Frail elderly persons with mobility problems achieve modest improvements with exercise programs. Resistance exercises, implemented by physical therapists, can improve strength and gait velocity, especially in frail patients with slowed gait. The load is increased every week or two until a plateau of strength is reached. Leg press machines train all the large muscle groups of the leg and provide back and pelvic support during lifting. However, these machines are not always accessible to elderly patients.
Chair rises with weight vests or weights attached to the waist are alternatives.
Instructions are required to reduce the risk of back injury due to excess lumbar lordosis. Step-ups and stair climbing with the same weights are also useful. Ankle plantar flexion can be performed with the same weights. Using knee extension machines or attaching sandbag weights to the ankle strengthens the quadriceps. The usual starting weight for frail persons is 3 kg.