Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial. Resistance exercise training improves heart rate variability in women with fibromyalgia Effects of Combined Resistance and Endurance Training Versus Resistance Training Alone on Strength, Exercise Capacity, and Quality of Life in Patients With COPD The effects of progressive strength training and aerobic exercise on muscle strength and cardiovascular fitness in women with fibromyalgia: a pilot study. Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure. Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia—a randomized controlled trial Once weekly combined resistance and cardiovascular training in healthy older men. Optimal load for increasing muscle power during explosive resistance training in older adults. Strength versus muscle power-specific resistance training in community-dwelling older adults. Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD. Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial Comparison of effect of aerobic cycle training and progressive resistance training on walking ability after stroke: a randomized sham exercise-controlled study. The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia. Effects of aerobic or aerobic and resistance training on cardiorespiratory and skeletal muscle function in heart failure: a randomized controlled pilot trial Effect of progressive resistance training on muscle performance after chronic stroke. Concurrent endurance and strength training not to failure optimizes performance gains. Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. Clinical benefits of the addition of lower extremity low-intensity resistance muscle training to early aerobic endurance training intervention in patients with coronary artery disease: a randomized controlled trial. Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial. Effects of systemic hypoxia on human muscular adaptations to resistance exercise training Effects of resistance training and chiropractic treatment in women with fibromyalgia. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. Upper-Body Resistance Training and Self-Efficacy Enhancement in COPD
BACKGROUND Exercise therapy is an effective component of fibromyalgia ( FM ) treatment . However , it is important to know the effects and specificities of the different types of exercise : muscle stretching and resistance training . AIM To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients . DESIGN R and omized controlled trial . SETTING Physical therapy service , FM outpatient clinic . POPULATION Forty-four women with FM ( 79 screened ) . METHODS Patients were r and omly allocated into a stretching group ( N.=14 ) , resistance group ( N.=16 ) , and control group ( N.=14 ) . Pain was assessed using the visual analog scale , pain threshold using a Fischer dolorimeter , FM symptoms using the Fibromyalgia Impact Question naire ( FIQ ) , and quality of life using the Medical Outcomes Study 36-item Short-Form Health Survey ( SF-36 ) . The three intervention groups continued with usual medical treatment . In addition , the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks . RESULTS After treatment , the stretching group showed the highest SF-36 physical functioning score ( P=0.01 ) and the lowest bodily pain score ( P=0.01 ) . The resistance group had the lowest FIQ depression score ( P=0.02 ) . The control group had the highest score for FIQ morning tiredness and stiffness , and the lowest score for SF-36 vitality . In clinical analyses , the stretching group had significant improvement in quality of life for all SF-36 domains , and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning , vitality , social function , emotional role , and mental health . CONCLUSIONS Muscle stretching exercise was the most effective modality in improving quality of life , especially with regard to physical functioning and pain , and resistance training was the most effective modality in reducing depression . CLINICAL REHABILITATION IMPACT The trial included a control group and two intervention groups , both of which received exercise programs created specifically for patients with FM . In clinical practice , we suggest including both modalities in an exercise therapy program for FM Fibromyalgia ( FM ) is characterized by generalized muscle pain , low muscle strength and autonomic dysfunction . Heart rate ( HR ) variability ( HRV ) is reduced in individuals with FM increasing their risk for cardiovascular morbidity and mortality . We tested the hypothesis that resistance exercise training ( RET ) improves HRV , baroreflex sensitivity ( BRS ) and muscle strength in women with FM . Women with FM ( n = 10 ) and healthy controls ( n = 9 ) , aged 27–60 years , were compared at baseline . Only women with FM underwent supervised RET 2 days per week for 16 weeks . Baseline and post‐training measurements included HRV and spontaneous baroreflex sensitivity ( BRS , alpha index ) from continuous electrocardiogram and blood pressure ( BP ) recorded with finger plethysmography during 5 min in the supine position . RR interval , total power , log transformed ( Ln ) squared root of the st and ard deviation of RR interval ( RMSSD ) , low‐frequency power and BRS were lower ( P<0·05 ) , and HR and pulse pressure were higher ( P<0·05 ) in women with FM than in healthy controls . After RET , mean ( SEM ) total power increased ( 387 ± 170 ms2 , P<0·05 ) , RMSSD increased ( 0·18 ± 0·08 Ln ms , P<0·05 ) and Ln of high‐frequency power increased ( 0·54 ± 0·27 Ln ms2 , P = 0·08 ) in women with FM . Upper and lower body muscle strength increased by 63 % and 49 % ( P<0·001 ) , and pain perception decreased by 39 % in women with FM . There were no changes in BRS , HR and BP after RET . Our study demonstrates that RET  improves total power , cardiac parasympathetic tone , pain perception and muscle strength in women with FM who had autonomic dysfunction before the exercise programme PURPOSE : To compare the effects of 12-week training periods ( 2 d·wk−1 ) involving resistance training only with the effects of 12-week training periods involving combined resistance ( once weekly ) and endurance ( once weekly ) training on strength , endurance performance , and quality of life . METHODS : Thirty-six patients with moderate-to-severe chronic obstructive pulmonary disease were r and omized to combined training ( REG ) , resistance training alone ( RG ) , or control ( CG ) groups . Patients were tested for maximal strength of the upper and lower extremities , power output of the lower extremities , maximal ( W max ) and submaximal exercise capacity , performance on a 6-minute walk test ( 6MWT ) , and quality of life . RESULTS : REG and RG induced similar maximal strength gains . Muscle power increased 19 % ( P ⩽ .01 ) and W max improved 13 % ( P < .05 ) in REG . Reductions ( P < .05 ) in the heart rate and blood lactate at a given submaximal workload were observed in REG . Improvements in 6MWT and quality of life were similar in both training groups . CONCLUSIONS : Compared with a twice-weekly resistance training program , the combination of once-weekly resistance and once-weekly endurance training not only produced similar gains in maximal strength , 6MWT performance , and quality of life but also produced improvements in muscle power and endurance performance . These findings may have implication s for the prescription of resistance and endurance exercise for patients with chronic obstructive pulmonary disease OBJECTIVE To determine the safety , feasibility and consequences of a program of progressive strength training and cardiovascular exercise in women with fibromyalgia syndrome ( FMS ) . METHODS Fifteen women with confirmed FMS were monitored for injury and exercise compliance , and assessed for muscle strength ( 1-repetition maximum technique ) , cardiovascular endurance ( 6-minute walk test ) , and functional status ( Fibromyalgia Impact Question naire [ FIQ ] ) before and after a 20-week exercise intervention . RESULTS Zero injuries and an 81 % compliance rate occurred during training . Improvement was seen in muscle strength of the lower ( 191 + /- 75 to 265 + /- 67 pounds ; P < 0.001 ) and upper ( 61 + /- 18 to 76 + /- 18 pounds ; P < 0.001 ) body , 6-minute walk distance ( 530 + /- 80 to 629 + /- 74 meters ; P < 0.001 ) , and in FIQ score ( 44 + /- 9 to 32 + /- 14 ; P < 0.01 ) . CONCLUSION A program of progressive strength training and cardiovascular exercise can be safe , well tolerated , and effective at improving muscle strength , cardiovascular endurance and functional status in women with FMS without exacerbating symptoms . This program may also contribute to a reduction in the severity of several symptoms Chronic heart failure ( CHF ) is characterized by a skeletal muscle myopathy not optimally addressed by current treatment paradigms or aerobic exercise . Sixteen older women with CHF were compared with 80 age-matched peers without CHF and r and omized to progressive resistance training or control stretching exercises for 10 wk . Women with CHF had significantly lower muscle strength ( P < 0.0001 ) but comparable aerobic capacity to women without CHF . Exercise training was well tolerated and result ed in no changes in resting cardiac indexes in CHF patients . Strength improved by an average of 43.4 + /- 8.8 % in resistance trainers vs. -1.7 + /- 2.8 % in controls ( P = 0.001 ) , muscle endurance by 299 + /- 66 % vs. 1 + /- 3 % ( P = 0.001 ) , and 6-min walk distance by 49 + /- 14 m ( 13 % ) vs. -3 + /- 19 m ( -3 % ) ( P = 0.03 ) . Increases in type I fiber area ( 9.5 + /- 16 % ) and citrate synthase activity ( 35 + /- 21 % ) in skeletal muscle were independently predictive of improved 6-min walk distance ( r2 = 0.78 ; P = 0.0024 ) . High-intensity progressive resistance training improves impaired skeletal muscle characteristics and overall exercise performance in older women with CHF . These gains are largely explained by skeletal muscle and not resting cardiac adaptations Introduction Fibromyalgia ( FM ) is characterized by persistent widespread pain , increased pain sensitivity and tenderness . Muscle strength in women with FM is reduced compared to healthy women . The aim of this study was to examine the effects of a progressive resistance exercise program on muscle strength , health status , and current pain intensity in women with FM . Methods A total of 130 women with FM ( age 22–64 years , symptom duration 0–35 years ) were included in this assessor-blinded r and omized controlled multi-center trial examining the effects of progressive resistance group exercise compared with an active control group . A person-centred model of exercise was used to support the participants ’ self-confidence for management of exercise because of known risks of activity-induced pain in FM . The intervention was performed twice a week for 15 weeks and was supervised by experienced physiotherapists . Primary outcome measure was isometric knee-extension force ( Steve Strong ® ) , secondary outcome measures were health status ( FIQ total score ) , current pain intensity ( VAS ) , 6MWT , isometric elbow-flexion force , h and -grip force , health related quality of life , pain disability , pain acceptance , fear avoidance beliefs , and patient global impression of change ( PGIC ) . Outcomes were assessed at baseline and immediately after the intervention . Long-term follow up comprised the self-reported question naires only and was conducted after 13–18 months . Between-group and within-group differences were calculated using non-parametric statistics . Results Significant improvements were found for isometric knee-extension force ( p = 0.010 ) , health status ( p = 0.038 ) , current pain intensity ( p = 0.033 ) , 6MWT ( p = 0.003 ) , isometric elbow flexion force ( p = 0.02 ) , pain disability ( p = 0.005 ) , and pain acceptance ( p = 0.043 ) in the resistance exercise group ( n = 56 ) when compared to the control group ( n = 49 ) . PGIC differed significantly ( p = 0.001 ) in favor of the resistance exercise group at post-treatment examinations . No significant differences between the resistance exercise group and the active control group were found regarding change in self-reported question naires from baseline to 13–18 months . Conclusions Person-centered progressive resistance exercise was found to be a feasible mode of exercise for women with FM , improving muscle strength , health status , and current pain intensity when assessed immediately after the intervention . Trial registration Clinical Trials.gov identification number : NCT01226784 , Oct 21 , 2010 PURPOSE To compare the effects of the 16-wk training period ( 2 d.wk(-1 ) ) of resistance training alone ( S ) , endurance training alone ( E ) , or combined resistance ( once weekly ) and endurance ( once weekly ) training ( SE ) on muscle mass , maximal strength and power of the leg and arm extensor muscles , and maximal workload ( Wmax ) by using a incremental cycling test in older men . METHODS Thirty-one healthy men ( 65 - 74 yr ) were divided into three treatment groups to train 2x wk(-1 ) for 16 wk : S ( N = 10 ) , E ( N = 11 ) , or SE ( N = 10 ; 1x wk(-1 ) S + 1x wk(-1 ) E ) . The subjects were tested at 8-wk intervals ( i.e. , weeks 8 and 16 ) . RESULTS There were no significant differences between  S- and SE-induced muscle hypertrophy ( 11 % and 11 % ) and maximal strength ( 41 % and 38 % ) gains of the legs as well as between E- and SE-induced Wmax ( 28 % and 23 % ) gains . The increase in arm strength in S ( 36 % ) was greater than that recorded in SE ( 22 % ) and greater than that recorded in E ( 0 % ) . CONCLUSIONS Prolonged combined resistance and endurance training in older men seemed to lead to similar gains in muscle mass , maximal strength , and power of the legs as resistance training alone and to similar gains in maximal peak power output measured in an incremental cycling test as endurance training alone . These findings may have an effect on how resistance exercise is prescribed to older adults BACKGROUND Muscle power ( force x velocity ) recedes at a faster rate than strength with age and may also be a stronger predictor of fall risk and functional decline . The optimal training paradigm for improving muscle power in older adults is not known , although some literature suggests high velocity , low load training is optimal in young adults . METHODS One hundred twelve healthy older adults ( 69 + /- 6 years ) were r and omly assigned to either explosive resistance training at 20 % ( G20 ) , 50 % ( G50 ) , or 80 % ( G80 ) one repetition maximum ( 1RM ) for 8 - 12 weeks or to a nontraining control group ( CON ) . Participants trained twice per week ( five exercises ; three sets of eight rapidly concentric and slow eccentric repetitions ) using pneumatic resistance machines . Repeated- measures analysis of variance and covariance ( ANOVA and ANCOVA ) were used to determine the effects of training . RESULTS Average peak power increased significantly and similarly in G80 ( 14 + /- 8 % ) , G50 ( 15 + /- 9 % ) , and G20 ( 14 + /- 6 % ) compared to CON ( 3 + /- 6 % ) ( p < .0001 ) . By contrast , a positive dose-response relationship with training intensity was observed for relative changes in average strength ( r = .40 , p = .0009 ) and endurance ( r = .43 , p = .0005 ) . Average strength increased in G80 ( 20 + /- 7 % ) , G50 ( 16 + /- 7 % ) , and G20 ( 13 + /- 7 % ) compared to CON ( 4 + /- 4 % ) ( p < .0001 ) . Average muscle endurance increased in G80 ( 185 + /- 126 % , p < .0001 ) , G50 ( 103 + /- 75 % , p = .0004 ) , and G20 ( 82 + /- 57 % , p = .0078 ) compared to CON ( 28 + /- 29 % ) . CONCLUSION Peak muscle power may be improved similarly using light , moderate , or heavy resistances , whereas there is a dose-response relationship between training intensity and muscle strength and endurance changes . Therefore , using heavy loads during explosive resistance training may be the most effective strategy to achieve simultaneous improvements in muscle strength , power , and endurance in older adults BACKGROUND Loss of muscle power due to normal aging has greater functional impact than loss of strength alone . The present study compared two resistance training programs , one aim ed at enhancing muscle power and one at increasing muscle strength , on muscle function and functional performance in older adults . METHODS Sixty-seven healthy , independent older adults ( 65 - 84 years ) were r and omized to a high-velocity varied resistance ( HV ) , constant resistance ( ST ) , or nontraining control ( CO ) group . Participants trained twice weekly for 24 weeks using six exercises .  Dynamic and isometric muscle strength , muscle power , movement velocity , muscle endurance , and a battery of functional performance tasks were assessed . Secondary outcomes included body composition , quality of life , and balance confidence . RESULTS Muscle strength increased significantly ( p < .001 ) and similarly in the training groups compared to controls ( HV , 51.0 + /- 9.0 % ; ST , 48.3 + /- 6.8 % ; CO , 1.2 + /- 5.1 % ) . Peak muscle power also increased with training ( p < .05 ) , with no difference between training groups . The change in peak power was 50.5 + /- 4.1 % , 33.8 + /- 3.8 % , and -2.5 + /- 3.9 % in the HV , ST , and CO groups , respectively . Training also improved selected functional performance tasks in the HV and ST groups compared to controls ( p < .05 ) , and the HV group reported improved quality of life ( p = .018 ) . CONCLUSION Muscle power and muscle strength improved similarly using either resistance training protocol , and these changes were accompanied by improvements in several functional performance tasks . However , improvements in the HV group occurred with less total work performed per training session PURPOSE Aerobic exercise training is a recognized approach for improving functional capacity in COPD . People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity . The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training . METHODS Patients were r and omized to : 1 ) sequential resistance then aerobic training ( RT-then-AT ) ( 8 weeks resistance training followed by 8 weeks aerobic exercise training ) , 2 ) control group ( CE-then-AT + RT ) ( 8 weeks of ' sham ' training followed by 8 weeks concurrent aerobic and resistance training ) , 3 ) control group ( CE-then-AT ) ( 8 weeks ' sham ' training followed by 8 weeks aerobic training ) . Outcomes were assessed at study entry , after week 8 , and after week 16 : aerobic exercise performance ; muscle strength and endurance . RESULTS 75 patients completed training :  FEV1 % pred 40 ± 10 , V˙O(2peak ) % predicted , 71 ± 22 , fat-free mass index 19.5 ± 3.1 . RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT , but improvements in aerobic exercise performance were similar . Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT . Sarcopenia was associated with poorer attendance , and lower aerobic and resistance training volumes . CONCLUSION Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training , other training outcomes were similar between the two groups , thus the sequential approach is not clearly superior to the concurrent approach in severe COPD . Clinical Trials.gov Identifier : NCT01058213 Background Fibromyalgia ( FM ) is characterized by persistent widespread pain , increased pain sensitivity and tenderness . Women with FM also report disability , in terms of negative consequences on activities of daily living . Our recent r and omized controlled trial ( RCT ) is the first study of resistance exercise to show positive effects on pain disability . The resistance exercise program of our RCT emphasized active involvement of participants in planning and progression of the exercise , using the principles of person-centeredness , to support each participant ’s ability to manage the exercise and the progress of it . The aim of this sub- study was to investigate explanatory factors for reduced pain disability in women with FM participating in a 15-week person-centered progressive resistance exercise program .  Methods A total of 67 women with FM were included in this sub- study of an RCT examining the effects of person-centered progressive resistance exercise performed twice a week for 15 weeks . Tests of physical capacity and health-related question naires were assessed at baseline and after the intervention period . Multivariable stepwise regression was used to analyze explanatory factors for improvements in pain disability . Results Reduced pain disability was explained by higher pain disability at baseline together with decreased fear avoidance beliefs about physical activity ( R2 = 28 , p = 0.005 ) . The improvements in the disability domains of recreation and social activity were explained by decreased fear avoidance beliefs about physical activity together with higher baseline values of each disability domain respectively ( R2 = 32 , p = 0.025 and R2 = 30 , p = 0.017 ) . The improvement in occupational disability was explained by higher baseline values of occupational disability ( R2 = 19 , p = 0.001 ) . Conclusion The person-centered resistance exercise intervention , based on principles of self-efficacy , had a positive effect on recreational , social and occupational disability . The reduced pain disability seemed to be mediated by decreased fear avoidance beliefs . Age , symptom duration , pain intensity , and muscle strength at baseline had no explanatory value for reduced pain disability , indicating that the person-centered resistance exercise program has the potential to work for anyone with FM who has interest in physical exercise . The trial was registered on October 21 , 2010 with Clinical Trials.gov identification number : NCT01226784 OBJECTIVES To determine whether changes in strength or cardiorespiratory fitness after exercise training improve walking ability in individuals who have had a stroke . DESIGN A sham exercise-controlled , r and omized two-by-two factorial design , in which the two factors investigated were cycle training ( AEROBIC ) and resistance training ( STRENGTH ) . SETTING University exercise laboratory . PARTICIPANTS Fifty-two individuals with a history of stroke ( aged 63+/-9 ; time since stroke , 57+/-54 months ) . INTERVENTION Participants undertook 30 exercise sessions over 10 to 12 weeks . Depending on group allocation , individuals underwent aerobic cycling plus sham progressive resistance training ( PRT ) ( n=13 ) , sham cycling plus PRT ( n=13 ) , aerobic cycling plus PRT ( n=14 ) , or sham cycling plus sham PRT ( n=12 ) . MEASUREMENTS Primary outcomes were 6-minute walk distance , habitual and fast gait velocities , and stair climbing power . Secondary outcomes included measures of cardiorespiratory fitness ; muscle strength , power , and endurance ; and psychosocial attributes . RESULTS Neither AEROBIC nor STRENGTH improved walking distance or gait velocity significantly more than sham exercise , although STRENGTH significantly improved participants ' stair climbing power by 17 % ( P=.009 ) , as well as their muscle strength , power , and endurance ; cycling peak power output ; and self-efficacy . Conversely , AEROBIC improved indicators of cardiorespiratory fitness only . Cycling plus PRT produced larger effects than either single modality for mobility and impairment outcomes . CONCLUSION Single-modality exercises targeted at existing impairments do not optimally address the functional deficits of walking but do ameliorate the underlying impairments . The underlying cardiovascular and musculoskeletal impairments are significantly modifiable years after stroke with targeted robust exercise OBJECTIVE To determine whether women with fibromyalgia benefit from strength training . DESIGN R and omized controlled trial . SETTING Testing was completed at the university and training was completed at a local community wellness facility . PARTICIPANTS Twenty-nine women ( age range , 18 - 54 y ) with fibromyalgia participated . Subjects were r and omly assigned to a control ( n=14 ; wait-listed for exercise ) or strength ( n=15 ) group . After the first 4 weeks , 7 ( 47 % ) women dropped from the strength group . INTERVENTION Subjects underwent 12 weeks of training on 11 exercises , 2 times a week , performing 1 set of 8 to 12 repetitions at 40 % to 60 % of their maximal lifts and were progressed to 60 % to 80 % . MAIN OUTCOME MEASURES Subjects were measured for strength , functionality , tender point sensitivity , and fibromyalgia impact . RESULTS The strength group significantly ( P < or = .05 ) improved upper- ( strength , 39+/-11 to 42+/-12 kg ; control , 38+/-13 to 38+/-12 kg ) and lower- ( strength , 68+/-28 to 82+/-25 kg ; control , 61+/-25 to 61+/-26 kg ) body strength . Upper-body functionality measured by the Continuous-Scale Physical Functional Performance test improved significantly ( strength , 44+/-11 to 50+/-16U ; control , 51+/-11 to 49+/-13U ) after training . Tender point sensitivity and fibromyalgia impact did not change . CONCLUSIONS Strength training improved strength and some functionality in women with fibromyalgia . Interventions with resistance have important implication s on independence and quality of life issues for women with fibromyalgia Objective : To examined the effects of different training modalities on exercise capacity ( Vo 2peak ) , systolic function , muscular strength and endurance and quality of life in heart failure patients . Design : R and omized controlled trial . Setting : Cardiac rehabilitation centre in Canada . Subjects : Forty-two individuals with heart failure ( 62 ± 12 years ; New York Heart Association ( NYHA ) classes I — III ) . Interventions : Aerobic training ( n = 14 ) , combined aerobic and resistance training ( n = 15 ) or usual care ( n = 13 ) three times per week for 12 weeks . Main measures : ( 1 ) Vo 2peak measured by symptom-limited grade d exercise test on cycle ergometer ; ( 2 ) systolic function assessed by two-dimensional echocardiography ; ( 3 ) muscular strength and muscular endurance measured by one-repetition maximum procedure ; and ( 4 ) quality of life assessed by question naires . Results : In the intention-to-treat analysis , neither aerobic nor combined aerobic and resistance training significantly improved Vo2peak , systolic function or quality of life compared with usual care . However , combined aerobic and resistance training significantly improved upper extremity strength ( 40.7 (14.0)—48.5 ( 16.0 ) kg , P<0.05 ) and muscular endurance ( 5.7 (2.7)—11.6 ( 7.6 ) reps , P<0.05 ) compared with aerobic training or usual care . In compliant participants ( exercise adherence 80 % ) , Vo2peak increased in the aerobic group ( 16.9 (6.0)—19.0 ( 6.8 ) , P= 0.026 ) and tended to increase in the combined training group ( 15.9 (5.0)—17.6 ( 5.6 ) , P= 0.058 ) compared with usual care . Quality of life was improved in the aerobic group only . Conclusions : Both aerobic and combined aerobic and resistance training are effective interventions to improve Vo2peak in compliant heart failure patients . Combined training may be more effective in improving muscle strength and endurance PURPOSE This study investigated the effects of high-intensity progressive resistance training ( PRT ) and high-intensity cycling ( cycling ) on muscle performance and the time course of strength gains in a chronic stroke population . METHODS Forty-eight individuals with chronic stroke sequelae ( mean + /- SD ; age = 63 + /- 9 yr , time since stroke = 57 + /- 54 months ) were r and omly allocated to one of four treatment groups : PRT + cycling , PRT + sham cycling , sham PRT + cycling , or sham PRT + sham cycling groups in a fully factorial clinical trial . Thirty exercise sessions were conducted over a 10- to 12-wk period . The main outcomes investigated were measures of unilateral muscle strength , peak power , and muscle endurance . RESULTS Those undergoing PRT improved their lower limb muscle strength , peak power , and endurance compared with participants receiving sham PRT or cycling only ( P < 0.05 ) , and combined exercise was not superior to PRT alone . Strength improvements occurred primarily during the first 6 to 8 wk ( 98%-100 % of total gain ) and then reached a plateau during the final 2 to 4 wk . CONCLUSION We have shown for the first time in a direct comparison study that high-intensity PRT , but not cycling or sham exercise , can improve muscle strength , peak power , and muscle endurance in both affected and unaffected lower limbs after chronic stroke by a significant and clinical ly meaningful amount . Although strength gains plateaued earlier than anticipated , adherence to the intended continuous high-intensity progressive overload protocol was largely achieved ( average load of 84 % + /- 4 % of one repetition maximum ) PURPOSE The purpose of this study was to examine the efficacy of 8 wk of resistance training to failure versus not to failure training regimens at both moderate and low volumes for increasing upper-body strength and power as well as cardiovascular parameters into a combined resistance and endurance periodized training scheme . METHODS Forty-three trained male rowers were matched and then r and omly assigned to four groups that performed the same endurance training but differed on their resistance training regimen : four exercises leading to repetition failure ( 4RF ; n = 14 ) , four exercises not leading to failure ( 4NRF ; n = 15 ) , two exercises not to failure ( 2NRF ; n = 6 ) , and control group ( C ; n = 8) . One-repetition maximum strength and maximal muscle power output during prone bench pull ( BP ) , average power during a 20-min all-out row test ( W 20 min ) , average row power output eliciting a blood lactate concentration of 4 mmol x L(-1 ) ( W 4 mmol x L(-1 ) ) , and power output in 10 maximal strokes ( W 10 strokes ) were assessed before and after 8 wk of periodized training . RESULTS 4NRF group experienced larger gains in one- repetition maximum strength and muscle power output ( 4.6 % and 6.4 % , respectively ) in BP compared with both 4RF ( 2.1 % and j1.2 % ) and 2NRF ( 0.6 % and -0.6 % ) . 4NRF and 2NRF groups experienced larger gains in W 10 strokes ( 3.6 % and 5 % ) and in W 20 min ( 7.6 % and 9 % ) compared with those found after 4RF ( -0.1 % and 4.6 % ) , whereas no significant differences between groups were observed in the magnitude of changes in W 4 mmol x L(-1 ) ( 4NRF = 6.2 % , 4RF = 5.3 % , 2NRF = 6.8 % , and C = 4.5 % ) . CONCLUSIONS An 8-wk linear periodized concurrent strength and endurance training program using a moderate number of repetitions not to failure ( 4NRF group ) provides a favorable environment for achieving greater enhancements in strength , muscle power , and rowing performance when compared with higher training volumes of repetitions to failure in experienced highly trained rowers BACKGROUND Considerable discrepancy exists in the literature on the proposed benefits of protein supplementation on the adaptive response of skeletal muscle to resistance-type exercise training in the elderly . OBJECTIVE The objective was to assess the benefits of timed protein supplementation on the increase in muscle mass and strength during prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . DESIGN Healthy elderly men ( n = 26 ) aged 72 + /- 2 y were r and omly assigned to a progressive , 12-wk resistance-type exercise training program with ( protein group ) or without ( placebo group ) protein provided before and immediately after each exercise session ( 3 sessions/wk , 20 g protein/session ) . One-repetition maximum ( 1RM ) tests were performed regularly to ensure a progressive workload during the intervention . Muscle hypertrophy was assessed at the whole-body ( dual-energy X-ray absorptiometry ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . RESULTS The 1RM strength increased approximately 25 - 35 % in both groups ( P < 0.001 ) . Dual-energy X-ray absorptiometry and computed tomography scans showed similar increases in leg muscle mass ( 6 + /- 1 % in both groups ; P < 0.001 ) and in the quadriceps ( 9 + /- 1 % in both groups ) , from 75.9 + /- 3.7 and 73.8 + /- 3.2 to 82.4 + /- 3.9 and 80.0 + /- 3.0 cm2 in the placebo and protein groups , respectively ( P < 0.001 ) . Muscle fiber hypertrophy was greater in type II ( placebo : 28 + /- 6 % ; protein : 29 + /- 4 % ) than in type I ( placebo : 5 + /- 4 % ; protein : 13 + /- 6 % ) fibers , but the difference between groups was not significant . CONCLUSION Timed protein supplementation immediately before and after exercise does not further augment the increase in skeletal muscle mass and strength after prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . This trial was registered at clinical trials.gov as NCT00744094 OBJECTIVE Muscle resistance training is often combined with aerobic endurance training during rehabilitation of patients with coronary artery disease . However , the clinical effects of additional lower-extremity low-intensity muscle resistance training during early rehabilitation ( within the first month after coronary revascularization ) in patients with coronary artery disease remain unclear . DESIGN Prospect i ve r and omized controlled trial . SUBJECTS Sixty patients with coronary artery disease . METHODS Subjects were r and omly assigned to early aerobic endurance training ( n = 30 ) or combined aerobic endurance and resistance muscle training ( n = 30 ) . Subjects performed 18 ( st and ard deviation 2 ) exercise sessions ( at 65 % VO(2peak ) , for 40 mins/session ) . In resistance muscle training , additional low-intensity ( 12 - 20 repetition maximum ) resistance muscle exercises were performed . The following parameters were evaluated : exercise capacity , body composition , blood lipid profile , glycaemic control , blood endothelial progenitor cell and cytokine content , and muscle performance . RESULTS A total of 47 patients with coronary artery disease completed the intervention . Total body lean tissue mass tended to increase with greater magnitude ( p = 0.07 ) , and blood high-density lipid cholesterol content increased with significantly greater magnitude in resistance muscle training ( p < 0.05 ) , compared with aerobic endurance training . Maximal exercise capacity , ventilatory threshold , and muscle performance increased , and steady-state exercise respiratory exchange ratio , and adipose tissue mass reduced significantly ( p < 0.05 ) , without differences between groups ( p < 0.05 ) . CONCLUSION In early aerobic endurance training intervention in patients with coronary artery disease , additional low-intensity resistance muscle training contributes to a greater increase in blood high-density lipid cholesterol content , and tends to affect lean tissue mass OBJECTIVE To determine whether progressive resistance training improves muscle strength , muscle endurance , and physical function in adults with Down syndrome . DESIGN Single-blind r and omized controlled trial . SETTING General community . PARTICIPANTS Adults ( N=20 ) with Down syndrome ( 13 men , 7 women ; mean age , 26.8+/-7.8 y ) were r and omly assigned through a concealed allocation block r and omized method to either an intervention group ( n=9 ) or a control group ( n=11 ) . INTERVENTION The intervention was a supervised , group progressive resistance training program , consisting of 6 exercises using weight machines performed twice a week for 10 weeks . Participants completed 2 to 3 sets of between 10 to 12 repetitions of each exercise until they reached fatigue . The control group continued with their usual activities . MAIN OUTCOME MEASURES The outcomes measured by blinded assessors were muscle strength ( 1-repetition maximum [ 1-RM ] ) , muscle endurance ( number of repetitions at 50 % of 1-RM ) for chest press and leg press , timed stairs test , and the grocery shelving task . RESULTS The intervention group showed significant improvement in upper-limb muscle endurance compared with the control group ( mean difference in the number of repetitions of the chest press at 50 % of 1-RM was 16.7 , 95 % confidence interval , [ CI ] 7.1 - 26.2 ) ; and a trend toward an improvement in upper-limb muscle strength ( mean difference in chest press 1-RM , 8.6 kg ; 95 % CI , -1.3 to 18.5 kg ) and in upper-limb function ( mean difference in grocery shelving task , -20.3s ; 95 % CI , -45.7 to 5.2s ) . There were no significant differences between the groups for lower-limb muscle performance or physical function measures . No major adverse events for the intervention were noted . CONCLUSIONS Progressive resistance training is a safe and feasible fitness option that can improve upper-limb muscle endurance in adults with Down syndrome ( ACTR identifier ACTRN 012606000515594 . ) Abstract Hypoxia is an important modulator of endurance exercise‐induced oxidative adaptations in skeletal muscle . However , whether hypoxia affects resistance exercise‐induced muscle adaptations remains unknown . Here , we determined the effect of resistance exercise training under systemic hypoxia on muscular adaptations known to occur following both resistance and endurance exercise training , including muscle cross‐sectional area ( CSA ) , one‐repetition maximum ( 1RM ) , muscular endurance , and makers of mitochondrial biogenesis and angiogenesis , such as peroxisome proliferator‐activated receptor‐γ coactivator‐1α ( PGC‐1α ) , citrate synthase ( CS ) activity , nitric oxide synthase ( NOS ) , vascular endothelial growth factor ( VEGF ) , hypoxia‐inducible factor‐1 ( HIF‐1 ) , and capillary‐to‐fiber ratio . Sixteen healthy male subjects were r and omly assigned to either a normoxic resistance training group ( NRT , n = 7 ) or a hypoxic ( 14.4 % oxygen ) resistance training group ( HRT , n = 9 ) and performed 8 weeks of resistance training .  Blood and muscle biopsy sample s were obtained before and after training . After training muscle CSA of the femoral region , 1RM for bench‐press and leg‐press , muscular endurance , and skeletal muscle VEGF protein levels significantly increased in both groups . The increase in muscular endurance was significantly higher in the HRT  group . Plasma VEGF concentration and skeletal muscle capillary‐to‐fiber ratio were significantly higher in the HRT group than the NRT group following training . Our results suggest that , in addition to increases in muscle size and strength , HRT may also lead to increased muscular endurance and the promotion of angiogenesis in skeletal muscle OBJECTIVE The objective of this study was to evaluate resistance training ( RES ) and RES combined with chiropractic treatment ( RES-C ) on fibromyalgia ( FM ) impact and functionality in women with FM . DESIGN The design of the study was a r and omized control trial . SETTING Testing and training were completed at the university and chiropractic treatment was completed at chiropractic clinics . PARTICIPANTS Participants ( 48 + /- 9 years ; mean + /- st and ard deviation ) were r and omly assigned to RES ( n = 10 ) or RES-C ( n = 11 ) . INTERVENTION Both groups completed 16 weeks of RES consisting of 10 exercises performed two times per week . RES-C received RES plus chiropractic treatment two times per week . OUTCOME MEASURES Strength was assessed using one repetition maximum for the chest press and leg extension . FM impact was measured using the FM impact question naire , myalgic score , and the number of active tender points . Functionality was assessed using the 10-item Continuous Scale Physical Functional Performance test . Analyses of variance with repeated measures compared groups before and after the intervention . RESULTS Six ( 6 ) participants discontinued the study : 5 from  RES  and 1 from RES-C.  Adherence to training was significantly higher in RES-C ( 92.0 + /- 7.5 % ) than in RES ( 82.8 + /- 7.5 % ) . Both groups increased ( p < or = 0.05 ) upper and lower body strength . There were similar improvements in FM impact in both groups . There were no group interactions for the functionality measures . Both groups improved in the strength domains ; however , only RES-C significantly improved in the pre- to postfunctional domains of flexibility , balance and coordination , and endurance . CONCLUSIONS In women with FM , resistance training improves strength , FM impact , and strength domains of functionality . The addition of chiropractic treatment improved adherence and dropout rates to the resistance training and facilitated greater improvements in the domains of functionality BACKGROUND Resistance exercise training was applied to patients with chronic heart failure ( CHF ) on the basis that it may partly reverse deficiencies in skeletal muscle strength and endurance , aerobic power ( VO(2peak ) ) , heart rate variability ( HRV ) , and forearm blood flow ( FBF ) that are all putative factors in the syndrome . METHODS AND RESULTS Thirty-nine CHF patients ( New York Heart Association Functional Class=2.3+/-0.5 ; left ventricular ejection fraction 28%+/-7 % ; age 65+/-11 years ; 33:6 male : female ) underwent 2 identical series of tests , 1 week apart , for strength and endurance of the knee and elbow extensors and flexors , VO(2peak ) , HRV , FBF at rest , and FBF activated by forearm exercise or limb ischemia . Patients were then r and omized to 3 months of resistance training ( EX , n=19 ) , consisting of mainly isokinetic ( hydraulic ) ergometry , interspersed with rest intervals , or continuance with usual care ( CON , n=20 ) , after which they underwent repeat endpoint testing . Combining all 4 movement patterns , strength increased for EX by 21+/-30 % ( mean+/-SD , P<.01 ) after training , whereas endurance improved 21+/-21 % ( P<.01 ) . Corresponding data for CON remained almost unchanged ( strength P<.005 , endurance P<.003 EX versus CON ) . VO(2peak ) improved in EX by 11+/-15 % ( P<.01 ) , whereas it decreased by 10+/-18 % ( P<.05 ) in CON ( P<.001 EX versus CON ) . The ratio of low-frequency to high-frequency spectral power fell after resistance training in EX by 44+/-53 % ( P<.01 ) , but was unchanged in CON ( P<.05 EX versus CON ) . FBF increased at rest by 20+/-32 % ( P<.01 ) , and when stimulated by submaximal exercise ( 24+/-32 % , P<.01 ) or limb ischemia ( 26+/-45 % , P<.01 ) in EX , but not in CON ( P<.01 EX versus CON ) . CONCLUSIONS Moderate-intensity resistance exercise training in CHF patients produced favorable changes to skeletal muscle strength and endurance , VO(2peak ) , FBF , and HRV Purpose Loss of skeletal muscle strength is commonly seen with chronic obstructive pulmonary disease ( COPD ) . The study aim was to determine the effects of comprehensive upper-body resistance training ( 8 different lifts ) and a self-efficacy enhancing intervention in COPD with respect to muscle strength , symptoms , functional status and exercise adherence . Methods This r and omized trial had 3 groups : upper-body resistance training with an intervention to enhance self-efficacy ( UBR + SE ) , upper-body resistance training and health education ( UBR + HE ) , gentle chair exercises and health education ( CE + HE ) . Subjects performed 16 weeks of supervised training , then 12 months of long-term maintenance at home . Outcomes were : muscle strength , dyspnea , functional status , self-efficacy , and adherence . Results Sixty-four subjects completed 16 wks of training : age 71 ± 8 yr , fat-free mass index 19 ± 3 kg/m2 , forced expiratory volume in one second 58 ± 18 percent predicted .  The UBR + SE intervention produced a 46 % increase in strength compared to a 36 % increase in the UBR + HE group ( P = 0.054 ) . The combined UBR + SE and UBR + HE groups produced a 41 % increase in strength compared to an 11 % increase in the CE+HE ( P < 0.001 ) . The combined UBR groups also demonstrated increases in lean arm mass ( P = 0.003 ) and a trend toward decreased dyspnea ( P = 0.053 ) . There were no group differences in attrition , attendance and training progression . Fifty subjects completed long-term maintenance and the UBR + SE and UBR + HE groups retained some gains in muscle strength , 24 % and 21 % respectively , and the CE + HE group lost 3 % of muscle strength from baseline . Conclusion The study provides strong evidence that comprehensive resistance training increased strength and lean arm mass and that strength can be partially maintained through a simple home program using h and weights . It provides limited evidence that upper-body resistance training improved dyspnea and that the exercise-specific self-efficacy enhancing intervention was beneficial
There were no statistically significant differences in attrition rates between the interventions .
In general , adverse effects were poorly recorded , but no serious adverse effects were reported .
The evidence ( rated as low quality ) suggested that moderate- and moderate- to high-intensity resistance training improves multidimensional function , pain , tenderness , and muscle strength in women with fibromyalgia .
The evidence ( rated as low quality ) also suggested that eight weeks of aerobic exercise was superior to moderate-intensity resistance training for improving pain in women with fibromyalgia .
There was low- quality evidence that 12 weeks of low-intensity resistance training was superior to flexibility exercise training in women with fibromyalgia for improvements in pain and multidimensional function .
There was low- quality evidence that women with fibromyalgia can safely perform moderate- to high-resistance training
BACKGROUND Fibromyalgia is characterized by chronic widespread pain that leads to reduced physical function .
Exercise training is commonly recommended as a treatment for management of symptoms .
We examined the literature on resistance training for individuals with fibromyalgia .
Resistance training is exercise performed against a progressive resistance with the intention of improving muscle strength , muscle endurance , muscle power , or a combination of these .
OBJECTIVES To evaluate the benefits and harms of resistance exercise training in adults with fibromyalgia .
We compared resistance training versus control and versus other types of exercise training .