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Isokinetics and Exercise Science 23 (2015) 53–60
DOI 10.3233/IES-140564
IOS Press

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Resistance training in older women:
Comparison of single vs. multiple sets on
muscle strength and body composition
Alex S. Ribeiroa,∗ , Brad J. Schoenfeldb, Fábio L. C. Pinaa, Mariana F. Souzaa,
Matheus A. Nascimentoa, Leandro dos Santosa, Melissa Antunesa and Edilson S. CyrinoaaStudy and Research Group in Metabolism, Nutrition, and Exercise, Londrina State University, Londrina, Paraná,
Brazilb
Exercise Science Department, CUNY Lehman College, Bronx, New York, NY, USA

Received 18 September 2014
Accepted 6 December 2014

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Abstract.
BACKGROUND: Studies are conflicting as to whether single-set resistance training (RT) are as effective as multi-set protocols
with respect to promoting muscular adaptations. Several meta-analyses have shown that a clear dose-response relationship exists
between RT volume and muscular adaptations. However, a majority of studies were not specific to older individuals, particularly
women.
OBJECTIVE: To determine changes in strength and body composition in elderly women following 1 vs. 3 sets of RT.
METHODS: Thirty older women participated in a 12-week supervised total body RT program. Participants were randomly
assigned to perform either 1 set (G1S) or 3 sets (G3S) per session. All other RT variables were held constant. Body composition
was assessed by dual X-ray absorptiometry, muscle strength was evaluated by 1RM in chest press and knee extension.
RESULTS: Increases in strength were significantly (p < 0.05) greater in G3S versus G1S in both the chest press (+26.6%,
versus +20.3%) and the knee extension (+23.9% versus +16.2%). No significant (p > 0.05) differences were noted in bodycomposition components between groups.
CONCLUSIONS: Findings indicate that multiple set protocols are required to optimize strength gains in older women. Changes
in body composition appear to be similar irrespective of training volume during the initial stages of RT.
Keywords: Strength training, fat-free mass, fat mass, volume

1. Introduction

Human muscle mass and force reach peak levels between the second and fourth decades of life [1]. Thereafter, it is estimated that we lose approximately 1/2% of
our muscle mass per year after the fourth decade of life,
increasing to 1%–2% annually after the age of 50 and∗ Corresponding author: Alex Silva Ribeiro, Carmela Dutra Street
862, Jataizinho, Paraná, Zip Code: 86210-000, Brazil. Tel.: +55
4332593860; E-mail: alex-silvaribeiro@hotmail.com.

then accelerating to 3% annually after the age of 60 [2,3]. This age-associated loss of muscle has been termedsarcopenia. Rates of decline are greater in sedentaryindividuals compared to those who are active, althoughleisure time physical activity has only minor effects on
attenuating muscle loss [2]. The decrease in muscularstrength and power associated with sarcopenia is at theroot of many of health and wellness issues independent on age, size, physical activity, or co-morbidities,
indicating a link between sarcopenia and generalized
frailty [2]. Muscle loss contributes to a reduced ability to carry out activities of daily living, impairing thec 2015 – IOS Press and the authors. All rights reserved
ISSN 0959-3020/15/$35.00 

A.S. Ribeiro et al. / Resistance training sets in elderly women

underestimate baseline scores, skewing pre- to poststudy differences in strength and thus potentially obscuring the effects of volume on results [17]. The purpose of this study was to evaluate differences between
1- and 3-set RT protocols on muscular adaptations in
untrained elderly women after a period of familiarization to exercise performance.

2. Methods

2.1. Participants

Thirty older women ( 60 years old) volunteered toparticipate in this study. Recruitment was carried out
through newspaper and radio advertisings, and homedelivery of leaflets in the central area and residential
neighborhoods. Participants were randomly assigned
to one of the two groups: a group that performed RTwith 1 set (G1S) and a group that performed RT with
3 sets (G3S). All participants completed health history
and physical activity questionnaires and met the following inclusion criteria: Non-hypertensive (systolicblood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg), non-diabetic, free from cardiac
or renal dysfunction, nonsmokers, not receiving hormonal replacement therapy, and were not performing
any regular physical exercise for more than once aweek over the six months preceding the beginning of
the study. Participants passed a diagnostic, graded exercise stress test with 12-lead ECG reviewed by a cardiologist and were released with no restrictions for participation in this study. Adherence to the program wasgood, with all subjects participating in >85% of thetotal sessions. Written informed consent was obtained
from all subjects after a detailed description of study
procedures was provided. This investigation was conducted according to the Declaration of Helsinki, andwas approved by the local University Ethics Committee.

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capacity for independent living and thereby increasing
the burden to the caregiver and community [4,5]. The
risk of disability is estimated to be as much as 4.6 times
higher in elderly sarcopenic individuals compared toage-matched persons with normal muscle mass [6]. Often this can necessitate home healthcare, hospitalization, or placement in a nursing home [6].
Older women are particularly susceptible to the debilitating effects of sarcopenia [7]. Because womenstart out with lower amounts of muscle mass compared
to men, the negative effects of muscle loss from aging
result in greater functional deficits. To this end, studies
show that between 3%–5% of individuals 65 years ofage and older are admitted to a skilled-nursing facility in the United States each year and the lifetime riskof admission to a nursing home for those in this age
bracket is approximately 45 percent for women and 28
percent for men [8].
Several meta-analyses have shown that a clear doseresponse relationship exists between resistance training (RT) volume and muscular adaptations, whereby
increased volume correlates with greater gains in muscle strength and hypertrophy at least up to a certain
point [9–12]. The caveat is a majority of studies included in these analyses were not specific to older individuals. It has been demonstrated that the elderly display an altered response to RT programs compared to
the young, thereby limiting generalizability between
these populations [13].
Studies investigating the dose-response relationshipin the elderly have produced disparate findings. Galvão
and Taaffe [14] found greater increases in some measures of maximal strength with 3 sets compared to 1 set
in a convenience sample of community-dwelling older
men and women, but no significant differences werenoted in body composition. More recently, Radaelli etal. [15] reported similar increases in muscle strengthand thickness between 1- and 3-set protocols in a groupof healthy older women over 13 weeks of RT. Followup work by the same group evaluated muscular adaptations between 1 and 3 set protocols at 6, 13, and20 weeks of regimented RT. Results showed that increases in lower body muscle strength and thickness
were significantly greater in the 3-set group comparedto 1 set only at the 20 week time point; no differenceswere noted in upper body muscle strength or thickness [16].
A confounding issue with previous research is that
subjects were initially unfamiliar with the exercises
used as well as the concept of one repetition maximum (1RM) testing. This lack of familiarity tends to

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2.2. Experimental design
The study was carried out over a period of 18 weeks,with 12 weeks directed to the RT program, 4 weeks
for data collection, and 2 weeks dedicated to exercise
learning. During weeks 1–2, participants underwent
6 familiarization sessions designed to acquaint themwith the exercises and equipment that composed the
RT program. Familiarization sessions were carried out
over nonconsecutive days and involved performing 1

A.S. Ribeiro et al. / Resistance training sets in elderly women

Familiarization
Sessions (Weeks 1-2)
Pre-Testing (Weeks 3-4)
Resistance Training
Protocol (Weeks 5-16)
Post-Testing(Weeks 17-18)

2.5. Muscle strength

Fig. 1. Study design.

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Body mass was measured to the nearest 0.1 kg using
a calibrated electronic scale (Filizola, model ID 110,
São Paulo, Brazil), with the participants wearing lightworkout clothing and no shoes. Height was measured
with a wooden stadiometer to the nearest 0.1 cm withsubjects standing without shoes. Body mass index was
calculated as body mass in kilograms divided by thesquare root of height in meters.
2.4. Body composition

Maximal dynamic strength was evaluated using the
1RM test assessed on chest press (CP) and knee extension (KE) performed in this exact order. Testing foreach exercise was preceded by a warm-up set (6–10
repetitions), with approximately 50% of the estimatedload used in the first attempt of the 1RM test. Thiswarm-up was also used to familiarize the subjects withthe testing equipment and lifting technique. The testing procedure was initiated 2 minutes after the warmup. The subjects were oriented to try to accomplish two
repetitions with the imposed load in three attempts inboth exercises. The rest period was 3 to 5 min between
each attempt, and 5 min between exercises. The 1RM
was recorded as the last resistance lifted in which thesubject was able to complete only one single maximal
execution [17]. Execution technique for each exercise
was standardized and continuously monitored to ensure reliability. All 1RM testing sessions were supervised by 2 experienced researchers for greater safety
and integrity of the subjects. Verbal encouragement
was given throughout each test. Three 1RM sessions
were performed separated by 48 hours (ICC  0.96).
The highest load achieved among the 3 sessions wasused for analysis in each exercise.

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set of 10–15 repetitions of each exercise with a lightload. Pre- and post-study testing was carried out atweeks 3–4 and 17–18, respectively, and comprised anthropometric, body composition and maximal dynamic
strength measurements; the RT program was carriedout during weeks 5–16. All sessions were supervisedby fitness personnel (graduate and post-graduate students). Subjects refrained from performing any othertype of physical exercise throughout the study period.
The study design is displayed in Fig. 1.
2.3. Anthropometryat the toes in order to immobilize the legs while thehands were maintained in a pronated position within
the scanning region. The subjects remained motionless during the entire scanning procedure. Both calibration and analysis were carried out by a skilledlaboratory technician. The equipment calibration followed the manufacturer’s recommendations. The software generated standard lines that set apart the limbs
from the trunk and head. These lines were adjusted by
the same technician using specific anatomical points
determined by the manufacturer. Analyses during theintervention were performed by the same technician
who was blinded to intervention time point. Previous
test-retest scans of eight older women resulted in an
SEM of 0.90 kg and ICC > 0.98 for %Fat, and an SEM
of 0.60 kg and ICC > 0.97 for FFM.

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Random Assignment to
G1S or G3S

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Fat-free mass (FFM) and body fat (%Fat) measurements were carried out using a dual energy X-ray absorptiometry (DXA) scan (Lunar Prodigy, model NRL
41990, GE Lunar, Madison, WI). Before scanning participants were instructed to remove all objects containing metal. Scans were performed with the subjects lying in the supine position along the table’s longitudinal centerline axis. Feet were taped secured together

2.6. Dietary intake
Participants were instructed by a dietitian to complete a food record on three nonconsecutive days
(two week days and one weekend day) pre- and posttraining. Subjects were given specific instructions regarding the recording of portion sizes and quantities

A.S. Ribeiro et al. / Resistance training sets in elderly women

to identify all food and fluid intake, in addition toviewing food models in order to enhance precision.
Total dietary energy, protein, carbohydrate, and lipid
content were calculated using nutrition analysis software (Avanutri Processor Nutrition Software, Rio deJaneiro, Brazil; Version 3.1.4). All subjects were asked
to maintain their normal diet throughout the study period.
2.7. Resistance training program

Variables
G1S (n = 15) G3S (n = 15)
Age (years)
65.6 ± 4.2
67.1 ± 4.3
Body mass (kg)63.5 ± 7.9
62.2 ± 8.5
Height (cm)157.1 ± 6.7
154.0 ± 4.3
Body mass index (kg/m2 ) 25.8 ± 3.3
26.2 ± 3.0
Relative body fat (%)
40.1 ± 6.3
36.5 ± 7.4
Absolute body fat (kg)25.3 ± 5.9
22.5 ± 7.5
Fat-free mass (kg)36.9 ± 3.5
37.8 ± 2.4

AU2.8. Statistical analyses
Normality was checked by the Shapiro-Wilk’s test.
The data were expressed as mean and standard deviation. Levene’s test was used to analyze the homogeneity of variances. Two-way analysis of variance(ANOVA) for repeated measures was used for within

p
0.89
0.80
0.11
0.78
0.55
0.38
0.16

Note. G1S = resistance training group that performed 1 set per exercise; G3S = resistance training group that performed 3 sets per
exercise.

group comparisons. In variables where sphericity was
violated as indicated by Mauchly’s test, the analyses
were adjusted using a Greenhouse-Geisser correction.
When F -ratio was significant, Bonferroni’s post hoc
test was employed to identify the mean differences.
Baseline differences comparisons were explored withan independent t-test. The effect size (ES) was calculated to verify the magnitude of the differences by Cohen’s d where an ES of 0.20–0.49 was considered as
small, 0.50–0.79 as moderate and  0.80 as large [20].
For all statistical analyses, significance was accepted
at p < 0.05. The data were stored and analyzed using STATISTICA software version 10.0 (STATSOFT
INC., Tulsa, OK, USA).

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The supervised RT was carried out over 12 weeks.
Training took place in the morning and was based onrecommendations for RT in elderly population to improve muscular endurance and strength [18,19]. All
participants were personally supervised by exercise
professionals with substantial experience in RT prescription throughout each training session in order toreduce deviations from the study protocol and to ensure subject safety. Subjects performed RT using a
combination of free weights and machines.
The RT protocol was a whole body program with
8 exercises performed in the following order: chestpress, horizontal leg press, seated row, knee extension,
preacher curl, leg curl, triceps pushdown, and seatedcalf raise. Participants performed between 10–15 RM
for each set. The participants were instructed to inspire
during the eccentric phase and exhale during the concentric phase of the exercise and to maintain the speedof movements at a ratio of 1:2 (concentric and eccentric phases, respectively). The rest interval ranged between 60–120 s for sets and exercises. The instructors
adjusted the loads of each exercise according to thesubject’s ability and improvements in exercise capacity throughout the study in order ensure that subjects
were using as much resistance as possible while maintaining proper technique. Progression was planned sothat when 15 repetitions were completed for two consecutive sessions, the load was increased 2–5% for theupper limb exercises and 5–10% for lower limb exercises (ACSM, 2009). At the end of each session, approximately five minutes were provided for stretching
the exercised muscles.

Table 1
General characteristics of the sample. Data are expressed as meanand standard deviation

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3. Results

Table 1 shows the general characteristics of the sample at pre-training. No significant differences between
groups were observed (p > 0.05).
Total energy and macronutrients daily intake at preand post-training are shown in Table 2. There were no
significant (p > 0.05) main effects or group vs. time interactions, indicating that the relative daily energy andmacronutrients intake did not change over time.
The body composition components variations frompre- to post-training after the 12 weeks of RT for bothgroups are presented in Fig. 2. There were no significant group vs. time interactions for any of the components analyzed (%Fat: F1 = 0.25, p = 0.62, FFM:
F1 = 0.08; p = 0.78). Similarly the main effect ofgroup did not reach values of statistical significance(%Fat: F1 = 2.21, p = 0.15, FFM: F1 = 0.57; p =0.46). However, for the main effect of time, statisticalsignificance was observed for %Fat (F1 = 9.97, p <0.05) and FFM (F1 = 7.60, p < 0.05), in which both
the groups decreased their %Fat (G1S = −2.7%, G3S= −1.7%) and increased their FFM (G1S = +1.1, G3S

A.S. Ribeiro et al. / Resistance training sets in elderly women57

Table 2
Dietary intake at pre- and post-training (12 weeks) according to resistance training group. Data are expressed as mean and standard deviation
G3S (n = 15)

3.8 ± 1.4
4.2 ± 1.6

3.9 ± 0.9
4.1 ± 0.8

Protein (g/kg)
Pre
Post

1.2 ± 0.5
1.2 ± 0.4

1.0 ± 0.2
0.9 ± 0.3

Fat (g/kg)
Pre
Post

0.9 ± 0.3
0.8 ± 0.2

Energy intake (kcal/kg)
Pre
Post

29.5 ± 9.6
30.7 ± 10.5

Effects
ANOVA
Group
Time
Interaction
ANOVA
Group
Time
Interaction
ANOVA
Group
Time
Interaction
ANOVA
Group
Time
Interaction

COPY

G1S (n = 15)
Carbohydrate (g/kg)
Pre
Post

0.8 ± 0.3
0.7 ± 0.1

25.6 ± 5.1
26.0 ± 4.7

Fp< 0.01
2.44
0.24

0.93
0.13
0.62

2.83
2.76
0.43

0.10
0.11
0.51

0.13
1.20
1.12

2.45
0.28
0.30

2.01
1.03
0.31

0.17
0.32
0.58

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Note. G1S = resistance training group that performed 1 set per exercise; G3S = resistance training group that performed 3 sets per exercise.

(a)

(b)

(b)

Fig. 2. Variations from pre- to post-training on relative body fat
and fat-free mass after the 12 weeks of resistance training in older
women (n = 30) according to the number of sets performed. ∗ p <0.05 vs. pre-training. There is no group by time interaction. Data areexpressed as mean and standard deviation.

Fig. 3. Muscular strength (1RM) in chest press and knee extension
at pre- and post-training in older women (n = 30) according to thenumber of sets performed during 12 weeks of resistance training.
∗ p < 0.05 vs. pre-training. There is a group by time interaction forboth chest press and knee extension. Data are expressed as mean andstandard deviation.

= +1.6%). ES of small magnitude was observed only
for FFM in both the groups (ES = 0.2).
Figure 3 shows pre- and post-study results for the
1RM in CP and KE for both the groups. There was significant group vs. time interaction for CP 1RM (F1 =10.22, p < 0.05) and for KE 1RM (F1 = 7.13, p <0.05), in which the G3S had higher increases than the
G1S (CP: G3S = +26.6%, G1S = +20.3%; KE: G3S= +23.9%, G1S = +16.2%) after the 12 week RT program. The ESs for BP 1RM and KE 1RM were considered large (G1S = 0.8, G3S = 2.2).

A.S. Ribeiro et al. / Resistance training sets in elderly women

4. Discussion

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The main findings of the present study were that a 3
set RT protocol produced superior increases in muscular strength compared to a 1-set protocol after 12 weeks
in elderly women, but improvements in body composition were similar regardless of the number of sets
performed. We had hypothesized that a higher training
volume would lead to greater improvements in muscular strength and body composition. This hypothesis was confirmed for the muscular strength outcomes,
which is consistent with the dose-response relationship between volume and strength reported in several
meta-analyses [9–12]. Given that subjects were untrained, differences between groups may be attributed
to greater improvements in neural adaptations (i.e., increases in motor-unit recruitment and rate coding of
motor units, improved synergistic or fixator contribution, and reductions in the coactivation of antagonists
muscles) brought about by an increased exposure to exercise performance in those performing multiple sets.
Neural adaptations have been determined to be the primary factor responsible for strength gains during theearly phase of RT [21]. Hypothetically, performing agreater number of sets should lead to greater motor
learning over time, thereby providing an advantage tothe 3-set group.
The results of our study are at odds with several
studies that examined the effects of performing 1 versus 3 sets on strength outcomes in elderly women. Both
Cannon and Marino [22] and Radaelli et al. [15] foundsimilar strength gains following performance of 1 versus 3 sets per exercise in elderly women. A possible explanation for the disparate findings between these studies and ours is that we provided a two-week familiarization period whereby subjects learned performanceof the exercises prior to undertaking 1RM tests. In
addition, current literature indicates that several 1RMsessions are beneficial in achieving accurate maximal
strength baseline scores [17,23], thus the three 1RM
sessions applied in our investigation may be considered a strong point, because such procedure can ensure the 1RM load stabilization prior intervention. For
example, Amarante do Nascimento et al. [17] investigated the number of 1RM testing sessions were necessary to achieve consistent 1RM load in older women,
and they observed that the stabilization of the load occurred between sessions 2 and 3, which confirms theneeded of several trials of 1RM to achieve a consistentevaluation. The fact that familiarization session were
not provided in the aforementioned studies suggests

the possibility that initial 1RM values were underestimated thereby skewing pre- to post-study results.
Single-set training has been recommended as a starting point for beginners engaged in RT [18,24]. With
respect to FFM outcomes, our results lend support
to such recommendations since single- and multiplesets routines resulted in similar body composition outcomes. A meta-analysis by Krieger [9] found that ESs
were 40% greater with performance of multi- compared to single-set protocols in both trained and untrained subjects. However the meta-analysis did not account for age as a covariate in regression, limiting generalizability to the present investigation. The resultsof our study are in agreement with previous findings
in untrained older women, suggesting single sets areequally as effective as multi-set protocols for increasing muscle mass during the initial weeks of RT in thispopulation [14,15]. However, it should be noted that
our study had duration of only 12 weeks. Radaelli etal. [16] reported that differences in quadriceps hypertrophy between 1- versus 3-set protocols were not evident in elderly women until 20 weeks of RT, at which
point multiple sets displayed a significant advantage.
Therefore, while single-set RT programs can provide
a time-efficient alternative for older women to develop
muscle mass, it appears that increasing the number ofsets is necessary to sustain greater hypertrophic increases over time. Future research should seek to better determine the dose-response relationship between
volume and hypertrophy in this population so that program design can be optimized to counteract sarcopenia
and maximize the accretion of functional muscle mass.
Previous research has shown reductions in body fat
in elderly women after a period of RT [25–27]. Although training with a higher volume may allow fora greater energy expenditure during the RT session,
we observed similar reductions in body fat between
groups. These results may be partly attributed to similar increases in lean tissue, given that FFM has beenshown to increase resting metabolic rate by approximately 7–8% [28–30]. Another factor to consider isthat single set protocols have been shown to produce
similar increases in excess post-exercise oxygen consumption compared to multi-set protocols in the 72hour period following RT [31]. Thus, any additional
calories expended during the RT session itself withhigher volume RT may have been overshadowed by theincreased energy expenditure following each exercise
bout. It should be noted that the body compositions
improvements observed in this investigation occurred
without alterations in the food habits of the individualsof both groups.

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5. Conclusion

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We conclude that an RT protocol comprising 3 sets
is superior to 1 set for promoting increases in muscle
strength after 12 weeks of RT in elderly women; however, the higher training volume does not induce better improvements in body composition. Taken together,
our results indicate that elderly women can take a flexible approach to program design during the early stagesof RT. If the individual’s goal is to maximally increase
muscle strength then a multiple set protocol would berecommended. However, if the goal is specifically to
improve body composition, a single-set protocol would
be adequate and can be accomplished in less time.

[9]

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It is important to point out that this study has several limitations. First, results are specific to 12-week
RT duration. Second, results are specific to untrained,
older women and cannot be necessarily generalized
to other populations. Therefore, our body composition
findings must be interpreted with some degree of caution. Follow-up work using direct imaging modalities
to assess hypertrophy is recommended. Finally, ourfindings are limited to 1 versus 3 sets of exercise.

59

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