Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: a randomized controlled trial High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis? A Randomized Controlled Trial to Reduce Falls in People With Parkinson’s Disease Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. Regenerate: assessing the feasibility of a strength-training program to enhance the physical and mental health of chronic post stroke patients with depression. A randomized controlled trial of progressive resistance training in depressed elders. Strength improvements with 1 yr of progressive resistance training in older women. Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial. Core self-evaluation as a predictor of strength training adoption in older adults. Progressive resistance training rebuilds lean body mass in head and neck cancer patients after radiotherapy--results from the randomized DAHANCA 25B trial. Resistance training improves muscle strength and functional capacity in multiple sclerosis Pilot randomized trial of progressive resistance exercise augmented by neuromuscular electrical stimulation for people with multiple sclerosis who use walking aids. Study of Mental Activity and Regular Training (SMART) in at risk individuals: A randomised double blind, sham controlled, longitudinal trial Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes. A Systematic Review of the Effects of Exercise Interventions on Body Composition in HIV+ Adults Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review. Effects of testosterone and progressive resistance exercise in healthy, highly functioning older men with low-normal testosterone levels. Effect of continuous progressive resistance training during hemodialysis on body composition, physical function and quality of life in end-stage renal disease patients: a randomized controlled trial Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial. Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. High-intensity progressive resistance training improves flat-ground walking in older adults with symptomatic peripheral arterial disease. Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson’s disease: study protocol for a randomised controlled trial A rationale and method for high-intensity progressive resistance training with children and adolescents. Falls and mobility in Parkinson's disease: protocol for a randomised controlled clinical trial Effect of resistance training on self-reported physical functioning in HIV infection. Effect of resistance training on physical disability in chronic heart failure. Progressive resistance exercise training and changes in resting-state functional connectivity of the caudate in persons with multiple sclerosis and severe fatigue: A proof-of-concept study Changes in Insulin Resistance and HbA1c Are Related to Exercise-Mediated Changes in Body Composition in Older Adults With Type 2 Diabetes Effect of progressive resistance training on muscle performance after chronic stroke. Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial. Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines Reductions in C-reactive protein in older adults with type 2 diabetes are related to improvements in body composition following a randomized controlled trial of resistance training A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial Comparison of effect of aerobic cycle training and progressive resistance training on walking ability after stroke: a randomized sham exercise-controlled study. Are interventions effective in improving the ability of older adults to rise from the floor independently? A mixed method systematic review Can progressive resistance training reverse cachexia in patients with rheumatoid arthritis? Results of a pilot study. Creatine Fails to Augment the Benefits from Resistance Training in Patients with HIV Infection: A Randomized, Double-Blind, Placebo-Controlled Study Effects of high- and low-velocity resistance training on the contractile properties of skeletal muscle fibers from young and older humans. Progressive resistance training improves gait initiation in individuals with Parkinson's disease. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial. Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial. Intensive physical training in geriatric patients after severe falls and hip surgery. Land-based versus aquatic resistance therapeutic exercises for older women with sarcopenic obesity: study protocol for a randomised controlled trial The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial Oral amino-acid provision does not affect muscle strength or size gains in older men. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Handgrip strength does not represent an appropriate measure to evaluate changes in muscle strength during an exercise intervention program in frail older people. The impact of resistance exercise training on the mental health of older Puerto Rican adults with type 2 diabetes. The effects of improved strength on obstacle negotiation in community-living older adults. The feasibility of progressive resistance training in women with polycystic ovary syndrome: a pilot randomized controlled trial The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial Resistance training on physical performance in disabled older female cardiac patients. A Comparison of the Clinical and Cost-Effectiveness of 3 Intervention Strategies for AIDS Wasting Physical activity, muscle function, falls and fractures Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. Single muscle fiber adaptations to resistance training in old (>80 yr) men: evidence for limited skeletal muscle plasticity. Effect of progressive resistance exercise on strength evolution of elderly patients living with HIV compared to healthy controls Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus. A randomised feasibility study of EPA and Cox-2 inhibitor (Celebrex) versus EPA, Cox-2 inhibitor (Celebrex), Resistance Training followed by ingestion of essential amino acids high in leucine in NSCLC cachectic patients - ACCeRT Study Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years: an 18-month randomized controlled trial A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Effects of traditional physical training and visual computer feedback training in frail elderly patients. A randomized intervention study. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Controlled examination of effects of progressive relaxation training on seizure reduction. Physical training improves motor performance in people with dementia: a randomized controlled trial. Exercise attenuates the weight-loss-induced reduction in muscle mass in frail obese older adults. Randomized controlled trial of intradialytic resistance training to target muscle wasting in ESRD: the Progressive Exercise for Anabolism in Kidney Disease (PEAK) study. Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: a randomized-controlled trial. Resistance training increases total daily energy expenditure in disabled older women with coronary heart disease. Progressive resistance training and mobility-related function in young people with cerebral palsy: a randomized controlled trial. Minimising disability and falls in older people through a post-hospital exercise program: a protocol for a randomised controlled trial and economic evaluation Qualitative outcomes of progressive resistance exercise for people with COPD Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial Tablet-Based Strength-Balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: A Phase II Preclinical Exploratory Trial Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review. Changes in Function and Disability After Resistance Training: Does Velocity Matter?: A Pilot Study Relaxation training in school classes does not reduce headache complaints. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. Once a week not enough, twice a week not feasible? A randomised controlled exercise trial in long-term care facilities [ISRCTN87177281]. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial. High intensity strength training improves strength and functional performance after stroke. The efficacy of counseling and progressive resistance home-exercises on adherence, health-related quality of life and function after discharge from a geriatric day-hospital. Effects of muscle strength training and megestrol acetate on strength, muscle mass, and function in frail older people. Enhancing quality of life in older adults: A comparison of muscular strength and power training DETRAINING AND TAPERING EFFECTS ON HORMONAL RESPONSES AND STRENGTH PERFORMANCE Balance training improves postural balance, gait, and functional strength in adolescents with intellectual disabilities: Single-blinded, randomized clinical trial. Development, feasibility, and efficacy of a customized exercise device to deliver intradialytic resistance training in patients with end stage renal disease: Non‐randomized controlled crossover trial Effects of different types of physical activity on the cognitive functions and attention in older people: A randomized controlled study The effect of progressive resistance training on oxidative stress and antioxidant enzyme activity in erythrocytes in untrained men. Exercise--it's never too late: the strong-for-life program. The Influence of Voice Volume, Pitch, and Speech Rate on Progressive Relaxation Training: Application of Methods from Speech Pathology and Audiology Tablet-Based Strength-Balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: Part 2 of a Phase II Preclinical Exploratory Trial Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge The effects of strength training on memory in older adults. The addition of electrical stimulation to progressive resistance training does not enhance the wrist strength of people with tetraplegia: a randomized controlled trial 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] Physical function predicts improvement in quality of life in elderly icelanders after 12 weeks of resistance exercise Efficacy of 2 non-weight-bearing interventions, proprioception training versus strength training, for patients with knee osteoarthritis: a randomized clinical trial. A home program of strength training, movement strategy training and education did not prevent falls in people with Parkinson's disease: a randomised trial. Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT. Muscle Strengthening in Children and Adolescents With Spastic Cerebral Palsy: Considerations for Future Resistance Training Protocols Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial A comparison of community-based resistance exercise and flexibility exercise for seniors. A combined inspiratory and expiratory muscle training program improves respiratory muscle strength and fatigue in multiple sclerosis. Community Weight Loss to Combat Obesity and Disability in At-Risk Older Adults How Physically Active Are People with Stroke in Physiotherapy Sessions Aimed at Improving Motor Function? A Systematic Review Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass Psychological effects of Yi Ren Medical Qigong and progressive resistance training in adults with type 2 diabetes mellitus: a randomized controlled pilot study. Muscle architecture and strength: adaptations to short-term resistance training in older adults. Randomized controlled trial of exercise training for older people (Sendai Silver Center Trial; SSCT): study design and primary outcome.
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 : Few high- quality trials have examined the effects of progressive resistance training ( PRT ) on people with multiple sclerosis ( MS ) . Objective : To determine the effectiveness of PRT for people with MS , focusing on improving the gait deficits common in this population . Methods : Using a single blind r and omized controlled trial , people with relapsing – remitting MS were r and omly allocated to either a PRT program targeting the lower limb muscles twice a week for 10 weeks ( n = 36 ) , or usual care plus an attention and social program conducted once a week for 10 weeks ( n = 35 ) . Outcomes were recorded at baseline , week 10 and week 22 . Results : Participants attended 92 % of training sessions , with no serious adverse events . At 10 weeks , no differences were detected in walking performance . However , compared with the comparison group PRT demonstrated increased leg press strength ( 16.8 % , SD 4.5 ) , increased reverse leg press strength ( 29.8 % , SD 12.7 ) , and increased muscle endurance of the reverse leg press ( 38.7 % , SD 32.8 ) . Improvements in favor of PRT were also found for physical fatigue ( Mean difference −3.9 units , 95%CI −6.6 to −1.3 ) , and the physical health domain of quality of life ( Mean difference 1.5 units , 95%CI 0.1 to 2.9 ) . At week 22 almost no between-group differences remained . Conclusion : PRT is a relatively safe intervention that can have short-term effects on reducing physical fatigue , increasing muscle endurance and can lead to small improvements in muscle strength and quality of life in people with relapsing – remitting MS . However , no improvements in walking performance were observed and benefits do not appear to persist if training is completely stopped 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 Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made Background : Multiple sclerosis ( MS ) is characterised by accelerated brain atrophy , which relates to disease progression . Previous research shows that progressive resistance training ( PRT ) can counteract brain atrophy in other population s. Objective : To evaluate the effects of PRT by magnetic resonance imaging ( MRI ) and clinical measures of disease progression in people with MS . Methods : This study was a 24-week r and omised controlled cross-over trial , including a Training ( n = 18 , 24 weeks of PRT followed by self-guided physical activity ) and Waitlist group ( n = 17 , 24 weeks of habitual lifestyle followed by PRT ) . Assessment s included disability measures and MRI ( lesion load , global brain volume , percentage brain volume change ( PBVC ) and cortical thickness ) . Results : While the MS Functional Composite score improved , Exp and ed Disability Status Scale , lesion load and global brain volumes did not differ between groups . PBVC tended to differ between groups and higher absolute cortical thickness values were observed in 19 of 74 investigated cortical regions after PRT . Observed changes were confirmed and reproduced when comparing relative cortical thickness changes between groups for four areas : anterior cingulate gyrus , temporal pole , orbital sulcus and inferior temporal sulcus . Conclusion : PRT seem to induce an increase in cortical thickness , indicating that PRT have a neuroprotective or even neuroregenerative effect in relapsing-remitting MS Background . Falls are common and disabling in people with Parkinson ’s disease ( PD ) . There is a need to quantify the effects of movement rehabilitation on falls in PD . Objective . To evaluate 2 physical therapy interventions in reducing falls in PD . Methods . We r and omized 210 people with PD to 3 groups :  progressive resistance strength training coupled with falls prevention education , movement strategy training combined with falls prevention education , and life-skills information ( control ) . All received 8 weeks of out-patient therapy once per week and a structured home program . The primary end point was the falls rate , recorded prospect ively over a 12 month period , starting from the completion of the intervention . Secondary outcomes were walking speed , disability , and quality of life . Results . A total of 1547 falls were reported for the trial . The falls rate was higher in the control group compared with the groups that received strength training or strategy training . There were 193 falls for the progressive resistance strength training group , 441 for the movement strategy group and 913 for the control group . The strength training group had 84.9 % fewer falls than controls ( incidence rate ratio [ IRR ] = 0.151 , 95 % CI 0.071 - 0.322 , P < .001 ) . The movement strategy training group had 61.5 % fewer falls than controls ( IRR = 0.385 , 95 % CI 0.184 - 0.808 , P = .012 ) . Disability scores improved in the intervention groups following therapy while deteriorating in the control group . Conclusions . Rehabilitation combining falls prevention education with strength training or movement strategy training reduces the rate of falls in people with mild to moderately severe PD and is feasible 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 OBJECTIVE The Regenerate pilot study explored whether a 10-week , community-based progressive resistance training ( PRT ) program could reduce depressive symptoms in depressed chronic stroke survivors . METHODS Participants were screened for depressive status using the PHQ-9 and confirmed by psychiatric assessment . Eligible people ( n = 45 ) were r and omised to PRT or a waiting-list comparison group .  The PRT program included two high intensity sessions/week for 10 weeks at a community-based gymnasium . Depressive status , physical and mental health and quality of life were measured at baseline , 10 weeks and 6 months . Muscle strength was assessed using 1 repetition maximum ( 1-RM ) for upper and lower limbs . RESULTS The participants ' median age was 69 years : 27 were male . The intervention group had lower depression scores than the comparison group at all time points . At 6-month follow-up , there was a trend for PRT participants to be more likely to be no longer depressed than the comparison group , but the difference was not significant after adjusting for baseline scores . There were modest improvements in health and wellbeing over time , but many scores were lower than reported in non-depressed people . Intervention participants demonstrated significant improvements in strength . Program adherence was good : on average 75 % of the 10-week program was completed . CONCLUSIONS The intervention appeared to be feasible within a community-based setting . To optimize stroke recovery and improve the quality of life of stroke survivors , health professionals should continue to focus on helping survivors ' mental health recovery as well their physical rehabilitation 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 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 BACKGROUND Physical inactivity , inadequate dietary protein , and low- grade systemic inflammation contribute to age-related muscle loss , impaired function , and disability . OBJECTIVE We assessed the effects of progressive resistance training ( PRT ) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass ( LTM ) , muscle size , strength and function , circulating inflammatory markers , blood pressure , and lipids in elderly women . DESIGN In a 4-mo cluster r and omized controlled trial , 100 women aged 60 - 90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat ( ∼160 g cooked ) to be consumed 6 d/wk [ resistance training plus lean red meat ( RT+Meat ) group ; n = 53 ] or control PRT [ 1 serving pasta or rice/d ; control resistance training ( CRT ) group ; n = 47 ) ] . All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d . RESULTS The mean ( ± SD ) protein intake was greater in the RT+Meat group than in the CRT group throughout the study ( 1.3 ± 0.3 compared with 1.1 ± 0.3 g · kg⁻¹ · d⁻¹ , respectively ; P < 0.05 ) . The RT+Meat group experienced greater gains in total body LTM ( 0.45 kg ; 95 % CI : 0.07 , 0.84 kg ) , leg LTM ( 0.22 kg ; 95 % CI : 0.02 , 0.42 kg ) , and muscle strength ( 18 % ; 95 % CI : 0.03 , 0.34 ) than did the CRT group ( all P < 0.05 ) . The RT+Meat group also experienced a 10 % greater increase in serum insulin-like growth factor I ( P < 0.05 ) and a 16 % greater reduction in the proinflammatory marker interleukin-6 ( IL-6 ) ( P < 0.05 ) after 4 mo . There were no between-group differences for the change in blood lipids or blood pressure . CONCLUSION A protein-enriched diet equivalent to ∼1.3 g · kg⁻¹ · d⁻¹ achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women . This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235 OBJECTIVE Progressive resistance training ( PRT ) counteracts sarcopenia and has been demonstrated to improve physical function and quality of life in older adults . Despite the clear benefits of PRT , participation remains low . The core self-evaluation ( CSE ) construct is theoretically antecedent to four personality traits : locus of control , self-esteem , neuroticism ( emotional stability ) , and generalized self-efficacy . We have examined the association of CSE with exercise adoption among older adults invited to participate in a PRT trial . We hypothesized that CSE would positively predict adoption of PRT . STUDY DESIGN All residents of two retirement communities were invited to complete question naires with items on demographics , physical activity , CSE , and general health . Following completion of question naires , residents were invited to take part in an on-site , 10-week r and omized controlled trial of a PRT-based exercise trial . RESULTS Thirty-eight of 358 residents ( 63.2 % women ; 76.6±6.1 year ; range 58 - 92 ) enrolled and 118 residents completed the question naires . Multiple regression analysis predicting PRT adoption indicated that the demographic variables accounted for 38 % of the variance . Inclusion of CSE ( β=.405 ) accounted for an additional 10 % of the variance in PRT adoption . CONCLUSION CSE was predictive of PRT adoption in this cohort , adding significantly to the predictive efficacy of known demographic predictors . This is the first study to show that CSE may influence adoption of PRT in any cohort PURPOSE The critical weight loss observed in head and neck squamous cell carcinoma ( HNSCC ) patients following radiotherapy  is mainly due to loss of lean body mass . This is associated with decreases in muscle strength , functional performance and Quality of Life ( QoL ) . The present study investigated the effect of progressive resistance training ( PRT ) on lean body mass , muscle strength and functional performance in HNSCC patients following radiotherapy .  PATIENTS AND METHODS Following radiotherapy HNSCC patients were r and omized into two groups : Early Exercise ( EE , n=20 ) initiated 12 weeks of PRT followed by 12 weeks of self-chosen physical activity . Delayed Exercise ( DE , n=21 ) initiated 12 weeks of self-chosen physical activity followed by 12 weeks of PRT .  Lean body mass , muscle strength , functional performance and QoL were evaluated at baseline and after week 12 and 24 . RESULTS In the first 12 weeks lean body mass increased by 4.3 % in EE after PRT and in the last 12 weeks by 4.2 % in DE after PRT . These increases were significantly larger than the changes after self-chosen physical activity ( p ≤ 0.005 ) . Regardless of PRT start-up time , the odds ratio of increasing lean body mass by more than 4 % after PRT was 6.26 ( p<0.05 ) . PRT significantly increased muscle strength , whereas functional performance increased significantly more than after self-chosen physical activity only after delayed onset of PRT . Overall QoL improved significantly more in EE than DE from baseline to week 12 . CONCLUSION PRT effectively increased lean body mass and muscle strength in HNSCC patients following radiotherapy  , irrespectively of early or delayed start-up Objective : To test the hypothesis that lower extremity progressive resistance training ( PRT ) can improve muscle strength and functional capacity in patients with multiple sclerosis ( MS ) and to evaluate whether the improvements are maintained after the trial . Methods : The present study was a 2-arm , 12-week , r and omized controlled trial including a post study follow-up period of 12 weeks . Thirty-eight moderately impaired patients with MS were r and omized to a PRT exercise group ( n = 19 ) or a control group ( n = 19 ) . The exercise group completed a biweekly 12-week lower extremity PRT program and was afterward encouraged to continue training . After the trial , the control group completed the PRT intervention . Both groups were tested before and after 12 weeks of the trial and at 24 weeks ( follow-up ) , where isometric muscle strength of the knee extensors ( KE MVC ) and functional capacity ( FS ; combined score of 4 tests ) were evaluated . Results : KE MVC and FS improved after 12 weeks of PRT in the exercise group ( KE MVC : 15.7 % [ 95 % confidence interval 4.3–27.0 ] , FS : 21.5 % [ 95 % confidence interval 17.0–26.1 ] ; p < 0.05 ) , and the improvements were better than in the control group ( p < 0.05 ) . The improvements of KE and FS in the exercise group persisted at follow-up after 24 weeks . Also , the exercise effects were reproduced in the control group during the 12-week posttrial PRT period . Conclusions : Twelve weeks of intense progressive resistance training of the lower extremities leads to improvements of muscle strength and functional capacity in patients with multiple sclerosis , the effects persisting after 12 weeks of self-guided physical activity . Level of evidence : The present study provides level III evidence supporting the hypothesis that lower extremity progressive resistance training can improve muscle strength and functional capacity in patients with multiple sclerosis OBJECTIVE To investigate the feasibility and preliminary outcomes of a home progressive resistance training ( PRT ) program augmented by neuromuscular electrical stimulation ( NMES ) . DESIGN R and omized controlled pilot trial . SETTING Participant homes . PARTICIPANTS People with multiple sclerosis ( MS ) ( N=37 ) who use a walking aid . INTERVENTIONS A 12-week home PRT program or the same program augmented by NMES . MAIN OUTCOME MEASURES Strength using h and -held dynamometry ; repeated sit to st and test ; Berg Balance Scale ; timed Up & Go test ; 12-Item Multiple Sclerosis Walking Scale ; Multiple Sclerosis Impact Scale-29 , version 2 ; and Modified Fatigue Impact Scale ( MFIS ) . The NMES group also completed a device usability question naire . RESULTS Only change in MFIS score was significantly greater in the NMES group than the PRT group ( P=.012 ) . The NMES group improved significantly in quadriceps endurance ( median of change , 8.5 ; P=.043 ) , balance ( median of change , 3.5 ; P=.001 ) , physical impact of MS ( median of change , -8.3 ; P=.001 ) , and impact of fatigue ( median of change , -17 ; P=.001 ) . Participants rated the device as highly usable . CONCLUSIONS This pilot study suggests that a home PRT program with NMES is feasible , and the neuromuscular electrical stimulation device is usable by this population . Only reduction in impact of fatigue was greater in the NMES than the PRT group Background The extent to which mental and physical exercise may slow cognitive decline in adults with early signs of cognitive impairment is unknown . This article provides the rationale and methodology of the first trial to investigate the isolated and combined effects of cognitive training ( CT ) and progressive resistance training ( PRT ) on general cognitive function and functional independence in older adults with early cognitive impairment : Study of Mental and Regular Training ( SMART ) . Our secondary aim is to quantify the differential adaptations to these interventions in terms of brain morphology and function , cardiovascular and metabolic function , exercise capacity , psychological state and body composition , to identify the potential mechanisms of benefit and broader health status effects . Methods SMART is a double-blind r and omized , double sham-controlled trial . One hundred and thirty-two community-dwelling volunteers will be recruited . Primary inclusion criteria are : at risk for cognitive decline as defined by neuropsychology assessment , low physical activity levels , stable disease , and age over 55 years . The two active interventions are computerized CT and whole body , high intensity PRT . The two sham interventions are educational videos and seated calisthenics . Participants are r and omized into 1 of 4 supervised training groups ( 2 d/wk × 6 mo ) in a fully factorial design . Primary outcomes measured at baseline , 6 , and 18 months are the Alzheimer 's Disease Assessment Scale ( ADAS-Cog ) , neuropsychological test scores , and Bayer Informant Instrumental Activities of Daily Living ( B-IADLs ) . Secondary outcomes are psychological well-being , quality of life , cardiovascular and musculoskeletal function , body composition , insulin resistance , systemic inflammation and anabolic/neurotrophic hormones , and brain morphology and function via Magnetic Resonance Imaging ( MRI ) and Spectroscopy ( fMRS ) . Discussion SMART will provide a novel evaluation of the immediate and long term benefits of CT , PRT , and combined CT and PRT on global cognitive function and brain morphology , as well as potential underlying mechanisms of adaptation in older adults at risk of further cognitive decline . Trial Registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : 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 Over the years , physical activity and exercise have been used to positively impact the health and quality of life of persons infected with HIV and , more recently , has been associated with a spectrum of body composition changes . The aim of this review was to examine the effects of various exercise interventions on body composition in HIV positive adults , using a search strategy of r and omized , controlled trials ( RCTs ) . A systematic review was performed by five independent review ers using a predetermined protocol adapted from previous research for assessing the articles for inclusion , the extracted data , and method ological quality . Eight RCTs involving 430 ( 26 % female ) HIV positive adults performing exercise a minimum of thrice weekly for at least six weeks were finally selected : Four were progressive resistance training ( PRT ) studies , three were aerobic training ( AT ) studies , and one involved yoga . In the PRT studies , there were significant increases in three anthropometric measures , namely , body mass , sum of skinfolds and sum of limb girths . In the AT studies , significant decreases were found in seven anthropometric measures , namely , body mass index , waist-hip ratio , body mass , triceps skinfold , waist circumference and sum of skinfolds . With yoga , the changes were non-significant . Exercise contributes to improved body composition and , when applied safely , appears to be beneficial for adults living with HIV/AIDS . However , these findings should be interpreted cautiously due to the relatively few RCTs published to date . Future studies would benefit from increased attention to sample size , female participants , participant follow-up , complete statistical analysis and intention-to-treat analysis Study design : A r and omized controlled trial . Objectives : To determine the effectiveness of electrical stimulation (ES)-evoked muscle contractions superimposed on progressive resistance training ( PRT ) for increasing voluntary strength in the quadriceps muscles of people with spinal cord injuries ( SCI ) . Setting : Sydney , Australia . Methods : A total of 20 people with established SCI and neurologically induced weakness of the quadriceps muscles participated in the trial . Participants were r and omized between experimental and control groups . Volunteers in the experimental group received ES superimposed on PRT to the quadriceps muscles of one leg thrice weekly for 8 weeks . Participants in the control group received no intervention . Assessment s occurred at the beginning and at the end of the 8-week period . The four primary outcomes were voluntary strength ( Nm ) and endurance ( fatigue ratio ) as well as the performance and satisfaction items of the Canadian Occupational Performance Measure ( COPM ; points ) . Results : The between-group mean differences ( 95 % confidence interval ( CI ) ) for voluntary strength and endurance were 14 Nm ( 1–27 ; P=0.034 ) and 0.1 ( −0.1 to 0.3 ; P=0.221 ) , respectively . The between-group median differences ( 95 % CI ) for the performance and satisfaction items of the COPM were 1.7 points ( −0.2 to 3.2 ; P=0.103 ) and 1.4 points ( −0.1 to 4.6 ; P=0.058 ) , respectively . Conclusion : ES superimposed on PRT  improves voluntary strength , although there is uncertainty about whether the size of the treatment effect is clinical ly important . The relative effectiveness of ES and PRT is yet to be determined QUESTION Does progressive resistance training improve strength and activity after stroke ? Does any increase in strength carry over to activity ? DESIGN Systematic review of r and omised trials with meta- analysis . PARTICIPANTS Adults who have had a stroke . INTERVENTION Progressive resistance training compared with no intervention or placebo . OUTCOME MEASURES The primary outcome was change in strength . This measurement had to be of maximum voluntary force production and performed in muscles congruent with the muscles trained in the intervention . The secondary outcome was change in activity . This measurement had to be a direct measure of performance that produced continuous or ordinal data , or with scales that produced ordinal data . RESULTS Eleven studies involving 370 participants were included in this systematic review . The overall effect of progressive resistance training on strength was examined by pooling change scores from six studies with a mean PEDro score of 5.8 , representing medium quality . The effect size of  progressive resistance training on strength was 0.98 ( 95 % CI 0.67 to 1.29 , I2=0 % ) . The overall effect of progressive resistance training on activity was examined by pooling change scores from the same six studies . The effect size of progressive resistance training on activity was 0.42 ( 95 % CI -0.08 to 0.91 , I2=54 % ) . CONCLUSION After stroke , progressive resistance training has a large effect on strength compared with no intervention or placebo . There is uncertainty about whether these large increases in strength carry over to improvements in activity . REVIEW REGISTRATION PROSPERO CRD42015025401 . [ Dorsch S , Ada L , Alloggia D ( 2018 ) Progressive resistance training increases strength after stroke but this may not carry over to activity : a systematic review . Journal of Physiotherapy 64 : 84 - 90 ] CONTEXT Aging in men is associated with reduced testosterone ( T ) levels and physiological changes leading to frailty , but the benefits of T supplementation are inconclusive . OBJECTIVE We studied the effects of T supplementation with and without progressive resistance training ( PRT ) on functional performance , strength , and body composition . DESIGN , SETTING , AND PARTICIPANTS We recruited 167 generally healthy community-dwelling older men ( 66 ± 5 years ) with low-normal baseline total T levels ( 200 - 350 ng/dL ) . INTERVENTION Subjects were r and omized to placebo or transdermal T gel [ 2 doses targeting either a lower ( 400 - 550 ng/dL ) or higher ( 600 - 1000 ng/dL ) T range ] and to either PRT or no exercise for 12 months . MAIN OUTCOME MEASURE The primary outcome was functional performance , whereas secondary outcomes were strength and body composition . RESULTS A total of 143 men completed the study . At 12 months , total T was 528 ± 287 ng/dL in subjects receiving any T and 287 ± 65 ng/dL in the placebo group . In the PRT group , function and strength were not different between T- and placebo-treated subjects , despite greater improvements in fat mass ( P = .04 ) and fat-free mass ( P = .01 ) with T. In the non-PRT group , T did not improve function but improved fat mass ( P = .005 ) , fat-free mass ( P = .03 ) , and upper body strength ( P = .03 ) compared with placebo . There were fewer cardiovascular events in the T-treated groups compared with placebo . CONCLUSIONS T supplementation was well tolerated and improved body composition but had no effect on functional performance . T supplementation improved upper body strength only in nonexercisers compared with placebo Objective : This study aim ed to investigate the effect of continuous progressive resistance training on body composition , functional capacity and self-reported quality of life in end-stage renal disease patients . Design : A r and omized controlled trial . Subjects : The study included 52 hemodialysis patients ( aged 55.7 ± 14.03 years ) r and omized into exercise ( progressive resistance training ( PRT ) , n = 28 ) or control ( CON , n = 24 ) groups . Intervention : Patients r and omized into the PRT group received prescribed strength exercises in two sets of 15–20 repetitions , in a repetition maximum training zone regime , thrice a week for 12 weeks , during hemodialysis . Patients r and omized into the CON group received a sham-exercise with active mobilization of the arms and legs without load and progression . Main outcome measure : Body composition using dual-energy X-ray absorptiometry ( DXA ) , strength using h and grip dynamometry ( HGS ) , repeated sit-to-st and test ( STT ) , 6-minute walk test , flexibility and the SF-36 question naire ( quality of life ( QoL ) ) were assessed at baseline and at 12 weeks . Results : Leg lean mass ( P = 0.04 , effect size ( ES ) of 0.56 ) , bone mineral content ( P = 0.02 , ES of 0.65 ) , leg strength in STT repetitions ( P = 0.01 , ES of 0.66 ) and flexibility ( P < 0.01 , ES of 1.03 ) were significantly improved in the PRT group compared to the CON group . Walking capacity , HGS and QoL were not different between the groups . Conclusion : 12 weeks of PRT with a repetition maximum training zone regime provided significant load to increase leg lean mass and STT performance as well as bone mineral content , compared to the CON , which continued to deteriorate . There was lack of efficacy on walking test , HGS and OBJECTIVES To determine whether improvements in aerobic capacity ( VO2peak ) and strength after progressive resistance training ( PRT ) mediate improvements in cognitive function . DESIGN R and omized , double-blind , double-sham , controlled trial . SETTING University research facility . PARTICIPANTS Community-dwelling older adults ( aged ≥55 ) with mild cognitive impairment ( MCI ) ( N = 100 ) . INTERVENTION PRT and cognitive training ( CT ) , 2 to 3 days per week for 6 months . MEASUREMENTS Alzheimer 's Disease Assessment Scale-cognitive subscale ( ADAS-Cog ) ; global , executive , and memory domains ; peak strength ( 1 repetition maximum ) ; and VO2peak . RESULTS PRT increased upper ( st and ardized mean difference ( SMD ) = 0.69 , 95 % confidence interval = 0.47 , 0.91 ) , lower ( SMD = 0.94 , 95 % CI = 0.69 - 1.20 ) and whole-body ( SMD = 0.84 , 95 % CI = 0.62 - 1.05 ) strength and percentage change in VO2peak ( 8.0 % , 95 % CI = 2.2 - 13.8 ) significantly more than sham exercise . Higher strength scores , but not greater VO2peak , were significantly associated with improvements in cognition ( P < .05 ) . Greater lower body strength significantly mediated the effect of PRT on ADAS-Cog improvements ( indirect effect : β = -0.64 , 95 % CI = -1.38 to -0.004 ; direct effect : β = -0.37 , 95 % CI = -1.51 - 0.78 ) and global domain ( indirect effect : β = 0.12 , 95 % CI = 0.02 - 0.22 ; direct effect : β = -0.003 , 95 % CI = -0.17 - 0.16 ) but not for executive domain ( indirect effect : β = 0.11 , 95 % CI = -0.04 - 0.26 ; direct effect : β = 0.03 , 95 % CI = -0.17 - 0.23 ) . CONCLUSION High-intensity PRT results in significant improvements in cognitive function , muscle strength , and aerobic capacity  in older adults with MCI  . Strength gains , but not aerobic capacity changes , mediate the cognitive benefits of PRT . Future investigations are warranted to determine the physiological mechanisms linking strength gains and cognitive benefits OBJECTIVES To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults . DESIGN R and omized , controlled trial . SETTING Retirement village . PARTICIPANTS Thirty-eight subjects ( 14 men and 24 women ) aged 76.6 + /- 6.1 . INTERVENTION A wait list control or 10 weeks of supervised exercise consisting of high-intensity ( 80 % of one-repetition maximum ( 1RM ) ) progressive resistance training ( PRT ) 3 days per week , moderate-intensity ( rating of perceived exertion 11 to 14/20 ) aerobic training 2 days per week , and progressive balance training 1 day per week . MEASUREMENTS Blinded assessment s of dynamic muscle strength ( 1RM ) , balance , 6-minute walk , gait velocity , chair st and , stair climb , depressive symptoms , self-efficacy , and habitual physical activity level . RESULTS Higher baseline strength and psychological well-being were associated with better functional performance . Strength gains over 10 weeks averaged 39+/-31 % in exercise , versus 21+/-24 % in controls ( P=.10 ) , with greater improvements in hip flexion ( P=.01 ) , hip abduction ( P=.02 ) , and chest press ( P=.04 ) in the exercise group . Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved . Stair climb power ( 12.3+/-15 % , P=.002 ) and chair st and time ( -7.1+/-15 % , P=.006 ) improved significantly and similarly in both groups . Reduction in depressive symptoms was significantly related to compliance ( attendance rate r=-0.568 , P=.009 , PRT progression in loading r=-0.587 , P=.02 , and total volume of aerobic training r=-0.541 , P=.01 ) , as well as improvements in muscle strength ( r=-0.498 , P=.002 ) . CONCLUSION Robust physical and psychological adaptations to exercise are linked , although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults PURPOSE To investigate the effect of progressive resistance training ( PRT ) on body composition , physical fitness , quality of life , lipid and nutritional profile of patients on hemodialysis ( HD ) . METHODS A non equivalent comparison group pretest and posttest design study was used with 40 participants who were r and omly assigned to the exercise group ( 20 participants ) and the comparison group ( 20 participants ) . The exercise group received PRT for 30 minutes per session , 3 sessions a week , for 12 weeks , while the comparison group received usual care . The PRT consisted of upper and lower body exercises using elastic b and s and s and bags . Outcome measures evaluated were : body composition , physical fitness , quality of life , and lipid profile . RESULTS Skeletal muscle mass , grip , leg muscle strength , and quality of life all improved significantly in the exercise group . Body fat rate , total cholesterol and triglyceride rate decreased significantly in the exercise group . CONCLUSION These results suggest that PRT improves body composition , physical fitness , quality of life , and lipid profile of patients on HD .  PRT using elastic b and s and s and bags can be utilized as part of a regular care plan for these patients OBJECTIVES To assess the efficacy of whole-body progressive resistance training ( PRT ) as a treatment for the symptoms of peripheral arterial disease ( PAD ) in older adults . DESIGN R and omized controlled pilot trial . SETTING University clinical weight training facility in Sydney , Australia . PARTICIPANTS Twenty-two older adults with symptomatic PAD . INTERVENTIONS The efficacy of supervised whole-body high-intensity PRT ( H-PRT ) with low-intensity nonprogressive resistance training ( L-RT ) and a usual care control group that performed unsupervised walking for 6 months was compared . MEASUREMENTS Pilot outcome measures included 6-minute walk ( 6 MW ) outcomes , body composition , dynamic muscle strength and endurance , and performance-based tests of function . RESULTS Mean age was 71.1 ± 7.2 . Mean ankle brachial index was 0.55 ± 0.13 .  Exercise adherence was similar in all groups ( P = .29 ) . H-PRT ( n = 8) improved total 6MW distance ( mean difference ( MD ) 62.6 ± 58.0 m , P = .02 ) significantly more than L-RT ( n = 7 ; MD=-48.2 ± 67.6 m ) and controls ( n = 7 ; MD=-9.9 ± 52.9 m ) . Change in 6MW onset of claudication was significantly and independently related to change in bilateral calf endurance ( correlation coefficient ( r ) = 0.65 , P = .03 ) , and change in 6MW distance was significantly and independently related to change in bilateral hip extensor endurance ( r = 0.71 , P = .02 ) in all groups . CONCLUSION H-PRT  significantly improved 6MW ability in older adults with intermittent claudication from PAD , whereas L-RT and unsupervised walking did not . Improvement in walking ability was significantly related to improvements in bilateral calf and hip extensor endurance , supporting further investigations targeted at musculoskeletal impairment in this cohort Background Parkinson ’s disease ( PD ) results from a loss of dopamine in the brain , leading to movement dysfunctions such as bradykinesia , postural instability , resting tremor and muscle rigidity . Furthermore , dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex ( M1 ) . Progressive resistance training ( PRT ) is a popular intervention in PD that improves muscular strength and results in clinical ly significant improvements on the Unified Parkinson ’s Disease Rating Scale ( UPDRS ) . In separate studies , the application of anodal transcranial direct current stimulation ( a-tDCS ) to the M1 has been shown to improve motor function in PD ; however , the combined use of tDCS and PRT has not been investigated . Methods / design We propose a 6-week , double-blind r and omised controlled trial combining M1 tDCS and PRT of the lower body in participants ( n = 42 ) with moderate PD ( Hoehn and Yahr scale score 2–4 ) . Supervised lower body PRT combined with functional balance tasks will be performed three times per week with concurrent a-tDCS delivered at 2 mA for 20 minutes ( a-tDCS group ) or with sham tDCS ( sham group ) . Control participants will receive st and ard care ( control group ) . Outcome measures will include functional strength , gait speed and variability , balance , neurophysiological function at rest and during movement execution , and the UPDRS motor subscale , measured at baseline , 3 weeks ( during ) , 6 weeks ( post ) , and 9 weeks ( retention ) . Ethical approval has been granted by the Deakin University Human Research Ethics Committee ( project number 2015 - 014 ) , and the trial has been registered with the Australian New Zeal and Clinical Trials Registry ( ACTRN12615001241527 ) . Discussion This will be the first r and omised controlled trial to combine PRT and a-tDCS targeting balance and gait in people with PD . The study will eluci date the functional , clinical and neurophysiological outcomes of combined PRT and a-tDCS . It is hypothesised that combined PRT and a-tDCS will significantly improve lower limb strength , postural sway , gait speed and stride variability compared with PRT with sham tDCS . Further , we hypothesise that pre-frontal cortex activation during dual-task cognitive and gait/balance activities will be reduced , and that M1 excitability and inhibition will be augmented , following the combined PRT and a-tDCS intervention . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12615001241527 . Registered on 12 November 2015 BACKGROUND The rising prevalence of obesity in children and adolescents is implicated in the metabolic abnormalities that track into adulthood . The associated increased incidence of insulin resistance , metabolic syndrome and type 2 diabetes being identified in younger cohorts has given rise to a critical global health issue . Muscular strength is a vital component of metabolic fitness that provides protection from insulin resistance in adults , and we have recently shown this to be true in children as well . Targeting muscular strength deficiencies at an early age may be an effective preventative strategy for metabolic syndrome and type 2 diabetes . PURPOSE There is limited evidence -based best practice for progressive resistance training ( PRT ) , adiposity and metabolic fitness in children and adolescents . The purpose of this paper is to describe the methodology we utilized for implementing a PRT program to avoid publication bias , enable replication of the study and share a novel program that we have found safe and suitable for use with youth . METHODS We conducted the first r and omized controlled trial ( RCT ) prescribing high-intensity PRT to children and adolescents ( 10 - 15 years ) as a community-based primary prevention program to address adiposity and metabolic health . Participants were instructed to complete 2 sets of 8 repetitions of 11 exercises targeting all the major muscle groups twice a week at an RPE of 15 - 18 for 8 weeks . RESULTS Primary outcome was waist circumference ; secondary outcomes included insulin resistance , lipid levels , muscle strength , cardiorespiratory fitness , body composition , self-efficacy , self-concept , habitual physical activity , nutritional and sedentary behavior patterns . CONCLUSION The supervised PRT program that we used with children and adolescents has been described in detail . The efficacy of this modality of exercise for metabolic fitness and other health outcomes is now under investigation Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson 's disease , this has not yet been confirmed with a large scale r and omised controlled clinical trial . The study will investigate the effects on falls , mobility and quality of life of ( i ) movement strategy training combined with falls prevention education , ( ii ) progressive resistance strength training combined with falls prevention education , ( iii ) a generic life-skills social program ( control group ) . Methods / Design People with idiopathic Parkinson 's disease who live at home will be recruited and r and omly allocated to one of three groups . Each person shall receive therapy in an out-patient setting in groups of 3 - 4 . Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks . All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase . Assessment s will occur before therapy , after the 8 week therapy program , and at 3 and 12 months after the intervention . A falls calendar will be kept by each participant for 12 months after outpatient therapy . Consistent with the recommendations of the Prevention of Falls Network Europe group , three falls variables will be used as the primary outcome measures : the number of fallers , the number of multiple fallers and the falls rate . In addition to quantifying falls , we shall measure mobility , activity limitations and quality of life as secondary outcomes . Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson 's disease who live at home . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : PURPOSE To assess whether progressive resistance training ( PRT ) improves functional status , measured using a vali date d Physical Function Scale , in both wasted and nonwasted patients with HIV infection , and to compare the relative contributions of increased lean body mass ( LBM ) and increased strength with the change in physical function . METHODS Six patients with AIDS wasting and 19 patients with HIV but without wasting  trained three times per week for 8 wk , followed by 8 wk of usual activity .  Physical function , strength , and LBM were measured at 0 , 8 , and 16 wk . Self-reported physical functioning was measured using the physical functioning subscale of the Medical Outcomes Study ( MOS ) Short Form-36 ( SF-36 ) question naire . RESULTS Significant improvements occurred in strength ( 1-RM averaged for four machines increased 44 % in the nonwasted and 60 % in the wasted patients , each P < 0.0001 ) and LBM ( 2.3 % increase in the nonwasted and 5.3 % in the wasted patients , each P < 0.05 ) with resistance training . Physical function increased significantly in the wasted subjects ( 6 points , P < 0.02 ) but not in the nonwasted subjects , so that at 16 wk the wasted subjects functioned at a higher level than the nonwasted patients ( P < 0.05 ) . Both increase in LBM ( P < 0.001 ) and increase in strength ( P < 0.001 ) were significantly and independently associated with increase in physical function . CONCLUSION PRT increases functional status in patients with HIV wasting , both by increasing strength and by increasing LBM PURPOSE Patients with chronic heart failure ( CHF ) report difficulty performing activities of daily living . To our knowledge , however , no study has directly measured performance in activities of daily living in these patients to systematic ally assess their level of physical disability . Moreover , the contribution of skeletal muscle weakness to physical disability in CHF remains unclear . Thus , we measured performance in activities of daily living in CHF patients and controls , its relationship to aerobic capacity and muscle strength , and the effect of resistance exercise training to improve muscle strength and physical disability . METHODS Patients and controls were assessed for performance in activities of daily living , self-reported physical function , peak aerobic capacity , body composition , and muscle strength before and after an 18-wk resistance training program . To remove the confounding effects of several disease-related factors ( muscle disuse , hospitalization , acute illness ) , we recruited controls with similar activity levels as CHF patients and tested patients > 6 months after any disease exacerbation/hospitalization . RESULTS Performance in activities of daily living was 30 % lower ( P < 0.05 ) in CHF patients versus controls and was related to both reduced aerobic capacity ( P < 0.001 ) and muscle strength ( P < 0.01 ) . Moreover , resistance training improved ( P < 0.05 to P < 0.001 ) physical function and muscle strength in patients and controls similarly , without altering aerobic capacity . CONCLUSIONS CHF patients are characterized by marked physical disability compared with age- and physical activity-matched controls , which is related to reduced aerobic capacity and muscle strength . CHF patients respond to resistance training with normal strength/functional adaptations . Our results support muscle weakness as a determinant of physical disability in CHF and show that interventions that increase muscle strength  ( resistance training ) reduce physical disability ABSTRACT Fatigue is one of the most disabling symptoms of multiple sclerosis ( MS ) . While progressive resistance training ( PRT ) has been shown to reduce fatigue in persons with MS , it is not clear why these reductions occur . One hypothesis is that PRT may induce functional changes to the cau date , a region highly implicated in MS fatigue . The aim of the current study was to study the effects of PRT on overall fatigue impact and resting-state functional connectivity of the cau date in persons with MS reporting severe fatigue . Participants were semi-r and omly assigned to either a 16-week home-based PRT ( n = 5 ) or stretching control ( n = 5 ) condition . Both groups demonstrated reductions in overall fatigue impact ( main effect of time : F = .84 , d = .65 ) . Significant group × time interactions were found , with the PRT group demonstrating post-training increases in functional connectivity between the cau date and left inferior parietal ( F = 66.0 , p < .001 ) , bilateral frontal ( both p < .001 ) , and right insula ( F = 21.8 , p = .002 ) regions compared to the stretching group . Furthermore , greater post-training increases in functional connectivity between the cau date and left inferior parietal region were associated with greater decreases in cognitive fatigue ( r = −.52 ) specifically . This study provides initial evidence for the cau date as a potential neural substrate for the beneficial effects of PRT on fatigue in persons with MS OBJECTIVE To investigate changes in body composition after 12 months of high-intensity progressive resistance training ( PRT ) in relation to changes in insulin resistance ( IR ) or glucose homeostasis in older adults with type 2 diabetes . RESEARCH DESIGN AND METHODS One-hundred three participants were r and omized to receive either PRT or sham exercise 3 days per week for 12 months . Homeostasis model assessment 2 of insulin resistance ( HOMA2-IR ) and glycosylated hemoglobin ( HbA1c ) were used as indices of IR and glucose homeostasis . Skeletal muscle mass ( SkMM ) and total fat mass were assessed using bioelectrical impedance . Visceral adipose tissue , mid-thigh cross-sectional area , and mid-thigh muscle attenuation were quantified using computed tomography . RESULTS Within the PRT group , changes in HOMA2-IR were associated with changes in SkMM ( r = −0.38 ; P = 0.04 ) and fat mass ( r = 0.42 ; P = 0.02 ) . Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR ( r = 0.35 ; P = 0.07 ) . Changes in HbA1c were related to changes in mid-thigh muscle attenuation ( r = 0.52 ; P = 0.001 ) . None of these relationships were present in the sham group ( P > 0.05 ) . Using ANCOVA models , participants in the PRT group who had increased SkMM had decreased HOMA2-IR ( P = 0.05 ) and HbA1c ( P = 0.09 ) compared with those in the PRT group who lost SkMM . Increases in SkMM in the PRT group decreased HOMA2-IR ( P = 0.07 ) and HbA1c ( P < 0.05 ) compared with those who had increased SkMM in the sham group . CONCLUSIONS Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT PURPOSE This study investigated the effects of high-intensity progressive resistance training ( PRT ) and high-intensity cycling ( cycling ) on muscle performance and the time course of strength gains in a chronic stroke population . METHODS Forty-eight individuals with chronic stroke sequelae ( mean + /- SD ; age = 63 + /- 9 yr , time since stroke = 57 + /- 54 months ) were r and omly allocated to one of four treatment groups : PRT + cycling , PRT + sham cycling , sham PRT + cycling , or sham PRT + sham cycling groups in a fully factorial clinical trial . Thirty exercise sessions were conducted over a 10- to 12-wk period . The main outcomes investigated were measures of unilateral muscle strength , peak power , and muscle endurance . RESULTS Those undergoing PRT improved their lower limb muscle strength , peak power , and endurance compared with participants receiving sham PRT or cycling only ( P < 0.05 ) , and combined exercise was not superior to PRT alone . Strength improvements occurred primarily during the first 6 to 8 wk ( 98%-100 % of total gain ) and then reached a plateau during the final 2 to 4 wk . CONCLUSION We have shown for the first time in a direct comparison study that high-intensity PRT , but not cycling or sham exercise , can improve muscle strength , peak power , and muscle endurance in both affected and unaffected lower limbs after chronic stroke by a significant and clinical ly meaningful amount . Although strength gains plateaued earlier than anticipated , adherence to the intended continuous high-intensity progressive overload protocol was largely achieved ( average load of 84 % + /- 4 % of one repetition maximum ) OBJECTIVE To confirm , in a r and omized controlled trial ( RCT ) , the efficacy of high-intensity progressive resistance training ( PRT ) in restoring muscle mass and function in patients with rheumatoid arthritis ( RA ) . Additionally , to investigate the role of the insulin-like growth factor ( IGF ) system in exercise-induced muscle hypertrophy in the context of RA . METHODS Twenty-eight patients with established , controlled RA were r and omized to either 24 weeks of twice-weekly PRT ( n = 13 ) or a range of movement home exercise control group ( n = 15 ) . Dual x-ray absorptiometry-assessed  body composition ( including lean body mass [ LBM ] , appendicular lean mass [ ALM ] , and fat mass ) ; objective physical function ; disease activity ; and muscle IGFs were assessed at weeks 0 and 24 . RESULTS Analyses of variance revealed that PRT increased LBM and ALM ( P < 0.01 ) ; reduced trunk fat mass by 2.5 kg ( not significant ) ; and improved training-specific strength by 119 % , chair st and s by 30 % , knee extensor strength by 25 % , arm curls by 23 % , and walk time by 17 % ( for objective function tests , P values ranged from 0.027 to 0.001 versus controls ) . In contrast , body composition and physical function remained unchanged in control patients . Changes in LBM and regional lean mass were associated with changes in objective function ( P values ranged from 0.126 to < 0.0001 ) . Coinciding with muscle hypertrophy , previously diminished muscle levels of IGF-1 and IGF binding protein 3 both increased following PRT ( P < 0.05 ) . CONCLUSION In an RCT , 24 weeks of PRT proved safe and effective in restoring lean mass and function in patients with RA . Muscle hypertrophy coincided with significant elevations of attenuated muscle IGF levels , revealing a possible contributory mechanism for rheumatoid cachexia . PRT should feature in disease management Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes Background Reductions in skeletal muscle mass and increased adiposity are key elements in the aging process and in the pathophysiology of several chronic diseases . Systemic low grade inflammation associated with obesity has been shown to accelerate the age-related decline in skeletal muscle . The aim of this investigation was to determine the effects of 12 months of progressive resistance training ( PRT ) on systemic inflammation , and whether reductions in systemic inflammation were associated with changes in body composition . We hypothesized that reductions in systemic inflammation following 12 months of PRT in older adults with type 2 diabetes would be associated with reductions in adiposity and increases in skeletal muscle mass . Methods Participants ( n = 103 ) were r and omized to receive either PRT or sham-exercise , 3 days a week for 12 months . C-reactive protein ( CRP ) was used to assess systemic inflammation . Skeletal muscle mass and total fat mass were determined using bioelectrical impedance . Results Twelve months of PRT tended to reduce CRP compared to sham exercise ( β = −0.25 , p = 0.087 ) . Using linear mixed-effects models , the hypothesized relationships between body composition adaptations and CRP changes were significantly stronger for skeletal muscle mass ( p = 0.04 ) and tended to be stronger for total fat mass ( p = 0.07 ) following PRT when compared to sham-exercise . Using univariate regression models , stratified by group allocation , reductions in CRP were associated with increases in skeletal muscle mass ( p = 0.01 ) and reductions in total fat mass ( p = 0.02 ) in the PRT group , but not in the sham-exercise group ( p = 0.87 and p = 0.32 , respectively ) . Conclusions We have shown for the first time that reductions in systemic inflammation in older adults with type 2 diabetes following PRT were associated with increases in skeletal muscle mass . Furthermore , reductions in CRP were associated with reductions in adiposity , but only when associated with PRT . Lifestyle interventions aim ed at reducing systemic inflammation in older adults with type 2 diabetes should therefore incorporate anabolic exercise such as PRT to optimize the anti-inflammatory benefits of favorable body composition adaptations 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 ABSTRACT Background Sarcopenic obesity is associated with disability in older people , especially in women .  Resistance exercises are recommended for this population , but their efficacy is not clear . Objective To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity . Method Twenty-eight women 65 to 80 years old , with a body mass index ≥30kg/m2 and h and grip strength ≤21 kg were r and omly allocated to two groups . The experimental group underwent a 10-week resistance exercise program design ed to improve strength , power , and endurance of lower-limb muscles , with open chain and closed chain exercises . The control group had their health status monitored through telephone calls . The primary outcomes were lower limb muscle performance measured by knee extensor strength , power and fatigue by isokinetic dynamometry , and mobility measured by the Short Physical Performance Battery and by gait velocity . The secondary outcome was health-related quality of life assessed by the SF-36 Question naire . Results The average rate of adherence was 85 % , with few mild adverse effects . There were no significant between-group differences for any of the outcomes . Conclusion In this study , a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity OBJECTIVES To determine whether changes in strength or cardiorespiratory fitness after exercise training improve walking ability in individuals who have had a stroke . DESIGN A sham exercise-controlled , r and omized two-by-two factorial design , in which the two factors investigated were cycle training ( AEROBIC ) and resistance training ( STRENGTH ) . SETTING University exercise laboratory . PARTICIPANTS Fifty-two individuals with a history of stroke ( aged 63+/-9 ; time since stroke , 57+/-54 months ) . INTERVENTION Participants undertook 30 exercise sessions over 10 to 12 weeks . Depending on group allocation , individuals underwent aerobic cycling plus sham progressive resistance training ( PRT ) ( n=13 ) , sham cycling plus PRT ( n=13 ) , aerobic cycling plus PRT ( n=14 ) , or sham cycling plus sham PRT ( n=12 ) . MEASUREMENTS Primary outcomes were 6-minute walk distance , habitual and fast gait velocities , and stair climbing power . Secondary outcomes included measures of cardiorespiratory fitness ; muscle strength , power , and endurance ; and psychosocial attributes . RESULTS Neither AEROBIC nor STRENGTH improved walking distance or gait velocity significantly more than sham exercise , although STRENGTH significantly improved participants ' stair climbing power by 17 % ( P=.009 ) , as well as their muscle strength , power , and endurance ; cycling peak power output ; and self-efficacy . Conversely , AEROBIC improved indicators of cardiorespiratory fitness only . Cycling plus PRT produced larger effects than either single modality for mobility and impairment outcomes . CONCLUSION Single-modality exercises targeted at existing impairments do not optimally address the functional deficits of walking but do ameliorate the underlying impairments . The underlying cardiovascular and musculoskeletal impairments are significantly modifiable years after stroke with targeted robust exercise Abstract Purpose : To review available evidence on older people ’s ability to get up off the floor independently and determine the effectiveness of interventions to improve older adults ’ ability to rise from the floor . Material s and methods : Seven data bases were search ed between January 1975 and June 2018 . Eligibility criteria included : people aged ≥60 ; interventions to improve strength/function including ability to get up off the floor  ( for intervention studies ) ; comparison groups ( for r and omized and nonr and omized controlled trials ) ; outcome : quantitative or qualitative evaluation of ability to get up off the floor . Selection of the studies was undertaken in three stages : ( 1 ) titles and abstract s were scanned by one review er , ( 2 ) full abstract screening by one review er , and ( 3 ) articles read in full by two review ers . Results of all articles are summarized and r and omized controlled trials ( RCT ) ( where possible ) were analyzed by meta- analysis to determine intervention effectiveness . Results : Forty-one studies met inclusion criteria . For each of the RCTs that utilized resistance training and /or teaching the skill , a reduction in time to get up off the floor were reported . However , meta-analyses of all RCT interventions indicated no significant change in time for older people to get up off the floor independently with intervention ( MD : –0.43[–1.38 , 0.51 ] ) . Sub-analyses of interventions utilizing resistance training showed an improvement trending towards significance ( MD : –0.81[–1.72 , 0.09 ] ) . Heterogeneity between studies was high , therefore results should be viewed with some caution . Conclusions : Resistance training interventions may improve  older people ’s ability to rise from the floor unassisted . However , knowledge of specific techniques to get up and the effect of simply practicing the task of getting off the floor need to be further explored . Implication for rehabilitation One in three older people living in the community fall each year One aspect of falling that is often overlooked is whether the older person can get themselves up off the floor independently or do they have to wait for assistance . Interventions that include resistance training may help the older person to be able to get up by themselves 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 Background Progressive resistance exercise training ( PRT ) improves physical functioning in patients with HIV infection .  Creatine supplementation can augment the benefits derived from training in athletes and improve muscle function in patients with muscle wasting . The objective of this study was to determine whether creatine supplementation augments the effects of PRT on muscle strength , energetics , and body composition in HIV-infected patients . Methodology /Principal Findings This is a r and omized , double blind , placebo-controlled , clinical research center-based , outpatient study in San Francisco . 40 HIV – positive men ( 20 creatine , 20 placebo ) enrolled in a 14-week study . Subjects were r and omly assigned to receive creatine monohydrate or placebo for 14 weeks . Treatment began with a loading dose of 20 g/day or an equivalent number of placebo capsules for 5 days , followed by maintenance dosing of 4.8 g/day or placebo . Beginning at week 2 and continuing to week 14 , all subjects underwent thrice-weekly supervised resistance exercise while continuing on the assigned study medication ( with repeated 6-week cycles of loading and maintenance ) . The main outcome measurements included muscle strength ( one repetition maximum ) , energetics ( 31P magnetic resonance spectroscopy ) , composition and size ( magnetic resonance imaging ) , as well as total body composition ( dual-energy X-ray absorptiometry ) . Thirty-three subjects completed the study ( 17 creatine , 16 placebo ) . Strength increased in all 8 muscle groups studied following PRT , but this increase was not augmented by creatine supplementation ( average increase 44 vs. 42 % , difference 2 % , 95 % CI −9.5 % to 13.9 % ) in creatine and placebo , respectively ) . There were no differences between groups in changes in muscle energetics . Thigh muscle cross-sectional area increased following resistance exercise , with no additive effect of creatine . Lean body mass ( LBM ) increased to a significantly greater extent with creatine . Conclusions / Significance Resistance exercise improved muscle size , strength and function in HIV-infected men .  While creatine supplementation produced a greater increase in LBM , it did not augment the robust increase in strength derived from PRT . Trial Registration Clinical Trials.gov A two-arm , prospect i ve , r and omized , controlled trial study was conducted to investigate the effects of movement velocity during progressive resistance training ( PRT ) on the size and contractile properties of individual fibers from human vastus lateralis muscles . The effects of age and sex were examined by a design that included 63 subjects organized into four groups : young ( 20 - 30 yr ) men and women , and older ( 65 - 80 yr ) men and women . In each group , one-half of the subjects underwent a traditional PRT protocol that involved shortening contractions at low velocities against high loads , while the other half performed a modified PRT protocol that involved contractions at 3.5 times higher velocity against reduced loads . Muscles were sample d by needle biopsy before and after the 14-wk PRT program , and functional tests were performed on permeabilized individual fiber segments isolated from the biopsies . We tested the hypothesis that , compared with low-velocity PRT , high-velocity PRT results in a greater increase in the cross-sectional area , force , and power of type 2 fibers . Both types of PRT increased the cross-sectional area , force , and power of type 2 fibers by 8 - 12 % , independent of the sex or age of the subject . Contrary to our hypothesis , the velocity at which the PRT was performed did not affect the fiber-level outcomes substantially . We conclude that , compared with low-velocity PRT , resistance training performed at velocities up to 3.5 times higher against reduced loads is equally effective for eliciting an adaptive response in type 2 fibers from human skeletal muscle An impaired ability to initiate walking is a common feature of postural instability and gait impairment in Parkinson 's disease . While progressive resistance training ( PRT ) has been proposed to be an effective modality to improve balance and gait function in people with Parkinson 's disease , there are a limited number of r and omized trials and no studies have evaluated gait initiation performance . Thus , the purpose of this study was to examine the potential benefits PRT on GI performance in people with Parkinson 's disease . Eighteen individuals with idiopathic PD were r and omly assigned to either a twice weekly PRT program or a non-contact control group for 10 weeks . Biomechanical analysis of GI was performed pre- and post-intervention . Dependent variables of interest included the displacement of the center-of-pressure ( COP ) during the anticipatory postural phase of GI as well as the initial stride length and velocity . The PRT group demonstrated improvements in the posterior displacement of the COP and the initial stride length and velocity . There were no improvements in any variables for the control subjects . These results suggest that PRT may be an effective non-pharmacological and nonsurgical treatment to improve GI performance in PWP Multimodal exercise programs incorporating traditional progressive resistance training ( PRT ) , weight-bearing impact training and /or balance training are recommended to reduce risk factors for falls and fracture . However , muscle power , or the ability to produce force rapidly , has emerged as a more crucial variable to functional decline than muscle strength or mass . The aim of this 12-month community-based r and omized controlled trial , termed Osteo-cise : Strong Bones for Life , was to evaluate the effectiveness and feasibility of a multimodal exercise program incorporating high-velocity (HV)-PRT , combined with an osteoporosis education and behavioral change program , on bone mineral density ( BMD ) , body composition , muscle strength and functional muscle performance in older adults . Falls incidence was evaluated as a secondary outcome . A total of 162 older adults ( mean ± SD ; 67 ± 6 years ) with risk factors for falls and /or low BMD were r and omized to the Osteo-cise program ( n = 81 ) or a control group ( n = 81 ) . Exercise consisted of fitness center-based HV-PRT , weight-bearing impact and challenging balance/mobility activities performed three times weekly . After 12 months , the Osteo-cise program led to modest but significant net gains in femoral neck and lumbar spine BMD ( 1.0 % to 1.1 % , p < 0.05 ) , muscle strength ( 10 % to 13 % , p < 0.05 ) , functional muscle power ( Timed Stair Climb , 5 % , p < 0.05 ) and dynamic balance ( Four Square Step Test 6 % , p < 0.01 ; Sit-to-St and , 16 % , p < 0.001 ) relative to controls . There was no effect on total body lean mass or mobility ( timed-up- and -go ) , and no difference in falls rate ( incidence rate ratio [ IRR ] , 1.22 ; 95 % confidence interval [ CI ] , 0.72 - 2.04 ) . In conclusion , this study demonstrates that the Osteo-cise : Strong Bones for Life community-based , multimodal exercise program represents an effective approach to improve multiple musculoskeletal and functional performance measures in older adults with risk factors for falls and /or low BMD . Although this did not translate into a reduction in the rate of falls , further large-scale trials are needed to evaluate the efficacy of this multimodal approach on reducing falls and fracture Background In-hospital progressive resistance training ( PRT ) has been shown to be an effective method of rehabilitation following hip surgery . The aim of this study was to assess whether a home-based PRT program would be beneficial in improving patients ’ muscle strength and physical function compared to st and ard rehabilitation .  Methods Subjects ( n = 49 ) either received home-based PRT rehabilitation  ( n = 25 ) or  st and ard rehabilitation  ( n = 24 ) in a prospect i ve single blinded r and omized trial carried out over a two-year period . The primary outcome measure was the maximal voluntary contraction of the operated leg quadriceps ( MVCOLQ ) with secondary measures of outcome being the sit to st and score ( ST ) , timed up and go ( TUG ) , stair climb performance ( SCP ) , the 6 min walk test ( 6MWT ) , and lean mass of the operated leg ( LM ) . Results Twenty-six patients completed follow up at 1 year ( n = 13 per group ) for the final comparative analysis . All the outcome measures showed marked progressive improvements from the baseline measures at 9–12 months post op ( Estimated effect ( std error ) ; p value)- MVCOLQ 26.50 ( 8.71 ) N p = 0.001 ; ST 1.37 ( 0.33 ) p = 0.0001 ; TUG −1.44 ( 0.45 ) s p = 0.0001 ; SCP −3.41(0.80)s p = 0.0001 ; 6MWT 45.61 (6.10)m p = 0.0001 ; LM 20 (204)g p = 0.326 ) following surgery for both groups . Overall , there was no significant effect for participation in the exercise regime compared with st and ard care for all outcomes assessed . Conclusions Overall , this study demonstrated that there is no significant difference between the two groups for participation in the home-based PRT exercise programme when compared to st and ard care for all outcomes .Trial registration IS RCT N 1309951 . Registered February 2011 AIM To compare the effect of multicomponent and resistance training and detraining on cognition and depressive symptoms in oldest-old community-dwelling people . METHODS A total of 69 sedentary older adults aged older than 80 years were assessed and r and omized into three groups ( control , multicomponent and resistance training ) . The multicomponent group performed protocol consisting of aerobic , strength and balance exercises . The resistance group participated in strength exercises using six machines . The control group did not perform any intervention . The training sessions had progressive intensity , lasted 16 weeks and included three sessions per week . The volunteers were assessed at baseline , at the end of the 16-week training sessions and after the 6-week detraining period . The assessment consisted of anamneses , Geriatric Depression Scale and cognition ( Montreal Cognitive Assessment , Clock Drawing Test , verbal fluency and dual task ) . RESULTS There were no significant differences between groups and times in any of variables ; however , the adherence to training was low , mainly in the multicomponent group . CONCLUSIONS R and omized controlled trials using adherence strategies and longer times comparing training variations are required to verify which training protocol s are more effective and consistent on cognition and depression in oldest-old people BACKGROUND Intensive exercise training can lead to improvement in strength and functional performance in older people living at home and nursing home residents . There is little information whether intensive physical exercise may be applicable and effective in elderly patients suffering from the acute sequelae of injurious falls or hip surgery . OBJECTIVE To assess the feasibility , safety and efficacy of intensive , progressive physical training in rehabilitation after hip surgery . DESIGN Prospect i ve , r and omised , placebo-controlled intervention study of a 3-months training intervention and a 3-months ' follow-up . SETTING Physical training 6 - 8 weeks after hip surgery . SUBJECTS Twenty-eight ( 15 intervention , 13 control ) elderly patients with a history of injurious falls admitted to acute care or inpatient rehabilitation because of acute fall-related hip fracture or elective hip replacement . METHODS Progressive resistance and functional training to improve strength and functional performance . RESULTS No training-related medical problems occurred in the study group . Twenty-four patients ( 86 % ) completed all assessment s during the intervention and follow-up period . Adherence was excellent in both groups ( intervention : 93 , 0+/-13 , 5 % versus control : 96 , 7+/-6 , 2 % ) . Training significantly increased strength , functional motor performance and balance and reduced fall-related behavioural and emotional problems . Some improvements in strength persisted during 3-months follow-up while other strength variables and functional performances were lost after cessation of training . Patients in the control group showed no change in strength , functional performance and emotional state during intervention and follow-up . CONCLUSIONS Progressive resistance training and progressive functional training are safe and effective methods to increase strength and functional performance during rehabilitation in patients after hip surgery and a history of injurious falls . Because part of the training improvements were lost after stopping the training , a continuing training regime should be established Background Sarcopenic obesity is a health condition that combines excess adipose tissue and loss of muscle mass and strength . Sarcopenic obesity predisposes to more functional disabilities than obesity or sarcopenia alone . Progressive resistance exercises are recommended for older people as a potential treatment for sarcopenia and also for obesity . However , there is a lack of evidence indicating which programmes are best applied to older people , and no studies have investigated their effects on sarcopenic obese people . The aims of this protocol study are to investigate and compare the efficacy of l and -based and aquatic resistance exercise programmes on improving muscle performance , functional capacity and quality of life of older women with sarcopenic obesity . Methods / Design This is a protocol study for a parallel r and omised controlled clinical trial . Eligible participants are older women ( ≥65 years ) with a body mass index ≥30 kg/m 2 and h and grip strength ≤21 kg force . A total sample of 36 participants will be r and omly allocated to one of the intervention groups in blocks of three : l and -based , aquatic or control . Each intervention group will undergo 2-week sessions of a 10-week therapeutic exercise programme for strength , power and endurance training of the lower-limb muscles . Participants in the control group will not participate in any strengthening activity for lower limbs and will receive telephone calls once a week . Baseline and final evaluation of outcomes will encompass muscle performance of the lower limbs assessed by an isokinetic dynamometer ; functional tests of usual walking speed , maximal walking speed ( shuttle walking test ) , stair speed and the Short Physical Performance Battery ; and health-related quality of life ( Medical Outcomes Study Short Form Question naire – SF-36 ) . Data collectors will be blinded to r and omisation and will not be in touch with participants during the interventions . Discussion This study is the first r and omised controlled trial design ed to evaluate resistance exercises in older patients with sarcopenic obesity . If our hypothesis proves correct , both intervention programmes will be effective , with the l and -based exercises conferring better results in muscle performance . Trial registration Registro Brasileiro de Ensaios Clínicos : Introduction Older breast cancer survivors ( BCS ) report more falls and functional limitations than women with no cancer history .  Exercise training could reduce risk factors for future falls and disability . Methods We conducted a r and omized , controlled trial in 106 early-stage , postmenopausal BCS who were ≥50 years old at diagnosis and post-treatment . Women were r and omly assigned to a 1-year resistance + impact exercise program or a stretching placebo program . Endpoints were one repetition maximum bench press and leg press strength , timed five chair st and s , 4 m usual walk speed , timed stance tests , h and grip strength , self-report physical function , and fatigue . We also examined the influence of age , adjuvant hormone therapy use , and exercise adherence on study outcomes . Results Women in the resistance + impact training program significantly improved maximal leg ( p < 0 .02 ) and bench ( p < 0 .02 ) press strength compared to the stretching group . Women who attended 50 % or more of prescribed resistance training sessions had significantly better changes in maximal strength measures compared to less adherent women . Conclusions Resistance + impact exercise is superior to stretching at improving maximal muscle strength and exercise adherence contributes to the degree of improvement . Implication s for cancer survivorsOlder BCS can safely engage in resistance exercise that improves lower and upper body strength , thereby reducing a risk factor for falls and future disability . However , the ability of resistance training to shift other indices of fall and disability risk , i.e. , balance and function , is unclear . Strategies to promote adherence to resistance training could lead to greater improvements in strength PURPOSE The intent of this investigation was to examine the effects of a daily oral provision consisting of amino acids ( L-lysine , L-leucine , L-valine , L-phenylalanine , L-threonine , L-histidine , L-isoleucine , and L-methionine ) in combination with carbohydrates ( dextrose , sucrose , and fructose ) on whole muscle strength and size characteristics during a 12-wk progressive knee extensor resistance training ( PRT ) program in older men ( > 65 yr ) . METHODS Seventeen older men were r and omly assigned to either the experimental ( EX ) or control ( CN ) groups . The EX ( N = 8) and CN ( N = 9 ) groups had the following characteristics-EX : 70.8 + /- 1.5 yr , 91.0 + /- 4.9 kg , and 177.0 + /- 3.9 cm ; CN : 72.1 + /- 1.9 yr , 75.4 + /- 4.7 kg , and 176.1 + /- 3.0 . Pre and post PRT maximal unilateral isometric torque ( N.m ) , isokinetic torque ( 1.05 , 1.57 , 2.09 , 3.14 , 4.19 , and 5.24 rad.s-1 ) , work capacity ( 30 consecutive reps at 3.14 rad.s-1 ) torque , one repetition maximum ( 1RM ) bilateral isotonic strength , and whole muscle cross-sectional area ( CSA ) of the mid-thigh were performed by computed tomography on each subject . RESULTS All variables showed an improvement with training ( P < 0.05 ) ; however , there were no differences between the groups . Both groups increased in isometric strength by 21 % , and isokinetic torque by 24 % to 11 % with the varying velocities ( 1.05 - 5.24 rad.s-1 ) . Whole muscle 1RM strength and thigh CSA increased 50 % and 6.5 % , respectively . Additionally , voluntary torque/CSA increased 12 % in both the EX and CN groups ( P < 0.05 ) . CONCLUSIONS In conclusion , these data suggest that whole muscle strength and size are not enhanced with a postexercise daily provision of an oral amino-acid complex during 12 wk of PRT in older men OBJECTIVES To investigate whether functionally based resistance exercise could improve strength , physical function , and disability among prostate cancer survivors ( PCS ) on and rogen deprivation therapy ( ADT ) ; and to explore potential mediators of changes in outcomes from exercise . DESIGN R and omized controlled trial . SETTING Academic medical center . PARTICIPANTS PCS ( N=51 ; mean age , 70.2y ) on ADT . INTERVENTION PCS were r and omized to moderate to vigorous intensity resistance training or stretching ( placebo control ) for 1 year . MAIN OUTCOME MEASURES Maximal leg press and bench press strength , objective and self-reported physical function , and self-reported disability . Hierarchical linear modeling was used to test for significant group × time differences adjusting for covariates . RESULTS Retention in the study was 84 % , and median attendance to supervised classes was 84 % in the resistance group . No study -related injuries occurred . Maximal leg strength ( P=.032 ) and bench press strength ( P=.027 ) were improved after 1 year of resistance training , whereas little change occurred from stretching .  Self-reported physical function improved with resistance training , whereas decreases occurred from stretching ( P=.016 ) . Disability lessened more with resistance training than stretching ( P=.018 ) . One-year change in leg press strength mediated the relation between groups ( resistance or stretching ) and 1-year change in self-reported disability ( P<.05 ) . CONCLUSIONS One year of resistance training improved muscle strength in and rogen-deprived PCS . Strengthening muscles using functional movement patterns may be an important feature of exercise programs design ed to improve perceptions of physical function and disability . Findings from this study contribute to the mounting evidence that exercise should become a routine part of clinical care in older men with advanced prostate cancer INTRODUCTION Although h and grip strength is considered a strong predictor of negative health outcomes , it is unclear whether h and grip strength represents a useful measure to evaluate changes in muscle strength following resistance-type exercise training in older people . We assessed whether measuring h and grip strength provides proper insight in the efficacy of resistance-type exercise training to increase muscle mass , strength , and physical performance in frail older people . METHODS Prefrail and frail older people ( ≥ 65 y ) were either conducting a 24-week resistance-type exercise training or no exercise training . Before , during , and after the intervention , h and grip strength ( JAMAR ) , lean body mass ( DXA ) , leg strength ( 1-RM ) , and physical performance ( SPPB ) were assessed . RESULTS H and grip strength correlated with appendicular lean mass ( r = 0.68 ; p < .001 ) and leg strength ( r = 0.67 ; p < .001 ) . After 24 weeks of whole body resistance-type exercise training , leg extension strength improved significantly better when compared with the control group ( 57 ± 2 - 78 ± 3 kg vs 57 ± 3 - 65 ± 3 kg : p < .001 ) . Moreover , physical performance improved significantly more in the exercise group ( 8.0 ± 0.4 - 9.3 ± 0.4 points ) when compared with the control group ( 8.3 ± 0.4 - 8.9 ± 0.4 points : p < .05 ) . These positive changes were not accompanied with any significant changes in h and grip strength ( 26.3 ± 1.2 - 27.6 ± 1.2 kg in the exercise group vs 26.6 ± 1.2 - 26.3 ± 1.3 kg in the control group : p = .71 ) . CONCLUSION Although h and grip strength strongly correlates with muscle mass and leg strength in frail older people , h and grip strength does not provide a valid means to evaluate the efficacy of exercise intervention programs to increase muscle mass or strength in an older population OBJECTIVE To determine the impact of a 16 week high-intensity progressive resistance exercise training ( PRT ) program on the mental health of older Puerto Rican adults with type 2 diabetes . METHODS Fifty-eight Puerto Rican adults were r and omly assigned to supervised PRT ( n = 29 ) or a control group ( n = 29 ) . A secondary analyses were conducted , and 2 mental health outcomes , the Geriatric Depression Scale and the SF-36 mental component summary score , were used to assess the impact of PRT on mental health status . At baseline , no differences were found on measures of self-reported mental health status . RESULTS PRT participants had significantly improved mental health status at follow-up ( 16 weeks ) . DISCUSSION The incorporation of exercise into treatment planning for older adults may have important benefits on their mental health status . More work is needed to underst and the mechanisms by which this occurred as well as the applicability of these findings to sustainable community programs 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 Background To evaluate the feasibility of executing a r and omized controlled trial of progressive resistance training ( PRT ) in women with polycystic ovary syndrome ( PCOS ) . Methods Women with PCOS were r and omized to an  experimental ( PRT ) group or a no-exercise ( usual care ) control group . The PRT group was prescribed two supervised and two unsupervised ( home-based ) training sessions per week for 12 weeks . Feasibility outcomes included recruitment and attrition , adherence , adverse events , and completion of assessment s. Secondary outcomes , collected pre and post intervention , included a range of pertinent physiological , functional and psychological measures . Results Fifteen participants were r and omised into the PRT group ( n = 8) or control group ( n = 7 ) ; five women ( n = 2 in PRT group and n = 3 in control group ) withdrew from the study . The most successful recruitment sources were Facebook ( 40 % ) and online advertisement ( 27 % ) , while least successful methods were referrals by clinicians , colleagues and flyers . In the PRT group , attendance to supervised sessions was higher ( 95 % ; st and ard deviation ±6 % ) compared to unsupervised sessions ( 51 % ; st and ard deviation ±28 % ) . No adverse events were attributed to PRT . Change in menstrual cycle status was not significantly different between groups over time ( p = 0.503 ) . However , the PRT group significantly increased body weight ( p = 0.01 ) , BMI ( p = 0.04 ) , lean mass ( p = 0.01 ) , fat-free mass ( p = 0.005 ) and lower body strength ( p = 0.03 ) , while reducing waist circumference ( p = 0.03 ) and HbA1c ( p = 0.033 ) versus the control group . The PRT group also significantly improved across several domains of disease-specific and general health-related quality of life , depression , anxiety and exercise self-efficacy . Conclusion A r and omized controlled trial of PRT in PCOS would be feasible , and this mode of exercise may elicit a therapeutic effect on clinical ly important outcomes in this cohort . The success of a large-scale trial required to confirm these findings would be contingent on addressing the feasibility hurdles identified in this study with respect to recruitment , attrition , compliance , and collection of st and ardized clinical data .Trial registration Australia New Zeal and Clinical Trials Registry ; ACTRN12614000517673 Registered 15 May 2014 Background : High-intensity progressive resistance training ( PRT ) improves adiposity and metabolic risk in adults , but has not been investigated in children within a r and omized controlled trial ( RCT ) . Objective : We hypothesized that high-intensity PRT ( 8 weeks , twice a week ) would decrease central adiposity in children , as assessed via waist circumference . Methods Design / Setting / Participants : Concealed r and omization stratified by age and gender was used to allocate rural New Zeal and school students to the wait-list control or PRT group . Intervention : Participants were prescribed two sets ( eight repetitions per set ) of 11 exercises targeting all the major muscle groups at high intensity . Primary Outcome : Waist circumference ; secondary outcomes included whole body fat , muscular fitness ( one repetition maximum ) , cardiorespiratory fitness ( peak oxygen consumption during a treadmill test ) , lipids , insulin sensitivity and fasting glucose . Results : Of the 78 children ( 32 girls and 46 boys ; mean age 12.2(1.3 ) years ) , 51 % were either overweight ( 33 % ) or obese ( 18 % ) . High-intensity PRT significantly improved waist circumference ( mean change PRT −0.8 ( 2.2 ) cm vs + 0.5 ( 1.7 ) cm control ; F=7.59 , P=0.008 ) , fat mass ( mean change PRT + 0.2 ( 1.4 ) kg vs + 1.0 ( 1.2 ) kg control ; F=6.00 , P=0.017 ) , percent body fat ( mean change PRT –0.3 (1.8)% vs + 1.2 (2.1)% control ; F=9.04 , P=0.004 ) , body mass index ( mean change PRT −0.01 ( 0.8 ) kg m−2 vs + 0.4 ( 0.7 ) kg m−2 control ; F=6.02 , P=0.017 ) , upper body strength ( mean change PRT+11.6(6.1 ) kg vs + 2.9(3.7 ) kg control ; F=48.6 , P<0.001 ) and lower body strength ( mean change PRT + 42.9(26.6 ) kg vs + 28.5(26.6 ) kg control ; F=4.72 , P=0.034 ) compared to the control group . Waist circumference decreased the most in those with the greatest baseline relative strength ( r=−0.257 , P=0.036 ) , and greatest relative ( r=−0.400 , P=0.001 ) and absolute ( r=0.340 , P=0.006 ) strength gains during the intervention . Conclusion : Isolated high-intensity PRT significantly improves central and whole body adiposity in association with muscle strength in normal-weight and overweight children . The clinical relevance and sustainability of these changes in adiposity should be addressed in future long-term studies 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 compare ox and rolone ( OX ) or strength training with nutrition alone ( NA ) for AIDS wasting . Subjects : Fifty patients with AIDS ; 47 completing the study . Interventions : R and omization to ( 1 ) NA with placebo pills , ( 2 ) nutrition with 10 mg of OX administered orally twice a day , or ( 3 ) nutrition with progressive resistance training ( PRT ) for 12 weeks . Main Outcome Measures : Midthigh cross-sectional muscle area ( CSMA ) , physical functioning ( PF ) , costs , and cost-effectiveness in dollars/ quality -adjusted life-years ( $ /QALYs ) . Results : The OX and PRT subjects had increases in CSMA ( 7.0 % ± 2.5 % , P = 0.01 ; 5.0 % ± 2.0 % , P = 0.04 , respectively ) , although these increases did not differ significantly from the NA arm ( NA : 1.0 % ± 1.0 % ; OX vs. NA : P = 0.09 ; PRT vs. NA : P = 0.26 ) . Only PRT caused significant improvements in PF ( mean ± SE : 10.4 ± 3.8 points on a 100-point scale ) and 7 measures of strength ( P values : 0.04 to < 0.001 ) . There were no overall differences between groups in PF change . Among patients with impaired baseline PF , however , OX was significantly less effective than NA and PRT was significantly better than NA . All treatments led to increases in protein intake and performance ; NA and PRT also increased caloric intake . The institutional costs per subject in this trial were $ 983 for NA , $ 3772 for OX , and $ 3189 for PRT . At a community-based level of intensity , the institutional costs per QALY were $ 45,000 ( range : $ 42,000-$64,000 ) for NA , $ 147,000 ( range : $ 147,000-$163,000 ) for OX , and $ 31,000 ( range : $ 21,000-$44,000 ) for PRT . Conclusions : OX and PRT induce similar improvements in body composition , but PRT improves quality of life more than nutrition or OX , particularly among patients with impaired PF . PRT was the most cost-effective intervention , and OX was the least cost-effective intervention Study design A thematic review . Objectives To evaluate if physical activity enhances muscle strength , improves balance , and reduces the fall frequency and the fracture incidence .  Background One of the major medical problems of today is the increasing incidence of fragility fractures .  Muscle strength and fall is one of the major determinants of a fracture . If physical activity could increase muscle strength , improve balance and reduce the fall frequency , then training could be recommended as prevention for fractures . Methods The review used Medline ( Pub Med ) and the search words exercise , physical activity , muscle strength , balance , falls , fractures . R and omized controlled trials ( RCT ) were predominantly included , although this not is a systematic review . Results The evidence that physical activity modifies the risk factors for fall is compelling , although RCT with fractures as end point are lacking . Physical activity is associated with improved muscle strength , co-ordination and balance .  Physical training increases muscle strength also in octogenarians by up to 200 % , i.e. a much more pronounced effect than the corresponding increase in muscle volume or bone mass . There is also evidence that physical activity decreases the actual number of falls . Observational cohort and case-control studies imply that physical activity is associated with reduced hip fracture risk . If exercise reduces the number of vertebral fractures and other fragility fractures are less evaluated . Conclusions Physical activity in older ages can be recommended to improve muscle strength and balance , to reduce the risk to fall and fractures , although the highest level of evidence – RCT with fracture as endpoint – is lacking 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 The purpose of this study was to investigate whole muscle and single muscle fiber adaptations in very old men in response to progressive resistance training ( PRT ) .  Six healthy independently living old men ( 82 + /- 1 yr ; range 80 - 86 yr , 74 + /- 4 kg )  resistance-trained the knee extensors ( 3 sets , 10 repetitions ) at approximately 70 % one repetition maximum 3 days/wk for 12 wk . Whole thigh muscle cross-sectional area ( CSA ) was assessed before and after PRT using computed tomography ( CT ) . Muscle biopsies were obtained from the vastus lateralis before and after the PRT program . Isolated myosin heavy chain ( MHC ) I and IIa single muscle fibers ( n = 267 ; 142 pre ; 125 post ) were studied for diameter , peak tension , shortening velocity , and power . An additional set of isolated single muscle fibers ( n = 2,215 ; 1,202 pre ; 1,013 post ) was used to identify MHC distribution . One repetition maximum knee extensor strength increased ( P < 0.05 ) 23 + /- 4 kg ( 56 + /- 4 to 79 + /- 7 kg ; 41 % ) . Muscle CSA increased ( P < 0.05 ) 3 + /- 1 cm2 ( 120 + /- 7 to 123 + /- 7 cm2 ; 2.5 % ) . Single muscle fiber contractile function and MHC distribution were unaltered with PRT . These data indicate limited muscle plasticity at the single-muscle fiber level with a resistance-training program among the very old . The minor increases in whole muscle CSA coupled with the static nature of the myocellular profile indicate that the strength gains were primarily neurological . These data contrast typical muscle responses to resistance training in young ( approximately 20 yr ) and old ( approximately 70 yr ) humans and indicate that the physiological regulation of muscle remodeling is adversely modified in the oldest old OBJECTIVES : Human Immunodeficiency Virus ( HIV ) infection worsens the frailty of elderly people , compromising their quality of life . In this study we prospect ively evaluated eleven patients living with HIV and 21 controls older than 60 years and without prior regular physical activity , who engaged in a one-year progressive resistance exercise program  to compare its effects on muscular strength , physical fitness and body composition . METHODS : Exercises for major muscular groups were performed 2 times/week , under professional supervision . Strength increase was evaluated bimonthly , while body composition , lipid and glycaemic profiles ( only of those living with HIV ) and physical fitness were evaluated before and after the one-year training . RESULTS : The participants living with HIV were lighter , had smaller Body Mass Index and were initially much weaker than controls . However , their strength increased more ( 1.52 - 2.33 times the baseline values for those living with HIV x 1.21 - 1.48 times for controls , p<0.01 ) , nullifying the differences initially seen . These effects were seen independently of gender , age or baseline physical activity . In addition , those living with HIV improved their fasting glucose levels and showed a tendency to improve their lipids after the one year training program . These effects were slightly more pronounced among those not using protease inhibitors , although not significantly . CONCLUSIONS : Resistance exercise safely increased the strength of older patients living with HIV adults , allowing them to achieve performance levels observed among otherwise healthy controls . These findings favor the recommendation of resistance exercise for elderly adults living with HIV adults This nonplacebo-controlled , open label , r and omized study was conducted to test the hypotheses that pharmacological doses of n and rolone decanoate would increase lean body tissue , muscle mass , and strength in immunodeficient human immunodeficiency virus-infected men , and that these effects would be enhanced with progressive resistance training ( PRT ) . Thirty human immunodeficiency virus-positive men with fewer than 400 CD4 lymphocytes/mm3 were r and omly assigned to receive weekly injections of n and rolone alone or in combination with supervised PRT at 80 % of the one-repetition maximum three times weekly for 12 weeks . Total body weight increased significantly in both groups ( 3.2 + /- 2.7 and 4.0 + /- 2.0 kg , respectively ; P < 0.001 ) , with increases due primarily to augmentation of lean tissue . Lean body mass determined by dual energy x-ray absorptiometry increased significantly more in the PRT group ( 3.9 + /- 2.3 vs. 5.2 + /- 5.7 kg , respectively ; P = 0.03 ) . Body cell mass by bioelectrical impedance analysis increased significantly ( P < 0.001 ) in both groups ( 2.6 + /- 1.0 vs. 2.9 + /- 0.8 kg ) , but to a similar magnitude ( P = NS ) . Significant increases in cross-sectional area by magnetic resonance imaging of total thigh muscles ( 1538 + /- 767 and 1480 + /- 532 mm2 ) , quadriceps ( 705 + /- 365 and 717 + /- 288 mm2 ) , and hamstrings ( 842 + /- 409 and 771 + /- 295 mm2 ) occurred with both treatment strategies ( P < 0.001 for the three muscle areas ) ; these increases were similar in both groups ( P = NS ) . By the one-repetition method , strength increased in both upper and lower body exercises , with gains ranging from 10.3 - 31 % in the n and rolone group and from 14.4 - 53.0 % in the PRT group ( P < 0.006 with one exception ) . Gains in strength were of significantly greater magnitude in the PRT group ( P < or = 0.005 for all comparisons ) , even after correction for lean body mass . Thus , pharmacological doses of n and rolone decanoate yielded significant gains in total weight , lean body mass , body cell mass , muscle size , and strength . The increases in lean body mass and muscular strength were significantly augmented with PRT Background Cancer cachexia is a syndrome of progressive weight loss . Non-small cell lung cancer patients experience a high incidence of cachexia of 61 % . Research into methods to combat cancer cachexia in various tumour sites has recently progressed to the combination of agents . The combination of the anti-cachectic agent Eicosapentaenoic acid ( EPA ) and the cyclo-oxygenase-2 ( COX-2 ) inhibitor celecoxib has been tested in a small study with some benefit . The use of progressive resistance training ( PRT ) followed by the oral ingestion of essential amino acids ( EAA ) , have shown to be anabolic on skeletal muscle and acceptable in older adults and other cancer groups . The aim of this feasibility study is to evaluate whether a multi-targeted approach encompassing a resistance training and nutritional supplementation element is acceptable for lung cancer patients experiencing cancer cachexia .  Methods / Design Auckl and 's Cancer Cachexia evaluating Resistance Training ( ACCeRT ) is an open label , prospect i ve , r and omised controlled feasibility study with two parallel arms . All patients will be treated with EPA and the COX-2 inhibitor celecoxib on an outpatient basis at the study site . In the experimental group patients will participate in PRT twice a week , followed by the ingestion of essential amino acids high in leucine .  A total of 21 patients are planned to be enrolled . Patients will be r and omised using 1:2 ratio with 7 patients enrolled into the control arm , and 14 patients into the treatment arm . The primary endpoint is the acceptability of the above multi-targeted approach , determined by an acceptability question naire . Discussion To our knowledge ACCeRT offers for the first time the opportunity to investigate the effect of stimulating the anabolic skeletal muscle pathway with the use of PRT along with EAA alongside the combination of EPA and celecoxib in this population .Trial registration Netherl and s Trial Register ( NTR ) : We examined the effects of progressive resistance training ( PRT ) and supplementation with calcium-vitamin D3 fortified milk on markers of systemic inflammation , and the relationship between inflammation and changes in muscle mass , size and strength . Healthy men aged 50–79 years ( n = 180 ) participated in this 18-month r and omized controlled trial that comprised a factorial 2 × 2 design . Participants were r and omized to ( 1 ) PRT + fortified milk supplement , ( 2 ) PRT , ( 3 ) fortified milk supplement , or ( 4 ) a control group . Participants assigned to PRT trained 3 days per week , while those in the supplement groups consumed 400 ml day−1 of milk containing 1,000 mg calcium plus 800 IU vitamin D3 . We collected venous blood sample s at baseline , 12 and 18 months to measure the serum concentrations of IL-6 , TNF-α and hs-CRP . There were no exercise × supplement interactions , but serum IL-6 was 29 % lower ( 95 % CI , −62 , 0 ) in the PRT group compared with the control group after 12 months . Conversely , IL-6 was 31 % higher ( 95 % CI , −2 , 65 ) in the supplement group compared with the non-supplemented groups after 12 and 18 months . These between-group differences did not persist after adjusting for changes in fat mass . In the PRT group , mid-tibia muscle cross-sectional area increased less in men with higher pre-training inflammation compared with those men with lower inflammation ( net difference ~2.5 % , p < 0.05 ) . In conclusion , serum IL-6 concentration decreased following PRT , whereas it increased after supplementation with fortified milk concomitant with changes in fat mass . Furthermore , low- grade inflammation at baseline restricted muscle hypertrophy following PRT OBJECTIVE To determine the efficacy of high-intensity progressive resistance training ( PRT ) on glycemic control in older adults with type 2 diabetes . RESEARCH DESIGN AND METHODS We performed a 16-week r and omized controlled trial in 62 Latino older adults ( 40 women and 22 men ; mean + /- SE age 66 + /- 8 years ) with type 2 diabetes r and omly assigned to supervised PRT or a control group .  Glycemic control , metabolic syndrome abnormalities , body composition , and muscle glycogen stores were determined before and after the intervention . RESULTS Sixteen weeks of PRT ( three times per week ) result ed in reduced plasma glycosylated hemoglobin levels ( from 8.7 + /- 0.3 to 7.6 + /- 0.2 % ) , increased muscle glycogen stores ( from 60.3 + /- 3.9 to 79.1 + /- 5.0 mmol glucose/kg muscle ) , and reduced the dose of prescribed diabetes medication in 72 % of exercisers compared with the control group , P = 0.004 - 0.05 . Control subjects showed no change in glycosylated hemoglobin , a reduction in muscle glycogen ( from 61.4 + /- 7.7 to 47.2 + /- 6.7 mmol glucose/kg muscle ) , and a 42 % increase in diabetes medications . PRT subjects versus control subjects also increased lean mass ( + 1.2 + /- 0.2 vs. -0.1 + /- 0.1 kg ) , reduced systolic blood pressure ( -9.7 + /- 1.6 vs. + 7.7 + /- 1.9 mmHg ) , and decreased trunk fat mass ( -0.7 + /- 0.1 vs. + 0.8 + /- 0.1 kg ; P = 0.01 - 0.05 ) . CONCLUSIONS PRT as an adjunct to st and ard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes BACKGROUND Physical training to increase muscle strength and balance is considered useful for prevention of falls in older people . AIM This study compares conventional balance training with visual computer feedback training . DESIGN This was a r and omized controlled 12-week intervention trial with pre- and post-training evaluations . SETTING Out- patients referred to a geriatric falls and balance clinic . POPULATION Thirty-five patients were r and omized into two training groups . METHODS Both groups received progressive resistance muscle strength training and physical fitness training . Additionally , one group received traditional balance training and the other group received computer feedback balance training .  Strength , physical endurance , balance and falls efficacy scale scoring were assessed before and after end of training . RESULTS Twenty-seven patients ( 77 % ) were available for the evaluation ; mean compliance was 71 % . In the combined group , significant mean improvement was observed in knee extension ( 19 % ) , ankle dorsiflexion ( 16 % ) , sitting to st and ing ( 16 % ) , and in the six-minute walk test ( 8 % ) . In the traditional balance training group , the static balance in the Modified Clinical Test of Sensory Interaction and Balance st and ing on a foam mat with closed eyes showed a significant increase ( 80 % ) . No increase occurred in the computer balance training group . However , the computer feed-back training group showed a marked improvement that was up to 400 % in the training specific performance . CONCLUSION Elderly frail patients were able to increase muscle strength and physical endurance . A limited improvement was seen in the static balance tests . The computer feedback group showed a remarkable increase in training specific performance . Clinical Rehabilitation Impact BACKGROUND Multiple sclerosis ( MS ) is a major cause of chronic , neurological disability , with a significant long-term disability burden , often requiring comprehensive rehabilitation . OBJECTIVES To systematic ally evaluate evidence from published Cochrane Review s of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS ( pwMS ) , to improve patient outcomes , and to highlight current gaps in knowledge . METHODS We search ed the Cochrane Data base of Systematic Review s up to December 2017 , to identify Cochrane Review s that assessed the effectiveness of organised rehabilitation interventions for pwMS . Two review ers independently assessed the quality of included review s , using the Revised Assessment of Multiple Systematic Review s ( R-AMSTAR ) tool , and the quality of the evidence for reported outcomes , using the GRADE framework . MAIN RESULTS Overall , we included 15 review s published in the Cochrane Library , comprising 164 r and omised controlled trials ( RCTs ) and four controlled clinical trials , with a total of 10,396 participants . The included review s evaluated a wide range of rehabilitation interventions , including : physical activity and exercise therapy , hyperbaric oxygen therapy ( HBOT ) , whole-body vibration , occupational therapy , cognitive and psychological interventions , nutritional and dietary supplements , vocational rehabilitation , information provision , telerehabilitation , and interventions for the management of spasticity . We assessed all review s to be of high to moderate method ological quality , based on R-AMSTAR criteria .Moderate- quality evidence suggested that physical therapeutic modalities ( exercise and physical activities ) improved functional outcomes ( mobility , muscular strength ) , reduced impairment ( fatigue ) , and improved participation ( quality of life ) . Moderate- quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation , and interventions that provided information improved patient knowledge . Low-qualitty evidence suggested that neuropsychological interventions , symptom-management programmes ( spasticity ) , whole body vibration , and telerehabilitation improved some patient outcomes . Evidence for other rehabilitation modalities was inconclusive , due to lack of robust studies . AUTHORS ' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit , although the certainty of evidence varies across the different types of interventions evaluated by the review s. Structured , multidisciplinary rehabilitation programmes and physical therapy ( exercise or physical activities ) can improve functional outcomes ( mobility , muscle strength , aerobic capacity ) , and quality of life . Overall , the evidence for many rehabilitation interventions should be interpreted cautiously , as the majority of included review s did not include data from current studies . More studies , with appropriate design , which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge We determined the efficacy of progressive muscle relaxation in reducing seizure frequency .  Subjects were 24 people with epilepsy attending an urban neurology clinic . The experimental design consisted of an 8-week baseline period , a treatment period of six sessions of progressive relaxation training ( PRT , n = 13 ) or quiet sitting ( QS , n = 11 ) and an 8-week follow up . In the PRT group , 11 subjects reported a decrease in seizure frequency ( p less than 0.01 ) , and in the QS group , 7 reported a decrease ( p greater than 0.05 ) . The mean decrease in seizure frequency was 29 % for the PRT group ( p less than 0.01 ) but only 3 % for the QS group ( p greater than 0.05 ) . This is the fifth recent report of a controlled study documenting the success of progressive relaxation therapy in seizure reduction . PRT is inexpensive and noninvasive and facilitates patient participation . Such a technique should be incorporated into clinical practice OBJECTIVES To determine whether a specific , st and ardized training regimen can improve muscle strength and physical functioning in people with dementia . DESIGN Double-blinded , r and omized , controlled trial with 3-month intervention and 3-month follow-up period in 2006 to 2009 . SETTING Outpatient geriatric rehabilitation . PARTICIPANTS Individuals with confirmed mild to moderate dementia , no severe somatic or psychological disease , and ability to walk 10 m. Most participants were still living independently with or without supportive care . INTERVENTION Supervised , progressive resistance and functional group training for 3 months specifically developed for people with dementia ( intervention , n = 62 ) compared with a low-intensity motor placebo activity ( control , n = 60 ) . MEASUREMENTS Primary outcome measures were one-repetition maximum in a leg press device for maximal strength and duration of the five-chair-st and test for functional performance . Secondary outcome measures were assessed for a number of established parameters for maximal strength , physical function , and physical activity . RESULTS Training significantly improved both primary outcomes ( percentage change from baseline : maximal strength , intervention group ( IG ) : + 51.5 ± 41.5 kg vs control group ( CG ) : -1.0 ± 28.9 kg , P < .001 ; functional performance , IG : -25.9 ± 15.1 seconds vs CG : + 11.3 ± 60.4 seconds , P < .001 ) . Secondary analysis confirmed effects for all strength and functional parameters . Training gains were partly sustained during follow-up . Low baseline performance on motor tasks but not cognitive impairment predicted positive training response . Physical activity increased significantly during the intervention ( P < .001 ) . CONCLUSION The intensive , dementia-adjusted training was feasible and substantially improved motor performance in frail , older people with dementia and may represent a model for structured rehabilitation or outpatient training PURPOSE To evaluate the effect of adding exercise to a hypocaloric diet on changes in appendicular lean mass and strength in frail obese older adults undergoing voluntary weight loss . METHODS Thirty frail older ( age , 70 + /- 5 yr ) obese ( body mass index , 37 + /- 5 kg.m ) adults were r and omly assigned to 6 months of diet/behavioral therapy ( diet group , n = 15 ) or diet or behavioral therapy plus exercise that incorporated progressive resistance training ( PRT ; diet + exercise group ; n = 15 ) . Body composition was assessed using dual-energy x-ray absorptiometry , and muscle strength was assessed using one-repetition maximum . The volume of upper extremity ( UE ) and lower extremity ( LE ) exercise training was determined by multiplying the average number of repetitions performed by the average weight lifted during the first three exercise sessions and during the last three exercise sessions of the study . RESULTS The diet and the diet + exercise groups had similar ( P > 0.05 ) decreases in weight ( 10.7 + /- 4.5 vs 9.7 + /- 4.0 kg ) and fat mass ( 6.8 + /- 3.7 vs 7.7 + /- 2.9 kg ) . However , the diet + exercise group lost less fat-free mass ( FFM ; 1.8 + /- 1.5 vs 3.5 + /- 2.1 kg ) , LE lean mass ( 0.9 + /- 0.8 vs 2.0 + /- 0.9 kg ) , and UE lean mass ( 0.1 + /- 0.2 vs 0.2 + /- 0.2 kg ) than the diet group ( P < 0.05 ) . The diet + exercise group had greater increases in percent of weight as FFM ( FFM / weight x 100 ) than the diet group ( 7.9 + /- 3.3 vs 5.4 + /- 3.7 % ; P < 0.05 ) . Despite lean mass losses , the diet + exercise group increased UE and LE strength in response to exercise ( 17 - 43 % ) , whereas the diet group maintained strength . The volume of UE and LE exercises correlated with the amount of UE and LE lean mass ( r = 0.64 - 0.84 ; P < 0.05 ) . CONCLUSION Exercise added to diet reduces muscle mass loss during voluntary weight loss and increases muscle strength in frail obese older adults . Regular exercise that incorporates PRT should be used to attenuate muscle mass loss in frail obese older adults on weight-loss therapy BACKGROUND To determine whether prolonged ( 24 weeks ) intradialytic progressive resistance training ( PRT ) could counteract muscle wasting more effectively than short- duration training ( 12 weeks ) in patients with end-stage renal disease . STUDY DESIGN R and omized controlled trial . SETTING & PARTICIPANTS 49 patients ( age , 62.6 + /- 14.2 years ; 0.3 to 16.7 years on hemodialysis therapy ) were r and omly assigned to PRT plus usual care for 24 weeks ( 24WK group ) or a crossover control group that received usual care for the first 12 weeks , then PRT plus usual care for the latter 12 weeks ( 12WK group ) . INTERVENTION Two sets of 10 free-weight PRT exercises were performed at a high intensity during routine thrice-weekly hemodialysis treatment under direct supervision . OUTCOMES & MEASUREMENTS Primary outcomes include thigh muscle cross-sectional area by means of computed tomography and intramuscular lipid content estimated through attenuation . Secondary outcomes include muscular strength , exercise capacity , and C-reactive protein level . RESULTS The 24WK group increased muscle cross-sectional area ( + 1.82 + /- 3.25 cm(2 ) ) compared with losses in the 12WK group ( -1.37 + /- 6.87 cm(2 ) ; relative effect size , 0.59 ; 95 % confidence interval [ CI ] , -0.27 to 6.65 ; P = 0.04 ) . However , this outcome did not achieve the level of statistical significance required ( P = 0.025 ) after Bonferroni correction for multiple primary outcomes . There was no significant change in intramuscular lipid content between groups ( + 0.19 + /- 1.32 versus + 0.16 + /- 1.69 Hounsfield units in the 24WK and 12WK groups , respectively ; P = 0.31 ) . Log C-reactive protein level tended to decrease in the 24WK group compared with the 12WK group ( relative effect size , -0.63 ; 95 % CI , -0.27 [ -0.54 to 0.00 ] ; P = 0.05 ) . The 24WK group improved muscular strength measures and exercise capacity throughout the trial . LIMITATIONS Single geographic site used ; no control group without exercise exposure ; unblinded assessment of some secondary outcome measures . CONCLUSIONS Prolonged intradialytic PRT did not significantly improve muscle cross-sectional area or intramuscular lipid content compared with a shorter duration of exercise . Future trials are required to more thoroughly investigate the clinical importance and magnitude of myogenic adaptations to PRT in this cohort BACKGROUND Aging is associated with decline in physical function that could result in the development of physical impairment and disability . Hence , interventions that simultaneously challenge balance ability , trunk ( core ) and extremity strength of older adults could be particularly effective in preserving and enhancing these physical functions . OBJECTIVE The purpose of this study was to compare the effects of feedback-based balance and core resistance training utilizing the a special computer-controlled device ( Huber ® ) with the conventional Pilates training on balance ability , neuromuscular function and body composition of healthy older women . METHODS Thirty-four older women ( age : 70±4 years ) were r and omly assigned to a  Huber group ( n=17 ) or Pilates group  ( n=17 ) . Both groups trained for 8 weeks , 3 times a week . Maximal isometric strength of the trunk flexors , extensors , and lateral flexors , leg power , upper-body strength , single- and dual-task static balance , and body composition were measured before and after the intervention programs . RESULTS Significant group × time interactions and main effects of time ( p<0.05 ) were found for body composition , balance ability in st and ard and dual-task conditions , all trunk muscle strength variables , and leg power in favor of the Huber group . The observed improvements in balance ability under both st and ard and dual-task conditions in the Huber group were mainly the result of enhanced postural control in medial-lateral direction ( p<0.05 ) . CONCLUSION Feedback-based balance and core resistance training proved to be more effective in improving single- and dual-task balance ability , trunk muscle strength , leg power , and body composition of healthy older women than the traditional Pilates training 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 AIM The aim of this study was to investigate whether individualized resistance training improves the physical mobility of young people with cerebral palsy ( CP ) . METHOD Forty-eight participants with spastic diplegic CP ( 26 males , 22 females ; mean age 18y 1mo , SD 1y 11mo ) classified as level II or III on the Gross Motor Function Classification System were allocated r and omly to progressive resistance training or usual-care control . Resistance training was completed twice weekly for 12 weeks at a community gymnasium under the supervision of a physiotherapist . Exercises were based on instrumented gait analysis and targeted muscles contributing to walking difficulties . Outcomes at 12 weeks and 24 weeks included objective measures of mobility ( 6-min walk test , instrumented gait analysis , and Gross Motor Function Measure dimensions D and E ) , participant-rated measures of mobility ( Functional Mobility Scale and Functional Assessment Question naire ) , and muscle performance . RESULTS The strength of targeted muscles increased by 27 % ( 95 % CI 8 - 46 % ) compared with control group . There were no between-group differences in any objective measure of mobility at 12 weeks ( 6-min walk test : mean difference 0.1 m ; 95 % CI -21 to 21 m ) or at 24 weeks . Participant-rated mobility improved ( Functional Mobility Scale at 5 m : mean 0.6 units ; 95 % CI 0.1 - 1.1 units ; Functional Assessment Question naire : 0.8 units ; 95 % CI 0.1 - 1.6 units ) compared with control group at 12 weeks . INTERPRETATION Individualized progressive resistance training increased strength in adolescents and young adults with spastic diplegic CP . Despite participant-rated benefits , the increased strength did not result in objective improvements in mobility Background Disability and falls are particularly common among older people who have recently been hospitalised . There is evidence that disability severity and fall rates can be reduced by well- design ed exercise interventions . However , the potential for exercise to have these benefits in older people who have spent time in hospital has not been established . This r and omised controlled trial will investigate the effects of a home-based exercise program on  disability and falls among people who have had recent hospital stays . The cost-effectiveness of the exercise program from the health and community service provider 's perspective will be established . In addition , predictors for adherence with the exercise program will be determined . Methods and design Three hundred and fifty older people who have recently had hospital stays will participate in the study . Participants will have no medical contraindications to exercise and will be cognitively and physically able to complete the assessment s and exercise program .  The primary outcome measures will be mobility-related disability ( measured with 12 monthly question naires and the Short Physical Performance Battery ) and falls ( measured with 12 monthly calendars ) . Secondary measures will be tests of risk of falling , additional measures of mobility , strength and flexibility , quality of life , fall-related self efficacy , health-system and community-service contact , assistance from others , difficulty with daily tasks , physical activity levels and adverse events . After discharge from hospital and completion of all hospital-related treatments , participants will be r and omly allocated to an intervention group or usual-care control group . For the intervention group , an individualised home exercise program will be established and progressed during ten home visits from a physiotherapist . Participants will be asked to exercise at home up to 6 times per week for the 12-month study period . Discussion The study will determine the impact of this exercise intervention on mobility-related disability and falls in older people who have been in hospital as well as cost-effectiveness and predictors of adherence to the program . Thus , the results will have direct implication s for the design and implementation of interventions for this high-risk group of older people . Trial Registration The protocol for this study is registered with the Australian New Zeal and Clinical Trials Registry ACTRN12607000563460 The outcomes of quantitative investigations examining the effectiveness of exercise interventions for people with COPD are limited by the small number of measurement tools that can be included . In contrast , qualitative inquiry allows broader exploration of the perceived outcomes of an intervention . The purpose of this investigation is to explore the qualitative outcomes of a progressive resistance exercise ( PRE ) program for people with COPD . People with COPD , enrolled in a r and omized controlled trial of PRE , were invited to participate in two semi-structured interviews conducted at the end ( 12 weeks ) and 12 weeks after the training intervention ( 24 weeks ) . Interviews were audiotaped , transcribed and then coded independently by two research ers . Themes relating to training outcomes were then developed and described . Twenty-two participants were interviewed at 12 weeks , and 19 participants at 24 weeks . After PRE , participants reported a range of physical gains , particularly with regard to improved strength and reduced breathlessness during daily activities . Improved control and confidence during activities of daily living were important psychological benefits perceived by people with COPD , as was the social support experienced during group training sessions . At 24 weeks , confidence persisted despite a perceived plateau or dissipation of physical gains .  People with COPD reported physical , psychological and social benefits after PRE , which had a positive effect on activity performance . Although the perceived physical benefits of training were not prominent at 24 weeks , feelings of increased confidence and control persisted . Chronic Respiratory Disease 2007 ; 4 : BACKGROUND : Physical activity ( PA ) reduces the rate of mobility disability , compared with health education ( HE ) , in at risk older adults . It is important to underst and aspects of performance contributing to this benefit . OBJECTIVE : To evaluate intervention effects on tertiary physical performance outcomes . DESIGN : The Lifestyle Interventions and Independence for Elders ( LIFE ) was a multi‐centered , single‐blind r and omized trial of older adults . SETTING : Eight field centers throughout the United States . PARTICIPANTS : 1635 adults aged 78.9 ± 5.2 years , 67.2 % women at risk for mobility disability ( Short Physical Performance Battery [ SPPB ] < 10 ) . INTERVENTIONS : Moderate PA including walking , resistance and balance training compared with HE consisting of topics relevant to older adults . OUTCOMES : Grip strength , SPPB score and its components ( balance , 4 m gait speed , and chair‐st and s ) , as well as 400 m walking speed . RESULTS : Total SPPB score was higher in PA versus HE across all follow‐up times ( overall P = .04 ) as was the chair‐st and component ( overall P < .001 ) . No intervention effects were observed for balance ( overall P = .12 ) , 4 m gait speed ( overall P = .78 ) , or grip strength ( overall P = .62 ) . However , 400 m walking speed was faster in PA versus HE group ( overall P = < .001 ) . In separate models , 29 % of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score , while 39 % was explained by change in the chair st and component . CONCLUSION : Lower extremity performance ( SPPB ) was significantly higher in the PA compared with HE group . Changes in chair‐st and score explained a considerable portion of the effect of PA on the reduction of major mobility disability‐consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability Background Fibromyalgia ( FM ) is characterized by persistent widespread pain , increased pain sensitivity and tenderness . Women with FM also report disability , in terms of negative consequences on activities of daily living . Our recent r and omized controlled trial ( RCT ) is the first study of resistance exercise to show positive effects on pain disability . The resistance exercise program of our RCT emphasized active involvement of participants in planning and progression of the exercise , using the principles of person-centeredness , to support each participant ’s ability to manage the exercise and the progress of it . The aim of this sub- study was to investigate explanatory factors for reduced pain disability in women with FM participating in a 15-week person-centered progressive resistance exercise program .  Methods A total of 67 women with FM were included in this sub- study of an RCT examining the effects of person-centered progressive resistance exercise performed twice a week for 15 weeks . Tests of physical capacity and health-related question naires were assessed at baseline and after the intervention period . Multivariable stepwise regression was used to analyze explanatory factors for improvements in pain disability . Results Reduced pain disability was explained by higher pain disability at baseline together with decreased fear avoidance beliefs about physical activity ( R2 = 28 , p = 0.005 ) . The improvements in the disability domains of recreation and social activity were explained by decreased fear avoidance beliefs about physical activity together with higher baseline values of each disability domain respectively ( R2 = 32 , p = 0.025 and R2 = 30 , p = 0.017 ) . The improvement in occupational disability was explained by higher baseline values of occupational disability ( R2 = 19 , p = 0.001 ) . Conclusion The person-centered resistance exercise intervention , based on principles of self-efficacy , had a positive effect on recreational , social and occupational disability . The reduced pain disability seemed to be mediated by decreased fear avoidance beliefs . Age , symptom duration , pain intensity , and muscle strength at baseline had no explanatory value for reduced pain disability , indicating that the person-centered resistance exercise program has the potential to work for anyone with FM who has interest in physical exercise . The trial was registered on October 21 , 2010 with Clinical Trials.gov identification number : NCT01226784 Background Reaction time , coordination , and cognition performance typically diminish in older adults , which may lead to gait impairments , falls , and injuries . Regular strength – balance exercises are highly recommended to reduce this problem and to improve health , well-being , and independence in old age . However , many older people face a lack of motivation in addition to other strong barriers to exercise . We developed ActiveLifestyle , an information technology (IT)-based system for active and healthy aging aim ing at improving balance and strength . ActiveLifestyle is a training app that runs on a tablet and assists , monitors , and motivates older people to follow personalized training plans autonomously at home . Objective The objectives were to ( 1 ) investigate which IT-mediated motivation strategies increase adherence to physical exercise training plans in older people , ( 2 ) assess the impact of ActiveLifestyle on physical activity behavior change , and ( 3 ) demonstrate the effectiveness of the ActiveLifestyle training to improve gait speed . Methods A total of 44 older adults followed personalized , 12-week strength and balance training plans . All participants performed the exercises autonomously at home . Question naires were used to assess the technological familiarity and stage of behavior change , as well as the effectiveness of the motivation instruments adopted by ActiveLifestyle . Adherence to the exercise plan was evaluated using performance data collected by the app and through information given by the participants during the study . Pretests and posttests were performed to evaluate gait speed of the participants before and after the study . Results Participants were 75 years ( SD 6 ) , predominantly female ( 64 % ) , held a trade or professional diploma ( 54 % ) , and their past profession was in a sitting position ( 43 % ) . Of the 44 participants who enrolled , 33 ( 75 % ) completed the study . The app proved to assist and motivate independently living and healthy older adults to autonomously perform strength – balance exercises ( median 6 on a 7-point Likert scale ) . Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan , as well as to change their behavior permanently toward a more physically active lifestyle . The exercises were effective to improve preferred and fast gait speed . Conclusions ActiveLifestyle assisted and motivated independently living and healthy older people to autonomously perform strength – balance exercises over 12 weeks and had low dropout rates . The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention . The adoption of assistive technology devices for physical intervention tends to motivate and retain older people exercising for longer periods of time BACKGROUND Frailty is common in older age , and is associated with important adverse health outcomes including increased risk of disability and long-term care admission . OBJECTIVES To evaluate whether home-based exercise interventions improve outcomes for frail older people . DATA SOURCES We search ed systematic ally for r and omised controlled trials ( RCTs ) and cluster RCTs , with literature search ing to February 2010 . STUDY SELECTION All trials that evaluated home-based exercise interventions for frail older people were eligible . Primary outcomes were mobility , quality of life and daily living activities . Secondary outcomes included long-term care admission and hospitalisation . RESULTS Six RCTs involving 987 participants met the inclusion criteria . Four trials were considered of high quality . One high quality trial reported improved disability in those with moderate but not severe frailty . Meta- analysis of long-term care admission rates identified a trend towards reduced risk . Inconsistent effects on other primary and secondary outcomes were reported in the other studies . CONCLUSIONS There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate , but not severe , frailty . There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission .  Home-based exercises are a potentially simple , safe and widely applicable intervention to prevent dependency decline for frail older people 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 The effect of teacher-presented Progressive Relaxation Training ( PRT ) on headaches , fear of failure and school problems was studied in school students . During ten physical education lessons , students received either PRT ( n = 110 ) or placebo training ( n = 92 ) . The effect of the training was investigated in students who indicated the presence of headaches in a pre-training diary . No significant differences were found between both training groups regarding headache frequency , duration and intensity and the psychological variables . On the basis of these and previous findings , it is recommended to present PRT to fairly small groups of self-selected subjects instead of complete classes CONTEXT Hip fractures are common in the elderly , and despite st and ard rehabilitation , many patients fail to regain their prefracture ambulatory or functional status . OBJECTIVE To determine whether extended outpatient rehabilitation that includes progressive resistance training improves physical function and reduces disability compared with low-intensity home exercise among physically frail elderly patients with hip fracture . DESIGN , SETTING , AND PATIENTS R and omized controlled trial conducted between August 1998 and May 2003 among 90 community-dwelling women and men aged 65 years or older who had had surgical repair of a proximal femur fracture no more than 16 weeks prior and had completed st and ard physical therapy .  INTERVENTION Participants were r and omly assigned to 6 months of either supervised physical therapy and exercise training ( n = 46 ) or home exercise ( control condition ; n = 44 ) . MAIN OUTCOME MEASURES Primary outcome measures were total scores on a modified Physical Performance Test ( PPT ) , the Functional Status Question naire physical function subscale ( FSQ ) , and activities of daily living scales . Secondary outcome measures were st and ardized measures of skeletal muscle strength , gait , balance , quality of life , and body composition . Participants were evaluated at baseline , 3 months , and 6 months . RESULTS Changes over time in the PPT and FSQ scores favored the physical therapy group ( P = .003 and P = .01 , respectively ) . Mean change ( SD ) in PPT score for physical therapy was + 6.5 ( 5.5 ) points ( 95 % confidence interval [ CI ] , 4.6 - 8.3 ) , and for the control condition was + 2.5 ( 3.7 ) points ( 95 % CI , 1.4 - 3.6 points ) . Mean change ( SD ) in FSQ score for physical therapy was + 5.2 ( 5.4 ) points ( 95 % CI , 3.5 - 6.9 ) and for the control condition was + 2.9 ( 3.8 ) points ( 95 % CI , 1.7 - 4.0 ) . Physical therapy also had significantly greater improvements than the control condition in measures of muscle strength , walking speed , balance , and perceived health but not bone mineral density or fat-free mass . CONCLUSION In community-dwelling frail elderly patients with hip fracture , 6 months of extended outpatient rehabilitation that includes progressive resistance training can improve physical function and quality of life and reduce disability compared with low-intensity home exercise 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 OBJECTIVES Protein supplementation has been proposed as an effective dietary strategy to augment the skeletal muscle adaptive response to prolonged resistance-type exercise training in elderly people . Our objective was to assess the impact of protein supplementation on muscle mass , strength , and physical performance during prolonged resistance-type exercise training in frail elderly men and women . DESIGN / SETTING / PARTICIPANTS A r and omized , double-blind , placebo-controlled trial with 2 arms in parallel among 62 frail elderly subjects ( 78 ± 1 year ) . These elderly subjects participated in a progressive resistance-type exercise training program ( 2 sessions per week for 24 weeks ) during which they were supplemented twice daily with either protein ( 2 * 15 g ) or a placebo .  MEASUREMENTS Lean body mass ( DXA ) , strength ( 1-RM ) , and physical performance ( SPPB ) were assessed at baseline , and after 12 and 24 weeks of intervention . RESULTS Lean body mass increased from 47.2 kg ( 95 % CI , 43.5 - 50.9 ) to 48.5 kg ( 95 % CI , 44.8 - 52.1 ) in the protein group and did not change in the placebo group ( from 45.7 kg , 95 % CI , 42.1 - 49.2 to 45.4 kg , 95 % CI , 41.8 - 48.9 ) following the intervention ( P value for treatment × time interaction = .006 ) . Strength and physical performance improved significantly in both groups ( P = .000 ) with no interaction effect of dietary protein supplementation . CONCLUSIONS Prolonged resistance-type exercise training represents an effective strategy to improve strength and physical performance in frail elderly people  . Dietary protein supplementation is required to allow muscle mass gain during exercise training in frail elderly people . TRIAL REGISTRATION clinical trials.gov identifier : NCT01110369 BACKGROUND Chronic pain and disability of the arm , shoulder , and h and severely affect labor market participation . Ergonomic training and education is the default strategy to reduce physical exposure and thereby prevent aggravation of pain . An alternative strategy could be to increase physical capacity of the worker by physical conditioning . OBJECTIVES To investigate the effect of 2 contrasting interventions , conventional ergonomic training ( usual care ) versus resistance training , on pain and disability in individuals with upper limb chronic pain exposed to highly repetitive and forceful manual work . STUDY DESIGN Examiner-blinded , parallel-group r and omized controlled trial with allocation concealment . SETTING Slaughterhouses located in Denmark , Europe . METHODS Sixty-six adults with chronic pain in the shoulder , elbow/forearm , or h and /wrist and work disability were r and omly allocated to 10 weeks of specific resistance training for the shoulder , arm , and h and muscles for 3 x 10 minutes per week , or ergonomic training and education ( usual care control group ) .  Pain intensity ( average of shoulder , arm , and h and , scale 0 - 10 ) was the primary outcome , and disability ( Work module of DASH question naire ) as well as isometric shoulder and wrist muscle strength were secondary outcomes . RESULTS Pain intensity , disability , and muscle strength improved more following resistance training than usual care ( P < 0.001 , P = 0.05 , P < 0.0001 , respectively [ corrected ] ) . Pain intensity decreased by 1.5 points ( 95 % confidence interval -2.0 to -0.9 ) following resistance training compared with usual care , corresponding to an effect size of 0.91 ( Cohen 's d ) . LIMITATIONS Blinding of participants is not possible in behavioral interventions . However , at baseline outcome expectations of the 2 interventions were similar . CONCLUSION Resistance training at the workplace results in clinical relevant improvements in pain , disability , and muscle strength in adults with upper limb chronic pain exposed to highly repetitive and forceful manual work . TRIAL REGISTRATION NCT01671267 OBJECTIVE To evaluate the effects of a progressive resistance strength training program on changes in muscle strength , gait , and balance in older individuals 1 yr after stroke , seven individuals were recruited who were greater than 60-yr-old , 1 yr after stroke , living at home , and able to follow verbal comm and s. DESIGN Subjects participated in a 12-wk 2x per wk resistance training program at 70 % of 1 repetition maximum . RESULTS Lower limb strength improved 68 % on the affected side and 48 % on the intact side during training , with the largest increases observed for hip extension ( affected side : 88 % , P < 0.01 ; intact side : 103 % , P < 0.001 ) . Repeated chair st and time decreased 21 % ( P < 0.02 ) . Motor performance assessed by the Motor Assessment Scale improved 9 % ( P < 0.04 ) and static and dynamic balance ( Berg balance scale ) improved 12 % ( P < 0.004 ) . Progressive resistance training in individuals 1 yr after stroke improves affected and intact side lower limb strength and was associated with gains in chair st and time , balance , and motor performance . CONCLUSIONS These results support the concept that strength training is an appropriate intervention to improve the quality of physical function in older community dwelling stroke survivors Loss of function and low exercise adherence is common among older people after hospitalization . The aim of this r and omized-controlled trial was to evaluate the effects of a combined counseling- and exercise program on changes in health-related quality of life ( HRQL ) and physical function in patients attending a day hospital and continuing exercise at home . The exercise program consisted of counseling , balance- and progressive resistance training and support from the physical therapist at Geriatric Day-Hospital ( GDH ) and home for the Intervention-group . The  Control-group received counseling , balance-training and support from the physical therapist .  The sample was recruited from a GDH in Norway . 108 participants were r and omized into the Intervention group ( IT ) ( n=53 ) or the Control group ( CT ) ( n=55 ) . After 3 months 77 participants were tested . The intention to treat analysis showed that the program had significant benefits in terms of Health Related Quality of Life , measured by SF-36 , on the domains vitality and bodily pain , in favor of the IT-group who performed the combined resistance exercises and balance program . All participants increased their scores on physical function , measured by Berg Balance Scale , Timed Up and Go , 5 times Sit-to-St and , 6 Min Walk Test and Activities Balance Confidence Scale , no group differences . Both groups were adherent to the  home exercise program The results show that it is possible to facilitate older people to increase their HRQL , physical function and level of physical activity through counseling , exercise and support from physical therapists 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 Although progressive resistance strength training ( ST ) has been found to improve various measures of physical functioning in older adults , the benefit to quality of life is unclear . Additionally , recent evidence suggests that high velocity power training ( PT ) may be more beneficial for physical functioning than ST , but it is not known whether this type of training impacts quality of life . The purpose of this study was to compare changes in multiple measures of quality of life result ing from ST vs. PT in older adults . A no exercise group was also included as control comparison condition . Methods Forty-five older adults ( M age = 74.8 years ; SD = 5.7 ) were r and omly assigned to either a ) PT , b ) ST , or c ) control group ( no exercise ) . Measures of self-efficacy ( SE ) , satisfaction with physical function ( SPF ) , and the Satisfaction with Life Scale ( SWL ) were assessed at baseline and following training . The resistance training conditions met 3 times per week for 12 weeks at an intensity of 70 % 1 repetition maximum . Results A series of ANCOVA 's comparing between group differences in change and controlling for baseline values revealed significant group differences in all three measures : SE ( F(2,31 ) = 9.77 ; p < .001 ) ; SPF ( F(2,32 ) = 3.36 ; p = .047 ) ; SWL ( F(2,31 ) = 4.76 ; p = .016 ) . Follow up analyses indicated that the PT group reported significantly more change in SE , SPF , and SWL than the control group whereas the ST group reported greater change than the control group only in SE . Conclusion These pilot data indicate that high velocity power training may influence multiple levels of quality of life over and above the benefits gained through traditional strength training This study examined the impact of 4 weeks of either complete cessation of training ( DTR ) or a tapering period ( TAP ; short-term reduction of the strength training volume , while the intensity is kept high ) , subsequent to 16 weeks of periodized heavy resistance training ( PRT ) on strength/power gains and the underlying physiologic changes in basal circulating anabolic/catabolic hormones in strength-trained athletes . Forty-six physically active men were matched and r and omly assigned to a TAP ( n = 11 ) , DTR ( n = 14 ) , or control group ( C ; n = 21 ) , subsequent to a 16-week PRT program . Muscular and power testing and blood draws to determine basal hormonal concentrations were conducted before the initiation of training ( T0 ) , after 16 weeks of training ( T1 ) , and after 4 weeks of either DTR or TAP ( T2 ) . Short-term DTR ( 4 weeks ) results in significant decreases in maximal strength ( −6 to −9 % ) and muscle power output ( −17 and −14 % ) of the arm and leg extensor muscles . However , DTR had a significant ( p > 0.01 ) larger effect on muscle power output more than on strength measurements of both upper and lower extremity muscles . Short-term ( 4 weeks ) TAP reached further increases for leg ( 2 % ) and arm ( 2 % ) maximal strength , whereas no further changes were observed in both upper and lower muscle power output . Short-term DTR result ed in a tendency for elevation resting serum insulin-like growth factor (IGF)-1 concentrations , whereas the corresponding TAP experienced elevation in resting serum insulin-like binding protein-3 ( IGFBP-3 ) . These data indicated that DTR may induce larger declines in muscle power output than in maximal strength , whereas TAP may result in further strength enhancement ( but not muscle power ) , mediated , in part , by training-related differences in IGF-1 and IGFBP-3 concentrations BACKGROUND Adolescents with intellectual disabilities often present with problems of balance and mobility .  Balance training is an important component of physical activity interventions , with growing evidence that it can be beneficial for people with intellectual disabilities . OBJECTIVE The aim of this study was to investigate the effect of balance training on postural balance , gait , and functional strength in adolescents with intellectual disabilities . METHODS Thirty-two adolescents with intellectual disabilities aged 14 - 19 years were r and omly assigned either to a balance training group ( n = 15 ) or a control group ( n = 16 ) . Subjects in the balance training group underwent balance training for 40 min per day , two times a week , for 8 weeks . All subjects were assessed with posture sway and the one-leg stance test for postural balance ; the timed up- and -go test and 10-m walk test for gait ; and sit to st and test for functional strength . RESULTS Postural balance and functional strength showed significant improvements in the balance training group ( p < 0.05 ) as compared to baseline ; however , postural balance and muscle strength showed no significant improvements in the control group . Further , postural balance and functional strength significantly improved in the balance training group compared with those in the control group . CONCLUSIONS Balance training for adolescents with intellectual disabilities might be beneficial for improving postural balance and functional strength Introduction This study assessed the feasibility and efficacy of a novel resistance training device used within an intradialytic progressive resistance training ( PRT ) intervention This study aim ed to evaluate the effects of different types of exercise on cognition . Eighty participants , 32 males and 48 females , aged 66.96 ± 11.73 , volunteered for this study . The participants were r and omly divided into the four following groups : Resistance Group ( RG ; n=20 ) , involved in high intensity strength training ; Cardiovascular Group ( CVG ; n=20 ) , involved in high intensity cardiovascular training ; Postural Group ( PG ; n=20 ) involved in low intensity training , based on postural and balance exercises ; and Control Group ( CG ; n=20 ) . Exercises were performed over the course of 12 weeks . All participants were tested for their cognitive functions pre- and post-intervention using the following neurocognitive tests : the Attentive Matrices Test , Raven 's Progressive Matrices , Stroop Color and Word Interference Test , Trail Making Test and Drawing Copy Test . Statistical analysis showed that the CVG group improved significantly in the Attentive Matrices Test and Raven 's Progressive Matrices ( both p=<0.05 ) , whereas the RG group improved in Drawing Copy Test time ( p=<0.05 ) . These results confirm that different types of exercise interventions  have unique effects on cognition .  Cardiovascular training is effective in improving performance attentive and analytic tasks , whereas resistance training is effective in improving praxis . Further investigation is necessary to evaluate the combination of the two exercise types in order to ascertain if their respective effects can be summated when performed together This study was undertaken to investigate the effects of progressive resistance-training ( PRT ) on plasma oxidative stress and antioxidant enzyme activity in erythrocytes . Twenty male volunteers were r and omly assigned to 2 groups : PRT and control . Blood sample s were collected before and after 8 wk of PRT and analyzed for enzymatic activities of superoxide dismutase ( SOD ) and glutathione peroxidase ( GPx ) in erythrocytes , plasma total antioxidant capacity ( TAC ) , and malondialdehyde concentration ( MDA , an index of lipid per oxida- tion in plasma ) .  Resistance training commenced with 8 exercises on nonconsecutive days for 8 wk at 50 % of estimated 1-repetition maximum ( E1RM ) and reached 80 % E1RM by Week 8 . The results showed that PRT significantly increased erythrocyte SOD activity ( 1,323 ± 212.52 vs. 1,449.9 ± 173.8 U/g Hb , p = .014 ) . Plasma concentration of MDA also decreased ( 5.39 ± 1.7 vs. 3.67.4 ± 0.7 nmol/ml , p = .030 ) , although TAC ( 1.42 ± 0.21 vs. 1.61 ± 0.19 mmol/L , p = .1530 ) and GPx ( 39.87 ± 11.5 vs. 48.18 ± 14.48 U/g Hb , p = .883 ) activity did not undergo any considerable changes . Based on these data , the authors conclude that an 8-wk program of PRT strengthens the defensive system of erythrocytes against free-radical damage and therefore can be applied as a useful approach to alleviate oxidative stress 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 Vocal characteristics of therapists , including voice volume , pitch and timbre of speech , and rate of speech have been hypothesized to facilitate the therapeutic process , particularly during procedures like progressive relaxation training ( PRT ) . Very little empirical work , however , has examined the relation between vocal characteristics and treatment process or outcome . The purpose of this study was to examine the role of vocal characteristics during a single session of PRT applying technological innovations devised for speech pathology and audiology setting s for evaluating therapist 's vocal characteristics . Forty-eight high anxious young adult women were r and omly assigned to one of four conditions for training : PRT with the recommended therapist voice ( RV ) that decreased in tone , volume , and rate across the session , PRT with conversational therapist voice during the session ( CV ) , a credible treatment control called systematic self-relaxation ( SR ) , or no treatment control ( NT ) . All subjects participated in a single PRT session during which heart rate , EMG , self-report measures of tension ( SRT ) and anxiety , and treatment credibility ratings were obtained . Results revealed significant reductions in SRT , self-reported anxiety , and heart rate for participants in all groups . Only the RV group displayed significant reductions in EMG when compared with the other three groups . Participants in the RV group also rated the therapist 's voice as “ more facilitating ” of relaxation when compared to the CV group . These results suggest that methods employed for evaluating the quality of vocal characteristics in speech and audiology clinics may be useful for evaluating the quality of therapist 's voice when conducting PRT Background Home-based exercise programs can improve physical functioning and health status of elderly people . Successful implementation of exercise interventions for older people presents major challenges and supporting elderly people properly while doing their home-based exercises is essential for training success . We developed a tablet-based system — ActiveLifestyle — that offers older adults a home-based strength-balance training program with incorporated motivation strategies and support features . Objective The goal was to compare 3 different home-based training programs with respect to their effect on measures of gait quality and physical performance through planned comparisons between ( 1 ) tablet-based and brochure-based interventions , ( 2 ) individual and social motivation strategies , and ( 3 ) active and inactive participants . Methods A total of 44 autonomous-living elderly people ( mean 75 , SD 6 years ) were assigned to 3 training groups : social ( tablet guided , n=14 ) , individual ( tablet guided , n=13 ) , and brochure ( brochure guided , n=17 ) . All groups joined a 12-week progressive home-based strength-balance training program . Outcome measures were gait performance under single and dual task conditions , dual task costs of walking , falls efficacy , and physical performance as measured by the Short Physical Performance Battery ( SPPB ) . Furthermore , active ( ≥75 % program compliance ) and inactive ( < 75 % program compliance ) individuals were compared based on their characteristics and outcome measures . Results The tablet groups showed significant improvements in single and dual task walking , whereas there were no significant changes observable in the brochure group . Between-groups comparisons revealed significant differences for gait velocity ( U=138.5 ; P=.03 , r=.33 ) and cadence ( U=138.5 , P=.03 r=.34 ) during dual task walking at preferred speed in favor of the tablet groups . The brochure group had more inactive participants , but this did not reach statistical significance ( U=167 , P=.06 , r=.29 ) . The active participants outperformed the inactive participants in single and dual task walking , dual task costs of walking , and SPPB scores . Significant between-groups differences were seen between the tablet groups and the brochure group , in favor of the tablet groups . Conclusions A tablet-based strength-balance training program that allows monitoring and assisting autonomous-living older adults while training at home was more effective in improving gait and physical performance when compared to a brochure-based program . Social or individual motivation strategies were equally effective . The most prominent differences were observed between active and inactive participants . These findings suggest that in older adults a tablet-based intervention enhances training compliance ; hence , it is an effective way to improve gait INTRODUCTION Increased physical activity ( PA ) is a crucial factor in the prevention of physical deterioration , and resistance training ( RT ) is also a common and effective intervention for older adults . However , the effects of PA as an adjunct to RT on frailty status remains unclear ; therefore , we clarified the effect of a PA intervention with feedback , as an adjunct to resistance strength training , on the physical and mental outcomes of frail older adults . MATERIAL S AND METHODS We employed a r and omized controlled trial . Community-dwelling frail older adults in Japan were recruited to participate . Forty-one participants ( mean age 81.5 ) were r and omly assigned to engage in a resistance training with PA ( RPA group ) or RT group for six months . Frailty status and frailty scores , which were measured according to the Cardiovascular Health Study criteria -muscle strength , mobility , instrumental activities of daily living , and health-related quality of life-were assessed . RESULTS Participants in the RPA group exhibited a significant increase in light-intensity PA , the number of steps taken daily ( p < 0.05 ) , and lower-limb muscle strength ( p < 0.05 ) and a significant decrease in frailty scores . However , pre- and postintervention frailty status , instrumental activities of daily living , and health-related quality of life did not differ significantly . CONCLUSIONS Implementation of a PA intervention as an adjunct to RT is feasible , as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms 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 authors examined whether resistance training has an effect on working memory span .  Participants included 210 community-residing older adults with at least one disability from the Strong for Life program , a r and omized controlled trial that examined the effects of home-based resistance exercise .  Memory was assessed with the WAIS backward digit span at baseline and 3 and 6 months into the intervention . Although there were no differences between the experimental treatment and control groups in average levels of memory change , within the treatment group change in resistance level during the intervention was a significant predictor of memory change , controlling for age , education , sex , and disability level . The results suggest that strength training can benefit memory among older adults , especially when using higher resistance levels Objective : To determine whether the addition of electrical stimulation to progressive resistance training increases the voluntary strength of the wrist muscles in people with tetraplegia . Design : Assessor-blind within-subject r and omised controlled trial . Setting : Two Australian spinal cord injury units and the community . Participants : Sixty-four wrists of 32 people with tetraplegia and bilateral weakness of the wrist extensor or flexor muscles ( grade 2 - 4 Medical Research Council grade s ) . Interventions : Participants ' wrists were r and omly allocated to one of two conditions . Wrist muscles of the experimental arm received electrical stimulation superimposed on progressive resistance training . The wrist muscles of the contralateral arm received sham electrical stimulation superimposed on progressive resistance training . Both arms received 6 sets of 10 contractions three times a week for eight weeks such that the only difference between arms was the application of electrical stimulation . Main Measures : The primary outcome was maximal voluntary isometric strength . Secondary outcomes were a fatigue resistance ratio representing voluntary and electrically-stimulated endurance . Measurements were taken at the start and end of the eight-week treatment period . Results : The mean treatment effect ( 95 % Confidence Interval ) of electrical stimulation for voluntary strength was 0.04 Nm ( 95 % CI , -0.5 to 0.6 ; p = 0.89 ) . The mean treatment effect ( 95 % CI ) for fatigue ratio representing voluntary endurance and electrically-stimulated endurance was -0.01 ( 95 % CI , -0.1 to 0.1 ; p = 0.78 ) and -0.07 ( 95 % CI , -0.3 to 0.1 ; p = 0.47 ) , respectively . Conclusions : Voluntary strength of the wrist is not enhanced by the addition of electrical stimulation to progressive resistance training programs in people with tetraplegia 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 Background Little is known about the effects of resistance training on health related quality of life ( HRQL )  in the elderly . Aim The main purpose of the study was to investigate the effects of resistance training on strength , body composition , functional capacity and HRQL in independent living elderly people . We hypothesised that resistance training would improve lean mass , muscle strength , physical function and HRQL . Methods Subjects ( N = 237 , 73.7±5.7yrs , 58.2 % female ) participated in a 12-week resistance exercise program ( 3 times/week ; 3 sets , 6–8 repetitions at 75–80 % of the 1-repetition maximum ) design ed to increase strength and muscle mass of major muscle groups . Body composition , quadriceps- and grip strength , timed up and go test ( TUG ) , six minute walk for distance ( 6MW ) and HRQL were measured at baseline and endpoint . Results Two hundred- and -four participants completed the study . Although the increase in lean mass was small ( + 0.8 kg , P<0.01 ) , quadriceps strength ( + 53.5N ) , grip strength ( + 3.0 lb ) , TUG ( -0.6sec ) , 6MW ( + 33.6 m ) and HRQL ( + 1.2 t-score ) improved significantly ( all P<0.01 ) . Changes in 6MW predicted improvement in HRQL after 12 weeks . Conclusions Our study shows that a 12-week resistance exercise program  significantly improves lean mass , muscle strength , physical function and HRQL  in elderly individuals , and that improvements in physical function predict improvements in HRQL . Our study indicates that resistance training should be promoted for the elderly as it has the potential to improve physical performance , thereby prolonging healthy , independent aging STUDY DESIGN R and omized clinical trial . OBJECTIVE To investigate the clinical and functional efficacy of 2 different non-weight-bearing exercise regimens , proprioceptive training ( PrT ) versus strength training ( ST ) , for patients with knee osteoarthritis ( OA ) . BACKGROUND Both strength and proprioceptive training are important interventions for individuals with knee OA . The benefits of weight-bearing exercises are generally recognized in the clinical setting . However , exercising in a st and ing or weight-bearing position may aggravate symptoms in patients with knee OA . METHODS AND MEASURES One hundred eight patients were r and omly assigned to the PrT , ST , or no exercise ( control ) group for an 8-week intervention . Both the PrT and ST interventions consisted of non-weight-bearing exercises .  Western Ontario and McMaster Universities Osteoarthritis Index-pain ( WOMAC-pain ) and -function scores , walking time on 3 different terrains , knee strength , and absolute knee reposition error were assessed before and after intervention . Data were analyzed using mixed-model ANOVAs . RESULTS Both PrT and ST significantly improved WOMAC-pain and -function score after intervention ( P<.008 ) . The improvement secondary to ST in the WOMAC-function scores ( 17.2 points ) and for knee extension strength ( 10.3 - 14.9 Nm ) was greater than the minimally clinical ly important difference for these measurements . The PrT group demonstrated greater improvement in walking time on a spongy surface and knee reposition error than the other 2 groups . No improvements were apparent in the control group . CONCLUSION Both types of non-weight-bearing exercises ( PrT and ST ) significantly improved outcomes in this study . PrT led to greater improvements in proprioceptive function , while ST result ed in a greater increase in knee extensor muscle strength QUESTIONS For people with idiopathic Parkinson 's disease , does a 6-week , comprehensive , home exercise program reduce falls and disability and improve health-related quality of life ? Is the program cost-effective ? DESIGN R and omised , controlled trial with concealed allocation and assessor blinding . PARTICIPANTS One hundred and thirty-three community-dwelling adults with Parkinson 's disease . INTERVENTION The experimental group completed a 6-week home program comprising progressive resistance strength training , movement strategy training and falls education . The control group completed 6 weeks of non-specific life skills training . Participants in both groups received weekly therapist-guided sessions for 6 consecutive weeks and a weekly self-directed home program . OUTCOME MEASURES The primary outcome was the rate of falls , documented for the 12-month period immediately after therapy . Secondary outcomes were disability and health-related quality of life , assessed before and after intervention and at a 12-month follow-up . RESULTS A total of 2255 falls were reported by the 12-month follow-up . The proportion of fallers in the experimental and control groups was 61 and 72 % , respectively , which was not statistically significantly different ( RR=0.85 , 95 % CI 0.66 to 1.09 ) . There was no significant between-group difference in the rate of falls ( incidence rate ratio=1.58 , 95 % CI 0.73 to 3.43 ) . A survival analysis of participant time to first fall did not show a significant between-group difference ( log-rank test χ2=0.79 , p=0.37 ) . No significant between-group differences occurred for mobility , disability or quality of life . The mean cost of delivering the experimental intervention was AUD1596 . CONCLUSION A home program of strength and movement strategy training and falls education does not prevent falls when applied at the dose used in this study . Arguably , the dosage of therapy was insufficient . Future trials need to explore further therapy content , repetitions and duration , in order to optimise outcomes and cost-effectiveness . [ Morris ME , Taylor NF , Watts JJ , Evans A , Horne M , Kempster P , Danoudis M , McGinley J , Martin C , Menz HB ( 2017 ) A home program of strength training , movement strategy training and education did not prevent falls in people with Parkinson 's disease : a r and omised trial . Journal of Physiotherapy 63 : 94 - 100 ] BACKGROUND Mild frailty or pre-frailty is common and yet is potentially reversible . Preventing progression to worsening frailty may benefit individuals and lower health/social care costs . However , we know little about effective approaches to preventing frailty progression . OBJECTIVES ( 1 ) To develop an evidence - and theory-based home-based health promotion intervention for older people with mild frailty . ( 2 ) To assess feasibility , costs and acceptability of ( i ) the intervention and ( ii ) a full-scale clinical effectiveness and cost-effectiveness r and omised controlled trial ( RCT ) . DESIGN Evidence review s , qualitative studies , intervention development and a feasibility RCT with process evaluation . INTERVENTION DEVELOPMENT Two systematic review s ( including systematic search es of 14 data bases and registries , 1990 - 2016 and 1980 - 2014 ) , a state-of-the-art review ( from inception to 2015 ) and policy review identified effective components for our intervention . We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people ( aged 65 - 94 years ) ( n = 44 ) , carers ( n = 12 ) and health/social care professionals ( n = 27 ) . These data , and our evidence review s , fed into development of the ' HomeHealth ' intervention in collaboration with older people and multidisciplinary stakeholders . ' HomeHealth ' comprised 3 - 6 sessions with a support worker trained in behaviour change techniques , communication skills , exercise , nutrition and mood . Participants addressed self-directed independence and well-being goals , supported through education , skills training , enabling individuals to overcome barriers , providing feedback , maximising motivation and promoting habit formation . FEASIBILITY RCT Single-blind RCT , individually r and omised to ' HomeHealth ' or treatment as usual ( TAU ) . SETTING Community setting s in London and Hertfordshire , UK . PARTICIPANTS A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty . MAIN OUTCOME MEASURES Feasibility - recruitment , retention , acceptability and intervention costs . Clinical and health economic outcome data at 6 months included functioning , frailty status , well-being , psychological distress , quality of life , capability and NHS and societal service utilisation/costs . RESULTS We successfully recruited to target , with good 6-month retention ( 94 % ) . Trial procedures were acceptable with minimal missing data . Individual r and omisation was feasible . The intervention was acceptable , with good fidelity and modest delivery costs ( £ 307 per patient ) . A total of 96 % of participants identified at least one goal , which were mostly exercise related ( 73 % ) . We found significantly better functioning ( Barthel Index + 1.68 ; p = 0.004 ) , better grip strength ( + 6.48 kg ; p = 0.02 ) , reduced psychological distress ( 12-item General Health Question naire -3.92 ; p = 0.01 ) and increased capability-adjusted life-years [ + 0.017 ; 95 % confidence interval ( CI ) 0.001 to 0.031 ] at 6 months in the intervention arm than the TAU arm , with no differences in other outcomes . NHS and carer support costs were variable but , overall , were lower in the intervention arm than the TAU arm . The main limitation was difficulty maintaining outcome assessor blinding . CONCLUSIONS Evidence is lacking to inform frailty prevention service design , with no large-scale trials of multidomain interventions . From stakeholder/public perspectives , new frailty prevention services should be personalised and encompass multiple domains , particularly socialising and mobility , and can be delivered by trained non-specialists . Our multicomponent health promotion intervention was acceptable and delivered at modest cost . Our small study shows promise for improving clinical outcomes , including functioning and independence . A full-scale individually RCT is feasible . FUTURE WORK A large , definitive RCT of the HomeHealth service is warranted . STUDY REGISTRATION This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials IS RCT N11986672 . FUNDING This project was funded by the National Institute for Health Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 21 , No. 73 . See the NIHR Journals Library website for further project information Resistance training of the lower limbs is now commonly used in clinical practice in children and adolescents with spastic cerebral palsy ( CP ) . However , the effectiveness of this type of training is still disputed . The most recently published systematic review with meta- analysis included interventions such as electrical stimulation and resistance training and found insufficient evidence to support or refute the efficacy of these exercises in children with CP . Thus , the aim of this article is to evaluate the extent to which training protocol s from the most recent r and omized controlled trials are in keeping with the evidence for effective resistance  training in children who are developing typically , as reflected in the training guidelines of the National Strength and Conditioning Association . Recommendations for resistance training protocol s , based on this evidence and appropriate to children with CP , are provided to help guide both future research and clinical practice for resistance training in children with CP Background and aims : This study investigated whether high-velocity high-power training ( POW )  improved lower extremity muscle power and quality in functionally-limited elders greater than traditional slow-velocity progressive resistance training ( STR ) . Methods : Fifty-seven community-dwelling older adults aged 74.2±7 ( range 65–94 yrs ) , Short Physical Performance Battery score 7.7±1.4 , were r and omized to either POW ( n=23 ) ( 12 females ) , STR ( n=22 ) ( 13 females ) or a control group of lower extremity stretching ( CON ) ( n=12 ) ( 6 females ) . Training was performed three times per week for 12 weeks and subjects completed three sets of double leg press and knee extension exercises at 70 % of the one repetition maximum ( 1RM ) . Outcome measures included 1RM strength and peak power ( PP ) . Total leg lean mass was determined using dual-energy X-ray absorptiometry to estimate specific strength and specific PP . Results : During training , power output was consistently higher in POW compared to STR for knee extension ( ∼2.3-fold ) and leg press ( ∼2.8-fold ) exercises ( p<0.01 ) . Despite this , PP and specific PP of the knee extensors increased similarly from baseline in POW and STR compared to CON ( p<0.01 ) , and no significant time-group interaction occurred for PP of the leg extensors . However , gains in leg press specific PP were significantly greater in POW compared to both STR and CON ( p<0.05 ) . Total leg lean mass did not change within any group . Conclusions : A short-term intervention of high-velocity power training and traditional slow-velocity progressive resistance training yielded similar increases of lower extremity power in the mobility-impaired elderly . Neuromuscular adaptations to power training , rather than skeletal muscle hypertrophy , may have facilitated the improvements in muscle quality . Additional studies are warranted to test the efficacy of power training in older individuals with compromised physical functioning 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 OBJECTIVE To determine the effects of a short- duration , combined ( inspiratory and expiratory ) , progressive resistance respiratory muscle training ( RMT ) protocol on respiratory muscle strength , fatigue , health-related quality of life , and functional performance in individuals with mild-to-moderate multiple sclerosis ( MS ) . DESIGN Quasi-experimental before-after trial . SETTING University rehabilitation research laboratory . PARTICIPANTS Volunteers with MS ( N=21 ) were divided into 2 groups : RMT ( n=11 ; 9 women , 2 men ; mean age ± SD , 50.9 ± 5.7y , mean Exp and ed Disability Status Scale score ± SD , 3.2 ± 1.9 ) and a control group that did not train ( n=10 ; 7 women , 3 men ; mean age ± SD , 56.2 ± 8.8y , mean Exp and ed Disability Status Scale score ± SD , 4.4 ± 2.1 ) . Exp and ed Disability Status Scale scores ranged from 1 to ≤6.5 . No patients withdrew from the study . INTERVENTION Training was a 5-week combined progressive resistance RMT program , 3d/wk , 30 minutes per session . MAIN OUTCOME MEASURES The primary outcome measures were maximal inspiratory pressure and expiratory pressure and the Modified Fatigue Impact Scale . All subjects completed secondary measures of pulmonary function , the six-minute walk test , the timed stair climb , the Multiple Sclerosis Self-Efficacy Scale , the Medical Outcomes Study 36-Item Short-Form Health Survey , and the Physical Activity Disability Scale . RESULTS Maximal inspiratory pressure and expiratory pressure ( mean ± SD ) increased 35 % ± 22 % ( P<.001 ) and 26 % ± 17 % ( P<.001 ) , respectively , whereas no changes were noted in the control group ( 12 % ± 23 % and -4 % ± 17 % ,  respectively ) . RMT improved fatigue ( Modified Fatigue Impact Scale , P<.029 ) , with no change or worsening in the control group . No changes were noted in the six-minute walk test , stair climb , Multiple Sclerosis Self-Efficacy Scale , or Physical Activity Disability Scale in the RMT group . The control group had decreases in emotional well-being and general health ( Medical Outcomes Study 36-Item Short-Form Health Survey ) . CONCLUSIONS A short- duration , combined RMT program improved inspiratory and expiratory muscle strength and reduced fatigue in patients with mild to moderate MS Background Among older , overweight , and obese adults with either cardiovascular disease or the metabolic syndrome , reduced mobility and loss of leg strength are important risk factors for morbidity , disability , and mortality . It is unclear whether community-based approaches to weight loss may be an effective solution to this public health challenge . Methods An 18-month three-site , r and omized controlled trial conducted by YMCA staff , with blinded assessors , enrolled 249 older , overweight , and obese adults with either cardiovascular disease or metabolic syndrome with r and omization to three interventions : weight loss alone ( WL ) , weight loss + aerobic training ( WL + AT ) , and weight loss + resistance training ( WT + RT ) . The dual primary outcomes were 400-m walk time in seconds and knee extensor strength in Newton meters . Results All groups lost weight from baseline : average baseline adjusted change of -6.1 % ( 95 % confidence interval [ CI ] : -7.5 to -4.7 ) for WL only , -8.6 % ( 95 % CI : -10.0 to -7.2 ) for WL + AT , and -9.7 % ( 95 % CI : -11.1 to -8.4 ) for WL + RT . Combined , the two physical activity + WL training groups had greater improvement in walk time than WL alone ( mean difference 16.9 seconds [ 95 % CI : 9.7 to 24.0 ] , p < .0001 ) . Baseline adjusted change in knee extensor strength was no greater with WL + RT than WL + AT ( mean difference -3.6 Nm [ 95 % CI : -7.5 to 0.3 ] , p = .07 ) . Conclusions At risk , older , overweight and obese adults can achieve clinical ly significant reductions in body weight with community-based weight loss programs . The change in percent weight loss and improvements in mobility are significantly enhanced when either RT or AT is combined with dietary WL Background . Targeted physical activity drives functional recovery after stroke . This review aim ed to determine the amount of time stroke survivors spend physically active during physiotherapy sessions . Summary of Review . A systematic search was conducted to identify published studies that investigated the use of time by people with stroke during physiotherapy sessions . Seven studies were included ; six observational and one r and omised controlled trial . People with stroke were found to be physically active for an average of 60 percent of their physiotherapy session duration . The most common activities practice d in a physiotherapy session were walking , sitting , and st and ing with a mean ( SD ) practice time of 8.7 ( 4.3 ) , 4.5 ( 4.0 ) , and 8.3 ( 2.6 ) minutes , respectively . Conclusion . People with stroke were found to spend less than two-thirds of their physiotherapy sessions duration engaged in physical activity . In light of dosage studies , practice time may be insufficient to drive optimal motor recovery 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 BACKGROUND Previous studies suggest that qigong therapy has physiological benefits for adults with type 2 diabetes ; however , information about the psychological benefits of qigong therapy in this population is limited . OBJECTIVE The objective of this research project was to identify psychological responses to qigong vs control interventions in adults with type 2 diabetes . DESIGN The research team design ed a r and omized , controlled , three-arm clinical trial comparing 12 weeks of Yi Ren Medical Qigong ( YRMQ ) , progressive resistance training ( PRT ) , and st and ard care . SETTING The study was performed at Bastyr University Research Institute , Kenmore , Washington . PARTICIPANTS Participants were 13 men and 19 women ( N=32 ) with diagnosed type 2 diabetes , a mean age of 56.3 ± 8.1 ( st and ard deviation ) years , glycated hemoglobin > 7.5 % , and fasting blood glucose > 7 mmol/dL ( 126 mg/dL ) . INTERVENTION For 12 weeks , participants in the YRMQ and PRT group attended a 1-hour weekly group session that a certified instructor led and were instructed to practice at least twice a week for 30 minutes . PRIMARY OUTCOME MEASURES The research team used the Perceived Stress Scale and the Beck Depression Inventory scores to analyze the data . RESULTS YRMQ decreased perceived-stress scores by 29.3 % ( P < .05 ) and depression scores by 14.3 % ( not significant [ NS ] ) . The active control group , PRT , also decreased stress scores by 18.6 % ( NS ) and decreased depression scores by 50 % ( P < .03 ) . Stress and depression measures remained unchanged in the st and ard care group . CONCLUSION YRMQ and PRT may be beneficial in reducing perceived stress and improving depression in patients with type 2 diabetes , although verification of the clinical significance of these findings requires a longer study with a larger sample size INTRODUCTION Muscle morphology and architecture changes in response to 6 weeks of progressive resistance training were examined in healthy older adults . METHODS In this r and omized , controlled design , muscle strength , quality , and architecture were evaluated with knee extension , DEXA , and ultrasound , respectively , in 25 older adults . RESULTS Resistance training result ed in significant increases in strength and muscle quality of 32 % and 31 % , respectively . Cross-sectional area of the vastus lateralis increased by 7.4 % ( p ≤ 0.05 ) . Physiological cross-sectional area ( PCSA ) of the thigh , a composite measure of muscle architecture , was related significantly to strength ( r = 0.57 ; p ≤ 0.01 ) and demonstrated a significant interaction after training ( p ≤ 0.05 ) . Change in PCSA of the vastus lateralis was associated with change in strength independent of any other measure . CONCLUSIONS Six weeks of resistance training was effective at increasing strength , muscle quality , and muscle morphology in older adult men and 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
PRT results in improvements to muscle strength and some aspects of functional limitation , such as gait speed , in older adults .
However , based on current data , the effect of PRT on physical disability remains unclear .
Further , due to the poor reporting of adverse events in trials , it is difficult to evaluate the risks associated with PRT
BACKGROUND The aim of this systematic review was to quantify the effectiveness of progressive resistance strength training ( PRT ) to reduce  physical disability in older people .