title: Balance, Muscle Strength, and Fear of Falling in Older Adults Early plateaus of power and torque gains during high- and low-speed resistance training of older women. Velocity training induces power-specific adaptations in highly functioning older adults. Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults. Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response. Circuit resistance training in chronic heart failure improves skeletal muscle mitochondrial ATP production rate--a randomized controlled trial. Effects of exercise on neurobehavioral function in community-dwelling older people more than 75 years of age. Effects of resistance and all-round, functional training on quality of life, vitality and depression of older adults living in long-term care facilities: a 'randomized' controlled trial [ISRCTN87177281] Effects of dynamic resistance training on heart rate variability in healthy older women Resistance training on physical performance in disabled older female cardiac patients. Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. EFFECTS OF A HEAVY AND A MODERATE RESISTANCE TRAINING ON FUNCTIONAL PERFORMANCE IN OLDER ADULTS Effects of muscle strength training and megestrol acetate on strength, muscle mass, and function in frail older people. Optimal load for increasing muscle power during explosive resistance training in older adults. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial The impact of nutritional supplementation and resistance training on the health functioning of free-living Chilean elders: results of 18 months of follow-up. Effect of protein source on resistive-training-induced changes in body composition and muscle size in older men. Improving cardiovascular fitness by strength or endurance training in women aged 76-78 years. A population-based, randomized controlled trial. Randomized controlled trial of exercise training for older people (Sendai Silver Center Trial; SSCT): study design and primary outcome. A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function. Resistance training for chronic heart failure patients on beta blocker medications. Strength training in old age: adaptation of antagonist muscles at the ankle joint. Resistance training effectiveness in patients with Charcot-Marie-Tooth disease: recommendations for exercise prescription. Muscle strength and fiber adaptations to a year-long resistance training program in elderly men and women. Resistance training in the early postoperative phase reduces hospitalization and leads to muscle hypertrophy in elderly hip surgery patients--a controlled, randomized study. Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation. Resistance training effects on muscular strength of elderly are related to intensity and gender. A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial Leptin and adiponectin responses in overweight inactive elderly following resistance training and detraining are intensity related. Large energetic adaptations of elderly muscle to resistance and endurance training. Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST). Preventing falls on an elderly care rehabilitation ward Comparison of heart-rate and blood-pressure increases during isokinetic eccentric versus isometric exercise in older adults. The Effects of Resistance Training and Walking on Functional Fitness in Advanced Old Age Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention. Impact of the fit and strong intervention on older adults with osteoarthritis. Injuries and adherence to walk/jog and resistance training programs in the elderly. The effects of high- and moderate-resistance training on muscle function in the elderly. Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old. Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse. Effects of nutritional supplementation and resistance training on muscle strength in free living elders. Results of one year follow. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects Strength/endurance training versus endurance training in congestive heart failure. High Intensity Resistance Training: Effects on Bone in Older Men and Women DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes? Strength and power changes of the human plantar flexors and knee extensors in response to resistance training in old age. A randomized controlled trial of a home exercise programme for elderly people with poor mobility. Homocysteine and lipoprotein levels following resistance training in older adults. Resistance training and reduction of treatment side effects in prostate cancer patients. Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. Ankle force and rate of force production increase following high intensity strength training in frail older adults Three-year controlled, randomized trial of the effect of dose-specified loading and strengthening exercises on bone mineral density of spine and femur in nonathletic, physically active women. Effects of long-term resistive training on mobility and strength in older adults with diabetes. Resistance exercise and bone turnover in elderly men and women. Progressive strength training in sedentary, older African American women. The effect of recombinant human growth hormone and resistance training on IGF-I mRNA expression in the muscles of elderly men. Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women. Comparison of once-weekly and twice-weekly strength training in older adults Increased Velocity Exercise Specific to Task (InVEST) training: a pilot study exploring effects on leg power, balance, and mobility in community-dwelling older women. Effectiveness of a home-based strengthening program for elderly males in Italy. A preliminary study Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. Musculoskeletal adaptations to resistance training in old age. Progressive Resistance Muscle Strength Training of Hospitalized Frail Elderly Once weekly combined resistance and cardiovascular training in healthy older men. Low intensity strength training for ambulatory stroke patients Balance and strength training in older adults: intervention gains and Tai Chi maintenance. Effect of exercise training on peak aerobic power, left ventricular morphology, and muscle strength in healthy older women. Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure. Efficacy of a home-based training program for older adults using elastic tubing Effect of resistance training on immunological parameters of healthy elderly women. Resistance versus endurance training in patients with COPD and peripheral muscle weakness Effects of resistance training on selected indexes of immune function in elderly women. Effects of testosterone and resistance training in men with chronic obstructive pulmonary disease. Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Resistance training increases total daily energy expenditure in disabled older women with coronary heart disease. Effect of intense strength training on standing balance, walking speed, and sit-to-stand performance in older adults. Cycling as a novel approach to resistance training increases muscle strength, power, and selected functional abilities in healthy older women. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Strength versus muscle power-specific resistance training in community-dwelling older adults. Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders. Effect of strength training on musculotendinous stiffness in elderly individuals The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. The relationship of joint symptoms with exercise performance in older adults. High-resistance versus variable-resistance training in older adults. [Strength training with elastic bands: measure of its effects in cardiac rehabilitation after coronary diseases]. The effect of different intensity modalities of resistance training on beat-to-beat blood pressure in cardiac patients. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. Effects of resistive and balance exercises on isokinetic strength in older persons. Combination training and resistance training as effective interventions to improve functioning in elders. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. Exercise training and heart rate variability in older adult female subjects. Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women. Effects of resistive training and chromium picolinate on body composition and skeletal muscle size in older women. [Physical training as treatment of reduced functional ability in frail 75+ year-olds living at home. A randomized intervention study in general practice with technological assessment elements]. Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain. Effects of physical exercise for elderly patients with physical impairments. Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial. Home-based resistance training improves femoral bone mineral density in women on hormone therapy A randomized controlled trial of rehabilitation after hospitalization in frail older women: effects on strength, balance and mobility. Resistance exercise training attenuates exercise-induced lipid peroxidation in the elderly The effects of resistance training on well-being and memory in elderly volunteers. Effect of aerobic and resistance training on fractionated reaction time and speed of movement. Moderate exercise improves gait stability in disabled elders. Effects of 16 weeks of resistance training on left ventricular morphology and systolic function in healthy men >60 years of age. Reduction of blood pressure response during strength training through intermittent muscle relaxations. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. Functional performance and quality of life related to training and detraining of community-dwelling elderly Aerobic and strength training in patients with chronic obstructive pulmonary disease. Effects of exercise training added to ongoing hormone replacement therapy on bone mineral density in frail elderly women. Heavy-resistance training in older Scandinavian men and women: short- and long-term effects on arm and leg muscles. Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. The effects of strength training on strength and health-related quality of life in older adult women. The effects of systematic resistance training in the elderly. Resistance and aerobic training in older men: effects on VO2peak and the capillary supply to skeletal muscle. Weighted stair climbing in mobility-limited older people: a pilot study. 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). Effects of muscle strength training and testosterone in frail elderly males. Exercise training improves overall physical fitness and quality of life in older women with coronary artery disease. Resistive training and chromium picolinate: effects on inositols and liver and kidney functions in older adults. Resistance and agility training reduce fall risk in women aged 75 to 85 with low bone mass: a 6-month randomized, controlled trial. A randomized controlled trial of progressive resistance training in depressed elders. Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes. Strength training can improve steadiness in persons with essential tremor. Strength training in older adults: an empowering intervention. IGF-1 bioavailability is increased by resistance training in older women with low bone mineral density Exercise training improves functional status in patients with peripheral arterial disease. Effects of high-intensity strength training on quality-of-life parameters in cardiac rehabilitation patients. Does Nutritional Supplementation Influence Adaptability of Muscle to Resistance Training in Men Aged 48 to 72 Years Functional tasks exercise versus resistance exercise to improve daily function in older women: a feasibility study. Systematic strength training as a model of therapeutic intervention. A controlled trial in postmenopausal women with osteopenia. A controlled trial of circuit weight training on aerobic capacity and myocardial oxygen demand in men after coronary artery bypass surgery. Muscle hypertrophy, strength development, and serum hormones during strength training in elderly women with fibromyalgia 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. Effect of additional functional exercises on balance in elderly people Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Light resistance and stretching exercise in elderly women: effect upon strength. Functional vs. Strength Training in Disabled Elderly Outpatients The effects of resistance training on functional outcomes in patients with chronic obstructive pulmonary disease Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure. Power training improves balance in healthy older adults. A CLINICAL TRIAL OF STRENGTHENING AND AEROBIC EXERCISE TO IMPROVE GAIT AND BALANCE IN ELDERLY MALE NURSING HOME RESIDENTS The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients--a pilot study. 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 Effects of a late-phase exercise program after total hip arthroplasty: a randomized controlled trial. Weight training to activities of daily living: helping older adults make a connection. Gait performance in dementia: the effects of a 6-week resistance training program in an adult day-care setting. Self-paced resistance training and walking exercise in community-dwelling older adults: effects on neuromotor performance. Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. Strength training reduces force fluctuations during anisometric contractions of the quadriceps femoris muscles in old adults. Strength training alters the viscoelastic properties of tendons in elderly humans. Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass Dynamic strength training in patients with early rheumatoid arthritis increases muscle strength but not bone mineral density. Exercise and Functional Tasks Among Adults Who Are Functionally Limited The effects of improved strength on obstacle negotiation in community-living older adults. A comparison of periodised and fixed repetition training protocol on strength in older adults. Resistance Training To Counteract the Catabolism of a Low-Protein Diet in Patients with Chronic Renal Insufficiency Effects of strength training on the incidence and progression of knee osteoarthritis. Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III. Effects of testosterone replacement and/or resistance exercise on the composition of megestrol acetate stimulated weight gain in elderly men: a randomized controlled trial. Comparison of High and Moderate Intensity of Strength Training on Mood and Anxiety in Older Adults Effects of Resistance Training on the Sit‐and‐Reach Test in Elderly Women Influence of resistance exercise on lumbar strength in older, overweight adults. Age effect on transcript levels and synthesis rate of muscle MHC and response to resistance exercise. Nutritional supplementation and resistance training in nutritionally at risk older adults following lower limb fracture: a randomized controlled trial Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. Effects of modest testosterone supplementation and exercise for 12 weeks on body composition and quality of life in elderly men. Cardiovascular responses of 70- to 79-yr-old men and women to exercise training. Effects of a short-term strength training programme on lymphocyte subsets at rest in elderly humans The Initial Effects of Low‐Volume Strength Training on Balance in Untrained Older Men and Women Resistance training and intra-abdominal adipose tissue in older men and women. Both resistance and agility training increase cortical bone density in 75- to 85-year-old women with low bone mass: a 6-month randomized controlled trial. The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65 to 89 years. Functional-task exercise versus resistance strength exercise to improve daily function in older women: a randomized, controlled trial. Strength training and hemodynamic responses to exercise. Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. Exercise programs for older men: mode and intensity to induce the highest possible health-related benefits. Effects of a low-intensity conditioning programme on V˙O2max and maximal instantaneous peak power in elderly women Effect of strength and power training on physical function in community-dwelling older adults. Rehabilitation of reaching after stroke: task-related training versus progressive resistive exercise. Resistance exercise dosage in older adults: single- versus multiset effects on physical performance and body composition. Knee extension strength and walking speed in relation to quadriceps muscle composition and training in elderly women. Randomized controlled trial of quadriceps training after proximal femoral fracture Efficacy of heavy-resistance training for active women over sixty: muscular strength, body composition, and program adherence. Impact of a home-based walking and resistance training program on quality of life in patients with heart failure. Long-term impact of Fit and Strong! on older adults with osteoarthritis. Effect of ceasing creatine supplementation while maintaining resistance training in older men. Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women. Improvements in quadriceps strength with regular seated exercise in the institutionalized elderly. Exercise: effects on physical functional performance in independent older adults. Strength improvements with 1 yr of progressive resistance training in older women. Strength training in older women: early and late changes in whole muscle and single cells. Growth hormone administration and exercise effects on muscle fiber type and diameter in moderately frail older people. Resistance training in patients with peripheral arterial disease: effects on myosin isoforms, fiber type distribution, and capillary supply to skeletal muscle. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial. Home-based trunk-strengthening exercise for osteoporotic and osteopenic postmenopausal women without fracture –a pilot study The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly. A longitudinal trial of weight training in the elderly: continued improvements in year 2. Changes in Function and Disability After Resistance Training: Does Velocity Matter?: A Pilot Study Physical fitness and psychological benefits of strength training in community dwelling older adults. Resistance training over 2 years increases bone mass in calcium-replete postmenopausal women. Energy Cost of Single‐Set Resistance Training in Older Adults Can progressive resistance training reverse cachexia in patients with rheumatoid arthritis? Results of a pilot study. Effect of resistance exercise on skeletal muscle myopathy in heart transplant recipients. Effects of strength training on total and regional body composition in older men. A predominantly home-based progressive resistance exercise program increases knee extensor strength in the short-term in people with chronic obstructive pulmonary disease: a randomised controlled trial. Physical exercise and comorbidity. Results from the Fitness and Arthritis in Seniors Trial (FAST) Effect of high-intensity strength-training on functional measures of balance ability in balance-impaired older adults. Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study. High-velocity resistance training increases skeletal muscle peak power in older women. RESISTANCE TRAINING AND DETRAINING EFFECTS ON FLEXIBILITY PERFORMANCE IN THE ELDERLY ARE INTENSITY‐DEPENDENT Fall risk index for elderly patients based on number of chronic disabilities. Effects of one year of resistance training on the relation between muscular strength and bone density in elderly women Resistive training and long-term function in older adults. Cost-effectiveness of aerobic and resistance exercise in seniors with knee osteoarthritis. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). Concentric versus combined concentric-eccentric isokinetic training: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee. Exercise--it's never too late: the strong-for-life program. Evaluation of a supervised exercise program in a geriatric population. High intensity knee extensor training, in patients with chronic heart failure. Major skeletal muscle improvement. Resistance exercise and physical performance in adults aged 60 to 83. A home-based exercise program for nondisabled older adults. The impact of exercise training on blood lipids in older adults. Training for muscle power in older adults: effects on functional abilities. Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge Effects of progressive resistance training on immune response in aging and chronic inflammation. Resistance training in postmenopausal women with and without hormone therapy. The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease. Weight Training Improves Walking Endurance in Healthy Elderly Persons Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. Can elderly patients who have had a hip fracture perform moderate- to high-intensity exercise at home? Physical Performance Effects of Low-Intensity Exercise among Clinically Defined High-Risk Elders The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old. Low-intensity exercise as a modifier of physical frailty in older adults. The effects of strength conditioning on older women's ability to perform daily tasks. High-intensity strength training of patients enrolled in an outpatient cardiac rehabilitation program. Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: A randomized, controlled trial. Effect of Resistance Training on Strength, Postural Control, and Gait Velocity among Older Adults Home exercise to improve strength and walking velocity after hip fracture: a randomized controlled trial. Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. Dynamic muscle strength alterations to detraining and retraining in elderly men. Effect of exercise intensity on bone density, strength, and calcium turnover in older women. A comparison of community-based resistance exercise and flexibility exercise for seniors. Site-specific effects of strength training on bone structure and geometry of ultradistal radius in postmenopausal women. Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint. In vivo human muscle structure and function: adaptations to resistance training in old age. Exercise training and nutritional supplementation for physical frailty in very elderly people. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke Balance Confidence Improves with Resistance or Agility Training Effects of a group-based exercise program on the mood state of frail older women after discharge from hospital. Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone. Effects of a 16-week progressive high-intensity strength training (HIST) on indexes of bone turnover in men over 65 years: A randomized controlled study Concurrent cardiovascular and resistance training in healthy older adults. Once a week not enough, twice a week not feasible? A randomised controlled exercise trial in long-term care facilities [ISRCTN87177281]. The effect of a 12-week dynamic resistance strength training program on gait velocity and balance of older adults. Preliminary Evaluation of a 10-wk. Resistance and Cardiovascular Exercise Protocol on Physiological and Psychological Measures for a Sample of Older Women Effects of a whole-body resistive training regimen in the elderly. A home-based resistance-training program
  using elastic bands for elderly patients
  with orthostatic hypotension
abstract: This study examined balance ability , lower-extremity muscle strength , fear of falling and their inter-relationships in 40 community-dwelling older adults ( > 65 years ) . Subjects who self-identified either as being fearful offalling or not ( no concern ) were screened to exclude those with known risk factors for falling .  Limits of stability , maximal isometric strength , gait speed , and fear of falling were contrasted between groups ( 27 control subjects , 13 fearful subjects ) . Those fearful of falling demonstrated smaller center of pressure ( COP ) excursions in anterior , left , and right directions ( p < .0001 ) and used a smaller percentage of their base of support during maximal weight shifting in combined anterior-posterior and right-left directions ( p < .001 ) compared to the control group . Strength did not differ between groups , but was associated with the ability to shift the COP in the anterior-posterior direction ( p < .05 ) . Fear of falling also related to weight shifting ability ( p < .017 ) . Seniors fearful of falling demonstrated limitations in balance ability and balance confidence that could not be explained by muscle weakness Periodization is the most effective approach to resistance training ; however , optimal cycle lengths for older persons are not known . This study examined the duration s of performance increments , plateaus , and decrements in women , ages 61 - 75 yr , over 9 wk of isokinetic training .  After a 2-wk adaptation cycle , older women trained for either power ( PWR ; 4.73 rad/s ; n = 9 ) or strength ( STR ; 1.05 rad/s ; n = 8) , 3 days/wk with a 1-day recovery between sessions . Repetitions were initially selected to equilibrate work volume between groups . Average power ( AP ) , peak torque ( PT ) , and total work ( TW ) curves were analyzed using forward and backward stepwise regression to ascertain inflections and plateaus . PWR training produced the highest AP , whereas STR produced the highest PT . TW was similar between groups . The AP curves of the PWR group initially showed a steep positive slope and then plateaued during week 3 . The right leg plateau lasted throughout training , whereas the left leg showed another positive inflection during weeks 7 and 8 . PWR group TW curves showed positive slopes throughout training . STR group PT curves for both legs showed initial positive slopes peaking between weeks 3 and 4 and declining thereafter . The TW curves for both legs showed slight negative slopes across the first 2 wk , steep positive slopes during weeks 3 - 6 , and a final plateau . Because improvements plateau early during PWR and STR training , isokinetic training prescriptions for optimizing strength and power improvements in older persons should use cycles of 3 - 4 wk to maximize gains OBJECTIVE To test the efficacy of high-velocity training in healthy older persons . DESIGN A 12-week r and omized trial , with subjects blocked for gender and residence , comparing high-velocity resistance training with a self-paced walking program . SETTING Retirement community . PARTICIPANTS Forty-three volunteers over the age of 70 years . INTERVENTION 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 . MAIN OUTCOME MEASURES 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 . RESULTS 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 . CONCLUSIONS 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 Background Depression is a disabling , prevalent condition . Physical activity programs may assist depression management in older people , ameliorate co-morbid conditions and reduce the need for antidepressants . The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training ( PRT ) program .  The study also aim ed to determine whether PRT improves depressive status in older depressed patients . Methods A r and omised controlled trial was conducted . People aged ≥ 65 years with depressive symptoms were recruited via general practice s. Following baseline assessment , subjects were r and omly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group . Follow-up assessment of depressive status , physical and psychological health , functional and quality of life status occurred post intervention and at six months . Results Three hundred and forty six people responded to the study invitation , of whom 22 % had depressive symptoms ( Geriatric Depression Scale , GDS-30 score ≥ 11 ) . Thirty two people entered the trial . There were no significant group differences on the GDS at follow-up . At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group , but this finding did not reach significance ( p = 0.08 ) . More of the PRT group ( 57 % ) had a reduction in depressive symptoms post program , compared to 44 % of the control group . It was not possible to discern which specific components of the program influenced its impact , but in post hoc analyses , improvement in depressive status appeared to be associated with the number of exercise sessions completed ( r = -0.8 , p < 0.01 ) . Conclusion The UPLIFT pilot study confirmed that older people with depression can be successfully recruited to a community based PRT program . The program can be offered by existing community-based facilities , enabling its ongoing implementation for the potential benefit of other older people BACKGROUND 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 st and ard 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 . METHODS Sixty community-dwelling adults > 60 years with major or minor depression were r and omized 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 . RESULTS 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 ) . CONCLUSIONS High intensity PRT is more effective than is low intensity PRT or GP care for the treatment of older depressed patients OBJECTIVE To determine the effect of frequency of resistive training on gain in muscle strength and neuromuscular performance in healthy older adults . DESIGN A r and omized 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 ) . SETTING An exercise facility at an academic medical center . SUBJECTS Forty-six community-dwelling healthy men ( n = 29 ) and women ( n = 17 ) aged 65 to 79 years . INTERVENTION 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 . MEASURES 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 t and em walk . RESULTS 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 t and em 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 ) . CONCLUSIONS 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 BACKGROUND 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 . METHODS AND RESULTS Twenty-nine patients with disabling claudication were r and omized 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 . Grade d 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 result ed 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 result ed in increases in peak exercise performance similar to those observed with 12 weeks of treadmill training alone . CONCLUSIONS 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 BACKGROUND We aim ed to determine the role of skeletal muscle mitochondrial ATP production rate ( MAPR ) in relation to exercise tolerance after resistance training ( RT ) in chronic heart failure ( CHF ) . METHODS AND RESULTS Thirteen CHF patients ( New York Heart Association functional class 2.3 + /- 0.5 ; Left ventricular ejection fraction 26 + /- 8 % ; age 70 + /- 8 years ) underwent testing for peak total body oxygen consumption ( VO(2peak ) ) , and resting vastus lateralis muscle biopsy . Patients were then r and omly allocated to 11 weeks of RT ( n = 7 ) , or continuance of usual care ( C ; n = 6 ) , after which testing was repeated . Muscle sample s were analyzed for MAPR , metabolic enzyme activity , and capillary density . VO(2peak ) and MAPR in the presence of the pyruvate and malate ( P+M ) substrate combination , representing carbohydrate metabolism , increased in RT ( P < .05 ) and decreased in C ( P < .05 ) , with a significant difference between groups ( VO(2peak ) , P = .005 ; MAPR , P = .03 ) . There was a strong correlation between the change in MAPR and the change in peak total body oxygen consumption ( VO(2peak ) ) over the study ( r = 0.875 ; P < .0001 ) , the change in MAPR accounting for 70 % of the change in VO(2peak ) . CONCLUSIONS These findings suggest that mitochondrial ATP production is a major determinant of aerobic capacity in CHF patients and can be favorably altered by muscle strengthening exercise OBJECTIVE We evaluated the effects of exercise on neurobehavioral function in healthy older people more than 75 years of age . DESIGN A r and omized controlled trial with 6-month follow-up was conducted . SETTING The study was performed in the rural town of Kahoku , Japan , the population of which is considered representative of the older population of Japan . PARTICIPANTS We studied 42 healthy volunteers ( 18 men and 24 women ; mean age , 79 years ( range 75 to 87 years ) ) who were r and omly assigned to one of two groups , exercise or control . INTERVENTION Subjects assigned to the exercise group were instructed to exercise for 60 minutes twice a week for 6 months . Subjects in the control group were not instructed to engage in an specific exercise regimen . MEASUREMENTS The following measurements were recorded for both groups at baseline and at 6-month follow-up : ( 1 ) Neurobehavioral function as determined by the following tests : Mini-Mental State Exam ( MMSE ) , Hasegawa Dementia Scale Revised ( HDSR ) , Visuospatial Cognitive Performance Test ( VCP-test ) , Button score , Up & Go test , and Functional Reach ; and ( 2 ) Body mass index and blood pressure . RESULTS The effects of exercise were shown in the Up & Go test , and Functional Reach ( ANOVA with repeated measures ) . CONCLUSION This study demonstrates the acceptability and effectiveness of exercise on neurobehavioral function , even in older people more than 75 years of age Background Regular physical activity may improve different aspects of wellbeing in older people , such as quality of life , vitality and depression . However , there is little experimental evidence to support this assumption . Therefore , we examined the effect of different training protocol s on quality of life , vitality and depression of older adults living in long-term care facilities . Methods Subjects ( n = 173 , aged 64 to 94 years , living in long-term care facilities ) , were r and omized to six months of three different moderate-intensity group exercise training protocol s , or to an ' educational ' control condition . Exercise consisted of two 45–60-minute training sessions per week of 1 ) resistance training ; 2 ) all-round , functional training ; or 3 ) a combination of both . Perceived health , the Geriatric Depression Scale ( GDS ) , the Vitality Plus Scale ( VPS ) and the Dementia Quality of Life question naire ( DQoL ) were administered at baseline and after six months . Results In the combined training group a small but significant decline was seen in perceived health , DQoL and VPS score compared to the control group . Conclusions We conclude that neither strength training nor all-round , functional training of moderate intensity is effective in improving quality of life , vitality or depression of older people living in long-term care facilities Twenty healthy women aged between 65 and 74 years , trained three times a week , for 16 weeks , on a cycle ergometer , to determine the effects of dynamic resistance training on heart rate variability ( HRV ) . Subjects were allocated to two training groups , high ( HI , n=10 ) and low ( LO , n=10 ) intensity . The HI group performed eight sets of 8 revolutions at 80 % of the maximum resistance to complete 2 pedal revolutions ( 2RM ) ; the LO group performed eight sets of 16 pedal revolutions at 40 % of 2RM . Subjects were tested twice before , as control period ( −4 weeks and 0 weeks ) and once after training ( 16 weeks ) for HRV , maximum voluntary contraction ( MVC ) of knee extensors and peak power ( Pp ) of lower limbs by jumping on a force platform . HRV was measured using time and frequency domain parameters . Two-way ANOVA for repeated measures was performed on all variables ( P<0.05 ) . Results showed no differences between training groups . Following training HRV was not modified , while MVC and Pp significantly increased . The two proposed forms of dynamic resistance training were appropriate to improve muscle power and strength in elderly females without affecting HRV . More research should verify the effects of an isometric and more prolonged training stimulus on HRV in older subjects PURPOSE We evaluated the value of resistance training on measures of physical performance in disabled older women with coronary heart disease ( CHD ) . METHODS The study intervention consisted of a 6-month program of resistance training in a r and omized controlled trial format . Training intensity was at 80 % of the single-repetition maximal lift . Control patients performed light yoga and breathing exercises . Study participants included 42 women with CHD , all > or= 65 yr of age and community dwelling . Subjects were screened by question naire to have low self-reported physical function . The primary study measurements related to the performance of 16 household activities of the Continuous Scale Physical Functional Performance test ( CSPFP ) . These ranged from dressing , to kitchen and cleaning activities , to carrying groceries and walking onto a bus with luggage , and a 6-min walk . Activities were measured in time to complete a task , weight carried during a task , or distance walked . Other measures included body composition , measures of aerobic fitness and strength , and question naire-based measures of physical function and depression score . RESULTS Study groups were similar at baseline by age , aerobic capacity , strength , body composition , and in performing the CSPFP . After conditioning , 13 of 16 measured activities were performed more rapidly , or with increased weight carried , compared with the control group ( all P < 0.05 ) . Maximal power for activities that involved weight-bearing over a distance , increased by 40 % ( P < 0.05 ) . CONCLUSIONS Disabled older women with CHD who participate in an intense resistance-training program improve physical capacity over a wide range of household physical activities . Benefits extend beyond strength-related activities , as endurance , balance , coordination , and flexibility all improved . Strength training should be considered an important component in the rehabilitation of older women with CHD OBJECTIVE 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 . DESIGN Subjects were matched for age and habitual physical activity and then r and omly assigned into either a control or an exercise group . SETTING The Muscle Function Laboratory , Royal Free Hospital School of Medicine , London . PARTICIPANTS 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 ) . INTERVENTIONS 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 . MEASUREMENTS Pre- and posttraining measurements were made for isometric knee extensor strength ( IKES ) , isometric elbow flexor strength ( IEFS ) , h and grip 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 . RESULTS 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 . CONCLUSIONS Progressive resistance exercise can produce substantial increases in muscle strength and in power st and ardized 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 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 r and omly 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 protocol OBJECTIVES To determine the independent and combined effects of progressive resistance muscle strength training ( PRMST ) and megestrol acetate ( MA ) on strength , muscle mass , and function in older recuperative care patients . DESIGN Double-blind , r and omized , controlled intervention using a two-by-two factorial design and conducted between 1999 and 2001 . SETTING University-affiliated Department of Veterans Affairs hospital . PARTICIPANTS Twenty-nine patients ( mean age 79.4 + /- 7.4 , 90 % white ) aged 65 and older and had recent functional decline . INTERVENTIONS After r and omization to one of four treatment groups ( low-resistance exercises plus 800 mg per day of MA or a placebo or high-intensity PRMST plus 800 mg/d of MA or placebo ) , subjects received training and the drug or placebo for 12 weeks . MEASUREMENTS Change in muscle strength , mid-thigh muscle area , and aggregate functional performance score as assessed using analysis of covariance . RESULTS Five subjects withdrew from the study before its completion . Based on intent-to-treat analyses , subjects who received high-intensity PRMST and placebo experienced the greatest strength gains . The addition of MA was associated with worse outcomes than with high-intensity exercise training alone , especially with regard to the leg exercises . Post hoc analysis demonstrated that subjects who received high-intensity PRMST and placebo experienced significantly greater percentage increases in leg strength than subjects in either of the MA treatment groups ( P<.05 for each comparison ) . There was also a significant negative effect of MA on physical function . In general , subjects who received MA experienced a deterioration in aggregate physical function scores , whereas the remaining subjects improved ( -0.80+/-0.40 vs 0.48+/-0.41 , P=.04 ) . There was not a significant interaction between exercise and MA for any outcome . CONCLUSION High-intensity PRMST is a safe and well-tolerated exercise regimen for frail elderly patients . The addition of MA appears to blunt the beneficial effects of PRMST , result ing in less muscle strength and functional performance gains BACKGROUND Muscle power ( force x velocity ) recedes at a faster rate than strength with age and may also be a stronger predictor of fall risk and functional decline . The optimal training paradigm for improving muscle power in older adults is not known , although some literature suggests high velocity , low load training is optimal in young adults . METHODS One hundred twelve healthy older adults ( 69 + /- 6 years ) were r and omly assigned to either explosive resistance training at 20 % ( G20 ) , 50 % ( G50 ) , or 80 % ( G80 ) one repetition maximum ( 1RM ) for 8 - 12 weeks or to a nontraining control group ( CON ) . Participants trained twice per week ( five exercises ; three sets of eight rapidly concentric and slow eccentric repetitions ) using pneumatic resistance machines . Repeated- measures analysis of variance and covariance ( ANOVA and ANCOVA ) were used to determine the effects of training . RESULTS Average peak power increased significantly and similarly in G80 ( 14 + /- 8 % ) , G50 ( 15 + /- 9 % ) , and G20 ( 14 + /- 6 % ) compared to CON ( 3 + /- 6 % ) ( p < .0001 ) . By contrast , a positive dose-response relationship with training intensity was observed for relative changes in average strength ( r = .40 , p = .0009 ) and endurance ( r = .43 , p = .0005 ) . Average strength increased in G80 ( 20 + /- 7 % ) , G50 ( 16 + /- 7 % ) , and G20 ( 13 + /- 7 % ) compared to CON ( 4 + /- 4 % ) ( p < .0001 ) . Average muscle endurance increased in G80 ( 185 + /- 126 % , p < .0001 ) , G50 ( 103 + /- 75 % , p = .0004 ) , and G20 ( 82 + /- 57 % , p = .0078 ) compared to CON ( 28 + /- 29 % ) . CONCLUSION Peak muscle power may be improved similarly using light , moderate , or heavy resistances , whereas there is a dose-response relationship between training intensity and muscle strength and endurance changes . Therefore , using heavy loads during explosive resistance training may be the most effective strategy to achieve simultaneous improvements in muscle strength , power , and endurance in older adults Background Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis ( OA ) . Strengthening the hip abductor and adductor muscles may influence joint loading and /or OA-related symptoms , but no study has evaluated these hypotheses directly . The aim of this r and omised , single-blind controlled trial is to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with medial compartment knee OA . Methods / Design 88 participants with painful , radiographically confirmed medial compartment knee OA and varus alignment will be recruited from the community and r and omly allocated to a hip strengthening or control group using concealed allocation stratified by disease severity . The hip strengthening group will perform 6 exercises to strengthen the hip abductor and adductor muscles at home 5 times per week for 12 weeks . They will consult with a physiotherapist on 7 occasions to be taught the exercises and progress exercise resistance . The control group will be requested to continue with their usual care . Blinded follow up assessment will be conducted at 12 weeks after r and omisation . The primary outcome measure is the change in the peak external knee adduction moment measured during walking . Question naires will assess changes in pain and physical function as well as overall perceived rating of change . An intention-to-treat analysis will be performed using linear regression modelling and adjusting for baseline outcome values and other demographic characteristics . Discussion Results from this trial will contribute to the evidence regarding the effect of hip strengthening on knee loads and symptoms in people with medial compartment knee OA . If shown to reduce the knee adduction moment , hip strengthening has the potential to slow disease progression . Trial Registration Australia New Zeal and Clinical Trials Registry Body composition changes and loss of functionality in the elderly are related to subst and ard diets and progressive sedentariness . The aim of this study was to assess the impact of an 18-mo nutritional supplementation and resistance training program on health functioning of elders . Healthy elders aged > or = 70 y were studied . Half of the subjects received a nutritional supplement . Half of the supplemented and nonsupplemented subjects were r and omly assigned to a resistance exercise training program . Every 6 mo , a full assessment was performed . A total of 149 subjects were considered eligible for the study and 98 ( 31 supplemented and trained , 26 supplemented , 16 trained and 25 without supplementation or training ) completed 18 mo of follow-up .  Compliance with the supplement was 48 % , and trained subjects attended 56 % of programmed sessions . Activities of daily living remained constant in the supplemented subjects and decreased in the other groups . Body weight and fat-free mass did not change . Fat mass increased from 22.2 + /- 7.6 to 24.1 + /- 7.7 kg in all groups . Bone mineral density decreased less in both supplemented groups than in the nonsupplemented groups ( ANOVA , P < 0.01 ) . Serum cholesterol remained constant in both supplemented groups and in the trained groups , but it increased in the control group ( ANOVA , P < 0.05 ) . Upper and lower limb strength , walking capacity and maximal inspiratory pressure increased in trained subjects . In conclusion , patients who were receiving nutritional supplementation and resistance training  maintained functionality , bone mineral density and serum cholesterol levels and improved their muscle strength BACKGROUND Aging is associated with reductions in muscle mass and strength , but nutrition and exercise interventions can delay this progression and enhance the quality of life . OBJECTIVE We examined whether the predominant source of protein consumed by older men influenced measures of muscle size and strength , body composition , resting energy expenditure , and skeletal muscle creatine concentrations in response to 12 wk of resistive training . DESIGN After consuming a lactoovovegetarian ( LOV ) diet for 2 wk , 21 men aged 65 + /- 5 y were r and omly assigned to either consume a beef-containing ( BC ) diet ( n = 10 ) or to continue the LOV diet ( n = 11 ) throughout resistive training . The BC diet included 0.6 g protein . kg(-1 ) . d(-1 ) from beef and the LOV diet included 0.6 g protein . kg(-1 ) . d(-1 ) from textured vegetable protein ( soy ) sources . The remaining protein in the diets came from self-selected LOV sources . RESULTS The mean total protein intake for both groups ranged from 1.03 to 1.17 g. kg(-1 ) . d(-1 ) during the intervention . Men in both groups had improvements ( 14 - 38 % ) in maximal dynamic strength of all the muscle groups trained with no significant difference between groups . With resistive training , cross-sectional muscle area of the vastus lateralis increased in both groups ( 4.2 + /- 3.0 % and 6.0 + /- 2.6 % for the LOV and BC groups , respectively ) with no significant difference between groups . Body composition , resting energy expenditure , and concentrations of muscle creatine , phosphocreatine , and total creatine did not differ significantly between groups or change over time . CONCLUSIONS These data suggest that increases in muscle strength and size were not influenced by the predominant source of protein consumed by older men with adequate total protein intake BACKGROUND there have been few population -based , r and omized controlled trials on the effects of strength or endurance training on cardiovascular fitness in older women . OBJECTIVE to study the effects of strength or endurance training on cardiovascular fitness in women aged 76 - 78 years . DESIGN a population -based , r and omized controlled trial . SETTING exercise laboratory in a university faculty of sport and health sciences . SUBJECTS we r and omly 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 . METHODS 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 . RESULTS 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 . CONCLUSIONS 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 Physical exercise is expected to improve and maintain physical function in older people , thus promoting health and preventing or postponing the onset of disability in later life . The Sendai Silver Center Trial ( SSCT ) was a r and omized controlled trial design ed to evaluate the efficacy of exercise training among healthy free-living older people . Sixty-five eligible participants , aged from 60 to 81 years , were r and omly allocated to an exercise group or a control group . The subjects in the exercise group were asked to attend training classes at the Sendai Silver Center , a municipal health and welfare facility in the center of Sendai City , at least twice a week for 25 weeks . Each training class , lasting two hours , started with a warm-up session , followed by an endurance session with a bicycle ergometer , and a resistance exercise training session using rubber films , and ended with a cool-down session . The subjects in the control group were asked to attend recreational classes at the Center twice a month . There were no drop-outs or accidents during the intervention . Comparison of maximum oxygen consumption ( VO2max ) before and after the 25-week intervention revealed a significant increase in the exercise group ( 2.1 ml/kg/min ) but no significant change in the control group . Our result is equivalent to the participants becoming younger in aerobic capacity by five years after six months of exercise training BACKGROUND AND PURPOSE Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments . The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities . A second aim was to analyze whether cognitive function was associated with the applicability of the program . SUBJECTS The subjects were 91 older people ( mean age=85.3 years , SD=6.1 , range=68 - 100 ) who were dependent in personal activities of daily living and r and omly assigned to participate in an exercise intervention .  Their mean score for the Mini-Mental State Examination ( MMSE ) was 17.5 ( SD=5.0 , range=10 - 29 ) . METHODS A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists . There were 29 exercise sessions over 13 weeks . Attendance , intensity of lower-limb strength and balance exercises , and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program . RESULTS The median attendance rate was 76 % .  Lower-limb strength exercises with high intensity were performed in a median of 53 % of the attended exercise sessions , and balance exercises with high intensity were performed in a median of 73 % of the attended exercise sessions . The median rate of sessions with adverse events was 5 % . All except 2 adverse events were assessed as minor and temporary , and none led to manifest injury or disease . No significant differences were observed in applicability when comparing participants with dementia and participants without dementia . In addition , there was no significant correlation between applicability and the MMSE score . DISCUSSION AND CONCLUSION The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use , regardless of cognitive function , among older people who are dependent in activities of daily living , living in residential care facilities , and have an MMSE score of 10 or higher BACKGROUND Resistance training increases the skeletal muscle strength and functional ability of chronic heart failure patients . However , there is limited data regarding the effect of resistance training on the hemodynamic responses and peak oxygen consumption ( peak VO(2 ) ) of chronic heart failure patients treated with beta-blocker . This study examined the effect of resistance training on hemodynamics , peak aerobic capacity , muscle strength and quality of life of chronic heart failure patients on beta-blockers medication . METHODS Fifteen men diagnosed with chronic heart failure were matched to either a resistance training program or non-training control group . At baseline and after 8 weeks of resistance training patients performed both Balke incremental and maximal strength tests and completed quality of life question naires . RESULTS The resistance training group demonstrated a significant increase of walking time and peak VO(2 ) by 11.7 % ( p=0.002 ) and approximately 19 % ( p<0.05 ) , respectively . Peak VO(2 ) was significantly correlated with both walking time ( r=0.54 , p=0.038 ) and change in total weight lifted ( r=0.55 , p=0.034 ) . Quality of life significantly increased by 87 % ( p=0.030 ) . The improvement in quality of life was correlated with post training peak VO(2 ) ( r=0.58 , p=0.025 ) and total weight lifted during the post maximal strength test ( r=-0.52 , p=0.047 ) . CONCLUSIONS The benefits from resistance training for chronic heart failure patients on beta-blocker medication included an increased aerobic and exercise capacity , skeletal muscle strength and most importantly , an improvement in the quality of life , which is the main goal of cardiac rehabilitation programs . Furthermore , with appropriate supervision , it is recommended that resistance exercise be added to the exercise rehabilitation program of these patients when possible 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 OBJECTIVES To determine the effects of a 12-week , home-based resistance exercise program on strength , body composition , and activities of daily living ( ADLs ) in men and women with Charcot-Marie-Tooth ( CMT ) disease and to design an ADL-based resistance exercise prescription template . DESIGN Double-blind , placebo-controlled study . SETTING Testing in a university setting ; exercise in patients ' homes . PARTICIPANTS Twenty CMT patients who volunteered . INTERVENTION Subjects progressively strength trained at home 3 d/wk for 12 weeks . MAIN OUTCOME MEASURES Timed ADLs , isometric strength , and body composition . RESULTS Absolute strength was greater in men with CMT in only 4 of 10 baseline measures ( P<.05 ) , but not when strength was normalized by lean mass . Training compliance was 87 % with no gender differences . At baseline , women had 80 % of normal strength in 4 of 10 measures , whereas men did not achieve 80 % of normal strength in any measure . After training , women had 80 % of normal strength in 8 of 10 measures , whereas men only had 80 % of normal strength in 1 . Training volumes and strength change scores showed no gender differences . ADLs improved after training with no gender differences ( P<.05 ) . An exercise prescription template was developed by using chair-rise time to estimate starting weights for lower body and supine rise for upper body . CONCLUSIONS Resistance training improved strength and ADLs equally in men and women . We design ed an exercise prescription recommendation , based on ADL performance BACKGROUND To study the effects of resistance training on muscle strength and size in older people , we enrolled 8 men and 17 women ( mean age 68.2 + /- 1 SEM ) into a one-year exercise trial . METHODS Subjects were r and omly assigned to exercise or control groups . Muscle biopsies were obtained from 11 subjects ( 8 exercisers/3 controls ) at baseline and after 15 weeks ; exercisers underwent another biopsy at 30 weeks . After testing maximum strength using the 1-RM method , the exercisers began a 12-exercise circuit ( 3 sets of 8 repetitions at 75 % of 1-RM ) , 3 times a week . The controls repeated the strength testing every 15 weeks . They were asked to continue usual activities and not to start any exercise program . RESULTS With exercise , muscle strength increased , average increases ranging from 30 % ( hip extensors ) to 97 % ( hip flexors ) . Strength increased rapidly over 3 months , then plateaued for the duration of the experiment . No strength changes were observed in sedentary controls . Cross-sectional area of type 1 muscle fibers increased in exercisers by 15 weeks ( 29.4 + /- 1 % , p < .02 ) and after 30 weeks ( 58.5 + /- 13.7 % , p < .002 ) compared to baseline . Type 2 fiber area did not change at 15 weeks , but increased by 30 weeks of training ( 66.6 + /- 9.5 % , p < .0002 ) . CONCLUSIONS These results suggest that prolonged moderate to high intensity resistance training may be carried out by healthy older adults with reasonable compliance , and that such training leads to sustained increases in muscle strength . These improvements are rapidly achieved and are accompanied by hypertrophy of both type 1 and type 2 muscle fibers OBJECTIVES To better underst and how immobilization and surgery affect muscle size and function in the elderly and to identify effective training regimes . DESIGN A prospect i ve r and omized , controlled study . SETTING Bispebjerg University Hospital , Copenhagen , Denmark . PARTICIPANTS Thirty-six patients ( aged 60 - 86 ) scheduled for unilateral hip replacement due to primary hip osteoarthrosis . INTERVENTION Patients were  r and omized to st and ard home-based rehabilitation ( 1 h/d x 12 weeks ) , unilateral neuromuscular electrical stimulation of the operated side ( 1 h/d x 12 weeks ) , or unilateral resistance training of the operated side ( 3/wk x 12 weeks ) . MEASUREMENTS Hospital length of stay ( LOS ) , quadriceps muscle cross-sectional area ( CSA ) , isokinetic muscle strength , and functional performance . Patients were tested presurgery and 5 and 12 weeks postsurgery . RESULTS Mean+/-st and ard error LOS was shorter for the resistance training group ( 10.0+/-2.4 days , P<.05 ) than for the st and ard rehabilitation group ( 16.0+/-7.2 days ) . Resistance training , but not electrical stimulation or st and ard rehabilitation , result ed in increased CSA ( 12 % , P<.05 ) and muscle strength ( 22 - 28 % , P<.05 ) . Functional muscle performance increased after resistance training ( 30 % , P<.001 ) and electrical stimulation ( 15 % , P<.05 ) but not after st and ard rehabilitation . CONCLUSION Postoperative resistance training effectively increased maximal muscle strength , muscle mass , and muscle function more than a st and ard rehabilitation regime . Furthermore , it markedly reduced LOS in elderly postoperative patients 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 design ed to determine whether specific muscle training techniques are helpful . METHODS : 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 r and omised 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 . RESULTS : 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 question naire showed significant improvements in dyspnoea and mastery of daily living activities in the trained group . CONCLUSIONS : 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 dem and s of daily living 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 r and omly 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 Summary This study showed that combination of strength , balance , agility and jumping training prevented functional decline and bone fragility in home-dwelling elderly women . The finding supports the idea that it is possible to maintain good physical functioning by multi-component exercise program and thus postpone the age-related functional problems . Introduction This 1-year r and omized , controlled exercise intervention trial assessed the effects of two different training programs and their combination on physical functioning and bone in home-dwelling elderly women . Methods One hundred and forty-nine healthy women aged 70–78 years were r and omly assigned into : group 1—resistance training ( RES ) , group 2—balance-jumping training ( BAL ) , group 3—combination of resistance and balance-jumping training ( COMB ) , and group 4—controls ( CON ) . Self-rated physical functioning , leg extensor force , dynamic balance , and bone mass and structure were measured . Results Self-rated physical functioning improved in the COMB group , but was reduced in the CON group ; the mean inter-group difference was 10 % ( 95 % CI : 0–22 % ) . Mean increase in the leg extensor force was higher in the RES ( 14 % ; 4–25 % ) and COMB ( 13 % ; 3–25 % ) compared with the CON groups . Dynamic balance improved in the BAL ( 6 % ; 1–11 % ) and in the COMB ( 8 % ; 3–12 % ) groups . There were no inter-group differences in BMC at the proximal femur . In those COMB women who trained at least twice a week , the tibial shaft structure weakened 2 % ( 0–4 % ) less than those in the CON group . Conclusions Strength , balance , agility , and jumping training ( especially in combination ) prevented functional decline in home-dwelling elderly women . In addition , positive effects seen in the structure of the loaded tibia indicated that exercise may also play a role in preventing bone fragility CONTEXT Adiponectin and leptin are closely related to weight control and energy balance , whereas exercise affects elderly metabolic regulation and functional capacity . OBJECTIVE The objective of this study was to investigate leptin and adiponectin responses in elderly males after exercise training and detraining .  DESIGN The study design was a 1-yr r and omized controlled trial . SETTING The study was performed at the Laboratory of Physical Education and Sport Science Department . PARTICIPANTS Fifty inactive men [ age , 65 - 78 yr ; body mass index ( BMI ) , 28.7 - 30.2 kg/m2 ] were recruited from a volunteer data base by word of mouth and fliers sent to medical practitioners , physiotherapists , and nursing homes in the local community . INTERVENTION(S ) Participants were r and omly assigned to a control ( n = 10 ) , low-intensity ( n = 14 ) , moderate-intensity ( n = 12 ) , or high-intensity training ( HI ; n = 14 ) group . Resistance training ( 6 months , 3 d/wk , 10 exercises/three sets ) was followed by 6 months of detraining . MAIN OUTCOME MEASURE(S ) Strength , exercise energy cost , skinfold sum , body weight , maximal oxygen consumption , resting metabolic rate ( RMR ) , and plasma leptin and adiponectin were determined at baseline and after training and detraining . RESULTS Strength , maximal oxygen consumption , RMR , and exercise energy cost increased ( P < 0.05 ) after training in an intensity-dependent manner . Skinfold sum and BMI were reduced by resistance training ( P < 0.05 ) , with HI being more effective ( P < 0.05 ) than moderate-intensity/low-intensity training . Leptin was diminished ( P < 0.05 ) by all treatments , whereas adiponectin increased ( P < 0.05 ) only in HI . Detraining maintained training-induced changes only in HI . The percent leptin decrease was associated ( P < 0.05 ) with the percent BMI decrease and the percent RMR increase , whereas the percent adiponectin increase was associated ( P < 0.05 ) with the percent BMI decrease . CONCLUSIONS Resistance training and detraining may alter leptin and adiponectin responses in an intensity-dependent manner . Leptin and adiponectin changes were strongly associated with RMR and anthropometric changes 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 dem and . 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 dem and ( -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 OBJECTIVES To examine the effects of 18-month aerobic walking and strength training programs on static postural stability among older adults with knee osteoarthritis . DESIGN R and omized , single-blind , clinical trial of therapeutic exercise . SETTING Both center-based ( university ) and home-based . PARTICIPANTS A cohort of 103 older adults ( age = 60 years ) with knee osteoarthritis who were participants in a large ( n = 439 ) clinical trial and who were r and omly assigned to undergo biomechanical testing . INTERVENTION An 18-month center- ( 3 months ) and home-based ( 15 months ) therapeutic exercise program . The subjects were r and omized to one of three treatment arms : ( 1 ) aerobic walking ; ( 2 ) health education control ; or ( 3 ) weight training . MEASUREMENTS Force platform static balance measures of average length ( Rm ) of the center of pressure ( COP ) , average velocity ( Vel ) of the COP , elliptical area ( Ae ) of the COP , and balance time ( T ) . Measures were made under four conditions : eyes open , double- and single-leg stances and eyes closed , double- and single-leg stances . RESULTS In the eyes closed , double-leg stance condition , both the aerobic and weight training groups demonstrated significantly better sway measures relative to the health education group . The aerobic group also demonstrated better balance in the eyes open , single-leg stance condition . CONCLUSIONS Our results suggest that long-term weight training and aerobic walking programs significantly improve postural sway in older , osteoarthritic adults , thereby decreasing the likelihood of larger postural sway disturbances relative to a control group Objective : 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 . Design : R and omized 2 × 2 controlled trial . Setting : Elderly care rehabilitation ward in a community hospital . Subjects : Fifty-four consecutive patients referred for rehabilitation . Outcome measures : The incidence of falls , and the change in strength . Results : 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 , h and grip strength improved more in those given additional exercise than conventional physiotherapy ( 2.1 kg versus – 0.3 kg , p < 0.05 ) . Conclusion : 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 The authors compared heart-rate and blood-pressure responses to typical isometric ( ISO ) and isokinetic ( 90 degrees /s ) eccentric ( ECC ) resistance-training protocol s in older adults . Twenty healthy older adults ( 74 + /- 5 years old ) performed r and omly ordered ISO and isokinetic ECC exercise ( 3 sets of 10 repetitions ) at a target intensity of 100 % of their peak ISO torque value . Heart rate and systolic ( SBP ) and diastolic ( DBP ) blood pressures were recorded continuously , and mean arterial pressure ( MAP ) and rate-pressure product ( RPP ) were calculated . ECC peak torque ( 139 + /- 33 N. m ) was significantly greater than ISO peak torque ( 115 + /- 26 N. m ; p < .001 ) . All variables increased significantly ( p < .001 ) during both ISO and ECC exercise .  Changes in SBP , DBP , MAP , and RPP were significantly greater during ISO exercise than during ECC exercise ( p < .001 ) . Clinical ly , an isokinetic ECC exercise program enables older adults to work at the same torque output with less cardiovascular stress than ISO exercise 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 r and omly 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 OBJECTIVE To evaluate the effects of isokinetic exercise versus a program of patient education on pain and function in older persons with knee osteoarthritis . DESIGN A r and omized , comparative clinical trial , with interventions lasting 8 weeks and evaluations of 12 weeks . SETTING An outpatient Veterans Affairs Medical Center clinic and an affiliated university hospital . PATIENTS One hundred thirteen men and women between 50 and 80 years old with diagnosed osteoarthritis of the knee ; 98 completed the entire assigned treatment . INTERVENTION Patients received either a regimen of isokinetic exercise of the quadriceps muscle three times weekly over 8 weeks or a series of 4 discussion s and lectures led by health care professionals . MAIN OUTCOME MEASURES 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 . RESULTS 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 . CONCLUSIONS Isokinetic exercise is an effective and well-tolerated treatment for knee osteoarthritis , but a much less costly education program also showed some benefits PURPOSE This study assessed the impact of a low cost , multicomponent physical activity intervention for older adults with lower extremity osteoarthritis . DESIGN AND METHODS A r and omized controlled trial compared the effects of a facility-based multiple-component training program followed by home-based adherence  ( n = 80 ) to a  wait list control group ( n = 70 ) . Assessment s were conducted at baseline and at 2 and 6 months following r and omization . The training program consisted of range of motion , resistance training , aerobic walking , and education-group problem solving regarding self-efficacy for exercise and exercise adherence . All training group participants developed individualized plans for posttraining adherence . RESULTS Relative to the persons in the control group , individuals who participated in the exercise program experienced a statistically significant improvement in exercise efficacy , a 48.5 % increase in exercise adherence , and a 13.3 % increase in 6-min distance walk that were accompanied by significant decreases in lower extremity stiffness at 2 and 6 months . Program participants also experienced a significant decrease in lower extremity pain and a borderline significant improvement in efficacy to adhere to exercise over time at 6 months ( p = .052 ) . In contrast , persons in the control group deteriorated over time on the efficacy and adherence measures and showed no change on the other measures . No adverse health effects were encountered . IMPLICATION S These benefits indicate that this low-cost intervention may hold great promise as one of a growing number of public health intervention strategies for older adults in the United States with osteoarthritis To evaluate the effects of 26 wk of aerobic and resistance training on the incidence of injury and program adherence in 70- to 79-yr-old men and women , 57 healthy volunteers ( 25 males , 32 females ) were r and omly assigned to a walk/jog ( W/J , N = 21 ) , strength ( STREN , N = 23 ) , or control ( CONT , N = 13 ) group . Walk/jog training was for 30 - 45 min , 3 d.wk-1 with intensity equal to 40 - 70 % heart rate max reserve ( HRmax reserve ) during the first 13 wk , and 75 - 85 % HRmax reserve for weeks 14 - 26 . STREN training consisted of one set ( 10 - 12 repetitions ) each of 10 variable resistance exercises performed to volitional fatigue . Forty-nine of the original participants completed the training program . Walk/jog training increased VO2max from 22.5 to 27.1 ml.kg-1.min-1 ( P less than or equal to 0.05 ) while STREN and CONT showed no change . STREN improved significantly in chest press and leg extension strength ( P less than or equal to 0.05 ) while W/J and CONT showed no change . Adherence to training was 20/23 ( 87 % ) and 17/21 ( 81 % ) in STREN and W/J , respectively . One repetition maximum ( 1-RM ) strength testing result ed in 11 injuries in the 57 subjects ( 19.3 % ) while STREN training result ed in only two injuries in 23 subjects ( 8.7 % ) . Walk training during weeks 1 - 13 result ed in one injury in 21 subjects ( 4.8 % ) . Eight of 14 subjects ( 57 % ) who began jogging intervals at week 14 incurred an injury : two of eight ( 25 % ) of the men and all of the women ( 6 of 6 ) . All W/J training injuries were to the lower extremity . ( ABSTRACT TRUNCATED AT 250 WORDS The purpose of this study was to investigate the effects of a 12-week resistance-training program on muscle strength and mass in older adults . Thirty-three inactive participants ( 60 - 74 years old ) were assigned to 1 of 3 groups : high-resistance training ( HT ) , moderate-resistance training ( MT ) , and control . After the training period , both HT and MT significantly increased 1-RM body strength , the peak torque of knee extensors and flexors , and the midthigh cross-sectional area of the total muscle . In addition , both HT and MT significantly decreased the abdominal circumference . HT was more effective in increasing 1-RM strength , muscle mass , and peak knee-flexor torque than was MT . These data suggest that muscle strength and mass can be improved in the elderly with both high- and moderate-intensity resistance training , but high-resistance training can lead to greater strength gains and hypertrophy than can moderate-resistance training OBJECTIVES 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 . DESIGN A 12-week controlled resistance-training study . SETTING Nursing homes in Copenhagen , Denmark . PARTICIPANTS Twenty-one frail nursing home residents aged 86 to 95 completed the study . INTERVENTION Ten participants were r and omized 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 . MEASUREMENTS 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 . RESULTS 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 . CONCLUSION 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 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 r and omized 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 ) st and ard 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 st and ard-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 implication s for elderly individuals PURPOSE To assess the effects of a one year nutritional supplementation and resistance training program on muscle strength and walking capacity in the elderly . MATERIAL AND METHODS Elderly subjects from two outpatient clinics received a nutritional supplement , that provided 400 Kcal , 15 g/protein and 50 % of vitamin DRVs per day . Half the subjects receiving and not receiving the supplement were r and omly assigned to a resistance exercise training program with two sessions per week . Every six months , body composition using DEXA , limb muscle strength , maximal inspiratory and expiratory pressures and walking capacity were assessed . RESULTS One hundred forty nine subjects were considered eligible and 101 ( 31 supplemented and trained , 28 supplemented , 16 trained and 26 without supplementation nor training ) completed the year of follow up . Overall compliance with the supplement was 48 22 % and trained subjects attended 56 21 % of programmed sessions . No changes in fat free mass were observed in any of the groups , but fat mass increased from 22.5 7.3 to 23.2 7.3 kg in all groups ( p < 0.001 ) . Upper and lower limb strength and walking capacity increased significantly in trained subjects whether supplemented or not . Maximal inspiratory pressure and right h and grip strength increased only in the supplemented and trained group . CONCLUSIONS Resistance training improved muscle strength and walking capacity PURPOSE To determine whether isokinetic training can improve the strength of the hemiparetic knee musculature , functional mobility , and physical activity and to evaluate its effect on spasticity in long-term stroke survivors . DESIGN Nonr and omized self-controlled trial . SUBJECTS A volunteer sample of 15 community-dwelling stroke survivors of at least 6 months . INTERVENTION A 6-week ( 3 days/week , 40 minutes/day ) program consisting of warm-up , stretches , reciprocal knee extension and flexion isokinetic strengthening , and cool-down for the paretic limb . MAIN OUTCOME MEASURES Peak isokinetic hamstring and quadriceps torque , quadriceps spasticity , gait velocity , timed Up and Go , timed stair climb , and the Human Activity Profile ( HAP ) scores were recorded at baseline , after training , and 4 weeks after training cessation ( follow-up ) . RESULTS Paretic muscle strength improved after training ( p < .05 ) while tone remained consistent ( p > .87 ) . Gait velocity increased after training ( p < .05 ) and at follow-up ( p < .05 ) . Changes in stair climbing and timed Up and Go were not significant ( p > .37 ; p > .91 ) , although subjects perceived gains in their physical abilities at follow-up ( p < .01 ) . CONCLUSIONS Gains in strength and gait velocity without concomitant increases in muscle tone are possible after a short-term strengthening program for stroke survivors . The psychological benefit associated with physical activity is significant Background and Purpose — To evaluate the efficacy of supervised high-intensity progressive resistance training ( PRT ) on lower extremity strength , function , and disability in older , long-term stroke survivors . Methods — Forty-two volunteers aged 50 years and above , 6 months to 6 years after a single mild to moderate stroke , were r and omized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press ( LP ) , unilateral paretic and nonparetic knee extension ( KE ) , ankle dorsiflexion ( DF ) , and plantarflexion ( PF ) exercises .  Functional performance was assessed using the 6-minute walk , stair-climb time , repeated chair-rise time , and habitual and maximal gait velocities . Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument ( LLFDI ) . Results — Single-repetition maximum strength significantly improved in the PRT group for LP ( 16.2 % ) , paretic KE ( 31.4 % ) , and nonparetic KE ( 38.2 % ) with no change in the control group . Paretic ankle DF ( 66.7 % versus −24.0 % ) , paretic ankle PF ( 35.5 % versus −20.3 % ) , and nonparetic ankle PF ( 14.7 % versus −13.8 % ) significantly improved in the PRT group compared with the control . The PRT group showed significant improvement in self-reported function and disability with no change in the control . There was no significant difference between groups for any performance-based measure of function . Conclusions — High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke , and results in reductions in functional limitations and disability The aim was to assess the effects of resistance training and vitamin D supplementation on physical performance of healthy elderly subjects . Ninety-six subjects , aged 70 years or more with 25 OH vitamin D levels of 16 ng/ml or less , were r and omized to a  resistance training or control group . Trained and control groups were further r and omized to receive in a double blind fashion , vitamin D 400 IU plus 800 mg of calcium per day or calcium alone . Subjects were followed for nine months . Serum 25 OH vitamin D increased from 12.4+/-2.2 to 25.8+/-6.5 ng/ml among subjects supplemented with vitamin D. Trained subjects had significant improvements in quadriceps muscle strength , the short physical performance test and timed up and go . The latter improved more in trained subjects supplemented with vitamin D. At the end of the follow up , gait speed was higher among subjects supplemented with vitamin ( whether trained or not ) than in non-supplemented subjects ( 838+/-147 and 768+/-127 m/12 min , respectively , p=0.02 ) . Romberg ratio was lower among supplemented controls than non-supplemented trained subjects ( 128+/-40 % and 144+/-37 % , respectively , p=0.05 ) . In conclusion , vitamin D supplementation improved gait speed and body sway , and training improved muscle strength PURPOSE The aim of this study was to compare the effects of endurance training alone ( ET ) with combined endurance and strength training ( CT ) on hemodynamic and strength parameters in patients with congestive heart failure ( CHF ) . METHODS Twenty male patients with CHF were r and omized into one of two training regimens consisting of endurance training or a combination of endurance and resistance training . Group ET had 40-min interval cycle ergometer endurance training three times per week . Group CT combined endurance and strength training with the same interval endurance training for 20 min , followed by 20 min of strength training .  Left ventricular function was assessed at baseline and after 40 training sessions by echocardiography and radionuclide ventriculography .  Work capacity was measured with cardiopulmonary exercise test ( CPX ) and lactate determination . Strength was measured with an isokinetic dynamometer . RESULTS After 40 sessions , the ET group improved functional class , work capacity , peak torque , and muscular endurance . However , peak O2 remained unchanged . Left ventricular ejection fraction ( LVEF ) and fractional shortening ( FS ) decreased , whereas left ventricular end-diastolic diameter ( LVED ) increased . The CT group improved NYHA score , working capacity , peak O2 , and peak lactate ; peak torque and muscular endurance , LVEF , and FS increased , whereas LVED decreased . Compared with ET , CT was significantly ( P < 0.05 ) better in improving LV function . CONCLUSION Combined endurance/strength training was superior to endurance training alone concerning improvement of LV function , peak VO2 , and strength parameters . It appears that for stable CHF patients , a greater benefit can be derived from this training modality Abstract . There is evidence that high intensity resistance training promotes bone maintenance in older women , however , the effect of high intensity free weight training has not been investigated in older men or women . Furthermore , little is known about the chronic effect of weight training on serum insulin growth factor-I ( IGF-I ) in this population . We compared the effects of a moderate intensity seated resistance-training program with a high intensity st and ing free weight exercise program on bone mass and serum levels of IGF-I and IGFBP3 in healthy older men and women . Twenty-eight men ( 54.6 ± 3.2 years ) and 26 nonestrogen-replaced women ( 52.8 ± 3.3 years ) served as their own controls for 12 weeks , then were r and omly assigned to a moderate or high intensity training group and trained three times/week for 24 weeks . Prior to and after the control period and at the end of training , bone mass and body composition were assessed by dual energy X-ray absorptiometry ( DXA ) , muscle strength by isokinetic dynamometry , muscular power by Wingate Anaerobic Power Test , and IGF-I by radioimmunoassay ( RIA ) . A repeated measures analysis of covariance ( ANCOVA ) revealed that high intensity training result ed in a gain in spine BMD in men ( 1.9 % ) , P < 0.05 , but not in women , whereas moderate intensity training produced no changes in either gender at this site . Increases were observed at the greater trochanter , P < 0.03 , in men regardless of training intensity , but not in women at any hip site . However , when compared with zero , both men and women in the high intensity group demonstrated significant increases in trochanteric BMD ( 1.3 % and 2.0 % , respectively ) and a decrease in femoral BMD ( −1.8 % ) . Neither circulating serum IGF-I nor IGFBP3 were altered by either training regimen , but both training programs result ed in improvements in total body strength ( 37.62 % ) and lean mass ( males 4.1 % , females 3.1 % ) . We conclude that although resistance training of moderate to high intensity produced similar muscle changes in older adults , a higher magnitude is necessary to stimulate osteogenesis at the spine . However , at the spine , intensity was not sufficient to offset low levels of estrogen in early postmenopausal women . Furthermore , bone changes were not accompanied by changes in circulating serum levels of IGF-I or IGFBP3 The plasma levels of dehydroepi and rosterone ( DHEA ) and its sulfated form ( DHEAS ) decline approximately 80 % between the ages of 25 and 75 yr . Muscle mass and strength also decrease with aging . Published data on the effects of DHEA replacement on muscle mass and strength are conflicting . The goals of this study were to determine whether DHEA replacement increases muscle mass and strength and /or enhances the effects of heavy resistance exercise in elderly women and men . We conducted a r and omized , double-blind , placebo-controlled study of the effects of 10 mo of DHEA replacement therapy with the addition of weightlifting exercise training during the last 4 mo of the study  ( DHEA + exercise group , n = 29 ; placebo + exercise group , n = 27 ) .  DHEA alone for 6 mo did not significantly increase strength or thigh muscle volume . However , DHEA therapy potentiated the effect of 4 mo of weightlifting training on muscle strength , evaluated by means of one-repetition maximum measurement and Cybex dynamometry , and on thigh muscle volume , measured by magnetic resonance imaging . Serum insulin-like growth factor concentration increased in response to DHEA replacement . This study provides evidence that DHEA replacement has the beneficial effect of enhancing the increases in muscle mass and strength induced by heavy resistance exercise in elderly individuals The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program ( RT+WLoss ) could maintain bone mineral density ( BMD ) and lean mass compared to moderate weight loss ( WLoss ) alone in older overweight adults with type 2 diabetes . We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program . This was a 12-month trial in which 36 sedentary , overweight adults aged 60 to 80 years with type 2 diabetes were r and omized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months ( phase 1 ) . Thereafter , all participants completed an additional 6-month home-based training without further dietary modification ( phase 2 ) . Total body and regional BMD and bone mineral content ( BMC ) , fat mass ( FM ) and lean mass ( LM ) were assessed by DXA every 6 months . Diet , muscle strength ( 1-RM ) and serum total testosterone , estradiol , SHBG , insulin and IGF-1 were measured every 3 months . No between group differences were detected for changes in any of the hormonal parameters at any measurement point . In phase 1 , after 6 months of gymnasium-based training , weight and FM decreased similarly in both groups ( P<0.01 ) , but LM tended to increase in the RT+WLoss ( n=16 ) relative to the WLoss ( n=13 ) group [ net difference ( 95 % CI ) , 1.8 % ( 0.2 , 3.5 ) , P<0.05 ] . Total body BMD and BMC remained unchanged in the RT+WLoss group , but decreased by 0.9 and 1.5 % , respectively , in the WLoss group ( interaction , P<0.05 ) . Similar , though non-significant , changes were detected at the femoral neck and lumbar spine ( L2-L4 ) . In phase 2 , after a further 6 months of home-based training , weight and FM increased significantly in both the RT+WLoss ( n=14 ) and WLoss ( n=12 ) group , but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months . These results indicate that in older , overweight adults with type 2 diabetes , dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health AIM The aim of the present study was to assess and compare the improvements of muscle strength and power induced by a 16-week resistive programme in a population of 16 older men aged 65 - 81 years . METHODS Training was performed three times per week at an intensity of 80 % of one repetition maximum ( 1RM ) and consisted of both calf raise and leg press exercises . Before- , during- and after-training , maximum isometric and isokinetic torques , maximum power , 1RM , muscle cross-sectional area ( CSA ) and electromyographic activity ( EMG ) of the plantar flexors ( PF ) and knee extensors ( KE )  were examined . RESULTS For the KE and PF , respectively , training result ed in a 29.9 + /- 4.4 % ( mean + /- SE ) and 21.6 + /- 5.4 % increase in 1RM ( P < 0.001 - 0.01 ) , a 19.4 + /- 4.3 and 12.4 + /- 4.7 % ( P < 0.001 - 0.05 ) increase in maximum isometric torque , and a 24.1 + /- 6.3 and 33.1 + /- 10.9 % ( P < 0.05 ) increase in maximum muscle power , calculated from torque-angular velocity curves . The large increase in torque and power was partly accounted by a significant increase in the CSA of the PF ( 5.0 + /- 0.7 % ) and KE ( 7.4 + /- 0.7 % ) , while no significant changes in integrated EMG activity of vastus lateralis and soleus muscles , and in extrapolated maximum shortening velocity were found . After training , a significant increase in torque/CSA ( 10.3 + /- 4 % , P < 0.05 ) was found for the KE but not for the PF . CONCLUSION Hence , hypertrophy can not alone justify the increase in torque , and other factors , such as an increase in individual fibre-specific tension ( in the case of KE ) , a decrease in antagonist muscles ' coactivation , an improved co-ordination and an increased neural drive of the other heads of quadriceps may have contributed to the increments in strength . The significant increase in muscle power seems particularly noteworthy with respect to daily activities involving the displacement of the body over time , namely , the generation of muscle power 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 r and om 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 St and 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 This investigation examined the effect of 6 months of high- or low-intensity resistance exercise on  serum homocysteine and lipoprotein ( a ) levels in adults aged 60 - 80 years . Forty-three men and women completed the study protocol . Subjects were r and omly assigned to a control ( n=10 ) , low-intensity ( LEX , n=18 ) , or high-intensity ( HEX , n=15 ) group . Subjects performed 6 months of resistance training at either 50 % of their one-repetition maximum for 13 repetitions ( LEX ) or 80 % of one-repetition maximum for eight repetitions ( HEX ) 3 times per week for 24 weeks . The load was increased by 5 % when their rating of perceived exertion dropped below 18 . One-repetition maximum ; serum homocysteine ; lipoprotein ( a ) ; total and high-density lipoprotein cholesterol ; and dietary intake of vitamins B12 , B6 , and folic acid were measured pre- and post study . Upper and lower body strength significantly ( p<0.05 ) increased for the LEX and HEX groups . Serum homocysteine decreased 5.30 % and 5.34 % for the LEX and HEX groups , respectively ( p<0.05 ) , but increased 6.1 % for the control group . A significant increase in lipoprotein ( a ) levels was noted in the control and LEX groups from pre- to post study . No significant differences were noted either pre- or post study for total and high-density lipoprotein cholesterol or any dietary variables . These data indicate that significant reductions in serum levels of homocysteine in the elderly can be derived from resistance exercise training PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects BACKGROUND Exercise programs improve balance , strength and agility in elderly people and thus may prevent falls . However , specific exercise programs that might be widely used in the community and that might be " prescribed " by physicians , especially for patients with osteoporosis , have not been evaluated . We conducted a r and omized controlled trial of such a program design ed specifically for women with osteoporosis . METHODS We identified women 65 to 75 years of age in whom osteoporosis had been diagnosed by dual-energy X-ray absorptiometry in our hospital between 1996 and 2000 and who were not engaged in regular weekly programs of moderate or hard exercise .  Women who agreed to participate were r and omly assigned to participate in a twice-weekly exercise class or to not participate in the class . We measured baseline data and , 20 weeks later , changes in static balance ( by dynamic posturography ) , dynamic balance ( by a timed figure-eight run ) and knee extension strength ( by dynamometry ) . RESULTS Of 93 women who began the trial , 80 completed it . Before adjustment for covariates , the intervention group tended to have greater , although nonsignificant , improvements in static balance ( mean difference 4.8 % , 95 % confidence interval [ CI ] -1.3 % to 11.0 % ) , dynamic balance ( mean difference 3.3 % , 95 % CI -1.7 % to 8.4 % ) and knee extension strength ( mean difference 7.8 % , 95 % CI -5.4 % to 21.0 % ) . Mean crude changes in the static balance score were -0.85 ( 95 % CI -2.91 to 1.21 ) for the control group and 1.40 ( 95 % CI -0.66 to 3.46 ) for the intervention group . Mean crude changes in figure-eight velocity ( dynamic balance ) were 0.08 ( 95 % CI 0.02 to 0.14 ) m/s for the control group and 0.14 ( 95 % CI 0.08 to 0.20 ) m/s for the intervention group . For knee extension strength , mean changes were -0.58 ( 95 % CI -3.02 to 1.81 ) kg/m for the control group and 1.03 ( 95 % CI -1.31 to 3.34 ) kg/m for the intervention group . After adjustment for age , physical activity and years of estrogen use , the improvement in dynamic balance was 4.9 % greater for the intervention group than for the control group ( p = 0.044 ) . After adjustment for physical activity , cognitive status and number of fractures ever , the improvement in knee extension strength was 12.8 % greater for the intervention group than for the control group ( p = 0.047 ) . The intervention group also had a 6.3 % greater improvement in static balance after adjustment for rheumatoid arthritis and osteoarthritis , but this difference was not significant ( p = 0.06 ) . INTERPRETATION Relative to controls , participants in the exercise program experienced improvements in dynamic balance and strength , both important determinants of risk for falls , particularly in older women with osteoporosis OBJECTIVE 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 . METHODS Forty-six community dwelling patients , aged 55 years or older with knee pain and radiographic evidence of knee OA , were r and omized 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 question naires to measure quality of life variables . RESULTS 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 . CONCLUSION High intensity , home based strength training can produce substantial improvements in strength , pain , physical function and quality of life in patients with knee OA Background and aims : The most common cause of accidental injury and death in people over age 65 results from impacts associated with falling . Balance impaired older adults have poorer balance control than healthy young adults or healthy older adults . Lack of sufficient lower extremity strength and inability to rapidly produce muscle force may contribute to diminished balance control in the elderly . This study evaluated the effect of a 10-week high intensity strength- training program targeting key lower extremity muscles for the purpose of improving postural control in frail older adults . Methods : Thirteen experimental and fourteen control subjects , all balance impaired older adults were evaluated in response to unexpected platform perturbations that simulated slips . Results : Following strength training the experimental group was significantly stronger than the control group . Mean ankle moments improved in the experimental group following strength training during forward sway ( Right : p=0.067 , Left : p=0.009 ) and backward sway ( Right : p=0.031 , Left : p=0.058 ) . For the backward sway condition the ankle rate of torque production increased significantly in the experimental group ( Right : p=0.016 , Left : p=0.031 ) . Conclusions : Enhancement of lower extremity strength contributed to improvements in balance stability demonstrated by greater ankle force production , in response to balance threats The objectives of this study were to evaluate ( 1 ) the effect of spinal muscle strengthening by loading exercises on the bone mineral density ( BMD ) of the spine , and ( 2 ) the effect of upper extremity loading exercises on the BMD of the midradius and femur in healthy , premenopausal women . The study design was a r and omized , controlled trial of 3 years ' duration . Ninety-six healthy , premenopausal , white women aged 30 - 40 years participated ; 67 completed the study . All subjects were in good health ( normal menses ) and were active , but not athletic ( that is , not involved in a regular sport activity ) . Subjects were r and omized to an exercise or control group . The exercise group performed a supervised , non-strenuous , weight-lifting exercise program . Exercise performance was supervised once a week at the medical facility . In addition , the subjects performed the exercises twice a week on their own . Dietary calcium intake was to be maintained at 1,500 mg/day in both groups . Bone density was measured at the lumbar spine and hip with dual-energy X-ray absorptiometry at 0 , 1 , and 3 years . BMD of the midradius was measured with single photon absorptiometry . Measurements of muscle strength were obtained at baseline and every 3 months for 3 years . Maximal oxygen uptake was measured , and the level of physical activity was recorded . Compliance with the exercise program was excellent during the first year of the study , but decreased thereafter . At the end of 3 years , subject withdrawal was about 34 % from the exercise group and about 22 % from the control group ( total subject withdrawal was about 30 % ) . Muscle strength in the exercise group increased significantly at all involved skeletal sites ( p values all < 0.001 ) . There was a modest positive correlation between the BMD of Ward 's triangle with spinal flexor strength ( r = 0.32 , p = 0.008 ) and with grip strength ( r = 0.38 , p = 0.001 ) . Comparing study groups , we found no significant effect of the loading and nonstrenuous strengthening exercises in the exercise group or free physical activity group ( our control group ) on BMD at the spine , hip , or midradius measurement sites . In active , but not athletic premenopausal women , additional moderate weight-lifting exercises showed no significant effect on BMD BACKGROUND 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 . METHODS 31 community-dwelling older adults with diabetes ( mean age = 66.1 years ) were r and omly 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 . RESULTS 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 . CONCLUSION 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 PURPOSE 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 . METHODS Sixty-two men and women ( 68.4 + /- 6 yr ) were stratified for strength and r and omly 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 . RESULTS 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 . CONCLUSION 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 PURPOSE This study investigated effects of an 8-wk , low-frequency and low-volume , supervised , progressive strength training program emphasizing free weight , multijoint movements on the muscular power , strength , endurance , and flexibility of African American women 44 to 68 yr of age . METHODS Nineteen sedentary African American women were r and omly assigned to a  strength training ( ST ) only group ( N = 12 ; mean age , 51 yr ) or a  nonexercise control ( C ) group ( N = 7 ; mean age , 52 yr ) . Maximal power , strength , absolute endurance , and flexibility were assessed before and after training . Subjects trained 2 d x wk(-1 ) using free weight ( barbells and dumbbells ) and machine ( plate loaded ) exercises for two to three sets of 8 to 10 repetitions on both primary and assistance exercises . RESULTS Upper body power ( medicine ball put distance ) significantly increased statistically ( P = 0.002 ) , but gains possibly lacked practical significance because of measurement variation . Lower body power ( peak watts on bicycle ) experienced a small , nonsignificant increase in the ST group . Significant increases ( P = 0.000 ) in 1RM muscle strength occurred in the ST group ( leg press , + 99.8 % ; bench press , + 34.4 % ) . Absolute endurance significantly increased ( P = 0.000 ) in the ST group ( leg press repetitions to failure at 70 % pretest 1RM , + 221 % ; bench press repetitions to failure at 50 % pretest 1RM , + 112 % ) . Significant flexibility gains occurred in the ST group ( sit- and -reach test , + 8.2 % ; P = 0.017 ) . No significant changes occurred in power , strength , absolute endurance , or flexibility in the C group . CONCLUSION This study demonstrates that 8 wk of low-frequency , supervised , progressive strength training emphasizing free weight , multijoint movements can safely cause significant gains in muscle strength , absolute endurance , and flexibility in older African American women The expression of two isoforms of insulin-like growth factor-I ( IGF-I ) : mechano growth factor ( MGF ) and IGF-IEa were studied in muscle in response to growth hormone ( GH ) administration with and without resistance training in healthy elderly men . A third isoform , IGF-IEb was also investigated in response to resistance training only . The subjects ( age 74 + /- 1 years , mean + /- S.E.M ) were assigned to either resistance training with placebo , resistance training combined with GH administration or GH administration alone . Real-time  quantitative RT-PCR was used to determine mRNA levels in biopsies from the vastus lateralis muscle at baseline , after 5 and 12 weeks in the three groups . GH administration did not change MGF mRNA at 5 weeks , but significantly increased IGF-IEa mRNA ( 237 % ) . After 12 weeks , MGF mRNA was significantly increased ( 80 % ) compared to baseline . Five weeks of resistance training significantly increased the mRNA expression of MGF ( 163 % ) , IGF-IEa ( 68 % ) and IGF-IEb ( 75 % ) . No further changes were observed after 12 weeks . However , after 5 weeks of training combined with GH treatment , MGF mRNA increased significantly ( 456 % ) and IGF-IEa mRNA by ( 167 % ) . No further significant changes were noted at 12 weeks . The data suggest that when mechanical loading in the form of resistance training is combined with GH , MGF mRNA levels are enhanced . This may reflect an overall up-regulation of transcription of the IGF-I gene prior to splicing It has been shown that high levels of high-density lipoprotein ( HDL ) cholesterol and low levels of low-density lipoprotein ( LDL ) cholesterol are associated with health maintenance in older women , but the few studies that have examined the relationship between exercise and plasma lipoprotein levels in this elderly population have been equivocal . In addition , there are no studies that examine the plasma lipoprotein response of two different types of exercise in a group of active but nonexercising women . Thus , the effects of exercise training on plasma lipoprotein levels in elderly women remain unclear . The purpose of this research was to examine the effects of endurance and resistance exercise on plasma lipoprotein levels in elderly women who were active but nonexercising prior to the study . A total of 45 healthy , active women , aged 70 - 87 years , were r and omly assigned to either an aerobic training ( AT , 76 + /- 5 years , n = 15 ) , resistance training ( RT , 73 + /- 3 years , n = 15 ) , or control ( C , 74 + /- 5 years , n = 15 ) group . The AT group walked 3 days a week at 70 % heart rate reserve . The duration on day 1 was 20 minutes , and it was increased by 5 minutes each day until subjects were walking for 50 minutes ( week 3 ) . The exercise training session for the RT group consisted of one to three sets of eight repetitions of eight different exercises at an eight repetition maximum ; the C group maintained normal activity . Weight and diet were unchanged across groups . The exercise interventions lasted 10 weeks . Blood sample s were obtained from all subjects at week 0 and week 11 . Training result ed in a significant decrease in 1-mile walk times and heart rate at completion of the walk for the AT group and a significant increase in eight repetition maximum of all RT exercises . Both AT and RT groups experienced increased HDL cholesterol and decreased triglycerides at week 11 compared with week 0 . There were no positive changes in control lipoproteins . Both triglycerides and the total cholesterol to HDL ratio increased significantly while total cholesterol , HDL cholesterol , and LDL cholesterol remained unchanged . The RT group also had significantly lower LDL cholesterol and total cholesterol compared with controls at week 11 . Both RT and endurance training result ed in favorable changes to plasma lipoprotein levels for elderly women in only 10 weeks . The fact that this occurred without concurrent changes in weight or diet is an indication that high-intensity exercise alone can be used to modify lipoproteins in population s of healthy elderly women Background : Strength training has been shown to benefit the health and function of older adults . Objective : To investigate whether one set of exercises performed once a week was as effective in increasing muscle strength as training twice a week . Methods : 18 subjects ( 7 women and 11 men ) aged 65–79 years were r and omly 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 × 2 analysis of variance . Results : 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 . Conclusions : 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 design ing strength-training programmes that are more time and cost efficient in producing health and fitness benefits for older adults OBJECTIVES To evaluate a dynamic form of weighted vest exercise suitable for home use and design ed to enhance muscle power , balance , and mobility . DESIGN A single-blind , r and omized , controlled trial . SETTING Outpatient exercise research facility situated within an academic long-term care center . PARTICIPANTS Twenty-one community-dwelling women aged 70 and older with a Short Physical Performance Battery ( SPPB ) score between 4 and 10 ( out of 12 ) . INTERVENTIONS Subjects were r and omized into a progressive resistance-training program using weighted vests for resistance with exercises design ed 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 . MEASUREMENTS Changes in muscle power , balance , and physical performance were compared . RESULTS 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 st and and SPPB score from baseline , and the InVEST group showed significant improvements in gait speed and chair st and from baseline ( P<.05 ) . InVEST produced significantly greater changes in chair st and time than control ( P<.05 ) . CONCLUSION 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 Background and aims : The practice of regular physical exercise has been shown to be effective in slowing the age-related progressive functional deterioration . Most exercise trials have been conducted with supervised training programs . The purpose of this study was to investigate the effectiveness of a 4-month home-based strength training on strength , function and personal satisfaction . Methods : Ten elderly men ( mean age 68.5 years ) were enrolled for home-based training  one month after completing a 4-month supervised program ; 12 age-matched men served as the control group . Subjects were asked to perform 3 sessions a week consisting of six resistance exercises with elastic b and s involving the major muscle groups of the upper and lower limbs . We had calculated the correlation between the elongation and resistance of the elastic b and s. The subjects were instructed to keep a diary reporting the execution of the session . We measured dynamic concentric strength of the muscle groups involved in the resistance exercises and maximal isometric strength of the knee extensors and elbow flexors before and after the 4- month home training . The Satisfaction Profile ( SAT-P ) question naire was administered before and one month after the completion of the training program for assessing personal satisfaction . Results : The final to baseline comparison showed a non-significant decrease in mean isometric maximal strength values for knee extensors and elbow flexors in the control group , while the exercise group significantly ( p=0.001 ) improved the average baseline values . Maximal dynamic concentric strength values decreased significantly in the control group , while significant improvements were observed in the exercising subjects . The SAT-P question naire did not show any difference in either group from baseline . The adherence-to- protocol rate based on self-report was 78 % . Conclusions : Home training with elastic b and s appears to be an effective low-cost modality of maintaining strength and function in an elderly population BACKGROUND Progressive resistance exercise training ( PRT ) has been shown to increase muscle strength and fat-free mass ( FFM ) in elderly persons . Limited information is available regarding the effects of PRT on lean and fat mass in frail elderly persons . METHODS Ninety-one community-dwelling sedentary men and women , 78 years and older with physical frailty ( defined using st and ardized objective criteria ) were enrolled in a 9-month trial of exercise training ( ET ) . Physical frailty was defined as having 2 of the 3 following criteria : modified Physical Performance Test score between 18 and 32 , peak aerobic power between 10 and 18 ml/kg/min , or self-report of difficulty or assistance with two instrumental activities of daily living or one basic activity of daily living . Participants were r and omly assigned to either a control ( CTL ) group that performed a low intensity home exercise program or a supervised ET group that performed 3 months of low intensity exercise and 3 months of PRT . RESULTS After completion of PRT , ET participants had greater improvements than did CTL participants in maximal voluntary force production for knee extension ( mean Delta + 5.3 + /- 13 ft/lb vs + 1.1 + /- 11 ft/lb , p = .05 ) , measured using isokinetic dynamometry . Total body FFM ( measured using dual energy x-ray absorptiometry ) increased in the ET group , but not in the CTL group ( mean Delta + 0.84 + /- 1.4 kg vs + 0.01 + /- 1.5 kg , p = .005 ) . Total , trunk , intra-abdominal , and subcutaneous fat mass ( measured using dual energy x-ray absorptiometry and (1)H-magnetic resonance imaging ) did not change in response to PRT . CONCLUSIONS Three months of supervised PRT induced improvements in maximal voluntary thigh muscle strength and whole body FFM in frail , community-dwelling elderly women and men . This supervised exercise program may not be sufficient to reduce whole-body or intra-abdominal fat area in this population Muscle weakness experienced in old age has many detrimental consequences for activities of daily life . Given the serious problems presented by weakness in old age , strategies to prevent or mitigate this process are of paramount importance . In recent years resistance training has emerged as an effective method for increasing strength in the elderly . Despite this , little is known regarding the muscular , neural and tendinous adaptations that occur with resistance training in old age . Hence , we have conducted a series of experiments to investigate these adaptations . We have found increases in maximal isometric and concentric torque by 9 - 37 % after resistance training in older people ( 65 - 81 years ) . Associated with these strength gains were increases in agonist muscle neural drive without any change in the co-activation of antagonist muscles .  Resistance training can cause increases in muscle size and also adaptations to the internal muscle structure . Tendons of older adults adapt to resistance training by increasing their stiffness and Young 's modulus . In conclusion , many of the musculoskeletal factors characterizing ageing can be at least partially mitigated by resistance training Sullivan DH , Wall PT , Bariola JR , Bopp MM , Frost YM : Progressive resistance muscle strength training of hospitalized frail elderly . Am J Phys Med Rehabil 2001;80:503–509 . Objective To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training . Design Muscle strength ( one repetition maximum ) , functional abilities ( sit-to-st and maneuver and 20-sec maximal safe gait speed ) , and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training . The nonr and omized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home . Participants included 19 recuperating elderly subjects ( 14 male , 5 female ; 13 ambulatory , 6 nonambulatory ) > 64 yr ( mean age , 82.8 ± 7.9 yr ) . Results The one repetition maximum increased an average of 74 % ± 49 % ( median , 70 % ; interquartile range , 38%–95 % , and an average of 20 ± 13 kg ( P = 0.0001 ) . Sit-to-st and maneuver times improved in 15 of 19 cases ( 79 % ) . Maximum safe gait speeds improved in 10 of 19 cases ( 53 % ) . Four of the six nonambulatory subjects progressed to ambulatory status . No subject experienced a complication . Conclusions A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses . A r and omized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages , if any , over routine posthospital care that includes traditional low-intensity physical therapy PURPOSE To compare the effects of the 16-wk training period ( 2 d.wk(-1 ) ) of resistance training alone ( S ) , endurance training alone ( E ) , or combined resistance ( once weekly ) and endurance ( once weekly ) training ( SE ) on muscle mass , maximal strength and power of the leg and arm extensor muscles , and maximal workload ( Wmax ) by using a incremental cycling test in older men . METHODS Thirty-one healthy men ( 65 - 74 yr ) were divided into three treatment groups to train 2x wk(-1 ) for 16 wk : S ( N = 10 ) , E ( N = 11 ) , or SE ( N = 10 ; 1x wk(-1 ) S + 1x wk(-1 ) E ) . The subjects were tested at 8-wk intervals ( i.e. , weeks 8 and 16 ) . RESULTS There were no significant differences between  S- and SE-induced muscle hypertrophy ( 11 % and 11 % ) and maximal strength ( 41 % and 38 % ) gains of the legs as well as between E- and SE-induced Wmax ( 28 % and 23 % ) gains . The increase in arm strength in S ( 36 % ) was greater than that recorded in SE ( 22 % ) and greater than that recorded in E ( 0 % ) . CONCLUSIONS Prolonged combined resistance and endurance training in older men seemed to lead to similar gains in muscle mass , maximal strength , and power of the legs as resistance training alone and to similar gains in maximal peak power output measured in an incremental cycling test as endurance training alone . These findings may have an effect on how resistance exercise is prescribed to older adults Purpose . To investigate feasibility and effectiveness of an individually-directed , group strength-training programme on  knee muscle strength after stroke . Method . Ten volunteers ( 62 ± 11 years , mean ± SD ) , 6 – 12 months after first-ever unilateral stroke , walking independently with or without aids were recruited . Using an A1-B-A2 design , 3 sets of baseline measures were taken at 2 weekly intervals ; volunteers then attended twice weekly sessions of low intensity progressive strengthening exercises and were assessed after each series of 8 sessions to a maximum of 24 sessions ; post training , measures were repeated after 4 – 6 weeks . Measures included isometric and concentric knee extensor muscle strength and 10 m walking velocity . Results . Strength of knee extensor muscles was improved after training ( ANOVA , p < 0.05 ) . On cessation of training , isometric strength increased by 58 ± 19 % and concentric strength at 30 ° /s by 51 ± 14 % ; walking velocity quickened from 0.47 ± 0.06 m · s−1 to 0.57 ± 0.08 m · s−1 ( t = −3.31 , p < 0.01 ) . These gains were maintained 4 – 6 weeks after completion of training . Conclusions . These findings support the use of low intensity strength training after stroke and confirm published evidence . It was feasible for one therapist to deliver the training programmes for 4 – 6 participants at a time ; an important feature when re sources are limited OBJECTIVE To determine the effect on balance and strength of 3 months of intensive balance and /or weight training followed by 6 months of low intensity Tai Chi training for maintenance of gains . DESIGN R and omized control intervention . Four groups in 2 x 2 design : Control , Balance , Strength , Balance + Strength , using blinded testers . SETTING Exercise and balance laboratory at University of Connecticut Health Center . PARTICIPANTS Subjects were 110 healthy community dwellers ( mean age 80 ) who were free of dementia , neurological disease , and serious cardiovascular or musculoskeletal conditions . INTERVENTIONS Short-term training ( 3 months ) occurred 3 times/week ( 45 minutes Balance and Strength , 90 minutes Balance + Strength ) . Balance training included equilibrium control exercises of firm and foam surfaces and center-of-pressure biofeedback . Strengthening consisted of lower extremity weight-lifting . All subjects than received long-term group Tai Chi instruction ( 6 months , 1 hour , 1 time/week ) . MEASUREMENTS Losses of balance during Sensory Organization Testing ( LOB ) , single stance time ( SST ) , voluntary limits of stability ( FBOS ) , summed isokinetic torque of eight lower extremity movements ( ISOK ) , and usual gait velocity ( GVU ) . RESULTS AND CONCLUSIONS Balance training meaningfully improved all balance measures by restoring performance to a level analogous to an individual 3 to 10 years younger : LOB = -2.0 + /- 0.3 ( adjusted paired differences , P < .005 ANOVA ) ; SST = 7.0 + /- 1.2 sec ; and FBOS = 9.0 + /- 2.0 % of foot length ( P < .05 ) . Strengthening increased ISOK by 1.1 + /- 0.1 Nm kg-1 ( P < .005 ) . There was no interaction between balance and strength training . Significant gains persisted after 6 months of Tai Chi , although there was some decrement 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 Chronic heart failure ( CHF ) is characterized by a skeletal muscle myopathy not optimally addressed by current treatment paradigms or aerobic exercise . Sixteen older women with CHF were compared with 80 age-matched peers without CHF and r and omized to progressive resistance training or control stretching exercises for 10 wk . Women with CHF had significantly lower muscle strength ( P < 0.0001 ) but comparable aerobic capacity to women without CHF . Exercise training was well tolerated and result ed in no changes in resting cardiac indexes in CHF patients . Strength improved by an average of 43.4 + /- 8.8 % in resistance trainers vs. -1.7 + /- 2.8 % in controls ( P = 0.001 ) , muscle endurance by 299 + /- 66 % vs. 1 + /- 3 % ( P = 0.001 ) , and 6-min walk distance by 49 + /- 14 m ( 13 % ) vs. -3 + /- 19 m ( -3 % ) ( P = 0.03 ) . Increases in type I fiber area ( 9.5 + /- 16 % ) and citrate synthase activity ( 35 + /- 21 % ) in skeletal muscle were independently predictive of improved 6-min walk distance ( r2 = 0.78 ; P = 0.0024 ) . High-intensity progressive resistance training improves impaired skeletal muscle characteristics and overall exercise performance in older women with CHF . These gains are largely explained by skeletal muscle and not resting cardiac adaptations The purpose of this study was to investigate the efficacy of , and the adherence to , a 12-week home-based progressive resistance training program for older adults utilizing elastic tubing . Sixty-two adults ( mean age , 71.2 years ) qualified to participate in the study . Subjects were r and omly assigned to either the exercise ( E ) ( n=31 ) or non-exercise ( NE ) group ( n=31 ) . Pre- and post-testing included isokinetic ( 1.05 rad · s −1 ) concentric/eccentric knee extension/flexion strength testing and flexibility measures of the hip , knee , and ankle . The E group trained three times per week , performing one to three sets of 10–12 repetitions for each of 12 resistance exercises . The exercises involved muscles of both the lower and upper body . Within the E group , 25 of the 31 subjects ( 80.6 % ) completed the study . Of the E subjects completing the study adherence to the three training sessions per week was 90 % ( range 72%–100 % ) . Training resistances used during workouts increased significantly with the average estimated increase being 82 % ( P<0.001 ) . The E group also demonstrated significant ( P<0.05 ) increases in isokinetic eccentric knee extension ( 12 % ) and flexion ( 10 % ) strength . No other significant changes were observed between E and NE groups . These results suggest that home-based resistance training programs utilizing elastic tubing can serve as a practical and effective means of eliciting strength gains in adults over the age of 65 PURPOSE To determine the effect of a 12-month moderate resistance training program on phenotypic and functional immunological parameters of previously sedentary , clinical ly healthy , elderly women . METHODS A total of 42 clinical ly healthy , sedentary females ( aged 60 - 77 yr old ) were r and omly assigned to either a moderate-intensity resistance training program or a control group during a 12-month longitudinal , r and omized , controlled , intervention study . Resistance training program consisted of three sets of 12 repetitions at 54.9 + /- 2.4 % 1RM for five different exercises performed three times per week during 12 months . Natural killer cell cytotoxic activity ( NKCA ) , lymphoproliferative response to the mitogen phytohemaglutinin ( PHA ) , and quantification of the lymphocytes ( CD3 , CD3CD19 , CD56 ) and sub population s ( CD4 , CD8 , CD56 , CD56 ) as well as cellular expression molecules ( CD25 , CD28 , CD45RA , CD45RO , CD69 , CD95 , HLA-DR ) were determined by immunological assays . RESULTS The experimental group increased muscle strength in 44 % and 48 % after 6 and 12 months , respectively ( P < 0.05 ) . There were no statistically significant differences between the groups or according to the time for quantitative ( CD3 , CD3CD19 , CD56 , CD4 , CD8 , CD45RA , CD45RO , CD56 , CD56 , CD95 , CD28 , CD25 , CD69 , HLA-DR ) and functional immunological parameters ( natural killer cell cytotoxic activity and lymphoproliferative response ) . CONCLUSION A 12-month moderate resistance training program increases muscle strength , but it does not change immune phenotypic and functional parameters of previously sedentary , clinical ly healthy , elderly women The effects of endurance training on exercise capacity and health-related quality of life ( HRQL ) in chronic obstructive pulmonary disease ( COPD ) patients have been studied thoroughly , while resistance training has been rarely evaluated . This study investigated the effects of resistance training in comparison with endurance training in patients with moderate to severe COPD and peripheral muscle weakness ( isometric knee extension peak torque < 75 % predicted ) . Forty-eight patients ( age 64±8 yrs , forced expiratory volume in one second 38±17 % pred ) were r and omly assigned to resistance training ( RT , n=24 ) or endurance training ( ET , n=24 ) . The former consisted of dynamic strengthening exercises . The latter consisted of walking , cycling and arm cranking .  Respiratory and peripheral muscle force , exercise capacity , and HRQL were re-evaluated in all patients who completed the 12-week rehabilitation ( RT n=14 , ET n=16 ) . Statistically significant increases in knee extension peak torque ( RT 20±21 % , ET 42±21 % ) , maximal knee flexion force ( RT 31±39 % , ET 28±37 % ) , elbow flexion force ( RT 24±19 % , ET 33±25 % ) , 6-min walking distance ( 6MWD ) ( RT 79±74 m , ET 95±57 m ) , maximum workload ( RT 15±16 Watt , ET 14±13 Watt ) and HRQL ( RT 16±25 points , ET 16±15 points ) were observed . No significant differences in changes in HRQL and 6MWD were seen between the two treatments . Resistance training and endurance training have similar effects on peripheral muscle force , exercise capacity and health-related quality of life in chronic obstructive pulmonary disease patients with peripheral muscle weakness Women aged 67 - 84 yr were r and omly 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 sample s 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 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 r and omized 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 BACKGROUND 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 . METHODS 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 r and omly assigned to one of three training groups : isometric-only , isokinetic concentric-only , or isokinetic eccentric-only . RESULTS 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 . CONCLUSIONS 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 result ed in improved stair ascent and descent performance OBJECTIVE To examine the effect of high-intensity progressive resistance training combined with moderate weight loss on glycemic control and body composition in older patients with type 2 diabetes . RESEARCH DESIGN AND METHODS Sedentary , overweight men and women with type 2 diabetes , aged 60 - 80 years ( n = 36 ) , were r and omized to high-intensity progressive resistance training plus moderate weight loss ( RT & WL group ) or moderate weight loss plus a control program ( WL group ) . Clinical and laboratory measurements were assessed at 0 , 3 , and 6 months . RESULTS HbA(1c ) fell significantly more in RT & WL than WL at 3 months ( 0.6 + /- 0.7 vs. 0.07 + /- 0.8 % , P < 0.05 ) and 6 months ( 1.2 + /- 1.0 vs. 0.4 + /- 0.8 % , P < 0.05 ) . Similar reductions in body weight ( RT & WL 2.5 + /- 2.9 vs. WL 3.1 + /- 2.1 kg ) and fat mass ( RT & WL 2.4 + /- 2.7 vs. WL 2.7 + /- 2.5 kg ) were observed after 6 months . In contrast , lean body mass ( LBM ) increased in the RT & WL group ( 0.5 + /- 1.1 kg ) and decreased in the WL group ( 0.4 + /- 1.0 ) after 6 months ( P < 0.05 ) . There were no between-group differences for fasting glucose , insulin , serum lipids and lipoproteins , or resting blood pressure . CONCLUSIONS High-intensity progressive resistance training , in combination with moderate weight loss , was effective in improving glycemic control in older patients with type 2 diabetes . Additional benefits of improved muscular strength and LBM identify high-intensity resistance training as a feasible and effective component in the management program for older patients with type 2 diabetes Physical activity energy expenditure ( PAEE ) is a determinant of prognosis and fitness in older patients with coronary heart disease ( CHD ) .  PAEE and total energy expenditure ( TEE ) are closely related to fatness , physical function , and metabolic risk in older individuals . The goal of this study was to assess effects of resistance training on PAEE , TEE , and fitness in older women with chronic CHD and physical activity limitations ( N = 51 , mean age : 72 + 5 yr ) . The study intervention consisted of a progressive , 6-mo program of resistance training vs. a control group condition of low-intensity yoga and deep breathing . The study interventions were completed by 42 of the 51 participants . The intervention group manifested a 177 + /- 213 kcal/day ( + 9 % ) increase in TEE , pre- to posttraining , measured by the doubly labeled water technique during a nonexercise 10-day period ( P < 0.03 vs. controls ) . This was due to a 50 + /- 74 kcal/day ( 4 % ) increase in resting metabolic rate measured by indirect calorimetry ( P < 0.01 , P < 0.05 vs. controls ) and a 123 + /- 214 kcal/day ( 9 % ) increase in PAEE ( P < 0.03 , P = 0.12 vs. controls ) . Resistance training was associated with significant increases in upper and lower body strength , but no change in fat-free mass , measured by dual X-ray absorptiometry , or left ventricular function , measured by echocardiography and Doppler . Women in the control group showed no alterations in TEE or its determinants . There were no changes between groups in body composition , aerobic capacity , or measures of mental depression . These results demonstrate that resistance training of 6-mo duration leads to an increase in TEE and PAEE in older women with chronic CHD BACKGROUND Muscle size and strength decrease with aging , and the result ant muscle weakness has been implicated in increased risk of falls in older adults . These falls have large economic and functional costs . METHODS The purpose of this r and omized , controlled study was to determine if an 8-week , 3-day per week intense ( 77.8 + /- 3.4 % of 1-repetition maximum [ 1RM ] ) strength training program could improve functional ability related to the risk of falling in subjects aged 61 - -87 years ( mean 72 , SD 6.3 ) . Twelve strength-training-naive subjects performed two sets of 10 repetitions for six lower body exercises while 12 subjects served as nonintervention controls . Subjects were tested pre- , mid- , and postintervention for strength gain and on three tests of functional ability . RESULTS Postintervention strength was significantly better ( p < .017 ) in all training subjects across all exercises , and no injuries were reported as a result of either training or 1RM testing . After controlling for preintervention differences , repeated measure analysis of covariance ( ANCOVA ) found a significant difference between experimental and nonintervention control subjects for postintervention maximal walking speed [ F(1,19 ) = 5.03 , p < .05 ] . There were no significant between-group differences for 1-leg blind balance time or 5-repetition sit-to-st and performance [ F(1,19 ) = .082 ; F(1,19 ) = .068 , respectively , p > .05 ] . CONCLUSIONS These findings suggest that strength training alone does not appear to enhance st and ing balance or sit-to-st and performance in active , community-dwelling older adults but that it may improve maximal walking speed . The relationship between strength gain and risk of falls remains unclear . The data do reinforce the notion that intense strength training is a safe and effective way to increase muscle strength in this population Cycling on a mechanically braked cycle ergometer was used as a novel approach to compare the effects of three different 16-wk resistance-training programs on isometric force , power output , and selected functional abilities in 31 healthy 65- to 74-yr-old women . Training was conducted three times per week . During each session , individuals of the speed group performed 8 sets of 16 pedal revolutions at 40 % of the maximal resistance to complete two revolutions ( 2 RM ) ; strength group performed 8 sets of 8 revolutions at 80 % of 2 RM ; and combination group performed 4 sets of 16 revolutions at 40 % and 4 sets of 8 revolutions at 80 % of 2 RM . During each set , all participants were required to pedal as fast as possible with a 2-min interval between sets . All training groups significantly increased force , power , and functional abilities ( maximal treadmill walking speed , vertical jumping , and box stepping ) at week 8 ( in the range from 6.5 to 20.8 % ) with no further improvement at week 16 ( except maximal treadmill walking speed ) , but no significant differences were observed between the three groups . The novel approach to performing both low- and high-resistance training , based on the use of a cycle ergometer , has been shown to be effective in improving strength , power , and functional abilities in a group of healthy women . Even fit older women can still improve in functional abilities . Interestingly , the " high-speed " and " low-speed " programs induced an increase in both power and strength of similar magnitude BACKGROUND The beneficial role of exercise in improving bone mineral density , muscle strength and balance , has been documented predominantly in younger population s. These findings may not apply to elderly population s with limited ability to perform exercises of high intensity . OBJECTIVE To examine the effects of Tai Chi ( TC ) and resistance exercise ( RTE ) on bone mineral density ( BMD ) , muscle strength , balance and flexibility in community living elderly people . DESIGN R and omised controlled trial , using blocked r and omization with stratification by sex . SETTING A community in the New Territories Region of Hong Kong , China . SUBJECTS One hundred eighty subjects ( 90 men , 90 women ) aged 65 - 74 , were recruited through advertisements in community centres . METHODS Subjects were assigned to participate in TC , RTE three times a week , or no intervention ( C ) for 12 months . Measurements were carried out at baseline , 6 and 12 months . Analyses of covariance ( ANCOVA ) adjusted for age , and baseline values of variables that were significantly different between groups : i.e. smoking and flexibility for men ; quadriceps strength for women . RESULTS Compliance was high  ( TC 81 % , RTE 76 % ) . In women , both TC and RTE groups had less BMD loss at total hip compared with controls . No effect was observed in men . No difference in either balance , flexibility or the number of falls was observed between either intervention or controls after 12 months . CONCLUSION The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes BACKGROUND Loss of muscle power due to normal aging has greater functional impact than loss of strength alone . The present study compared two resistance training programs , one aim ed at enhancing muscle power and one at increasing muscle strength , on muscle function and functional performance in older adults . METHODS Sixty-seven healthy , independent older adults ( 65 - 84 years ) were r and omized to a high-velocity varied resistance ( HV ) , constant resistance ( ST ) , or nontraining control ( CO ) group . Participants trained twice weekly for 24 weeks using six exercises .  Dynamic and isometric muscle strength , muscle power , movement velocity , muscle endurance , and a battery of functional performance tasks were assessed . Secondary outcomes included body composition , quality of life , and balance confidence . RESULTS Muscle strength increased significantly ( p < .001 ) and similarly in the training groups compared to controls ( HV , 51.0 + /- 9.0 % ; ST , 48.3 + /- 6.8 % ; CO , 1.2 + /- 5.1 % ) . Peak muscle power also increased with training ( p < .05 ) , with no difference between training groups . The change in peak power was 50.5 + /- 4.1 % , 33.8 + /- 3.8 % , and -2.5 + /- 3.9 % in the HV , ST , and CO groups , respectively . Training also improved selected functional performance tasks in the HV and ST groups compared to controls ( p < .05 ) , and the HV group reported improved quality of life ( p = .018 ) . CONCLUSION Muscle power and muscle strength improved similarly using either resistance training protocol , and these changes were accompanied by improvements in several functional performance tasks . However , improvements in the HV group occurred with less total work performed per training session BACKGROUND 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 . METHODS The authors conducted a single-blinded , r and omized , 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 . RESULTS 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 . CONCLUSIONS 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 The present study deals with the question whether 24-week strength training alters neuromechanical properties of plantar flexors in elderly people ( 73–83 years ) . The first purpose of the present study was to evaluate the effect of strength training on musculotendinous ( MT ) stiffness of the triceps surae ( TS ) . The training was performed twice per week and mainly consisted of three series of ten repetitions of calf-rise and leg-press exercises at 75 % of the three-repetition maximum . Using quick-release movements at different levels of submaximal torques performed measurements of MT stiffness . Surface electromyograms ( EMG ) of each part of the TS and the tibialis anterior were also recorded . A stiffness index ( SI ) , defined as the slope of the angular stiffness – torque relationship ( SIMT-Torque ) , was used to quantify changes in MT stiffness . Results showed a significant decrease in SIMT-Torque by 25.2 % following training ( P<0.05 ) . The second purpose of the study was to evaluate whether neural mechanism has influences on this decrease . Therefore , an activation SI , defined as the slope of the angular stiffness – EMG relationship ( SIMT-EMG ) was used to overcome the influence of changes in agonist activity , and thus to quantify changes in MT intrinsic elastic properties . SIMT-EMG only decreased by 11.2 % following training ( P<0.05 ) . The present results underlined that MT stiffness decreases following training in elderly individuals , counterbalancing the effect of ageing . These changes seem not only to be due to peripheral but also to neural adaptations OBJECTIVE To examine the effects of an 8-week home-based resistance exercise program on balance , power , and mobility in adults with multiple sclerosis . DESIGN Experimental group design . SETTING General community . PARTICIPANTS Twenty-nine women ( age , 50.3+/-8.5 y ) and 8 men ( age , 51.1+/-7.1 y ) were stratified by disability level and age and were r and omized into exercise ( n=19 ) and control ( n=17 ) groups . INTERVENTION The exercise group had lower-extremity resistance training 3 times a week . The control group maintained current level of physical activity . Main outcome measures Primary outcome measures included balance , as measured by anteroposterior sway , mediolateral sway , and sway velocity using the AccuSway(PLUS ) force platform ; mobility as assessed with the Up and Go test ; and leg power as assessed with the Leg Extensor Power Rig . RESULTS Leg extensor power improved significantly in the exercise group ( pretest , 3.19+/-1.36 W/kg ; posttest , 3.95+/-1.23 W/kg ; P=.004 ) , although measures of balance and mobility did not change . CONCLUSIONS The home-based resistance program was well tolerated by participants and offered a practical means to improve leg extensor power in a short period of time OBJECTIVES The objective of this study is to determine if exercise increases joint symptoms in older adults with a history of arthritis or produces symptoms in older adults without such history . In addition , we examine whether joint symptoms explain the large observed variation in strength gain in older adults undergoing vigorous strength training exercise  , and report the incidence of musculoskeletal injuries upon initiation of an exercise program . DESIGN A population -based , single blinded , r and omized controlled trial with three exercise groups and one control group . SETTING A large urban health maintenance organization . PARTICIPANTS Older men and women ( N = 105 ) aged 68 to 85 , with leg strength below the 50th percentile for their age , sex , height , and weight and without neuromuscular disease or active cardiovascular disease . INTERVENTIONS Supervised exercise in 1-hour sessions , three times each week , for 24 to 26 weeks . One exercise group did strength training ( ST ) using weight machines ( n = 25 ) ; another group did endurance training ( ET ) using stationary cycles ( n = 25 ) ; and the third group did combined strength training and endurance training ( ST+ET ) ( n = 25 ) . The control group ( n = 30 ) received no intervention . MEASUREMENTS Strength was measured at the ankle , knee , hip , and elbow using an isokinetic dynamometer . Joint symptoms were rated on a 6-point scale ( 0 = none , 5 = severe ) . Arthritis severity was based on self-reported use of arthritis medication . Health status was measured with subscales of the SF-36 and Sickness Impact Profile ( SIP ) . RESULTS Joint symptoms fluctuated over time in all exercise groups , but they did not improve or worsen significantly in any group . The physical dimension of the SIP and SF-36 subscale scores , including Bodily Pain Scores , did not change over time in any group . Subjects with arthritis and joint symptoms gained as much strength with strength training as did subjects without joint symptoms . Adjustment for age , gender , baseline strength , adherence , and exercise group did not affect this finding . The rate of minor musculoskeletal injuries was 2.2 injuries per 1000 exercise hours . CONCLUSIONS Moderate intensity stationary cycle exercise and vigorous intensity strength training do not appear to produce or exacerbate joint symptoms in older adults . Joint symptoms did not explain the large variation in gains in strength in older adults participating in a st and ardized strength training exercise program .  Musculoskeletal injuries occurred relatively infrequently , and no major injuries occurred . In evaluating joint pain that occurs in older adults in well regulated exercise programs , clinicians should consider other etiologies before attributing pain to exercise per se PURPOSE The purpose of this study was to compare the effects of high-resistance ( HR ) training , 3 times.wk(-1 ) at 80 % maximum strength ( 1RM ) with 3 times.wk(-1 ) variable-resistance ( VR ) training ( once-weekly training at 80 % , 65 % , and 50 % 1RM ) in older adults . METHODS The study was a 6-month resistance training intervention conducted in the Birmingham Alabama metropolitan area , and included healthy volunteer men and women over the age of 60 . Twenty-eight subjects were assigned r and omly to two training groups . Eight volunteers served as controls . Before and after 25 wk of training , body composition was measured by densitometry ; strength by isometric tests ; and difficulty in performing daily activity tasks ( DAT ) by measuring heart rate , oxygen uptake , electromyography , and perceived exertion . In addition , 1RM strength was measured every 25 d throughout the 6 months of training . Repeated measures ANOVA and paired t-tests with Bonferroni corrections for additive alpha were used to analyze the data . RESULTS The control group did not significantly change in any study parameter . No significant change in body weight occurred for any group . However , the HR and VR groups increased fat free mass ( FFM ) similarly ( 1.8 kg and 1.9 kg , respectively ) . Both training groups increased strength significantly , without significant differences in change . No significant change in oxygen uptake occurred during DAT . However , there was a significant time effect for heart rate and perceived exertion . Greater decrease in normalized integrated electromyography during the carry task was found in the VR group over the HR and control groups . CONCLUSION Despite similar increases in strength and fat free mass , the VR group decreased difficulty of performing the carry task more than the HR group . These data suggest that larger improvements in DAT may be achieved if frequency of high-resistance training is less than 3 times.wk(-1 ) OBJECTIVES To compare high intensity strength training with weightlifting exercises or with elastic b and s. SETTING Outpatient unit of cardiac rehabilitation . TYPE : Prospect i ve r and omised clinical trial . POPULATION Inclusion of coronary patients in phase II after medical or surgical treatment of a myocardiac infa rct ion , without cardiac insufficiency ; beta-blockers were accepted . METHOD Evaluation of coronary patients at beginning and at the end of a 4 week cardiac rehabilitation program . It included progressive aerobic training according to Karvonen method for all the patients , associated with weightlifting exercises ( Koch press ) in the control group , or use of elastic b and s in the experimental group .  Cardiac rate , oxygen consumption at rest and at maximum power were the main criteria with also muscle strength of quadriceps , hamstrings , biceps brachii , latissimus dorsi and triceps brachii , body mass indexes , quality of life with SF-36 , anxiety ( stay T test ) and perceived exertion with the Borg 10-point category-ratio scale , myotendinous injuries ( Shaw scale ) . RESULTS Twenty-six coronary patients , all male from 45 to 65 years old , all receiving beta-blockers , were included , 13 in each group . Control and experimental groups were initially similar . At the end of the 4 week program , all the two groups improved significantly their strength and power and there were no differences between the two groups . Perceived exertion was lower in the group using elastic b and s and there were no myotendinous lesions . CONCLUSION Strength training with elastic b and s is a low-cost , attractive , playful technique , proposed to a group of coronary patients , which appears as effective in cardiac rehabilitation as individual weightlifting training BACKGROUND Resistance training has been introduced in cardiac rehabilitation to give more benefit than traditional training . Haemodynamic evaluation of cardiac patients to resistance training has generally consisted of continuous HR monitoring and discontinuous blood pressure measurements . DESIGN AND METHODS Blood pressure ( BP ) and heart rate ( HR ) responses to resistance training were evaluated using continuous monitoring ( Finapres ) during low ( four sets of 17 repetitions at 40 % of the one-repetition maximum strength [ 1-RM ] ) and high intensity resistance training ( four sets of 10 repetitions at 70 % of 1-RM ) on a leg extension machine in 14 patients who participated in a rehabilitation programme .  Work volume was identical in the low- and high-level resistance training . RESULTS The HR and systolic blood pressure ( SBP ) during low intensity resistance training were always larger than during high intensity ( P<0.001 ) . Peak SBP increased from set 1 to set 3 and 4 during both low and high intensity resistance training ( P<0.05 ) . Peak HR was larger in set 4 ( 95+/-11 bpm ) than in set 1 only during low intensity resistance training ( 91+/-12 bpm ) ( P<0.05 ) . One-minute recovery periods did not allow a return to baseline HR and SBP during both low and high intensity modalities . CONCLUSIONS The SBP and HR responses to resistance training are related to the duration of exercise . Sets with < or = 10 repetitions of high intensity should be preferred to longer sets with low intensity . Pauses between exercise sets should exceed 1 min . Blood pressure should be measured during the last repetitions of the exercise set BACKGROUND 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 . METHODS The study was a single-blinded , r and omized 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 r and om 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 . RESULTS 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 r and omization , control subjects had more outpatient clinic visits ( p < .06 ) and were more likely to sustain hospital costs over $ 5000 ( p < .05 ) . CONCLUSIONS 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 OBJECTIVE 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 . DESIGN R and omized 3-month clinical trial . Subjects ( n = 110 , mean age 80 ) were r and omized to 4 groups in a 2 x 2 design ( control , resistive , balance , combined resistive/balance ) . INTERVENTIONS Resistive training involved knee extension and flexion , hip abduction and extension , and plantar and dorsiflexion using simple resistive machines and s and bags . Balance training consisted of exercises to improve postural control . The control group attended 5 health-related discussion sessions . MEASUREMENTS 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 . MAIN RESULTS 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 . CONCLUSION 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 The purpose of the study was to determine whether resistance training ( RT ) or a combination of resistance and aerobic training ( CT ) result ed in the most improvement in measures of functional ability in functionally limited elders . Elderly adults who exhibited some limits in functional ability were r and omly assigned to either a CT , RT , or control ( C ) group . Both RT and CT exercised three times per week for 16 weeks . At Weeks 0 and 17 , participants completed six measures of strength and six functional tests . A 3 ( group ) x 3 ( time ) ANOVA with repeated measures on the time factor was used to analyze the results . CT and RT scored significantly better than C at Week 17 for biceps curl , elbow extension , chair st and , and time up the stairs . These findings demonstrate that RT and CT are both effective at increasing measures of strength and functional ability in elderly adults who begin exercise with functional limitations OBJECTIVE To determine how multiple risk factors for osteoporotic fractures could be modified by high-intensity strength training exercises in postmenopausal women . DESIGN R and omized controlled trial of 1-year duration . SETTING Exercise laboratory at Tufts University , Boston , Mass. POPULATION 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 . INTERVENTIONS High-intensity strength training exercises 2 days per week using five different exercises ( n = 20 ) vs untreated controls ( n = 19 ) . MAIN OUTCOME MEASURES Dual energy x-ray absorptiometry for bone status , one repetition maximum for muscle strength , 24-hour urinary creatinine for muscle mass , and backward t and em walk for dynamic balance . RESULTS 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 ) . CONCLUSIONS 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 INTRODUCTION Prior investigations in post-myocardial infa rct ion 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 r and omized trial , this study sought to prospect ively compare the effects of endurance and strength training on HRV in 45 healthy elderly females ( average age 69.9 + /- 0.9 years ) . METHODS 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 st and ard measures of HRV . INTERVENTION 15 subjects were r and omized to endurance trained ( ET ) , 15 subjects to strength training ( ST )  , and  15 subjects to no training ( NT ) for six months . RESULTS Training result ed 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 result ed in a significant increase in most time domain and all frequency domain measures of HRV . ST result ed in no significant change in HRV measures . CONCLUSION Strength training , as opposed to endurance training has no significant impact on HRV . This suggests that exercise interventions design ed 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 The purpose of this study was to determine the effects of a 12-month resistance training program , of two different intensities , on bone mineral density ( BMD ) in healthy , older women . Twenty-six Caucasian women ( aged 65 - 79 years ) completed the study . Subjects were r and omly assigned to one of three groups : high-intensity ( HI ; n = 8) , low-intensity ( LI ; n = 7 ) , and control ( CON ; n = 11 ) . The active groups performed 10 exercises , 3 days/week under supervision . Exercise intensity was maintained at 80 % of one-repetition maximum ( 1-RM ) for the HI groups , and at 40 % 1-RM for the LI group . The volume of work was maintained constant between the two groups by assigning the LI group twice as many repetitions for each exercise . Maximal muscular strength and BMD of the lumbar spine and total hip were measured at baseline and at 12 months . Strength was evaluated using the 1-RM method , and BMD was determined by dual-energy X-ray absorptiometry . Exercise session attendance was similar for the two groups ( 81.0 % HI ; 76.8 % LI ) . Muscular strength improved in the exercisers compared with the CON group ( p < or = 0.05 ) . Percentage change in lumbar spine BMD was 0.7 + /- 1.9 % , 0.5 + /- 2.4 % , and -0.1 + /- 2.3 % for the HI , LI , and CON groups , respectively . Percentage change in total hip BMD was 0.8 + /- 2.3 % ( HI ) , 1.0 + /- 1.7 % ( LI ) , and 0.9 + /- 1.3 % ( CON ) . Group differences in BMD change were not significant ( p > 0.05 ) . These findings suggest that high-intensity and low-intensity resistance training regimens effectively increase muscular strength , but not lumbar spine or total hip BMD , in healthy , older women This study assessed the effect of resistive training ( RT ) , with or without highdose chromium picolinate ( Cr-pic ) supplementation , on body composition and skeletal muscle size of older women . Seventeen sedentary women , age range 54 - 71 years , BMI 28.8 + /- 2.4 kg/m2 , were r and omly assigned ( double-blind ) to groups ( Cr-pic , n = 9 ; Placebo , n = 8) that consumed either 924 micrograms Cr/d as Cr-pic or a low-Cr placebo ( < 0.2 microgram Cr/d ) during a 12-week RT program ( 2 day/week , 3 sets.exercise-1.d-1 , 80 % of 1 repetition maximum ) . Urinary chromium excretion was 60-fold higher in the Cr-pic group , compared to the Placebo group ( p < .001 ) , during the intervention . Resistive training increased maximal strength of the muscle groups trained by 8 to 34 % ( p < .001 ) , and these responses were not influenced by Cr-pic supplementation . Percent body fat and fat-free mass were unchanged with RT in these weight-stable women , independent of Cr-pic supplementation . Type I and type II muscle fiber areas of the m. vastus lateralis were not changed over time and were not influenced by Cr-pic supplementation . These data demonstrate that high-dose Cr-pic supplementation did not increase maximal strength above that of resistive training alone in older women . Further , these data show that , under these experimental conditions , whole body composition and skeletal muscle size were not significantly changed due to resistive training and were not influenced by supplemental chromium picolinate INTRODUCTION The aim of this study was to establish the value of physical training as a treatment of reduced physical ability in frail , elderly patients living at home . MATERIAL AND METHODS 46 community-dwelling frail elderly patients ( > 74 years ) participated in a r and omised , controlled intervention study . The intervention group was transported to training , whilst the control group was not activated . All had their physical functional ability determined using SF-36 , Berg 's Balance Scale , 10 m walking test and muscle strength test . RESULTS The intervention group had a significant improvement in functional ability measured by means of Berg 's Balance Scale , walking test , muscle strength test and SF-36 ( p < 0.01 ) compared with the control group . The average cost per patient was estimated at 121 DKK per training session , equivalent to 1452 DKK for a 12-week training period . DISCUSSION The establishing of a " multi-component-training " as a treatment offer , to which general practitioners could refer their patients , would involve some costs , but savings due to reduced nursing care can be expected OBJECTIVE To examine the effects of aerobic and resistance exercise on self-efficacy beliefs in older adults with knee osteoarthritis ( OA ) and to determine whether self-efficacy and knee pain mediated the effects of the treatments on stair time performance and health perceptions . METHODS Measures of self-efficacy , knee pain , stair climbing performance , and health perceptions were collected prior to r and omization and again at an 18-month followup in older adults with knee OA who were assigned to 1 of 3 treatment conditions : aerobic exercise , resistance training , or health education control .  All analyses were conducted on the intention-to-treat principle . RESULTS Both exercise treatments increased self-efficacy for stair climbing in comparison to the health education control group . Both knee pain and self-efficacy mediated the effect of the treatments on stair climb time , whereas only knee pain mediated health perceptions . CONCLUSIONS The findings suggest that control beliefs and changes in physical symptoms such as knee pain are important outcomes in physical activity programs with patients who have OA of the knee . Moreover , these variables mediate the effects that such programs have on disability and health perceptions Exercise is known to preserve many physiological responses in the healthy elderly , yet those with physical impairments are often discouraged from exercising . The authors studied the effects of a closely supervised exercise program design ed specifically for elders with health problems and functional limitations . Tests , selected for their relevance to clinical patient management , included the Self Evaluation of Life Function question naire , treadmill performance , and tests of autonomic nervous system and neuromotor functions .  Ambulatory volunteers , aged 64 to 83 years , with noncardiac health problems , were r and omly assigned to a control group ( CG ; n = 17 ) or a 16-week exercise group ( EG ; 3 hr/wk , n = 18 ) . Nine of the control and 13 of the exercise subjects completed the study . All EG dropouts were due to illness . EG attendance averaged 87 % , and subjects trained at a heart rate ( HR ) of 103 + /- 5 beats/min ( SD ) ( 98 % of prescription HR ) . Though EG test responses showed a tendency to improve , none reached statistical significance . This result was affected by the small number completing the study and the variability inherent in such a sample . Though these impaired elderly subjects enthusiastically and safely participated with high attendance and at an exercise intensity adequate to expect benefit , measurable training effects were not demonstrated OBJECTIVE This 8 week r and omized , double blind clinical trial compared the effect of a combined home based progressive exercise program and treatment with the nonsteroidal medication oxaprozin to treatment with oxaprozin alone on pain and physical functioning in older community dwelling patients with unilateral knee osteoarthritis ( OA ) . METHODS Efficacy variables measured before and after 8 weeks included ( 1 ) pain using the Western Ontario McMaster ( WOMAC ) pain , physical disability , and stiffness subscales and a 10 point visual analog scale ( VAS ) before and after self-paced walking ( SPW ) and stepping ( SPS ) functional tasks ; ( 2 ) physical function using the time to complete a self-paced 40 m walk ( SPW ) and 20 cycles of 2 steps ( SPS ) : ( 3 ) physical activity level using the Physical Activity Scale for Elderly ( PASE ) ; ( 4 ) clinical measures of knee functioning ( range of motion ) .  One hundred seventy-nine men and women ( mean age 74 + /- 6 yrs ) with radiographic evidence of mild/moderate medial compartment OA were r and omized to either a progressive home based knee exercise program ( n = 88 ) or a control program ( n = 89 ) . All patients were given oxaprozin 1,200 mg per os daily . RESULTS We observed significant reduction from baseline in activity related pain ( VAS ) ; and improvement in SPW and SPS test time , passive range of motion , and PASE after 8 weeks in both groups . These changes were significantly greater ( p < 0.05 ) in the exercise versus sham group . CONCLUSION Addition of a progressive exercise program to nonsteroidal antiinflammatory therapy in patients with knee OA can improve measures of activity and activity related pain more than medication alone This study tested whether moderate resistance training would improve femoral bone mineral density ( BMD ) in long-term users of hormone therapy with low BMD . The study was a 2-year r and omized , controlled , trial ( RCT ) of moderate resistance training of either the lower extremity or the upper extremity . Eighty-five women participated in a 6-month observation period . The setting was center-based and home-based training . The participants were 189 women aged 59–78 years , with total femur T-scores from −0.8 to −2.8 and on hormone therapy ( HT ) for a minimum of 2 years ( mean 11.8 years ) ; 153 completed the trial .  Lower extremity training used weight belts ( mean 7.8 kg ) in step-ups and chair rises ; upper extremity training used elastic b and s and dumbbells .  Measurements were BMD and body composition [ dual-energy X-ray absorptiometry ( DXA ) ] , bone turnover markers . Total femoral BMD showed a downward trend during the observation period : 0.35%±0.18 % ( P=0.14 ) . The response to training was similar in the upper and lower groups in the primary outcomes . At 2 years , total femoral BMD increased 1.5 % ( 95 % CI 0.8%–2.2 % ) in the lower group and 1.8 % ( 95 % CI 1.1%–2.5 % ) in the upper group . Trochanter BMD increased 2.4 % ( 95 % CI 1.3%–3.5 % ) in the lower group and 2.5 % ( 95 % CI 1.4%–3.6 % ) in the upper group ( for both analyses time effect P<0.001 ) . At 1 year , a bone resorption marker ( C-telopeptide ) decreased 9 % ( P=0.04 ) . Bone formation markers , bone-specific alkaline phosphatase , decreased 5 % ( P<0.001 ) , and N-terminal type I procollagen peptide decreased 7 % ( P=0.01 ) . Body composition ( percent lean and percent body fat ) was maintained in both groups . We concluded that long-term moderate resistance training  reversed bone loss , decreased bone turnover , increased femur BMD , and maintained body composition . The similarity of response in upper and lower groups supports a systemic response rather than a site-specific response to moderate resistance training When frail older people become acutely ill , they are at increased risk of further functional deterioration and rehabilitation is needed to restore functioning . The effects of an out-patient multicomponent training program including strength training after hospitalization were studied in a r and omized controlled trial . Sixty-eight women ( mean age 83.0 + /- 3.9 years ) who were hospitalized due to an acute illness and were mobility impaired at admission were r and omized into training ( N = 34 ) and home exercise ( N = 34 ) groups . Maximal voluntary isometric strength of knee extension and hip abduction , dynamic balance , and maximal walking speed were measured before and after the 10-week training period , and 3 and 9 months after the end of the intervention . After the intervention , significant improvements were observed in the training group compared to the home exercise group in the maximal voluntary isometric knee extension strength ( 20.8 % vs. 5.1 % , P= 0.009 ) , balance scale ( + 4.4 points vs. -1.3 points , P= 0.001 ) and walking speed ( + 0.12 m s-1 vs. -0.05 m s-1 , P= 0.022 ) . Effects on knee extension and hip abduction strength , balance and walking speed were observed 3 months later , and some effects on hip abduction strength ( 9.0 % vs. -11.8 % , P= 0.004 ) and mobility were still apparent even 9 months after the intervention Abstract . This study examined the effects of 6 months of resistance exercise ( RX ) on basal and post-aerobic exercise lipid peroxidation ( LIPOX ) .  Men and women [ n=62 , mean ( SD ) age 68.4 ( 6 ) years ] were divided r and omly into either a control ( n=16 , CON ) , low-intensity training [ LEX n=24 ; 50 % one-repetition maximum ( 1RM ) , 13 repetitions/exercise ] , or high-intensity training ( HEX n=22 , 80 % 1RM , 8 repetitions/exercise ) group . Pre- and post-training , subjects performed a grade d aerobic exercise test ( GXT ) . Blood sample s were collected prior to and 10 min following each GXT . Subjects trained 3 times per week for 6 months using 12 RX machines . LIPOX was determined by measuring levels of thiobarbituric reactive acid substances ( TBARS ) and lipid hydroperoxides ( PEROX ) . RX had no effect on resting LIPOX . Post-training , post-GXT TBARS were lower in the LEX and HEX groups by 14 % and 18 % , respectively , compared to CON ( P<0.05 ) . Post-GXT PEROX levels were lower ( P<0.05 ) in LEX and HEX compared to CON [ CON 3.51 ( 0.56 ) nmol/ml , LEX 2.89 ( 0.80 ) nmol/ml , HEX 2.99 ( 0.63 ) nmol/ml ] . Serum total and non-protein ( glutathione ) thiols were higher in the LEX and HEX groups following training compared to CON ( P<0.05 ) . These data suggest that RX can ( 1 ) reduce serum LIPOX , ( 2 ) provide protection against oxidizing agents in vitro , and ( 3 ) provide a " cross-protection " against the oxidative stress generated by aerobic exercise , perhaps mediated by improvements in the thiol portion of the antioxidant defense OBJECTIVE To determine the short- and long-term effects of resistance training on muscle strength , psychological well-being , control-beliefs , cognitive speed and memory in normally active elderly people . METHODS 46 elderly people ( mean age 73.2 years ; 18 women and 28 men ) , were r and omly assigned to training and control groups ( n=23 each ) . Pre- and post-tests were administered 1 week before and 1 week after the 8-week training intervention . The training sessions , performed once a week , consisted of a 10 min warm-up phase and eight resistance exercises on machines . RESULTS There was a significant increase in maximum dynamic strength in the training group . This training effect was associated with a significant decrease in self-attentiveness , which is known to enhance psychological well-being . No significant changes could be observed in control-beliefs . Modest effects on cognitive functioning occurred with the training procedure : although there were no changes in cognitive speed , significant pre/post-changes could be shown in free recall and recognition in the experimental group . A post-test comparison between the experimental group and control group showed a weak effect for recognition but no significant differences in free recall . Significant long-term effects were found in the training group for muscular strength and memory performance ( free recall ) 1 year later . CONCLUSION An 8-week programme of resistance training lessens anxiety and self-attentiveness and improves muscle strength To evaluate the effect of aerobic and variable resistance exercise training on fractionated reaction time ( RT ) and speed of movement ( SM ) in elderly individuals , premotor time ( PMT ) , motor time ( MT ) , total RT , and SM were measured in 49 healthy , untrained men and women , 70 to 79 years of age , before and after 6 months of training . Subjects were r and omized into either a walk/jog ( n = 17 ) , a strength training ( n = 20 ) , or a control group ( n = 12 ) . Improvements in aerobic capacity were only weakly related to reduced total RT ( r = 0.30 , p less than .05 ) . Analysis of covariance revealed that there were no differences ( p greater than .05 ) among the three groups after training with respect to PMT , MT , total RT , and SM . These findings indicate that 6 months of aerobic and strength training did not induce significant changes in RT or SM in this group BACKGROUND Decreased muscle strength impedes elders ' functional performance in daily activities such as gait . The mechanisms whereby increased strength improves gait are unknown . METHODS A prospect i ve , blinded , r and omized trial of moderate intensity strength exercise was conducted and its impact was measured on functional mobility during gait in 132 functionally limited elders . Lower extremity strength was measured , including hip abductor , hip extensor , and knee extensor strength . Of the 132 subjects , 120 subjects ( mean age , 75.1 yrs ) completed 6 months of elastic b and resistance training at least 3 times a week or served as no-exercise controls . RESULTS Subjects increased their lower extremity strength in the exercise and control groups , by 17.6 % and 7.3 % ( p < .01 ) , respectively . Gait stability improved significantly more in the exercise group than in the control group ( p < .05 ) . Increases in forward gait velocity were not significantly different between groups . Peak mediolateral velocity and base of support improved in the exercise group , but not in the control group . Change in lower extremity strength correlated significantly but weakly with many of the gait variables . CONCLUSIONS Gait stability , especially mediolateral steadiness , improved in the exercise group but not in the control group . These results show that even moderate strength gains benefit gait performance in elders and thus provide a sound basis for encouraging low-intensity strength training for elders with functional limitations 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 r and omly 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 UNLABELLED The increase in blood pressure during training is a disadvantage of strength training  in the elderly . To reduce this effect it is generally recommended to apply lower levels of relative muscle strength with longer contraction duration s or higher number of repetitions ( continuous mode ( CM ) , e. g. 50 % of maximal strength , 10 to 15 repetitions without pauses ) . Alternatively , higher contraction forces could be combined with frequent periods of muscle relaxation and fewer repetitions ( intermittent mode ( IM ) , e. g. 80 % of maximal strength , 8 repetitions consisting of 1.5 s concentric contraction , 1.5 s eccentric contraction and 3 s pause ) . We compared the blood pressure effects of both approaches during leg press exercise in two age groups ( 10 subjects aged 22 to 42 y , 9 subjects aged 60 to 72 y ) .  Blood pressure was measured continuously by a non-invasive method ( FINAPRES , Ohmeda 2300 , Englewood USA ) . RESULTS 1 . The age of the subjects had no significant influence on the slopes of blood pressure increase during the different exercise modes . 2 . The frequent insertion of short ( 3 s ) periods of muscle relaxation ( IM ) decreased the blood pressure response more effectively than a reduction in contraction strength alone ( CM ) . Short muscle relaxations have an immediate , mechanical effect on blood pressure and they allow a metabolic recovery which attenuates the trend of blood pressure increase BACKGROUND Resistance exercise training was applied to patients with chronic heart failure ( CHF ) on the basis that it may partly reverse deficiencies in skeletal muscle strength and endurance , aerobic power ( VO(2peak ) ) , heart rate variability ( HRV ) , and forearm blood flow ( FBF ) that are all putative factors in the syndrome . METHODS AND RESULTS Thirty-nine CHF patients ( New York Heart Association Functional Class=2.3+/-0.5 ; left ventricular ejection fraction 28%+/-7 % ; age 65+/-11 years ; 33:6 male : female ) underwent 2 identical series of tests , 1 week apart , for strength and endurance of the knee and elbow extensors and flexors , VO(2peak ) , HRV , FBF at rest , and FBF activated by forearm exercise or limb ischemia . Patients were then r and omized to 3 months of resistance training ( EX , n=19 ) , consisting of mainly isokinetic ( hydraulic ) ergometry , interspersed with rest intervals , or continuance with usual care ( CON , n=20 ) , after which they underwent repeat endpoint testing . Combining all 4 movement patterns , strength increased for EX by 21+/-30 % ( mean+/-SD , P<.01 ) after training , whereas endurance improved 21+/-21 % ( P<.01 ) . Corresponding data for CON remained almost unchanged ( strength P<.005 , endurance P<.003 EX versus CON ) . VO(2peak ) improved in EX by 11+/-15 % ( P<.01 ) , whereas it decreased by 10+/-18 % ( P<.05 ) in CON ( P<.001 EX versus CON ) . The ratio of low-frequency to high-frequency spectral power fell after resistance training in EX by 44+/-53 % ( P<.01 ) , but was unchanged in CON ( P<.05 EX versus CON ) . FBF increased at rest by 20+/-32 % ( P<.01 ) , and when stimulated by submaximal exercise ( 24+/-32 % , P<.01 ) or limb ischemia ( 26+/-45 % , P<.01 ) in EX , but not in CON ( P<.01 EX versus CON ) . CONCLUSIONS Moderate-intensity resistance exercise training in CHF patients produced favorable changes to skeletal muscle strength and endurance , VO(2peak ) , FBF , and HRV Purpose . Despite clear evidence of physiological declines during detraining , the effects of detraining on functional performance and quality of life have not often been investigated . The purpose of this study was to investigate functional performance and quality of life measures after a training and detraining programme with community-dwelling elderly . Method . Twenty-three subjects took part in a combined programme of muscle strengthening and aerobic conditioning twice a week and were assessed at baseline , after training , and after one , two , and three months of detraining .  Functional performance was assessed by gait speed and by the rate of ascending and descending stairs , while quality of life was evaluated by the Nottingham Health Profile . Results . Repeated measures ANOVA showed that gains observed in measures of gait speed , ascending , and descending stairs returned to baseline after one , two , and three months of detraining , respectively . However , the gains in quality of life remained unchanged . Conclusions . One-month detraining was enough to show functional decline , with gait speed the most sensitive parameter to detect these changes and QL measure most resilient , beneficial factor during the detraining process . Based on these findings , it is recommended that programmes devised for elderly should not be interrupted , to maintain the acquired benefits The purpose of this study was to evaluate whether strength training is a useful addition to aerobic training in patients with chronic obstructive pulmonary disease ( COPD ) . Forty-five patients with moderate to severe COPD were r and omized to 12 wk of aerobic training alone ( AERO ) or combined with strength training ( AERO + ST ) . The AERO regimen consisted of three weekly 30-min exercise sessions on a calibrated ergocycle , and the ST regimen included three series of eight to 10 repetitions of four weight lifting exercises .  Measurements of peripheral muscle strength , thigh muscle cross-sectional area ( MCSA ) by computed tomographic scanning , maximal exercise capacity , 6-min walking distance ( 6MWD ) , and quality of life with the chronic respiratory question naire were obtained at baseline and after training . Thirty-six patients completed the program and constituted the study group . The strength of the quadriceps femoris increased significantly in both groups ( p < 0.05 ) , but the improvement was greater in the AERO + ST group ( 20 + /- 12 % versus 8 + /- 10 % [ mean + /- SD ] in the AERO group , p < 0.005 ) . The thigh MCSA and strength of the pectoralis major muscle increased in the AERO + ST group by 8 + /- 13 % and 15 + /- 9 % , respectively ( p < 0.001 ) , but not in the AERO group ( 3 + /- 6 % and 2 + /- 10 % , respectively , p > 0.05 ) . These changes were significantly different in the two study groups ( p < 0.01 ) . The increase in strength of the latissimus dorsi muscle after training was modest and of similar magnitude for both groups . The changes in peak exercise work rate , 6MWD , and quality of life were comparable in the two groups . In conclusion , the addition of strength training to aerobic training in patients with COPD is associated with significantly greater increases in muscle strength and mass , but does not provide additional improvement in exercise capacity or quality of life OBJECTIVES To determine whether exercise training added to ongoing hormone replacement therapy ( HRT ) increases bone mineral density ( BMD ) in physically frail elderly women . DESIGN Prospect i ve controlled trial . SETTING University-based research center . PARTICIPANTS Twenty-eight women on HRT , aged 75 and older with physical frailty . INTERVENTIONS Participants were assigned to 9 months of supervised ( EXER ) or home ( HOME ) exercise . The EXER program started with physical therapy and gradually incorporated resistance and endurance training . The HOME program consisted of flexibility exercises . MEASUREMENTS Changes in BMD and body composition . RESULTS There were larger increases in lumbar spine BMD in response to EXER than with HOME ( 3.5 % vs 1.5 % , P = .048 ) , with a trend for larger increases in total body BMD ( 1.5 % vs 0.2 % , P = .058 ) . There were no significant between-group differences in hip BMD . The EXER group had decreases in weight ( -2.2 + /- 0.3 kg , P = .010 ) and fat mass ( -2.7 + /- 0.4 kg , P = .018 ) and increases in muscle strength ( 9 - 30 % , P < .05 ) . CONCLUSION In physically frail elderly women on HRT  , relatively vigorous exercise training significantly increased lumbar spine BMD . The improved BMD and strength in response to exercise could reduce fracture risk in frail women already on HRT 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 Sc and inavian 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 Sc and inavian 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 This study examines and compares the effect of aerobic and resistance exercise on emotional and physical function among older persons with initially high or low depressive symptomatology . Data are from the Fitness , Arthritis and Seniors Trial , a trial among 439 persons 60 years or older with knee osteoarthritis r and omized to health education  ( control ) , resistance exercise , or aerobic exercise groups .  Depressive symptoms ( assessed by the Center for Epidemiologic Studies --Depression scale ) and physical function ( disability , walking speed , and pain ) were assessed at baseline and after 3 , 9 , and 18 months . Compared with results for the control group , aerobic exercise significantly lowered depressive symptoms over time . No such effect was observed for resistance exercise . The reduction in depressive symptoms with aerobic exercise was found both among the 98 participants with initially high depressive symptomatology and among the 340 participants with initially low depressive symptomatology and was the strongest for the most compliant persons . Aerobic and resistance exercise significantly reduced disability and pain and increased walking speed both , and to an equal extent , in persons with high depressive symptomatology and persons with low depressive symptomatology 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 b and s in 62 community-dwelling women with a mean age of 68 years . Participants were r and omly assigned to either an exercise or a control group . Pre- and postintervention assessment s 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 b and s 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 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 r and omly 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 ) 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 OBJECTIVES To evaluate weighted stair climbing exercise ( SCE ) as a means of increasing lower extremity muscle power in mobility-limited older people . DESIGN Single-blinded , r and omized controlled pilot study . SETTING Human physiology laboratory of a metropolitan university . PARTICIPANTS Forty-five community-dwelling people aged 65 and older who had baseline mobility limitations manifested by scores of 11 or lower on the Short Physical Performance Battery ( SPPB ) . INTERVENTIONS Subjects were r and omized into one of two 12-week exercise programs . The intervention group ( SCE ) ( n = 23 ) ascended and descended stairs , at a set pace , while wearing a weighted vest . The control group ( WALK ) ( n = 22 ) participated in a st and ardized walking program . MEASUREMENTS Primary and secondary outcomes included measures of muscle power and strength , submaximal aerobic capacity , and physical performance . RESULTS SCE produced 17 % improvement in double leg press peak power in comparison with WALK ( P = .013 ) and significant improvement in stair climbing power from baseline ( 12 % ) . Improvement in submaximal aerobic performance was equivalent for both groups . Although not statistically significant , effect size estimates suggest that SCE can potentially influence knee extension power and strength . Stair climb time was improved in both groups , whereas SCE produced significant improvements from baseline SPPB score in a subcohort of participants . CONCLUSIONS These findings suggest that SCE maybe a useful component of a home exercise program design ed to enhance lower extremity muscle power , aerobic capacity , and functional performance . Further investigation is needed involving larger sample sizes and direct comparisons with other forms of resistance training OBJECTIVE To determine the effects of structured exercise programs on  self-reported disability in older adults with knee osteoarthritis . SETTING AND DESIGN A r and omized , single-blind clinical trial lasting 18 months conducted at 2 academic medical centers . PARTICIPANTS A total of 439 community-dwelling adults , aged 60 years or older , with radiographically evident knee osteoarthritis , pain , and self-reported physical disability .  INTERVENTIONS An aerobic exercise program , a resistance exercise program , and a health education program . MAIN OUTCOME MEASURES 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 . RESULTS 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 . Postr and omization , participants in the aerobic exercise group had a 10 % lower adjusted mean ( + /- SE ) score on the physical disability question naire ( 1.71 + /- 0.03 vs 1.90 + /- 0.04 units ; P<.001 ) , a 12 % lower score on the knee pain question naire ( 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 question naire ( 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 . CONCLUSIONS 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 PURPOSE 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 . METHODS 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 r and omization 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 . RESULTS 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 . CONCLUSION 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 BACKGROUND Older women with coronary artery disease ( CAD ) have reduced peak aerobic power ( Vo(2)peak ) , muscle strength , and quality of life ( QOL ) . Exercise interventions that can improve Vo(2)peak and muscle strength may also result in an improvement in QOL . This study compared the effect of aerobic training ( AT ) or combined aerobic and strength training ( COMT ) on Vo(2)peak , distance walked in 6 min , upper- and lower-extremity maximal strength , and QOL in 18 women ( age range , 60 to 80 years ) with documented CAD . METHODS After baseline testing , subjects were r and omly assigned to AT ( treadmill and cycle exercise , n = 9 ) or COMT ( treadmill and cycle exercise plus upper- and lower-extremity strength training , n = 9 ) , and each group exercised 3 d/wk for 8 weeks . RESULTS Both AT and COMT result ed in a similar increase in Vo(2)peak , distance walked in 6 min , lower-extremity strength , and emotional and global QOL . COMT improved upper-extremity strength , and physical and social QOL , which was unchanged after AT . CONCLUSIONS Older women with CAD should perform aerobic and strength training to attain optimal improvements in overall physical fitness and QOL This study assessed the effects of resistive training ( RT ) with or without chromium picolinate ( Cr-pic ) supplementation on the 24-h urinary excretions of myo-inositol , D-chiro-inositol , and pinitol , as well as clinical indices of kidney and liver functions . Thirty-two nondiabetic subjects , age 62 + /- 4 y , performed RT twice weekly for 12 wk and consumed either 924 ug Cr/d as Cr-pic ( n = 17 ) or a placebo ( n = 15 ) . Whole-body strength increased in all subjects by 20 % and urinary chromium excretion increased 47-fold in the Cr-pic group . Urinary myo-inositol , D-chiro-inositol , and pinitol were not changed with RT or influenced by Cr-pic .  Serum indices of kidney and liver functions were within clinical ly normal ranges at baseline and the end of the study . These results suggest that RT did not influence the urinary excretions of inositols . High dose Cr-pic did not influence the urinary excretion of inositols and the selected indices of kidney and liver functions in conjunction with RT OBJECTIVES To compare the effectiveness of group resistance and agility-training programs in reducing fall risk in community-dwelling older women with low bone mass . DESIGN A r and omized , controlled , single-blind 25-week prospect i ve study with assessment s at baseline , midpoint , and trial completion . SETTING Community center . PARTICIPANTS Community-dwelling women aged 75 to 85 with low bone mass . INTERVENTION Participants were r and omly assigned to one of three groups : resistance training ( n=32 ) , agility training ( n=34 ) , and stretching ( sham ) exercises ( n=32 ) . The exercise classes for each study arm were held twice weekly . MEASUREMENTS The primary outcome measure was fall risk ( derived from weighted scores from tests of postural sway , reaction time , strength , proprioception , and vision ) , as measured using a Physiological Profile Assessment ( PPA ) . Secondary outcome measures were ankle dorsiflexion strength , foot reaction time , and Community Balance and Mobility Scale score . RESULTS Attendance at the exercise sessions for all three groups was excellent : resistance training ( 85.4 % ) , agility training ( 87.3 % ) , and stretching program ( 78.8 % ) . At the end of the trial , PPA fall-risk scores were reduced by 57.3 % and 47.5 % in the resistance and agility-training groups , respectively , but by only 20.2 % in the stretching group . In the resistance and agility groups , the reduction in fall risk was mediated primarily by improved postural stability , where sway was reduced by 30.6 % and 29.2 % , respectively . There were no significant differences between the groups for the secondary outcomes measures . Within the resistance-training group , reductions in sway were significantly associated with improved strength , as assessed using increased squat load used in the exercise sessions . CONCLUSION These findings support the implementation of community-based resistance and agility-training programs to reduce fall risk in older women with low bone mass . Such programs may have particular public health benefits because it has been shown that this group is at increased risk of falling and sustaining fall-related fractures BACKGROUND Depression in elderly people may be contributed to by the multiple losses of aging . Exercise has the potential to positively impact many of these losses simultaneously . We tested the hypothesis that progressive resistance training ( PRT ) would reduce depression while improving physiologic capacity , quality of life , morale , function and self-efficacy without adverse events in an older , significantly depressed population . METHODS We conducted a 10-week r and omized controlled trial of volunteers aged 60 and above with major or minor depression or dysthymia . Subjects were r and omized for 10 weeks to either a supervised PRT program three times a week or an attention-control group . RESULTS A total of 32 subjects aged 60 - 84 , mean age 71.3 + /- 1.2 yr , were r and omized and completed the study . No significant adverse events occurred . Median compliance was 95 % . PRT significantly reduced all depression measures ( Beck Depression Inventory in exercisers 21.3 + /- 1.8 to 9.8 + /- 2.4 versus controls 18.4 + /- 1.7 to 13.8 + /- 2 , p = .002 ; Hamilton Rating Scale of Depression in exercisers 12.3 + /- 0.9 to 5.3 + /- 1.3 versus controls 11.4 + /- 1.0 to 8.9 + /- 1.3 , p = .008 ) . Quality of life subscales of bodily pain ( p = .001 ) , vitality ( p = .002 ) , social functioning ( p = .008 ) , and role emotional ( p = .02 ) were all significantly improved by exercise compared to controls . Strength increased a mean of 33 % + /- 4 % in exercisers and decreased 2 % + /- 2 % in controls ( p < .0001 ) . In a multiple stepwise regression model , intensity of training was a significant independent predictor of decrease in depression scores ( r2 = .617 , p = .0002 ) . CONCLUSIONS PRT is an effective antidepressant in depressed elders , while also improving strength , morale , and quality of life OBJECTIVE To evaluate the influence of a twice-weekly progressive resistance training ( PRT ) program , without a concomitant weight loss diet , on abdominal fat and insulin sensitivity in older men with type 2 diabetes . RESEARCH DESIGN AND METHODS Nine older men ( aged 66.6 + /- 3.1 ) with type 2 diabetes participated in a 16-week PRT supervised program ( 50 - 80 % of the one repetition maximum ) , for all main muscle groups .  Basal glycemia , HbA(1c ) , diet , habitual physical activity , body composition , and upper/lower maximal strength were measured . Insulin sensitivity was determined according to Bergman 's minimal model procedure and abdominal fat was obtained by computed tomography . The measurements were taken 4 weeks before training ( -4 ) , immediately before training ( 0 ) , and at 8-week intervals ( i.e. , weeks 8 and 16 ) during the 16-week training period . RESULTS No significant variation was observed in any of the above selected parameters during the 4-week control period . After PRT , both leg and arm maximal strength increased significantly by 17.1 and 18.2 % , respectively . Visceral and subcutaneous abdominal fat decreased significantly by 10.3 % ( from 249.5 + /- 97.9 to 225.6 + /- 96.6 cm(3 ) , P < 0.01 ) and by 11.2 % ( from 356.0 + /- 127.5 to 308.6 + /- 118.8 cm(3 ) , P < 0.01 ) , respectively , while no changes were observed in body mass . PRT significantly increased insulin sensitivity by 46.3 % ( from 2.0 + /- 1.2 to 2.8 + /- 1.6 . 10(4 ) . min(-1 ) . muU(-1 ) . ml(-1 ) , P < 0.01 ) , whereas it significantly decreased ( -7.1 % , P < 0.05 ) fasting blood glucose ( from 146.6 + /- 28.3 to 135.0 + /- 29.3 mg/dl ) . Finally , a 15.5 % increase in energy intake ( from 2,287.1 + /- 354.7 to 2,619.0 + /- 472.1 kcal/day , P < 0.05 ) was observed . CONCLUSIONS Two sessions per week of PRT , without a concomitant weight loss diet , significantly improves insulin sensitivity and fasting glycemia and decreases abdominal fat in older men with type 2 diabetes We evaluated the effect of a strength-training program on the ability of persons with essential tremor  to exert steady forces with the index finger . Thirteen subjects with a diagnosis of essential tremor were assigned to three different groups : one group trained with heavy loads , one with light loads , and one did not perform any training . Subjects attempted to generate steady contractions during both postural and constant-force tasks . Steadiness was quantified by the root mean square amplitude of acceleration during postural tasks and the st and ard deviation and coefficient of variation of force during the constant-force tasks . Subjects who performed the training program with heavy loads experienced an increase in steadiness around the target force during the constant-force tasks . Subjects in the other two groups did not exhibit any changes . These findings suggest that strength training can decrease the magnitude of tremor . However , we did not observe any associated improvements in functional abilities PURPOSE This study evaluated the benefits of adding a psychological empowerment intervention ( PEI ) to traditional strength training ( TST ) on social cognitive variables in community-dwelling older adults . METHODS Thirty-eight participants were r and omly assigned to either a PEI or a TST intervention for 6 wk . Before r and om assignment and following training , participants completed measures of self-efficacy for upper and lower body strength as well as the desire to be able to lift specific amounts of weight . Both treatments involved two sessions per week of center-based training and one session per week of home-based training . The PEI condition also included a group-mediated intervention that was design ed to increase self-efficacy for physical strength and the desire for upper and lower body strength . RESULTS General linear models on difference scores revealed that the two groups experienced differential gains in the desire for upper body strength ( P = 0.023 , effect size ( ES ) = 0.79 ) and were marginally different in gains for upper body strength self-efficacy ( P = 0.065 , ES = 0.63 ) . On a four-point scale , the adjusted mean ( + /-SE ) differences for the PEI group on the desire for upper body strength was 0.71 ( + /-0.12 ) as compared to 0.27 ( + /-0.13 ) for the TST group , whereas the PEI group 's improvement in self-efficacy for upper body strength was 25.70 ( + /-3.02 ) as compared to 17.18 ( + /-3.19 ) for the TST group . CONCLUSIONS Empowerment-based exercise programs may be particularly motivating for older adults by creating a more meaningful physical activity experience for them 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 result ed 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 PURPOSE In patients with intermittent claudication ( IC ) a structured walking exercise program improves exercise performance . However , few studies have evaluated the effects of exercise training on functional status during daily activities . We hypothesized that a supervised exercise training program would improve functional status in patients with IC , with 24 weeks of training more beneficial than 12 weeks . A secondary aim was to evaluate the effects of strength training and combinations of strength and treadmill training on functional status . METHODS Twenty-nine men with disabling IC were r and omized to 12 weeks of either supervised treadmill training ( 3 hr/wk at a work intensity sufficient to produce claudication ) , strength training ( 3 hr/wk of resistive training of six muscle groups of each leg ) , or to a nonexercising control group .  Functional status was assessed by question naires characterizing walking ability ( Walking Impairment Question naire , WIQ ) , habitual physical activity level ( Physical Activity Recall , PAR ) , and physical , social , and role functioning , well-being , and overall health ( Medical Outcomes Study SF-20 , MOS ) . Patients alos had their activity levels monitored with an activity monitor ( Vitalog ) . RESULTS After 12 weeks of treadmill training  PAR scores increased by 48 metabolic equivalent hr/wk , the MOS physical functioning score by 24 percentage points , and the number of bouts of walking activity measured by the Vitalog by 4.5 bouts/hr ( all p < 0.05 ) . No changes were seen in WIQ scores . After 12 additional weeks of treadmill training improvements initially observed in the PAR , MOS , and Vitalog scores were maintained , and in addition the ability to walk distances ( WIQ ) improved by 31 percentage points , and the IC severity score had improved by 29 percentage points ( both p < 0.05 ) . After 12 weeks of strength training patients improved their WIQ walking speed , stair climbing scores , and MOS well-being scores with no other changes in functional status . Subjects in the control group did not improve functional status by any measure . Twelve weeks of treadmill training after the strength training program maintained WIQ walking speed scores , and activity level defined by Vitalog improved . Twelve weeks of combined treadmill and strength training after the control period had no effect on functional status . CONCLUSIONS A supervised treadmill training program improved functional status during daily activities , with 24 weeks more effective than 12 . In addition , treadmill training alone was more effective in improving functional status in patients with IC than strength training or combinations of the training modalities Cardiac rehabilitation programs have not consistently been shown to improve the psychological well being of their patients . In our study of 38 cardiac patients ( 29 men and 9 women ) , a variety of quality -of-life parameters were assessed before and after they completed either 12 weeks of high-intensity strength training or flexibility training added to their outpatient cardiac rehabilitation  aerobic exercise program . The strength-trained patients increased their self-efficacy scores for lifting ( 29 % vs 4 % , p < 0.05 ) , push-ups ( 65 % vs. 17 % , p < 0.01 ) , climbing ( 36 % vs 0 % , p < 0.001 ) , and jogging ( 100 % vs -9 % , p < 0.001 ) , when compared with the flexibility-trained patients . The strength group also had greater improvements in Profile of Mood States dimensions : total mood disturbance ( 123 % vs 18 % , p < 0.05 ) , depression/dejection ( 73 % vs 15 % , p < 0.05 ) , and fatigue/inertia ( 42 % vs 3 % p < 0.05 ) , than did the flexibility group . The Medical Outcome Survey Short Form 36 role emotional health domain scores were significantly improved in the strength group when compared with the flexibility group ( 64 % vs 0 % , p < 0.05 ) , and the role limitation scores improved in both groups . Increases in strength were associated with enhanced self efficacy and improved mood and well-being scores ( n = 34 , r = 0.30 to 0.53 , p < 0.05 ) . High-intensity strength training added to a cardiac rehabilitation program of selected patients leads to improvements in quality -of-life parameters . These data , in conjunction with improvements in strength , strongly support the value of adding high-intensity strength training to cardiac rehabilitation programs Background and Purpose : Isotonic strength training can result in neuromuscular improvements evidence d in other forms of muscular effort , ie , isokinetic or isometric , especially in young subjects ; however , it is unclear if older muscle maintains this same adaptive ability . Additionally , it is not known if the benefits of resistance training can be augmented by creatine and protein supplementation in older men . Therefore , the purpose of this study was to assess changes in isokinetic parameters at varying speeds in men aged 48 to 72 years ( mean = 57 ± 2.1 ) following 16 weeks of isotonic resistance training and creatine and /or protein supplementation . Methods : Forty‐two male subjects were r and omly assigned to 1 of 4 training groups : ( 1 ) resistance training placebo ( n = 10 ) , ( 2 ) resistance trained creatine supplemented ( n = 10 ) , ( 3 ) resistance trained protein supplemented ( n = 11 ) , and ( 4 ) resistance trained creatine and protein supplemented ( n = 11 ) . The program consisted of progressive overload resistance training ( 3 d/wk ) and supplement consumption following the workout . Results : There were significant time effects ( P ≤ .05 ) for peak torque ( PT ) , time to PT , and average power for both the knee extensors and flexors at all velocities . However , no significant group or group by time interactions were noted , indicating that the supplementation protocol s had no added benefits . Conclusions : Men aged 48 to 72 years maintained their ability to improve isokinetic muscle function following isotonic training , however , supplementation did not enhance muscle adaptability OBJECTIVE To evaluate the feasibility of a new functional tasks exercise program , design ed to improve functional performance of community-dwelling older women , by comparing it with a resistance exercise program . DESIGN A 12-week , r and omized , single-blind pilot study . SETTING A community leisure center . PARTICIPANTS Twenty-four community-dwelling , medically stable women ( mean age , 74.6+/-4.8 y ) were r and omized to the functional tasks exercises ( function group ) or the resistance exercises ( resistance group ) . Three participants withdrew from the study . INTERVENTIONS Exercises were given 3 times weekly for 12 weeks . The functional tasks exercise program aim ed to improve daily tasks in the domains first affected in older adults , whereas the resistance exercise program focused on strengthening the muscle groups that are important for functional performance . MAIN OUTCOME MEASURES Participant satisfaction with the exercises , Assessment of Daily Activity Performance ( ADAP ) , and , as a secondary outcome , muscle strength and power . RESULTS Exercise adherence was 81 % in the function group and 90 % in the resistance group . Participants reported greater satisfaction with the resistance exercises than with the functional exercises . The ADAP total score improved with time ( P = .001 ; mean change function group , 7.5 U ; 95 % confidence interval [ CI ] , 2.1 - 12.8 ; resistance group , 2.8 U , 95 % CI , -0.4 to 5.9 ) , as did isometric knee extensor strength ( P = .001 ; mean change function group , 6.4 % ; 95 % CI , -1.6 to 14.5 ; resistance group , 14.4 % ; 95 % CI , 6.4 - 22.2 ) . Testing for differences in outcomes between the 2 groups showed no statistically significant differences . CONCLUSIONS The functional tasks exercise program is feasible and shows promise of being more effective for functional performance than a resistance exercise program . A r and omized controlled trial with a larger sample size is needed to test the difference between the 2 programs Physical exercise is often recommended as a therapeutic tool to combat pre- and postmenopausal loss of bone density . However , the relationship between training dosage ( intensity , duration , frequency ) and the effect on bone density still is undergoing discussion . Furthermore , the exercise quantification programs are often described so inadequately that they are neither quantitatively nor qualitatively reproducible . The aim of this investigation was to determine whether a clearly defined training of muscle strength , under defined safety aspects , performed only twice weekly , can counteract bone density loss in women with postmenopausal osteopenia . Data from 16 women in the training group ( age , 63.6 + /- 6.2 yr ) and 15 women in the control group ( age , 67.4 + /-9.7 yr ) , of comparable height and weight , were evaluated .  Strength training was performed for 6 mo as continually adapted strength training , providing an intensity of about 70 % of each test person 's one repetition maximum . Bone mineral density of lumbar vertebrae 2 to 4 and the femoral neck was measured by dual-energy x-ray absorptiometry . Maximum performance in watts and parameters of hemodynamics were controlled with a bicycle ergometer test to maximal effort . In addition , metabolic data were assessed . In the lumbar spine and femoral neck , the training group showed no significant changes , whereas the control group demonstrated a significant loss of bone mineral density , especially in the femoral neck ( P<0.05 ) . The strength increase was highly significant in all exercised muscle groups , rising to about 70 % above the pretraining status ( P<0.001 ) . Heart rate and blood pressure data indicated a slight economization , metabolism was not significantly influenced . Based on these findings , we conclude that continually adapted strength training is an effective , safe , reproducible , and adaptable method of therapeutic strength training , following only two exercise sessions per week BACKGROUND Cardiovascular benefits of resistance training in cardiac patients have been suggested but not studied in a r and omized , 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 dem and ( mVO2 ) in men after coronary artery bypass surgery . METHODS Twenty-six , post-coronary bypass male subjects ( mean 19 months after bypass ) , aged 60 + /- 8.5 years , were r and omly 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 . RESULTS 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 . CONCLUSIONS 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 Objective : To examine the effects of strength training on maximal force , cross‐sectional area ( CSA ) , and electromyographic ( EMG ) activity of muscles and serum hormone concentrations in elderly females with fibromyalgia ( FM ) . Methods : Twenty‐six patients with FM were r and omly assigned to a  training ( FMT ; n = 13 ; mean age 60 years ) or a  control ( FMC ; n = 13 ; 59 years ) group . FMT performed progressive strength training twice a week for 21 weeks . The measurements included maximal isometric and concentric leg extension forces , EMG activity of the vastus lateralis and medialis , CSA of the quadriceps femoris , and serum concentrations of testosterone ( T ) , free testosterone ( FT ) , growth hormone ( GH ) , insulin‐like growth factor‐1 ( IGF‐1 ) , dehydroepi and rosterone sulfate ( DHEAS ) , and cortisol . Subjectively perceived symptoms of FM were also assessed . Results : All patients were able to complete the training . In FMT strength training led to increases of 36 % ( p<0.001 ) and 33 % ( p<0.001 ) in maximal isometric and concentric forces , respectively . The CSA increased by 5 % ( p<0.001 ) and the EMG activity in isometric action by 47 % ( p<0.001 ) and in concentric action by 57 % ( p<0.001 ) . Basal serum hormone concentrations remained unaltered during strength training . The subjective perceived symptoms showed a minor decreasing tendency ( ns ) . No statistically significant changes occurred in any of these parameters in FMC . Conclusion : Progressive strength training  increases strength , CSA , and voluntary activation of the trained muscles in elderly women with FM , while the measured basal serum hormone concentrations remain unaltered . Strength training benefits the overall physical fitness of the patients without adverse effects or any exacerbation of symptoms and should be included in the rehabilitation programmes of elderly patients with FM OBJECTIVE 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 ) . DESIGN Single blind , three arm , r and omised controlled trial . SUBJECTS 105 community living participants aged 50 years and over with clinical OA of the hip or knee . METHODS Participants were r and omised 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 assessment s ( 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 ) . RESULTS 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 . CONCLUSION Functional gains were achieved with both exercise programmes compared with the control group Objective : To evaluate the additional effect of functional exercises on balance and lower extremity function among hostel-dwelling elderly people partaking in strength , training . Design : A r and omized two-group parallel controlled trial . Setting : A senior resident ’s hostel in Switzerl and . Participants : Thirty-two individuals r and omized to either strength or strength and functional exercise groups . Interventions : Both groups received machine-driven strength training for 45 min , twice weekly , for 12 weeks . The strength and functional exercises group received an additional 30 min of functional exercise training , once weekly . Main outcome measures : Tinetti test , balance tests and a physical performance test . Assessment s were performed before and after the intervention . Results : Improvements for the balance test depended on the type of training ( significant interaction effects [ F(1,20)= 6.7 ; P = 0.018 ] ) . This test improved from 11.3 ∓ 11.7 to 17 ∓ 11.2 ( P = 0.009 ) in the combined training group ( n = 12 ) and remained from 7.3 ∓ 9.5 to 6.9 ∓ 9.2 unchanged ( P = 0.821 ) in the strength training group ( n = 13 ) . A significant difference between groups following training was observed ( P = 0.031 ) . The Tinetti balance score and the chair st and test of the physical performance assessment improved from 14.3 ∓ 1.9 to 15.3 ∓ 1.1 ( P = 0.026 ) and 1.8 ∓ 1.2 to 2.8 ∓ 1.1 ( P = 0.012 ) respectively in the combined training group only . Conclusions : Our findings suggest that twice-weekly lower extremity strength training of 12 weeks ’ duration in hostel-dwelling elderly people  only improves task-specific balance performance and lower extremity physical function when additional functional exercises are added BACKGROUND Systemic inflammation and protein-energy malnutrition may be associated with poor outcomes in kidney disease . METHODS We studied 26 adults ( age , 65 + /- 10 [ SD ] years ) with chronic kidney disease , not on dialysis therapy . Subjects were r and omly 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 . RESULTS 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 ) . CONCLUSION 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 Forty-seven elderly women ( 63 to 88 years of age , mean = 71 years ) were studied to determine the effect of a 25-week light resistance and aerobic exercise program upon arm and leg strength . Three groups were formed :  nonexercising controls  ( C , n = 12 ) , exercise ( EN , n = 18 ) and exercise with light weights on on the wrists and ankles ( EW , n = 17 ) . Exercise was performed for one hour , three times/week . Subjects were pretested and posttested for maximal isokinetic muscle strength ( angular velocity 60 degrees/sec ) for elbow flexion and extension , shoulder internal and external rotation , and knee flexion and extension . Dunn planned contrasts were used to compare C vs exercise groups combined ( EN + EW ) and EN vs EW . No significant differences were found among groups at baseline . EN + EW improved significantly ( p less than 0.05 ) more than C in elbow extension ( 17 % ) , shoulder internal rotation ( 14 % ) , shoulder external rotation ( 9 % ) , and knee flexion ( 20 % ) . No significant differences were found between EN and EW . These data indicate that elderly women can achieve substantial gains in the strength of arm and leg musculature as a result of regular light resistance and aerobic exercise , but that the use of light weights on the wrists and ankles for added resistance did not enhance this effect Krebs DE , Scarborough DM , McGibbon CA : Functional vs. strength training in disabled elderly out patients . Am J Phys Med Rehabil 2007;86:93–103 . Objective : To determine whether high-intensity functional training ( FT ) or strength training ( ST ) better enables impairment , disability , and functional gains among disabled community-dwelling elders . Design : R and omized , blinded , prospect i ve 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 st and ) or progressive resistive ST using elastic b and s with intensity , therapist contact , and home practice similar to those of FT . Results : 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 . Conclusions : 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 Aerobic exercise training is used for rehabilitation in patients with chronic obstructive pulmonary disease ( COPD ) , although it has little effect on muscle weakness and atrophy . Resistance training may be a useful addition to aerobic programs for these patients . The purpose of the present study was to investigate the effects of resistance training in addition to aerobic training on functional outcomes in patients with COPD . Seventeen COPD patients enrolled in an aerobic-based program that met twice a week were assigned to a 12-week control/aerobic [ CON : n=8 ; 63 ( 8) years ; mean ( SD ) ] or a resistance/aerobic group [ RES : n=9 ; 61 ( 7 ) years ] . RES trained an additional twice a week on 12 resistance machines , performing three sets of 8–12 repetitions at 32–64 % of their one-repetition maximum ( 1-RM ) lifts . RES ( P<0.05 ) increased upper ( 36 % ) and lower ( 36 % ) body strength , as well as lean body mass ( 5 % ) , while CON showed little to no change . The 12-min walk distance increased ( P<0.05 ) in only the RES [ 676 ( 219 ) to 875 ( 172 ) m ] . Measurements of three of the eight tasks of activities of daily living improved in RES ( P<0.05 ) compared to CON . This study demonstrated that progressive resistance training was well tolerated and improved functional outcomes in COPD patients that were currently involved in an aerobic training program BACKGROUND 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 . METHODS 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 r and omized 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 . RESULTS 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 ) . CONCLUSIONS 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 BACKGROUND Age-related decline in muscle power may be an early indicator of balance deficits and fall risk , even in nonfrail adults . This study examined the dose-dependent effect of power training on balance performance in healthy older adults . METHODS One hundred twelve community-dwelling healthy older adults ( 69 + /- 6 years ) were r and omized to 8 - 12 weeks of power training at 20 % ( LOW ) , 50 % ( MED ) , or 80 % ( HIGH ) of maximal strength , or a nontraining control ( CON ) group . Participants trained twice weekly ( five exercises ; three sets of eight rapid concentric/slow eccentric repetitions ) using pneumatic resistance machines .  Balance , muscle performance ( strength , power , endurance , contraction velocity ) , and body composition were measured . RESULTS Power training significantly improved balance performance ( p = .006 ) in participants who underwent power training compared to controls . Low intensity power training produced the greatest improvement in balance performance ( p = .048 ) . Average contraction velocity at low load ( 40 % one repetition maximum [ 1RM ] ) at baseline independently predicted improvement in balance following training ( r = -.29 , p = .004 ) . CONCLUSIONS Power training improves balance , particularly using a low load , high velocity regimen , in older adults with initial lower muscle power and slower contraction . Further studies are warranted to define the mechanisms underlying this adaptation , as well as the optimum power training intensity for a range of physiological and clinical outcomes in older adults with varying levels of health status and functional independence The purpose of this study was to determine whether a moderate to high intensity strengthening and aerobic exercise program can improve the strength , exercise capacity , gait and balance of deconditioned male nursing home residents . Ambulatory subjects who scored 30 or less on the modified Tinetti gait and balance assessment scale , who demonstrated less than 80 % of age-matched lower extremity strength on isokinetic muscle testing and who gave informed consent were enrolled . Subjects were r and omized to either an  exercise ( n = 8) or a  control ( n = 6 ) group . All participants underwent an exercise test to determine maximal oxygen uptake ( Vo2max ) and received quantitative gait and balance measurements . The subjects assigned to the exercise group then completed a 12-wk program of weight training for the lower extremities and stationary cycling . Both the exercise and control groups were then retested . Ten outcome variables were assessed : Tinetti mobility scores , Vo2max , isokinetic-tested lower extremity strength and endurance , stride length , gait velocity , stance time , gait duration , cadence and balance . The exercise group , after completion of the program , demonstrated significant improvements in Tinetti mobility scores ( P < 0.05 ) , combined right and left quadricep muscle strength ( P < 0.01 ) , right and left lower extremity muscular endurance ( P < 0.01 ) , left stride length and gait velocity ( P < 0.05 ) , although other outcome variables changed insignificantly . The control group revealed no changes of significance with the exception of improvement of the combined right and left hamstring muscle strength ( P < 0.05 ) . Nevertheless , for those outcome variables that had improved significantly in the exercise group , the changes amounted to only a 5 to 10 % increase over the baseline measurements . These findings showed that an appropriately design ed high intensity exercise program can result in significant although limited improvements for clinical mobility scores , strength , muscular endurance and certain gait parameters OBJECTIVE To compare 16 weeks of isometric versus dynamic resistance training versus a control on knee pain and functioning among patients with knee osteoarthritis ( OA ) . DESIGN R and omized clinical trial . SETTING Outpatient setting . PARTICIPANTS A total of 102 volunteer subjects with OA of the knee r and omized to isometric ( n=32 ) and dynamic ( n=35 ) resistance training groups or a control ( n=35 ) . INTERVENTIONS 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 . MAIN OUTCOME MEASURES 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 . RESULTS 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 . CONCLUSION Dynamic or isometric resistance training improves functional ability and reduces knee joint pain of patients with knee OA PURPOSE And rogen 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 . METHODS In a two-site study , 155 men with prostate cancer who were scheduled to receive and rogen deprivation therapy for at least 3 months after recruitment were r and omly 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 question naires after 12 weeks . Secondary outcomes were muscular fitness and body composition . RESULTS 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 . CONCLUSION Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving and rogen deprivation therapy .  This form of exercise can be an important component of supportive care for these patients 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 assessment s 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 st and s in 30 s , lung function ( FEV1 ) and self-reported health . Subjects were r and omized 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 result ed in significant improvements in muscle size , knee extension strength , leg extension power , functional performance and self-reported health in elderly male COPD patients 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 r and omly 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 ) × 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 × 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 × 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 . Am . J. Hum . Biol . 17:746–751 , 2005 . © 2005 Wiley‐Liss , OBJECTIVE To investigate the effects of a late-phase exercise program for patients who underwent total hip arthroplasty ( THA ) 4 to 12 months earlier . DESIGN A single-blind , r and omized controlled trial . SETTING Exercises were performed in subjects ' homes . Exercise instruction and measurements taken before and after the trial were performed in an outpatient research and treatment center . PARTICIPANTS Convenience sample of 34 adults 4 to 12 months post-THA r and omly allocated to experimental or control groups . Twenty-eight subjects completed the study . INTERVENTION An 8-week , hip-exercise intervention , during which the control group received basic isometric and active range of motion exercises ; the experimental group received strength and postural stability exercises . MAIN OUTCOME MEASURES Score on the 12-Item Hip Question naire ; fear of falling ; hip flexor , extensor , abductor , and knee extensor muscle torque ; and postural stability in single stance . RESULTS There was a statistically significant improvement in all measures of self-perceived function , muscle strength ( hip flexors , 24.4 % ; hip extensors , 47.8 % ; hip abductors , 41.2 % ; knee extensors , 23.4 % ) , and postural stability ( 36.8 % ) in the experimental group and no significant change in the control group . Neither group had statistically significant changes in fear of falling measures . CONCLUSIONS An exercise program emphasizing weight bearing and postural stability significantly improved muscle strength , postural stability , and self-perceived function in patients 4 to 12 months after THA PURPOSE To compare a weight training alone treatment ( WT ) to an innovative WT plus education treatment ( WT + ED ) about the use of strength-training gains when performing activities of daily living ( ADL ) with respect to their effects on ADL self-efficacy and performance . METHODS Twenty-three men and 41 women ( mean age = 74.4 + /- 3.7 yr ) were r and omly assigned to WT or WT + ED . Both groups performed 12 wk ( two sessions per week ) of WT targeting eight major muscle groups . WT + ED received behavioral training and associated written material s emphasizing the link between WT and ADL . WT received a placebo educational intervention . Baseline and posttest measures were collected for self-efficacy for performing eight lab-based ADL tasks and performance of the eight ADL tasks . A manipulation check compared participants ' knowledge of ADL that might be improved through WT . RESULTS The WT + ED treatment listed more ADL that could be improved with WT and had greater posttest self-efficacy for performing the ADL lab tasks than the WT treatment . Greater ADL self-efficacy did not translate into better ADL performance . CONCLUSIONS A targeted educational intervention can help older adults generalize the benefits and confidence obtained through WT to their performance of ADL . Further research is needed to determine the behavioral and psychosocial impact of enhanced ADL self-efficacy on older adults BACKGROUND Age-related declines in balance and muscle power are largely responsible for the changes in the various components of gait performance among elderly people . But these can often be remedied with strength training .  People with cognitive impairment frequently demonstrate impaired gait , putting them at increased risks for falls and serious injury . OBJECTIVES This paper reports on the effects of a six-week pilot study of moderate intensity strength training on the gait of elderly individuals with dementia who attend a day-care center . METHODS Twenty-six adults ( 23 female , three male ) , age = 79.2 + /- 6.6 years , completed the study . Each subject completed a baseline assessment of lower extremity strength and gait . Gait was evaluated using free- and fast-gait speed over a 6-meter course , the Tinetti-Gait Assessment scale , the ' Timed-Up- and -Go ' , and the Gait Assessment Rating Scale ( GARS ) . The intervention consisted of moderate-intensity progressive resistance lower extremity exercise using Therab and , for two to three sessions per week over the six weeks . Post-intervention assessment of strength and gait was repeated at the completion of the sixth week . Multiple paired t-tests were calculated for each outcome measure . RESULTS The baseline assessment of gait suggests a high degree of frailty and risk for falls in the sample . Although post-intervention scores reflected improvement on all gait measures , the only statistically significant change observed was in fast-gait time . CONCLUSION A six-week resistance training program proved to be of insufficient duration , intensity or specificity to produce significant change in gait outcome measures , with the exception of fast speed gait BACKGROUND Resistance-training intervention studies have demonstrated meaningful health benefits in older adults ; however , most have used exercises performed at specific intensities on expensive equipment , which limit their widespread applicability . We tested whether two self-paced , less expensive exercise protocol s could be effective and safe for modifying neuromotor performance and functional capacity in community-dwelling adults 65 - 95 years of age . METHODS One hundred and thirty-one subjects were r and omized to a  novel resistance training , walking , or control group .  Subjects determined their level of resistance or walking intensity ( self-paced ) on a session-by-session basis . Muscle strength , balance , reaction time , stair climbing speed , and a timed pen pickup task were measured before and after the intervention period . Exercisers met three times per week for 10 months . RESULTS Significant improvements in t and em stance and single-legged stance with eyes open times and stair climbing speed were seen in both exercise groups . In addition , resistance trainers improved their muscle strength and ability to pick up an object from the floor and reduced the number of missteps taken during t and em walking , and walkers reduced t and em walking time . Controls showed no significant improvement in any variable . CONCLUSIONS The two self-paced exercise protocol s were effective at improving neuromotor performance and functional capacity in the study sample and show promise as a safe , effective , cost-efficient , acceptable exercise model for primary and secondary prevention in the general population of community-dwelling older adults OBJECTIVES Although deficits in skeletal muscle strength , gait , balance , and oxygen uptake are potentially reversible causes of frailty , the efficacy of exercise in reversing frailty in community-dwelling older adults has not been proven . The aim of this study was to determine the effects of intensive exercise training ( ET ) on measures of physical frailty in older community-dwelling men and women . DESIGN R and omized controlled trial . SETTING Medical school research center . PARTICIPANTS One hundred fifteen sedentary men and women ( mean age + /- st and ard deviation = 83 + /- 4 ) with mild to moderate physical frailty , as defined by two of the following three criteria : Modified Physical Performance Test ( modified PPT ) score between 18 and 32 , peak oxygen uptake ( VO2 peak ) between 10 and 18 mL/kg/min , and self-report of difficulty or assistance with one basic activity of daily living ( ADL ) , or two instrumental ADLs . INTERVENTION Participants were r and omly assigned to a control group that performed a 9-month low-intensity home exercise program ( control ) or an exercise-training program ( ET ) . The control intervention primarily consisted of flexibility exercises . ET began with 3 months of flexibility , light-resistance , and balance training . During the next 3 months , resistance training was added , and , during the next 3 months , endurance training was added . MEASUREMENTS Modified PPT score , VO2 peak , performance of ADLs as measured by the Older Americans Re sources and Services instrument , and the Functional Status Question naire ( FSQ ) . RESULTS ET result ed in significantly greater improvements than home exercise in three of the four primary outcome measures . Adjusted 95 % confidence bounds on the magnitude of improvement in the ET group compared with the control group were 1.0 to 5.2 points for the modified PPT score , 0.9 to 3.6 mL/kg/min for VO2 peak , and 1.6 to 4.9 points for the FSQ score . CONCLUSIONS Our results show that intensive ET can improve measures of physical function and pre clinical disability in older adults who have impairments in physical performance and oxygen uptake and are not taking hormone replacement therapy better than a low-intensity home exercise program 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 st and ard 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 The effect of strength training for 14 weeks on patella tendon viscoelastic properties was investigated in a group of elderly individuals . Participants were assigned to training ( age [ mean + /- SD ] 73.6 + /- 3.4 years ; n = 7 ) or control ( age 66.4 + /- 1.7 years ; n = 7 ) groups .  Training was performed three times per week and consisted of two series of 10 repetitions of leg-extension and leg-press exercises at 80 % of the 5-repetition maximum .  Tendon elongation during an isometric knee-extension contraction-relaxation was measured using ultrasonography . Tendon stiffness was calculated from the gradient of the estimated force-elongation relationship and mechanical hysteresis was calculated as the area between loading-unloading curves . Knee-flexor coactivation , estimated from biceps femoris muscle electromyographic activity , was unaltered ( P > 0.05 ) after the training and control periods . No changes ( P > 0.05 ) were observed in stiffness or hysteresis after the control period . In contrast , tendon stiffness increased from 1376 + /- 811 to 2256 + /- 1476 N x mm(-1 ) ( P < 0.01 ) and hysteresis decreased from 33 + /- 5 to 24 + /- 4 % ( P < 0.05 ) , after training . These training-induced adaptations have implication s for maximal muscle force , rate of force development , and metabolic cost of locomotion 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 r and omized 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 OBJECTIVE To assess the effects of 12 months ' dynamic strength training on muscle strength and bone mineral density ( BMD ) at the lumbar spine and femoral neck in patients with early rheumatoid arthritis ( RA ) . METHODS Thirty-two subjects in the training group ( EG ) and 33 in the control group ( CG ) completed the study . EG carried out strength training 2 times a week with moderate loads of 50 - 70 % of repetition maximum . They were also encouraged to do recreational physical activities . CG performed recreational physical activities and range of motion exercises .  Maximal strength of the knee extensors , trunk extensors and flexors , and grip strength were recorded with dynamometers . BMD was measured using dual x-ray absorptiometry . Modified Disease Activity Score , erythrocyte sedimentation rate , and pain were used for the estimation of disease activity , and Stanford Health Assessment Question naire to measure functional disability . RESULTS The 12 month resistance training in EG led to statistically significant mean increases of 22 - 35 % in all muscle groups examined . CG patients were also able to increase their strength to some degree ( 3 - 24 % ) , but at the end of the study strengths in CG were significantly lower than in EG . By the end of the study lumbar spine BMD had changed by + 0.19 % ( 4.24 ) in EG and by -1.14 % ( 4.36 ) in CG . The corresponding changes of femoral BMD were + 1.10 % ( 3.71 ) and -0.03 % ( 3.58 ) . The changes in BMD were minor and statistically not significant in both groups . However , femoral BMD was found to be decreased among those patients treated periodically with oral glucocorticoids ( n = 15 , 3 subjects from EG and 12 from CG ) compared with changes in BMD among those not treated with systemic glucocorticoids ( n = 50 ) . CONCLUSION Minimally supervised strength training result ed in significant improvements in muscle strength without detrimental effects on disease activity . The detected annual changes in central BMD were minor and statistically insignificant in both groups . Special attention should be focused on those patients with RA with high disease activity and concomitant glucocorticoid treatment 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 r and omized 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 assessment s 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 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 r and omised to either a control ( n=16 ) or experimental group ( n=29 ) . The experimental subjects exercised for 24 weeks on a progressive resistance-training program design ed 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 l and ing velocity result ed 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 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 protocol s 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 protocol s of 18 weeks or less Chronic renal insufficiency , regardless of cause , generally progresses to end-stage renal disease ( 1 ) . Malnutrition and muscle wasting in chronic uremia often parallel the progression of renal failure ( 2 ) . They also contribute to excess morbidity and mortality in patients with renal disease ( 3 ) . Protein-restricted diets delay the progression of renal disease ( 4 , 5 ) and alleviate uremic symptoms ( 6 ) . Although nutritional status , as assessed by biochemical and anthropometric indicators , may be maintained during protein restriction ( 6 , 7 ) , studies have shown that deterioration of nutritional status is associated with low energy and protein intake in patients with chronic renal insufficiency ( 8) . Resistance training increases nitrogen retention ( 9 ) , protein synthesis ( 10 ) , and expression of insulin-like growth factor I in skeletal muscle ( 11 ) ; ameliorates losses of muscle mass and function ; and enhances quality of life ( 12 ) in both healthy and unwell persons . The anabolic potential of resistance training counteracts the catabolism of HIV infection ( 13 ) and myopathy secondary to corticosteroid use in cardiac transplantation ( 14 ) , the loss of lean tissue during energy restriction for obesity ( 15 ) , and the interleukin-mediated myopathy of chronic heart failure ( 16 ) . However , its utility as an adjunctive treatment off setting the catabolism of a low-protein diet in uremic patients is not known ( 17 ) . We conducted a r and omized , controlled trial to determine whether resistance training would preserve lean body mass , nutritional status , and muscle function through alterations in protein turnover ( synthesis and oxidation ) in patients with moderate chronic renal insufficiency who were consuming a low-protein diet to slow the progression of renal failure . Methods Study Design Patients older than 50 years of age with chronic renal insufficiency were r and omly assigned to a low-protein diet plus resistance training or a low-protein diet plus sham exercises ( referred to as low-protein diet alone ) . Patients were asked to follow a low-protein diet ( 0.6 g/kg of body weight per day ) for 2 to 8 weeks ( run-in period ) before r and omization . They continued the low-protein diet for an additional 12 weeks after r and omization ( intervention period ) ( Figure 1 ) . The Human Investigation Review Committee at Tufts University , Boston , Massachusetts , and collaborating hospitals approved the study , and written informed consent was obtained from all patients . Figure 1 . Flow of patients through the study . * The post office returned letters because addresses were incorrect or persons had relocated . No patients withdrew , experienced ineffective interventions , or were lost to follow-up . One patient in each group had incomplete postintervention measures because of health-related reasons . HNRCA = Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging . Study Sample Patients were recruited from the nephrology clinic at New Engl and Medical Center , Saint Elizabeth 's and Newton Wellesley Hospitals , and the Lahey Hitchcock Clinic , all in Boston , Massachusetts .  Screening procedures took place at the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging ( HNRCA ) at Tufts University . These procedures included sociodemographic and health history question naires ; physical examination ; electrocardiography ; blood hematology , chemistry , and urine analyses ; and a treadmill stress test .  Eligibility criteria included serum creatinine concentrations between 133 and 442 mol/L ( 1.5 and 5.0 mg/dL ) and physician approval to follow a low-protein diet .  A nephrologist confirmed renal diagnosis by review ing renal biochemistry results and clinical records . Exclusion criteria were myocardial infa rct ion ( within the past 6 months ) , any unstable chronic condition , dementia , alcoholism , dialysis or previous renal transplantation , current resistance training , recent involuntary weight change ( 2 kg ) , albumin level less than 30 g/L , proteinuria greater than 10 g/d , or abnormal stress test results at screening ( 18 ) . Reasons for early withdrawal from the study included loss of more than 25 % of initial body weight ; need for dialysis or transplantation ; development of any serious condition requiring hospitalization or precluding exercise ; and signs of malnutrition , such as a decrease in serum transferrin levels to less than 1.5 g/L or a 15 % decrease in hemoglobin or leukocyte count to below baseline levels . Diet Dietary intake of macronutrients and micronutrients and adherence to the low-protein diet were monitored twice per week during the run-in period and weekly during the intervention period by 3-day assisted dietary records ( including week and weekend days ) and regular meetings with the study dietitian , who was not blinded to group assignment . Dietary data were coded and analyzed by using Nutritionist-IV software ( N-Squared Computing , San Bruno , California ) . Patients collected one 24-hour urine specimen for every 3-day dietary record . Protein intake was also estimated by urea nitrogen levels ( 19 ) calculated from urine collection s and was used to assess adherence , which was defined as intake within 15 % of the prescribed low-protein intake ( 0.6 g/kg per day ) . Patients were counseled to reduce their habitual protein intake by eating food sources with less protein or by reducing portion sizes of higher-protein foods . Behavior modification strategies , including tips , recipes , food models , and self-monitoring tools for protein counts , were provided . These strategies were adapted from the Modification of Diet in Renal Disease Study ( 20 ) . Exercise Muscle strength was determined twice before r and omization and once after 12 weeks by measuring one repetition maximum ( 1 RM ) ( 21 ) using Keiser resistance training equipment ( Keiser Sports Health Equipment , Inc. , Fresno , California ) . One repetition maximum is the heaviest load that can be lifted once in good form through the full range of motion . Five machines ( chest and leg press , latissimus pull-down , knee extension , and knee flexion ) were used to include functionally large muscle groups . The better of the two baseline measurements of 1 RM was used in analyses and to set initial training loads for patients r and omly assigned to resistance training . All exercise sessions were performed at the HNRCA three times per week under the supervision of an exercise physiologist . Vital signs and body weight were recorded before each session . Patients who performed  resistance training  had monthly 1 RM testing on each machine . Workload during training was adjusted to reflect 80 % of the most recent 1 RM . In addition , patients ' workloads were progressively increased as appropriate according to the trainer 's objective perception of patients ' difficulty with workloads at each session . Patients performed three sets of eight repetitions on each machine per session , which lasted about 45 minutes ( 21 ) . Patients assigned to the  low-protein diet alone performed five to eight sham exercises ( gentle movements while st and ing , sitting , and bending ) for the upper and lower body . These were design ed not to have a physiologic impact but to provide trainer contact time similar to that of the resistance training group . Study Measures All measures were taken before ( week 0 ) and 12 weeks after r and omization . Observers were blinded to study group assignment at all times , except during assessment s of postintervention muscle strength . Main Outcome Measures Total body potassium is the best single measure of body cell mass closely linked to functional status ( 22 ) , prognosis , and survival ( 23 ) . Body cell mass ( muscle and viscera ) comprises the metabolically active tissues where protein is targeted ( 24 ) . Potassium-40 represents approximately 0.0118 % of total body potassium . Loss of total body potassium occurs in patients following low-protein diets ( 25 ) and in patients with renal disease ( 26 ) , as well as in patients with many other wasting syndromes .  Total body potassium  was determined in the body composition laboratory at HNRCA , with a coefficient of variation of 5 % ( 24 ) . Regional body composition of the area involving the mid-thigh muscle was determined by computerized tomography of the nondominant thigh . A Siemens DR3 CT Scanner ( Somatom-Siemens , Erlangen , Germany ) was used to obtain an 8-mm scan at the midpoint between the inguinal crease and the proximal pole of the patella . Images were digitized and analyzed to the nearest 0.01 cm2 , as described elsewhere ( coefficient of variation , 0.5 % to 1.5 % ) ( 21 ) . Type I and type II muscle-fiber cross-sectional areas were determined from vastus lateralis muscle biopsies of the nondominant thigh , performed with a 5-mm Bergstrom needle ( 27 ) . Sections were stained with adenosine triphosphatase ( pH , 4.3 ) to visualize type I and type II fibers . A slide preparation was made for each biopsy specimen , and 50 to 150 fibers per patient were analyzed by light microscopy ( coefficient of variation , 3 % ) ( 11 , 27 ) . Anthropometry Body weights were measured to the nearest 0.1 kg on a Toledo Weight-Plate ( Bay State Scale & Systems , Inc. , Burlington , Massachusetts ) . Height was measured once to the nearest 0.25 cm , without shoes , by using a wall-mounted stadiometer . Body mass index was determined from body weight and height as kg/m2 . Biochemical Measures All measurements were collected in the fasting state in a blinded fashion at the nutrition evaluation laboratory at HNRCA ( coefficient of variation , 5 % to 10 % ) . Urea nitrogen and creatinine concentrations in serum and urine and levels of plasma insulin-like growth factor I were determined , as described elsewhere ( 25 , 27 ) . In addition , blood cell count ; hematocrit ; and levels of serum albumin , transferrin , and prealbumin were measured monthly to evaluate nutritional status . Glomerular Filtration Rate Glomerular filtration rate was measured as the renal clearance of 125I-iothalamate ( Glofil , Cypros Pharmaceutical Corp. , Carlsbad , California ) , with a coefficient of OBJECTIVE Quadriceps weakness is a risk factor for incident knee osteoarthritis ( OA ) . We describe a r and omized controlled trial of effects of lower-extremity strength training on incidence and progression of knee OA . METHODS 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 r and omized 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 . Assessment s of isokinetic lower-extremity strength and highly st and ardized knee radiographs were obtained at baseline and 30 months . RESULTS 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 . CONCLUSION 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 OBJECTIVE To determine the effect of a low load resistance exercise training program on muscle strength , functional outcome , and cardiovascular endurance . METHODS Forty-nine patients , 37 women and 12 men between the ages of 35 - 76 yrs ( mean 60.5 yrs ) , with definite rheumatoid arthritis ( RA ) functional class II and III ( mean disease duration of 10.5 yrs ) were r and omly assigned to exercise and control groups for a 12 wk resistive muscle training program . A circuit weight bearing form of training was incorporated using light loads with high repetitions . A video tape demonstrating the exercises was given to all exercising participants to enable them to continue the program at home at least 3 times per wk with a biweekly self-report evaluation . Baseline and post-intervention evaluations included joint activity , muscle strength , endurance , functional outcome , and self-report . Cardiovascular fitness measured by treadmill time , anaerobic threshold and peak oxygen consumption ( VO2 ) in this group were assessed at baseline and 12 wks . RESULTS A significant improvement at 12 wks was noted in the exercise group for self-reported joint count ( p = 0.02 ) , number of painful joints ( p = 0.004 ) , HAQ ( p = 0.012 ) , sit-to-st and time ( p = 0.02 ) , grip strength ( p = 0.05 ) knee extension 60 degrees ( p = 0.03 ) , Arthritis Impact Measurement Scales dexterity ( p = 0.02 ) , and time to anaerobic threshold ( p = 0.03 ) . Significant improvement in the exercise group compared to the control group was noted for self-reported joint count ( p = 0.02 ) , night time pain ( p = 0.05 ) , and sit-to-st and time ( p = 0.02 ) . Increase in treadmill time was not statistically significant nor was a change in peak oxygen consumption ( VO2 ) noted . Abnormalities on initial treadmill screening were detected in 2 of 49 asymptomatic patients . They were excluded from the study and subsequent workup revealed significant coronary artery disease . CONCLUSION Low load resistive muscle training increased functional capacity as reported by patients and is a clinical ly safe form of exercise in functional class II and III RA . Screening this population for dormant coronary artery disease is recommended Megestrol acetate ( MA ) ( Bristol-Myers Squibb Co. , Princeton , NJ ) increases weight gain in AIDS and cancer patients and in age-related cachexia ; however , the weight gain is predominately fat . We determined if adding resistance exercise and /or testosterone ( T ) replacement to MA administration would result in a more favorable body composition change than MA alone . Thirty older men ( aged 67.0 + /- 5.8 ) completed this 12-wk study . All subjects received MA and were r and omly assigned to one of the following groups : placebo ( P ) injections , resistance training ( RT ) and P ( RT + P ) , weekly injections of T ( 100 mg/wk ) or , RT and T ( RT + T ) . The mean increase in body weight for all groups combined was 3.8 kg ( P < 0.0001 ) , but this increase was not different between groups . There was a significant interaction for the change in thigh muscle cross-sectional area ( P = 0.0006 ) . Thigh muscle cross-sectional area was significantly reduced from baseline by 5.20 [ 1.62 ] cm(2 ) ( P = 0.05 ) in P which was not prevented in T [ -4.44 ( 1.66 ) cm(2 ) from baseline ; P = 0.04 ] . RT prevented this decline [ + 0.61 ( 1.41 ) cm(2 ) from baseline ] . Muscle cross-sectional area increased 4.51 ( 1.69 ) cm(2 ) from baseline in RT + T ( P = 0.002 vs. P and P = 0.002 vs. T ) . Despite significant weight gain , MA appears to have an antianabolic effect on muscle size even when combined with T replacement . Resistance exercise attenuated this reduction in muscle mass and when combined with T had an anabolic effect on muscle mass This study was design ed to examine the psychological benefits of anaerobic exercise for older adults . Specifically , strength training was employed to examine the effects on mood and anxiety in a group of healthy but sedentary older women . 36 women ( mean age = 68.5 yr . ) were r and omly assigned to groups given high intensity or moderate intensity strength training or to a control group . Strength training was conducted three days a week for 12 weeks . After the training period , both high and moderate strength-training programs produced marked improvements in muscle strength and body composition compared to the control subjects . The average improvements in the high and moderate intensity strength-training groups for muscle strength were 40.5 and 35.5 % , respectively , and for percent body fat 1.52 and 2.50 % , respectively . As for psychological changes , both training groups significantly improved positive mood ( vigor ) , and the moderate intensity group significantly reduced trait anxiety compared to means of the control group . Also , both training groups showed some decrease in tension and state anxiety after the training period . These findings provide evidence for the effectiveness of anaerobic training to enhance perception of psychological well-being in older women . A moderate intensity rather than high intensity of training regimen may be more beneficial for sedentary older women to improve psychological health The study showed the effects of a 10-week resistance training program on flexibility of elderly women ( n = 11 ) between 62 and 78 years of age . The control group was composed of 8 women ( 62 to 73 years old ) who were physically inactive .  Flexibility was evaluated through the sit- and -reach test , performed both before and after the training program . After an initial evaluation , individuals started a training program , which consisted of 8 exercises for the entire body , without the performance of any flexibility exercise . The training program result ed in significant increase ( p < 0.001 ) of flexibility in elderly women ( 13 % ) . No significant differences were found in the control group . We conclude that weight training without performance stretching exercises does increase flexibility in elderly women OBJECTIVE To measure lumbar extensor strength in overweight ( OVW ) and nonoverweight ( NOVW ) elderly adults before and after resistance exercise training ( RX ) . DESIGN Descriptive , comparative study . SETTING University-based wellness center and research facility . PARTICIPANTS Eighty-four adults ( age range , 60 - 83 y ) were placed into 1 of 2 groups based on body mass index ( BMI ): control ( NOVW ; mean BMI , 22.5 kg/m(2 ) ) or OVW ( mean BMI , 29.2 kg/m(2 ) ) . Subjects were then r and omly assigned to either a resistance exercise ( RX ) or nonexercising group . INTERVENTION Six months of total body RX and isolated lumbar extension exercise . MAIN OUTCOME MEASURES Body composition , isometric lumbar extension strength , and 1-repetition maximum for each of the training exercises . RESULTS Upper-body strength increased by 18.3 % and 17.2 % for the NOVW-RX and OVW-RX groups , respectively . Lower-body strength increased by 12.7 % and 19.5 % for the NOVW-RX and OVW-RX groups , respectively . At baseline , the OVW participants had greater total lumbar extension strength ( 1067 Nm vs 714 Nm ) compared with the NOVW participants ( P<.05 ) . When expressed per kilogram of fat-free mass , there were no differences in baseline total lumbar extension strength . After RX , lumbar extension strength increased by 58 % and 34 % for the NOVW-RX and OVW-RX groups , respectively ( P<.05 ) . No changes in lumbar extension , upper- or lower-body strength were noted for the nontraining groups . CONCLUSIONS OVW subjects were found to have greater absolute and similar relative , upper-body , lower-body , and lumbar extension strength at baseline when compared with their NOVW counterparts . Also , isolated lumbar extension exercise was effective in improving lumbar extensor strength in OVW and NOVW persons 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 sample s 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 Objective : 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 . Design : R and omized controlled trial with 12-week masked outcome assessment . Setting : Teaching hospital . Participants : One hundred nutritionally at risk older adults hospitalized following a fall-related lower limb fracture . Intervention : 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 ) . Measurements : Weight change , quadriceps strength , gait speed , quality of life and health care utilization at completion of the 12-week intervention . Results : 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 . Conclusion : Frail , undernourished older adults with a fall-related lower limb fracture experience clinical ly 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 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 OBJECTIVE 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 . DESIGN Double-blind , placebo-controlled r and omized study ( testosterone ) , and additional r and omization 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 . METHODS Seventy sedentary , community dwelling men were r and omized to a 5 mg testoderm transdermal system applied daily vs placebo system , and additionally r and omized to a home-based resistance exercise program . Subjects were r and omized 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 question naire ) and body composition ( measured by dual x-ray absorptiometry scan ) . RESULTS 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 . CONCLUSIONS 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 This study determined the effects of endurance or resistance exercise training on maximal O2 consumption ( VO2max ) and the cardiovascular responses to exercise of 70- to 79-yr-old men and women . Healthy untrained subjects were r and omly assigned to a control group ( n = 12 ) or to an endurance ( n = 16 ) or resistance training group ( n = 19 ) . Training consisted of three sessions per week for 26 wk . Resistance training consisted of one set of 8 - 12 repetitions on 10 Nautilus machines . Endurance training consisted of 40 min at 50 - 70 % VO2max and at 75 - 85 % VO2max for the first and last 13 wk of training , respectively . The endurance training group increased its VO2max by 16 % during the first 13 wk of training and by a total of 22 % after 26 wk of training ; this group also increased its maximal O2 pulse , systolic blood pressure , and ventilation , and decreased its heart rate and perceived exertion during submaximal exercise . The resistance training group did not elicit significant changes in VO2max or in other maximal or submaximal cardiovascular responses despite eliciting 9 and 18 % increases in lower and upper body strength , respectively . Thus healthy men and women in their 70s can respond to prolonged endurance exercise training with adaptations similar to those of younger individuals . Resistance training in older individuals has no effect on cardiovascular responses to submaximal or maximal treadmill exercise Abstract 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 r and omly 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 · kg−1LBM ( lean body mass ) ] , chest press [ from means of 5.4 ( SEM 0.3 ) to 6.2 ( SEM 0.3 ) N · kg−1LBM ] and bilateral leg extension [ from means of 6.3 ( SEM 0.2 ) to 7.4 ( SEM 0.3 ) N · kg−1LBM ] 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 Evidence indicates that leg weakness in older adults is associated with decreased control of balance . The gender-specific implication s of strength training on control of balance in older men and women remains unknown . This study examined the initial adaptations to 12 weeks of low-volume , single-set-to-failure strength training and its effect on quadriceps strength and control of multidirectional balance in previously untrained older men ( n = 11 ) and women ( n = 11 ) 59–83 years of age .  Leg strength increased 23–30 % ( p < 0.001 ) across genders ; however , the effect on balance varied between genders . No significant changes were noted in the women , whereas 37 % ( p < 0.014 ) more sway in the medial-lateral direction was noted in the men , with no change in the anterior-posterior direction . These results demonstrate that this training protocol may not be effective for improving balance and may lead to worsening of balance in older men PURPOSE Little is known concerning the effects of resistance-exercise training ( RT ) on older adult 's intra-abdominal adipose tissue ( IAAT ) . The purpose of this study was to determine the effects of RT on fat distribution in 12 women and 14 men , aged 61 - 77 yr . METHODS Computed tomography IAAT and abdominal subcutaneous adipose tissue ( SAT ) , densitometry-determined body composition , one-repetition maximum ( 1-RM ) , and isometric strength were measured before and after 25 wk of RT . Training consisted of two sets of 10 repetitions at 65 - 80 % of 1-RM , three times each week . RESULTS There were similar increases in strength for both the men and women . Women improved 22 % and 38 % in the isometric strength test and 1-RM test , respectively , whereas the men improved 21 % and 36 % , respectively . A significant increase in fat-free mass ( FFM ) was found for both men and women . However , there was a significant gender x time interaction , which indicated that men increased FFM more than women ( 2.8 kg vs 1.0 kg , respectively ) . Similar decreases in fat mass ( FM ) were found for the men ( 1.8 kg ) and women ( 1.7 kg ) . However , women lost a significant amount of IAAT ( 131 to 116 cm2 ) , whereas the men did not ( 143 to 152 cm2 ) . Similarly , women also lost a significant amount of SAT ( 254 to 239 cm2 ) , but men did not ( 165 to 165 cm2 ) . CONCLUSION Despite similar decreases in FM after a 25-wk RT program , older women lost significant amounts of IAAT and SAT , whereas the older men did not A r and omized , controlled , single-blinded 25-wk prospect i ve study was conducted to compare the effects of group-based resistance and agility training on bone , as measured by both dual-energy X-ray absorptiometry ( DXA ) and peripheral quantitative computed tomography ( pQCT ) , in older women with low bone mass . Ninety-eight community-dwelling women aged 75 - 85 yr were r and omized to one of three experimental groups : resistance training ( n = 32 ) , agility training ( n = 34 ) , or stretching ( sham exercise ) ( n = 32 ) . Total hip , femoral neck , and trochanteric bone mineral density ( BMD ) were measured by DXA . Peripheral QCT measurements were performed at the tibia and radius . The pQCT outcome measures at the shaft regions were cortical bone content , cortical bone cross-sectional area , cortical bone density , and density-weighted polar section modulus ( SSI ) . The pQCT outcome measures at the distal sites were total bone content , total bone cross-sectional area , and total bone density . At trial completion , the agility training group significantly increased cortical bone density by 0.5 + /- 0.2 % ( SE ) at the tibial shaft compared with a 0.4 + /- 0.3 % loss in the stretching group . The resistance training group significantly increased cortical bone density ( 1.4 + /- 0.6 % ) at the radial shaft compared , with a 0.4 + /- 0.5 % loss in the agility training group . No significant between-group differences were observed in the other bone outcome measures ( by DXA or pQCT ) . Future research is needed to determine the mechanism(s ) responsible for the observed adaptation of the cortical bone to mechanical loading OBJECTIVE Risk of falling increases as people age , and decreased leg strength and poor balance have been implicated as contributors . Our aims were to:1 ) assess the efficacy of a fall-prevention exercise program on balance and leg strength in women aged 65 to 89 years and 2 ) conduct a 1-year follow-up to determine the effect of exercise on fall rates . METHODS Forty women were classified by falling history and fear of falling and assigned to exercise and control groups using stratified r and omization . We used the Berg Balance Scale , Get-up and Go , Functional Reach , and Wall-Sit Tests to evaluate changes in balance and leg strength before and after a supervised 15-week exercise program ( 31-hr sessions/week ) . We conducted 1-year follow-up telephone interviews and compared the number of falls reported by exercise and control groups . The study used a 2 x 2 ( exercise/control by pretest/post-test ) factorial design with the testing times being a repeated factor , so we used analysis of variance ( ANOVA ) to evaluate differences between the 2 groups across testing times . Power analysis computed a priori with STPLAN software ( Version 4.2 ) showed that a sample size of 40 was necessary to determine statistical differences in balance and leg strength . RESULTS Exercise subjects showed significant improvement on 5 of 14 items ( 5.2 % , p < or = 05 to 34.4 % , p < or = .01 ) in the Berg Balance Scale and on the total score ( 6.8 % , p < or = .05 ) . Leg strength increased significantly ( p < or = .05 ) on post-test as measured by the Wall-Sit Test . Control subjects reported 6 falls and exercise subjects no falls during the follow-up year , but this difference was not significant using Fischer 's exact test ( p=.106 ) . CONCLUSION The exercise program result ed in increased balance and leg strength , but did not result in a significant difference in falls during the follow-up period . Further research with a larger and possibly older sample is needed to more adequately investigate this question . Health care providers who work with older women should provide exercise programs in which balance and leg strength are emphasized OBJECTIVES To determine whether a functional-task exercise program and a resistance exercise program have different effects on the ability of community-living older people to perform daily tasks . DESIGN A r and omized , controlled , single-blind trial . SETTING Community leisure center in Utrecht , the Netherl and s. PARTICIPANTS Ninety-eight healthy women aged 70 and older were r and omly assigned to the functional-task exercise program ( function group , n=33 ) , a resistance exercise program ( resistance group , n=34 ) , or a control group ( n=31 ) . Participants attended exercise classes three times a week for 12 weeks . MEASUREMENTS Functional task performance ( Assessment of Daily Activity Performance ( ADAP ) ) , isometric knee extensor strength ( IKES ) , h and grip strength , isometric elbow flexor strength ( IEFS ) , and leg extension power were measured at baseline , at the end of training ( at 3 months ) , and 6 months after the end of training ( at 9 months ) . RESULTS The ADAP total score of the function group ( mean change 6.8 , 95 % confidence interval (CI)=5.2 - 8.4 ) increased significantly more than that of the resistance group ( 3.2 , 95 % CI=1.3 - 5.0 ; P=.007 ) or the control group ( 0.3 , 95 % CI=-1.3 - 1.9 ; P<.001 ) . Moreover , the ADAP total score of the resistance group did not change significantly compared with that of the control group . In contrast , IKES and IEFS increased significantly in the resistance group ( 12.5 % , 95 % CI=3.8 - 21.3 and 8.6 % , 95 % CI=3.1 - 14.1 , respectively ) compared with the function group ( -2.1 % , 95 % CI=-5.4 - 1.3 ; P=.003 and 0.3 % , 95 % CI=-3.6 - 4.2 ; P=.03 , respectively ) and the control group ( -2.7 % , 95 % CI=-8.6 - 3.2 , P=.003 and 0.6 % , 95 % CI=-3.4 - 4.6 ; P=.04 , respectively ) . Six months after the end of training , the increase in ADAP scores was sustained in the function group ( P=.002 ) . CONCLUSION Functional-task exercises are more effective than resistance exercises at improving functional task performance in healthy elderly women and may have an important role in helping them maintain an independent lifestyle Sixty-two older adults ( 68.4+/-6 years ) were r and omized into a control group ( n=16 ) , low-intensity exercise group ( n=22 , LEX ; 50 % 1-repetition maximum ; 13 repetitions per exercise ) , or a high-intensity exercise group ( n=24 , HEX ; 80 % 1-repetition maximum ; eight repetitions per exercise ) group . Subjects trained for 24 weeks , performing 1 set for each of 13 exercises . Subjects performed a grade d exercise test ( GXT ) at baseline and after 24 weeks of strength training .  Heart rate , systolic , and diastolic blood pressures were measured at rest , during the GXT and 1 , 3 , and 5-min post-GXT . Mean arterial pressure was also calculated . Post-training , time to peak systolic and diastolic blood pressures and heart rate was increased in the LEX and HEX groups by 22.9 % and 44.5 % , respectively ( p<0.05 ) . Diastolic blood pressure , heart rate , and mean arterial pressure during the GXT were significantly decreased ( p<0.05 ) in the HEX group following training . Post-GXT heart rate was lower in the HEX and LEX groups compared to control ( p<0.05 ) indicating a more rapid recovery . Resistance exercise prolongs the onset of peak cardiovascular responses , decreases the cardiovascular response to exertion , and improves recovery from maximal exertion Increased gait instability is common in older adults , even in the absence of overt disease . The goal of the present study was to quantitatively investigate the factors that contribute to gait instability and its potential reversibility in functionally impaired older adults . We studied 67 older men and women with functional impairment before and after they participated in a r and omized placebo-controlled , 6-mo multimodal exercise trial .  We found that 1 ) gait instability is multifactorial ; 2 ) stride time variability is strongly associated with functional status and performance-based measures of function that have previously been shown to predict significant clinical outcomes such as morbidity and nursing home admission ; 3 ) neuropsychological status and health-related quality of life play important , independent roles in gait instability ; and 4 ) improvement in physiological capacity is associated with reduced gait instability . Although the etiology of gait instability in older persons with mild-moderate functional impairment is multifactorial , interventions design ed to reduce gait instability may be effective in bringing about a more consistent and more stable walking pattern BACKGROUND Although health-related benefits of fitness training in older men are well established , it is not clear yet which mode and intensity of a exercise program is most effective . This study addresses whether the combination of endurance ( ED ) and resistance training in older men have supplementary health-related benefits in addition to profits attained through endurance training alone . Additionally , effects of moderate- and low-intensity resistance training are compared . METHODS Men , 55 - 75 years of age , were r and omly assigned to a  control group ( N = 13 ) or one of three exercise groups ( 20 weeks , two to three times per week ) : endurance plus moderate resistance ( MR ) training ( N = 22 ) , endurance plus low resistance ( LR ) training ( N = 22 ) and endurance training only ( N = 22 ) . Cardiovascular ( CV ) risk factors , muscular fitness and postural control were assessed before and after training . RESULTS All exercise groups revealed significant ( P < 0.05 ) improvements in resting heart rate , work capacity and recovery , waist girth , insulin response and knee-extensor strength with no differences among groups . Body composition , resting metabolic rate ( RMR ) , VO2peak and postural control did not change in exercise groups . CONCLUSION In older men , a fitness program consisting of 20 weeks endurance training combined with resistance training is equally effective as endurance training alone . Moderate vs. low resistance training added to endurance training yields similar health-related benefits Abstract The effects of 12 weeks of a low-intensity general conditioning programme on maximal instantaneous peak power ( W˙peak ) and maximal oxygen uptake ( V˙O2max ) were examined in 20 elderly women . After medical , familiarisation , and ethical procedures , the subjects were r and omly divided into either a training and or a control group . The training group [ n = 11 ; mean ( SD ) age 63.0 ( 3.1 ) years ] agreed to take part in a 12-week training programme at an exercise intensity kept under 60 % of the heart rate reserve for about 60 min , 3 times a week . The control group [ n = 9 ; mean ( SD ) age 63.5 ( 3.3 ) years ]  did not perform any particular physical training . Before and after the training period , all participants underwent  anthropometric measures  and a  maximal cycling test  to exhaustion to measure their V˙O2max . In addition , W˙peak was determined 1 week later by the subjects performing a vertical jump from a squatting position on a force platform . Following training , neither the anthropometric characteristics nor the V˙O2max changed in either of the groups . In contrast , W˙peak increased significantly ( P < 0.001 ) in the training group , but did not change in the control group . This result could be interpreted as the result of an improved level of neuromuscular activation . Furthermore , it shows that although muscle power declines with age at a faster rate than does aerobic power , its sensitivity to training seems to be higher than that of the aerobic system BACKGROUND 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 . METHODS The purpose s 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 r and omly 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 . RESULTS 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 . CONCLUSIONS Power training was more effective than strength training for improving physical function in community-dwelling older adults OBJECTIVE To evaluate the effectiveness of 2 rehabilitative approaches for improving paretic limb reaching by chronic stroke subjects . DESIGN Pre- and posttest reaching to targets ipsilateral , midline , and contralateral to the impaired side . SETTING Training in subjects ' homes ; testing in a laboratory setting . PARTICIPANTS Twelve poststroke volunteers were matched using the Motor Assessment Scale ( MAS ) and then were r and omly assigned to 1 of 2 training conditions . Subjects were subsequently categorized as at a high or low functional level , using the reaching pretest movement time scores . INTERVENTIONS Training ( trunk unrestrained ) using the paretic limb was 4 weeks ( 12 sessions ) . Task-related training ( TRT ) involved reaching to objects placed across the workspace . Progressive resistive exercise ( PRE ) involved whole-arm pulling against resistive therapeutic tubing in planes and distances similar to that in TRT . Main outcome measures Kinematic analysis of arm trajectory and trunk motion using the Peak Performance System , as well as scores on the MAS and the Rivermead Motor Assessment ( RMA ) . RESULTS For low-level groups , TRT result ed in increased substitutive trunk use at the target ipsilateral to the moving arm , and for midline and contralateral targets after PRE . Only low-level , TRT subjects straightened h and paths , which suggested better coordination of elbow-shoulder motion , and improved on the RMA . High-level subjects decreased trunk use at ipsilateral target after PRE , which was not observed after TRT . No significant differences between training conditions were found for other kinematic variables . CONCLUSIONS Training benefits appear to depend on initial level of functioning . Although compensatory trunk use was evident , low-level subjects seemed to benefit most from TRT . High-level subjects , whose kinematics showed fairly normal movement organization , demonstrated less compensatory movement after PRE OBJECTIVES To determine whether variation in resistance exercise volume affects muscle function and physical performance response in older adults . DESIGN A r and omized trial with subjects assigned to a single-set ( 1-SET ) or three-set ( 3-SET ) exercise group . SETTING An exercise facility at the University of Queensl and . PARTICIPANTS Twenty-eight community-dwelling men and women aged 65 to 78 . INTERVENTION 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 . MEASUREMENTS 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 st and ing , and stair climbing ability . In addition , body composition was determined using dual energy x-ray absorptiometry . RESULTS 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 . CONCLUSION 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 design ing time-efficient exercise regimens to enhance neuromuscular function in older adults Knee extension strength , walking speed , quadriceps muscle mass and composition of the muscle compartment were studied in 66 to 85-year-old female athletes and controls .  Maximal voluntary knee extension force , force/body mass , extension torque , torque/body mass and walking speed were higher for the athletes than the controls . A muscle index indicating intramuscular fat and connective tissue measured using ultrasonography was lower for the athletes than the controls . There were no differences between the study groups in knee extension force related either to cross-sectional area ( CSA ) or lean tissue area ( CSAL ) of the quadriceps . Within the subgroups , there was no significant correlation between knee extension torque and CSA or CSAL of the same muscle . In the athletes high knee extension torque/body mass was related to a low muscle index and high walking speed to a low relative proportion of fat in the muscle . The muscle index was lower the more kilometers trained during the preceding year . In the controls high knee extension torque/body mass and high walking speed were related to a low relative proportion of fat . Knee extension torque and walking speed were higher the more kilometers walked during the preceding year . The results indicate that elderly female athletes have superior muscle performance compared to their age-peers . Performance in a maximal isometric strength test in elderly women is not clearly related to muscle mass . However , to some extent it is related to the composition of the same muscle , especially the degree to which fat is infiltrated into the muscle Objective : To determine whether systematic progressive high-intensity quadriceps training increases leg extensor power and reduces disability in patients rehabilitating after proximal femoral fracture . Design : Open parallel group r and omized controlled trial comparing the addition of six weeks quadriceps training ( 40 patients ) with st and ard physiotherapy alone ( 40 patients ) . The training group exercised twice weekly , with six sets of 12 repetitions of knee extension ( both legs ) , progressing up to 80 % of their one-repetition maximum . Setting : Orthogeriatric unit , and community follow-up . Subjects : Eighty patients rehabilitating after proximal femoral fracture . Main outcome measures : Measurements of leg extensor power ( Nottingham Power Rig ) , functional mobility ( elderly mobility score ) , disability ( Barthel Index ) and quality of life ( Nottingham Health Profile ) were made at baseline , after six weeks ( at the end of the intervention ) and at 16 weeks . Results : Leg extensor power increased significantly in the quadriceps training group ( fractured leg mean improvement at six weeks 157 % ( st and ard error 16 ) , nonfractured leg 80 % ( 12 ) ) compared with the control group ( 63 % ( 11 ) and 26 % ( 8) respectively , unpaired Student 's t-test p = 0.007 and p = 0.01 for between-group comparisons ) . Significant benefits were maintained at 16 weeks . Quadriceps training result ed in a greater increase in elderly mobility scale score compared with st and ard rehabilitation ( between-group difference of 2.5 ( 95 % CI 1.1,3.8 ) at week 6 and 1.9 ( 0.4,3.4 ) at week 16 ) . Barthel score increased significantly from week 0 to 6 in the quadriceps training group compared with controls ( Mann – Whitney U-test p = 0.05 ) . Patients in the quadriceps training group scored significantly better in the energy subscore of the Nottingham Health Profile at the end of follow-up ( Mann – Whitney U-test p = 0.0185 ) . Conclusions : Progressive high-intensity quadriceps training in elderly proximal femoral fracture patients increased leg extensor power and reduced disability . This was accompanied by an increase in energy as measured by the Nottingham Health Profile . This intervention may provide a simple practical way of improving outcome in these patients OBJECTIVE 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 . DESIGN This study was design ed as a stratified , r and omized , non-blinded trial . Subjects were stratified into rank-ordered pairs by level of physical activity according to the Blair Seven-Day Recall , then r and omly assigned into either a weight-training ( WT , n = 18 ) or control ( CON , n = 18 ) group . PARTICIPANTS AND SETTING 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 . RESULTS 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 . CONCLUSIONS 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 Patients with heart failure ( HF ) often have profound activity limitations and diminished quality of life ( QOL ) due to symptoms of dyspnea and fatigue . Although recent studies demonstrate positive physiologic and psychological benefits of low to moderate intensity , supervised , aerobic exercise training performed 3 to 5 days/ week for 20 to 40 minutes ' duration , in a monitored setting , the efficacy of a home-based exercise program combining endurance and resistance exercise on symptoms and QOL , are unknown . This r and omized controlled study examined the efficacy , safety , and adherence rates of a 3-month home-based combined walking and resistance exercise program on symptoms and QOL in 40 women and men aged 30 to 76 years with New York Heart Association class II to III HF . Baseline and 3-month evaluations consisted of a chronic HF question naire to assess symptoms and QOL and exercise capacity by symptom-limited treadmill exercise test with respiratory gas analysis . The exercise intervention improved fatigue ( p = 0.02 ) , emotional function ( p = 0.01 ) , and mastery ( p = 0.04 ) . Overall exercise adherence was excellent ( 90 % ) and there were no reported adverse events . A moderate intensity home-based combined walking and resistance program for patients with class II to III HF is safe and effective in reducing symptoms and improving QOL PURPOSE We present final outcomes from the multiple-component Fit and Strong ! intervention for older adults with lower extremity osteoarthritis . DESIGN AND METHODS A r and omized controlled trial compared the effects of this exercise and behavior-change program followed by home-based reinforcement  ( n=115 ) with a wait list control  ( n=100 ) at 2 , 6 , and 12 months . Fit and Strong ! combined flexibility , aerobic walking , and resistance training with education and group problem solving to enhance self-efficacy for exercise and maintenance of physical activity . All participants developed individualized plans for long-term maintenance . RESULTS Relative to controls , treatment participants experienced statistically significant improvements in self-efficacy for exercise  ( p=.001 ) , minutes of exercise per week ( p=.000 ) , and lower extremity stiffness ( p=.018 ) at 2 months . These benefits were maintained at 6 months and were accompanied by increased self-efficacy for adherence to exercise over time ( p=.001 ) , reduced pain ( p=.040 ) , and a marginally significant increase in self-efficacy for arthritis pain management ( p=.052 ) . Despite a substantially smaller sample size at 12 months , significant treatment-group effects were maintained on self-efficacy for exercise ( p=.006 ) and minutes of exercise per week ( p=.001 ) , accompanied by marginally significant reductions in lower extremity stiffness ( p=.056 ) and pain ( p=.066 ) . No adverse health effects were seen . Effect sizes for self-efficacy for exercise and for maintenance of physical activity were 0.798 and 0.713 , and 0.905 and 0.669 , respectively , in the treatment group at 6 and 12 months . IMPLICATION S This consistent pattern of benefits indicates that this low-cost intervention is efficacious for older adults with lower extremity osteoarthritis The authors previously found that creatine ( Cr ) combined with 12 weeks of resistance training enhanced muscle strength and endurance and lean tissue mass ( LTM ) in older men . Their purpose in this study was to assess these variables with cessation of Cr combined with 12 weeks of reduced training ( 33 % lower volume ) in a subgroup of these men ( n = 8 , 73 years old ) compared with 5 men ( 69 years old ) who did not receive Cr .  Strength ( 1-repetition maximum [ 1-RM ] ) , endurance ( maximum number of repetitions over 3 sets at 70 - 80 % 1-RM ) , and LTM ( dual-energy X-ray absorptiometry ) were assessed before and after 12 weeks of Cr cessation combined with reduced-volume training . No changes in strength or LTM occurred . Muscle endurance was significantly reduced ( 7 - 21 % ; p < .05 ) , with the rate of change similar between groups . Withdrawal from Cr had no effect on the rate of strength , endurance , and loss of lean tissue mass with 12 weeks of reduced-volume training OBJECTIVE To examine the effect of 6 months of high- or low-intensity resistance exercise on aerobic capacity and treadmill time to exhaustion in adults aged 60 to 83 years . METHODS Sixty-two men and women completed the study protocol . Subjects were matched for strength and r and omly assigned to a control ( n = 16 ) , low-intensity exercise ( LEX , n = 24 ) , or high-intensity exercise ( HEX , n = 22 ) group . 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 per week for 24 weeks . One set each of 12 exercises was performed . Strength was measured for the leg press , chest press , leg curl , leg extension ,  overhead press , biceps curl , seated row , and triceps dip . Muscular endurance was measured for the leg press and chest press . Aerobic capacity ( peak oxygen consumption [ VO(2)peak ] ) was measured during an incremental treadmill test ( Naughton ) . Treadmill time to exhaustion was measured as the time to exhaustion during the incremental exercise test . RESULTS The 1-RM significantly increased ( P < or = .05 ) for all exercises tested for both the HEX and LEX groups . Aerobic capacity increased ( P < or = .05 ) by 23.5 % ( 20.2 to 24.7 mL x kg(-1 ) x min(-1 ) ) and by 20.1 % ( 20.9 to 24.4 mL x kg(-1 ) x min(-1 ) ) for the LEX and HEX groups , respectively . Treadmill time increased ( P < or = .05 ) by 26.4 % and 23.3 % for the LEX and HEX groups , respectively . CONCLUSIONS Significant improvements in aerobic capacity and treadmill time to exhaustion can be obtained in older adults as a consequence of either high- or low-intensity resistance exercise . These findings suggest that increased strength , as a consequence of resistance exercise training , may allow older adults to reach and /or improve their aerobic capacity The quadriceps strength of a group of residents homes for the elderly ( mean age 83 years ) was assessed in a r and omized controlled trial of seated group exercise versus group reminiscence therapy .  Fifty-five of 65 volunteers completed the 6-month study , with 4 dropouts from the exercise group , and 6 dropouts from the reminiscence group . There were no adverse effects . Average of attendance at the exercise sessions was 72 % ( range , 18 % to 98 % ) and 62 % ( range , 29 % to 100 % ) at the reminiscence sessions . The reminiscence sessions comprised group interaction and discussion prompted by the use of reminiscence aids . By the end of the study , the change observed in the exercise group was significantly different from the reminiscence group in terms of quadriceps strength ( p < 0.01 , Mann-Whitney U test ) . Both groups improved equally in their ability to climb up steps , but neither cognitive function ( Mini-Mental State Examination ) nor reaction time altered significantly BACKGROUND Age-related loss in physiologic capacities contributes to the decline in physical function in the elderly population . Despite the beneficial effects of exercise interventions on maximal physiologic capacity measures , the functional benefits have not been shown in independently living older adults . The objective of this study was to evaluate exercise in independent older adults for significant and meaningful improvements in physical function , not detected by commonly used measures of physical function . METHODS In a r and omized controlled study , 49 independently living men and women were assigned to either a nonexercise control group ( Control ; n = 26 ) or an exercise training group ( Exercise ; n = 23 ) . Participants ( age = 76+/-4 ) in good general health were recruited from retirement communities or apartments . The combined endurance and strength training was performed at 75 % to 80 % intensity ; the groups met 3 times/week for 6 months of supervised sessions . Outcome measures included physical capacity , health status , and physical function using a newly developed performance test -- the Continuous Scale-Physical Functional Performance test ( CS-PFP ) . RESULTS Compared to the Control group , the Exercise group showed significant increases in maximal oxygen consumption ( 11 % ) and muscle strength ( 33 % ) . No significant differences were found between groups for changes in the Sickness Impact Profile , SF-36 scales , or the 6-minute walk . However , the CS-PFP score improved significantly in the Exercise group ( 14 % , effect size 0.80 ) . CONCLUSIONS Independent older adults gain meaningful functional benefits from several months of exercise training . The public health importance of physical activity may relate not just to its role in preventing decline , but also to its role in enhancing physical function Thirty-nine healthy women ( 59.5 + /- 0.9 yr ) were r and omized to either a control group ( CON ) or a progressive resistance training group ( PRT ) that trained twice weekly for 12 months . PRT trained at 80 % or more ( average of 84 % ) of their most recent one repetition maximum ( 1RM ) on the lateral pull-down ( LPD ) , knee extensor ( KE ) , and double leg press ( DLP ) apparatus . One RM was measured for each exercise once monthly in PRT and at baseline , mid study , and end of study in CON . One RM significantly increased in PRT for all muscle groups trained compared to CON ( P < 0.0001 ) . Increases of 73.7 + /- 12 % , 35.1 + /- 3 % , and 77.0 + /- 5 % , respectively , for KE , DLP , and LPD in PRT and 12.7 % + /- 8 % , 3.7 % + /- 3 % , and 18.4 % + /- 4 % , respectively , in CON were observed . Approximately 50 % of the gains in KE and LPD and 40 % in the DLP were seen in the first 3 months of the study . In all three exercises , strength gains in PRT continued over the entire 12-month period . These data indicate that high-intensity strength training results in substantial , continual increases in strength in postmenopausal women for at least 12 months , with the greatest gains seen in the first 3 months of training 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 r and omized 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 can not 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 OBJECTIVE 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 . DESIGN Placebo-controlled , r and omized , double blind trial . SETTING Outpatient clinical research center at an urban university-affiliated teaching hospital . PARTICIPANTS 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 . INTERVENTION R and om assignment to a 6-month course of one of four protocol s : rhGH administered subcutaneously daily at bedtime , rhGH and a structured resistance exercise program , structured resistance exercise with placebo injections , or placebo injections only . MEASUREMENTS 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 . RESULTS The administration of rhGH result ed 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 ) . CONCLUSIONS 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 result ed 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 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 r and omized 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 OBJECTIVE To examine whether improvements in glycemic control and body composition result ing from 6 months of supervised high-intensity progressive resistance training could be maintained after an additional 6 months of home-based resistance training . RESEARCH DESIGN AND METHODS We performed a 12-month r and omized controlled trial in 36 sedentary , overweight men and women with type 2 diabetes ( aged 60 - 80 years ) who were r and omly assigned to moderate weight loss plus high-intensity progressive resistance training ( RT&WL group ) or moderate weight loss plus a control program ( WL group ) . Supervised gymnasium-based training for 6 months was followed by an additional 6 months of home-based training .  Glycemic control ( HbA1c ) , body composition , muscle strength , and metabolic syndrome abnormalities were assessed at 0 , 3 , 6 , 9 , and 12 months . RESULTS Compared with the WL group , HbA1c decreased significantly more in the RT&WL group ( -0.8 % ) during 6 months of supervised gymnasium-based training ; however , this effect was not maintained after an additional 6 months of home-based training . In contrast , the greater increase in lean body mass ( LBM ) observed in the RT&WL group compared with the WL group ( 0.9 kg , P < 0.05 ) after the gymnasium-based training tended to be maintained after the home-based training ( 0.8 kg , P = 0.08 ) . Similarly , the gymnasium-based increases in upper body and lower body muscle strength in the RT&WL group were maintained over the 12 months ( P < 0.001 ) . There were no between-group differences for changes in body weight , fat mass , fasting glucose , or insulin at 6 or 12 months . CONCLUSIONS In older adults with type 2 diabetes , home-based progressive resistance training was effective for maintaining the gymnasium-based improvements in muscle strength and LBM but not glycemic control . Reductions in adherence and exercise training volume and intensity seem to impede the effectiveness of home-based training for maintaining improved glycemic control OBJECTIVE 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 . DESIGN A prospect i ve , r and omized , controlled , semicrossover trial was design ed 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 . SETTING A LTC facility , which included both assisted living ( AL ) and nursing home ( NH ) residents . PARTICIPANTS Twenty frail residents ( 5 from NH , 15 from AL ) aged 75 to 99 years at one LTC facility . INTERVENTION After r and om 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 b and s ( therab and s ) 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 . MEASUREMENTS AND METHODS 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 . RESULTS 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 st and ard 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 . CONCLUSION 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 Objectives : To investigate whether a 12-week home-based programme of trunk-strengthening exercise could benefit spinal mobility , function and quality of life for osteoporotic and osteopenic postmenopausal women without fracture . Design s : R and omized controlled clinical trial . Setting : Department of Physical Therapy in National Taiwan University Hospital . Subjects : Twenty-eight postmenopausal women ( mean age 60.39=9.3 years ) diagnosed with osteoporosis or osteopenia without fracture history were recruited for this study . Subjects were r and omly assigned into exercise or control groups , each consisting of 14 subjects . Interventions : The 12-week exercise programme included strengthening routines for the trunk extensor and flexor muscles . The subjects performed three sets of 10 repetitions for each of the exercises , with programmes carried out three times per day at home . Main outcome measurements : Muscular strength , spinal range of motion ( ROM ) and motion velocity , Oswestry Disability Question naire ( ODQ ) and quality of life ( QOL ) were measured before the start and after completion of the exercise programme . Results : Statistically significant improvements were demonstrated in spinal ROM and motion velocity in the sagittal and frontal planes for the exercise group ( pB=0.05 ) . Further , the strength of the trunk flexors and extensors increased after exercise training ( pB=0.05 ) . ODQ measure was significantly reduced in the exercise group ( pB=0.05 ) , while the controls showed no significant change . Subjects in the exercise group showed better satisfaction in some domains of the Short-Form-36 Health Survey quality of life question naire ( pB=0.05 ) . Conclusions : This 12-week home-based trunk-strengthening exercise programme could improve trunk mobility and strength , and enhance QOL in osteoporotic and osteopenic postmenopausal women without vertebral fracture . Future study should recruit more cases or more severe subjects to verify the results Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N . m were r and omized  to different versions of a strength-training program for the knee-extensors : to a high-guidance group ( HG ; two group sessions supervised by a physical therapist and one unsupervised home session per week , n = 17 ) , a medium-guidance group ( MG ; one supervised group session and two unsupervised home sessions per week , n = 16 ) , or a control group ( C ; no exercise , n = 16 ) . Maximal isometric knee strength increased more in HG than in C ( p = .03 ) and with increasing guidance ( p = .03 ) . The effect was mainly the result of participants with low initial strength . Walking speed increased more for HG than for C ( p = .02 ) and than for MG ( p = .06 ) . No statistically significant improvements were seen on other functional tests . In summary , the study shows a trend toward better results with more supervision , but more and larger studies are needed to confirm this We conducted a 2-year ( 42 weeks of consecutive training in each year , separated by 10 weeks of testing and vacation time ) r and omized , controlled trial of weight training in 142 healthy male and female subjects , aged 60 to 80 years . Measurements included dynamic strength , symptom-limited endurance in cycling , treadmill walking and stair climbing , muscle size , and bone mineral density and content of the lumbar spine and whole body .  One hundred and thirteen subjects completed the study ( 57 exercise , 56 control ) , with a mean attendance of 85 % among the exercisers . Muscle strength was unchanged in the control subjects but increased ( collapsed across age and gender ) from 32 % ( leg press ) to 90 % ( military press ) in the exercisers . Symptom-limited endurance in cycling , treadmill walking , and stair climbing increased in the exercisers by ( mean + /- SE ) 6.2 + /- 0.8 % , 29.2 + /- 7.3 % , and 57 + /- 12 % , respectively ; the only change in the controls was an unanticipated 33 % increase in stair climbing performance during the first year . These values were unchanged in the controls . Cross-sectional area of the knee extensors increased by 8.7 + /- 0.9 % in the trained subjects and was unchanged in controls . Measures of whole body , lumbar spine bone mineral density , and lumbar spine bone mineral content were unchanged in the exercisers , but whole body bone mineral content decreased by 1 % . In contrast , there were small increases ( < 4.0 % ) in bone mineral density among the controls . Long-term weight training proved to be a safe and well-tolerated mode of exercise for the elderly . Increased strength was associated with muscle hypertrophy in each year , and with increased endurance in cycling , walking , and stair climbing . There were no changes in bone mineral density but a small reduction in whole body bone mineral content Sayers SP , Bean J , Cuoco A , LeBrasseur NK , Jette A , Fielding RA : Changes in function and disability after resistance training : Does velocity matter ? A pilot study . Am J Phys Med Rehabil 2003;82:605–613 . Objective To compare the effects of high- and low-velocity resistance training on functional performance and disability outcomes in physically limited older women . Design A total of 16 wk of high-velocity resistance training or traditional low-velocity resistance training consisting of knee extension and leg press exercises was performed three times per week by 30 women with self-reported disability to compare their effect on functional performance and disability . Tests of dynamic balance , stair-climb time , chair-rise time , and gait velocity were used to assess changes in functional performance . Changes in disability were assessed using the Medical Outcomes Study Short Form . Results Dynamic balance and stair-climb time improved 8 % and 10 % , respectively , with training . Self-reported disability , physical functioning , role physical , and mental health improved 11 , 9 , and 5 % with training , respectively . There were no significant differences between high- and low-velocity training groups . Conclusions High- and low-velocity training achieved similar improvements in functional performance and disability . Improvements in functional performance and disability were modest compared with robust increases in strength and power . Specific modes of training or behavioral strategies may be necessary to optimize improvements in these outcomes Previous studies concerning psychological benefits of exercise among the elderly has focused predominantly on the effects of aerobic exercise . In the present study , psychological and behavioral adaptations in response to 12-weeks of strength training were examined in medically healthy but sedentary 42 older adults ( mean age = 68 years ) . The purpose of this study was to evaluate the effects of high and low intensity resistance training intensity on a ) muscular fitness , b ) psychological affect , and c ) neurocognitive functioning . Subjects were r and omly assigned to high intensity/low volume ( EXH : 2 sets of 8 to 10 repetitions for 75 to 85 % of 1 RM ) , low intensity/high volume ( EXL : 2 sets of 14 to 16 repetitions for 55 to 65 % of 1 RM ) , or no exercise control programs . Prior to and following the 12-week program , subjects underwent comprehensive physiological and psychological evaluations . Physiological assessment included measurements of blood pressure , heart rate , arm and leg muscle strength , body composition , and oxygen consumption ( VO2max ) . Psychological measures included evaluations of mood , anxiety , and physical self-efficacy as well as cognitive functioning . The results of this study indicated that both high and low intensity strength programs were associated with marked improvements in physiological fitness and psychological functioning . Specifically , subjects in the strength training programs increased overall muscle strength by 38.6 % and reduced percent body fat by 3.0 % . Favorable psychological changes in the strength-trained subjects included improvements in positive and negative mood , trait anxiety , and perceived confidence for physical capability . The treatment effects of neurocognitive functioning were not significant . In summary , this study demonstrated that participation in 12-weeks of high or low intensity strength training can improve overall physical fitness , mood , and physical self-efficacy in older adults while cognitive functioning remains constant Underst and ing the stress/strain relationship between exercise and bone is critical to underst and ing the potential benefit of exercise in preventing postmenopausal bone loss . This study examined the effect of a 2-year exercise intervention and calcium supplementation ( 600 mg ) on bone mineral density ( BMD ) in 126 postmenopausal women ( mean age , 60 + /- 5 years ) . Assignment was by block r and omization to one of three groups : strength ( S ) , fitness ( F ) , or nonexercise control ( C ) . The two exercise groups completed three sets of the same nine exercises , three times a week . The S group increased the loading , while the F group had additional stationary bicycle riding with minimal increase in loading .  Retention at 2 years was 71 % ( 59 % in the S group , 69 % in the F group , and 83 % in the C group ) , while the exercise compliance did not differ between the exercise groups ( S group , 74 + /- 13 % ; F group , 77 + /- 14 % ) . BMD was measured at the hip , lumbar spine , and forearm sites every 6 months using a Hologic 4500 . Whole body BMD also was measured every 6 months on a Hologic 2000 . There was no difference between the groups at the forearm , lumbar spine , or whole body sites . There was a significant effect of the  strength program  at the total ( 0.9 + /- 2.6 % ; p < 0.05 ) and intertrochanter hip site ( 1.1 + /- 3.0 % ; p < 0.01 ) . There was a significant time and group interaction ( p < 0.05 ) at the intertrochanter site by repeated measures . This study shows the effectiveness of a progressive strength program in increasing bone density at the clinical ly important hip site . We concluded that a strength program could be recommended as an adjunct lifestyle approach to osteoporosis treatment or used in combination with other therapies & NA ; Phillips , W.T. , and J.R. Ziuraitis . Energy cost of single‐set resistance training in older adults . J. Strength Cond . Res . 18(3):606–609 . 2004.—The purpose of this study was ( a ) to assess the intensity and energy cost of a single‐set resistance training ( RT ) protocol as recommended by the recent American College of Sports Medicine ( ACSM ) guidelines for older adults and ( b ) to compare obtained values to those recently reported as eliciting health benefits via endurance‐based physical activity ( PA ) . Five males and 5 females ( 73.1 ± 5.5 years ) performed 1 set of 15 repetitions of 8 RT exercises while connected to a portable metabolic unit ( CosMed K4b2 ) . The RT intensity ( metabolic equivalents [ METs ] ) was 3.3 ± 0.7 ( males ) and 3.0 ± 0.6 ( females ) . Energy cost ( kcal ) was 84.2 ± 14.6 ( males ) and 69.7 ± 17.4 ( females ) . We conclude that a single‐set 8‐exercise RT protocol may be a feasible alternative for achieving moderate intensity ( 3–6 METs ) for older adults but that additional sets and /or repetitions appear to be necessary to accumulate moderate amounts ( 150–200 kcal ) of PA OBJECTIVE . A Phase II trial was performed as a preliminary test of the efficacy and safety of progressive resistance training ( PRT ) as adjunct treatment for rheumatoid cachexia . METHODS Ten mildly disabled patients with well-controlled rheumatoid arthritis ( RA ) trained , on average , 2.5 times per week for 12 weeks . Ten age and sex matched RA patients with similar disease characteristics were non-r and omly assigned to a control group .  Body composition , physical function , and disease activity were assessed pre and post intervention period . RESULTS Between group comparisons at followup by ANCOVA using baseline scores as covariate showed significant increases in fat-free mass ( + 1253 g , p = 0.004 ) , total body protein ( + 1063 g , p = 0.044 ) , and arm ( + 280 g , p = 0.005 ) and leg ( + 839 g , p = 0.001 ) lean mass ( a proxy measure of total body skeletal muscle mass ) in response to PRT with no exacerbation of disease activity . There was also a trend for loss of fat mass in the trunk ( -752 g , p = 0.084 ) and a significant reduction in percent body fat ( -1.1 % , p = 0.047 ) . Changes in body composition were associated with improvements in various measures of physical function . CONCLUSION Intense PRT with adequate volume seems to be an effective and safe intervention for stimulating muscle growth in patients with RA . Pending confirmation of these results in a larger r and omized controlled trial that includes patients with more active and severe disease , a similar PRT program should be included in the management of RA as adjunct treatment for cachexia The purpose of this study was to determine the efficacy of resistance exercise in reversing skeletal muscle myopathy in heart transplant recipients . Myopathy , engendered by both heart failure and immunosuppression with glucocorticoids , is a post-transplant complication . The sequelae of myopathic disease includes fiber-type shifts and deficits in aerobic metabolic capability . We r and omly assigned patients to either 6 months of  resistance exercise ( training group ; n = 8) or a control ( control group ;  n = 7 ) group . Exercise was initiated at 2 months after transplant . Biopsy of the right vastus lateralis was performed before and after the 6-month intervention . Myosin heavy chain ( MHC ) composition was assessed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Biochemical assays were performed to determine citrate synthase , 3-hydroxyacyl-CoA-dehydrogenase , and lactate dehydrogenase activity . There were no group differences ( p > or=0.05 ) in MHC composition and enzymatic reserve at baseline . Improvements in the training group for citrate cynthase ( + 40 % ) , 3-hydroxyacyl-CoA-dehydrogenase ( + 10 % ) , and lactate dehydrogenase activity ( + 48 % ) were significantly greater ( p < or=0.05 ) than in the control group ( + 10 % , -15 % , and + 20 % , respectively ) . Oxidative type 1 MHC isoform concentration increased significantly in the training group ( + 73 % , p < or=0.05 ) but decreased in the control group ( -28 % ; p < or=0.05 ) . Glycolytic type 2x MHC isoform increased significantly ( 17 % ; p < or=0.05 ) in the control group but decreased ( -33 % ; p < or=0.05 ) in the training group . This is the first study to demonstrate that resistance training elicits myofibrillar shifts from less oxidative type II fibers to more oxidative fatigue-resistant type I fibers in heart transplant recipients .  Resistance exercise initiated early in the post-transplant period is efficacious in changing skeletal muscle phenotype through increases in enzymatic reserve and shifts in fiber morphology The effects of a 16-wk strength-training program on total and regional body composition were assessed by dual-energy X-ray absorptiometry ( DEXA ) , magnetic resonance imaging ( MRI ) , and hydrodensitometry in 13 untrained healthy men [ 60 + /- 4 ( SD ) yr ] . Nine additional men ( 62 + /- 6 yr ) served as inactive controls . The strength-training program result ed in substantial increases in both upper ( 39 + /- 8 % ; P < 0.001 ) and lower ( 42 + /- 14 % ; P < 0.001 ) body strength . Total fat-free mass ( FFM ) increased by 2 kg ( 62.0 + /- 7.1 to 64.0 + /- 7.2 kg ; P < 0.001 ) , and total fat mass decreased by the same amount ( 23.8 + /- 6.7 to 21.8 + /- 6.0 kg ; P < 0.001 ) when measured by DEXA . When measured by hydrodensitometry , similar increases in FFM ( 61.3 + /- 7.8 to 63.0 + /- 7.6 kg ; P < 0.01 ) and decreases in fat mass ( 23.8 + /- 7.9 to 22.1 + /- 7.7 kg ; P < 0.001 ) were observed . When measured by DEXA , FFM was increased in the arms ( 6.045 + /- 0.860 to 6.418 + /- 0.803 kg ; P < 0.01 ) , legs ( 19.416 + /- 2.228 to 20.131 + /- 2.303 kg ; P < 0.001 ) , and trunk ( 29.229 + /- 4.108 to 30.134 + /- 4.184 kg ; P < 0.01 ) , whereas fat mass was reduced in the arms ( 2.383 + /- 0.830 to 2.128 + /- 0.714 kg ; P < 0.01 ) , legs ( 7.583 + /- 1.675 to 6.945 + /- 1.551 kg ; P < 0.001 ) , and trunk ( 12.216 + /- 4.143 to 11.281 + /- 3.653 kg ; P < 0.01 ) as a result of training . ( ABSTRACT TRUNCATED AT 250 WORDS QUESTIONS Does a 12-week , predominantly home-based program of progressive resistance exercises reduce impairments , activity limitations , and participation restrictions in people with chronic obstructive pulmonary disease ? Are any gains maintained 12 weeks after the cessation of the program ? DESIGN R and omised controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis . PARTICIPANTS 54 people with moderately severe chronic obstructive pulmonary disease not undergoing pulmonary rehabilitation . INTERVENTION The experimental group performed six progressive resistance exercises three times per week ( once a week hospital-based , twice a week home-based ) for 12 weeks . Exercise intensity was three sets of 8 to 12 repetition maximum progressed against elasticised b and s of increasing resistance . The control group received no intervention . OUTCOME MEASURES Primary outcomes were strength ( knee extensor , hip abductor , shoulder horizontal flexor , shoulder flexor ) measured using h and -held dynamometry , and walking capacity measured by the 6-minute Walk Test performed before and after intervention and again at 12 weeks after the cessation of intervention . RESULTS The experimental group increased their knee extensor strength by 4.9 kg ( 95 % CI 1.1 to 8.7 ) more than the control group by Week 12 . However , this gain was not maintained at Week 24 . No difference between the groups was found for any of the other primary outcomes . CONCLUSIONS A predominantly home-based progressive resistance exercise program led to modest improvements in knee extensor strength in people with chronic obstructive pulmonary disease . However , 44 % of the experimental group were unable to complete the exercise program , highlighting the need to underst and factors influencing adherence to exercise in this population Background and aims : Physical exercise is associated with a lower risk of disability . The impact of comorbidity on the benefits from physical exercise has not been clearly investigated . Elders with comorbidity may benefit from physical exercise to preserve physical function . Methods : Data are from 435 participants with knee osteoarthritis aged ≥60 years enrolled in the Fitness and Arthritis in Seniors Trial ( FAST ) , who were r and omly assigned to 18-month health educational ( HE ) , weight training ( WT ) , or aerobic exercise ( AE ) interventions .  Comorbidity was defined as the presence of osteoarthritis and ≥2 clinical conditions . Percent changes in the 6-minute walk test , self-reported disability and knee pain from baseline to 3- , 9- , and 18-month follow-up visits were analyzed according to comorbidity , using analysis of variance . Significance s were adjusted using the Bonferroni method . Results : Mean age of the sample was 68.7 years . In participants with comorbidity ( n=197 ) , those in the AE intervention showed significant improvement in walking speed , compared to WT and HE groups , since the beginning of follow-up . Subjects with comorbidity in AE and WT groups showed improvement of the disability score at the 3-month follow-up visit compared to those in the HE group . This improvement was maintained at the end of the follow-up by the only AE group compared to the HE one ( p=0.06 ) . In participants with comorbidity  , the pain score was improved by the AE intervention . Conclusions : AE and WT interventions improve physical function in individuals with comorbidity . AE improves physical function and knee pain independently of the presence of comorbidity OBJECTIVE The aim of this study was to evaluate the effect of a 10-week , high-intensity strength-training program targeting key lower extremity muscles for the purpose of improving postural control in balance-impaired older adults . METHODS A quasi-experimental , delayed entry controlled design was used to evaluate balance ability in balance-impaired older adults after participation in 10 weeks of high-intensity strength training focused on the quadriceps , hamstrings , tibialis anterior , and gastrocnemius muscles . Participants were evaluated using vali date d clinical measures of functional balance ability : the Berg Balance Scale , the Timed Up and Go , and the Activities-Specific Balance Confidence Scale . RESULTS After strength training , the exercisers were significantly stronger than the control subjects . They improved significantly on the Berg Balance Scale ( P = .030 ) from a mean score of 48.8 + /- 2.4 of 56 before training to 51.2 + /- 4.3 of 56 after training . The Timed Up and Go ( P = .045 ) and the Activities-Specific Balance Confidence Scale ( P = .038 ) also improved significantly in the experimental group . These changes are associated with a decrease in fall risk . CONCLUSIONS High-intensity strength training can safely and effectively strengthen lower extremity muscles in balance-impaired older adults , result ing in significant improvements in functional balance ability and decreased fall risk This study was design ed to assess the effects of 18 months of resistance exercise on regional and total bone mineral density ( BMD ) and soft tissue lean mass ( STL ) in premenopausal women aged 28 - 39 r and omly assigned to an exercise or control group .  Twenty-two exercise and 34 control subjects completed the 18-month training study . All subjects were previously inactive and untrained women . Initial , 5- , 12- and 18-month assessment s were made of total and regional BMD and total and regional STL using dual energy X-ray absorptiometry . All subjects consumed a 500 mg/day elemental calcium supplement throughout the study . Initial Ca intake without supplement averaged 1,023 mg/day in total sample . Serum levels of bone osteocalcin and dietary assessment s using 12 r and omly assigned days of diet records were also completed . Muscular strength was assessed from both 1 repetition maximum ( RM ) testing of 10 weightlifting exercises and by peak torque for hip abduction/adduction and knee extension/flexion . Training increased strength by 58.1 % based on 1 RM testing and by 33.8 % based on isokinetic testing at 18 months versus baseline . BMD increased significantly above baseline at the lumbar spine for the exercise group at 5 months ( 2.8 % ) , 12 months ( 2.3 % ) , and 18 months ( 1.9 % ) as compared with controls . Femur trochanter BMD increased significantly ( p < 0.05 ) in the exercise group at 12 months ( 1.8 % ) and 18 months ( 2.0 % ) but not at 5 months ( 0.7 % ) as compared with controls . No changes in total BMD , arm BMD , or leg BMD were found . There was a 20 % increase in BGP in the exercise group as compared with controls at 5 months and this difference was maintained throughout the study . For STL , significant increases for total , arm , and leg were found at 5 , 12 , and 18 months for the exercise group versus control ranging from 1 - 6 % over baseline . These results support the use of strength training for increasing STL and muscular strength with smaller but significant regional increases in BMD in the premenopausal population OBJECTIVES 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 ) . DESIGN R and omized controlled trial . SETTING University-based human physiology laboratory . PARTICIPANTS Thirty women with self-reported dis-ability ( aged 73 + 1 , body mass index 30.1 + 1.1 kg/mn ) . INTERVENTION We conducted a r and omized 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 ) . MEASUREMENTS One-repetition maximum ( 1 RM ) and peak power for KE and LP . RESULTS 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 result ed 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 ) . CONCLUSIONS 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 The present investigation attempted to determine whether resistance exercise intensity affects flexibility and strength performance in the elderly following a 6-month resistance training and detraining period . Fifty-eight healthy , inactive older men ( 65–78 yrs ) were r and omly assigned to 1 of 4 groups : a control group ( C , n = 10 ) , a low-intensity resistance training group ( LI , n = 14 , 40 % of 1 repetition maximum [ 1RM ] ) , a moderate-intensity resistance training group ( MI , n = 12 , 60 % of 1RM ) , or a high-intensity resistance training group ( HI , n = 14 , 80 % of 1RM ) . Subjects in exercise groups followed a 3 days per week , whole-body ( 10 exercises , 3 sets per exercise ) protocol for 24 weeks . Training was immediately followed by a 24-week detraining period  . Strength ( bench and leg press 1RM ) and range of motion in trunk , elbow , knee , shoulder , and hip joints were measured at baseline and during training and detraining . Resistance training increased upper-(34 % in LI , 48 % in MI , and 75 % in HI ) and lower-body strength ( 38 % in LI , 53 % in MI , and 63 % in HI ) in an intensity-dependent manner . Flexibility demonstrated an intensity-dependent enhancement ( 3–12 % in LI , 6–22 % in MI , and 8–28 % in HI ) . Detraining caused significant losses in strength ( 70–98 % in LI , 44–50 % in MI , and 27–29 % in HI ) and flexibility ( 90–110 % in LI , 30–71 % in MI , and 23–51 % in HI ) in an intensity-dependent manner . Results indicate that resistance training by itself improves flexibility in the aged . However , intensities greater than 60 % of 1RM are more effective in producing flexibility gains , and strength improvement with resistance training is also intensity-dependent . Detraining seems to reverse training strength and flexibility gains in the elderly in an intensity-dependent manner The present study was design ed to identify prospect ively the individual chronic characteristics associated with falling among elderly persons and to test the hypothesis that risk of falling increases as the number of chronic disabilities increases . Seventy-nine consecutive admissions to three intermediate care facilities were evaluated . Twenty-five of the subjects became recurrent fallers . The nine risk factors included in the fall risk index were mobility score , morale score , mental status score , distant vision , hearing , postural blood pressure , results of back examination , postadmission medications , and admission activities of daily living score . A subject 's fall risk score was the number of index factors present . The proportions of recurrent fallers increased from 0 percent ( 0 of 30 ) in those with 0 to three risk factors , to 31 percent ( 11 of 35 ) in those with four to six factors , to 100 percent ( 14 of 14 ) in those with seven or more factors . Falling , at least among some elderly persons , appears to result from the accumulated effect of multiple specific disabilities . Some of these disabilities may be remediable . The  mobility test  , the best single predictor of recurrent falling , may be useful clinical ly because it is simple , recreates fall situations , and provides a dynamic , integrated assessment of mobility Objectives —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 . Methods —Forty four healthy sedentary women ( mean age 68.8 years ) volunteered for this study and were r and omly 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 . Results —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 . Conclusions —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 The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults .  A repeated- measures experimental research design was employed as a sample of 55 apparently healthy , older , community-dwelling volunteers ( 30 exercisers- 25 women and 5 men ; 25 comparisons- 16 women and 9 men ) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function . Strength and function were evaluated at 6-month intervals . The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention . Furthermore , a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence PURPOSE The purpose of this study was to determine , in a r and omized clinical trial of 439 individuals with knee osteoarthritis , the incremental cost-effectiveness of aerobic versus weight resistance training , compared with an education control intervention . METHODS Cost estimates of the intervention were based upon the cost of purchasing from the community similar services to provide exercise or health education . Effect at 18 months was measured using several variables , including : self-reported disability score , 6-min walking distance , stair climb , lifting and carrying task , car task , and measures of pain frequency and pain intensity on ambulation and transfer . RESULTS The total cost of the educational intervention was $ 343.98 per participant . The aerobic exercise intervention cost $ 323.55 per participant , and the resistance training intervention cost $ 325.20 per participant . On all but two of the outcome variables , the incremental savings per incremental effect for the resistance exercise group was greater than for the aerobic exercise group . CONCLUSION The data obtained from this study suggest that , compared with an education control , resistance training for seniors with knee osteoarthritis is more economically efficient than aerobic exercise in improving physical function . However , the magnitude of the difference in efficiency between the two approaches is small BACKGROUND Pharmacological treatment of depression in geriatric patients is often difficult . Although unsupervised exercise has been shown to benefit younger depressed patients , there is no evidence that unsupervised exercise can be used as a maintenance treatment for depression in elderly patients . Our aim was to test the feasibility and efficacy of unsupervised exercise as a long-term treatment for clinical depression in elderly patients . METHODS We studied 32 subjects ( 71.3 + /- 1.2 years of age , mean + /- SE ) in a 20-week , r and omized , controlled trial , with follow-up at 26 months . Subjects were community-dwelling patients with major or minor depression or dysthymia . Exercisers engaged in 10 weeks of supervised weight-lifting exercise followed by 10 weeks of unsupervised exercise . Controls attended lectures for 10 weeks . No contact was made with either group after 20 weeks until final follow-up . Blinded assessment was made with the Beck Depression Inventory ( BDI ) , the Philadelphia Geriatric Morale Scale , and Ewart 's Self Efficacy Scale at 20 weeks and with the BDI and physical activity question naire at 26 months . RESULTS Patients r and omized to the exercise condition completed 18 + /- 2 sessions of unsupervised exercise during Weeks 10 to 20 . The BDI was significantly reduced at both 20 weeks and 26 months of follow-up in exercisers compared with controls ( p < .05-.001 ) . At the 26-month follow-up , 33 % of the exercisers were still regularly weight lifting , versus 0 % of controls ( p < .05 ) . CONCLUSIONS Unsupervised weight-lifting exercise maintains its antidepressant effectiveness at 20 weeks in depressed elderly patients . Long-term changes in exercise behavior are possible in some patients even without supervision OBJECTIVES 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 . DESIGN Multicenter , r and omized , controlled trial with a factorial design . SETTING Five hospitals in Auckl and , New Zeal and , and Sydney , Australia . PARTICIPANTS Two hundred forty-three frail older people . INTERVENTIONS Patients were r and omized 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 . MEASUREMENTS 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 . Assessment s took place in the participants ' homes at 3 and 6 months after r and omization and were performed by blinded assessors . RESULTS 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 . CONCLUSION 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 OBJECTIVE To compare the effects of concentric and coupled concentric-eccentric isokinetic resistance training on functional capacity and symptoms of patients with osteoarthrosis ( OA ) of both knees . DESIGN Repeated measures . SETTING A university exercise physiology laboratory . PARTICIPANTS Twenty-three volunteers , ages 41 to 75 years . Patients were r and omly assigned to 3 groups : concentric ( CON , n = 9 ) , concentric-eccentric ( CON-ECC , n = 8) , and nontreatment ( NONTX , n = 6 ) . INTERVENTIONS The CON group performed 12 concentric contractions of each knee extensor and flexor muscles ; the CON-ECC group performed 6 concentric and 6 eccentric contractions of each knee muscle group by using a spectrum of angular velocities ranging from 30 degrees/s to 180 degrees/s with 30 degrees/s intervals , for both sides , 3 days a week for 8 weeks . MAIN OUTCOME MEASURES Functional capacity ( rising from a chair , walking , stair climbing and descending ) and pain during rest and activities , peak torque , and cross-sectional area ( CSA ) of knee muscle groups of subjects were tested before and after training . RESULTS Both training groups showed marked decreases ( P < .001 ) in pain scores and increases ( P < .001 ) in functional capacity together with increases ( P < .05 - -.01 ) in peak torque and CSA of knee muscles . However , the NONTX group did not display these marked changes after the 8-week period . The results also indicated that concentric-eccentric training has a greater influence on functional capacity , especially stair climbing and descending , than that of concentric training when compared with NONTX group ; however , the improvements in pain measurements were better in the CON group compared with the CON-ECC group after the training . CONCLUSIONS The results suggest that with the isokinetic resistance training used in this study , it is possible to improve functional capacity and decrease pain in patients with OA of the knee . The results also showed that extensive training involving a high number of repetitions and eccentric contractions was safe , effective , and well tolerated for the patients with knee OA OBJECTIVES This investigation determined whether an in-home resistance training program achieved health benefits in older adults with disabilities . METHODS A r and omized 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 . Assessment s were conducted at baseline and at 3 and 6 months following r and omization . The program consisted of videotaped exercise routines performed with elastic b and s of varying thickness . RESULTS 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 t and em gait , and a 15 % to 18 % reduction in physical and overall disability at the 6-month follow-up . No adverse health effects were encountered . CONCLUSIONS These findings provide important evidence that home-based resistance exercise programs design ed for older persons with disabilities hold promise as an effective public health strategy Most studies that assess the effects of exercise in the elderly involve subjects who are in good health . The objective of this prospect i ve longitudinal study was to examine the impact of exercise on cardiovascular fitness , flexibility , and strength in an elderly population that included chronically ill individuals . Patients were recruited initially from a population of veterans over 64 years of age who use a VA outpatient clinic as their regular source of care . The exercise intervention consisted of 90 minutes of exercise 3 days per week at 70 % of the patient 's maximal capacity . Activities included stationary cycling , stretching , weight training , and walking .  Of 69 patients who began the program , 49 ( 71 % ) reached 4-month follow-up . Most patients completing follow-up ( 76 % ) had at least one chronic disease , such as arthritis , hypertension , or heart disease . Patients who dropped out were more likely to have multiple chronic illnesses than those who remained in the program . Average weekly attendance was 65 % and was stable over time . Improvements in cardiovascular fitness at 4-month follow-up were significant : Metabolic equivalents increased from 7.1 + /- 2.3 to 8.3 + /- 2.6 ( P less than .001 ) , treadmill time increased from 8.5 + /- 3.8 to 11.2 + /- 4.2 minutes ( P less than .001 ) , submaximal heart rate decreased from 123.7 + /- 18.8 to 118.8 + /- 19.4 beats per minute ( P less than .001 ) and resting heart rate decreased from 68.1 + /- 10.6 to 63.3 + /- 11.6 beats per minute ( P = .005 ) . ( ABSTRACT TRUNCATED AT 250 WORDS Skeletal muscle adaptations to high intensity knee extensor strength and /or endurance training in patients with chronic heart failure were investigated . Eleven patients with chronic heart failure were r and omized into two groups and exercised the m. quadriceps femoris 3 days/week for 8 weeks . After training , the maximal exercise intensity tolerated on the ergometer cycle was raised from 99 ( 32 ) to 114 ( 40 ) watts ( W , P < 0.05 ) for all 11 patients . Peak dynamic knee extensor work rate showed the greatest increase after endurance training ( 40 % , P < 0.01 ) . Maximal dynamic and isometric strength were elevated by 40 - 45 % ( P < 0.05 ) after strength training . The cross-sectional area of m. quadriceps femoris was increased in the strength-trained legs ( 9 % , P < 0.05 ) , and the capillary per fibre ratio of m. vastus lateralis was raised by 47 and 58 % in the endurance-trained legs ( P < 0.05 ) . The oxidative enzyme activity in m. vastus lateralis was significantly raised above 50 % after endurance training , whereas glycolytic enzyme activity was unaltered . The peripheral skeletal musculature in patients with chronic heart failure adapts fairly quickly to high intensity knee extensor training . This results in a marked rise in local , and a small rise in total work capacity , indicating maintained plasticity of skeletal muscle in chronic heart failure patients OBJECTIVES This investigation examined the effect of 6 months of high- or low-intensity resistance exercise on muscular strength and endurance and stair climbing ability in adults aged 60 to 83 . DESIGN A r and omized controlled trial . SETTING University of Florida Center for Exercise Science . PARTICIPANTS Sixty-two men and women completed the study protocol . Subjects were matched for strength and r and omly assigned to a control ( n = 16 ) , low-intensity ( LEX , n = 24 ) , or high-intensity ( HEX , n = 22 ) group . INTERVENTION Six months of progressive , whole-body resistance training . Subjects trained at 50 % of their one-repetition maximum ( 1RM ) for 13 repetitions ( LEX ) or 80 % of 1RM for eight repetitions ( HEX ) three times per week for 24 weeks using resistance machines . One set each of 12 exercises was performed . MEASUREMENTS One-repetition maximum was measured for eight different exercises . Muscular endurance was measured using leg press and chest press machines . Low back strength was measured using a lumbar extension machine . Stair climbing ability was assessed as the time to ascend one flight of stairs . RESULTS 1RM significantly increased for all exercises tested for the HEX and LEX groups ( P < or = .050 ) . The increases in total strength ( sum of all eight 1RMs ) were 17.2 % and 17.8 % for the LEX and HEX groups , respectively . Muscular endurance improved by 79.2 % and 105.0 % for the leg press , and 75.5 % and 68.0 % for the chest press for the LEX and HEX groups , respectively . The time to ascend one flight of stairs significantly decreased for both the LEX and HEX groups ( P < or = .050 ) . Lumbar extension strength increased by 62.6 % and 39.5 % for the LEX and HEX groups , respectively . CONCLUSIONS These data indicate that significant and similar improvements in strength , endurance , and stair climbing time can be obtained in older adults as a consequence of high- or low-intensity resistance exercise training . These findings may have an effect on how resistance exercise is prescribed to older adults OBJECTIVES 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 . DESIGN AND SETTING We enrolled 102 nondisabled , community-dwelling older people aged 66 to 87 , identified from the Medicare beneficiary list , into a r and omized , controlled trial . MEASUREMENTS Effectiveness was based on change in isokinetic upper and lower extremity muscle strength , psychologic well-being , and health status . RESULTS 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 . CONCLUSION Study results reveal that the Strong for Life program , design ed to be widely disseminated to the nondisabled older population , has many short-term positive benefits Increasing physical activity is often prescribed to improve blood lipids ; however , the efficacy of exercise in improving blood lipids in older adults is not clear . The objective of this study was to examine the effects of different exercise modes on blood lipid levels in previously sedentary older adults engaging in a 16-week exercise intervention .  One hundred thirty-one subjects ( mean age 74.6+/-6 years ) were r and omly assigned to a resistance training group , aerobic walking group , combined exercise group , or nonexercising control group .  Blood lipids were measured at baseline , 8 weeks , and postintervention . Exercise mode did not impact blood lipids . All groups had lower lipid levels over time . Total cholesterol , low- and high-density lipoprotein , and triglycerides were significantly lower . The decrease in all groups , including the controls , may be due to a seasonal effect in older adults that has been documented in younger individuals 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 r and omized controlled trial of 10-wks duration . The exercise group ( Ex , n = 18 ) underwent simple , progressive lower body resistance exercises , specifically aim ed 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 st and , 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 st and , 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 Background and aims : An acute illness may place older frail people at increased risk of losing independence in functional abilities . Physical exercise may reduce the risk by improving muscle strength and balance . However , the effects of physical training on functional abilities have not been studied among frail , very old people recovering from an acute illness . The aim of this study was to determine the effects of a group-based exercise program on their ability to carry out self-care ( ADL ) and instrumental activities ( IADL ) relevant to daily life after discharge from hospital . Methods : This r and omized controlled trial examined 68 community-dwelling women aged 75 years or older ( mean age 83.0 , SD 3.9 ) who were hospitalized due to an acute illness , and were mobility-impaired at admission . Participants were recruited from the geriatric ward of a primary -care health-center hospital , and were r and omized into group-based strength training ( n=34 ) and control ( n=34 ) groups . The 10-week group-based intervention included strength training and functional exercises . The control group received instructions for a home exercise training program , including functional exercises but no further encouragement to exercise . The level of independence in ADL and IADL was evaluated , using a 13-item scale with stepwise grading from fully independent to fully dependent . Measurements took place immediately before and after the intervention , and three and nine months later . Results : The intervention did not have any significant main effect ( p=0.407 ) , nor was there any significant interaction between follow-up time and intervention ( p=0.854 ) . Conclusions : The multi-component outpatient strength training program did not improve autonomy in expert-evaluated ADL/IADL functions 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 ( P BMC ) sub population s , cytokine and prostagl and in ( 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 P BMC 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 PURPOSE The main purpose of this study was to analyze the impact of a 1-yr resistance-training program on body composition and muscle strength in postmenopausal women , and to describe the impact of hormone replacement therapy ( HRT ) on body composition changes , with and without exercise . Secondarily , we wanted to study dose-response relationships between measures of program compliance and changes in primary outcomes . METHODS Subjects were postmenopausal women ( 40 - 66 yr ) r and omly assigned to an exercise ( EX ) group ( N = 117 ) and a nonexercise group ( N = 116 ) . The EX group participated in a 1 yr trainer-supervised resistance-training program , 60 - 75 min.d-1 , 3 d.wk-1 . Lean soft tissue ( LST ) and fat tissue ( FT ) changes were measured by dual-energy x-ray absorptiometry and strength by one-repetition maximum testing . RESULTS Significant ( P < 0.001 ) gains in LST were observed for women who exercised , regardless of HRT status , whereas women who did not exercise lost LST ( P < 0.05 ) if they were not taking HRT , and gained LST ( P = 0.08 ) if they were on HRT . The only significant FT losses were observed for women who exercised while on HRT ( P < 0.05 ) . Strength increases were observed at all sites ( P < 0.001 ) . Total weight lifted by subjects in their training sessions was a significant predictor of changes in LST ( P < 0.001 ) and strength ( P < 0.01 ) . CONCLUSIONS Resistance and weight-bearing exercise significantly changed total and regional body composition in postmenopausal women by increasing LST in all women and decreasing FT in women on HRT . Hormone therapy showed no independent effects on body composition , but it protected nonexercising women from losses in LST . The lean and muscle strength changes observed were partially dependent on the volume of training , as expressed by attendance and total weight lifted in 1 yr of training Background : Data regarding the effect of exercise programmes on older adults ’  health-related quality of life ( HRQOL ) and habitual physical activity are inconsistent . Objective : 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 . Methods : Ninety-eight women were r and omised 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 question naire and self-reported physical activity were obtained at baseline , directly after completion of the intervention ( 3 months ) , and 6 months later ( 9 months ) . Results : 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 . Conclusions : 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 underst and ing of the effect of exercise interventions in older adults OBJECTIVE To assess immediate and near-term effects of 2 exercise training programs for persons with idiopathic Parkinson 's disease ( IPD ) . DESIGN R and omized control trial . SETTING Public health facility and medical center . PARTICIPANTS Fifteen persons with IPD . INTERVENTION Combined group ( balance and resistance training ) and balance group ( balance training only ) underwent 10 weeks of high-intensity resistance training ( knee extensors and flexors , ankle plantarflexion ) and /or balance training under altered visual and somatosensory sensory conditions , 3 times a week on nonconsecutive days . Groups were assessed before , immediately after training , and 4 weeks later . MAIN OUTCOME MEASURES Balance was assessed by computerized dynamic posturography  , which determined the subject 's response to reduced or altered visual and somatosensory orientation cues ( Sensory Orientation Test [ SOT ] ) . Muscle strength was assessed by measuring the amount of weight a participant could lift , by using a st and ardized weight- and -pulley system , during a 4-repetition-maximum test of knee extension , knee flexion , and ankle plantarflexion . RESULTS Both types of training improved SOT performance . This effect was larger in the combined group . Both groups could balance longer before falling , and this effect persisted for at least 4 weeks . Muscle strength increased marginally in the balance group and substantially in the combined group , and this effect persisted for at least 4 weeks . CONCLUSION Muscle strength and balance can be improved in persons with IPD by high-intensity resistance training and balance training Physical disability is common among older persons living within the community . The Framingham Disability Study [ 1 , 2 ] reported that , among community-dwelling persons older than 70 years of age , 49 % of women and 27 % of men have substantial mobility or work limitations . More recently , a 4-year prospect i ve trial of healthy elderly persons with no disability at baseline showed that lower-extremity physical performance at baseline was highly predictive for the subsequent development of disability [ 3 ] . Muscle mass , strength , and endurance decrease with age , and a close correlation between short-course walking speed and the size and strength of leg muscles has been shown in institutionalized nonagenarians [ 4 ] . Furthermore , resistance training in this population has been shown to result in increased measures of physical performance and corresponding increases in muscle strength , size , and short-course walking speed [ 4 , 5 ] . Our goal was to determine whether resistance training would improve walking endurance and lower-limb strength in nondisabled , community-dwelling elderly persons . Methods Twenty-four sedentary , healthy persons ( 11 men and 13 women ) were r and omly assigned within sex groups either to a 12-week resistance-training program or to sedentary control status .  The mean age of the participants was 70.4 4 years ( range , 65 to 79 years ) , and no differences in mean age were seen between groups ( 69.9 4 years in the resistance-training group ; 70.7 5 years in the control group [ P > 0.2 ] ) . The  resistance-training group was composed of 6 men and 6 women ; the control group consisted of 5 men and 7 women . Participants did symptom-limited treadmill stress tests at baseline , and we collected expired gas to determine peak aerobic capacity . We used a Horizon Metabolic Measurement Cart ( Sensormedics , Yorba Linda , California ) to analyze expired air .  Participants were excluded if they had angina or electrocardiographic ischemia ( defined as ST-segment depression more than 1 mm ) during the exercise test ( n = 2 ) , if their resting blood pressure was higher than 160/90 mm Hg ( n = 4 ) , or if they had a noncardiopulmonary limitation of exercise capacity , such as claudication , arthritis , or cerebrovascular disease ( n = 1 ) . We tested 29 participants to arrive at the final study sample of 24 persons . No participants were receiving calcium- or -blocking medications or estrogen-replacement therapy , and none had diabetes . We determined body composition by using underwater weighing and correcting for residual volume [ 6 ] . Leg-muscle mass was determined by dual-energy x-ray absorptiometry [ 7 ] . Strength was evaluated on a Universal Gym apparatus ( Universal , Cedar Rapids , Iowa ) by measuring the single repetition maximal lift for leg extension , leg flexion , and bench press . We measured submaximal endurance capacity on the treadmill by first having participants walk for 5 minutes at an intensity of 50 % of their previously determined peak aerobic capacity . Participants then gradually increased their walking intensity to 80 % of peak aerobic capacity by 10 minutes of the continuous protocol and proceeded until exhaustion ( n = 24 ) or 45 minutes , at which time the test was terminated . Because none of the participants had angina , claudication , or exercise-limiting arthritis , exhaustion was defined as a combination of leg fatigue , dyspnea , and overall body fatigue . During endurance testing , heart rate , blood pressure , oxygen uptake , and perceived exertion [ 8 ] were measured at 5-minute intervals until exhaustion . After 12 weeks , variables were measured again , and walking endurance was measured at the same absolute workload as before conditioning . The weight-training regimen consisted of three sets of eight repetitions of seven exercises done using a Universal Gym apparatus 3 days per week . The exercises ( and primary muscles exercised ) were leg extension ( quadriceps ) , leg curl ( hamstrings ) , arm extension ( triceps ) , arm curl ( biceps ) , lateral pull-down ( latissimus dorsi and biceps ) , bench press ( pectoralis major and triceps ) , and squat ( gluteals and quadriceps ) . A rest period of 1 to 2 minutes was taken between sets . The participants began at a resistance of 50 % of their single repetition maximum . The resistance was then increased progressively until participants were exercising at 80 % of their single repetition maximum by week 9 . Strength was retested intermittently , and the training loads were adjusted as required . The participants did not train aerobically . Controls were instructed not to alter their home activity habits . A two-factor analysis of variance was done on baseline measures , with sex and training groups as the factors [ 9 ] . Women differed from men in baseline measures of fitness , strength , and body composition , but no sex-group interactions were seen . Pre- to postconditioning measures were analyzed using repeated-measure analysis of variance with results separated by sex . Data collected during the submaximal endurance study were analyzed for perceived exertion , heart rate , and systolic blood pressure ( excluding rest and exhaustion values ) by repeated-measure analysis of variance . Relations between variables were studied by linear regression analysis . Data are presented as mean SD . Analyses were done using BMDP New System for Windows , Version 1.0 ( BMDP Statistical Software , Los Angeles , California ) . Results After the 12-week resistance-training program , strength increased substantially in the  resistance-training group . The single repetition maximums increased by 29 % 24 % for leg extension , 65 % 79 % for leg flexion , and 29 % 15 % for bench press . When results were analyzed separately by sex and compared with results in controls , single repetition maximums for leg extension increased significantly among women ( P < 0.01 ) but not among men ( P = 0.12 ) ( Table 1 ) . Similarly , single repetition maximums for bench press increased significantly among women ( P < 0.01 ) but not among men ( P = 0.12 ) . Both women and men had increased single repetition maximums for leg flexion compared with controls ( P < 0.01 for women and P < 0.05 for men ) . It should be noted that the study was not design ed to fully address sex-specific outcomes . The control group showed no change in strength measures over the 12-week period , and the strength changes for each of the exercises in the intervention group when sexes were combined were significantly greater than the measures in the controls ( P < 0.005 ) ( Table 1 ) . Table 1 . Resistance-Training and Control Groups at Baseline and 12 Weeks Women in our study had lower measures of peak aerobic capacity at baseline than men ( 21.5 1.1 mL/kg min1 compared with 28.8 1.5 mL/kg min1 ; P = 0.03 ) and lower measures of strength as measured by single repetition maximum for leg extension ( 23.5 1.0 kg compared with 42.8 4 kg ; P = 0.001 ) , leg curl ( 5.3 0.4 kg compared with 14.4 1.5 kg ; P = 0.003 ) , and bench press ( 20.9 1.1 kg compared with 31.3 2.2 kg ; P = 0.008 ) . Neither women nor men showed changes in peak aerobic capacity after resistance training . No participant had significant changes in body weight , percentage of body fat , fat mass , or fat-free mass as measured by underwater weighing ( Table 1 ) . Analysis of regional body composition measured by dual-energy x-ray absorptiometry scanning showed an increased lean mass of the leg with weight training when compared with controls ( P = 0.02 ) ( Table 1 ) . This was due to an increase among women ( P < 0.02 ) ; no increase was seen among men ( P > 0.2 ) . Peak aerobic capacity was unaltered in both groups , regardless of sex . The primary outcome variable of interest was walking endurance time . After the resistance-training program , mean walking time until exhaustion for the resistance-training group increased by 38 % , from 25 4 minutes to 34 9 minutes . In contrast , no change was seen in the control group ( 20 5 minutes to 19 10 minutes ; P = 0.005 for comparison between groups ) . The increase in endurance time was due primarily to increases seen among men ( P < 0.02 ) rather than among women ( P > 0.2 ) . Mean exercise intensity , measured at 10 minutes of the endurance protocol at baseline , was 82 % of peak aerobic capacity in both the training group and the control group ( P > 0.2 between groups ) . Before the study intervention , none of the 24 participants completed the full 45-minute endurance protocol . After conditioning , 3 of the 12 participants who received resistance training and 1 of 12 controls completed the entire protocol . After conditioning , mean scores for perceived exertion for all submaximal data points from 10 minutes until the end of the walking endurance protocol ( not including the exhaustion point ) were lower in the resistance-training group than in the control group ( P = 0.03 ) ( Figure 1 ) . Mean submaximal heart rate and systolic blood pressure measures were lower after conditioning ; however , when groups were compared by repeated-measure analysis of variance , differences between groups were not significant ( Figure 1 ) . Submaximal or peak exercise oxygen consumption did not change during the endurance testing . Figure 1 . Conditioning data in the resistance-training group . For all 24 participants , significant relations were seen between change in walking endurance and change in strength measures for leg extension ( r = 0.48 [ 95 % CI , 0.10 to 0.74 ] ; P = 0.02 ) and leg flexion ( r = 0.46 [ CI , 0.07 to 0.73 ] ; P = 0.03 ) . Baseline peak aerobic capacity ( r = 0.10 [ CI , 0.48 to 0.3 ] ; P > 0.2 ) and baseline endurance time ( r = 0.41 [ CI , 0.22 to 0.73 ] ; P = 0.13 ) were not significantly related to change in endurance capacity in the resistance-training group of 12 participants . Discussion We show that healthy , community-dwelling elders can improve walking endurance and leg strength by participating in a resistance-training program . This finding is relevant to persons at risk for disability because walking endurance and leg strength are important components of physical functioning [ 3 ] . Resistance training improves walking endurance in at OBJECTIVE To determine the effectiveness of progressive resistance strengthening exercises to improve gross motor function and walking in patients receiving intensive rehabilitation after stroke . DESIGN R and omized controlled trial . SETTING Five inpatient rehabilitation programs affiliated with teaching hospitals . PARTICIPANTS Inclusion criteria included less than 6 months poststroke and recovery of the leg stages 3 to 5 on the Chedoke-McMaster Stroke Assessment ( CMSA ) . INTERVENTIONS Both groups received conventional physical therapy programs . In addition , the experimental group performed 9 lower-extremity progressive resistance exercises 3 times a week for the duration of their stay , whereas the control group did the same exercises and for the same duration but without resistance . MAIN OUTCOME MEASURES The Disability Inventory of the CMSA and the 2-minute walk test ( 2MWT ) at baseline , 4 weeks , discharge , and 6 months after discharge . RESULTS Over the length of stay , the rate of change in the Disability Inventory was.27 points per day in the experimental group and .29 points per day in the control group ; the between-group difference was -.02 points per day ( 95 % confidence interval [ CI ] , -.10 to.06 ; P=.62 ) . At discharge , the rate of change in the 2MWT was -.01 m in the experimental group and .15 m in the control group ; the between-group difference was -.16 m ( 95 % CI , -.37 to.05 ; P=.14 ) . CONCLUSIONS Progressive resistance strengthening exercises as applied in our study were not effective when compared with the same exercises given without resistance OBJECTIVE To investigate the effects of a dynamic , intensive exercise regimen on pain , disease activity , and physical functioning in active rheumatoid arthritis ( RA ) . METHODS 64 patients with RA with a mean age of 60 ( 13 ) years and mean disease duration of 8 ( 8) years , admitted to hospital because of active disease , were r and omly assigned to an  intensive exercise programme or to a  conservative exercise programme during their period in hospital with a mean length of 30 ( 14 ) days . The intensive exercise programme consisted of knee and shoulder dynamic and isometric muscle strengthening exercises against resistance five times a week and conditioning bicycle training three times a week and was supplemental to the conservative exercise programme of range of motion and isometric exercises . Indices of disease activity , pain , muscle strength , and functional ability were assessed at 0 , 3 , 6 , 12 , and 24 weeks by a blinded observer . RESULTS The medical treatment during the study was the same in both groups . Both groups improved in measures of disease activity , differences between groups were not statistically significant . The mean improvement in disease activity score at 24 weeks in the intensive and conservative exercise group was −1.4 ( 1.5 ) and −0.7 ( 1.4 ) , respectively . Measures of physical functioning improved significantly for patients in the intensive exercise group , and differences between groups were statistically significant for measures of muscle strength . CONCLUSION A short term intensive exercise programme in active RA is more effective in improving muscle strength than a conservative exercise programme and does not have deleterious effects on disease activity We sought to determine whether creatine monohydrate ( CrM ) supplementation would enhance the increases in strength and fat-free mass that develop during resistance exercise training in older adults . Twenty-eight healthy men and women over the age of 65 years participated in a whole-body resistance exercise program 3 days per week for 14 weeks . The study participants were r and omly allocated , in a double-blind fashion , to receive either CrM ( 5 g/d + 2 g of dextrose ; n = 14 ) or placebo ( 7 g of dextrose ; n = 14 ) . The primary outcome measurements included the following : total body mass , fat-free mass , one-repetition maximum strength for each body part , isometric knee extension , h and grip , and dorsiflexion strength , chair st and performance , 30-m walk test , 14-stair climb performance , muscle fiber type and area , and intramuscular total creatine . Fourteen weeks of resistance exercise training result ed in significant increases in all measurements of strength and functional tasks and muscle fiber area for both groups ( p < .05 ) . CrM supplementation result ed in significantly greater increases in fat-free mass and total body mass , as compared with placebo ( p < .05 ) . The CrM group also showed a greater increase in isometric knee extension strength in men and women , as compared with placebo ( p < .05 ) , and also greater gains in isometric dorsiflexion strength ( p < .05 ) , but in men only . There was a significant increase in intramuscular total creatine in the CrM group ( p < .05 ) . Finally , there were no significant side effects of treatment or exercise training . This study confirms that supervised heavy resistance exercise training can safely increase muscle strength and functional capacity in older adults . The addition of CrM supplementation to the exercise stimulus enhanced the increase in total and fat-free mass , and gains in several indices of isometric muscle strength BACKGROUND AND PURPOSE 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 . SUBJECTS 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 r and omly assigned to a resistance training group , an aerobic training group , or a control group . METHODS 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 . RESULTS 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 . DISCUSSION AND CONCLUSION 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 Background : Falls are among the leading causes of injuries and deaths . Results from a number of studies have suggested that a community-based exercise program may be effective in improving lower body strength , although some have shown only limited improvements . However , the impact of these programs on gait and balance are equivocal . Further , studies that have specifically targeted deconditioned elderly individuals , rather than individuals drawn from the general community , either showed limited or no improvements in gait and balance . Objective : This study examined the effectiveness of a community-based , short-term , low-intensity exercise intervention strategy on measures of mobility skills , gait and balance , and muscle strength for a clinical ly targeted group of elderly individuals at high risk of falls . Methods : 245 men and women aged 60 years or older were r and omized into either an intervention or control group and received a baseline ( T1 ) assessment . Subjects in the intervention group received up to 24 sessions ( 45 min long ) of low-intensity st and ard exercise modalities tailored to the individual patient over an 8- to 10-week period . At the conclusion of the program , the participants in the intervention group were instructed to continue performing the exercises at home until 1 year after T1 . Measures of physical function and performance were collected for all subjects at three different points of study enrollment . Results : Of the subjects assessed at baseline , 138 ( 56 % ) also had a postintervention assessment ( T2 ) , 128 ( 52 % ) had a 6-month follow-up assessment ( T3 ) , and 105 subjects had assessment s at all time points . Primary analyses were based on the 105 subjects who had assessment s at all time points . Intervention and control subjects did not differ in any of the physical function or performance measures at baseline . Between T1 and T2 , the intervention subjects showed significantly greater improvement than the control subjects on all outcomes , with improvements plateauing for most measures between T2 and T3 . Gait and balance scores continued to improve throughout the study period for both groups of subjects . Conclusions : This easily implemented , low-intensity exercise program may lead to improvements in physical functioning that are retained over the long term and effectively targets a clinical ly defined population of deconditioned elders at high risk of falling and sustaining serious injury Where strength training has been used in conjunction with functional-task training in older people , not only have there been improvements in leg strength but also improved function has been measured ( e.g. , Skelton & McLaughlin , 1996 ) . Many studies use participants from care homes rather than community dwellers . We investigated changes in leg power , balance , and functional mobility in community-dwelling sedentary men and women over 70 years of age ( n = 6 for training group [ TR ] ; n = 10 for control group [ CN ] ) .  Progressive training took place over 24 weeks using seated and nonseated exercise . For TR , leg power increased 40 % , from 108 + /- 40 to 141 + /- 53 W ( p < .01 ) ; dynamic balance increased 48 % , from 22.3 + /- 7.9 to 33.1 + /- 6.1 cm ( p < .01 ; functional reach ) ; and functional mobility increased 12 % , from 7.46 + /- 1.32 to 6.54 + /- 1.41 s ( p < .05 ; timed walk ) . CN showed no significant change . In conclusion , a community-based exercise program led to large improvements in leg-extensor power , dynamic balance , and functional mobility OBJECTIVE To examine the effects of a 3-month low-intensity exercise program on physical frailty . DESIGN R and omized clinical trial . SETTING Regional tertiary-care hospital and academic medical center with an outpatient rehabilitation fitness center . PARTICIPANTS Eighty-four physically frail older adults ( mean age , 83 + /- 4 yrs ) . INTERVENTION Three-month low-intensity supervised exercise ( n = 48 ) versus unsupervised home-based flexibility activities ( n = 36 ) . MAIN OUTCOME MEASURES Physical performance test , measures of balance , strength , flexibility , coordination , speed of reaction , peripheral sensation . RESULTS Significant improvement was made by the exercise group on our primary indicator of frailty , a physical performance test ( PPT ) ( 29 + /- 4 vs 31 + /- 4 out of a possible 36 points ) , as well as many of the risk factors previously identified as contributors to frailty ; eg , reductions in flexibility , strength , gait speed , and poor balance . Although the home exercise control group showed increases in range of motion , the improvements in flexibility did not translate into improvements in physical performance capacity as assessed by the PPT . CONCLUSIONS Our results suggest that physical frailty is modifiable with a program of modest activities that can be performed by virtually all older adults . They also indicate that exercise programs consisting primarily of flexibility activities are not likely to reverse or attenuate physical frailty . Although results suggest that frailty is modifiable , it is not likely to be eliminated with exercise , and efforts should be directed toward preventing the condition OBJECTIVES The objectives of this study were to determine the effects of a strength-training program on walking speed and relative muscular stress , as measured by normalized integrated electromyographic ( nIEMG ) activity , while carrying a box of groceries and st and ing from a chair . DESIGN Prospect i ve intervention study . SETTING Volunteer subjects from the community of Birmingham , Alabama . PARTICIPANTS Fourteen healthy women aged 60 to 77 years . INTERVENTION Sixteen weeks of total body strength conditioning . MEASUREMENTS Before and after 16 weeks of strength conditioning , the following variables were evaluated for all subjects : ( 1 ) strength , six isotonic tests and two isometric tests ; ( 2 ) walking velocity ; ( 3 )  nIEMG of the biceps while carrying a box of groceries ;  and ( 4 )  nIEMG of the rectus femoris while st and ing from a chair .  MAIN RESULTS After the strength training program , subjects ' isotonic strength increased significantly , an average of 52 % on the isotonic tests and 31 % on the isometric tests . Walking velocity also increased significantly ( 18 % ) . nIEMG of the biceps decreased 36 % while carrying a box of groceries . Rectus femoris nIEMG decreased 40 % while st and ing and 47 % while sitting . CONCLUSIONS After strength conditioning , healthy older women showed not only substantially increased strength but also improvements in walking velocity and the ability to carry out daily tasks such as rising from a chair and carrying a box of groceries PURPOSE This r and omized controlled study assessed whether adding a program of high-intensity strength training ( 80 % of maximum ) to an outpatient cardiac rehabilitation program would be a safe and effective means of improving muscle strength and body composition . METHODS Thirty-eight cardiac patient volunteers ( 29 men and 9 women ) were r and omized  to either high-intensity strength training or flexibility training added concurrently to a 12-week outpatient cardiac rehabilitation aerobic exercise program .  Muscle strength , local muscle endurance , joint flexibility , maximum treadmill tolerance time , and body composition were measured before and after completion of the training . RESULTS The strength-trained patients ( n = 18 ) had greater increases in mean strength ( 90 + /- 19 % versus 9 + /- 4 % , P < 0.0001 ) and local muscle endurance ( 20 versus 6 times , P < 0.0001 ) , and decreases in mean perceived exertion for lifting the initial one repetition maximum load ( 11 + /- 1 versus 15 + /- 1 , P < 0.0001 ) when compared with flexibility-trained patients ( n = 16 ) . The strength group lost more body fat ( 2.8 + /- 2.0 versus 1.3 + /- 2.0 kg , P < 0.01 ) , tended to gain more lean tissue ( 1.5 + /- 2.3 versus 0.5 + /- 1.2 kg , P < 0.10 ) , and had greater improvements in treadmill time ( 2.3 + /- 1.3 versus 1.2 + /- 1.0 minute , P < 0.02 ) than did the flexibility group . Improvements in joint flexibility were similar for each group . None of the subjects had evidence of cardiac ischemia or arrhythmia during the training sessions . CONCLUSIONS Medically supervised high-intensity strength training is well tolerated when added to the aerobic training of cardiac rehabilitation programs and allows patients to aggressively gain the strength and endurance they will need to complete daily living tasks at lower perceived efforts . Strength training also reduces cardiac risk factors by improving body composition and maximum treadmill exercise time Patients who are on hemodialysis commonly experience muscle wasting and weakness , which have a negative effect on physical functioning and quality of life . The objective of this study was to determine whether anabolic steroid administration and resistance exercise training induce anabolic effects among patients who receive maintenance hemodialysis . A r and omized 2 x 2 factorial trial of anabolic steroid administration and resistance exercise training was conducted in 79 patients who were receiving maintenance hemodialysis at University of California , San Francisco-affiliated dialysis units . Interventions included double-blinded weekly n and rolone decanoate ( 100 mg for women ; 200 mg for men ) or placebo injections and lower extremity resistance exercise training for 12 wk during hemodialysis sessions three times per week using ankle weights . Primary outcomes included change in lean body mass ( LBM ) measured by dual-energy x-ray absorptiometry , quadriceps muscle cross-sectional area measured by magnetic resonance imaging , and knee extensor muscle strength . Secondary outcomes included changes in physical performance , self-reported physical functioning , and physical activity . Sixty-eight patients completed the study . Patients who received n and rolone decanoate increased their LBM by 3.1 + /- 2.2 kg ( P < 0.0001 ) . Exercise did not result in a significant increase in LBM . Quadriceps muscle cross-sectional area increased in patients who were assigned to exercise ( P = 0.01 ) and to n and rolone ( P < 0.0001 ) in an additive manner . Patients who exercised increased their strength in a training-specific fashion , and exercise was associated with an improvement in self-reported physical functioning ( P = 0.04 compared with nonexercising groups ) . N and rolone decanoate and resistance exercise produced anabolic effects among patients who were on hemodialysis . Further studies are needed to determine whether these interventions improve survival The purpose of this study was to examine the effects of a 14-week resistance training program on the anile 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 b and s ( Therab and ) 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 OBJECTIVE To determine the effect of a home exercise program on strength , postural control , and mobility following hip fracture . DESIGN R and omized controlled trial of 1 month 's duration . SETTING Daily exercise carried out within the subjects ' home environments . PARTICIPANTS Forty-two people 64 to 94 years of age , 35 of whom were living independently in the community and 7 of whom were residing in institutional care . Subjects were recruited on average 7 months after a fall-related hip fracture and r and omly allocated to either the intervention or the control group ( n = 21 each ) . The groups were well matched in terms of medical conditions , medication use , disability , and activity levels . INTERVENTION A " home-based " program of weight-bearing exercise established at a visit by a physiotherapist . MAIN OUTCOME MEASURES Quadriceps strength , postural sway , functional reach , weight-bearing ability , walking velocity , and self-rated fall risk . The subjects undertook these assessment s at the beginning and end of the trial . RESULTS At pretest , exercisers and controls performed similarly in all tests . At the end of the trial , the intervention group showed significantly greater quadriceps strength in the affected ( hip-fractured ) leg and increased walking velocity . The intervention subjects also improved their weight-bearing ability and reported reduced subjective falls risk . In contrast , there were no significant improvements in any of the test measures in the controls . Within the intervention group , improvements in quadriceps strength were significantly associated with improved performances in the weight-bearing test measures and with increased walking velocity . CONCLUSIONS This exercise program improved strength and mobility following hip fracture . Further research is needed to ascertain whether the extent of this improvement in these fall risk factors is sufficient to prevent falls BACKGROUND 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 . METHODS 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 r and om 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 . RESULTS 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 . CONCLUSIONS 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 Skeletal muscle wasting is common and insidious in patients who receive maintenance hemodialysis treatment for the management of ESRD . The objective of this study was to determine whether 12 wk of high-intensity , progressive resistance training ( PRT ) administered during routine hemodialysis treatment could improve skeletal muscle quantity and quality versus usual care . Forty-nine patients ( 62.6 + /- 14.2 yr ; 0.3 to 16.7 yr on dialysis ) were recruited from the outpatient hemodialysis unit of the St. George Public Hospital ( Sydney , Australia ) . Patients were r and omized to PRT + usual care ( n = 24 ) or  usual care control only  ( n = 25 ) . The PRT group performed two sets of 10 exercises at a high intensity ( 15 to 17/20 on the Borg Scale ) using free weights , three times per week for 12 wk during routine hemodialysis treatment . Primary outcomes included thigh muscle quantity ( cross-sectional area [ CSA ] ) and quality ( intramuscular lipid content via attenuation ) evaluated by computed tomography scan . Secondary outcomes included muscle strength , exercise capacity , body circumference measures , proinflammatory cytokine C-reactive protein , and quality of life . There was no statistically significant difference in muscle CSA change between groups . However , there were statistically significant improvements in muscle attenuation , muscle strength , mid-thigh and mid-arm circumference , body weight , and C-reactive protein in the PRT group relative to the nonexercising control group . These findings suggest that patients with ESRD can improve skeletal muscle quality and derive other health-related adaptations solely by engaging in a 12-wk high-intensity PRT regimen during routine hemodialysis treatment sessions . Longer training duration s or more sensitive analysis techniques may be required to document alterations in muscle CSA To investigate the effects of cessation and subsequent resumption of training on muscle strength in elderly men , 11 men ( aged 65 - 77 years ) , just completing a 24-week r and omized controlled trial of recombinant human growth hormone ( rhGH ) and resistance exercise ( rhGH  , n = 6 ; placebo , n = 5 ) , detrained for 12 weeks and subsequently retrained for 8 weeks . During the detraining and retraining phase , subjects did not receive rhGH . The resistance programme included three sets of eight repetitions at 75 % of one-repetition maximum ( 1-RM ) , three times per week , for 10 upper and lower body exercises .  Dynamic muscle strength was assessed by the 1-RM method every 2 weeks for 44 weeks . Needle biopsies of vastus lateralis muscle were obtained from seven men . Muscle strength increased during initial training by 40.4 + /- 5.5 % ( mean + /- SEM ) , ranging from 26.0 + /- 5.0 to 83.9 + /- 15.6 % , depending on muscle group . Increased strength was accompanied by hypertrophy ( P < 0.05 ) of type I ( 17.4 + /- 4.1 % ) and II ( 25.8 + /- 12.4 % ) muscle fibres . Of initial strength gains , only 29.9 + /- 5.2 % was lost with detraining . However , type I and II fibre cross-sectional area reverted to pretraining values . After 8 weeks of retraining , muscle strength returned to trained values , but without a significant change in fibre morphology . The results indicate that elderly men lose some muscle strength following short-term detraining , but that only a brief period of retraining suffices to regain maximal strength . Reversal of fibre cross-sectional area with detraining , and only modest improvement with retraining , suggests that much of the retention in strength with detraining and reacquisition of lost strength with retraining reflects neural adaptation PURPOSE This study examined the effects of 24 wk of high intensity strength training or low intensity walking on lumbar bone mineral density ( BMD ) , muscular strength , and calcium turnover in Australian women either taking hormone replacement therapy ( HRT ) or not taking HRT .  METHODS A subject pool of 64 women between 45 - 65 yr and r and omly allocated into weights ( N = 21 ) , walking ( N = 20 ) , weightsHRT ( N = 14 ) , and walkingHRT ( N = 9 ) groups completed this study . All subjects trained twice weekly in either a 50-min walking or weight-training program ( 60 - 90 % IRM ) . Measurements included maximal isometric knee strength , IRM bench press , IRM squat , isokinetic back strength , lumbar ( L2-L4 ) BMD , serum osteocalcin , and urinary deoxypyridinoline crosslinks ( Dpd ) . RESULTS No significant group differences in BMD were evident at the completion of training . However , a significant ( P < 0.05 ) within group change was apparent for the walking group since BMD decreased 1.3 % below baseline testing . Osteocalcin levels increased significantly ( P < 0.05 ) in the walking ( 22 % ) group . Maximal bench press and squat strength improved significantly ( P < 0.05 ) in the weights ( 25.8 % and 37.7 % ) and weightsHRT ( 25.4 % and 35.7 % ) groups . The weights group also increased significantly ( P < 0.05 ) in isokinetic back strength ( 22.2 % ) . CONCLUSION It was concluded that short-term high intensity resistance training provides an effective means for increasing muscular strength in women between 45 and 65 yr . The training effects on lumbar BMD were not apparent in the present study Progressive resistance training has positive effects on the health of elderly people , however exercise programs for seniors frequently focus on other forms of exercise . This study is a r and omised trial with a blinded assessor comparing a  community based progressive resistance training program ( n = 20 ) with a flexibility program ( n = 20 ) , both one hour twice weekly for 10 weeks . Outcomes were strength , gait , balance and quality of life .  Progressive resistance training had a greater effect than flexibility training on right sided quadriceps strength ( mean difference between groups = 7.7 % ; 95 % CI 3.6 - 11.8 % , p < 0.003 MANOVA ) , left sided quadriceps strength ( mean difference = 9.9 % ; 95 % CI 5.6 - 14.2 % , p < 0.003 MANOVA ) , left sided biceps strength ( mean difference = 15.2 % ; 95 % CI 11.7 - 19.2 % , p < 0.003 MANOVA ) , functional reach ( mean difference = 11.7 % ; 95 % CI 7.1 - 16.3 % , p < 0.003 MANOVA ) and step test ( mean difference = 8.6 % ; 95 % CI 3.8 - 13.4 % , p < 0.003 MANOVA ) . Neither group had improvements in SF36 quality of life measures . Results suggest progressive resistance training produces greater strength , gait and balance improvements  in elderly people than a flexibility exercise program Knowledge of the effects of exercise on bone mass in postmenopausal women is limited and controversial . Animal studies have shown that the response of bone to bending strain is an alteration of bone geometry . We studied 250 postmenopausal women , aged 52 - 72 years , willing to participate in a 6-month exercise program .  The first 125 started the program immediately and the remaining 125 served as controls . The training program included exercises design ed to maximize the stress on the wrist . One hundred and eighteen of the active group and 116 of the control group completed the study and were reassessed 6 months later . Bone mineral density ( BMD ) of the femoral neck , lumbar spine , ultradistal and proximal radius was measured by dual-energy X-ray absorptiometry ( DXA ) both before and at the end of the exercise program . The forearm was also evaluated by peripheral quantitative computed tomography , which measures the area , bone mineral content ( BMC ) , and volumetric density for both the cortical and the trabecular component . The results showed that the DXA measurements at the femoral neck , lumbar spine , ultradistal and proximal radius were similar between the two groups . No significant difference was detected after the exercise program at the proximal radius . At the ultradistal radius , the cross-sectional area of cortical bone rose by 2.8 + /- 15.0 % ( SD , p < 0.05 ) , apparently for both periosteal apposition and corticalization of the trabecular tissue . The volumetric density of cortical bone rose by 2 . 2 + /- 15.8 % ( p < 0.1 ) , and that of trabecular bone decreased by 2.6 + /- 10.7 % ( p < 0.01 ) . The combined changes in both bone volume and density in the exercise group were associated with marked increase in cortical BMC ( 3.1 + /- 10.7 % , p < 0.01 ) and decrease in trabecular BMC ( -3.4 + /- 14.2 % , p < 0.05 ) , which were statistically different from those observed in the control group ( p < 0.05 ) . In conclusion , these results confirm that site-specific moderate physical exercises have very little effect on bone mass . However , it appears that some exercises may reshape the bone segment under stress by increasing both the cross-sectional area and the density of the cortical component . These structural changes are theoretically associated with increases in the bending strength This study was design ed 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 r and omly 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 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 BACKGROUND 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 . METHODS We conducted a r and omized , 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 . RESULTS 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 . CONCLUSIONS 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 Objective : To examine the effectiveness of task-oriented progressive resistance strength training on lower extremity strength and functional performance in chronic stroke subjects . Design : Single-blind , r and omized controlled trial . Setting : Medical centre and district hospital . Subjects : Forty-eight subjects at least one year post stroke . Interventions : Participants r and omly allocated to two groups , control  ( n-/24 ) and experimental  ( n-/24 ) . Subjects in the control group did not receive any rehabilitation training . Subjects in the experimental group were put on a four-week task-oriented progressive resistance strength training . Main measures : Lower extremity muscle strength , gait velocity , cadence , stride length , six-minute walk test , step test , and timed up and go test . Results : Muscle strength significantly improved in the experimental group for strong side muscle groups ( ranged from 23.9 % to 36.5 % ) and paretic side muscle groups ( ranged from 10.1 % to 77.9 % ) . In the control group muscle strength changes ranged from 6.7 % gain to 11.2 % decline . The experimental group showed significant improvement in all selected measures of functional performance except for the step test . In the control group , the number of repetitions of the step test significantly decreased ( -20.3 % ) with no change in other functional tests . There was a significant difference between groups for muscle strength and all functional measures . The strength gain was significantly associated with gain in the functional tests . Conclusions : The task-oriented progressive resistance strength training programme could improve lower extremity muscle strength in individuals with chronic stroke and could carry over into improvement in functional abilities Background : While the fear of falling is a common psychological consequence of falling , older adults who have not fallen also frequently report this fear . Fear of falling can lead to activity restriction that is self-imposed rather than due to actual physical impairments . Evidence suggests that exercise can significantly improve balance confidence , as measured by falls-related self-efficacy scales . However , there are no prospect i ve reports that correlate change in balance confidence with changes in fall risk and physical abilities as induced by participating in a group-based exercise program . Objective : The primary purpose of this prospect i ve study was to examine the relationship between the change in balance confidence and the changes in fall risk and physical abilities in older women with confirmed low bone mass after 13 weeks of exercise participation . The secondary purpose of this study was to examine the relationship between the change in balance confidence and the change in physical activity level . Methods : The sample comprised 98 women aged 75–85 years with low bone mass . Participants were r and omly assigned to one of three groups : resistance training ( n = 32 ) , agility training ( n = 34 ) , and stretching ( sham ) exercises ( n = 32 ) . The 50-min exercise classes for each study arm were held twice weekly at a local YMCA community centre . Results : Both resistance training and agility training significantly improved balance confidence by 6 % from baseline after 13 weeks . However , the change in balance confidence was only weakly correlated with improved general physical function and not significantly correlated with the changes in fall risk score , postural stability , gait speed , or physical activity level . As well , we observed balance confidence enhancement in the presence of increased fall risk or deterioration in physical abilities . Conclusions : Two different types of exercise training  improved balance confidence in older women with low bone mass . This change in balance confidence was significantly correlated with change in general physical function . Because of the observation of discordance between balance confidence change and changes in fall risk and physical abilities , those who design group-based exercise programs for community-dwelling older adults may wish to consider including an education component on factors that influence fear of falling . Objective changes in fall risk factors can not be assumed to mirror change in fear of falling and physical abilities in older adults in the short-term BACKGROUND Older people with somatic illnesses are at increased risk of depression . It is not known whether exercise alleviates depressive symptoms in frail , very old people recuperating from an acute illness . OBJECTIVE To determine the effects of a group-based exercise training program on mood . METHODS Sixty-eight women ( mean age 83.0 , SD 3.9 years ) who were hospitalized due to an acute illness , and were mobility impaired at admission , were r and omized into group-based 10-week strength training intervention ( N=34 ) and home exercise control ( N=34 ) groups . Twenty-four women in the training and 28 in the control group completed the follow-up . Measures of mood state with the Zung Self-Rating Depression Scale ( ZSDS ) were performed before and after the training intervention , and follow-up data was collected 3 and 9 months after the end of the intervention . RESULTS After the intervention , there was a significant improvement in mood in the intervention group compared to the home exercise control group : -3.1 ( SD 9.0 ) points vs + 1.3 ( SD 7.6 ) points ( p=0.048 ) and the positive effect was still apparent three months after the intervention ceased : -2.6 ( SD 7.7 ) points vs + 3.5 ( SD 9.7 ) points ( p=0.015 ) . Improvement of mood state at the first follow-up measurement was associated with the improvement in lower limb isometric muscle strength .  CONCLUSIONS Group-based exercise program organized in the context of a Finnish health care organization improved mood in frail older women recuperating from an acute illness 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 r and omized 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 The aim of the present study was to evaluate the effects of a 16-week progressive high-intensity strength training ( HIST ) program on peripheral markers of bone turnover ( bone Gla protein , BGP ; bone alkaline phosphatase , B-AP ; N-terminal propeptide of type I procollagen , PINP ; C-terminal cross-linked telopeptide of type I collagen , ICTP ) in healthy , elderly men over 65 yr of age . Thirty healthy men ( aged 65–81 yr ) , performing light to moderate daily physical activity , were r and omly divided into two groups . Group 1 ( no.=16 ) followed a supervised 16-week progressive HIST program , while subjects of group 2 ( no.=14 ) , used as controls , were requested to maintain their habitual level of physical activity for 16 weeks . HIST program consisted of 6 different sets of exercise ( 2 involving the major muscle groups of the lower limb and 4 involving those of the upper limb ) . Three sessions/week , during which 10 repetitions of each exercise set were completed , were performed . Lower limb exercises shifted from 50 to 80 % of the one maximal repetition ( 1MR ) during the first month of the protocol and were thereafter maintained at an intensity of 80 % 1MR throughout the training . Upper limb exercises shifted from 40 to 65 % of 1MR with a similar pattern . All sessions were preceded by 15 min of cycloergometer exercise at 50 % of maximal oxygen uptake and by a warm-up of 15 repetitions at 20 % of 1MR of each exercise set . The HIST program did not significantly change BGP ( mean±SE , before : 15.6±1.2 μg/l vs after : 16.0±1.2 μg/l , NS ) and PINP levels ( before : 44.6±6.7 μg/l vs after : 43.1±6.0 μg/l , NS ) . On the contrary , serum B-AP significantly increased ( before : 50.2±6.1 IU/l vs after : 62.3±7.0 IU/l , p<0.001 ) and serum ICTP slightly reduced ( before : 4.0±0.3 μg/l vs after : 3.8±0.3 μg/l , p<0.05 ) . When bone turnover was expressed as the ratio between bone formation to bone resorption ( B-AP/ICTP ratio ) , a significant improvement in this ratio was found in all subjects of group 1 ( before : 12.9±1.3 IU/μg vs after : 17.3±1.5 IU/μg , p<0.0001 ) , while no significant changes were observed in Group 2 . No significant changes of IGF-I levels were observed after the HIST program ( before : 94.9±9.4 μg/l vs after : 89.9±9.7 μg/l ) . No significant changes of BGP , PINP , B-AP , ICTP , B-APICTP ratio and IGF-I levels were observed in controls ( group 2 ) during the 16 weeks of observation . Although the positive effects of a progressive HIST program  on B-AP levels and B-AP-ICTP ratio seem promising , the support of bone mass measurement and the determination of other bone markers are requested to better identify exercise protocol ( duration , intensity ) for elderly people PURPOSE 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 . METHODS 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 . RESULTS 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 . CONCLUSIONS 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 OBJECTIVE To evaluate the effectiveness of three different training protocol s on physical function of older adults living in long-term care facilities . Emphasis was placed on feasibility in real-life situations . METHODS Subjects ( N=224 ) were r and omised to 6 months of twice weekly ( 1 ) resistance training ; ( 2 ) all-round functional-skills training ; ( 3 ) a combination of both ; or ( 4 ) a control program .  Fitness and performance measures and self-reported disability were measured at baseline and after 24 weeks intervention . RESULTS Attendance to the strength training was 76 % , to the functional-skills training 70 % and to the combined training 73 % . In those who attended at least 75 % of all classes ( n=97 ) the functional-skills and combined training program improved several fitness and performance measures compared to the control group . CONCLUSION Twice weekly functional-skills training , or a combination of resistance and functional-skills training can improve several fitness and performance measures of institutionalised older people . PRACTICE IMPLICATION S An important finding from our study was that less than twice a week exercise training is not enough for functional improvement , while it proved difficult for the elderly subjects to exercise twice weekly . Education on the health benefits of regular exercise , and a larger availability of classes in long-term care facilities may improve attendance 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 r and omized 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 A preliminary 10-wk . study was conducted to determine the effect a combined strength and cardiovascular exercise protocol had on both physiological and psychological change in 17 older ( M age = 66.8 yr . ) , formerly sedentary women . The protocol was associated with better adherence than typically found for new and returning exercisers . Significant improvements over 10 wk . were found on Body Mass Index , body fat , resting heart rate , and balance . Significant , positive changes in mean ratings were also found on Physical Self-concept , Total Mood Disturbance , Depression , and Fatigue ( small to moderate treatment effect sizes ) . Although no significant changes were found for rated Tension , Vigor , Anger , and Confusion , mean changes were in the desired direction and rated Tension showed a moderate effect size . The need for replication , including a control group and follow-up , plus continued research on exercise protocol s both well-tolerated and effective for older individuals and other specific groups , were discussed Twenty active elderly subjects ( mean age = 66.4 years , range 51 - 81 ) participated in a 12-week weight-training program to determine the possibility of increasing muscular strength and lean body weight . The training utilized variable resistance weight machines which trained the major muscle groups . The male subjects ( n = 11 ) experienced an average increase of 66.1 % ( SD = 19.39 , p < 0.00001 ) in total maximum weight lifted while the females ( n = 9 ) showed an average increase of 72.2 % ( SD = 33.44 , p < 0.001 ) . Lean body weight , which was calculated by skinfold measurements for each group did increase , but was not statistically significant ( males p < 0.11 , females p < 0.18 ) . The study demonstrated the positive effects a weight-training regimen can have on an elderly population Abstract .Falls are a common hazard in the elderly . Orthostatic hypotension ( OH ) is prevalent in older patients and contributes to the high incidence of falls . Our aim was to test whether a home-based resistance-training program ( HBRT ) using elastic resistance b and s could safely and effectively increase muscle strength and functional ability , and attenuate the orthostatic fall in blood pressure .  Eight subjects ( > 60 yrs ) underwent orthostatic provocations ; muscle strength testing ( isometric and dynamic ) , and a functional test of gait and mobility ( Timed Up & Go ) , at baseline and following 8 weeks of training . Ten exercises were assigned and customized to each participant . At 8 weeks , significant increases occurred in dynamic strength in the chest press ( p = 0.017 ) , quadriceps extension ( p = 0.017 ) , and leg press ( p = 0.025 ) ; no significant differences occurred in isometric strength or in blood pressures . Functional mobility increased in 7 of 8 subjects . There were no falls during the investigation period . Conclusion A HBRT program using elastic resistance b and s effectively increases dynamic muscle strength in elderly individuals with OH . Although no changes occurred in orthostatic blood pressures , which could be attributed to the limited length of the program , this therapy may be recognized as a safe method to improve strength , functional ability , and promote physical activity – variables that can reduce the incidence of falls and enhance the quality of life in this population
target: Serious adverse events were rare , and no serious events were reported to be directly related to the exercise programme .
  This review provides evidence that PRT is an effective intervention for improving physical functioning in  older people , including improving strength and the performance of some simple and complex activities .
background: BACKGROUND Muscle weakness in old age is associated with physical function decline .
  Progressive resistance strength training ( PRT ) exercises are design ed to increase strength .
  OBJECTIVES To assess the effects of PRT on older people and identify adverse events .