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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,328,305
In vivo human muscle structure and function: adaptations to resistance training in old age.
This study investigated changes in elderly muscle joint angle-torque relation induced by resistance training. Older adults were assigned to either training (n = 9, age 74.3 +/- 3.5 years; mean +/-s.d.) or to control groups (n = 9, age 67.1 +/- 2 years). Leg-extension and leg-press exercises were performed three times per week for 14 weeks. Maximal isometric knee extension torque was measured across the knee joint angle range of movement. Vastus lateralis muscle architecture was examined in vivo using ultrasonography. The vastus lateralis muscle fascicle force was estimated from the measured joint torque, enabling construction of the fascicle length-force relation. Electromyographic (EMG) activity was measured from representative agonist and antagonist muscles. Training altered the angle-torque relation: (a) displacing it by 9-31% towards higher torque values (P < 0.05); and (b) shifting the optimal angle from 70 deg (corresponding torque: 121.4 +/- 61 N m) before to 60 deg (134.2 +/- 57.2 N m; P < 0.05) after training. Training also altered the fascicle length-force relation: (a) displacing it by 11-35% towards higher force values; and (b) shifting the optimal fascicle length from 83.7 +/- 8 mm (corresponding force: 847.9 +/- 365.3 N) before to 93.2 +/- 12.5 mm (939.3 +/- 347.8 N; P < 0.01) after training. The upward displacement of the angle-torque relation was mainly due to a training-induced increase in agonist activation, whilst the shift in the optimal angle was associated with changes in muscle-tendon properties.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,763,795
Preventing falls on an elderly care rehabilitation ward.
Comparison of two flooring types--carpet and vinyl--in the bed areas, and two modes of physiotherapy--conventional therapy and additional leg strengthening exercises--in avoiding falls. Randomized 2 x 2 controlled trial. Elderly care rehabilitation ward in a community hospital. Fifty-four consecutive patients referred for rehabilitation. The incidence of falls, and the change in strength. There were 10 falls on carpet, and only a single fall on vinyl floor covering (relative risk 8.3, 95% confidence interval 0.95-73, p = 0.05). There were four falls in those receiving additional exercise, and seven falls in those receiving only conventional physiotherapy (relative risk 0.21, 95% confidence interval 0.04-1.2, p = 0.12). Fifty-nine per cent of patients were able to complete strength measurements on admission and discharge. In these, handgrip strength improved more in those given additional exercise than conventional physiotherapy (2.1 kg versus -0.3 kg, p < 0.05). There is no evidence to support either intervention in preventing falls on a rehabilitation ward, but within this low-powered study, there was a strong trend towards vinyl being superior.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,271,690
Effects of testosterone and resistance training in men with chronic obstructive pulmonary disease.
Dysfunction of the muscles of ambulation contributes to exercise intolerance in chronic obstructive pulmonary disease (COPD). Men with COPD have high prevalence of low testosterone levels, which may contribute to muscle weakness. We determined effects of testosterone supplementation (100 mg of testosterone enanthate injected weekly) with or without resistance training (45 minutes three times weekly) on body composition and muscle function in 47 men with COPD (mean FEV(1) = 40% predicted) and low testosterone levels (mean = 320 ng/dl). Subjects were randomized to 10 weeks of placebo injections + no training, testosterone injections + no training, placebo injections + resistance training, or testosterone injections + resistance training. Testosterone injections yielded a mean increase of 271 ng/dl in the nadir serum testosterone concentration (to the middle of the normal range for young men). The lean body mass (by dual-energy X-ray absorptiometry) increase averaged 2.3 kg with testosterone alone and 3.3 kg with combined testosterone and resistance training (p < 0.001). Increase in one-repetition maximum leg press strength averaged 17.2% with testosterone alone, 17.4% with resistance training alone, and 26.8% with testosterone + resistance training (p < 0.001). Interventions were well tolerated with no abnormalities in safety measures. Further studies are required to determine long-term benefits of adding testosterone supplementation and resistance training to rehabilitative programs for carefully screened men with COPD and low testosterone levels.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,048,421
Can elderly patients who have had a hip fracture perform moderate- to high-intensity exercise at home?
The majority of patients after a hip fracture do not return to prefracture functional status. Depression has been shown to affect recovery. Although exercise can reduce impairments, access issues limit elderly people from participating in facility-based programs. The primary purpose of this study was to determine the effects and feasibility of a home exercise program of moderate- or high-intensity exercise. A secondary purpose was to explore the relationship of depression and physical recovery. Thirty-three elderly people (24 women, 9 men; mean = 78.6 years of age, SD = 6.8, range = 64-89) who had completed a regimen of physical therapy following hip fracture participated in the study. Subjects were randomly assigned to a resistance training group, an aerobic training group, or a control group. Subjects were tested before and upon completion of the exercise trial. Isometric lower-extremity force, 6-minute-walk distance, free gait speed, mental status, and physical function were measured. Each exercise session was supervised by a physical therapist, and subjects received 20 visits over 12 weeks. The control group received biweekly mailings. The resistance training group performed 3 sets of 8 repetitions at the 8-repetition maximum intensity using a portable progressive resistance exercise machine. The aerobic training group performed activities that increased heart rate 65% to 75% of their age-predicted maximum for 20 continuous minutes. Resistance and aerobic training were performed without apparent adverse effects, and adherence was 98%. All groups improved in distance walked, force produced, gait speed, and physical function. Isometric force improved to a greater extent in the intervention groups than in the control group. Depressive symptoms interacted with treatment group in explaining the outcomes of 6-minute-walk distance and gait speed. High-intensity exercise performed in the home is feasible for people with hip fracture. Larger sample sizes may be necessary to determine whether the exercise regimen is effective in reducing impairments and improving function. Depression may play a role in the level of improvement attained.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,842,574
Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women.
The effects of 52 weeks resistance training at one of two exercise intensities on thigh muscle strength, fiber cross-sectional area (CSA), and tissue composition were studied in healthy 65-79-year-old women. Subjects were assigned to either a control (CO), high-intensity (HI) or low-intensity (LO) training group. Exercise regimens consisted of three sets of leg press, knee extension, and knee flexion exercises, 3 days/week, at either 80% of one-repetition maximum (1-RM) for seven repetitions (HI) or 40% of 1-RM for 14 repetitions (LO). Dynamic muscle strength was evaluated by 1-RM, thigh lean tissue mass (LTM), fat mass, and bone mineral density (BMD, g/cm2) by dual energy X-ray absorptiometry, and fiber CSA of vastus lateralis m. by histomorphometry. Muscle strength increased, on average (+/- SEM), by 59.4 +/- 7.9% and 41.5 +/- 7.9% for HI and LO, respectively, compared to 1.3 +/- 4.8% in CO (P = 0.0001). Type I fiber CSA increased over time (P < 0.05) in both exercise groups, with a trend for increased type II area (HI, P = 0.06; LO, P = 0.11). There was no significant effect of either exercise program on thigh tissue composition, except for BMD at the 1/3 site (middle third of the femur), where LO and CO groups experienced a decline (P < 0.05) of -2.2 +/- 0.5% and -1.8 +/- 0.6%, respectively, while HI maintained BMD (+1.0 +/- 1.0%). Both training programs produced significant gains in thigh muscle strength, which were associated with fiber hypertrophy, although these did not translate into appreciable alterations in thigh tissue composition.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,983,182
Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults.
The aim of the present study was to compare the changes in voluntary strength (isometric, concentric, and eccentric) and functional mobility in response to maximal isokinetic eccentric-only resistance training to those elicited by maximal isometric-only or maximal isokinetic concentric-only resistance training in older adults. Twelve women (73 +/- 7 years) and 18 men (73 +/- 5 years) completed a 12-week training program (three times per week) using a Biodex System 3 dynamometer. Primary outcome measures included peak isometric and isokinetic (concentric and eccentric) knee extensor strength, concentric work, concentric power, stair ascent and descent, and gait speed. Participants were randomly assigned to one of three training groups: isometric-only, isokinetic concentric-only, or isokinetic eccentric-only. All three training groups demonstrated an increase in peak isometric and isokinetic concentric and eccentric strength following 12 weeks of training (p <.01). Step time was positively influenced (p <.03) by all three training modes; however, gait speed was unchanged following 12 weeks of training. All three training groups experienced a significant increase in peak concentric work and concentric power (p <.01) with the concentric training group demonstrating the largest increases in both peak concentric work and concentric power when compared to the isometric and eccentric training groups. It was clear that all three resistance training programs (isometric, concentric, and eccentric) in older adults were effective in increasing strength, concentric work, and concentric power over the 12-week training period. Furthermore, 12 weeks of resistance training resulted in improved stair ascent and descent performance.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
14,966,771
Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow.
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. 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 randomized 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). Moderate-intensity resistance exercise training in CHF patients produced favorable changes to skeletal muscle strength and endurance, VO(2peak), FBF, and HRV.
54
54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,076,785
Once weekly combined resistance and cardiovascular training in healthy older men.
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. 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). 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%). 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.
54
54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,147,561
Improving cardiovascular fitness by strength or endurance training in women aged 76-78 years. A population-based, randomized controlled trial.
there have been few population-based, randomized controlled trials on the effects of strength or endurance training on cardiovascular fitness in older women. to study the effects of strength or endurance training on cardiovascular fitness in women aged 76-78 years. a population-based, randomized controlled trial. exercise laboratory in a university faculty of sport and health sciences. we randomly assigned 42 medically-screened women aged 76-78 years, drawn from the population register to strength (n=16), endurance (n=15) or control (n=11) groups. subjects in the two exercise groups performed a supervised, individually tailored 18-week strength or endurance training programme. Controls continued with physical activity at their normal level. the strength training group showed an increase in cycle ergometer peak power from 68.1 to 70.3 W (P=0.035 compared with controls). Their peak power per kg body weight increased from 1.02 to 1.05, while that of the endurance training group increased from 0.91 to 0.93 (P=0.027 and P=0.049 respectively). Peak oxygen uptake increased from 18.1 to 19.7 ml x kg(-1) x min(-1) in the strength and from 17.1 to 18.2 in the endurance group (non-significant). Six subjects (19%) in the exercise groups withdrew from the study because of health problems. even with its limitations, the study suggests that the effect of 18-week strength or endurance training on cardiovascular fitness among women aged >/=75 is relatively small. Furthermore, health problems can emerge during training programmes in medically-screened elderly women.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,398,892
Resistance exercise dosage in older adults: single- versus multiset effects on physical performance and body composition.
To determine whether variation in resistance exercise volume affects muscle function and physical performance response in older adults. A randomized trial with subjects assigned to a single-set (1-SET) or three-set (3-SET) exercise group. An exercise facility at the University of Queensland. Twenty-eight community-dwelling men and women aged 65 to 78. Progressive resistance training consisting of seven exercises targeting the major muscle groups of the upper and lower body performed on exercise machines twice weekly for 20 weeks at eight-repetition maximum (RM) intensity. Muscle function included isotonic muscle strength (1-RM) of the seven exercises, isokinetic and isometric knee extensor strength, and muscle endurance for the chest press and leg press exercises. Physical performance included timed chair rise, usual and fast 6-m walk, 6-m backwards walk, 400-m walk, floor rise to standing, and stair climbing ability. In addition, body composition was determined using dual energy x-ray absorptiometry. Isotonic muscle strength increased in both exercise groups for all seven exercises (P<.01), with the gain in the 3-SET group greater (P<.05) for the seated row, triceps extension, and knee extension (analysis of covariance). Similarly, muscle endurance gains were greater for the 3-SET than the 1-SET group (P<.01), with no significant difference between groups for isokinetic and isometric knee extensor strength. Both groups improved (P<.05) in the chair rise (1-SET, 10.1%; 3-SET, 13.6%), 6-m backwards walk (1-SET, 14.3%; 3-SET, 14.8%), 400-m walk (1-SET, 3.8%; 3-SET, 7.4%), and stair climbing test (1-SET, 7.7%; 3-SET, 6.4%), with the only difference between groups for the 400-m walk (P<.05). There was no difference between groups for change in body composition. Resistance training consisting of only single-set exercises is sufficient to significantly enhance muscle function and physical performance, although muscle strength and endurance gains are greater with higher-volume work. These findings have application in designing time-efficient exercise regimens to enhance neuromuscular function in older adults.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
14,728,633
Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old.
To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low-grade inflammation. A 12-week controlled resistance-training study. Nursing homes in Copenhagen, Denmark. Twenty-one frail nursing home residents aged 86 to 95 completed the study. Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist. Muscle strength, plasma levels of TNF-alpha, soluble TNF receptor (sTNFR)-1, and interleukin (IL)-6 were measured before and at the end of the intervention period. The training program improved muscle strength but did not affect plasma levels of TNF-alpha and sTNFR-I or IL-6. However, plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength. Low-grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that the antiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation.
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54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,983,181
A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults.
Although exercise has been shown to relieve depression, little is known about its mechanism or dose-response characteristics. We hypothesized that high intensity progressive resistance training (PRT) would be more effective than either low intensity PRT or standard care by a general practitioner (GP) in depressed elderly persons, and that high intensity PRT would provide superior benefits in quality of life, sleep quality, and self-efficacy. Sixty community-dwelling adults >60 years with major or minor depression were randomized to supervised high intensity PRT (80% maximum load) or low intensity PRT (20% maximum load) 3 days per week for 8 weeks, or GP care. A 50% reduction in the Hamilton Rating Scale of Depression score was achieved in 61% of the high intensity, 29% of the low intensity, and 21% of the GP care group (p =.03). Strength gain was directly associated with reduction in depressive symptoms (r = 0.40, p =.004), as was baseline social support network type (F = 3.52, p =.015), whereas personality type, self-efficacy, and locus of control were unrelated to the antidepressant effect. Vitality quality-of-life scale improved more in the high intensity group than in the others (p =.04). Sleep quality improved significantly in all participants (p <.0001), with the greatest relative change in high intensity PRT (p =.05). High intensity PRT is more effective than is low intensity PRT or GP care for the treatment of older depressed patients.
54
54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,075,779
A comparison of periodised and fixed repetition training protocol on strength in older adults.
It has been forwarded that strength training is the primary intervention for improving and maintaining functional independence of the elderly. The purpose of this study was to determine if a periodised strength-training program was superior to a fixed repetition protocol for enhancing strength in older adults. Previously untrained male and female participants (71.6+/-5.3 y) were separated into three groups: fixed repetition (FR: n= 18), periodised (PER: n= 21) and control (C: n= 21). FR and PER protocols trained 2 days/week performing knee extensions, leg press, leg curl, biceps curl, triceps extension, lat pull downs, shoulder press and seated bench press. FR performed three sets of 9RM/exercise throughout the 18-week study. PER performed two sets of 15RM/exercise (weeks 1-6), three sets of 9RM/exercise (weeks 7-12) and four sets of 6RM/exercise (weeks 13-18). Pre-post 1RM were collected for each exercise. The sum of 1RM for the eight exercises was considered indicative of total body strength and served as the dependent variable. An ANOVA with Bonferroni post hoc was utilised to analyse the data. FR (p< 0.01) and PER (p< 0.01) groups experienced significant strength gains compared to C but were not different from each other. The results suggest that previously untrained older adults could expect similar strength gains from FR or PER strength-training protocols of 18 weeks or less.
54
54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
17,132,757
Effects of modest testosterone supplementation and exercise for 12 weeks on body composition and quality of life in elderly men.
One of the factors that may promote deterioration in quality of life and body composition in elderly men is the relative decline in serum testosterone levels with aging. In this study, we assessed the effects of modest doses of testosterone and a home-based strengthening program on quality of life and body composition in elderly men with relative testosterone insufficiency. Double-blind, placebo-controlled randomized study (testosterone), and additional randomization to a resistance exercise program or no additional exercise for 12 weeks in men between ages of 65 and 85 years with relative testosterone insufficiency. Seventy sedentary, community dwelling men were randomized to a 5 mg testoderm transdermal system applied daily vs placebo system, and additionally randomized to a home-based resistance exercise program. Subjects were randomized to Group 1 (testosterone plus exercise), Group 2 (testosterone plus no exercise), Group 3 (placebo plus exercise), and Group 4 (placebo plus no exercise). Endpoints included quality of life (assessed by the short form-36 questionnaire) and body composition (measured by dual x-ray absorptiometry scan). Serum testosterone increased by a mean of 10.0 +/- 1.9, 6.6 +/- 1.6, 0.52 +/- 0.6, and 0.5 +/- 0.6 nmol/l in Groups 1, 2, 3, and 4 respectively. There was a significant interaction of testosterone and exercise on quality of life in the domains of physical functioning (P = 0.03), role physical (P = 0.01), general health (P = 0.049), and social functioning (P = 0.04). There were no effects of testosterone or exercise on quality of life alone, nor in body composition parameters. Modest testosterone supplementation to elderly men with relative testosterone insufficiency improved quality of life when accompanied by an exercise program. The combination of testosterone and exercise may be an important strategy in the elderly, though further studies are necessary to determine the long-term impact on body composition and function and for analysis of risk/benefit ratios as well.
54
54
CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,972,618
Optimal load for increasing muscle power during explosive resistance training in older adults.
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. One hundred twelve healthy older adults (69 +/- 6 years) were randomly 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. 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%). 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.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,356,801
Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure.
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 randomized 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 resulted 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.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
7,560,695
Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older.
To determine the effects of 12 weeks of progressive resistance strength training on the isometric strength, explosive power, and selected functional abilities of healthy women aged 75 and over. Subjects were matched for age and habitual physical activity and then randomly assigned into either a control or an exercise group. The Muscle Function Laboratory, Royal Free Hospital School of Medicine, London. Fifty-two healthy women were recruited through local and national newspapers. Five dropped out before and seven (4 exercisers and 3 controls) during the study. Pre- and posttraining measurements were obtained from 20 exercisers (median age 79.5, range 76 to 93 years) and 20 controls (median age 79.5, range 75 to 90 years). Training comprised one supervised session (1 hour) at the Medical School and two unsupervised home sessions (supported by an exercise tape and booklet) per week for 12 weeks. The training stimulus was three sets of four to eight repetitions of each exercise, using rice bags (1-1.5 kg) or elastic tubing for resistance. The exercises were intended specifically to strengthen the muscles considered relevant for the functional tasks, but were not to mimic the functional measurements. No intervention was prescribed for the controls. Pre- and posttraining measurements were made for isometric knee extensor strength (IKES), isometric elbow flexor strength (IEFS), handgrip strength (HGS), leg extensor power (LEP), and anthropometric indices (Body impedance analysis, arm muscle circumference, and body weight). Functional ability tests were chair rise, kneel rise, rise from lying on the floor, 118-m self-paced corridor walk, stair climbing, functional reach, stepping up, stepping down, and lifting weights onto a shelf. Pre- and posttraining comparisons were made using analysis of variance or analysis of covariance (using weight as a covariate) for normally distributed continuous data and one-sided Fishers exact test (2 x 2 table) for discontinuous data. Improvements in IKES (mean change 27%, P = .03), IEFS (22%, P = .05), HGS (4%, P = .05), LEP/kg (18%, P = .05) were associated with training, but the improvement in LEP (18%, P = .11) did not reach statistical significance. There was an association between training and a reduction in normal pace kneel rise time (median change 21%, P = .02) and a small improvement in step up height (median 5%, P = .005). The other functional tests did not improve. Progressive resistance exercise can produce substantial increases in muscle strength and in power standardized for body weight in healthy, very old women. However, isolated increases in strength and LEP/kg may confer only limited functional benefit in healthy, independent, very old women.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,440,838
Efficacy of heavy-resistance training for active women over sixty: muscular strength, body composition, and program adherence.
To determine the effects of resistance training on muscular strength, body composition (percent fat and lean tissue mass), and program adherence in active women over 60 years of age. This study was designed as a stratified, randomized, non-blinded trial. Subjects were stratified into rank-ordered pairs by level of physical activity according to the Blair Seven-Day Recall, then randomly assigned into either a weight-training (WT, n = 18) or control (CON, n = 18) group. Thirty-six women over the age of 60 (67.1 +/- 1.5, chi +/- SE) were recruited from the San Diego community. All subjects had to be engaging in some form of aerobic exercise at least 3 days each week for a minimum of 6 months. MEASUREMENTS AND INTERVENTION: Subjects engaged in isotonic training 3 days/week on Polaris machines at a target intensity of 80% of the 1 repetition maximum (1 RM) for three sets of seven exercises selected to train major muscle groups of the trunk and upper and lower body. The 1 RM was re-tested every 6 weeks in WT and the workload adjusted to maintain target intensity. The 1 RM was tested at 0, 12, and 24 weeks in CON. Body fatness and lean tissue mass, excluding skeletal mass, were assessed at 0 and 24 weeks by dual energy radiography using a total body scan. Increases in muscle strength of the weight trainers were significant for all seven exercises (5%-65%), with the greatest gains in the shoulder and trunk muscles. Percent body fat of weight trainers decreased significantly (from 38.8% to 37.9%, P < 0.05), while lean tissue mass increased by 1.5 kg (P < 0.01). No changes in body composition were observed in control subjects. Overall program adherence was 83% (15 weight trainers and 15 control women completed the study). Monthly attendance averaged 86.8 +/- 3.3%, with no incidence of injury during the training sessions. These data indicate that heavy-resistance weight training is safe and enjoyable for older women and that meaningful gains in muscular strength and body composition can be made even in women who are already highly active.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,581,562
Concurrent cardiovascular and resistance training in healthy older adults.
The recommendations for exercise training and physical activity for older adults include cardiovascular and resistance training components (CVT and RT, respectively). The purpose of the present investigation was to compare the fitness benefits of concurrent CVT and RT with those attained through an equivalent duration of CVT or RT alone. Thirty-six participants (ages 60-84) were assigned to a control group or to one of three exercise treatment groups. The treatment groups exercised three times per week for 12 wk using RT (N = 11), CVT (N = 10), or CVT and RT (BOTH, N = 9). Pre- and post-training, participants performed a submaximal exercise test (GXT), five repetition-maximum strength tests (5RM), and the AAHPERD functional fitness test for older adults. All exercise treatment groups revealed lower resting heart rate and rate-pressure product; lower exercise diastolic blood pressure and rating of perceived exertion; increased GXT duration; increased leg, back, and shoulder 5RM scores; and improved AAHPERD flexibility, coordination, and cardiovascular endurance scores. The exercise treatment groups responded differently on the following: RT and BOTH enhanced arm and chest strength more than CVT; and BOTH enhanced AAHPERD strength and agility scores more than CVT or RT. Concurrent CVT and RT is as effective in eliciting improvements in cardiovascular fitness and 5RM performance as CVT or RT, respectively. Moreover, incorporating both CVT and RT in exercise programs for older adults may be more effective in optimizing aspects of functional fitness than programs that involve only one component.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,299,253
Large energetic adaptations of elderly muscle to resistance and endurance training.
This study determined the cellular energetic and structural adaptations of elderly muscle to exercise training. Forty male and female subjects (69.2 +/- 0.6 yr) were assigned to a control group or 6 mo of endurance (ET) or resistance training (RT). We used magnetic resonance spectroscopy and imaging to characterize energetic properties and size of the quadriceps femoris muscle. The phosphocreatine and pH changes during exercise yielded the muscle oxidative properties, glycolytic ATP synthesis, and contractile ATP demand. Muscle biopsies taken from the same site as the magnetic resonance measurements were used to determine myosin heavy chain isoforms, metabolite concentrations, and mitochondrial volume densities. The ET group showed changes in all energetic pathways: oxidative capacity (+31%), contractile ATP demand (-21%), and glycolytic ATP supply (-56%). The RT group had a large increase in oxidative capacity (57%). Only the RT group exhibited change in structural properties: a rise in mitochondrial volume density (31%) and muscle size (10%). These results demonstrate large energetic, but smaller structural, adaptations by elderly muscle with exercise training. The rise in oxidative properties with both ET and RT suggests that the aerobic pathway is particularly sensitive to exercise training in elderly muscle. Thus elderly muscle remains adaptable to chronic exercise, with large energetic changes accompanying both ET and RT.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,597,320
Weight training improves walking endurance in healthy elderly persons.
To determine the effect of a resistance-training program on walking endurance in a healthy, community-dwelling elderly population. 12- week randomized, controlled trial comparing a resistance- training group with a nonexercising control group. Hospital-affiliated outpatient exercise facility. 24 healthy men and women who were 65 years of age or older (mean age +/-SD, 70.4 +/- 4 years; range, 65 to 79 years). The primary outcome variable was exhaustive submaximal walking time measured at an intensity of 80% of baseline peak aerobic capacity. Participants in the resistance-training program increased submaximal walking endurance by 9 minutes (from 25 +/- 4 minutes to 34 +/- 9 minutes; P=0.001), a 38% increase, whereas no change was seen in controls (20 +/- 5 minutes to 19 +/- 10 minutes; P greater than 0.2; P=0.005 between groups). The relation between change in leg strength and change in walking endurance was significant (r=0.48; P=0.02). Neither group showed a change in peak aerobic capacity or in whole-body composition, although fat-free mass of the leg increased in the exercise group. Resistance training for 3 months improves both leg strength and walking endurance in healthy, community-dwelling elderly persons. This finding is relevant to older persons at risk for disability, because walking endurance and leg strength are important components of physical functioning.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,527,474
Growth hormone administration and exercise effects on muscle fiber type and diameter in moderately frail older people.
Reduced muscle mass and strength are characteristic findings of growth hormone deficiency (GHD) and aging. We evaluated measures of muscle strength, muscle fiber type, and cross sectional area in response to treatment with recombinant human growth hormone (rhGH) with or without a structured resistance exercise program in frail older subjects. Placebo-controlled, randomized, double blind trial. Outpatient clinical research center at an urban university-affiliated teaching hospital. Thirty-one consenting older subjects (mean age 71.3 +/- 4.5 years) recruited as a subset of a larger project evaluating rhGH and exercise in older people, who underwent 62 quadricep-muscle biopsies. Random assignment to a 6-month course of one of four protocols: rhGH administered subcutaneously daily at bedtime, rhGH and a structured resistance exercise program, structured resistance exercise with placebo injections, or placebo injections only. Muscle biopsy specimens were obtained from the vastus lateralis muscle. Isokinetic dynamometry strength tests were used to monitor individual progress and to adjust the weights used in the exercise program. Serum insulin-like growth factor-I (IGF-I) was measured and body composition was measured using a Hologic QDR 1000W dual X-ray densitometer. The administration of rhGH resulted in significant increase in circulating IGF-I levels in the individuals receiving rhGH treatment. Muscle strength increased significantly in both the rhGH/exercise (+55.6%, P =.0004) as well as the exercise alone (+47.8%, P =.0005) groups. There was a significant increase in the proportion of type 2 fibers between baseline and six months in the combined rhGH treated subjects versus those not receiving rhGH (P =.027). Our results are encouraging in that they suggest an effect of growth hormone on a specific aging-correlated deficit. IGF-I was increased by administrating rhGH and muscle strength was increased by exercise. The administration of rhGH to frail older individuals in this study resulted in significant changes in the proportions of fiber types. Whether changes in fiber cross-sectional area or absolute number occur with long-term growth hormone administration requires further study.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,770,641
The effects of improved strength on obstacle negotiation in community-living older adults.
Poor mobility has been associated with age-related deterioration in muscle strength. While previous work has examined the effects of improved strength on level walking, we have quantified the effects of a resistance-training program on obstructed gait tasks using biomechanical-dependent measures. Forty-five community-dwelling participants aged 62 years or older were randomised to either a control (n=16) or experimental group (n=29). The experimental subjects exercised for 24 weeks on a progressive resistance-training program designed to improve lower body strength. Dynamic strength was assessed at weeks 0 and 24 as well as specific laboratory gait kinetics and kinematics during stepping over an obstacle and negotiation of a raised surface set at 10, 20 and 30% of each subject's leg length. Significant strength improvements (P<0.05), ranging between 197 and 285%, were recorded in the experimental group. The strength gains in the experimental group were accompanied by significant increases in obstacle-crossing stride velocity (range 5.5-15.5%) due to increases in stride length and decreases in stride duration for both gait tasks. Significant changes in the peak vertical and anterior-posterior ground reaction forces as well as in kinematic variables associated with a safe obstacle traverse such as vertical obstacle heel clearance, limb flexion at obstacle crossing, horizontal foot placement and vertical landing velocity resulted in an improved crossing strategy in the experimental subjects. These findings provide evidence of significant improvements in obstructed gait function of community-living older adults associated with a systematic resistance-training program.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,604,366
Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint.
This study was designed to determine whether an 8-week isokinetic muscle-strength-training program improved the functional health status of patients with osteoarthritis of the knee joint. Twenty volunteers with osteoarthritis of the knee joint were randomly assigned to either an experimental (n=10) or control (n=10) group. The experimental group completed six sets of five maximal contractions three times per week for 8 weeks on a Cybex II dynamometer at 90 degrees per second. Both groups were pre- and posttest for extension and flexion strength of the right and left legs, the 50-foot walk time, range of motion at the knee joint, the Osteoarthritis Screening Index (OASI), and the Arthritis Impact Measurement Scale (AIMS). There was a significant decrease in pain and stiffness, and a significant increase in mobility. There was also a significant decline in arthritis activity in the experimental group as measured by the OASI and AIMS. The experimental group significantly increased in all strength measures, while the control group increased in only right leg flexion and left leg extension across the training period.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,470,977
The effects of resistance training and walking on functional fitness in advanced old age.
The authors assessed the effects of resistance training and walking exercise on measures of functional fitness. Sixty-four volunteers (average age 83.5 years) from an independent-living facility were randomly assigned to walking, resistance training, or control groups. Participants in the walking and resistance-training groups engaged in two exercise sessions per week for 16 weeks. Measures of functional fitness included upper and lower body strength, hip and shoulder flexibility, agility and balance, coordination, blood pressure, and resting heart rate. Repeated measures analysis of variance was used to examine pretest to posttest differences. Both exercise groups showed significant improvements relative to control group in upper and lower body strength, shoulder flexibility, and agility and balance exercise. Findings demonstrate that exercise can lead to improvements in multiple domains of functional fitness even among very old, previously sedentary individuals, possibly making activities of daily living easier to perform.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,796,680
Effects of resistance training on physical function in older disabled women with coronary heart disease.
We studied whether disabled older women with coronary heart disease can perform resistance training at an intensity sufficient to improve measured and self-reported physical function [n = 30, 70.6 +/- 4.5 (SD) yr]. Compared with the controls, the resistance-training group showed significant improvements in overall measured physical function score using the Continuous-Scale Physical Functional Performance Test (+24 vs. +3%). The Continuous-Scale Physical Functional Performance Test measures physical function for 15 practical activities, such as carrying groceries or climbing stairs. Resistance training led to improved measures for domains of upper body strength (+18 vs. +6%), lower body strength (+23 vs. +6%), endurance (+26 vs. +1%), balance and coordination (+29 vs. -2%), and 6-min walk (+15 vs. +7%). Women involved in the flexibility-control group showed essentially no improvement for physical function measures. No changes were observed for body composition, aerobic capacity, or self-reported physical function in either group. In conclusion, disabled older women with coronary heart disease who participate in strength training are able to train at an intensity sufficient to result in improvements in multiple domains of measured physical functional performance, despite no change in lean body mass.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,642,153
A home-based exercise program for nondisabled older adults.
This paper describes a videotaped, home-based, strength training program, titled Strong-for-Life and reports on its effectiveness in improving muscle strength, psychological well-being, and health status in a sample of older persons. We enrolled 102 nondisabled, community-dwelling older people aged 66 to 87, identified from the Medicare beneficiary list, into a randomized, controlled trial. Effectiveness was based on change in isokinetic upper and lower extremity muscle strength, psychologic well-being, and health status. Results revealed several statistically significant short-term benefits after 12 to 15 weeks of exercise, especially for men. Younger older adults demonstrated a 10% improvement in knee extensor strength relative to control subjects. Older male exercisers achieved significant differences relative to controls in perceived anger, tension, and overall social functioning. Male exercisers, in general, achieved significant improvement in perceived vigor. Women did not report psychological benefits following participation in the program. Study results reveal that the Strong for Life program, designed to be widely disseminated to the nondisabled older population, has many short-term positive benefits.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,522,954
Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults.
To determine the effect of frequency of resistive training on gain in muscle strength and neuromuscular performance in healthy older adults. A randomized controlled trial with subjects assigned either to high-intensity resistance training 1 (EX1), 2 (EX2), or 3 (EX3) days per week for 24 weeks or to a control group (CO). An exercise facility at an academic medical center. Forty-six community-dwelling healthy men (n = 29) and women (n = 17) aged 65 to 79 years. Progressive resistance training consisting of three sets of eight exercises targeting major muscle groups of the upper and lower body, at 80% of one-repetition maximum (1-RM) for eight repetitions, either 1, 2, or 3 days per week. Dynamic muscle strength (1-RM) using isotonic equipment every 4 weeks, bone mineral density and body composition by dual energy X-ray absorptiometry (DXA), and neuromuscular performance by timed chair rise and 6-meter backward tandem walk. For each of the eight exercises, muscle strength increased in the exercise groups relative to CO (P < .01), with no difference among EX1, EX2 and EX3 groups at any measurement interval. Percent change averaged 3.9 +/- 2.4 (CO), 37.0 +/- 15.2 (EX1), 41.9 +/- 18.2 (EX2), and 39.7 +/- 9.8 (EX3). The time to rise successfully from the chair 5 times decreased significantly (P < .01) at 24 weeks, whereas improvement in the 6-meter backward tandem walk approached significance (P = .10) in the three exercise groups compared with CO. Changes in chair rise ability were correlated to percent changes in quadriceps strength (r = -0.40, P < .01) and lean mass (r = -0.40, P < .01). A program of once or twice weekly resistance exercise achieves muscle strength gains similar to 3 days per week training in older adults and is associated with improved neuromuscular performance. Such improvement could potentially reduce the risk of falls and fracture in older adults.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
17,062,657
Comparison of once-weekly and twice-weekly strength training in older adults.
Strength training has been shown to benefit the health and function of older adults. To investigate whether one set of exercises performed once a week was as effective in increasing muscle strength as training twice a week. 18 subjects (7 women and 11 men) aged 65-79 years were randomly assigned to two groups. Both groups performed one set of exercises to muscular fatigue; group 1 trained 1 day/week and group 2 trained 2 days/week on three lower and three upper body exercises for 9 weeks. The data were analysed using a mixed model 2 x 2 analysis of variance. A significant main effect of time (p<0.001), but not group, on one-repetition maximum scores was observed. No significant interaction was observed between time and group and therefore no difference in strength changes between training once a week versus twice a week after 9 weeks. One set of exercises performed once weekly to muscle fatigue improved strength as well as twice a week in the older adult. Our results provide information that will assist in designing strength-training programmes that are more time and cost efficient in producing health and fitness benefits for older adults.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,987,467
Exercise--it's never too late: the strong-for-life program.
This investigation determined whether an in-home resistance training program achieved health benefits in older adults with disabilities. A randomized controlled trial compared the effects of assigning 215 older persons to either a home-based resistance exercise training group or a waiting list control group. Assessments were conducted at baseline and at 3 and 6 months following randomization. The program consisted of videotaped exercise routines performed with elastic bands of varying thickness. High rates of exercise adherence were achieved, with 89% of the recommended exercise sessions performed over 6 months. Relative to controls, subjects who participated in the program achieved statistically significant lower extremity strength improvements of 6% to 12%, a 20% improvement in tandem gait, and a 15% to 18% reduction in physical and overall disability at the 6-month follow-up. No adverse health effects were encountered. These findings provide important evidence that home-based resistance exercise programs designed for older persons with disabilities hold promise as an effective public health strategy.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
14,644,853
Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme.
To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Single blind, three arm, randomised controlled trial. 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Functional gains were achieved with both exercise programmes compared with the control group.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,248,468
Resistance training effects on muscular strength of elderly are related to intensity and gender.
The purpose of this study was to determine whether a high intensity (HI) versus a moderate (MI) or low-intensity (LI) training program would be more effective in improving the isokinetic knee extension muscular performance in healthy inactive men and women. Sixty-four participants, men and women, were randomly assigned to one of four groups: control group (C), LI (50% of 1RM), the MI group (70% of 1RM) and the HI (90% of 1RM). Participants exercised on three resistance exercise machines: leg extension, leg curls and leg press. The isokinetic testing method (concentric mode) applied prior to and at the end of the training period (16 weeks, three 3 times per week) to assess the knee muscular performance. MANOVA repeated measures revealed that the HI group demonstrated the most strength gains following a speed specificity pattern (most considerable improvement occurred at or near slow speeds from 7.3% to 11.2% for male and from 2.3% to 15.2% for female). In addition, males demonstrated a greater improvement of knee extension power output than females. In conclusion, HI strength training is proposed for elderly men and women as the most effective protocol. Furthermore only at low-velocity testing, women of the HI showed a greater change than men (p < 0.05). Regarding strength increase in relation to various testing velocities, a greater increase was found in HI at low velocities, with the other training groups exhibiting almost similar strength increase at all tested speeds.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,588,571
A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS).
To determine the effectiveness of vitamin D and home-based quadriceps resistance exercise on reducing falls and improving the physical health of frail older people after hospital discharge. Multicenter, randomized, controlled trial with a factorial design. Five hospitals in Auckland, New Zealand, and Sydney, Australia. Two hundred forty-three frail older people. Patients were randomized to receive a single dose of vitamin D (calciferol, 300,000 IU) or placebo tablets and 10 weeks of high-intensity home-based quadriceps resistance exercise or frequency-matched visits. The primary endpoints were physical health according to the short-form health survey at 3 months and falls over 6 months. Physical performance and self-rated function were secondary endpoints. Assessments took place in the participants' homes at 3 and 6 months after randomization and were performed by blinded assessors. There was no effect of either intervention on physical health or falls, but patients in the exercise group were at increased risk of musculoskeletal injury (risk ratio = 3.6, 95% confidence interval = 1.5-8.0). Vitamin D supplementation did not improve physical performance, even in those who were vitamin D deficient (<12 ng/mL) at baseline. Neither vitamin D supplementation nor a home-based program of high-intensity quadriceps resistance exercise improved rehabilitation outcomes in frail older people after hospitalization. There was no effect of vitamin D on physical performance, and the exercises increased the risk of musculoskeletal injury. These findings do not support the routine use of these interventions at these dosages in the rehabilitation of frail older people.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,690,445
Effects of one year of resistance training on the relation between muscular strength and bone density in elderly women.
There is a paucity of long term studies on exercise training in elderly women. The purpose of this study was to investigate the effects of one year of progressive resistance exercise (PRE) on dynamic muscular strength and the relations to bone mineral density (BMD) in elderly women. Forty four healthy sedentary women (mean age 68.8 years) volunteered for this study and were randomly assigned to either an exercise group or a control group. The exercise group were involved in three one hour sessions a week for 52 weeks of supervised PRE to strengthen the large muscle groups of the body, while the control group were instructed to continue their normal lifestyle. The exercise circuit included three sets of eight repetitions at 75% of one repetition maximum focused on the large muscle groups. BMD was measured by dual energy x ray absoptiometry (Lunar DPX) at the lumbar spine and at three sites in the proximal femur. Other selected parameters of physical fitness were also measured. Statistical analyses (analysis of covariance) showed significant strength gains (p < 0.01) in bilateral bench press (> 29%), bilateral leg press (> 19%), and unilateral biceps curl (> 20%). No significant difference between groups was evident in body weight, grip strength, flexibility, waist to hip ratio, or the sum of eight skinfolds. Significant relations (p < 0.05) were recorded between dynamic leg strength and the BMD of the femoral neck, Ward's triangle, and the lumbar spine. Significant strength changes, after one year of PRE, were evident in elderly women, and the muscle increases may parallel changes in BMD; however, correlation coefficients were moderate.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,193,338
Resistance and functional training reduces knee extensor position fluctuations in functionally limited older adults.
The purpose of this study was to determine the effect of task-specificity on knee extensor steadiness adaptations in functionally limited older adults. Twenty-four functionally limited older adults (74.6+/-7.6 years: 22 women, 2 men) completed a 10-week control period followed by 10 weeks (2 days/week) of resistance (RT), functional (FT) (practicing everyday tasks, i.e., chair rises) or functional + resistance (FRT) training, which featured both shortening and lengthening movements. During testing, subjects performed a steady isometric [10, 25, 50% of maximal voluntary contraction (MVC)] and shortening/lengthening (5, 30, 65% of MVC) knee extensor contractions. There were no steadiness (isometric, shortening or lengthening contractions) changes in the control period and no adaptations in isometric steadiness due to training. RT induced a 37% reduction in shortening fluctuations at 5% of MVC and 35% reduction in lengthening fluctuations at both 30% and 65% of MVC. FRT induced a 60% reduction in shortening fluctuations at 30% of MVC. No adaptations in dynamic steadiness were observed in the FT group. Further analysis indicated that those who were the least steady at baseline showed the greatest training effects during isometric (RT: R (2)=0.25, FRT: R (2)=0.49, FT: R (2)=0.38), shortening (RT: R (2)=0.36, FRT: R (2)=0.36, FT: R (2)=0.35) and lengthening (RT: r (2)=0.29, FRT: r (2)=0.44) contractions. In conclusion, steadiness improvements in groups performing resistance exercise, without a concomitant improvement in the FT group, supports a role for task-specificity in explaining steadiness adaptations, particularly for unsteady older adults.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
17,013,851
Effects of strength training on the incidence and progression of knee osteoarthritis.
Quadriceps weakness is a risk factor for incident knee osteoarthritis (OA). We describe a randomized controlled trial of effects of lower-extremity strength training on incidence and progression of knee OA. A total of 221 older adults (mean age 69 years) were stratified by sex, presence of radiographic knee OA, and severity of knee pain, and were randomized to strength training (ST) or range-of-motion (ROM) exercises. Subjects exercised 3 times per week (twice at a fitness facility, once at home) for 12 weeks, followed by transition to home-based exercise after 12 months. Assessments of isokinetic lower-extremity strength and highly standardized knee radiographs were obtained at baseline and 30 months. Subjects in both groups lost lower-extremity strength over 30 months; however, the rate of loss was slower with ST than with ROM. Compared with ROM, ST decreased the mean rate of joint space narrowing (JSN) in osteoarthritic knees by 26% (P = not significant). However, the difference between ST and ROM groups with respect to frequency of knee OA progression in JSN consensus ratings was marginally significant (18% versus 28%; P = 0.094). In knees that were radiographically normal at baseline, JSN >0.50 mm was more common in ST than in ROM (34% versus 19%; P = 0.038). Incident JSN was unrelated to exercise adherence or changes in quadriceps strength or knee pain. The ST group retained more strength and exhibited less frequent progressive JSN over 30 months than the ROM group. The increase in incident JSN >0.50 mm in ST is unexplained and requires confirmation.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,807,578
Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial.
The purpose of this pilot was to determine whether a strength and flexibility program in frail long-term care facility (LTC) residents would result in improved function. A prospective, randomized, controlled, semicrossover trial was designed with participants assigned either to group exercise (EX) or recreational therapy (C). In the EX group, the intervention continued for 1 year. In the C group, recreation continued for 6 months; these controls were then crossed over to the same exercise intervention as the EX group and followed for an additional 6 months. Functional outcomes were measured at baseline and 3, 6, 9, and 12 months for both groups. A LTC facility, which included both assisted living (AL) and nursing home (NH) residents. Twenty frail residents (5 from NH, 15 from AL) aged 75 to 99 years at one LTC facility. After random group assignment, the EX group met 1 hour three times per week. An exercise physiologist and LTC staff conducted sessions which included seated range of motion (ROM) exercises and strength training using simple equipment such as elastic resistance bands (therabands) and soft weights. The C group met three times per week and participated in activities such as painting during the first 6 months, before crossing over to exercise. Objective measures of physical and cognitive function were obtained at baseline and 3, 6, 9, and 12 months using the timed get-up-and-go test (TUG), Berg balance scale, physical performance test (PPT), and mini-mental status exam (MMSE). Because we were interested in the impact of exercise on multiple endpoints and to protect the type I error rate, a global hypothesis test was used. There was a significant overall impact across the four measures of the exercise intervention (P = 0.013). Exercise benefit as indicated by the difference between exercise and control conditions showed exercise decreased TUG by 18 seconds, which represents an effect size (in standard deviation units) of 0.50, increased PPT scores by 1.3, with effect size = 0.40, increased Berg scores by 4.8, with effect size of 0.32, and increased MMSE by 3.1, with effect size = 0.54. Except for the Berg, 90% confidence intervals on these exercise effects excluded 0. Frail elderly in a LTC facility were able to participate and benefit from a strength training program. The program was delivered with low-cost equipment by an exercise physiologist and LTC staff. The advantage of such a program is that it provides recreational and therapeutic benefits.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,553,360
Exercise training and heart rate variability in older adult female subjects.
Prior investigations in post-myocardial infarction and healthy elderly subjects have established that heart rate variability (HRV) predicts mortality. Predominantly cross-sectional studies have shown an association between endurance training and measures of HRV. In a randomized trial, this study sought to prospectively compare the effects of endurance and strength training on HRV in 45 healthy elderly females (average age 69.9 +/- 0.9 years). All subjects were rigorously screened to be normal by history, physical, blood tests, ECG, ETT and echocardiogram. All subjects were monitored for 24 hours by a 2-channel Holter before and after training. Artifacts and arrhythmias were manually removed. Tapes were examined for standard measures of HRV. 15 subjects were randomized to endurance trained (ET), 15 subjects to strength training (ST), and 15 subjects to no training (NT) for six months. Training resulted in a significant increase in VO2max in the ET (+7.4%, p = 0.005) group only. There was a small but not significant decrease in HR with both the ET and ST groups. ET resulted in a significant increase in most time domain and all frequency domain measures of HRV. ST resulted in no significant change in HRV measures. Strength training, as opposed to endurance training has no significant impact on HRV. This suggests that exercise interventions designed to improve strength (such as weight-lifting) will have little to no impact on HRV, suggesting that aerobic and strength training operate through different mechanisms to reduce cardiac risk.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,982,665
High-velocity resistance training increases skeletal muscle peak power in older women.
Peak power declines more precipitously than strength with advancing age and is a reliable measure of impairment and a strong predictor of functional performance. We tested the hypothesis that a high-velocity resistance-training program (HI) would increase muscle power more than a traditional low-velocity resistance-training program (LO). Randomized controlled trial. University-based human physiology laboratory. Thirty women with self-reported dis-ability (aged 73 + 1, body mass index 30.1 + 1.1 kg/mn). We conducted a randomized trial comparing changes in skeletal muscle power and strength after 16 weeks of HI or LO. Training was performed three times per week, and subjects completed three sets (8-10 repetitions) of leg press (LP) and knee extension (KE) exercises at 70% of the one-repetition maximum (IRM). One-repetition maximum (1 RM) and peak power for KE and LP. LP and KE relative training force and total work were similar between groups (P > .05). However, HI generated significantly higher power during training sessions than LO for LP (3.7-fold greater, P < .001) and KE (2.1-fold greater, P < .001). Although LP and KE 1RM muscle strength increased similarly in both groups asa result of the training (P < .001), LP peak power increased significantly more in HI than in LO (267 W vs 139 W, P < .001). Furthermore, HI resulted in a significantly greater improvement in LP power at 40%, 50%, 60%,70%, 80%, and 90% of the 1 RM than did LO (P <.05). HI improved 1RM strength similarly and was more effective in improving peak power than was traditional LO in older women. Improvements in lower extremity peak power may exert a greater influence on age-associated reductions in physical functioning than other exercise interventions.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,271,767
A controlled trial of circuit weight training on aerobic capacity and myocardial oxygen demand in men after coronary artery bypass surgery.
Cardiovascular benefits of resistance training in cardiac patients have been suggested but not studied in a randomized, controlled trial of circuit weight training (CWT) without an aerobic exercise component. The purpose of the current study was to examine the effects of 10 weeks of CWT on muscular strength, peak oxygen consumption (peak VO2), and myocardial oxygen demand (mVO2) in men after coronary artery bypass surgery. Twenty-six, post-coronary bypass male subjects (mean 19 months after bypass), aged 60 +/- 8.5 years, were randomly allocated to 10 weeks of CWT at 40 to 60% of maximum voluntary contraction (n = 12) or to a control group (n = 14). Muscular strength was assessed using a modified one repetition maximum technique. Peak VO2 was recorded during symptom-limited treadmill exercise. Rate pressure product, as an indirect measure of mVO2, was measured during isometric, isodynamic, and dynamic exercise. No ischemic symptoms nor electrocardiographic changes were recorded during testing or training. Strength increased by 18% (P < 0.005) in five out of seven exercises in the training group, but was unchanged in the control group. Training did not improve peak VO2. Rate pressure product during isometric and isodynamic exercise decreased from pre- to post-testing (P < 0.05) but was equivalent to that seen in the control group. Moderate intensity CWT is safe and can improve strength in selected low-risk patients after coronary artery bypass surgery. However, it does not significantly increase peak VO2 nor reduce mVO2 during isometric, isodynamic, and dynamic exercise.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,469,475
The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.
To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee. Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables. Patients in the strength training group who completed the trial had a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modified intent to treat analysis, self-reported pain improved by 36% and physical function by 38% in the strength training group versus 11 and 21%, respectively, in the control group (p = 0.01 for between group comparison). In addition, those patients in the strength training group who completed the trial had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean improvement in self-reported physical function (p < 0.01 vs controls), and improvements in physical performance, quality of life, and self-efficacy when compared to the control group. High intensity, home based strength training can produce substantial improvements in strength, pain, physical function and quality of life in patients with knee OA.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,090,633
Effects of a short-term strength training programme on lymphocyte subsets at rest in elderly humans.
The effects of a short-term strength training programme on resting lymphocyte subsets and stress hormone concentrations were analysed in 32 elderly sedentary subjects. Out of these 32 subjects, 8 women and 8 men [mean age 70.1 (SEM 1.0) years] were randomly assigned to a 8-week strength training programme which consisted of three sets of eight repetitions at 80% of one repetition maximum, for leg press, bilateral leg extension and seated chest press, 3 days a week. The remaining 8 women and 8 men [mean age 70.5 (SEM 0.9) years] served as controls. Absolute counts of lymphocyte subsets (CD20+, CD3+, CD3+CD4+, CD3+CD8+, CD3-CD56+CD16+) were measured with a new technique combining fluorescent microspheres and flow cytometry. In the trained subjects, substantial increases in strength took place in one repetition maximum during the 8-week training period for leg press [from means of 20.7 (SEM 1.0) to 23.6 (SEM 1.0) N x kg(-1) LBM (lean body mass)], chest press [from means of 5.4 (SEM 0.3) to 6.2 (SEM 0.3) N x kg(-1) LBM] and bilateral leg extension [from means of 6.3 (SEM 0.2) to 7.4 (SEM 0.3) N x kg(-1) LBM] movements. Baseline cortisol concentration (P < 0.01), CD20+ cell count (P < 0.05), CD3+ cell count (P < 0.05), and CD4+ cell count (P < 0.01) decreased in both groups secondary to circannual variations between winter and summer. No significant effect of strength training on resting adrenaline, noradrenaline and cortisol concentrations or distributions of lymphocyte subsets at rest was observed. The main finding of this study was to demonstrate that 8-week is too short a duration for a strength training programme to modify counts of lymphocyte subsets at rest in elderly sedentary adults.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,650,680
The effects of strength training on strength and health-related quality of life in older adult women.
The short-term effects of an accessible exercise intervention on the strength and health-related quality of life (HRQOL) among older adult women were evaluated. We conducted an 8-week resistance training intervention utilizing elastic bands in 62 community-dwelling women with a mean age of 68 years. Participants were randomly assigned to either an exercise or a control group. Pre- and postintervention assessments included strength tests and HRQOL. Results revealed significant increases in three major muscles compared to the control group. However, there were no significant changes on either mental or physical health functioning. The elastic bands provide older adult women with an inexpensive, practical exercise program that effectively increases strength within 8 weeks but may have little effect on self-reported HRQOL.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,980,206
A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST).
To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. An aerobic exercise program, a resistance exercise program, and a health education program. The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x-ray score, aerobic capacity, and knee muscle strength. A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (+/- SE) score on the physical disability questionnaire (1.71 +/- 0.03 vs 1.90 +/- 0.04 units; P<.001), a 12% lower score on the knee pain questionnaire (2.1 +/- 0.05 vs 2.4 +/- 0.05 units; P=.001), and performed better (mean [+/- SE]) on the 6-minute walk test (1507 +/- 16 vs 1349 +/- 16 ft; P<.001), mean (+/-SE) time to climb and descend stairs (12.7 +/- 0.4 vs 13.9 +/- 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 +/- 0.2 vs 10.0 +/- 0.1 seconds; P<.001), and mean (+/-SE) time to get in and out of a car (8.7 +/- 0.3 vs 10.6 +/- 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74 +/- 0.04 vs 1.90 +/- 0.03 units; P=.003), 8% lower pain score (2.2 +/- 0.06 vs 2.4 +/- 0.05 units; P=.02), greater distance on the 6-minute walk (1406 +/- 17 vs 1349 +/- 16 ft; P=.02), faster times on the lifting and carrying task (9.3 +/- 0.1 vs 10.0 +/- 0.16 seconds; P=.001), and the car task (9.0 +/- 0.3 vs 10.6 +/- 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,761,216
The effects of systematic resistance training in the elderly.
The aim of the study was to examine the effects of a maximal resistance training following the principles of the most effective resistance training known from sport adapted to elderly people. Twenty-four subjects were randomly assigned into a training group (10 females and 4 males, age; 76.2 +/- 3.2 years) that underwent a training program and a control group (6 females and 4 males, age; 76.6 +/- 2.7 years) that did not participate in the training program. Before and after the training period, both groups were identically examined (blood and urine sample, spiroergometric testing, morphological measurements). The training group underwent a 12-week training program. Eight different exercises for the largest muscle groups of the largest joints were defined as one training circle. Training took place twice a week and commenced with two training circles per week (one circle per training session). After every four weeks, one training circle per week was added until four training circles per week were reached. Before, after every four weeks (changes in training amount) and after the training period, the maximum strength was measured. Data was analysed by the independent T-test and the analysis of variance, in case of significance, the dependent T-test and the Scheffé-test were used. In the resistance training group, the fat-free body mass was increased by approximately 2.9 +/- 0.5 kg, with no significant difference between females and males. Ergometrical fitness was increased by approximately 15 %, while the maximum oxygen uptake was increased by approximately 12 %. Maximum strength was increased between 26 % (bench pull) and 38 % (leg press). Resistance training that consisted of two training sessions per week was found to be at least as efficient as resistance training that included three training sessions per week, provided that the number of sets performed were equal. Seventy-five-year-old females were found to have a significantly higher body fat content than males of the same age (37 % versus 26 %, respectively). However, the decrease in body fat mass due to resistance training was found to be equal in both females and males (- 4 +/- 0.8 kg). Furthermore, there was almost no difference in muscle strength between the sexes for this age group (for example; leg press: females 86 kg versus males 82 kg).
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,042,537
Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease.
Systemic inflammation and protein-energy malnutrition may be associated with poor outcomes in kidney disease. We studied 26 adults (age, 65 +/- 10 [SD] years) with chronic kidney disease, not on dialysis therapy. Subjects were randomly assigned to resistance training (n = 14) or a control group (n = 12) for 12 weeks, while counseled to consume a low-protein diet (protein, approximately 0.6 g/kg/d). We determined whether resistance training reduces levels of inflammatory mediators (serum C-reactive protein [CRP] and interleukin-6 [IL-6]), in addition to previously reported improvements in nutritional and functional status in this same subject population. Serum CRP levels were reduced in subjects undergoing resistance training (-1.7 mg/L) compared with controls (1.5 mg/L; P = 0.05). Similarly, IL-6 levels were reduced in the resistance-exercise group versus controls (-4.2 versus 2.3 pg/mL; P = 0.01). Resistance training lead to skeletal muscle hypertrophy, shown by increases in type I (24% +/- 31%) and type II (22% +/- 41%) muscle fiber cross-sectional areas, compared with control subjects (-14% +/- 34% and -13% +/- 18%, respectively; P < 0.05). Muscle strength also improved with resistance training (28% +/- 14%) compared with controls (-13% +/- 22%; P = 0.001). Resistance training reduced inflammation and improved nutritional status in individuals with moderate chronic kidney disease consuming a low-protein diet. These results need to be investigated further in larger cohorts of patients with varying stages of kidney disease to determine whether resistance training can improve disease outcomes long term.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,730,397
Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial.
Chronic renal insufficiency leads to muscle wasting, which may be exacerbated by low-protein diets prescribed to delay disease progression. Resistance training increases protein utilization and muscle mass. To determine the efficacy of resistance training in improving protein utilization and muscle mass in patients with chronic renal insufficiency treated with a low-protein diet. Randomized, controlled trial. Tufts University, Boston, Massachusetts. 26 older patients with moderate renal insufficiency (17 men, 9 women) who had achieved stabilization on a low-protein diet. During a run-in period of 2 to 8 weeks, patients were instructed and their adherence to the low-protein diet (0.6 g/kg of body weight per day) was evaluated. They were randomly assigned to a low-protein diet plus resistance training (n = 14) or a low-protein diet alone (n = 12) for 12 weeks. Total body potassium, mid-thigh muscle area, type I and II muscle-fiber cross-sectional area, and protein turnover. Mean protein intake was 0.64 +/- 0.07 g/kg per day after stabilization. Total body potassium and type I and II muscle-fiber cross-sectional areas increased in patients who performed resistance training by a mean (+/-SD) of 4% +/- 8%, 24% +/- 31%, and 22% +/- 29%, respectively, compared with those who did not. Leucine oxidation and serum prealbumin levels also improved significantly. Patients assigned to resistance training maintained body weight compared with those who were not. Improvement in muscle strength was significantly greater with resistance training (32% +/- 14%) than without (-13% +/- 20%) (P < 0.001). By improving muscle mass, nutritional status, and function, resistance training seems to be effective against the catabolism of a low-protein diet and uremia in patients with renal failure.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,586,856
Effect of strength and power training on physical function in community-dwelling older adults.
The performance of daily tasks, such as stair climbing or lifting an object, requires both muscle strength and power. Age-associated reductions in strength and power can affect an older adult's ability to complete daily tasks such as stair climbing and lifting a child. The purposes of this study were to determine whether power training was more efficacious than strength training for improving whole-body physical function in older adults and to examine the relationship between changes in anaerobic power and muscle strength and changes in physical function. Thirty-nine men and women (mean age +/- SD = 72.5 +/- 6.3 years) with below-average leg extensor power were randomly assigned to control (C, n = 15), strength-training (ST, n = 13) or power-training (PT, n = 11) groups. The ST and PT groups met 3 days per week for 16 weeks; the C group maintained usual activity and attended three lectures during the course of the study. Primary outcome measures included the Continuous Scale Physical Functional Performance test, maximal strength, and anaerobic power. After baseline was controlled for, the Continuous Scale Physical Functional Performance test total score was significantly greater for the PT group than for the ST (p =.033) and C (p =.016) groups. Maximal strength was significantly greater for the ST group than for the C group (p =.015) after the intervention. There was no significant difference between groups for peak anaerobic power. Power training was more effective than strength training for improving physical function in community-dwelling older adults.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,183,776
Strength training and detraining effects on muscular strength, anaerobic power, and mobility of inactive older men are intensity dependent.
Although strength training (ST) enhances physical function in the elderly, little is known about the effect of training intensity on training and detraining adaptations in musculoskeletal fitness. To determine the effect of exercise intensity on strength, anaerobic power, and mobility of older men subjected to a 24 week ST protocol followed by prolonged detraining. Fifty two healthy but inactive older men (mean (SD) age 71.2 (4.1) years) were assigned to a control (n = 14), low intensity training (LIST; n = 18; 55% 1RM), or high intensity training (HIST; n = 20; 82% 1RM) group. They carried out a 24 week, whole body (10 exercises, two to three sets/exercise) ST programme followed by a 48 week detraining period. Upper and lower body strength, anaerobic power (Wingate testing), and mobility (timed up and go, walking, climbing stairs) were measured at baseline and immediately after training and during detraining. Although low intensity training improved (p<0.05) strength (42-66%), anaerobic power (10%), and mobility (5-7%), high intensity training elicited greater (p<0.05) gains (63-91% in strength, 17-25% in anaerobic power, 9-14% in mobility). All training induced gains in the LIST group had been abolished after four to eight months of detraining, whereas in the HIST group strength and mobility gains were maintained throughout detraining. However, anaerobic power had returned to baseline levels after four months of detraining in both groups. Higher intensity training protocols induce greater gains in strength, anaerobic power, and whole body physical function of older men. Moreover, higher intensity training may maintain the gains for more prolonged periods after training ceases.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,842,358
The effects of strength training, cardiovascular training and their combination on flexibility of inactive older adults.
The purpose of this study was to investigate the effects of aerobic training, strength training and their combination on joint range of motion of inactive older individuals. Thirty-two inactive older men (65 - 78 yr) were assigned to one of four groups (n = 8 per group): control (C), strength training (ST), cardiovascular training (CT), and combination of strength and aerobic training (SA). Subjects in the S, A, and SA trained three times a week for 16 weeks. ST included 10 resistance exercises for the major muscle groups at an intensity of 55 - 80% of 1-RM and CT included walking/jogging at 50 - 80 % of maximal heart rate. Body weight and height, physical activity level and maximal oxygen uptake (.VO(2)max) were measured before the training period. Isokinetic (60 and 180 deg x sec(-1)) and concentric strength (1-RM in bench and leg press) were assessed prior to and at the end of the training period. Hip flexion, extension, abduction, and adduction, shoulder extension, flexion, and adduction, knee flexion, elbow flexion and sit-and-reach score were determined before and at 8 and 16 weeks of training. There were no differences between groups in .VO(2)max, body weight, and height (p < 0.05). ST and SA but not CT and C increased isokinetic and concentric strength at the end of the training period (p < 0.05). ST and SA increased significantly (p < 0.05) sit-and-reach performance, elbow flexion, knee flexion, shoulder flexion and extension and hip flexion and extension both at mid- and post-training. CT increased (p < 0.05) only hip flexion and extension at post training. Results indicate that resistance training may be able to increase range of motion of a number of joints of inactive older individuals possibly due to an improvement in muscle strength.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,008,666
A randomized controlled trial of progressive resistance training in depressed elders.
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. We conducted a 10-week randomized controlled trial of volunteers aged 60 and above with major or minor depression or dysthymia. Subjects were randomized for 10 weeks to either a supervised PRT program three times a week or an attention-control group. A total of 32 subjects aged 60-84, mean age 71.3 +/- 1.2 yr, were randomized 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). PRT is an effective antidepressant in depressed elders, while also improving strength, morale, and quality of life.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,933,485
Effects of progressive resistance training on immune response in aging and chronic inflammation.
The effects of 12 wk of progressive resistance strength training on in vivo and in vitro immune parameters were evaluated in a controlled study of eight subjects with rheumatoid arthritis (RA), eight healthy young (22-30 yr), and eight healthy elderly (65-80 yr) individuals. Six healthy elderly (65-80 yr) nontraining control subjects were also evaluated to account for seasonal and psychosocial effects. Training subjects exercised at 80% of their one-repetition maximum and performed eight repetitions per set, three sets per session on a twice weekly basis. Peripheral blood mononuclear cell (PBMC) subpopulations, cytokine and prostaglandin (PG) E2 production, proliferative response, and delayed type hypersensitivity (DTH) skin response were measured before and after 12 wk of training. Training did not induce changes in PBMC subsets, interleukin (IL)-1 beta, tumor necrosis factor-alpha (TNF), IL-6, IL-2, or PGE2 production, lymphocyte proliferation, or DTH response in any of the training groups, compared with control subjects. These data suggest that 12 wk of high-intensity progressive resistance strength training does not affect immune function in young or elderly healthy individuals or subjects with RA.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,940,735
The effect of functional tasks exercise and resistance exercise on health-related quality of life and physical activity. A randomised controlled trial.
Data regarding the effect of exercise programmes on older adults' health-related quality of life (HRQOL) and habitual physical activity are inconsistent. To determine whether a functional tasks exercise programme (enhances functional capacity) and a resistance exercise programme (increases muscle strength) have a different effect on the HRQOL and physical activity of community-dwelling older women. Ninety-eight women were randomised to a functional tasks exercise programme (function group), a resistance exercise programme (resistance group), or normal activity group (control group). Participants attended exercise classes three times a week for 12 weeks. The SF-36 Health Survey questionnaire and self-reported physical activity were obtained at baseline, directly after completion of the intervention (3 months), and 6 months later (9 months). At 3 months, no difference in mean change in HRQOL and physical activity scores was seen between the groups, except for an increased SF-36 physical functioning score for the resistance group compared with the control group (p = 0.019) and the function group (p = 0.046). Between 3 and 9 months, the self-reported physical functioning score of the function group decreased to below baseline (p = 0.026), and physical activity (p = 0.040) decreased in the resistance group compared with the function group. Exercise has a limited effect on the HRQOL and self-reported physical activity of community-living older women. Our results suggest that in these subjects HRQOL measures may be affected by ceiling effects and response shift. Studies should include performance-based measures in addition to self-report HRQOL measures, to obtain a better understanding of the effect of exercise interventions in older adults. Copyright 2007 S. Karger AG, Basel.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,440,412
Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders?
Strength loss is strongly associated with functional decline and is reversible with exercise. The effect of increased strength on function has not been clearly established. The purpose of this study was to determine whether strength gain is associated with improvement in physical performance and disability. One hundred functionally impaired community-dwelling men and women (77.6 +/- 7.6 yrs) were tested at baseline and outcome for lower extremity strength, physical performance, and disability. After random group assignment, exercise participants received strengthening exercises in their homes three times a week for 10 weeks while control subjects continued their normal activities. Using multiple regression techniques, the relationship between strength gain and improvement in physical performance and disability was assessed, controlling for age, depression, and baseline strength. A significant impact of strength gain on mobility skills (p = .0009) was found. The impact of strength gain on chair rise performance was significant in participants who were more impaired (p = .04). Strength gain was associated with gain in gait speed (p = .02) and in falls efficacy (p = .05), but not with other balance, endurance, or disability measures. Lower extremity strength gain is associated with gains in chair rise performance, gait speed, and in mobility tasks such as gait, transfers, stooping, and stair climbing, but not with improved endurance, balance, or disability. Strength gain is also associated with improvement in confidence in mobility. Factors that may influence the ability of strength gain to affect function are initial level of frailty and specificity of exercise. These results support the idea that strength training is an intervention that can potentially improve physical health status in many frail elders.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,902,533
Effects of long-term resistive training on mobility and strength in older adults with diabetes.
Strength training has been shown to be beneficial in older adults. However, very little data exist on the effects of strength training in older diabetics. 31 community-dwelling older adults with diabetes (mean age = 66.1 years) were randomly assigned to either an exercise (EX) or control (CO) group. The EX group trained the plantar flexors, knee extensors, knee flexors, hip extensors, and hip flexors muscle groups at 50%, 60%, and 70% of 1-repetition maximum, 2.6 days a week, for 24 months. Mobility tests included the timed up and go, 50-foot walk, and walking up and down 8 stairs. Strength and mobility for both groups were evaluated at 6-month intervals. There was a group and time effect as the EX group increased 31.4% (p <.001) in strength for all muscle groups after the first 6 months of training, and the strength gains were retained for the duration of the training intervention. There was also a group and time effect for mobility as performance increased 8.6% and 9.8% (p =.032 and p = 0.031) for the first 6 and 12 months, respectively, but decreased to 4.6% above baseline at the end of the intervention. There were essentially no changes from baseline strength or mobility values for the CO group. In conclusion, these data suggest that a moderate-intensity resistive-training program can improve mobility and strength for the duration of a 24-month intervention in older adults with diabetes, thus potentially reducing the rate of mobility loss during aging.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,095,421
Effects of a heavy and a moderate resistance training on functional performance in older adults.
Resistance training can improve strength and functional performance, but there is little information about the effect of training intensity on functional performance in older adults. The purpose of this study was to determine the effect of 12 weeks of heavy (80% of 1 repetition maximum [1RM]) and moderate (60% of 1RM) resistance training on functional performance in healthy, inactive older adults, ages 60-74 years. Volunteer subjects were assigned randomly to a control group (CS, n = 10), heavy resistance training group (HRT, n = 11), or moderate resistance training group (MRT, n = 12) and participated in 12 weeks of strength training, 3 times per week. Performance measurements included 1RM lower-body strength, chair-rising time, walking velocity, stair-climbing time, and flexibility. Significant differences between HRT and MRT were found for 1RM strength of the lower limbs after the training period. Functional performance improved similarly for both HRT and MRT after the training period. Functional performance can be improved significantly with either heavy or moderate resistance training, without significant differences in the effectiveness of the 2 training protocols.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,702,262
Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass.
The purpose of the study was to compare the effects of three different types of group-based exercise programs (resistance training, agility training and general stretching) on back pain and health-related quality of life in older (aged 75-85 years) community-dwelling women with low bone mass (i.e., osteopenia or osteoporosis). The design was a 25-week randomized controlled trial. Participating were 98 community-dwelling women with low bone mass between the ages of 75 to 85 years old. We assessed back pain and its related disability and health-related quality of life. All three types of group-based exercise programs significantly reduced back pain and its related disabilities, but only resistance and agility training significantly improved health-related quality of life in community-dwelling older women with low bone mass. Baseline physical activity level and class attendance were significant predictors of change in health-related quality of life. Change in back pain and its related disabilities after 25 weeks of exercise intervention was significantly correlated with change in health-related quality of life and changes in the domains of pain and physical function. Resistance and agility training significantly enhanced health-related quality of life and may have done so by increasing social interactions and support, enhancing self-efficacy of physical abilities and modifying the experience of back pain. These data provide valuable insight into the specifics of exercise prescription for older women with low bone mass. Future studies may wish to use individualized quality of life measures to further delineate the effects of different types of exercise on quality of life in older adults with low bone mass.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,775,717
Heavy-resistance training in older Scandinavian men and women: short- and long-term effects on arm and leg muscles.
The short- and long-term effects of heavy-resistance training (85% of one-repetition maximum (RM)) on elbow flexion and knee extension dynamic and isokinetic strength and on morphology in the biceps brachii and vastus lateralis muscles were evaluated during 1 year in 35 Scandinavian men and women, aged 70-77 years, 12 of whom formed a control group. After the first 11 weeks of training (n = 23; 3 times/week) elbow flexion and knee extension dynamic strength (1 RM) had increased [mean +/- SD] 49% +/- 16 and 163% +/- 75, respectively, with no significant difference between men and women. For the following 27 weeks, strength was maintained with one training session per week (n = 12) but dropped without training (n = 11). After the final 11 weeks of training (n = 11; 3 times/week), strength had further increased 32% +/- 16 in both the arm and the leg. Isokinetic strength measurements (Cybex II; 30 degrees/s) revealed similar but smaller gains than for dynamic strength. Muscle biopsies (n = 20) taken at the start and after the first 11 weeks of training showed a significant increase in the area of both type 1 and type 2 fibers in the biceps brachii muscle and a positive significant correlation between the percentage increase in the proportional area of type 2 fibers in the vastus lateralis muscle and the percentage increase in knee extension dynamic muscle strength. In conclusion, older Scandinavian men and women have a high capacity both to improve and to maintain muscle strength, some of which is mediated through an adaptation in the muscle fiber type population.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,719,029
Nutritional supplementation and resistance training in nutritionally at risk older adults following lower limb fracture: a randomized controlled trial.
To describe the independent and combined effects of oral nutrition supplementation and resistance training on health outcomes in nutritionally at risk older adults following lower limb fracture. Randomized controlled trial with 12-week masked outcome assessment. Teaching hospital. One hundred nutritionally at risk older adults hospitalized following a fall-related lower limb fracture. Commenced seven days after injury. Consisted of daily multinutrient energy-dense oral supplement (6.3 kJ/mL) individually prescribed for six weeks (n = 25), tri-weekly resistance training for 12 weeks (n = 25), combined treatment (n = 24) or attention control plus usual care and general nutrition and exercise advice (n = 26). Weight change, quadriceps strength, gait speed, quality of life and health care utilization at completion of the 12-week intervention. At 12 weeks, all groups lost weight: nutrition -6.2% (-8.4, -4.0); resistance training -6.3% (-8.3, -4.3); nutrition and resistance training -4.7% (-7.4, -2.0); attention control -5.2% (-9.0, -1.5). Those receiving resistance training alone lost more weight than those receiving the combined treatment (P= 0.029). Significant weight loss was prevented if supplement was consumed for at least 35 days. Groups were no different at 12 weeks for any other outcome. Frail, undernourished older adults with a fall-related lower limb fracture experience clinically significant weight loss that is unable to be reversed with oral nutritional supplements. Those receiving a programme of resistance training without concurrent nutrition support are at increased risk of weight loss compared with those who receive a combined nutrition and resistance training intervention. In this high-risk patient group it is possible to prevent further decline in nutritional status using oral nutritional supplements if strategies are implemented to ensure prescription is adequate to meet energy requirements and levels of adherence are high.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
1,864,770
Muscle hypertrophy response to resistance training in older women.
We conducted a 12-wk resistance training program in elderly women [mean age 69 +/- 1.0 (SE) yr] to determine whether increases in muscle strength are associated with changes in cross-sectional fiber area of the vastus lateralis muscle. Twenty-seven healthy women were randomly assigned to either a control or exercise group. The program was satisfactorily completed and adequate biopsy material obtained from 6 controls and 13 exercisers. After initial testing of baseline maximal strength, exercisers began a training regimen consisting of seven exercises that stressed primary muscle groups of the lower extremities. No active intervention was prescribed for the controls. Increases in muscle strength of the exercising subjects were significant compared with baseline values (28-115%) in all muscle groups. No significant strength changes were observed in the controls. Cross-sectional area of type II muscle fibers significantly increased in the exercisers (20.1 +/- 6.8%, P = 0.02) compared with baseline. In contrast, no significant change in type II fiber area was observed in the controls. No significant changes in type I fiber area were found in either group. We conclude that a program of resistance exercise can be safely carried out by elderly women, such a program significantly increases muscle strength, and such gains are due, at least in part, to muscle hypertrophy.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,104,869
Resistance and aerobic training in older men: effects on VO2peak and the capillary supply to skeletal muscle.
Both aerobic training (AT) and resistance training (RT) may increase aerobic power (VO2peak) in the older population; however, the role of changes in the capillary supply in this response has not been evaluated. Twenty healthy men (age 65-74 yr) engaged in either 9 wk of lower body RT followed by 9 wk of AT on a cycle ergometer (RT-->AT group) or 18 wk of AT on a cycle ergometer (AT-->AT group). RT was performed three times per week and consisted of three sets of four exercises at 6-12 repetitions maximum. AT was performed three times per week for 30 min at 60-70% heart rate reserve. VO2peak was increased after both RT and AT (P < 0.05). Biopsies (vastus lateralis) revealed that the number of capillaries per fiber perimeter length was increased after both AT and RT (P < 0.05), paralleling the changes in VO2peak, whereas capillary density was increased only after AT (P < 0.01). These results, and the finding of a significant correlation between the change in capillary supply and VO2peak (r = 0.52), suggest the possibility that similar mechanisms may be involved in the increase of VO2peak after high-intensity RT and AT in the older population.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
9,224,433
The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults.
The study tested the effect of strength and endurance training on gait, balance, physical health status, fall risk, and health services use in older adults. The study was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults (n = 105) age 68-85 with at least mild deficits in strength and balance were selected from a random sample of enrollees in a health maintenance organization. The intervention was supervised exercise (1-h sessions, three per week, for 24-26 weeks), followed by self-supervised exercise. Exercise groups included strength training using weight machines (n = 25), endurance training using bicycles (n = 25), and strength and endurance training (n = 25). Study outcomes included gait tests, balance tests, physical health status measures, self-reported falls (up to 25 months of follow-up), and inpatient and outpatient use and costs. There were no effects of exercise on gait, balance, or physical health status. Exercise had a protective effect on risk of falling (relative hazard = .53, 95% CI = .30-.91). Between 7 and 18 months after randomization, control subjects had more outpatient clinic visits (p < .06) and were more likely to sustain hospital costs over $5000 (p < .05). Exercise may have beneficial effects on fall rates and health care use in some subgroups of older adults. In community-living adults with mainly mild impairments in gait, balance, and physical health status, short-term exercise may not have a restorative effect on these impairments.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,105,515
High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors.
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. Forty-two volunteers aged 50 years and above, 6 months to 6 years after a single mild to moderate stroke, were randomized 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). 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. High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke, and results in reductions in functional limitations and disability.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,163,735
Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure.
Beneficial training outcomes have been reported in patients with chronic heart failure (CHF) following leg exercise training. However, data from more comprehensive training programs are limited. The aim of this study was to test the hypothesis that exercise training applying the concept of comprehensive local muscle training can improve aerobic and functional working capacity as well as quality of life in patients with CHF. Twenty-four men and women [age 63+/-9 years (mean+/-S.D.)] with stable, moderate chronic heart failure (left ventricular ejection fraction 30+/-10%), were investigated in a randomized controlled study with a training group of 16 patients and a control group of 8 patients. The training was performed as an aerobic resistance training by activating all the main muscle groups, one at a time. The patients exercised for 1 h, three times per week for 8 weeks. Patient groups did not differ at baseline. Peak oxygen uptake (8%, P<0.03), the distance walked in a 6-min walking test (11%, P<0.002), the health-related quality of life (P<0.001) and plasma norepinephrine levels at rest (32%, P<0.003) and at submaximal intensities (P<0.03) improved after training. No changes were found in the control group, except for decreased peak oxygen uptake (P<0.02) and quality of life scores (P<0.03). Since comprehensive physical training activating a minor muscle mass at a time markedly improves exercise capacity and quality of life and reduces catecholamine levels, it can be recommended for the rehabilitation of patients with CHF under supervision of a physical therapist.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
14,565,966
Strength training reduces force fluctuations during anisometric contractions of the quadriceps femoris muscles in old adults.
The greater fluctuations in motor output that are often exhibited by old adults can be reduced with strength training. The purpose of the study was to determine the effect of strength and steadiness training by old adults on fluctuations in force and position during voluntary contractions with the quadriceps femoris muscle. Healthy old adults (65-80 yr) completed 16 wk of heavy-load (80% of maximum, n = 11) strength training, heavy-load steadiness training (n = 6), or no training (n = 9). Steadiness training required subjects to match the angular displacement about the knee joint to a constant-velocity template. The Heavy-Load group experienced a 5.5% increase in muscle volume, a 25% increase in maximal voluntary contraction force, and a 26% increase in the one-repetition (1-RM) load. The Heavy-Load Steady group experienced increases of 11.5, 31, and 36%, respectively. The maximal electromyogram signal of quadriceps femoris increased by 51% in the two training groups. The coefficient of variation (CV) for force during submaximal isometric contractions did not change with training for any group. Although both training groups also experienced a reduction in CV for force during anisometric contractions with a 50% 1-RM load, the standard deviation of position did not change with time for any group. The Heavy-Load Steady group also experienced a reduction in CV for force during the training contractions performed with the 80% 1-RM load. Thus strength training reduced the force fluctuations of the quadriceps femoris muscles during anisometric contractions but not during isometric contractions.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,596,486
Contrasting effects of resistance and aerobic training on body composition and metabolism after diet-induced weight loss.
This study examined whether exercise training facilitates maintenance of body weight at reduced levels following weight loss by attenuating weight loss-induced reductions in resting metabolism and fat oxidation. The effects of 12 weeks (three times per week) of either aerobic or weight training exercise on body weight, body composition, and energy metabolism during rest and following a meal in 18 older (mean +/- SE, 61 +/- 1 years; range, 56 to 70) subjects who had recently lost a mean of 9 +/- 1 kg were studied. During the exercise training period, the aerobic training group (five women, four men) had a significant (P < .05) reduction in body weight (-2.5 +/- 0.6 kg) as compared with the weight training group (five women, four men) (0.4 +/- 0.9 kg). Eight of nine aerobic training subjects lost additional weight, while six of nine weight training subjects gained weight. Neither type of training reversed the depressions in resting metabolism or fat oxidation rates (ie, resting or postprandial) that had occurred as a consequence of the prior weight loss. Thus, alterations in resting metabolism or fat oxidation (resting or postprandial) do not appear to be the mechanism(s) by which exercise training facilitates maintenance of diet-induced weight loss.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
1,549,826
Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation.
BACKGROUND PATIENTS: with chronic airflow obstruction are often limited by muscle fatigue and weakness. As exercise rehabilitation programmes have produced modest improvements at best a study was designed to determine whether specific muscle training techniques are helpful. Thirty four patients with chronic airflow limitation (forced expiratory volume in one second (FEV1) 38% of predicted values) were stratified for FEV1 to vital capacity (VC) ratio less than 40% and arterial oxygen desaturation during exercise and randomised to a control or weightlifting training group. In the experimental group training was prescribed for upper and lower limb muscles as a percentage of the maximum weight that could be lifted once only. It was carried out three times a week for eight weeks. Three subjects dropped out of each group; results in the remaining 14 patients in each group were analysed. Adherence in the training group was 90%. In the trained subjects muscle strength and endurance time during cycling at 80% of maximum power output increased by 73% from 518 (SE69) to 898 (95) s, with control subjects showing no change (506 (86) s before training and 479 (89) s after training). No significant changes in maximum cycle ergometer exercise capacity or distance walked in six minutes were found in either group. Responses to a chronic respiratory questionnaire showed significant improvements in dyspnoea and mastery of daily living activities in the trained group. Weightlifting training may be successfully used in patients with chronic airflow limitation, with benefits in muscle strength, exercise endurance, and subjective responses to some of the demands of daily living.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
7,990,242
Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial.
To determine how multiple risk factors for osteoporotic fractures could be modified by high-intensity strength training exercises in postmenopausal women. Randomized controlled trial of 1-year duration. Exercise laboratory at Tufts University, Boston, Mass. Forty postmenopausal white women, 50 to 70 years of age, participated in the study; 39 women completed the study. The subjects were sedentary and estrogen-deplete. High-intensity strength training exercises 2 days per week using five different exercises (n = 20) vs untreated controls (n = 19). Dual energy x-ray absorptiometry for bone status, one repetition maximum for muscle strength, 24-hour urinary creatinine for muscle mass, and backward tandem walk for dynamic balance. Femoral neck bone mineral density and lumbar spine bone mineral density increased by 0.005 +/- 0.039 g/cm2 (0.9% +/- 4.5%) (mean +/- SD) and 0.009 +/- 0.033 g/cm2 (1.0% +/- 3.6%), respectively, in the strength-trained women and decreased by -0.022 +/- 0.035 g/cm2 (-2.5% +/- 3.8%) and -0.019 +/- 0.035 g/cm2 (-1.8% +/- 3.5%), respectively, in the controls (P = .02 and .04). Total body bone mineral content was preserved in the strength-trained women (+2.0 +/- 68 g; 0.0% +/- 3.0%) and tended to decrease in the controls (-33+77 g; -1.2% +/- 3.4%, P = .12). Muscle mass, muscle strength, and dynamic balance increased in the strength-trained women and decreased in the controls (P = .03 to < .001). High-intensity strength training exercises are an effective and feasible means to preserve bone density while improving muscle mass, strength, and balance in postmenopausal women.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,254,902
Effects of progressive strength training on the performance of the Functional Reach Test and the Timed Get-Up-and-Go Test in an elderly population from the rural north of Portugal.
The purpose of this study was to examine the effect of an intensity progressive strength training program on the performance of two tests related to fall risk: the Functional Reach Test (FRT) and the Timed Get-Up-and-Go Test (TUG). Twenty subjects were randomly included in one experimental group (age 73 +/- 6 years old) and one control group (age 75 +/- 5 years old). Subjects from the experimental group participated in a strength-training program consisting of three sessions each week for a period of 14 consecutive weeks, from 50% to 80% of 1RM. A 2 (group: experimental vs. control) x 2 (pre-post: pre-test vs. post-test) repeated measures ANOVA was carried out on subjects in TUG and FRT performance. Mean FRT results from the pre-test were significantly lower than mean results from post-test. The two main effects were qualified by a significant group x pre-post interaction, F(1,18) = 39.23, P < 0.001, identifying markedly different performance profiles. Mean TUG results from the pre-test were significantly lower than mean results from post-test. The two main effects were qualified by a significant group x pre-post interaction, F(1,18) = 50.74, P < 0.001, again identifying markedly different performance profiles. Globally, the obtained results through our progressive strength-training program showed important improvements in functional task performance and in preventing falls. Copyright 2005 Wiley-Liss, Inc
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,860,465
Effect of exercise training on peak aerobic power, left ventricular morphology, and muscle strength in healthy older women.
The effect that aerobic (AT) and/or strength training (ST) has on altering peak aerobic power (VO2peak), muscle strength, left ventricular (LV) morphology, and diastolic filling in healthy older women is not known. We assessed the effects of 12 weeks of AT, ST, combined aerobic and strength training (COMT), or no training (NT) on VO2peak, muscle strength, LV morphology, and diastolic filling in 31 healthy women (68 +/- 4 years). Relative VO2peak was significantly greater after 12 weeks of AT, ST, or COMT. Upper and lower extremity strength were significantly higher after 12 weeks of ST or COMT with no change after AT or NT. LV morphology and diastolic filling were not altered after 12 weeks of AT, ST, COMT, or NT. Twelve weeks of ST or COMT are as effective as 12 weeks of AT for increasing relative VO2peak, however, ST and COMT are more effective than AT for improving overall muscle strength.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,481,277
Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients--a pilot study.
This study investigated the effects of heavy resistance training in elderly males with chronic obstructive pulmonary disease (COPD). 18 Home-dwelling male patients (age range: 65-80 years), with a mean forced expiratory volume in the first second (FEV1) of 46 +/- 3.4% of predicted value, were recruited. Baseline and post-training assessments included: Cross-sectional area (CSA) of quadriceps assessed by MRI, isometric and isokinetic knee extension strength, isometric trunk strength, leg extension power, normal and maximal gait-speed on a 30 m track, stair climbing time, number of chair stands in 30 s, lung function (FEV1) and self-reported health. Subjects were randomized to a resistance training group (RE, n = 9) or a control group conducting breathing exercises (CON, n = 9). RE performed heavy progressive resistance training twice a week for 12 weeks. 6 RE and 7 CON completed the study. In RE the following improved (P < 0.05): Quadriceps CSA: 4%, isometric knee extension strength: 14%, isokinetic knee extension strength at 60 degrees /s.: 18%, leg extension power: 19%, maximal gait speed: 14%, stair climbing time: 17%, isometric trunk flexion: 5% and self-reported health. In CON no changes were found. In conclusion, 12 weeks of heavy resistance training twice a week resulted in significant improvements in muscle size, knee extension strength, leg extension power, functional performance and self-reported health in elderly male COPD patients.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,760,343
Effects of 16 weeks of resistance training on left ventricular morphology and systolic function in healthy men >60 years of age.
Resistance training (RT) has gained popularity as an effective form of exercise for older adults. However, the effects of RT on left ventricular (LV) morphology and systolic function in older persons is not well known. The purpose of this study was to assess the effects of 16 weeks of RT on LV morphology and systolic function in healthy older men. Subjects were randomly assigned into a RT group (n = 10; mean+/- SD age, 68 +/- 3 years) or a nonexercise control group (n = 10; age 68 +/- 4 years). RT was performed 3 times per week for 16 weeks at a mean intensity between 60% and 80% of 1 repetition maximum. Leg and bench press 1 repetition maximum and 2-dimensional echocardiography were performed at baseline and after 4, 8, 12, and 16 weeks of training in the RT group. Sixteen weeks of RT was associated with an increase in leg press maximal strength (baseline, 285 +/- 48 kg; after 16 weeks, 367 +/- 47 kg; p <0.05) and bench press maximal strength (baseline, 59 +/- 11 kg; after 16 weeks, 69 +/- 11 kg; p <0.05). No change in leg press maximal strength (baseline, 291 +/- 59 kg; after 16 weeks, 290 +/- 53 kg; p >0.05) or bench press maximal strength (baseline, 60 +/- 9 kg; after 16 weeks, 61 +/- 13 kg; p > .05) was found in control subjects during the same time. RT was not associated with changes in LV cavity size, wall thickness, mass, or systolic function after 4, 8, 12, and 16 weeks of exercise. Thus, 16 weeks of RT was sufficient to increase leg press and bench press maximal strength but did not alter the size or systolic function of the senescent left ventricle.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
17,134,517
Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms.
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 aimed to determine whether PRT improves depressive status in older depressed patients. A randomised controlled trial was conducted. People aged > or = 65 years with depressive symptoms were recruited via general practices. Following baseline assessment, subjects were randomly 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. Three hundred and forty six people responded to the study invitation, of whom 22% had depressive symptoms (Geriatric Depression Scale, GDS-30 score > or = 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). 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.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,158,921
Age effect on transcript levels and synthesis rate of muscle MHC and response to resistance exercise.
Experimental evidence indicates that a lower synthesis rate of muscle contractile protein myosin heavy chain (MHC) occurs in age-related muscle wasting and weakness. To determine the molecular mechanism of this lower synthesis of MHC, we measured transcript levels of isoforms of MHC (MHCI, MHCIIa, and MHCIIx) in muscle biopsy samples of 7 young (20-27 yr), 12 middle-aged (47-60 yr), and 14 older (>65 yr) people. We further determined the effect of 3 mo of resistance exercise training (exercise) vs. nonintervention (control) on transcript levels of MHC isoforms on these subjects and the fractional synthesis rate (FSR) of MHC in 39 people aged 46-79 yr. MHCI mRNA levels did not significantly change with age, but MHCIIa decreased 38% (P < 0.05) from young to middle age and further decreased 50% (P < 0.05) from middle to old age. MHCIIx decreased 84% (P < 0.05) from young to middle age and 48% from middle to old age (P < 0.05). Exercise increased FSR of MHC by 47% (P < 0.01) and mixed muscle protein by 56% (P < 0.05). Exercise training results in an increase (85%) in transcript levels of MHCI and a decrease in the transcript levels of MHCIIa and MHCIIx. In conclusion, an age-related lowering of the transcript levels of MHCIIa and MHCIIx is not reversed by exercise, whereas exercise results in a higher synthesis rate of MHC in association with an increase in MHCI isoform transcript levels.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,064,101
Effects of resistive and balance exercises on isokinetic strength in older persons.
To determine the safety and efficacy of 3 months of resistive training of multiple lower extremity muscle groups compared with balance training in persons over 75 years. Randomized 3-month clinical trial. Subjects (n = 110, mean age 80) were randomized to 4 groups in a 2 x 2 design (control, resistive, balance, combined resistive/balance). Resistive training involved knee extension and flexion, hip abduction and extension, and plantar and dorsiflexion using simple resistive machines and sandbags. Balance training consisted of exercises to improve postural control. The control group attended 5 health-related discussion sessions. Summed isokinetic moments (N m) of 8 leg movements: hip, knee and ankle flexion/extension, and hip abduction/adduction. Secondary outcomes were gait velocity and chair rise time. Summed peak moment increased in both resistive exercise-trained groups (13% increase in the resistive group and 21% in the combined training group, P < 0.001). The effect of resistance training was significant (MANOVA F = 21.1, P < 0.001), but balance training did not improve strength, and there was no interaction (positive or negative) between balance and resistive training. Maximal gait velocity and chair rise time did not improve. Eleven subjects (20%) had musculoskeletal complaints related to resistive training, but all were able to complete the program with modifications. Resistive training using simple equipment is an effective and acceptable method to increase overall leg strength in older persons. Resistive or balance training did not improve maximal gait velocity or chair rise time in this sample of relatively healthy older persons.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,721,238
Resistance exercise in men receiving androgen deprivation therapy for prostate cancer.
Androgen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue, functional decline, increased body fatness, and loss of lean body tissue. These physical changes can negatively affect health-related quality of life. Resistance exercise may help to counter some of these side effects by reducing fatigue, elevating mood, building muscle mass, and reducing body fat. In a two-site study, 155 men with prostate cancer who were scheduled to receive androgen deprivation therapy for at least 3 months after recruitment were randomly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks (82 men) or to a waiting list control group (73 men). The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported questionnaires after 12 weeks. Secondary outcomes were muscular fitness and body composition. Men assigned to resistance exercise had less interference from fatigue on activities of daily living (P =.002) and higher quality of life (P =.001) than men in the control group. Men in the intervention group demonstrated higher levels of upper body (P =.009) and lower body (P <.001) muscular fitness than men in the control group. The 12-week resistance exercise intervention did not improve body composition as measured by changes in body weight, body mass index, waist circumference, or subcutaneous skinfolds. Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving androgen deprivation therapy. This form of exercise can be an important component of supportive care for these patients.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,441,371
Velocity training induces power-specific adaptations in highly functioning older adults.
To test the efficacy of high-velocity training in healthy older persons. A 12-week randomized trial, with subjects blocked for gender and residence, comparing high-velocity resistance training with a self-paced walking program. Retirement community. Forty-three volunteers over the age of 70 years. Power group: high-velocity leg exercises 3 times weekly with weekly increases in resistance combined with 45 minutes of moderate, nonresistance exercise weekly. Walking group: moderate intensity exercise 30 minutes daily, 6 days weekly. Variables measured included leg press peak power and leg extensor strength. Functional performance outcomes included: 6-minute walk distance, Short Physical Performance Battery, Physical Performance Test, and Medical Outcomes Study Short-Form Health Survey. Peak power improved 22% (p =.004) in the power group (3.7 +/- 1.0 W/kg to 4.5 +/- 1.4 W/kg) but did not change in the walking group (3.99 +/-.76 W/kg to 3.65 +/-.94 W/kg). Leg extensor power at resistance of 50%, 60%, and 70% of body weight increased 50%, 77%, and 141%, respectively, in the power group (p <.0001, repeated-measures analysis of variance). Strength improved 22% in the power-trained individuals and 12% in the walkers (p <.0001). Training did not improve functional task performance in either group. One subject developed a radiculopathy during training. Resistance training focusing on speed of movement improved leg power and maximal strength substantially, but did not improve functional performance in healthy high-functioning older volunteers. Copyright 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,086,665
Increased Velocity Exercise Specific to Task (InVEST) training: a pilot study exploring effects on leg power, balance, and mobility in community-dwelling older women.
To evaluate a dynamic form of weighted vest exercise suitable for home use and designed to enhance muscle power, balance, and mobility. A single-blind, randomized, controlled trial. Outpatient exercise research facility situated within an academic long-term care center. Twenty-one community-dwelling women aged 70 and older with a Short Physical Performance Battery (SPPB) score between 4 and 10 (out of 12). Subjects were randomized into a progressive resistance-training program using weighted vests for resistance with exercises designed to be specific to mobility tasks and have a component performed at the fastest possible velocity (Increased Velocity Exercise Specific to Task (InVEST), n=11) or a control exercise group (control, n=10), which performed slow-velocity, low-resistance exercise. Both groups exercised three times a week for 12 weeks. Changes in muscle power, balance, and physical performance were compared. In comparison to control group, InVEST group manifested significant improvements (P<.05) in leg power across measurements obtained at 75% to 90% of the one-repetition maximum. Both groups demonstrated significant improvements in chair stand and SPPB score from baseline, and the InVEST group showed significant improvements in gait speed and chair stand from baseline (P<.05). InVEST produced significantly greater changes in chair stand time than control (P<.05). InVEST training appears be an effective means of enhancing leg power and chair rise in this population and is worthy of further investigation as a means of enhancing balance and mobility.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
14,571,463
Strength training in older women: early and late changes in whole muscle and single cells.
In order to examine the relative contribution of neural- and muscle-based adaptation to strength training, we studied early (2 weeks) and later (12 weeks) effects of strength training on muscle size and strength and type I single-fiber size and contractility in 14 elderly women (aged 68-79 years) and seven young controls. Older subjects were randomized to training (n = 7) or control (n = 7) groups. Strength did not change, but whole muscle size increased significantly after 2 weeks. After 12 weeks, strength, whole muscle size, and specific force all increased. No changes occurred in the control group. In single fibers, no changes in size and contractility were noted after 2 weeks, but specific force was higher in the training group after 12 weeks. Early adaptations to strength training in elderly women cannot be attributed to changes at the cellular level and therefore occur primarily in the central nervous system. Later, cellular adaptations in specific force track closely whole muscle changes.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,782,642
Resistance exercise and bone turnover in elderly men and women.
This investigation examined the effect of 6 months of high- or low-intensity resistance exercise (REX) on bone mineral density (BMD) and biochemical markers of bone turnover in adults aged 60-83 yr. Sixty-two men and women (68.4 +/- 6 yr) were stratified for strength and randomly assigned to a control (CON, N = 16), low-intensity (LEX, N = 24), or high-intensity (HEX, N = 22) group. Subjects participated in 6 months of progressive REX training. Subjects trained at either 50% of their one repetition maximum (1-RM) for 13 repetitions (LEX) or 80% of 1-RM for 8 repetitions (HEX) 3 times x wk(-1) for 24 wk. One set each of 12 exercises was performed. 1-RM was measured for eight exercises. BMD was measured for total body, femoral neck, and lumbar spine by dual energy x-ray absorptiometry (DXA). Serum levels of bone-specific alkaline phosphatase (BAP), osteocalcin (OC), and pyridinoline cross-links (PYD) were measured. 1-RM significantly increased for all exercises tested for both the HEX and LEX groups (P < and = 0.050). The percent increases in total strength (sum of all eight 1-RMs) were 17.2% and 17.8% for the LEX and HEX groups, respectively. Bone mineral density (BMD) of the femoral neck significantly (P < 0.05) increased by 1.96% for the HEX group. No other significant changes for BMD were found. OC increased by 25.1% and 39.0% for the LEX and HEX groups, respectively (P < 0.05). BAP significantly (P < 0.05) increased 7.1% for the HEX group. These data indicate high-intensity REX training was successful for improving BMD of the femoral neck in healthy elderly subjects. Also, these data suggest REX increased bone turnover, which over time may lead to further changes in BMD.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,732,251
Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women.
The separate effects of 18 weeks of intensive strength and endurance training on isometric knee extension (KE) and flexion (KF) strength and walking speed were studied in 76- to 78- year-old women. Maximal voluntary isometric force for both KE and KF was measured in a sitting position on a custom-made dynamometer chair at a knee angle of 60 degrees from full extension. Maximal walking speed was measured over a distance of 10 m. The endurance-trained women increased KE torque and KE torque/body mass after the first 9 weeks of training when compared with the controls. when comparing the baseline, 9 week and 18 week measurements within the groups separately, both the endurance- and strength-training groups increased KE torque, KE torque/body mass and walking speed. Individual changes in KE torque/body mass before and after 18 weeks of training averaged 19.1% in the strength group, 30.9% in the endurance group and 2.0% in the controls. This study indicates that in elderly women the effects of physical training on muscle strength and walking speed occur after endurance as well as strength training. The considerable interindividual variation in change of muscle performance is also worth noticing.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,260,965
Effects of muscle strength training and testosterone in frail elderly males.
Determine the independent and combined effects of progressive resistance muscle strength training (PRMST) and testosterone on strength, muscle mass, and function in hypogonadal elderly male recuperative care patients. Between 1999 and 2004, 71 subjects (mean age 78.2 +/- 6.4 yr, 86% white) were enrolled. After baseline one-repetition maximum (1RM) strength testing and then randomization to one of four treatment groups (low-resistance (20% of the 1RM) exercises and weekly injections of either 100 mg of testosterone enanthate or placebo or high-intensity PRMST (> or =80% 1RM) and weekly injections), each subject received training and injections for 12 wk. Ten subjects withdrew from the study before its completion. Based on intent-to-treat analyses, strength improved in all groups, but was greater with high-intensity PRMST compared with low-resistance exercise (e.g., leg press, (mean +/- SE), 28 +/- 4 vs 13 +/- 4%, P = 0.009). Although testosterone led to significantly greater increases in midthigh cross-sectional muscle area compared with placebo (7.9 +/- 1.3 vs 2.4 +/- 1.4%, P = 0.005), it produced only a nonsignificant trend toward greater strength gains (e.g., leg press 25 +/- 4 vs 16 +/- 4%, P = 0.144). Change in aggregate functional performance score (the sum of 4 functional performance test scores) did not differ between the four intervention groups nor with high-intensity PRMST compared with low-resistance exercise (7 +/- 5 vs 15 +/- 5%, P = 0.263). There was not a significant interaction between exercise and testosterone for any outcome. High-intensity PRMST is as safe and well tolerated as a similarly structured low-resistance exercise regimen for very frail elderly patients, but produces greater muscle strength improvements. The addition of testosterone leads to greater muscle size and a trend toward greater strength but did not produce a synergistic interaction with exercise. Neither intervention had a significant effect on functional performance.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,669,348
A randomized controlled trial of a home exercise programme for elderly people with poor mobility.
Eighty-six elderly people with limited mobility and dependence in at least one activity of daily living were recruited to a home exercise study. The subjects (mean age 82 years) were allocated at random to either a strength exercise group, a mobility exercise group or a health education group. Subjects were visited for 30 minutes every 3-4 weeks by a physiotherapist who gave both verbal and written instruction. Sixty-nine of the original 86 completed the 6-month study, with five drop-outs from the strength group, ten drop-outs from the mobility group, and two drop-outs from the health education group. By the end of the study, there were no significant differences between the groups with regard to changes in outcome variables. The results showed a trend towards improvement in both the exercise groups in both Sit to Stand and Timed Get Up and Go tests, but this failed to attain statistical significance. Further work is required to identify the optimal exercise intervention for this subgroup of the elderly population.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,368,355
Effects of resistance training on selected indexes of immune function in elderly women.
Women aged 67-84 yr were randomly assigned to either resistance exercise (RE, n = 15) or control group (C, n = 14). RE group completed 10 wk of resistance training, whereas C group maintained normal activity. Blood samples were obtained from the RE group (at the same time points as for resting C) at rest, immediately after resistance exercise, and 2 h after exercise before (week 0) and after (week 10) training. Mononuclear cell (CD3+, CD3+CD4+, CD3+CD8+, CD19+, and CD3-CD16+CD56+) number, lymphocyte proliferative (LP) response to mitogen, natural cell-mediated cytotoxicity (NCMC), and serum cortisol levels were determined. Strength increased significantly in RE subjects (%change 8-repetition maximum = 148%). No significant group, exercise time, or training effects were found for CD3+, CD3+CD4+, or CD3+CD8+ cells, but there was a significant exercise time effect for CD3-CD16+CD56+ cells. LP response was not different between groups, across exercise time, or after training. NCMC was increased immediately after exercise for RE subjects at week 0 and for RE and C groups at week 10. The week 0 and week 10 NCMC values were above baseline for both RE and C groups 2 h after exercise. In conclusion, acute resistance exercise did not result in postexercise suppression of NCMC or LP, and 10 wk of resistance training did not influence resting immune measures in women aged 67-84 yr.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,375,679
The effect of a 12-week dynamic resistance strength training program on gait velocity and balance of older adults.
This study tested whether a 12-week dynamic resistance strength training program can change gait velocity and improve measures of balance among adults age 65 and older. Fifty-five community-dwelling adults (mean age = 71.1) were randomized into an exercise (n = 25) or control (n = 30) group. The exercisers were requested to complete three bouts of strength training per week for 12 weeks using elastic tubing. At posttest the exercisers demonstrated slower gait velocity, enhanced balance, and an improved ability to walk backward, although none of these posttest measures was significantly different from the control group.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,708,256
IGF-1 bioavailability is increased by resistance training in older women with low bone mineral density.
We investigated if long-term resistance training would increase insulin-like growth factor-1 (IGF-1) bioavailabilty at rest in older women (68+/-1 years) with low bone mineral density. IGF-1 levels were significantly lower (P<0.05), and insulin-like growth factor binding proteins -1 and -3 (IGFBP-1 and IGFBP-3) significantly higher than an age-matched healthy normal group. Resistance training resulted in significant (P<0.05) increases in repetition maximums across all exercises (range 41-78%). Resting IGF-1 levels were significantly (P<0.05) elevated (70%) by the resistance training whereas no significant changes occurred in IGFBP-1 and IGFBP-3 levels. IGFBP-1/IGF-1 and IGFBP-3/IGF-1 ratios were significantly decreased (approximately - 50%) as a result of resistance training (P<0.05). Thus, IGF-1 bioavailability was increased as a result of resistance training induced increases in IGF-1 levels in older women with low bone mineral density. These alterations in the IGF-1 system may be contributing to the significant strength gain observed with the resistance training in this population.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,970,279
Effect of resistance training on strength, postural control, and gait velocity among older adults.
The purpose of this study was to examine the effects of a 14-week resistance training program on the ankle strength, training intensity, postural control, and gait velocity of older adults. Forty-two older adults (mean age = 72), 21 in the resistance and control groups, completed the 14-week project. The resistance training group participated in 14 weeks of resistance training three times per week using elastic bands (Theraband) for resistance. Isokinetic ankle strength, training intensity, postural stability, and gait velocity were measured prior to and following the 14-week intervention. Following the training, the resistance group exhibited improved ankle dorsiflexion, training resistances, and gait velocity, but showed no change in plantar flexion or postural control. The control group also exhibited improvements in dorsiflexion, but these gains were approximately one-half of the gains observed in the resistance training group. Finally, when adjusted for baseline differences, subjects in the resistance training group demonstrated no changes in the dependent measures over the control group.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,123,761
Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders.
The purpose of this efficacy study was to measure the dose-response effect of a free weight-based resistance training program by comparing the effects of two training intensities (low-moderate and high) of the knee extensor (KE) muscles on muscle function, functional limitations, and self-reported disability. The authors conducted a single-blinded, randomized, placebo-controlled trial. Twenty-two institutionalized elders (mean age, 81.5 years) were assigned to either high-intensity strength training (HI; n = 8), low-moderate intensity strength training (LI; n = 6), or weight-free placebo-control training (PC; n = 8). The HI group trained at 80% of their 1-repetition maximum and the LI group trained at 40%. All groups performed 3 sets of 8 repetitions, 3 times per week for 10 weeks. Outcome measures included KE maximal strength, KE endurance, and functional performance as assessed by 6-minute walking, chair-rising, and stair-climbing tests, and by self-reported disability. KE strength and endurance, stair-climbing power, and chair-rising time improved significantly in the HI and LI groups compared with the PC group. Six-minute walking distance improved significantly in the HI group but not in the LI group compared with the PC group. Changes observed in HI were significantly different from those observed in the LI group for KE strength and endurance and the 6-minute walking test, with a trend in the same direction for chair-rising and stair-climbing. Changes in strength were significantly related to changes in functional outcomes, explaining 37% to 61% of the variance. These results show strong dose-response relationships between resistance training intensity and strength gains, and between strength gains and functional improvements after resistance training. Low-moderate intensity resistance training of the KE muscles may not be sufficiently robust from a physiologic perspective to achieve optimal improvement of functional performance. Supervised HI, free weight-based training for frail elders appears to be as safe as lower intensity training but is more effective physiologically and functionally.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,235,596
The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee.
To compare 16 weeks of isometric versus dynamic resistance training versus a control on knee pain and functioning among patients with knee osteoarthritis (OA). Randomized clinical trial. Outpatient setting. A total of 102 volunteer subjects with OA of the knee randomized to isometric (n=32) and dynamic (n=35) resistance training groups or a control (n=35). Strength exercises for the legs, 3 times weekly for 16 weeks. Dynamic group: exercises across a functional range of motion; isometric: exercises at discrete joint angles. The time to descend and ascend a flight of 27 stairs and to get down and up off of the floor. Knee pain was assessed immediately after each functional task. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess perceived pain, stiffness, and functional ability. In the isometric group, time to perform all 4 functional tasks decreased (P<.05) by 16% to 23%. In the dynamic group, time to descend and ascend stairs decreased by 13% to 17%. Both groups decreased knee pain while performing the functional tasks by 28% to 58%. Other measures of pain and functioning were significantly and favorably affected in the training groups. The improvements in the 2 training groups as a result of their respective therapies were not significantly different. The control group did not change over the duration of the study. Dynamic or isometric resistance training improves functional ability and reduces knee joint pain of patients with knee OA.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,781,902
Exercise and functional tasks among adults who are functionally limited.
This study compared the efficacy of 16 weeks of either resistance training, aerobic walking, or combined resistance training and aerobic walking on the performance of functional tasks among adults age 65 years and older with limited functional ability. One hundred thirty-one older adult individuals were randomized into four groups: resistance training, aerobic walking, combined resistance and aerobic walking groups, or a nonexercise control group. Each of the exercise groups documented 70% compliance with their respective exercise intervention, which included three weekly exercise sessions. At baseline, and 8 and 16 weeks following baseline, all participants completed six assessments of their functional ability. Analysis of covariance indicated that all three exercise intervention groups significantly improved measures of functional ability, with the resistance group demonstrating the most consistent gains over the six measures. These findings indicate that older adults who are functionally limited can improve their functional ability through a variety of types of exercise.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
12,825,328
Training for muscle power in older adults: effects on functional abilities.
The purpose of this study was to determine the influence of simple, progressive lower body exercise training, focusing on strength and power, on functional abilities in frail older adults. Twenty-five residents of a long-term care facility (75-94 yrs) participated in this randomized controlled trial of 10-wks duration. The exercise group (Ex, n = 18) underwent simple, progressive lower body resistance exercises, specifically aimed at improving muscle power, 3 times/wk; the control subjects (Con, n = 7) maintained their usual daily activities. Knee extensor strength and power were measured on an isokinetic dynamometer (180 degrees/s), and functional performance was assessed from a 6-m walk timed test, a 30-s chair stand, and an 8-ft up-and-go timed test, before and after the 10-wk intervention period. Significant increases were found in the Ex group for eccentric (44%) and concentric (60%) average power (p < 0.05), and improvements were seen on each functional test: the 8-foot up-and-go, chair stand, and walk time improved by 31%, 66%, and 33%, respectively (p < 0.05). No significant change occurred in the Con group. In conclusion, simple progressive exercise training, even in the 10th decade, increases muscle power and is associated with an improved performance of functional activities using the trained muscles.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
16,372,326
Strength training in old age: adaptation of antagonist muscles at the ankle joint.
The purpose of this study was to determine whether strength training could reduce the deficit in plantarflexion (PF) maximal voluntary contraction (MVC) torque observed in previous studies in older subjects relative to young adults. Accordingly, the effects of a 6-month strength training program on the muscle and neural properties of the major muscle groups around the ankle were examined. PF and dorsiflexion (DF) isometric MVC torques were measured and surface electromyographic activity of the triceps surae and tibialis anterior muscles was recorded. The strength training program was very effective in improving strength in PF (+24.5%), and it thus reduced the DF-to-PF MVC torque ratio; in addition, it also induced gains in DF (+7.6%). Thus, there must be an improvement in ankle joint stability. In PF, gains were due particularly to a modification of the agonist neural drive; in DF, the gains appeared to be the consequence of a reduction in antagonist coactivation. Our findings indicate that the investigation of one muscle group should always be accompanied by examination of its antagonist muscle group.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
10,527,090
Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention.
To evaluate the effects of isokinetic exercise versus a program of patient education on pain and function in older persons with knee osteoarthritis. A randomized, comparative clinical trial, with interventions lasting 8 weeks and evaluations of 12 weeks. An outpatient Veterans Affairs Medical Center clinic and an affiliated university hospital. One hundred thirteen men and women between 50 and 80 years old with diagnosed osteoarthritis of the knee; 98 completed the entire assigned treatment. Patients received either a regimen of isokinetic exercise of the quadriceps muscle three times weekly over 8 weeks or a series of 4 discussions and lectures led by health care professionals. Variables studied for change were isokinetic and isometric quadriceps strength, pain and function determined by categorical and visual analog scales, and overall status using physician and patient global evaluations by the Arthritis Impact Scale, version 2, Western Ontario McMaster's Arthritis Index, and Medical Outcome Study Short Form 36. Both treatment groups showed significant strength gains (p < .05), which occurred over a wider velocity spectrum for the exercise group. Exercised patients also had improved pain scores for more of the variables measured than those receiving education. Both groups had positive functional outcomes and slightly improved measures of overall status. Isokinetic exercise is an effective and well-tolerated treatment for knee osteoarthritis, but a much less costly education program also showed some benefits.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
11,445,595
Resistance training in patients with peripheral arterial disease: effects on myosin isoforms, fiber type distribution, and capillary supply to skeletal muscle.
The purpose of this study was to investigate the effects of a progressive resistance training program on myosin heavy chain isoform expression, fiber type, and capillarization in patients with symptomatic peripheral arterial disease. Patients were randomized to either a training group (n = 11, mean +/- SD, 70 +/- 6 years, 4 men, 7 women) or a control group (n = 9, 66 +/- 6 years, 5 men, 4 women). The training sessions were completed 3 times/week, using 2 sets of various exercises, each performed for 8-15 repetitions. Muscle biopsies were obtained before and after 24 weeks from the medial gastrocnemius. Following the 24-week training program, the training group had significantly decreased the percentage of myosin heavy chain type IIB. The proportion of type IIB/AB fibers as measured by using myosin adenosine triphosphatase histochemistry decreased significantly in the training group. There were significant increases in type I and type II fiber areas, and capillary density also increased significantly in the training group. There were significant increases in 10 repetition maximum leg press and calf press strengths in the trained subjects. There were no significant changes in any of the measurements in the control group. It is concluded that progressive resistance training results in significant increases in muscle strength and alters skeletal muscle composition of subjects with peripheral arterial disease.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,574,091
The effect of resistance-training intensity on strength-gain response in the older adult.
This study examined how training intensity affects strength gains in older adults over an 18-week training period using nonperiodized, progressive resistance-training protocols. Untrained men and women participants were separated into 4 groups: group A (n = 17, 71.4 +/- 4.6 years) performed 2 sets of 15 repetitions maximum (RM), group B (n = 13, 71.5 +/- 5.2 years) performed 3 sets of 9 RM, group C (n = 17, 69.4 +/- 4.4 years) performed 4 sets of 6 RM, group D (n = 14, 72.3 +/- 5.9 years) served as controls. Training groups exercised 2 days/week performing 8 resistance exercises. Except for training intensity, the acute program variables were equated between groups. A 1RM for 8 exercises was obtained every 6 weeks. The total of 1RM for the 8 exercises served as the dependent variable. Results: repeated measures analysis of variance (ANOVA) and Scheffe post hoc revealed that, at 6 weeks, only groups B and C were significantly stronger than group D (p < 0.01). By weeks 12 and 18, all training groups were significantly stronger than controls (p < 0.01). However, no difference existed between groups A, B, and C at any time. The data suggests that, for protocols with equated acute program variables, strength gain is similar over 18 weeks for training intensities ranging from 6 to 15 RM in previously untrained older adults. When programming nonperiodized, progressive resistance exercise for novice senior lifters, in the initial phases of the program, a wide range of intensities may be employed with similar strength gain.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
17,251,692
Functional vs. strength training in disabled elderly outpatients.
To determine whether high-intensity functional training (FT) or strength training (ST) better enables impairment, disability, and functional gains among disabled community-dwelling elders. Randomized, blinded, prospective clinical trial in a large, tertiary care outpatient rehabilitation department. Fifteen elders (62-85 yrs old) referred for physical therapy with one or more impairments, including lower-limb arthritis, participated in 6 wks of FT (weekly outpatient and three to five times per week of home practice in rapid and correct execution of locomotor activities of daily living, including gait, stepping, and sit to stand) or progressive resistive ST using elastic bands with intensity, therapist contact, and home practice similar to those of FT. Both groups significantly improved their combined lower-extremity strength (hip abduction, ankle dorsiflexion, knee flexion, ankle plantarflexion, and knee extension) (P = 0.003), but no statistical difference between the ST and FT group gains (P = 0.203) was found. Subjects in both interventions improved their gait speed, but the FT group improved more than the ST group (P = 0.001). During chair rise, the FT group improved their maximum knee torque more than the ST group (P = 0.033), indicating that they employed a more controlled and efficient movement strategy. These data suggest that an intensive FT intervention results in strength improvements of comparable magnitude as those attained from ST and that FT also confers greater improvements in dynamic balance control and coordination while performing daily life tasks.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
7,923,674
Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response.
In patients with intermittent claudication, a supervised walking exercise program increases peak exercise performance and community-based functional status. Patients with peripheral arterial disease also have muscle weakness in the affected extremity that may contribute to the walking impairment. However, the potential benefits of training modalities other than walking exercise, such as strength training, have not been critically evaluated in this patient population. The present study tested the hypothesis that a strength training program would be as effective as treadmill walking exercise and that combinations of strengthening and walking exercise would be more effective than either alone in improving exercise performance. Twenty-nine patients with disabling claudication were randomized to 12 weeks of supervised walking exercise on a treadmill (3 h/wk at a work intensity sufficient to produce claudication), strength training (3 h/wk of resistive training of five muscle groups of each leg), or a nonexercising control group. Graded treadmill testing was performed to maximally tolerated claudication pain to define changes in peak exercise performance. After 12 weeks, patients in the treadmill training program had a 74 +/- 58% increase in peak walking time as well as improvements in peak oxygen consumption (VO2) and the onset of claudication pain. Patients in the strength-trained group had a 36 +/- 48% increase in peak walking time but no change in peak VO2 or claudication onset time. Control subjects had no changes in any of these measures over the 12-week period. After the first 12 weeks, patients in the initial walking exercise group continued for 12 more weeks of supervised treadmill training. This resulted in an additional 49 +/- 53% increase in peak walking time (total of 128 +/- 99% increase over the 24 weeks). After the initial 12 weeks, patients in the strength-trained group began 12 weeks of supervised treadmill training, and patients in the control group participated in a 12-week combined program of strengthening and treadmill walking exercise. The combined strength and treadmill training program and treadmill training after 12 weeks of strength training resulted in increases in peak exercise performance similar to those observed with 12 weeks of treadmill training alone. A supervised treadmill walking exercise program is an effective means to improve exercise performance in patients with intermittent claudication, with continued improvement over 24 weeks of training. In contrast, 12 weeks of strength training was less effective than 12 weeks of supervised treadmill walking exercise. Finally, strength training, whether sequential or concomitant, did not augment the response to a walking exercise program.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
7,874,586
Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone.
We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength, peak power output in cycle ergometry, symptom limited endurance during progressive treadmill walking and stair climbing, knee extensor cross-sectional areas, and bone mineral density and content in healthy males and females aged 60-80 years, currently enrolled in a 2-year resistance training program. Subjects were randomized into either exercise (EX) or control (CON) groups (60-70 years: 38 males and 36 females; 70-80 years: 25 males and 43 females). EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50-80% of the load that they could lift once only (1 RM); CON did usual daily activities. After the 10 months there was no change in 1 RM strength in CON, but significant gains (mean increases up to 65%) in EX (no independent age or gender effects); 30% and 47% of the increase in 1 RM had occurred by 6 and 12 weeks, respectively. In EX, the 7.1% increase in peak cycling power output was significantly greater than in CON (+1.1%). The 17.8% improvement in symptom limited treadmill walking endurance was also greater than in CON (+3.4%), but the difference between groups during stair climbing was not significant (EX + 57%, CON + 33%). The cross-sectional areas of the knee extensors increased significantly by 5.5% in EX but were unchanged in CON. There were no changes in bone mineral density or content in either group. We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength, muscle size, and functional capacity.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
8,190,152
Exercise training and nutritional supplementation for physical frailty in very elderly people.
Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people, the efficacy of interventions targeted specifically at these deficits has not been carefully studied. We conducted a randomized, placebo-controlled trial comparing progressive resistance exercise training, multinutrient supplementation, both interventions, and neither in 100 frail nursing home residents over a 10-week period. The mean (+/- SE) age of the 63 women and 37 men enrolled in the study was 87.1 +/- 0.6 years (range, 72 to 98); 94 percent of the subjects completed the study. Muscle strength increased by 113 +/- 8 percent in the subjects who underwent exercise training, as compared with 3 +/- 9 percent in the nonexercising subjects (P < 0.001). Gait velocity increased by 11.8 +/- 3.8 percent in the exercisers but declined by 1.0 +/- 3.8 percent in the nonexercisers (P = 0.02). Stair-climbing power also improved in the exercisers as compared with the nonexercisers (by 28.4 +/- 6.6 percent vs. 3.6 +/- 6.7 percent, P = 0.01), as did the level of spontaneous physical activity. Cross-sectional thigh-muscle area increased by 2.7 +/- 1.8 percent in the exercisers but declined by 1.8 +/- 2.0 percent in the nonexercisers (P = 0.11). The nutritional supplement had no effect on any primary outcome measure. Total energy intake was significantly increased only in the exercising subjects who also received nutritional supplementation. High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people. In contrast, multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty.
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CD002759
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. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
15,247,162
Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse.
The ability to develop muscle force rapidly may be a very important factor to prevent a fall and to perform other tasks of daily life. However, information is still lacking on the range of training-induced neuromuscular adaptations in elderly humans recovering from a period of disuse. Therefore, the present study examined the effect of three types of training regimes after unilateral prolonged disuse and subsequent hip-replacement surgery on maximal muscle strength, rapid muscle force [rate of force development (RFD)], muscle activation, and muscle size. Thirty-six subjects (60-86 yr) were randomized to a 12-wk rehabilitation program consisting of either 1) strength training (3 times/wk for 12 wk), 2) electrical muscle stimulation (1 h/day for 12 wk), or 3) standard rehabilitation (1 h/day for 12 wk). The nonoperated side did not receive any intervention and thereby served as a within-subject control. Thirty subjects completed the trial. In the strength-training group, significant increases were observed in maximal isometric muscle strength (24%, P < 0.01), contractile RFD (26-45%, P < 0.05), and contractile impulse (27-32%, P < 0.05). No significant changes were seen in the two other training groups or in the nontrained legs of all three groups. Mean electromyogram signal amplitude of vastus lateralis was larger in the strength-training than in the standard-rehabilitation group at 5 and 12 wk (P < 0.05). In contrast to traditional physiotherapy and electrical stimulation, strength training increased muscle mass, maximal isometric strength, RFD, and muscle activation in elderly men and women recovering from long-term muscle disuse and subsequent hip surgery. The improvement in both muscle mass and neural function is likely to have important functional implications for elderly individuals.
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