Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: a randomized controlled trial Progressive resistance training rebuilds lean body mass in head and neck cancer patients after radiotherapy--results from the randomized DAHANCA 25B trial. Resistance training improves muscle strength and functional capacity in multiple sclerosis Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial A randomized controlled trial of progressive resistance training in depressed elders. Single muscle fiber adaptations to resistance training in old (>80 yr) men: evidence for limited skeletal muscle plasticity. Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms Strength improvements with 1 yr of progressive resistance training in older women. Effects of high-intensity resistance training in patients with rheumatoid arthritis: 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. Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training Effect of progressive resistance training on muscle performance after chronic stroke. Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial. Effects of testosterone and progressive resistance exercise in healthy, highly functioning older men with low-normal testosterone levels. A rationale and method for high-intensity progressive resistance training with children and adolescents. Creatine Fails to Augment the Benefits from Resistance Training in Patients with HIV Infection: A Randomized, Double-Blind, Placebo-Controlled Study High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors Reductions in C-reactive protein in older adults with type 2 diabetes are related to improvements in body composition following a randomized controlled trial of resistance training Core self-evaluation as a predictor of strength training adoption in older adults. Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. Effect of continuous progressive resistance training during hemodialysis on body composition, physical function and quality of life in end-stage renal disease patients: a randomized controlled trial Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial.
Background : Few high- quality trials have examined the effects of progressive resistance training ( PRT ) on people with multiple sclerosis ( MS ) . Objective : To determine the effectiveness of PRT for people with MS , focusing on improving the gait deficits common in this population . Methods : Using a single blind r and omized controlled trial , people with relapsing – remitting MS were r and omly allocated to either a PRT program targeting the lower limb muscles twice a week for 10 weeks ( n = 36 ) , or usual care plus an attention and social program conducted once a week for 10 weeks ( n = 35 ) . Outcomes were recorded at baseline , week 10 and week 22 . Results : Participants attended 92 % of training sessions , with no serious adverse events . At 10 weeks , no differences were detected in walking performance . However , compared with the comparison group PRT demonstrated increased leg press strength ( 16.8 % , SD 4.5 ) , increased reverse leg press strength ( 29.8 % , SD 12.7 ) , and increased muscle endurance of the reverse leg press ( 38.7 % , SD 32.8 ) . Improvements in favor of PRT were also found for physical fatigue ( Mean difference −3.9 units , 95%CI −6.6 to −1.3 ) , and the physical health domain of quality of life ( Mean difference 1.5 units , 95%CI 0.1 to 2.9 ) . At week 22 almost no between-group differences remained . Conclusion : PRT is a relatively safe intervention that can have short-term effects on reducing physical fatigue , increasing muscle endurance and can lead to small improvements in muscle strength and quality of life in people with relapsing – remitting MS . However , no improvements in walking performance were observed and benefits do not appear to persist if training is completely stopped PURPOSE The critical weight loss observed in head and neck squamous cell carcinoma ( HNSCC ) patients following radiotherapy  is mainly due to loss of lean body mass . This is associated with decreases in muscle strength , functional performance and Quality of Life ( QoL ) . The present study investigated the effect of progressive resistance training ( PRT ) on lean body mass , muscle strength and functional performance in HNSCC patients following radiotherapy .  PATIENTS AND METHODS Following radiotherapy HNSCC patients were r and omized into two groups : Early Exercise ( EE , n=20 ) initiated 12 weeks of PRT followed by 12 weeks of self-chosen physical activity . Delayed Exercise ( DE , n=21 ) initiated 12 weeks of self-chosen physical activity followed by 12 weeks of PRT .  Lean body mass , muscle strength , functional performance and QoL were evaluated at baseline and after week 12 and 24 . RESULTS In the first 12 weeks lean body mass increased by 4.3 % in EE after PRT and in the last 12 weeks by 4.2 % in DE after PRT . These increases were significantly larger than the changes after self-chosen physical activity ( p ≤ 0.005 ) . Regardless of PRT start-up time , the odds ratio of increasing lean body mass by more than 4 % after PRT was 6.26 ( p<0.05 ) . PRT significantly increased muscle strength , whereas functional performance increased significantly more than after self-chosen physical activity only after delayed onset of PRT . Overall QoL improved significantly more in EE than DE from baseline to week 12 . CONCLUSION PRT effectively increased lean body mass and muscle strength in HNSCC patients following radiotherapy  , irrespectively of early or delayed start-up Objective : To test the hypothesis that lower extremity progressive resistance training ( PRT ) can improve muscle strength and functional capacity in patients with multiple sclerosis ( MS ) and to evaluate whether the improvements are maintained after the trial . Methods : The present study was a 2-arm , 12-week , r and omized controlled trial including a post study follow-up period of 12 weeks . Thirty-eight moderately impaired patients with MS were r and omized to a PRT exercise group ( n = 19 ) or a control group ( n = 19 ) . The exercise group completed a biweekly 12-week lower extremity PRT program and was afterward encouraged to continue training . After the trial , the control group completed the PRT intervention . Both groups were tested before and after 12 weeks of the trial and at 24 weeks ( follow-up ) , where isometric muscle strength of the knee extensors ( KE MVC ) and functional capacity ( FS ; combined score of 4 tests ) were evaluated . Results : KE MVC and FS improved after 12 weeks of PRT in the exercise group ( KE MVC : 15.7 % [ 95 % confidence interval 4.3–27.0 ] , FS : 21.5 % [ 95 % confidence interval 17.0–26.1 ] ; p < 0.05 ) , and the improvements were better than in the control group ( p < 0.05 ) . The improvements of KE and FS in the exercise group persisted at follow-up after 24 weeks . Also , the exercise effects were reproduced in the control group during the 12-week posttrial PRT period . Conclusions : Twelve weeks of intense progressive resistance training of the lower extremities leads to improvements of muscle strength and functional capacity in patients with multiple sclerosis , the effects persisting after 12 weeks of self-guided physical activity . Level of evidence : The present study provides level III evidence supporting the hypothesis that lower extremity progressive resistance training can improve muscle strength and functional capacity in patients with multiple sclerosis Study design : A r and omized controlled trial . Objectives : To determine the effectiveness of electrical stimulation (ES)-evoked muscle contractions superimposed on progressive resistance training ( PRT ) for increasing voluntary strength in the quadriceps muscles of people with spinal cord injuries ( SCI ) . Setting : Sydney , Australia . Methods : A total of 20 people with established SCI and neurologically induced weakness of the quadriceps muscles participated in the trial . Participants were r and omized between experimental and control groups . Volunteers in the experimental group received ES superimposed on PRT to the quadriceps muscles of one leg thrice weekly for 8 weeks . Participants in the control group received no intervention . Assessment s occurred at the beginning and at the end of the 8-week period . The four primary outcomes were voluntary strength ( Nm ) and endurance ( fatigue ratio ) as well as the performance and satisfaction items of the Canadian Occupational Performance Measure ( COPM ; points ) . Results : The between-group mean differences ( 95 % confidence interval ( CI ) ) for voluntary strength and endurance were 14 Nm ( 1–27 ; P=0.034 ) and 0.1 ( −0.1 to 0.3 ; P=0.221 ) , respectively . The between-group median differences ( 95 % CI ) for the performance and satisfaction items of the COPM were 1.7 points ( −0.2 to 3.2 ; P=0.103 ) and 1.4 points ( −0.1 to 4.6 ; P=0.058 ) , respectively . Conclusion : ES superimposed on PRT  improves voluntary strength , although there is uncertainty about whether the size of the treatment effect is clinical ly important . The relative effectiveness of ES and PRT is yet to be determined BACKGROUND Depression in elderly people may be contributed to by the multiple losses of aging . Exercise has the potential to positively impact many of these losses simultaneously . We tested the hypothesis that progressive resistance training ( PRT ) would reduce depression while improving physiologic capacity , quality of life , morale , function and self-efficacy without adverse events in an older , significantly depressed population . METHODS We conducted a 10-week r and omized controlled trial of volunteers aged 60 and above with major or minor depression or dysthymia . Subjects were r and omized for 10 weeks to either a supervised PRT program three times a week or an attention-control group . RESULTS A total of 32 subjects aged 60 - 84 , mean age 71.3 + /- 1.2 yr , were r and omized and completed the study . No significant adverse events occurred . Median compliance was 95 % . PRT significantly reduced all depression measures ( Beck Depression Inventory in exercisers 21.3 + /- 1.8 to 9.8 + /- 2.4 versus controls 18.4 + /- 1.7 to 13.8 + /- 2 , p = .002 ; Hamilton Rating Scale of Depression in exercisers 12.3 + /- 0.9 to 5.3 + /- 1.3 versus controls 11.4 + /- 1.0 to 8.9 + /- 1.3 , p = .008 ) . Quality of life subscales of bodily pain ( p = .001 ) , vitality ( p = .002 ) , social functioning ( p = .008 ) , and role emotional ( p = .02 ) were all significantly improved by exercise compared to controls . Strength increased a mean of 33 % + /- 4 % in exercisers and decreased 2 % + /- 2 % in controls ( p < .0001 ) . In a multiple stepwise regression model , intensity of training was a significant independent predictor of decrease in depression scores ( r2 = .617 , p = .0002 ) . CONCLUSIONS PRT is an effective antidepressant in depressed elders , while also improving strength , morale , and quality of life The purpose of this study was to investigate whole muscle and single muscle fiber adaptations in very old men in response to progressive resistance training ( PRT ) .  Six healthy independently living old men ( 82 + /- 1 yr ; range 80 - 86 yr , 74 + /- 4 kg )  resistance-trained the knee extensors ( 3 sets , 10 repetitions ) at approximately 70 % one repetition maximum 3 days/wk for 12 wk . Whole thigh muscle cross-sectional area ( CSA ) was assessed before and after PRT using computed tomography ( CT ) . Muscle biopsies were obtained from the vastus lateralis before and after the PRT program . Isolated myosin heavy chain ( MHC ) I and IIa single muscle fibers ( n = 267 ; 142 pre ; 125 post ) were studied for diameter , peak tension , shortening velocity , and power . An additional set of isolated single muscle fibers ( n = 2,215 ; 1,202 pre ; 1,013 post ) was used to identify MHC distribution . One repetition maximum knee extensor strength increased ( P < 0.05 ) 23 + /- 4 kg ( 56 + /- 4 to 79 + /- 7 kg ; 41 % ) . Muscle CSA increased ( P < 0.05 ) 3 + /- 1 cm2 ( 120 + /- 7 to 123 + /- 7 cm2 ; 2.5 % ) . Single muscle fiber contractile function and MHC distribution were unaltered with PRT . These data indicate limited muscle plasticity at the single-muscle fiber level with a resistance-training program among the very old . The minor increases in whole muscle CSA coupled with the static nature of the myocellular profile indicate that the strength gains were primarily neurological . These data contrast typical muscle responses to resistance training in young ( approximately 20 yr ) and old ( approximately 70 yr ) humans and indicate that the physiological regulation of muscle remodeling is adversely modified in the oldest old Background Depression is a disabling , prevalent condition . Physical activity programs may assist depression management in older people , ameliorate co-morbid conditions and reduce the need for antidepressants . The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training ( PRT ) program .  The study also aim ed to determine whether PRT improves depressive status in older depressed patients . Methods A r and omised controlled trial was conducted . People aged ≥ 65 years with depressive symptoms were recruited via general practice s. Following baseline assessment , subjects were r and omly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group . Follow-up assessment of depressive status , physical and psychological health , functional and quality of life status occurred post intervention and at six months . Results Three hundred and forty six people responded to the study invitation , of whom 22 % had depressive symptoms ( Geriatric Depression Scale , GDS-30 score ≥ 11 ) . Thirty two people entered the trial . There were no significant group differences on the GDS at follow-up . At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group , but this finding did not reach significance ( p = 0.08 ) . More of the PRT group ( 57 % ) had a reduction in depressive symptoms post program , compared to 44 % of the control group . It was not possible to discern which specific components of the program influenced its impact , but in post hoc analyses , improvement in depressive status appeared to be associated with the number of exercise sessions completed ( r = -0.8 , p < 0.01 ) . Conclusion The UPLIFT pilot study confirmed that older people with depression can be successfully recruited to a community based PRT program . The program can be offered by existing community-based facilities , enabling its ongoing implementation for the potential benefit of other older people Thirty-nine healthy women ( 59.5 + /- 0.9 yr ) were r and omized to either a control group ( CON ) or a progressive resistance training group ( PRT ) that trained twice weekly for 12 months . PRT trained at 80 % or more ( average of 84 % ) of their most recent one repetition maximum ( 1RM ) on the lateral pull-down ( LPD ) , knee extensor ( KE ) , and double leg press ( DLP ) apparatus . One RM was measured for each exercise once monthly in PRT and at baseline , mid study , and end of study in CON . One RM significantly increased in PRT for all muscle groups trained compared to CON ( P < 0.0001 ) . Increases of 73.7 + /- 12 % , 35.1 + /- 3 % , and 77.0 + /- 5 % , respectively , for KE , DLP , and LPD in PRT and 12.7 % + /- 8 % , 3.7 % + /- 3 % , and 18.4 % + /- 4 % , respectively , in CON were observed . Approximately 50 % of the gains in KE and LPD and 40 % in the DLP were seen in the first 3 months of the study . In all three exercises , strength gains in PRT continued over the entire 12-month period . These data indicate that high-intensity strength training results in substantial , continual increases in strength in postmenopausal women for at least 12 months , with the greatest gains seen in the first 3 months of training OBJECTIVE To confirm , in a r and omized controlled trial ( RCT ) , the efficacy of high-intensity progressive resistance training ( PRT ) in restoring muscle mass and function in patients with rheumatoid arthritis ( RA ) . Additionally , to investigate the role of the insulin-like growth factor ( IGF ) system in exercise-induced muscle hypertrophy in the context of RA . METHODS Twenty-eight patients with established , controlled RA were r and omized to either 24 weeks of twice-weekly PRT ( n = 13 ) or a range of movement home exercise control group ( n = 15 ) . Dual x-ray absorptiometry-assessed  body composition ( including lean body mass [ LBM ] , appendicular lean mass [ ALM ] , and fat mass ) ; objective physical function ; disease activity ; and muscle IGFs were assessed at weeks 0 and 24 . RESULTS Analyses of variance revealed that PRT increased LBM and ALM ( P < 0.01 ) ; reduced trunk fat mass by 2.5 kg ( not significant ) ; and improved training-specific strength by 119 % , chair st and s by 30 % , knee extensor strength by 25 % , arm curls by 23 % , and walk time by 17 % ( for objective function tests , P values ranged from 0.027 to 0.001 versus controls ) . In contrast , body composition and physical function remained unchanged in control patients . Changes in LBM and regional lean mass were associated with changes in objective function ( P values ranged from 0.126 to < 0.0001 ) . Coinciding with muscle hypertrophy , previously diminished muscle levels of IGF-1 and IGF binding protein 3 both increased following PRT ( P < 0.05 ) . CONCLUSION In an RCT , 24 weeks of PRT proved safe and effective in restoring lean mass and function in patients with RA . Muscle hypertrophy coincided with significant elevations of attenuated muscle IGF levels , revealing a possible contributory mechanism for rheumatoid cachexia . PRT should feature in disease management 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 BACKGROUND Progressive resistance exercise training ( PRT ) has been shown to increase muscle strength and fat-free mass ( FFM ) in elderly persons . Limited information is available regarding the effects of PRT on lean and fat mass in frail elderly persons . METHODS Ninety-one community-dwelling sedentary men and women , 78 years and older with physical frailty ( defined using st and ardized objective criteria ) were enrolled in a 9-month trial of exercise training ( ET ) . Physical frailty was defined as having 2 of the 3 following criteria : modified Physical Performance Test score between 18 and 32 , peak aerobic power between 10 and 18 ml/kg/min , or self-report of difficulty or assistance with two instrumental activities of daily living or one basic activity of daily living . Participants were r and omly assigned to either a control ( CTL ) group that performed a low intensity home exercise program or a supervised ET group that performed 3 months of low intensity exercise and 3 months of PRT . RESULTS After completion of PRT , ET participants had greater improvements than did CTL participants in maximal voluntary force production for knee extension ( mean Delta + 5.3 + /- 13 ft/lb vs + 1.1 + /- 11 ft/lb , p = .05 ) , measured using isokinetic dynamometry . Total body FFM ( measured using dual energy x-ray absorptiometry ) increased in the ET group , but not in the CTL group ( mean Delta + 0.84 + /- 1.4 kg vs + 0.01 + /- 1.5 kg , p = .005 ) . Total , trunk , intra-abdominal , and subcutaneous fat mass ( measured using dual energy x-ray absorptiometry and (1)H-magnetic resonance imaging ) did not change in response to PRT . CONCLUSIONS Three months of supervised PRT induced improvements in maximal voluntary thigh muscle strength and whole body FFM in frail , community-dwelling elderly women and men . This supervised exercise program may not be sufficient to reduce whole-body or intra-abdominal fat area in this population OBJECTIVES To determine whether improvements in aerobic capacity ( VO2peak ) and strength after progressive resistance training ( PRT ) mediate improvements in cognitive function . DESIGN R and omized , double-blind , double-sham , controlled trial . SETTING University research facility . PARTICIPANTS Community-dwelling older adults ( aged ≥55 ) with mild cognitive impairment ( MCI ) ( N = 100 ) . INTERVENTION PRT and cognitive training ( CT ) , 2 to 3 days per week for 6 months . MEASUREMENTS Alzheimer 's Disease Assessment Scale-cognitive subscale ( ADAS-Cog ) ; global , executive , and memory domains ; peak strength ( 1 repetition maximum ) ; and VO2peak . RESULTS PRT increased upper ( st and ardized mean difference ( SMD ) = 0.69 , 95 % confidence interval = 0.47 , 0.91 ) , lower ( SMD = 0.94 , 95 % CI = 0.69 - 1.20 ) and whole-body ( SMD = 0.84 , 95 % CI = 0.62 - 1.05 ) strength and percentage change in VO2peak ( 8.0 % , 95 % CI = 2.2 - 13.8 ) significantly more than sham exercise . Higher strength scores , but not greater VO2peak , were significantly associated with improvements in cognition ( P < .05 ) . Greater lower body strength significantly mediated the effect of PRT on ADAS-Cog improvements ( indirect effect : β = -0.64 , 95 % CI = -1.38 to -0.004 ; direct effect : β = -0.37 , 95 % CI = -1.51 - 0.78 ) and global domain ( indirect effect : β = 0.12 , 95 % CI = 0.02 - 0.22 ; direct effect : β = -0.003 , 95 % CI = -0.17 - 0.16 ) but not for executive domain ( indirect effect : β = 0.11 , 95 % CI = -0.04 - 0.26 ; direct effect : β = 0.03 , 95 % CI = -0.17 - 0.23 ) . CONCLUSION High-intensity PRT results in significant improvements in cognitive function , muscle strength , and aerobic capacity  in older adults with MCI  . Strength gains , but not aerobic capacity changes , mediate the cognitive benefits of PRT . Future investigations are warranted to determine the physiological mechanisms linking strength gains and cognitive benefits 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 ) OBJECTIVES To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults . DESIGN R and omized , controlled trial . SETTING Retirement village . PARTICIPANTS Thirty-eight subjects ( 14 men and 24 women ) aged 76.6 + /- 6.1 . INTERVENTION A wait list control or 10 weeks of supervised exercise consisting of high-intensity ( 80 % of one-repetition maximum ( 1RM ) ) progressive resistance training ( PRT ) 3 days per week , moderate-intensity ( rating of perceived exertion 11 to 14/20 ) aerobic training 2 days per week , and progressive balance training 1 day per week . MEASUREMENTS Blinded assessment s of dynamic muscle strength ( 1RM ) , balance , 6-minute walk , gait velocity , chair st and , stair climb , depressive symptoms , self-efficacy , and habitual physical activity level . RESULTS Higher baseline strength and psychological well-being were associated with better functional performance . Strength gains over 10 weeks averaged 39+/-31 % in exercise , versus 21+/-24 % in controls ( P=.10 ) , with greater improvements in hip flexion ( P=.01 ) , hip abduction ( P=.02 ) , and chest press ( P=.04 ) in the exercise group . Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved . Stair climb power ( 12.3+/-15 % , P=.002 ) and chair st and time ( -7.1+/-15 % , P=.006 ) improved significantly and similarly in both groups . Reduction in depressive symptoms was significantly related to compliance ( attendance rate r=-0.568 , P=.009 , PRT progression in loading r=-0.587 , P=.02 , and total volume of aerobic training r=-0.541 , P=.01 ) , as well as improvements in muscle strength ( r=-0.498 , P=.002 ) . CONCLUSION Robust physical and psychological adaptations to exercise are linked , although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults CONTEXT Aging in men is associated with reduced testosterone ( T ) levels and physiological changes leading to frailty , but the benefits of T supplementation are inconclusive . OBJECTIVE We studied the effects of T supplementation with and without progressive resistance training ( PRT ) on functional performance , strength , and body composition . DESIGN , SETTING , AND PARTICIPANTS We recruited 167 generally healthy community-dwelling older men ( 66 ± 5 years ) with low-normal baseline total T levels ( 200 - 350 ng/dL ) . INTERVENTION Subjects were r and omized to placebo or transdermal T gel [ 2 doses targeting either a lower ( 400 - 550 ng/dL ) or higher ( 600 - 1000 ng/dL ) T range ] and to either PRT or no exercise for 12 months . MAIN OUTCOME MEASURE The primary outcome was functional performance , whereas secondary outcomes were strength and body composition . RESULTS A total of 143 men completed the study . At 12 months , total T was 528 ± 287 ng/dL in subjects receiving any T and 287 ± 65 ng/dL in the placebo group . In the PRT group , function and strength were not different between T- and placebo-treated subjects , despite greater improvements in fat mass ( P = .04 ) and fat-free mass ( P = .01 ) with T. In the non-PRT group , T did not improve function but improved fat mass ( P = .005 ) , fat-free mass ( P = .03 ) , and upper body strength ( P = .03 ) compared with placebo . There were fewer cardiovascular events in the T-treated groups compared with placebo . CONCLUSIONS T supplementation was well tolerated and improved body composition but had no effect on functional performance . T supplementation improved upper body strength only in nonexercisers compared with placebo BACKGROUND The rising prevalence of obesity in children and adolescents is implicated in the metabolic abnormalities that track into adulthood . The associated increased incidence of insulin resistance , metabolic syndrome and type 2 diabetes being identified in younger cohorts has given rise to a critical global health issue . Muscular strength is a vital component of metabolic fitness that provides protection from insulin resistance in adults , and we have recently shown this to be true in children as well . Targeting muscular strength deficiencies at an early age may be an effective preventative strategy for metabolic syndrome and type 2 diabetes . PURPOSE There is limited evidence -based best practice for progressive resistance training ( PRT ) , adiposity and metabolic fitness in children and adolescents . The purpose of this paper is to describe the methodology we utilized for implementing a PRT program to avoid publication bias , enable replication of the study and share a novel program that we have found safe and suitable for use with youth . METHODS We conducted the first r and omized controlled trial ( RCT ) prescribing high-intensity PRT to children and adolescents ( 10 - 15 years ) as a community-based primary prevention program to address adiposity and metabolic health . Participants were instructed to complete 2 sets of 8 repetitions of 11 exercises targeting all the major muscle groups twice a week at an RPE of 15 - 18 for 8 weeks . RESULTS Primary outcome was waist circumference ; secondary outcomes included insulin resistance , lipid levels , muscle strength , cardiorespiratory fitness , body composition , self-efficacy , self-concept , habitual physical activity , nutritional and sedentary behavior patterns . CONCLUSION The supervised PRT program that we used with children and adolescents has been described in detail . The efficacy of this modality of exercise for metabolic fitness and other health outcomes is now under investigation Background Progressive resistance exercise training ( PRT ) improves physical functioning in patients with HIV infection .  Creatine supplementation can augment the benefits derived from training in athletes and improve muscle function in patients with muscle wasting . The objective of this study was to determine whether creatine supplementation augments the effects of PRT on muscle strength , energetics , and body composition in HIV-infected patients . Methodology /Principal Findings This is a r and omized , double blind , placebo-controlled , clinical research center-based , outpatient study in San Francisco . 40 HIV – positive men ( 20 creatine , 20 placebo ) enrolled in a 14-week study . Subjects were r and omly assigned to receive creatine monohydrate or placebo for 14 weeks . Treatment began with a loading dose of 20 g/day or an equivalent number of placebo capsules for 5 days , followed by maintenance dosing of 4.8 g/day or placebo . Beginning at week 2 and continuing to week 14 , all subjects underwent thrice-weekly supervised resistance exercise while continuing on the assigned study medication ( with repeated 6-week cycles of loading and maintenance ) . The main outcome measurements included muscle strength ( one repetition maximum ) , energetics ( 31P magnetic resonance spectroscopy ) , composition and size ( magnetic resonance imaging ) , as well as total body composition ( dual-energy X-ray absorptiometry ) . Thirty-three subjects completed the study ( 17 creatine , 16 placebo ) . Strength increased in all 8 muscle groups studied following PRT , but this increase was not augmented by creatine supplementation ( average increase 44 vs. 42 % , difference 2 % , 95 % CI −9.5 % to 13.9 % ) in creatine and placebo , respectively ) . There were no differences between groups in changes in muscle energetics . Thigh muscle cross-sectional area increased following resistance exercise , with no additive effect of creatine . Lean body mass ( LBM ) increased to a significantly greater extent with creatine . Conclusions / Significance Resistance exercise improved muscle size , strength and function in HIV-infected men .  While creatine supplementation produced a greater increase in LBM , it did not augment the robust increase in strength derived from PRT . Trial Registration Clinical Trials.gov Background and Purpose — To evaluate the efficacy of supervised high-intensity progressive resistance training ( PRT ) on lower extremity strength , function , and disability in older , long-term stroke survivors . Methods — Forty-two volunteers aged 50 years and above , 6 months to 6 years after a single mild to moderate stroke , were r and omized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press ( LP ) , unilateral paretic and nonparetic knee extension ( KE ) , ankle dorsiflexion ( DF ) , and plantarflexion ( PF ) exercises .  Functional performance was assessed using the 6-minute walk , stair-climb time , repeated chair-rise time , and habitual and maximal gait velocities . Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument ( LLFDI ) . Results — Single-repetition maximum strength significantly improved in the PRT group for LP ( 16.2 % ) , paretic KE ( 31.4 % ) , and nonparetic KE ( 38.2 % ) with no change in the control group . Paretic ankle DF ( 66.7 % versus −24.0 % ) , paretic ankle PF ( 35.5 % versus −20.3 % ) , and nonparetic ankle PF ( 14.7 % versus −13.8 % ) significantly improved in the PRT group compared with the control . The PRT group showed significant improvement in self-reported function and disability with no change in the control . There was no significant difference between groups for any performance-based measure of function . Conclusions — High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke , and results in reductions in functional limitations and disability Background Reductions in skeletal muscle mass and increased adiposity are key elements in the aging process and in the pathophysiology of several chronic diseases . Systemic low grade inflammation associated with obesity has been shown to accelerate the age-related decline in skeletal muscle . The aim of this investigation was to determine the effects of 12 months of progressive resistance training ( PRT ) on systemic inflammation , and whether reductions in systemic inflammation were associated with changes in body composition . We hypothesized that reductions in systemic inflammation following 12 months of PRT in older adults with type 2 diabetes would be associated with reductions in adiposity and increases in skeletal muscle mass . Methods Participants ( n = 103 ) were r and omized to receive either PRT or sham-exercise , 3 days a week for 12 months . C-reactive protein ( CRP ) was used to assess systemic inflammation . Skeletal muscle mass and total fat mass were determined using bioelectrical impedance . Results Twelve months of PRT tended to reduce CRP compared to sham exercise ( β = −0.25 , p = 0.087 ) . Using linear mixed-effects models , the hypothesized relationships between body composition adaptations and CRP changes were significantly stronger for skeletal muscle mass ( p = 0.04 ) and tended to be stronger for total fat mass ( p = 0.07 ) following PRT when compared to sham-exercise . Using univariate regression models , stratified by group allocation , reductions in CRP were associated with increases in skeletal muscle mass ( p = 0.01 ) and reductions in total fat mass ( p = 0.02 ) in the PRT group , but not in the sham-exercise group ( p = 0.87 and p = 0.32 , respectively ) . Conclusions We have shown for the first time that reductions in systemic inflammation in older adults with type 2 diabetes following PRT were associated with increases in skeletal muscle mass . Furthermore , reductions in CRP were associated with reductions in adiposity , but only when associated with PRT . Lifestyle interventions aim ed at reducing systemic inflammation in older adults with type 2 diabetes should therefore incorporate anabolic exercise such as PRT to optimize the anti-inflammatory benefits of favorable body composition adaptations OBJECTIVE Progressive resistance training ( PRT ) counteracts sarcopenia and has been demonstrated to improve physical function and quality of life in older adults . Despite the clear benefits of PRT , participation remains low . The core self-evaluation ( CSE ) construct is theoretically antecedent to four personality traits : locus of control , self-esteem , neuroticism ( emotional stability ) , and generalized self-efficacy . We have examined the association of CSE with exercise adoption among older adults invited to participate in a PRT trial . We hypothesized that CSE would positively predict adoption of PRT . STUDY DESIGN All residents of two retirement communities were invited to complete question naires with items on demographics , physical activity , CSE , and general health . Following completion of question naires , residents were invited to take part in an on-site , 10-week r and omized controlled trial of a PRT-based exercise trial . RESULTS Thirty-eight of 358 residents ( 63.2 % women ; 76.6±6.1 year ; range 58 - 92 ) enrolled and 118 residents completed the question naires . Multiple regression analysis predicting PRT adoption indicated that the demographic variables accounted for 38 % of the variance . Inclusion of CSE ( β=.405 ) accounted for an additional 10 % of the variance in PRT adoption . CONCLUSION CSE was predictive of PRT adoption in this cohort , adding significantly to the predictive efficacy of known demographic predictors . This is the first study to show that CSE may influence adoption of PRT in any cohort PURPOSE To investigate the effect of progressive resistance training ( PRT ) on body composition , physical fitness , quality of life , lipid and nutritional profile of patients on hemodialysis ( HD ) . METHODS A non equivalent comparison group pretest and posttest design study was used with 40 participants who were r and omly assigned to the exercise group ( 20 participants ) and the comparison group ( 20 participants ) . The exercise group received PRT for 30 minutes per session , 3 sessions a week , for 12 weeks , while the comparison group received usual care . The PRT consisted of upper and lower body exercises using elastic b and s and s and bags . Outcome measures evaluated were : body composition , physical fitness , quality of life , and lipid profile . RESULTS Skeletal muscle mass , grip , leg muscle strength , and quality of life all improved significantly in the exercise group . Body fat rate , total cholesterol and triglyceride rate decreased significantly in the exercise group . CONCLUSION These results suggest that PRT improves body composition , physical fitness , quality of life , and lipid profile of patients on HD .  PRT using elastic b and s and s and bags can be utilized as part of a regular care plan for these patients Objective : This study aim ed to investigate the effect of continuous progressive resistance training on body composition , functional capacity and self-reported quality of life in end-stage renal disease patients . Design : A r and omized controlled trial . Subjects : The study included 52 hemodialysis patients ( aged 55.7 ± 14.03 years ) r and omized into exercise ( progressive resistance training ( PRT ) , n = 28 ) or control ( CON , n = 24 ) groups . Intervention : Patients r and omized into the PRT group received prescribed strength exercises in two sets of 15–20 repetitions , in a repetition maximum training zone regime , thrice a week for 12 weeks , during hemodialysis . Patients r and omized into the CON group received a sham-exercise with active mobilization of the arms and legs without load and progression . Main outcome measure : Body composition using dual-energy X-ray absorptiometry ( DXA ) , strength using h and grip dynamometry ( HGS ) , repeated sit-to-st and test ( STT ) , 6-minute walk test , flexibility and the SF-36 question naire ( quality of life ( QoL ) ) were assessed at baseline and at 12 weeks . Results : Leg lean mass ( P = 0.04 , effect size ( ES ) of 0.56 ) , bone mineral content ( P = 0.02 , ES of 0.65 ) , leg strength in STT repetitions ( P = 0.01 , ES of 0.66 ) and flexibility ( P < 0.01 , ES of 1.03 ) were significantly improved in the PRT group compared to the CON group . Walking capacity , HGS and QoL were not different between the groups . Conclusion : 12 weeks of PRT with a repetition maximum training zone regime provided significant load to increase leg lean mass and STT performance as well as bone mineral content , compared to the CON , which continued to deteriorate . There was lack of efficacy on walking test , HGS and BACKGROUND Physical inactivity , inadequate dietary protein , and low- grade systemic inflammation contribute to age-related muscle loss , impaired function , and disability . OBJECTIVE We assessed the effects of progressive resistance training ( PRT ) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass ( LTM ) , muscle size , strength and function , circulating inflammatory markers , blood pressure , and lipids in elderly women . DESIGN In a 4-mo cluster r and omized controlled trial , 100 women aged 60 - 90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat ( ∼160 g cooked ) to be consumed 6 d/wk [ resistance training plus lean red meat ( RT+Meat ) group ; n = 53 ] or control PRT [ 1 serving pasta or rice/d ; control resistance training ( CRT ) group ; n = 47 ) ] . All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d . RESULTS The mean ( ± SD ) protein intake was greater in the RT+Meat group than in the CRT group throughout the study ( 1.3 ± 0.3 compared with 1.1 ± 0.3 g · kg⁻¹ · d⁻¹ , respectively ; P < 0.05 ) . The RT+Meat group experienced greater gains in total body LTM ( 0.45 kg ; 95 % CI : 0.07 , 0.84 kg ) , leg LTM ( 0.22 kg ; 95 % CI : 0.02 , 0.42 kg ) , and muscle strength ( 18 % ; 95 % CI : 0.03 , 0.34 ) than did the CRT group ( all P < 0.05 ) . The RT+Meat group also experienced a 10 % greater increase in serum insulin-like growth factor I ( P < 0.05 ) and a 16 % greater reduction in the proinflammatory marker interleukin-6 ( IL-6 ) ( P < 0.05 ) after 4 mo . There were no between-group differences for the change in blood lipids or blood pressure . CONCLUSION A protein-enriched diet equivalent to ∼1.3 g · kg⁻¹ · d⁻¹ achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women . This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235
Serious adverse events were rare , and no serious events were reported to be directly related to the exercise programme .
This review provides evidence that PRT is an effective intervention for improving physical functioning in  older people , including improving strength and the performance of some simple and complex activities .
BACKGROUND Muscle weakness in old age is associated with physical function decline .
Progressive resistance strength training ( PRT ) exercises are design ed to increase strength .
OBJECTIVES To assess the effects of PRT on older people and identify adverse events .