risks and Benefits 
A risk to study participants is the potential for loss of confidentiality of study data.   
Measures to protect the confidentiality of study data will be implemented as described in 
the Data Handling and Recordkeeping section below.  
Another risk to participants is injury or medical event relating to exercise.  
Measures to protect subjects include adequate facilities at site of intervention, such as a 
well-maintained space and equipment that is regularly inspected for safety. An AED is 
also available in the facility. Provisions for emergency treatment available in the location 
also include a level 2 trauma center hospital located less than 1 mile from the facility. 
Appropriately qualified PI will be conducting this study, with qualifications including 
certification in Barbell Rehab Method and Basic Life Support CPR, as well as classroom 
and clinical education in occupational therapy assessment and intervention. Trained 
fitness professionals are also employed on site and will be present throughout the 
intervention. 
 
Potential benefits include: 
• Improved ability for subjects to participate in desired daily activities 
• Improved mental health of subjects 
• Improved physical health of subjects 
• Improved subject knowledge of exercise options, safety, form, and benefits 
Data safety will be monitored by the PI and reviewed every 30 days for risk trends.  
Data Handling and Recordkeeping 
The Principal Investigator will carefully monitor study procedures to protect the safety of 
research subjects, the quality of the data and the integrity of the study. 
Names will be coded in recorded data, with the key to the code kept separately. Each 
participant will be identified by a number (e.g. "Participant 2") in all recorded data. The 
key linking the recorded data to the participants will be destroyed at the end of the 
study. Data will be stored via UAMS-monitored database, UAMS BOX, and made 
accessible only to the PI and Sub-Investigator.  
At the conclusion of the study, the data will be retained for 7 years in UAMS BOX 
according to UAMS administrative policy before destruction. 
Multisite Research  

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 6 
This study has one PI. The PI is responsible for all data collection, data 
management/storage, protocol modification, and submission of amendments to IRB. 
UAMS is the Reviewing IRB. University of Arkansas Fayetteville and Washington 
Regional Medical Center are Relying Institutions.  
Fitness professionals that will be onsite are employed by Washington Regional Medical 
Center. They will not be part of the research team, nor will they participate in the 
consent, data collection, or data analysis. Their role is strictly an added safety 
component of additional trained individuals present at the facility during intervention, 
however not involved in the study directly.  
No research elements will be conducted by University of Arkansas Fayetteville or 
Washington Regional Medical Center entities. The PI is a student in a dual-enrolled 
program within both UAMS and UAF. One employee at the Washington Regional 
Medical Center (facility manager) will serve as a site mentor and content expert for 
advising the PI throughout the study, though not conducting any data collection, data 
analysis, or partaking in consent procedures.  
The PI retains responsibility for overseeing protocol implementation, including 
adherence to IRB-approved protocol in intervention implementation and for maintaining 
all data confidentiality. PI will retain responsibility for reporting any adverse events, 
including data related adverse events. 
Data Analysis 
Data from the objective assessments conducted in this study will be analyzed using 
statistical analysis to determine if a clinically significant difference exists between the 
pre- and post-test scores for each assessment. The threshold for clinical significance is 
5 points on the PHQ-9 (Kroenke et al., 1999). There is limited research published on the 
minimal clinically important difference (MCID) for the PSS, however it is estimated to be 
about 4 points (Drachev et al., 2020). In prior research with community-dwelling older 
adults, the MCID for the COPM was found to be 3 points for both performance and 
satisfaction sections (Tuntland et al., 2016).  
Themes in subjective data will be coded and analyzed from identification of any 
changes in subjects’ interviews.  
Ethical Considerations 
This study will be conducted in accordance with all applicable government regulations 
and University of Arkansas for Medical Sciences research policies and 
procedures.  This protocol and any amendments will be submitted and approved by the 
IRB as required. 
There will be no compensation for subjects for participation in this study. 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 7 
The informed consent of each subject, using IRB-approved consent materials, will be 
obtained before that subject begins any study procedures.  All subjects for this study will 
be provided a consent form on paper describing this study in language understandable 
to the study population. Consent materials will provide sufficient information for subjects 
to make an informed decision about their participation in this study.  The person 
obtaining consent will thoroughly explain what the subjects need to know about the 
study, including study requirements, study risks and benefits.  The consent process will 
take place in person at the facility prior to beginning initial session, on the same day or 
up to several days prior to the start of the study.  Participation privacy will be maintained 
and questions regarding participation will be answered.  No coercion or undue influence 
will be used in the consent process.  This consent form must be signed by the subject, 
and the person obtaining the consent.  The participant will receive a paper copy of the 
signed consent form, and the informed consent process will be documented in the 
research record.   
The consent process will be documented separately via a written note in the research 
for each subject. 
Dissemination of Data 
Results of this study may be used for presentations, posters, or publications. The 
publications will not contain any identifiable information that could be linked to a 
participant. 
 
References 
 
 
 
 
Coelho-Júnior, H., Uchida, M., Picca, A., Bernabei, R., Landi, F., Calvani, R., Cesari, 
M., & Marzetti, E. (2021). Evidence-based recommendations for resistance and 
power training to prevent frailty in community-dwellers. Aging Clinical 
Experimental Research 33, 2069–2086. https://doi.org/10.1007/s40520-021-
01802-5  
 
 
 
Cranmer, M. & Walston, Z. (2022). Heavy resistance training in the management of hip 
pain in older adults: A case series. Physiotherapy Theory & Practice, 38(12), 
2241-2249. https://doi.org/10.1080/09593985.2021.1917022  
Drachev, S. N., Stangvaltaite-Mouhat, L., Bolstad, N. L., Johnsen, J. K., Yushmanova, 
T. N., & Trovik, T. A. (2020). Perceived stress and associated factors in Russian 
medical and dental Students: A cross-sectional study in North-West Russia. 
International Journal of Environmental Research and Public Health, 17(15), 
5390. https://doi.org/10.3390/ijerph17155390 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 8 
Gupta, S., Bansal, K., & Saxena, P. (2022). A clinical trial to compare the effects of 
aerobic training and resistance training on sleep quality and quality of life in older 
adults with sleep disturbance. Sleep Science, 15(2), 188–195. 
https://doi.org/10.5935/1984-0063.20220040 
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (1999). Patient Health Questionnaire-9 
(PHQ-9) [Database record]. APA PsycTests. 
Lai, X., Zhu, H., Wu, Z., Chen, B., Jiang, Q., Du, H., & Huo, X. (2023). Dose–response 
effects of resistance training on physical function in frail older Chinese adults: A 
randomized controlled trial. Journal of Cachexia, Sarcopenia and Muscle, 14(6), 
2824–2834. https://doi.org/10.1002/jcsm.13359  
Macaulay, T., Pa, J., Kutch, J., Lane, C., Duncan, D., Yan, L., & Schroeder, E. (2021). 
12 weeks of strength training improves fluid cognition in older adults: A 
nonrandomized pilot trial. Public Library of Science One, 16(7) 
https://doi.org/10.1371/journal.pone.0255018 
 
 
 
Marzuca-Nassr, G., Alegría-Molina, A., SanMartín-Calísto, Y., Artigas-Arias, M., Huard, 
N., Sapunar, J., Salazar, L., Verdijk, L., & Van Loon, L. (2024). Muscle mass and 
strength gains following resistance exercise training in older adults 65-75 years 
and older adults above 85 years. International Journal of Sport Nutrition and 
Exercise Metabolism, 34(1), 11–19. https://doi.org/10.1123/ijsnem.2023-0087 
Syed-Abdul, M., McClellan, C., Parks, E., & Ball, S. (2022). Effects of a resistance 
training community program in older adults. Ageing and Society, 42(8), 1863–
1878. https://doi.org/10.1017/S0144686X20001786   
Tuntland, H., Aaslund, M. K., Langeland, E., Espehaug, B., & Kjeken, I. (2016). 
Psychometric properties of the Canadian Occupational Performance Measure in 
home-dwelling older adults. Journal of Multidisciplinary Healthcare, 9, 411–423. 
https://doi.org/10.2147/JMDH.S113727  
 
 
 
 
Voulgaridou, G., Papadopoulou, S. D., Spanoudaki, M., Kondyli, F., Alexandropoulou, I., 
Michailidou, S., Zarogoulidis, P., Matthaios, D., Giannakidis, D., Romanidou, M., 
& Papadopoulou, S. K. (2023). Increasing muscle mass in elders through diet 
and exercise: A literature review of recent RCTs. Foods, 12(6), 1218-. 
https://doi.org/10.3390/foods12061218  
 
 

Title: 
Occupational Impacts of Compound Resistance Training in Community-Dwelling Older 
Adults 
PI: 
Alexis Skalberg 
Institution: 
University of Arkansas for Medical Sciences 
 
Version #: 
1 
Protocol 
IRB# 298900 
Date: 
6/6/2025 
UAMS IRB template version dated 12.06.2021 
Page 9