PRT had a large positive effect on strength ( 41 trials , 1955 participants ) , but there was statistical heterogeneity that was not explained by differences in study quality , participant characteristics or the exercise program .
REVIEW ER 'S CONCLUSIONS PRT appears to be an effective intervention to increase strength in older people and has a positive effect on some functional limitations .
However , the effect of this intervention on more substantive outcomes such as measures of disability or HRQOL remains unclear .
BACKGROUND Muscle weakness in old age , is associated with physical disability and an increased risk of falls .
Progressive resistance strength ( PRT ) training exercises ( i.e. movements performed against a specific external force that is regularly increased during training ) are design ed to increase strength in older people .
OBJECTIVES To assess the effect of PRT on measures of physical disability , functional limitation and impairment in older people  , and identify adverse events .
Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study.
OBJECTIVE The purpose s of this pilot study were to determine if a combined dietary and exercise intervention would result in significant weight loss in older obese adults with knee osteoarthritis , and to compare the effects of exercise plus dietary therapy with exercise alone on gait , strength , knee pain , biomarkers of cartilage degradation , and physical function . DESIGN Single-blind , two-arm , r and omized clinical trial conducted for 24 weeks . SETTING A university health and exercise science center . PARTICIPANTS Twenty-four community-dwelling obese older adults aged > or = 60 years , body mass index > or = 28 , knee pain , radiographic evidence of knee osteoarthritis , and self-reported physical disability . INTERVENTION R and omization into two groups : exercise and diet ( E&D ) and exercise alone ( E ) . Exercise consisted of a combined weight training and walking program for 1 hour three times per week . The dietary intervention included weekly sessions with a nutritionist utilizing cognitive-behavior modification to change dietary habits to reach a group goal of an average weight loss of 15 lb ( 6.8 kg ) over 6 months . MEASUREMENTS All measurements were conducted at baseline and 3 and 6 months , except for synovial fluid analysis , which was obtained only at baseline and 6 months . In addition , weight was measured weekly in the E&D group . Physical disability and knee pain were measured by self-report and physical performance was measured using the 6-minute walk and stair climb tasks . Biomechanical testing included kinetic and kinematic analysis of gait and isokinetic strength testing . Synovial fluid was analyzed for levels of total proteoglycan , keratan sulfate , and interleukin-1 beta . RESULTS Twenty-one of the 24 participants completed the study , with one dropout in the E&D group and two in the E group . The E&D group lost a mean of 18.8 lb ( 8.5 kg ) at 6 months compared with 4.0 lb ( 1.8 kg ) in the E group ( P = .01 ) . Significant improvements were noted in both groups in self-reported disability and knee pain intensity and frequency as well as in physical performance measures . However , no statistical differences were found between the two groups at 6 months in knee pain scores or self-reported performance measures of physical function . There was no difference in knee strength between the groups , with both groups showing modest improvements from baseline to 6 months . At 6 months , the E&D group had a significantly greater loading rate ( P = .03 ) and maximum braking force ( P = .01 ) during gait . There were no significant between-group differences in the other biomechanical measures . Synovial fluid sample s were obtainable at both baseline and 6 months in eight participants ( four per group ) . The level of keratan sulfate decreased similarly in both groups from an average baseline of 96.8 + /- 37.1 to 71.5 + /- 23 ng/microg total proteoglycan . The level of IL-1 decreased from 25.3 + /- 9.8 at baseline to 8.3 + /- 6.1 pg/mL. The decrease in IL-1 correlated with the change in pain frequency ( r = -0.77 , P = .043 ) . CONCLUSIONS Weight loss can be achieved and sustained over a 6-month period in a cohort of older obese persons with osteoarthritis of the knee through a dietary and exercise intervention . Both exercise and combined weight loss and exercise regimens lead to improvements in pain , disability , and performance . Moreover , the trends in the biomechanical data suggest that exercise combined with diet may have an additional benefit in improved gait compared with exercise alone . A larger study is indicated to determine if weight loss provides additional benefits to exercise alone in this patient population
PRT had a large positive effect on strength ( 41 trials , 1955 participants ) , but there was statistical heterogeneity that was not explained by differences in study quality , participant characteristics or the exercise program .
REVIEW ER 'S CONCLUSIONS PRT appears to be an effective intervention to increase strength in older people and has a positive effect on some functional limitations .
However , the effect of this intervention on more substantive outcomes such as measures of disability or HRQOL remains unclear .
BACKGROUND Muscle weakness in old age , is associated with physical disability and an increased risk of falls .
Progressive resistance strength ( PRT ) training exercises ( i.e. movements performed against a specific external force that is regularly increased during training ) are design ed to increase strength in older people .
OBJECTIVES To assess the effect of PRT on measures of physical disability , functional limitation and impairment in older people  , and identify adverse events .