title: Exercise, Fitness, and Neurocognitive Function in Older Adults: The “Selective Improvement” and “Cardiovascular Fitness” Hypotheses The effects of aerobic and resistance exercises in obese women A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial Resistance, aerobic, and combination training on vascular function in overweight and obese adults. Effects of Core Instability Strength Training on Trunk Muscle Strength, Spinal Mobility, Dynamic Balance and Functional Mobility in Older Adults Impact of Training Modality on Strength and Physical Function in Older Adults Functional vs. Strength Training in Disabled Elderly Outpatients Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. Reliability of the PEDro scale for rating quality of randomized controlled trials. Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women. Resistance exercise training improves heart rate variability and muscle performance: a randomized controlled trial in coronary artery disease patients.
abstract: Background Although basic research has uncovered biological mechanisms by which exercise could maintain and enhance adult brain health , experimental human studies with older adults have produced equivocal results . Purpose This r and omized clinical trial aim ed to investigate the hypotheses that ( a ) the effects of exercise training on the performance of neurocognitive tasks in older adults is selective , influencing mainly tasks with a substantial executive control component and ( b ) performance in neurocognitive tasks is related to cardiorespiratory fitness . Methods Fifty-seven older adults ( 65–79 years ) participated in aerobic or strength- and -flexibility exercise training for 10 months . Neurocognitive tasks were selected to reflect a range from little ( e.g. , simple reaction time ) to substantial ( i.e. , Stroop Word – Color conflict ) executive control . Results Performance in tasks requiring little executive control was unaffected by participating in aerobic exercise .  Improvements in Stroop Word – Color task performance were found only for the aerobic exercise group . Changes in aerobic fitness were unrelated to changes in neurocognitive function . Conclusions Aerobic exercise in older adults can have a beneficial effect on the performance of speeded tasks that rely heavily on executive control . Improvements in aerobic fitness do not appear to be a prerequisite for this beneficial effect Objective : To compare the effects of aerobic and resistance exercise on weight , muscle strength , cardiovascular fitness , blood pressure and mood in obese women who were not on an energy-restricted diet . Design : R and omized , prospect i ve , controlled trial . Setting : Department of Physical Medicine and Rehabilitation , University Hospital . Subjects : Sixty obese women were assigned to one of three groups : aerobic exercise ( n=20 ) , resistance exercise ( n=20 ) and control group ( n=20 ) . Interventions : The aerobic exercise group performed both walking and leg cycle exercise with increasing duration and frequency . The resistance exercise group performed progressive weight-resistance exercises for the upper and lower body . Main outcome measures : Before and after a 12-week period , all subjects were evaluated by anthropometric measurement , rating of mood , cardiorespiratory capacity and maximum strength of trained muscles . Results : After a 12-week training period , subjects in the resistance group showed significant improvement in one-repetition maximum test of hip abductors ( 7.95±3.58 kg ) , quadriceps ( 14±7.18 kg ) , biceps ( 3.37± 2.84 kg ) and pectorals ( 8.75±5.09 kg ) compared with those in the control group ( P<0.001 ) . VO2 max increased ( 0.51±0.40 ) and Beck Depression Scale scores decreased ( -5.40±4.27 ) in the aerobic exercise group compared with the control group , significantly ( P<0.001 ) . Only in hip abductor muscle strength was there a significant increase in the resistance exercise group compared with the aerobic exercise group ( P < 0.05 ) . Conclusion : Both aerobic exercise and resistance exercise result ed in improved performance and exercise capacity in obese women .  While aerobic exercise appeared to be beneficial with regard to improving depressive symptoms and maximum oxygen consumption , resistance exercise was beneficial in increasing muscle strength 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 The authors investigated the effects of moderate-intensity resistance , aerobic , or combined exercise on  blood pressure and arterial stiffness in overweight and obese individuals compared with no exercise . Participants were r and omized to 4 groups : control , aerobic , resistance , and combination . Assessment s were made at baseline , week 8 , and week 12 . In participant- design ated responders , those in the intervention groups who had improved levels of systolic blood pressure ( SBP ) or augmentation index ( AI ) , we observed a significant decrease of SBP in aerobic ( -4 % , P=.027 ) , resistance ( -5.1 % , P=.04 ) , and combination groups ( -6.3 % , P=.000 ) at week 8 and in the combination group ( -6.3 % , P=.005 ) at week 12 , compared with baseline . AI was significantly lower at week 12 in the aerobic ( -12 % , P=.047 ) , resistance ( -9.5 % , P=.036 ) , and combination ( -12.7 % , P=.003 ) groups compared with baseline , as well as in the combination group ( -10.7 % , P=.047 ) compared with the control group . We did not observe significant changes in SBP , DBP , or AI between the interventions when assessing the entire cohort , although there were significant improvements in a subgroup of responders . Thus , some but not all overweight and obese individuals can improve blood pressure and arterial stiffness by participating in regular combination exercise , decreasing the risk of developing cardiovascular disease Background : Age-related postural misalignment , balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors .  Core instability strength training ( CIT ) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength , spinal mobility and balance performance . Objective : The objective was to investigate the effects of CIT on measures of trunk muscle strength , spinal mobility , dynamic balance and functional mobility in seniors . Methods : Thirty-two older adults were r and omly assigned to an intervention group ( INT ; n = 16 , aged 70.8 ± 4.1 years ) that conducted a 9-week progressive CIT or to a control group ( n = 16 , aged 70.2 ± 4.5 years ) . Maximal isometric strength of the trunk flexors/extensors/lateral flexors ( right , left)/rotators ( right , left ) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program . Dynamic balance ( i.e. walking 10 m on an optoelectric walkway , the Functional Reach test ) and functional mobility ( Timed Up and Go test ) were additionally tested . Results : Program compliance was excellent with participants of the INT group completing 92 % of the training sessions . Significant group × test interactions were found for the maximal isometric strength of the trunk flexors ( 34 % , p < 0.001 ) , extensors ( 21 % , p < 0.001 ) , lateral flexors ( right : 48 % , p < 0.001 ; left : 53 % , p < 0.001 ) and left rotators ( 42 % , p < 0.001 ) in favor of the INT group . Further , training-related improvements were found for spinal mobility in the sagittal ( 11 % , p < 0.001 ) and coronal plane ( 11 % , p = 0.06 ) directions , for stride velocity ( 9 % , p < 0.05 ) , the coefficient of variation in stride velocity ( 31 % , p < 0.05 ) , the Functional Reach test ( 20 % , p < 0.05 ) and the Timed Up and Go test ( 4 % , p < 0.05 ) in favor of the INT group . Conclusion : CIT proved to be a feasible exercise program for seniors with a high adherence rate . Age-related deficits in measures of trunk muscle strength , spinal mobility , dynamic balance and functional mobility can be mitigated by CIT . This training regimen could be used as an adjunct or even alternative to traditional balance and /or resistance training Background : The importance of maintaining strength in older adults is well documented and various training modalities have been recommended ; however , the effectiveness of various interventions with high translation to public health practice has not been completely characterized . Additionally , the interrelations among mode , strength , and lower extremity physical function ( LEPF ) changes in older adults warrant further investigation . Purpose : The primary aims were to examine the effectiveness of cardiovascular endurance training ( CVE ) compared with balance and flexibility training ( FLEX ) and to explore the relationship of muscle strength to LEPF . Methods : Fifty-five adults ( 69.1 ± 5.6 years , 35 female ) were r and omly assigned to 10 months of CVE or FLEX . Knee extension and flexion at 60 and 120 ° ·s–1 were measured using an isokinetic dynamometer  . LEPF was measured using a battery of tasks . The CVE group exercised using treadmills , cycles , and elliptical trainers . The FLEX group participated in a group exercise class that incorporated flexibility and balance activities . Results : The CVE training group significantly improved peak oxygen consumption by 6 % ( p = 0.03 ) , while the FLEX training group showed no change ( p = 0.47 ) . Participants significantly improved peak torque at both speeds and muscle actions by 21–65 % ( p ≤ 0.05 ) , with no group effect ( p > 0.05 ) . Both groups also significantly improved performance on all LEPF tasks included in this study ( 4–7 % , p ≤ 0.05 ) . Significant correlations ( all p = 0.00 ) were found between improvements in strength and improvements in LEPF including timed walk and peak torque extension and flexion at 60 ° ·s–1 ( r = 0.40 and 0.27 , respectively ) , obstacle walk and peak torque extension and flexion at 60 and 120 ° ·s–1 ( r range 0.27–0.40 ) , and stair ascent and peak torque extension at 120 ° ·s–1 ( r = 0.37 ) . Conclusions : Sedentary older adults achieve similar improvements in strength and LEPF  with either CVE or FLEX training with the latter being related to improvements in leg strength 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 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 BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . 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 BACKGROUND Resistance exercise ( RE ) is an important part of cardiac rehabilitation . However , it is not known about the low intensity of RE training that could modify the heart rate variability ( HRV ) , muscular strength and endurance in patients with coronary artery disease ( CAD ) . AIM To investigate the effects of high repetition/low load resistance training ( HR/LL-RT ) program on HRV and muscular strength and endurance in CAD patients . DESIGN R and omized and controlled trial . SETTING Patients seen at the Cardiopulmonary Physical Therapy Laboratory between May 2011 and November 2013 . POPULATION Twenty male patients with CAD were r and omized to a training group ( 61.3±5.2 years ) or control group ( 61±4.4 years ) . METHODS 1 repetition maximum ( 1-RM ) maneuver , discontinuous exercise test on the leg press ( DET-L ) , and resting HRV were performed before and after 8 weeks of HR/LL-RT on a 45 ° leg press . RMSSD , SD1 , mean HR and ApEn indices were calculated . The HR/LL-RT program consisted of a lower limb exercise using a 45 ° leg press ; 3 sets of 20 repetitions , two times a week . The initial load was set at 30 % of the 1-RM load and the duration of the HR/LL-RT program was performed for 8 weeks . RESULTS After 8 weeks of HR/LL-RT there were significant increases of RMSSD and SD1 indices in the training group only ( P<0.05 ) . There was a significant decrease in mean HR after HR/LL-RT in the training group ( P<0.05 ) . There was a significantly higher ApEn after in the training group ( P<0.05 ) . There were significantly higher values in the training group in contrast to the control group ( P<0.05 ) . CONCLUSION These results show positive improvements on HRV , as well as muscle strength and endurance in CAD patients . CLINICAL REHABILITATION IMPACT Eight weeks of HR/LL-RT is an effective sufficient to beneficially modify important outcomes as HRV , muscle strength and endurance in CAD patients
target: According to the GRADE system , there is very low quality evidence that functional training is better than other interventions to improve cardiovascular parameters .
background: BACKGROUND Functional training is a new training vision that was prepared from the gesture imitation of daily activities .
  Although your use has become popular in clinical practice , the influence of the several cardiorespiratory adjustments performed during the functional training in different population s and conditions is unknown .
  So , the aim of this systematic review was to gather information in the literature regarding the influence of functional training on cardiorespiratory parameters .