Inclusion Criteria:  Primary  1.Community-indwelling individuals with age>=55 years, who lived adjacent to a community hospital were surveyed.  Secondary  Adults with mini-mental state examination (MMSE) score > 24 Negative lumbar spine as well as lower extremity degenerative joint disorder were recruited.  Exclusion Criteria:  unstable angina unstable BP severe aortic stenosis inflammatory disease within recent 3 months uncontrolled or severe cardiac dysrhythmias uncompensated HF embolic disease within recent 3 months ST segment displacement>=2 mm at rest uncontrolled diabetes sarcopenia Patients with absolute contraindications of exercise training (Pescatello LS, Arena R, Riebe D and Thompson PD. ACSM's guidelines for exercise testing and prescription. 9th ed. Philadelphia, PA.: Wolters Kluwer/Lippincott Williams & Wilkins; 2014.)