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 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 Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial A randomized controlled trial of progressive resistance training in depressed elders. Single muscle fiber adaptations to resistance training in old (>80 yr) men: evidence for limited skeletal muscle plasticity. Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms Strength improvements with 1 yr of progressive resistance training in older women. Effects of high-intensity resistance training in patients with rheumatoid arthritis: 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. Effects of progressive resistance training on body composition in frail older adults: results of 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 Effect of progressive resistance training on muscle performance after chronic stroke. Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial. Effects of testosterone and progressive resistance exercise in healthy, highly functioning older men with low-normal testosterone levels. A rationale and method for high-intensity progressive resistance training with children and adolescents. Creatine Fails to Augment the Benefits from Resistance Training in Patients with HIV Infection: A Randomized, Double-Blind, Placebo-Controlled Study High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors 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 Core self-evaluation as a predictor of strength training adoption in older adults. Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. 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 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. Efficacy of 2 non-weight-bearing interventions, proprioception training versus strength training, for patients with knee osteoarthritis: a randomized clinical trial. High-intensity progressive resistance training improves flat-ground walking in older adults with symptomatic peripheral arterial 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. Regenerate: assessing the feasibility of a strength-training program to enhance the physical and mental health of chronic post stroke patients with depression. 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 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 Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. 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. Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson’s disease: study protocol for a randomised controlled trial Randomized controlled trial of intradialytic resistance training to target muscle wasting in ESRD: the Progressive Exercise for Anabolism in Kidney Disease (PEAK) study. Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years: an 18-month randomized controlled trial Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus. Pilot randomized trial of progressive resistance exercise augmented by neuromuscular electrical stimulation for people with multiple sclerosis who use walking aids. Effect of resistance training on self-reported physical functioning in HIV infection. Changes in Insulin Resistance and HbA1c Are Related to Exercise-Mediated Changes in Body Composition in Older Adults With Type 2 Diabetes A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Effects of muscle strength training and megestrol acetate on strength, muscle mass, and function in frail older people. Effects of high- and low-velocity resistance training on the contractile properties of skeletal muscle fibers from young and older humans. Does an early home-based progressive resistance training program improve function following total hip replacement? Results of a randomized controlled study Exercise attenuates the weight-loss-induced reduction in muscle mass in frail obese older adults. Oral amino-acid provision does not affect muscle strength or size gains in older men. A Comparison of the Clinical and Cost-Effectiveness of 3 Intervention Strategies for AIDS Wasting DETRAINING AND TAPERING EFFECTS ON HORMONAL RESPONSES AND STRENGTH PERFORMANCE Musculoskeletal adaptations to resistance training in old age. Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis? A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Exercise training and nutritional supplementation for physical frailty in very elderly people. Can progressive resistance training reverse cachexia in patients with rheumatoid arthritis? Results of a pilot study. Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial Short-term progressive resistance exercise may not be effective at increasing wrist strength in people with tetraplegia: a randomised controlled trial. Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised 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. Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Old women with a recent fall history show improved muscle strength and function sustained for six months after finishing training Land-based versus aquatic resistance therapeutic exercises for older women with sarcopenic obesity: study protocol for a randomised controlled trial Physical function predicts improvement in quality of life in elderly icelanders after 12 weeks of resistance exercise 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 Effect of resistance training on physical disability in chronic heart failure. The Boston FICSIT study: the effects of resistance training and nutritional supplementation on physical frailty in the oldest old. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews High intensity strength training improves strength and functional performance after stroke. Blood flow restriction walking and physical function in older adults: A randomized control trial. Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial. Effects of 8-week combined training on body composition, isokinetic strength, and cardiovascular disease risk factors in older women Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial. Progressive resistance training improves gait initiation in individuals with Parkinson's disease. High-velocity resistance training increases skeletal muscle peak power in older women. Intensive physical training in geriatric patients after severe falls and hip surgery. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial Resistance exercise dosage in older adults: single- versus multiset effects on physical performance and body composition. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Upper extremity muscle volumes and functional strength after resistance training in older adults. Multicomponent Training Program with Weight-Bearing Exercises Elicits Favorable Bone Density, Muscle Strength, and Balance Adaptations in Older Women Positive effects of 1-year football and strength training on mechanical muscle function and functional capacity in elderly men Increases in muscle strength and balance using a resistance training program administered via a telecommunications system in older adults. A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING Progressive Resistance Exercise Training in CKD: A Feasibility Study. Controlled examination of effects of progressive relaxation training on seizure reduction. Progressive resistance training and mobility-related function in young people with cerebral palsy: a randomized controlled trial. Residual effects of muscle strength and muscle power training and detraining on physical function in community-dwelling prefrail older adults: a randomized controlled trial Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge Effects of training on functional performance in 65, 75 and 85 year-old women: experiences deriving from community based studies in Odense, Denmark. 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 feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: a randomized-controlled trial. 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 Resistive training and long-term function in older adults. Effect of elastic band‐based high‐speed power training on cognitive function, physical performance and muscle strength in older women with mild cognitive impairment Strength versus muscle power-specific resistance training in community-dwelling older adults. Growth hormone administration and exercise effects on muscle fiber type and diameter in moderately frail older people. Training for muscle power in older adults: effects on functional abilities. Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: a randomized pilot trial. Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old. Effects of resistance exercise and fortified milk on skeletal muscle mass, muscle size, and functional performance in middle-aged and older men: an 18-mo randomized controlled trial. Combined aerobic and resistance exercise program improves task performance in patients with heart failure. The effects of resistance training on well-being and memory in elderly volunteers. Muscle architecture and strength: adaptations to short-term resistance training in older adults. The effects of improved strength on obstacle negotiation in community-living older adults. Effects of whole body vibration training on cardiorespiratory fitness and muscle strength in older individuals (a 1-year randomised controlled trial). Efficacy of whey protein supplementation on resistance exercise-induced changes in lean mass, muscle strength, and physical function in mobility-limited older adults. Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. Weighted stair climbing in mobility-limited older people: a pilot study. Long-term impact of strength training on muscle strength characteristics in older adults. Effects of a 12-wk resistance exercise program on skeletal muscle strength in children with burn injuries. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone. The effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older men Fish oil-derived n-3 PUFA therapy increases muscle mass and function in healthy older adults. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke Muscle strength and fiber adaptations to a year-long resistance training program in elderly men and women. Muscle function in aged women in response to a water-based exercises program and progressive resistance training. Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: A randomized, controlled trial. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults Physical training improves motor performance in people with dementia: a randomized controlled trial. Prevalence and correlates of resistance training in a regional Australian population The value of strength training for older adults. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults. Effect of progressive resistance exercise on strength evolution of elderly patients living with HIV compared to healthy controls Effectiveness of functional progressive resistance exercise training on walking ability in children with cerebral palsy: a randomized controlled trial. The effect of progressive resistance training on oxidative stress and antioxidant enzyme activity in erythrocytes in untrained men. Physical fitness and psychological benefits of strength training in community dwelling older adults. Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly The effects of strength training on strength and health-related quality of life in older adult women. Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure. Exercise dosing to retain resistance training adaptations in young and older adults. Strength Training Following Hematopoietic Stem Cell Transplantation Psychological effects of Yi Ren Medical Qigong and progressive resistance training in adults with type 2 diabetes mellitus: a randomized controlled pilot study. Optimal load for increasing muscle power during explosive resistance training in older adults. Effects of combined sensory and muscular training on balance in Japanese older adults. Four-month course of soluble milk proteins interacts with exercise to improve muscle strength and delay fatigue in elderly participants. A home-based exercise program for nondisabled older adults. Physical activity, muscle function, falls and fractures Upper‐Body Progressive Resistance Training Improves Strength and Household Physical Activity Performance in Women Attending Cardiac Rehabilitation Effect of protein source on resistive-training-induced changes in body composition and muscle size in older men. Short-term, light- to moderate-intensity exercise training improves leg muscle strength in the oldest old: a randomized controlled trial. The Otago Exercise Program performed as group training versus home training in fall-prone older people: a randomized controlled 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 Exercise: effects on physical functional performance in independent older adults. Neuromuscular adaptations during bilateral versus unilateral strength training in middle-aged and elderly men and women. Tablet-Based Strength-Balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: A Phase II Preclinical Exploratory Trial Single- and multiple-set resistance training improves skeletal and respiratory muscle strength in elderly women Plasma hormones, muscle mass and strength in resistance-trained postmenopausal women. Endurance exercise training during haemodialysis improves strength, power, fatigability and physical performance in maintenance haemodialysis patients. Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial. Effects of Moderate- Versus High-Intensity Exercise Training on Physical Fitness and Physical Function in People With Type 2 Diabetes: A Randomized Clinical Trial Gait performance in dementia: the effects of a 6-week resistance training program in an adult day-care setting. Effects of Core Instability Strength Training on Trunk Muscle Strength, Spinal Mobility, Dynamic Balance and Functional Mobility in Older Adults Strength training increases maximum working capacity in patients with COPD--randomized clinical trial comparing three training modalities. Effects of traditional physical training and visual computer feedback training in frail elderly patients. A randomized intervention study. Exercise induced effects on muscle function and range of motion in patients with hip osteoarthritis Hip muscle and hand-grip strength to differentiate between older fallers and non-fallers: a cross-sectional validity study [Strength and coordination training for prevention of falls in the elderly]. The effect of a training program combined with augmented afferent feedback from the feet using shoe insoles on gait performance and muscle power in older adults: a randomised controlled trial High-Intensity Progressive Resistance Training Increases Strength With No Change in Cardiovascular Function and Autonomic Neural Regulation in Older Adults. Effectiveness of a home-based strengthening program for elderly males in Italy. A preliminary study Progressive Resistance Muscle Strength Training of Hospitalized Frail Elderly The effects of progressive resistance training for children with cerebral palsy The Home-Based Older People's Exercise (HOPE) trial: study protocol for a randomised controlled trial Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients--a pilot study. 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] Adaptations to long-term strength training of ankle joint muscles in old age Effects of detraining subsequent to strength training on neuromuscular function in patients with inflammatory arthritis. The influence of short-term strength training on health-related quality of life and executive cognitive function. A Combined Aerobic and Resistance Exercise Program Improves Physical Functional Performance in Patients With Heart Failure: A Pilot Study Home-based resistance training: predictors of participation and adherence. Investigation of Clinical Effects of High- and Low-Resistance Training for Patients With Knee Osteoarthritis: A Randomized Controlled Trial Effect of intense strength training on standing balance, walking speed, and sit-to-stand performance in older adults. Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial Resistance training and reduction of treatment side effects in prostate cancer patients. A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial Efficacy of lower-limb muscle training modalities in severely dyspnoeic individuals with COPD and quadriceps muscle weakness: results from the DICES trial Associations between physical fitness and HbA1c in type 2 diabetes mellitus Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD. Resistance exercise: an effective strategy to reverse muscle wasting in hemodialysis patients? Exercise training improves overall physical fitness and quality of life in older women with coronary artery disease. The effects of aerobic and resistance exercises in obese women Resistance training improves cardiovascular risk factors in obese women despite a significative decrease in serum adiponectin levels. The effects of high- and moderate-resistance training on muscle function in the elderly. A home-based, transtheoretical change model designed strength training intervention to increase exercise to prevent osteoporosis in Iranian women aged 40-65 years: a randomized controlled trial. Creatine Monohydrate and Conjugated Linoleic Acid Improve Strength and Body Composition Following Resistance Exercise in Older Adults A Systematic Review of the Effects of Exercise Interventions on Body Composition in HIV+ Adults Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults. Age effect on transcript levels and synthesis rate of muscle MHC and response to resistance exercise. Comparing endurance- and resistance-exercise training in people with multiple sclerosis: a randomized pilot study Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. Exercise training in the debilitated aged: strength and functional outcomes. Lower limb muscle strengthening does not change frontal plane moments in women with knee osteoarthritis: A randomized controlled trial. Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Whole body vibration for older persons: an open randomized, multicentre, parallel, clinical trial Power training induced change in bradykinesia and muscle power in Parkinson's disease. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. A home-based resistance-training program
using elastic bands for elderly patients
with orthostatic hypotension High-speed circuit training vs hypertrophy training to improve physical function in sarcopenic obese adults: A randomized controlled trial Muscle hypertrophy response to resistance training in older women. Protein Ingestion before Sleep Increases Muscle Mass and Strength Gains during Prolonged Resistance-Type Exercise Training in Healthy Young Men. The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. Midlife hand grip strength as a predictor of old age disability. Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain. Effects of fitness and vibration training on muscle quality: a 1-year postintervention follow-up in older men. Effects of different doses of high-speed resistance training on physical performance and quality of life in older women: a randomized controlled trial Effects of elastic band resistance training and nutritional supplementation on physical performance of institutionalised elderly — A randomized controlled trial Strategic creatine supplementation and resistance training in healthy older adults. Insulin-like growth factor I in skeletal muscle after weight-lifting exercise in frail elders. Enhancing quality of life in older adults: A comparison of muscular strength and power training 1,25-Dihydroxyvitamin D3 and muscle strength in the elderly: a randomized controlled trial. Progressive resistance versus relaxation training for breast cancer patients during adjuvant chemotherapy: design and rationale of a randomized controlled trial (BEATE study). Clinical meaningfulness of the changes in muscle performance and physical function associated with testosterone administration in older men with mobility limitation. The Osteogenic Effect of Impact-Loading and Resistance Exercise on Bone Mineral Density in Middle-Aged and Older Men: A Pilot Study Training and Detraining Effects on Functional Fitness after a Multicomponent Training in Older Women Protein supplementation during resistance-type exercise training in the elderly. Supervised exercise training improves aerobic capacity and muscle strength in older women with heart failure. Feasibility and impact of a physical exercise program in patients with advanced cancer: a pilot study. Effect of Laser Therapy on Chronic Osteoarthritis of the Knee in Older Subjects. A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function. Upper-Body Resistance Training and Self-Efficacy Enhancement in COPD Strength training at high versus low external resistance in older adults: Effects on muscle volume, muscle strength, and force–velocity characteristics Resistance exercise and physical performance in adults aged 60 to 83. The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial. Effects of resistance and aerobic exercise on physical function, bone mineral density, OPG and RANKL in older women Exercise Interventions in Children with Cancer: A Review Comparative effects of light or heavy resistance power training for improving lower extremity power and physical performance in mobility-limited older adults. The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial Effects of vibration exercise on muscle performance and mobility in an older population. The efficacy of a muscle exercise program to improve functional performance of the knee in patients with osteoarthritis. Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study. Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. Effects of ballistic stretching training on the properties of human muscle and tendon structures. Effects of velocity loss during resistance training on athletic performance, strength gains and muscle adaptations Effects of muscle strength training and testosterone in frail elderly males. Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis Effectiveness of an intervention to prevent frailty in pre-frail community-dwelling older people consulting in primary care: a randomised controlled trial Is strength training the more efficient training modality in chronic heart failure? Effects of a Group-Based Exercise and Educational Program on Physical Performance and Disease Self-Management in Rheumatoid Arthritis: A Randomized Controlled Study Efficacy of heavy-resistance training for active women over sixty: muscular strength, body composition, and program adherence. Recovery of muscle strength following multi-level orthopaedic surgery in diplegic cerebral palsy. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. Relaxation training in school classes does not reduce headache complaints. Is Hand-Held Dynamometry Useful for the Measurement of Quadriceps Strength in Older People? A Comparison with the Gold Standard Biodex Dynamometry Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Effect of strength and power training on physical function in community-dwelling older adults. Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB‐HF) trial: Design and rationale Resistance Training Leads to Clinically Meaningful Improvements in Control of Glycemia and Muscular Strength in Untrained Middle-aged Patients with type 2 Diabetes Mellitus The Seattle FICSIT/MoveIt study: the effect of exercise on gait and balance in older adults. Functional-task exercise versus resistance strength exercise to improve daily function in older women: a randomized, controlled trial. Comparison of once-weekly and twice-weekly strength training in older adults Changes in muscle mass, muscle strength, and power but not physical function are related to testosterone dose in healthy older men. A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response. Effect of PNF stretching training on the properties of human muscle and tendon structures. Velocity training induces power-specific adaptations in highly functioning older adults. Progressive Resistance Training to Impact Physical Fitness and Body Weight in Pancreatic Cancer Patients: A Randomized Controlled Trial The efficacy of home-based muscle training for the elderly osteoporotic women: the effects of daily muscle training on quality of life (QoL). Efficacy of a home-based training program for older adults using elastic tubing Improvement in Aerobic Capacity After an Exercise Program in Sporadic Inclusion Body Myositis Combined training enhances skeletal muscle mitochondrial oxidative capacity independent of age. Effects of different types of physical activity on the cognitive functions and attention in older people: A randomized controlled study Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Muscle strength and mobility in vitamin D-insufficient female geriatric patients: a randomized controlled trial on vitamin D and calcium supplementation
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 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 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 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 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 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 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 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 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 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 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 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 ) 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 Muscle weakness experienced in old age has many detrimental consequences for activities of daily life . Given the serious problems presented by weakness in old age , strategies to prevent or mitigate this process are of paramount importance . In recent years resistance training has emerged as an effective method for increasing strength in the elderly . Despite this , little is known regarding the muscular , neural and tendinous adaptations that occur with resistance training in old age . Hence , we have conducted a series of experiments to investigate these adaptations . We have found increases in maximal isometric and concentric torque by 9 - 37 % after resistance training in older people ( 65 - 81 years ) . Associated with these strength gains were increases in agonist muscle neural drive without any change in the co-activation of antagonist muscles .  Resistance training can cause increases in muscle size and also adaptations to the internal muscle structure . Tendons of older adults adapt to resistance training by increasing their stiffness and Young 's modulus . In conclusion , many of the musculoskeletal factors characterizing ageing can be at least partially mitigated by resistance training 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 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 BACKGROUND Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people , the efficacy of interventions targeted specifically at these deficits has not been carefully studied . METHODS We conducted a r and omized , placebo-controlled trial comparing progressive resistance exercise training , multinutrient supplementation , both interventions , and neither in 100 frail nursing home residents over a 10-week period . RESULTS The mean ( + /- SE ) age of the 63 women and 37 men enrolled in the study was 87.1 + /- 0.6 years ( range , 72 to 98 ) ; 94 percent of the subjects completed the study .  Muscle strength increased by 113 + /- 8 percent in the subjects who underwent exercise training , as compared with 3 + /- 9 percent in the nonexercising subjects ( P < 0.001 ) . Gait velocity increased by 11.8 + /- 3.8 percent in the exercisers but declined by 1.0 + /- 3.8 percent in the nonexercisers ( P = 0.02 ) . Stair-climbing power also improved in the exercisers as compared with the nonexercisers ( by 28.4 + /- 6.6 percent vs. 3.6 + /- 6.7 percent , P = 0.01 ) , as did the level of spontaneous physical activity . Cross-sectional thigh-muscle area increased by 2.7 + /- 1.8 percent in the exercisers but declined by 1.8 + /- 2.0 percent in the nonexercisers ( P = 0.11 ) . The nutritional supplement had no effect on any primary outcome measure . Total energy intake was significantly increased only in the exercising subjects who also received nutritional supplementation . CONCLUSIONS High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people . In contrast , multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty OBJECTIVE . 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 / objectives : A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program . The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass , muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation . Subjects/ Methods : A total of 161 men and women , 65–91 years old , participated in a r and omized , controlled , double-blind intervention study , involving dietary supplementation and a 12-week resistance exercise program , design ed to increase muscle mass and strength of all major muscle groups . Participants exercised three times a week and received either 20 g of whey protein ( n=83 ) or isocaloric carbohydrate ( n=78 ) in liquid form immediately after each workout . Data were obtained at baseline and end point . Results : The primary outcomes , lean body mass , strength and physical function increased significantly during the course of the study . Type of dietary supplementation did not influence gains in lean body mass ( P=0.365 ) , quadriceps strength ( P=0.776 ) or performance during a 6-min walk ( P=0.726 ) or a timed up- and -go test ( P=0.151 ) . Twenty participants discontinued the intervention . Conclusions : Ingestion of 20 g of whey protein immediately after resistance exercise three times per week , does not lead to greater gains in lean body mass , strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate QUESTIONS Is an 8-week progressive resistance exercise program effective for increasing strength in the wrist muscles of people with tetraplegia ? Is it effective for improving muscle endurance and participants ' perceptions about use of their h and s for activities of daily living ? DESIGN R and omised controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis . PARTICIPANTS Thirty-two people with tetraplegia and neurological weakness of their wrist flexor or extensor muscles . INTERVENTION The wrist muscles of one r and omly-chosen h and were trained 3 times a week for 8 weeks . The control group received no intervention . OUTCOME MEASURES The primary outcome was strength measured as maximal voluntary isometric torque in Nm . The secondary outcomes were muscle endurance measured as fatigue resistance and participants ' perceptions about use of their h and s using the Canadian Occupational Performance Measure . RESULTS The mean effect on maximal voluntary isometric torque was 0.2 Nm ( 95 % CI -0.5 to 0.8 ) . This represents an 8 % increase of mean initial strength ; less than the 20 % deemed clinical ly worthwhile at the commencement of the study . The mean effect on fatigue resistance was 0.1 ( 95 % CI 0.0 to 0.2 ) . The mean effect on participants ' perceptions of performance was -0.3 ( 95 % CI -1.9 to 1.2 ) and satisfaction was -0.3 ( 95 % CI -1.6 to 1.0 ) . CONCLUSION The results indicate that progressive resistance exercise has no effect on participants ' perceptions about h and function . However , it is not yet clear whether progressive resistance exercise programs improve strength and endurance in muscles with neurologically-induced weakness following tetraplegia OBJECTIVE To examine if 2 weekly sessions of supervised progressive resistance training ( PRT ) in combination with 5 weekly sessions of unsupervised home-based exercise is more effective than 7 weekly sessions of unsupervised home-based exercise in improving leg-extension power of the operated leg 10 weeks after total hip replacement ( THR ) in patients with lower pre-operative function . METHOD A total of 73 patients scheduled for THR were r and omised ( 1:1 ) to intervention group ( IG , home based exercise 5 days/week and PRT 2 days/week ) or control group ( CG , home based exercise 7 days/week ) . The primary endpoint was change in leg extension power at 10 week follow up . Secondary outcomes were isometric hip muscle strength , sit-to-st and test , stair climb test , 20 m walking speed and patient-reported outcome ( HOOS ) . RESULTS Sixty-two completed the trial ( 85 % ) .  Leg extension power increased from baseline to the 10 week follow up in both groups ; mean [ 95 % CI ] IG : 0.29 [ 0.13 ; 0.45 ] and CG : 0.26 [ 0.10 ; 0.42 ] W/kg , with no between-group difference ( primary outcome ) ( P = 0.79 ) . Maximal walking speed ( P = 0.008 ) and stair climb performance ( P = 0.04 ) improved more in the IG compared to CG , no other between-group differences existed . CONCLUSIONS In this trial , supervised PRT twice a week in addition to 5 weekly sessions of unsupervised exercise for 10 weeks was not superior to 7 weekly sessions of unsupervised home-based exercise for 10 weeks in improving the primary outcome , leg-extension power of the operated leg , at the primary endpoint 10 weeks after surgery in THR patients with lower pre-operative function . TRIAL REGISTRATION NCT01214954 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 OBJECTIVE To determine the effects of 12 weeks of progressive resistance strength training on the isometric strength , explosive power , and selected functional abilities of healthy women aged 75 and over . DESIGN Subjects were matched for age and habitual physical activity and then r and omly assigned into either a control or an exercise group . SETTING The Muscle Function Laboratory , Royal Free Hospital School of Medicine , London . PARTICIPANTS Fifty-two healthy women were recruited through local and national newspapers . Five dropped out before and seven ( 4 exercisers and 3 controls ) during the study . Pre- and posttraining measurements were obtained from 20 exercisers ( median age 79.5 , range 76 to 93 years ) and 20 controls ( median age 79.5 , range 75 to 90 years ) . INTERVENTIONS Training comprised one supervised session ( 1 hour ) at the Medical School and two unsupervised home sessions ( supported by an exercise tape and booklet ) per week for 12 weeks . The training stimulus was three sets of four to eight repetitions of each exercise , using rice bags ( 1 - 1.5 kg ) or elastic tubing for resistance . The exercises were intended specifically to strengthen the muscles considered relevant for the functional tasks , but were not to mimic the functional measurements . No intervention was prescribed for the controls . MEASUREMENTS Pre- and posttraining measurements were made for isometric knee extensor strength ( IKES ) , isometric elbow flexor strength ( IEFS ) , h and grip strength ( HGS ) , leg extensor power ( LEP ) , and anthropometric indices ( Body impedance analysis , arm muscle circumference , and body weight ) . Functional ability tests were chair rise , kneel rise , rise from lying on the floor , 118-m self-paced corridor walk , stair climbing , functional reach , stepping up , stepping down , and lifting weights onto a shelf . Pre- and posttraining comparisons were made using analysis of variance or analysis of covariance ( using weight as a covariate ) for normally distributed continuous data and one-sided Fishers exact test ( 2 x 2 table ) for discontinuous data . RESULTS Improvements in IKES ( mean change 27 % , P = .03 ) , IEFS ( 22 % , P = .05 ) , HGS ( 4 % , P = .05 ) , LEP/kg ( 18 % , P = .05 ) were associated with training , but the improvement in LEP ( 18 % , P = .11 ) did not reach statistical significance . There was an association between training and a reduction in normal pace kneel rise time ( median change 21 % , P = .02 ) and a small improvement in step up height ( median 5 % , P = .005 ) . The other functional tests did not improve . CONCLUSIONS Progressive resistance exercise can produce substantial increases in muscle strength and in power st and ardized for body weight in healthy , very old women . However , isolated increases in strength and LEP/kg may confer only limited functional benefit in healthy , independent , very old women BACKGROUND muscle wasting is associated with a detrimental outcome in older people . Muscle strength measurements could be useful as part of a clinical evaluation of oldest old patients to determine who are most at risk of accelerated decline in the near future . OBJECTIVE this study aim ed to assess if h and grip strength predicts changes in functional , psychological and social health among oldest old . DESIGN the Leiden 85-plus Study is a prospect i ve population -based follow-up study . SUBJECTS five-hundred fifty-five , all aged 85 years at baseline , participated in the study . METHODS h and grip strength was measured with a h and grip strength dynamometer .  Functional , psychological and social health were assessed annually . Baseline data on chronic diseases were obtained from the treating physician , pharmacist , electrocardiogram and blood sample analysis . RESULTS at age 85 , lower h and grip strength was correlated with poorer scores in functional , psychological and social health domains ( all , P < 0.001 ) . Lower baseline h and grip strength predicted an accelerated decline in activities of daily living ( ADL ) and cognition ( both , P < or= 0.001 ) , but not in social health ( P > 0.30 ) . CONCLUSION poor h and grip strength predicts accelerated dependency in ADL and cognitive decline in oldest old . Measuring h and grip strength could be a useful instrument in geriatric practice to identify those oldest old patients at risk for this accelerated decline 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 and aims : Restricted physical activity as a consequence of chronic disease or injury is a predictor of functional decline . The aim of this study was to test the hypothesis that a 6-month multidimensional training program would have sustained beneficial effects upon the physiological , functional and psychological condition of old women with a recent history of falls . Methods : Participants were 65 home-dwelling women ( 70–90 years ) identified from hospital records as having had an accidental fall . After assessment of muscle strength , balance performance , walking speed , balance confidence , and physical activity level , the participants were r and omly assigned to a control group ( n=33 ) or a training group ( n=32 ) , who performed a multidimensional training program including moderate resistance exercise and balance exercise twice weekly for 6 months . Measurements were repeated after 6 and 12 months . Results : Six months of multidimensional training result ed in significant improvements and between-group differences in isometric knee extension strength ( p<0.05 ) , trunk extension/flexion strength ( p<0.001 ) , habitual/maximal walking speed ( p<0.001 ) and balance performance ( p<0.001 ) . At follow-up , 6 months after intervention , these improvements were preserved in the training group and there was also a significant between-group difference with regard to balance confidence . No between-group differences were found concerning number of falls or physical activity level during the one-year study period . Conclusions : A multi-dimensional training program produced significant improvements in physiological and functional risk factors for falls and disability in women aged 70–90 years with a recent history of falls 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 : 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 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 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 Research indicates that lower extremity muscle weakness in the elderly is consistently related to impaired mobility and fall risk . Reversible components of the muscle weakness of aging include underuse syndromes and undernutrition , both of which are prevalent in nursing home population s. The Boston FICSIT study is a nursing home-based intervention to improve muscle strength through progressive resistance training of the lower extremities and /or multi-nutrient supplementation in chronically institutionalized subjects aged 70 - 100 . Baseline measurements of falls , medical status , psychological variables , functional status , nutritional intake and status , body composition , muscle mass and morphology , muscle function , and gait and balance are taken . The nursing home residents are then r and omly assigned to one of four treatment groups for 10 weeks : ( 1 ) high intensity progressive resistance training of the hip and knee extensors 3 days per week ; ( 2 ) multi-nutrient supplementation with a 360-kcal high carbohydrate , low fat liquid supplement every day ; ( 3 ) a combination of groups ( 1 ) and ( 2 ) ; and ( 4 ) a control group . Both non-supplemented groups receive a liquid placebo every day , and both non-exercising groups attend three sessions of " leisure activities " every week in order to control for the attentional aspects of the exercise and nutritional interventions . At the end of the 10-week period , all baseline measurements are re-assessed 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 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 OBJECTIVES The progressive age-related declines in muscle health and physical function in older adults are related to muscle size and strength . Walking with an applied blood flow restriction is an alternative to maintain muscle volume in older adults to increase the value for time spent walking . Therefore , the aim of this study was to examine the effect of adding blood flow restriction to low-intensity walking on clinical measures of physical function . DESIGN / METHODS Sedentary older men and women were r and omised to either a low-intensity blood flow restriction walking group ( BFRW ; n=10 ) , or a non-blood flow restriction walking control group ( CON ; n=9 ) . Participants were assessed at baseline , three-weeks and six-weeks for the 30second sit to st and , six-minute walk test , timed up and go  , and a modified Queen  's  College step test  . While a rating of perceived exertion ( RPE ) for training sessions at baseline , three-weeks and six-weeks . RESULTS BFRW typically result ed in a 2.5 - 4.5 fold greater improvement in performance on all measures of physical function compared with CON among these older adults . However , RPE was greater for BFRW at all time points ( for baseline , three-weeks , six-weeks : 14±0 ; 11±0 ; 11±0 ) compared with CON ( 8±0 ; 7±0 ; 8±0 ) , despite declining across the study for BFRW . CONCLUSIONS The greater improvement in physical function with blood flow restriction demonstrates how this addition can increase the quality of simple walking exercise for population s that may be contraindicated to heavy-load resistance training 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 and aims Decline in muscle endurance and strength as well as attenuated cardiac function with aging not only leads to overall physical function decline but also has a close relationship with cardiovascular disease occurrence . This study examined the effects of an 8-week combined training program ( i.e. , consisting of both aerobic and resistance training ) on body composition , isokinetic strength , and cardiovascular disease ( CVD ) risk factors in older women . Methods Nineteen women , aged 65–75 years , were r and omly assigned to either a combined training ( CT , n = 9 ) or an aerobic training ( AT , n = 10 ) group . Body composition and isokinetic strength were assessed before and after the exercise program . Blood sample s were collected to identify CVD risk factors . Results At the end of the training program , body mass , body fat mass , percent body fat , and body mass index decreased significantly and lean mass increased significantly in the CT group compared with those in the AT group ( p < 0.05 ) . Isokinetic strength was also significantly greater in the CT group than in the AT group ( p < 0.05 ) . In addition , the C-reactive protein level was significantly lower in the CT group than in the AT group , whereas interleukin-6 , tumor necrosis factor-α , and total cholesterol levels were significantly lower in both groups ( p < 0.05 ) . Conclusions An 8-week combined exercise program  benefits body composition , especially lean mass , and positively affects isokinetic strength and CVD risk factors . Therefore , increasing lean mass and strength by continuously participating in a combined exercise program may be an effective treatment for preventing and improving CVD in older women OBJECTIVE To determine whether progressive resistance training improves muscle strength , muscle endurance , and physical function in adults with Down syndrome . DESIGN Single-blind r and omized controlled trial . SETTING General community . PARTICIPANTS Adults ( N=20 ) with Down syndrome ( 13 men , 7 women ; mean age , 26.8+/-7.8 y ) were r and omly assigned through a concealed allocation block r and omized method to either an intervention group ( n=9 ) or a control group ( n=11 ) . INTERVENTION The intervention was a supervised , group progressive resistance training program , consisting of 6 exercises using weight machines performed twice a week for 10 weeks . Participants completed 2 to 3 sets of between 10 to 12 repetitions of each exercise until they reached fatigue . The control group continued with their usual activities . MAIN OUTCOME MEASURES The outcomes measured by blinded assessors were muscle strength ( 1-repetition maximum [ 1-RM ] ) , muscle endurance ( number of repetitions at 50 % of 1-RM ) for chest press and leg press , timed stairs test , and the grocery shelving task . RESULTS The intervention group showed significant improvement in upper-limb muscle endurance compared with the control group ( mean difference in the number of repetitions of the chest press at 50 % of 1-RM was 16.7 , 95 % confidence interval , [ CI ] 7.1 - 26.2 ) ; and a trend toward an improvement in upper-limb muscle strength ( mean difference in chest press 1-RM , 8.6 kg ; 95 % CI , -1.3 to 18.5 kg ) and in upper-limb function ( mean difference in grocery shelving task , -20.3s ; 95 % CI , -45.7 to 5.2s ) . There were no significant differences between the groups for lower-limb muscle performance or physical function measures . No major adverse events for the intervention were noted . CONCLUSIONS Progressive resistance training is a safe and feasible fitness option that can improve upper-limb muscle endurance in adults with Down syndrome ( ACTR identifier ACTRN 012606000515594 . ) 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 OBJECTIVES Peak power declines more precipitously than strength with advancing age and is a reliable measure of impairment and a strong predictor of functional performance . We tested the hypothesis that a high-velocity resistance-training program ( HI ) would increase muscle power more than a traditional low-velocity resistance-training program ( LO ) . DESIGN R and omized controlled trial . SETTING University-based human physiology laboratory . PARTICIPANTS Thirty women with self-reported dis-ability ( aged 73 + 1 , body mass index 30.1 + 1.1 kg/mn ) . INTERVENTION We conducted a r and omized trial comparing changes in skeletal muscle power and strength after 16 weeks of HI or LO . Training was performed three times per week , and subjects completed three sets ( 8 - 10 repetitions ) of leg press ( LP ) and knee extension ( KE ) exercises at 70 % of the one-repetition maximum ( IRM ) . MEASUREMENTS One-repetition maximum ( 1 RM ) and peak power for KE and LP . RESULTS LP and KE relative training force and total work were similar between groups ( P > .05 ) . However , HI generated significantly higher power during training sessions than LO for LP ( 3.7-fold greater , P < .001 ) and KE ( 2.1-fold greater , P < .001 ) . Although LP and KE 1RM muscle strength increased similarly in both groups asa result of the training ( P < .001 ) , LP peak power increased significantly more in HI than in LO ( 267 W vs 139 W , P < .001 ) . Furthermore , HI result ed in a significantly greater improvement in LP power at 40 % , 50 % , 60%,70 % , 80 % , and 90 % of the 1 RM than did LO ( P < .05 ) . CONCLUSIONS HI improved 1RM strength similarly and was more effective in improving peak power than was traditional LO in older women . Improvements in lower extremity peak power may exert a greater influence on age-associated reductions in physical functioning than other exercise interventions 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 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 OBJECTIVES To determine whether variation in resistance exercise volume affects muscle function and physical performance response in older adults . DESIGN A r and omized trial with subjects assigned to a single-set ( 1-SET ) or three-set ( 3-SET ) exercise group . SETTING An exercise facility at the University of Queensl and . PARTICIPANTS Twenty-eight community-dwelling men and women aged 65 to 78 . INTERVENTION Progressive resistance training consisting of seven exercises targeting the major muscle groups of the upper and lower body performed on exercise machines twice weekly for 20 weeks at eight-repetition maximum ( RM ) intensity . MEASUREMENTS Muscle function included isotonic muscle strength ( 1-RM ) of the seven exercises , isokinetic and isometric knee extensor strength , and muscle endurance for the chest press and leg press exercises . Physical performance included timed chair rise , usual and fast 6-m walk , 6-m backwards walk , 400-m walk , floor rise to st and ing , and stair climbing ability . In addition , body composition was determined using dual energy x-ray absorptiometry . RESULTS Isotonic muscle strength increased in both exercise groups for all seven exercises ( P<.01 ) , with the gain in the 3-SET group greater ( P<.05 ) for the seated row , triceps extension , and knee extension ( analysis of covariance ) . Similarly , muscle endurance gains were greater for the 3-SET than the 1-SET group ( P<.01 ) , with no significant difference between groups for isokinetic and isometric knee extensor strength . Both groups improved ( P<.05 ) in the chair rise ( 1-SET , 10.1 % ; 3-SET , 13.6 % ) , 6-m backwards walk ( 1-SET , 14.3 % ; 3-SET , 14.8 % ) , 400-m walk ( 1-SET , 3.8 % ; 3-SET , 7.4 % ) , and stair climbing test ( 1-SET , 7.7 % ; 3-SET , 6.4 % ) , with the only difference between groups for the 400-m walk ( P<.05 ) . There was no difference between groups for change in body composition . CONCLUSION Resistance training consisting of only single-set exercises is sufficient to significantly enhance muscle function and physical performance , although muscle strength and endurance gains are greater with higher-volume work . These findings have application in design ing time-efficient exercise regimens to enhance neuromuscular function in older adults 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 Aging leads to a decline in strength and an associated loss of independence . The authors examined changes in muscle volume , maximum isometric joint moment , functional strength , and 1-repetition maximum ( 1RM ) after resistance training ( RT ) in the upper extremity of older adults . They evaluated isometric joint moment and muscle volume as predictors of functional strength . Sixteen healthy older adults ( average age 75 ± 4.3 yr ) were r and omized  to a 6-wk upper extremity RT program or control group . The RT group increased 1RM significantly ( p < .01 for all exercises ) . Compared with controls , r and omization to RT led to greater functional pulling strength ( p = .003 ) , isometric shoulder-adduction moment ( p = .041 ) , elbow-flexor volume ( p = .017 ) , and shoulder-adductor volume ( p = .009 ) . Shoulder-muscle volumes and isometric moments were good predictors of functional strength . The authors conclude that shoulder strength is an important factor for performing functional reaching and pulling tasks and a key target for upper extremity RT interventions Physical exercise is advised as a preventive and therapeutic strategy against aging-induced bone weakness . In this study we examined the effects of 8-month multicomponent training with weight-bearing exercises on different risk factors of falling , including muscle strength , balance , agility , and bone mineral density ( BMD ) in older women . Participants were r and omly assigned to either an exercise-training group ( ET , n = 30 ) or a control group ( CON , n = 30 ) . Twenty-seven subjects in the ET group and 22 in the CON group completed the study . Training was performed twice a week and was design ed to load bones with intermittent and multidirectional compressive forces and to improve physical function . Outcome measures included lumbar spine and proximal femoral BMD ( by dual X-ray absorptiometry ) , muscle strength , balance , h and grip strength , walking performance , fat mass , and anthropometric data . Potential confounding variables included dietary intake , accelerometer-based physical activity , and molecularly defined lactase nonpersistence . After 8 months , the ET group decreased percent fat mass and improved h and grip strength , postural sway , strength on knee flexion at 180 ° /s , and BMD at the femoral neck ( + 2.8 % ) . Both groups decreased waist circumference and improved dynamic balance , chair st and performance , strength on knee extension for the right leg at 180 ° /s , and knee flexion for both legs at 60 ° /s . No associations were found between lactase nonpersistence and BMD changes . Data suggest that 8 months of moderate-impact weight-bearing and multicomponent exercises reduces the potential risk factors for falls and related fractures in older women Purpose A decline in physical capacity takes place with increasing age that negatively affects overall physical function including work ability and the ability to perform typical activities of daily living ( ADL ) . The overall aim of the present study was to determine the neuromuscular adaptations to long-term ( 1 year ) football and strength training in older untrained adults , and to assess the concurrent effect on functional ADL capacity . Methods Twenty-seven healthy elderly males ( 68.2 ± 3.2 years ) were r and omly assigned to 12 months of either recreational football training ( FT : n = 10 ) , strength training ( ST : n = 9 ) or served as inactive controls ( CON : n = 8) . Recreational football training consisted of small-sided training sessions whereas strength training consisted of high intensity exercises targeting the lower extremity and upper body . Maximal thigh muscle strength and rate of force development ( RFD ) were assessed with isokinetic dynamometry , while postural balance and vertical jumping performance were evaluated using force plate analysis . Furthermore , functional ability was evaluated by stair-ascent and chair-rising testing . Results A total of nine , nine and seven participants from FT , ST and CON , respectively , were included in the analysis . Both exercise regimens led to substantial gains in functional ability , evidence d by 24 and 18 % reduced stair-ascent time , and 32 and 21 % increased chair-rising performance in FT and ST , respectively ( all P < 0.05 ) . Long-term strength training led to increased concentric ( 14 % ; P < 0.01 ) and isometric ( 23 % ; P < 0.001 ) quadriceps and isometric hamstring strength ( 44 % ; P < 0.0001 ) , whereas football training mainly result ed in enhanced hamstring strength ( 18 % , P < 0.05 ) and RFD ( 89 % , P < 0.0001 ) . Conclusions Long-term ( 1 year ) strength training led to increased quadriceps and hamstring strength , whereas the adaptations to football training mainly included enhanced strength and rapid force capacity of the hamstring muscles . Gains in functional ability were observed in response to both training regimens , evidence d by reduced stair-ascent time and increased chair-rising performance  . Long-term football exercise and strength training both appear to be effective interventional strategies to improve factors of importance for ADL by counteracting the age-related decline in lower limb strength and functional capacity among old male adults . This could potentially be a way to improve work ability of senior workers BACKGROUND Resistance training programs have been found to improve muscle strength , physical function , and depressive symptoms in middle-aged and older adults . These programs have typically been provided in clinical facilities , health clubs , and senior centers , which may be inconvenient and /or cost prohibitive for some older adults . The purpose of this study was to investigate the effectiveness of an automated telemedicine intervention that provides real-time guidance and monitoring of resistance training in the home . METHODS A r and omized clinical trial in 103 middle-aged or older participants . Participants were assigned to use of a theory-driven interactive voice response system design ed to promote resistance training ( Telephone-Linked Computer-based Long-term Interactive Fitness Trainer ; n = 52 ) or to an attention control ( n = 51 ) for a period of 12 months . Measurements of muscle strength , balance , walk distance , and mood were obtained at baseline , 3 , 6 , and 12 months . RESULTS We observed increased strength , improved balance , and fewer depressive symptoms in the intervention group than in the control group . Using generalized estimating equations modeling , group differences were statistically significant for knee flexion strength ( p = .035 ) , single-leg stance time ( p = .029 ) , and Beck Depression Inventory ( p = .030 ) . CONCLUSIONS This computer-based telecommunications exercise intervention led to improvements in participants ' strength , balance , and depressive symptoms . Because of their low cost and easy accessibility , computer-based interventions may be a cost-effective way of promoting exercise in the home Abstract Objective . To investigate the efficacy of a guided and grade d home-based exercise program for improving a range of physical outcomes in older people . Design . Controlled clinical trial of 16 weeks Setting . Two geographical areas in Gent , Belgium Participants . 66 independent-living older people ( age : 71 - 98 ) with a history of falls and moderate physical impairment Intervention . Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant ’s home . Different types of exercises on balance , aerobic performance , flexibility , and muscle strength were provided . Main outcome measures . Muscle strength , static and dynamic balance , aerobic performance , activities in daily living , fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention . Results : At baseline , there were no significant differences in the measured variables between exercise and control groups . After 16 weeks , the exercise group showed significantly improved ankle muscle strength , balance performance and aerobic capacity , and decreased fear of falling , dependency in daily activities and avoidance of daily activities compared to the control group . The improvements in knee muscle strength , timed chair st and s , and functional reach were not significant . Conclusion : The home-based , individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment . The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation BACKGROUND Skeletal muscle wasting in chronic kidney disease ( CKD ) is associated with morbidity and mortality . Resistance exercise results in muscle hypertrophy in the healthy population , but is underinvestigated in CKD . We aim ed to determine the feasibility of delivering a supervised progressive resistance exercise program in CKD , with secondary aims to investigate effects on muscle size , strength , and physical functioning . STUDY DESIGN Parallel r and omized controlled feasibility study . SETTING & PARTICIPANTS Patients with CKD stages 3b to 4 were r and omly assigned to the exercise ( n=20 ; 11 men ; median age , 63 [ IQR , 57 - 65 ] years ; median estimated glomerular filtration rate , 28.5 [ IQR , 19.0 - 32.0 ] mL/min/1.73 m(2 ) ) or nonexercise control ( n=18 ; 14 men ; median age , 66 [ IQR , 45 - 79 ] years ; estimated glomerular filtration rate , 20.5 [ IQR , 16.0 - 26.0 ] mL/min/1.73 m(2 ) ) group . INTERVENTION Patients in the exercise group undertook an 8-week progressive resistance exercise program consisting of 3 sets of 10 to 12 leg extensions at 70 % of estimated 1-repetition maximum thrice weekly . Patients in the control group continued with usual physical activity . OUTCOMES Primary outcomes were related to study feasibility : eligibility , recruitment , retention , and adherence rates . Secondary outcomes were muscle anatomical cross-sectional area , muscle volume , pennation angle , knee extensor strength , and exercise capacity . MEASUREMENTS Two- and 3-dimensional ultrasonography of skeletal muscle , dynamometry , and shuttle walk tests at baseline and 8 weeks . RESULTS Of 2,349 patients screened , 403 were identified as eligible and 38 enrolled in the study . 33 ( 87 % ) completed the study , and those in the exercise group attended 92 % of training sessions . No changes were seen in controls for any parameter . Progressive resistance exercise increased muscle anatomical cross-sectional area , muscle volume , knee extensor strength , and exercise capacity . LIMITATIONS No blinded assessors , magnetic resonance imaging not used to assess muscle mass , lack of a healthy control group . CONCLUSIONS This type of exercise is well tolerated by patients with CKD and confers important clinical benefits ; however , low recruitment rates suggest that a supervised outpatient-based program is not the most practical implementation strategy 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 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 Although resistance exercise interventions have been shown to be beneficial in prefrail or frail older adults it remains unclear whether there are residual effects when the training is followed by a period of detraining . The aim of this study was to establish the sustainability of a muscle power or muscle strength training effect in prefrail older adults following training and detraining . Methods 69 prefrail community-dwelling older adults , aged 65–94 years were r and omly assigned into three groups : muscle strength training ( ST ) , muscle power training ( PT ) or controls . The exercise interventions were performed for 60 minutes , twice a week over 12 weeks . Physical function ( Short Physical Performance Battery = SPPB ) , muscle power ( sit-to-st and transfer = STS ) , self-reported function ( SF-LLFDI ) and appendicular lean mass ( aLM ) were measured at baseline and at 12 , 24 and 36 weeks after the start of the intervention . Results For the SPPB , significant intervention effects were found at 12 weeks in both exercise groups ( ST : p = 0.0047 ; PT : p = 0.0043 ) . There were no statistically significant effects at 24 and 36 weeks . In the ST group , the SPPB declined continuously after stop of exercising whereas the PT group and controls remained unchanged . No effects were found for muscle power , SF-LLFDI and aLM . Conclusions The results showed that both intervention types are equally effective at 12 weeks but did not result in statistically significant residual effects when the training is followed by a period of detraining . The unchanged SPPB score at 24 and 36 weeks in the PT group indicates that muscle power training might be more beneficial than muscle strength training . However , more research is needed on the residual effects of both interventions . Taken the drop-out rates ( PT : 33 % , ST : 21 % ) into account , muscle power training should also be used more carefully in prefrail older adults . Trial registration This trial has been registered with clinical trials.gov ( NCT00783159 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 aim of the Odense training studies is to eluci date if regular physical training influences the expected decline in physical functional ability in order to assess capacity for postponing dependence in old age . All participants were healthy community-dwelling women representing three different age-cohorts of 65 , 75 and 85 year-old subjects . The 65 and 85 year-old participants of the training group took part in physical class-based exercises for eight months with one session of 60 min a week , whereas the 75 year-old women trained twice a week over eight months . The multicomponent training consisted of various exercises typically involving body awareness , rhythm , aerobic performance ( walking ) , muscle strength and muscle endurance , flexibility , reaction and balance exercises . Physical ability was measured as physical performance test ( PPT ) , isometric muscle strength of the trunk , hip and leg , aerobic capacity and walking speed . This shows that regular training can significantly improve physical ability of elderly women with regard to PPT , maximal oxygen uptake and maximal walking speed , suggesting that both young-old and old-old women are able to benefit from regular tailored exercise training . Thus , physical training of old community-dwelling women appears to represent a prophylactic remedy that merits further research aim ed at evaluating the preliminary findings of the present studies in larger , less selective groups of participants 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 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 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 ) : The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults .  A repeated- measures experimental research design was employed as a sample of 55 apparently healthy , older , community-dwelling volunteers ( 30 exercisers- 25 women and 5 men ; 25 comparisons- 16 women and 9 men ) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function . Strength and function were evaluated at 6-month intervals . The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention . Furthermore , a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence AIM The effectiveness of resistance training in improving cognitive function in older adults is well demonstrated . In particular , unconventional high-speed resistance training can improve muscle power development . In the present study , the effectiveness of 12 weeks of elastic b and -based high-speed power training ( HSPT ) was examined . METHODS Participants were r and omly assigned into a HSPT group ( n = 14 , age 75.0 ± 0.9 years ) , a low-speed strength training ( LSST ) group ( n = 9 , age 76.0 ± 1.3 years ) and a control group ( CON ; n = 7 , age 78.0 ± 1.0 years ) .  A 1-h exercise program was provided twice a week for 12 weeks for the HSPT and LSST groups , and balance and tone exercises were carried out by the CON group . RESULTS Significant increases in levels of cognitive function , physical function , and muscle strength were observed in both the HSPT and LSST groups . In cognitive function , significant improvements in the Mini-Mental State Examination and Montreal Cognitive Assessment were seen in both the HSPT and LSST groups compared with the CON group . In physical functions , Short Physical Performance Battery scores were increased significantly in the HSPT and LSST groups compared with the CON group . In the 12 weeks of elastic b and -based training , the HSPT group showed greater improvements in older women with mild cognitive impairment than the LSST group , although both regimens were effective in improving cognitive function , physical function and muscle strength . CONCLUSIONS We conclude that elastic b and -based HSPT , as compared with LSST , is more efficient in helping older women with mild cognitive impairment to improve cognitive function , physical performance and muscle strength . Geriatr Gerontol Int 2017 ; 17 : 765 - 772 BACKGROUND Loss of muscle power due to normal aging has greater functional impact than loss of strength alone . The present study compared two resistance training programs , one aim ed at enhancing muscle power and one at increasing muscle strength , on muscle function and functional performance in older adults . METHODS Sixty-seven healthy , independent older adults ( 65 - 84 years ) were r and omized to a high-velocity varied resistance ( HV ) , constant resistance ( ST ) , or nontraining control ( CO ) group . Participants trained twice weekly for 24 weeks using six exercises .  Dynamic and isometric muscle strength , muscle power , movement velocity , muscle endurance , and a battery of functional performance tasks were assessed . Secondary outcomes included body composition , quality of life , and balance confidence . RESULTS Muscle strength increased significantly ( p < .001 ) and similarly in the training groups compared to controls ( HV , 51.0 + /- 9.0 % ; ST , 48.3 + /- 6.8 % ; CO , 1.2 + /- 5.1 % ) . Peak muscle power also increased with training ( p < .05 ) , with no difference between training groups . The change in peak power was 50.5 + /- 4.1 % , 33.8 + /- 3.8 % , and -2.5 + /- 3.9 % in the HV , ST , and CO groups , respectively . Training also improved selected functional performance tasks in the HV and ST groups compared to controls ( p < .05 ) , and the HV group reported improved quality of life ( p = .018 ) . CONCLUSION Muscle power and muscle strength improved similarly using either resistance training protocol , and these changes were accompanied by improvements in several functional performance tasks . However , improvements in the HV group occurred with less total work performed per training session OBJECTIVE Reduced muscle mass and strength are characteristic findings of growth hormone deficiency ( GHD ) and aging . We evaluated measures of muscle strength , muscle fiber type , and cross sectional area in response to treatment with recombinant human growth hormone ( rhGH ) with or without a structured resistance exercise program in frail older subjects . DESIGN Placebo-controlled , r and omized , double blind trial . SETTING Outpatient clinical research center at an urban university-affiliated teaching hospital . PARTICIPANTS Thirty-one consenting older subjects ( mean age 71.3 + /- 4.5 years ) recruited as a subset of a larger project evaluating rhGH and exercise in older people , who underwent 62 quadricep-muscle biopsies . INTERVENTION R and om assignment to a 6-month course of one of four protocol s : rhGH administered subcutaneously daily at bedtime , rhGH and a structured resistance exercise program , structured resistance exercise with placebo injections , or placebo injections only . MEASUREMENTS Muscle biopsy specimens were obtained from the vastus lateralis muscle . Isokinetic dynamometry strength tests were used to monitor individual progress and to adjust the weights used in the exercise program . Serum insulin-like growth factor-I ( IGF-I ) was measured and body composition was measured using a Hologic QDR 1000W dual X-ray densitometer . RESULTS The administration of rhGH result ed in significant increase in circulating IGF-I levels in the individuals receiving rhGH treatment . Muscle strength increased significantly in both the rhGH/exercise ( + 55.6 % , P = .0004 ) as well as the exercise alone ( + 47.8 % , P = .0005 ) groups . There was a significant increase in the proportion of type 2 fibers between baseline and six months in the combined rhGH treated subjects versus those not receiving rhGH ( P = .027 ) . CONCLUSIONS Our results are encouraging in that they suggest an effect of growth hormone on a specific aging-correlated deficit . IGF-I was increased by administrating rhGH and muscle strength was increased by exercise . The administration of rhGH to frail older individuals in this study result ed in significant changes in the proportions of fiber types . Whether changes in fiber cross-sectional area or absolute number occur with long-term growth hormone administration requires further study The purpose of this study was to determine the influence of simple , progressive lower body exercise training , focusing on strength and power , on functional abilities in frail older adults . Twenty-five residents of a long-term care facility ( 75 - 94 yrs ) participated in this r and omized controlled trial of 10-wks duration . The exercise group ( Ex , n = 18 ) underwent simple , progressive lower body resistance exercises , specifically aim ed at improving muscle power , 3 times/wk ; the control subjects ( Con , n = 7 ) maintained their usual daily activities . Knee extensor strength and power were measured on an isokinetic dynamometer ( 180 degrees/s ) , and functional performance was assessed from a 6-m walk timed test , a 30-s chair st and , and an 8-ft up- and -go timed test , before and after the 10-wk intervention period . Significant increases were found in the Ex group for eccentric ( 44 % ) and concentric ( 60 % ) average power ( p < 0.05 ) , and improvements were seen on each functional test : the 8-foot up- and -go , chair st and , and walk time improved by 31 % , 66 % , and 33 % , respectively ( p < 0.05 ) . No significant change occurred in the Con group . In conclusion , simple progressive exercise training , even in the 10th decade , increases muscle power and is associated with an improved performance of functional activities using the trained muscles BACKGROUND Kidney failure is associated with muscle wasting and physical impairment . Moderate- to high-intensity strength training improves physical performance , nutritional status and quality of life in people with chronic kidney disease and in dialysis patients . However , the effect of low-intensity strength training has not been well documented , thus representing the objective of this pilot study . METHODS Fifty participants ( mean + /- SD , age 69 + /- 13 years ) receiving long-term haemodialysis ( 3.7 + /- 4.2 years ) were r and omized to intra-dialytic low-intensity strength training or stretching ( attention-control ) exercises twice weekly for a total of 48 exercise sessions . The primary study outcome was physical performance assessed by the Short Physical Performance Battery score ( SPPB ) after 36 sessions , if available , or carried forward from 24 sessions . Secondary outcomes included lower body strength , body composition and quality of life . Measurements were obtained at baseline and at completion of 24 ( mid ) , 36 ( post ) and 48 ( final ) exercise sessions . RESULTS Baseline median ( IQR ) SPPB score was 6.0 ( 5.0 ) , with 57 % of the participants having SPPB scores below 7 . Exercise adherence was 89 + /- 15 % . The primary outcome could be computed in 44 participants . SPPB improved in the strength training group compared to the attention-control group [ 21.1 % ( 43.1 % ) vs. 0.2 % ( 38.4 % ) , respectively , P = 0.03 ] . Similarly , strength training participants exhibited significant improvements from baseline compared to the control group in knee extensor strength , leisure-time physical activity and self-reported physical function and activities of daily living ( ADL ) disability ; all P < 0.02 . Adverse events were common but not related to study participation . CONCLUSIONS Intra-dialytic , low-intensity progressive strength training was safe and effective among maintenance dialysis patients . Further studies are needed to establish the generalizability of this strength training program in dialysis patients OBJECTIVES To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low- grade inflammation . DESIGN A 12-week controlled resistance-training study . SETTING Nursing homes in Copenhagen , Denmark . PARTICIPANTS Twenty-one frail nursing home residents aged 86 to 95 completed the study . INTERVENTION Ten participants were r and omized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks ; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist . MEASUREMENTS Muscle strength , plasma levels of TNF-alpha , soluble TNF receptor (sTNFR)-1 , and interleukin (IL)-6 were measured before and at the end of the intervention period . RESULTS The training program improved muscle strength but did not affect plasma levels of TNF-alpha and sTNFR-I or IL-6 . However , plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength . CONCLUSION Low- grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old . Furthermore , data suggest that the antiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system , but the small sample size limited this interpretation Limited data have suggested that the consumption of fluid milk after resistance training ( RT ) may promote skeletal muscle hypertrophy . The aim of this study was to assess whether a milk-based nutritional supplement could enhance the effects of RT on muscle mass , size , strength , and function in middle-aged and older men . This was an 18-mo factorial design ( r and omized control trial ) in which 180 healthy men aged 50 - 79 yr were allocated to the following groups : 1 ) exercise + fortified milk , 2 ) exercise , 3 ) fortified milk , or 4 ) control . Exercise consisted of progressive RT with weight-bearing impact exercise . Men assigned to the fortified milk consumed 400 ml/day of low-fat milk , providing an additional 836 kJ , 1000 mg calcium , 800 IU vitamin D(3 ) , and 13.2 g protein per day . Total body lean mass ( LM ) and fat mass ( FM ) ( dual-energy X-ray absorptiometry ) , midfemur muscle cross-sectional area ( CSA ) ( quantitative computed tomography ) , muscle strength , and physical function were assessed . After 18 mo , there was no significant exercise by fortified milk interaction for total body LM , muscle CSA , or any functional measure . However , main effect analyses revealed that exercise significantly improved muscle strength ( approximately 20 - 52 % , P < 0.001 ) , LM ( 0.6 kg , P < 0.05 ) , FM ( -1.1 kg , P < 0.001 ) , muscle CSA ( 1.8 % , P < 0.001 ) , and gait speed ( 11 % , P < 0.05 ) relative to no exercise . There were no effects of the fortified milk on muscle size , strength , or function . In conclusion , the daily consumption of low-fat fortified milk does not enhance the effects of RT on skeletal muscle size , strength , or function in healthy middle-aged and older men with adequate energy and nutrient intakes OBJECTIVES To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association ( NYHA ) class II and III patients and systolic heart failure ( HF ) . DESIGN R and omized controlled trial . SETTING Home based . PARTICIPANTS Stable patients ( N=24 ; mean age , 60 ± 10 y ; left ventricular ejection fraction , 25 % ± 9 % ; 50 % white ; 50 % women ) with New York Heart Association ( NYHA ) classes II and III ( NYHA class III , 58 % ) systolic heart failure ( HF ) . INTERVENTION A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise . Attention control wait list participants performed light stretching and flexibility exercises . MAIN OUTCOME MEASURES A 10-item performance-based physical function measure , the Continuous Scale Physical Functional Performance test ( CS-PFP10 ) , was the major outcome variable and included specific physical activities measured in time to complete a task , weight carried during a task , and distance walked . Other measures included muscle strength , HRQOL ( Minnesota Living With Heart Failure Question naire , Epworth Sleepiness Scale ) , functional capacity ( Duke Activity Status Index ) , and disease severity ( brain natriuretic peptide ) levels . RESULTS After the exercise intervention , 9 of 10 specific task activities were performed more rapidly , with increased weight carried by exercise participants compared with the attention control wait list group . Exercise participants also showed significant improvements in CS-PFP10 total score ( P<.025 ) , upper and lower muscle strength , and HRQOL ( P<.001 ) compared with the attention control wait list group . Adherence rates were 83 % and 99 % for the aerobic and resistance training , respectively . CONCLUSIONS Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach . Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify . Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population OBJECTIVE To determine the short- and long-term effects of resistance training on muscle strength , psychological well-being , control-beliefs , cognitive speed and memory in normally active elderly people . METHODS 46 elderly people ( mean age 73.2 years ; 18 women and 28 men ) , were r and omly assigned to training and control groups ( n=23 each ) . Pre- and post-tests were administered 1 week before and 1 week after the 8-week training intervention . The training sessions , performed once a week , consisted of a 10 min warm-up phase and eight resistance exercises on machines . RESULTS There was a significant increase in maximum dynamic strength in the training group . This training effect was associated with a significant decrease in self-attentiveness , which is known to enhance psychological well-being . No significant changes could be observed in control-beliefs . Modest effects on cognitive functioning occurred with the training procedure : although there were no changes in cognitive speed , significant pre/post-changes could be shown in free recall and recognition in the experimental group . A post-test comparison between the experimental group and control group showed a weak effect for recognition but no significant differences in free recall . Significant long-term effects were found in the training group for muscular strength and memory performance ( free recall ) 1 year later . CONCLUSION An 8-week programme of resistance training lessens anxiety and self-attentiveness and improves muscle strength 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 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 whole body vibration ( WBV ) training appears to be an efficient alternative for conventional resistance training in older individuals . So far , no data exist about the vibratory effect on cardiorespiratory fitness . OBJECTIVES this r and omised controlled trial assessed the effects of 1-year WBV training on cardiorespiratory fitness and muscle strength in community-dwelling adults over the age of 60 . METHODS a total of 220 adults ( mean age 67.1 years ) were r and omly assigned to a WBV group , fitness group or control group . The WBV group exercised on a vibration platform , and the fitness group performed cardiovascular , resistance , balance and stretching exercises . The control group did not participate in any training .  Heart rate was measured during a single WBV session . Peak oxygen uptake ( VO(2peak ) ) and time-to-peak exercise ( TPE ) were measured during progressive bicycle ergometry . Muscle strength was assessed by a dynamometer . RESULTS heart rate increased significantly during WBV training . After 1 year , VO(2peak ) , TPE and muscle strength increased significantly in the WBV and fitness groups . Both training groups improved similarly in VO(2peak ) and muscle strength . The fitness group improved significantly more in TPE than the WBV group . CONCLUSION WBV training in community-dwelling elderly appears to be efficient to improve cardiorespiratory fitness and muscle strength BACKGROUND Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass . Further studies are required to determine whether this effect extends to mobility-limited older adults . The objectives of the study were to compare the effects of whey protein concentrate ( WPC ) supplementation to an isocaloric control on changes in whole-body lean mass , mid-thigh muscle cross-sectional area , muscle strength , and stair-climbing performance in older mobility-limited adults in response to 6 months of resistance training ( RT ) . METHODS Eighty mobility-limited adults aged 70 - 85 years were r and omized to receive WPC ( 40g/day ) or an isocaloric control for 6 months . All participants also completed a progressive high-intensity RT intervention . Sample sizes were calculated based on the primary outcome of change in whole-body lean mass to give 80 % power for a 0.05-level , two-sided test . RESULTS Lean mass increased 1.3 % and 0.6 % in the WPC and control groups , respectively . Muscle cross-sectional area was increased 4.6 % and 2.9 % in the WPC and control groups , respectively , and muscle strength increased 16%-50 % in WPC and control groups . Stair-climbing performance also improved in both groups . However , there were no statistically significant differences in the change in any of these variables between groups . CONCLUSIONS These data suggest that WPC supplementation at this dose does not offer additional benefit to the effects of RT in mobility-limited older adults IMPORTANCE While vitamin D supplementation and exercise are recommended for prevention of falls for older people , results regarding these 2 factors are contradictory . OBJECTIVE To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women . DESIGN , SETTING , AND PARTICIPANTS A 2-year r and omized , double-blind , placebo-controlled vitamin D and open exercise trial conducted between April 2010 and March 2013 in Tampere , Finl and . Participants were 409 home-dwelling women 70 to 80 years old . The main inclusion criteria were at least 1 fall during the previous year , no use of vitamin D supplements , and no contraindication to exercise . INTERVENTIONS Four study groups , including placebo without exercise , vitamin D ( 800 IU/d ) without exercise , placebo and exercise , and vitamin D ( 800 IU/d ) and exercise . MAIN OUTCOMES AND MEASURES The primary outcome was monthly reported falls . Injurious falls and the number of fallers and injured fallers were reported as secondary outcomes . In addition , bone density , physical functioning ( muscle strength , balance , and mobility ) , and vitamin D metabolism were assessed . RESULTS Intent-to-treat analyses showed that neither vitamin D nor exercise reduced falls . Fall rates per 100 person-years were 118.2 , 132.1 , 120.7 , and 113.1 in the placebo without exercise , vitamin D without exercise , placebo and exercise , and vitamin D and exercise study groups , respectively ; however , injurious fall rates were 13.2 , 12.9 , 6.5 , and 5.0 , respectively . Hazard ratios for injured fallers were significantly lower among exercisers with vitamin D ( 0.38 ; 95 % CI , 0.17 - 0.83 ) and without vitamin D ( 0.47 ; 95 % CI , 0.23 - 0.99 ) . Vitamin D maintained femoral neck bone mineral density and increased tibial trabecular density slightly . However , only exercise improved muscle strength and balance .  Vitamin D did not enhance exercise effects on physical functioning . CONCLUSIONS AND RELEVANCE The rate of injurious falls and injured fallers more than halved with strength and balance training in home-dwelling older women , while neither exercise nor vitamin D affected the rate of falls . Exercise improved physical functioning . Future research is needed to determine the role of vitamin D in the enhancement of strength , balance , and mobility . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00986466 OBJECTIVES To evaluate weighted stair climbing exercise ( SCE ) as a means of increasing lower extremity muscle power in mobility-limited older people . DESIGN Single-blinded , r and omized controlled pilot study . SETTING Human physiology laboratory of a metropolitan university . PARTICIPANTS Forty-five community-dwelling people aged 65 and older who had baseline mobility limitations manifested by scores of 11 or lower on the Short Physical Performance Battery ( SPPB ) . INTERVENTIONS Subjects were r and omized into one of two 12-week exercise programs . The intervention group ( SCE ) ( n = 23 ) ascended and descended stairs , at a set pace , while wearing a weighted vest . The control group ( WALK ) ( n = 22 ) participated in a st and ardized walking program . MEASUREMENTS Primary and secondary outcomes included measures of muscle power and strength , submaximal aerobic capacity , and physical performance . RESULTS SCE produced 17 % improvement in double leg press peak power in comparison with WALK ( P = .013 ) and significant improvement in stair climbing power from baseline ( 12 % ) . Improvement in submaximal aerobic performance was equivalent for both groups . Although not statistically significant , effect size estimates suggest that SCE can potentially influence knee extension power and strength . Stair climb time was improved in both groups , whereas SCE produced significant improvements from baseline SPPB score in a subcohort of participants . CONCLUSIONS These findings suggest that SCE maybe a useful component of a home exercise program design ed to enhance lower extremity muscle power , aerobic capacity , and functional performance . Further investigation is needed involving larger sample sizes and direct comparisons with other forms of resistance training OBJECTIVE To evaluate the long-term preventive impact of strength training on muscle performance in older adults . DESIGN A 7-year follow-up on a 1-year r and omized controlled trial comparing the effects of combined resistance training and aerobic training and whole-body vibration training on muscle performance . SETTING University training center . PARTICIPANTS Men and women ( N=83 ; control [ CON ] group , n=27 ; strength-training intervention [ INT ] group , n=56 ) between 60 and 80 years of age . INTERVENTIONS The INT group exercised 3 times weekly during 1 year , performing a combined resistance training and aerobic training program or a whole-body vibration training program . The former training program was design ed according to American College of Sports Medicine guidelines . The whole-body vibration training program included unloaded static and dynamic leg exercises on a vibration platform . The CON group did not participate in any training program . MAIN OUTCOME MEASURES Static strength ( STAT ) , dynamic strength at 60 ° /s ( DYN60 ) and at 240 ° /s ( DYN240 ) , speed of movement at 20 % ( S20 ) . RESULTS From baseline to postintervention , muscle performance did not change in the CON group , except for S20 ( + 6.55%±2.88 % , P<.001 ) . One year of strength training increased ( P≤.001 ) STAT ( + 11.46%±1.86 % ) , DYN60 ( + 6.96%±1.65 % ) , DYN240 ( + 9.25%±1.68 % ) , and S20 ( + 7.73%±2.19 % ) in the INT group . Between baseline and follow-up , muscle performance decreased ( P<.001 ) in both groups . However , STAT and DYN60 showed a significantly lower loss in the INT group ( -8.65%±2.35 % and -7.10%±2.38 % , respectively ) compared with the CON group ( -16.47%±2.69 % and -15.08%±2.27 % , respectively ) . This positive impact might be due to the preservation of the training-induced gains , given the similar annual decline rates in both groups from postintervention to follow-up . Additionally , in trained participants , aging seems to impact velocity-dependent strength and power more compared with basic strength , as the total losses in DYN240 ( CON , -15.93%±2.64 % ; INT , -11.39%±1.95 % ) and S20 ( CON , -14.39%±2.10 % ; INT , -13.16%±1.72 % ) did not differ significantly between the groups . CONCLUSIONS A 1-year strength-training intervention results in an improved muscle performance in older adults 7 years after their enrollment in the intervention . However , an extensive exercise program can not attenuate the age-related decline once the intervention stops The posttraumatic response to burn injury leads to marked and prolonged skeletal muscle catabolism and weakness , which persist despite st and ard rehabilitation programs of occupational and physical therapy . We investigated whether a resistance exercise program would attenuate muscle loss and weakness that is typically found in children with thermal injury . We assessed the changes in leg muscle strength and lean body mass in severely burned children with > 40 % total body surface area burned . Patients were r and omized to a 12-wk st and ard hospital rehabilitation program supplemented with an exercise training program ( n = 19 ) or to a home-based rehabilitation program without exercise ( n = 16 ) . Leg muscle strength was assessed before and after the 12-wk rehabilitation or training program at an isokinetic speed of 150 degrees /s . Lean body mass was assessed using dual-energy X-ray absorptiometry . We found that the participation in a resistance exercise program results in a significant improvement in muscle strength , power , and lean body mass relative to a st and ard rehabilitation program without exercise We sought to determine whether creatine monohydrate ( CrM ) supplementation would enhance the increases in strength and fat-free mass that develop during resistance exercise training in older adults . Twenty-eight healthy men and women over the age of 65 years participated in a whole-body resistance exercise program 3 days per week for 14 weeks . The study participants were r and omly allocated , in a double-blind fashion , to receive either CrM ( 5 g/d + 2 g of dextrose ; n = 14 ) or placebo ( 7 g of dextrose ; n = 14 ) . The primary outcome measurements included the following : total body mass , fat-free mass , one-repetition maximum strength for each body part , isometric knee extension , h and grip , and dorsiflexion strength , chair st and performance , 30-m walk test , 14-stair climb performance , muscle fiber type and area , and intramuscular total creatine . Fourteen weeks of resistance exercise training result ed in significant increases in all measurements of strength and functional tasks and muscle fiber area for both groups ( p < .05 ) . CrM supplementation result ed in significantly greater increases in fat-free mass and total body mass , as compared with placebo ( p < .05 ) . The CrM group also showed a greater increase in isometric knee extension strength in men and women , as compared with placebo ( p < .05 ) , and also greater gains in isometric dorsiflexion strength ( p < .05 ) , but in men only . There was a significant increase in intramuscular total creatine in the CrM group ( p < .05 ) . Finally , there were no significant side effects of treatment or exercise training . This study confirms that supervised heavy resistance exercise training can safely increase muscle strength and functional capacity in older adults . The addition of CrM supplementation to the exercise stimulus enhanced the increase in total and fat-free mass , and gains in several indices of isometric muscle strength The purpose of this study was to evaluate the effect of a 12-week intradialytic progressive resistance training ( PRT ) regimen on circulating pro- and anti-inflammatory cytokines .  Forty-nine patients ( 62.6 ± 14.2 years ) 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 ( n = 25 ) . The PRT group performed two sets of 10 exercises at high intensity using free-weights , 3 times per week for 12 weeks during dialysis , while the control group did not exercise . Tumor necrosis factor-alpha , interleukin-1b , interleukin-6 ( IL-6 ) , interleukin-8 ( IL-8 ) , interleukin-10 , and interleukin-12 were measured in serum before and after the intervention period . Muscle cross-sectional area ( CSA ) , intramuscular lipid , intermuscular adipose tissue , and subcutaneous and total thigh fat , evaluated via computed tomography of the non-dominant mid-thigh , were also collected at both time points . All cytokines were significantly elevated in the total cohort at baseline compared with normative data . There were no cytokine changes over time or between groups ( p > 0.05 ) . In secondary analyses pooling the groups , changes in logIL-6 and IL-8 were inversely related to changes subcutaneous thigh fat ( p < 0.05 ) while changes in logIL-6 were also inversely related to changes in thigh muscle CSA , and total thigh fat ( p < 0.03 ) . These data suggest that 12 weeks of intradialytic progressive resistance training does not improve circulating pro- and anti-inflammatory markers . Further research is required to eluci date the implication s and mechanisms of the relationships between IL-6 and IL-8 and body composition in ESRD We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength , peak power output in cycle ergometry , symptom limited endurance during progressive treadmill walking and stair climbing , knee extensor cross-sectional areas , and bone mineral density and content in healthy males and females aged 60 - 80 years , currently enrolled in a 2-year resistance training program . Subjects were r and omized into either exercise ( EX ) or control ( CON ) groups ( 60 - 70 years : 38 males and 36 females ; 70 - 80 years : 25 males and 43 females ) . EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50 - 80 % of the load that they could lift once only ( 1 RM ) ; CON did usual daily activities . After the 10 months there was no change in 1 RM strength in CON , but significant gains ( mean increases up to 65 % ) in EX ( no independent age or gender effects ) ; 30 % and 47 % of the increase in 1 RM had occurred by 6 and 12 weeks , respectively . In EX , the 7.1 % increase in peak cycling power output was significantly greater than in CON ( + 1.1 % ) . The 17.8 % improvement in symptom limited treadmill walking endurance was also greater than in CON ( + 3.4 % ) , but the difference between groups during stair climbing was not significant ( EX + 57 % , CON + 33 % ) . The cross-sectional areas of the knee extensors increased significantly by 5.5 % in EX but were unchanged in CON . There were no changes in bone mineral density or content in either group . We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength , muscle size , and functional capacity Objectives Creatine and protein supplementation can enhance the training outcomes of young subjects , but it is not clear if there are benefits for older individuals . Therefore , the purpose of this study was to determine the effects of creatine and protein supplementation on strength gains following a traditional resistance training program for middle-aged and older men . Design , Setting , Participants This study assessed changes in strength of men aged 48–72 years following 14 weeks of resistance training supplemented with creatine and /or protein . A double-blind , r and omized , placebo-controlled design placed 42 males into one of four groups : Resistance Trained Placebo ( RTP , n=10 ) ; Resistance Trained Creatine ( RTCr , 5 g Cr , n=10 ) ; Resistance Trained Protein ( RTPr , 35 g whey Pr , n=11 ) ; or Resistance Trained Creatine and Protein ( RTCrPr , 5 g Cr and 35 g Pr , n=11).InterventionAll groups trained 3 days per week for 14 weeks . The resistance training program was based on progressive overload . Training loads corresponded to 80 % 1RM ( one repetition maximum strength ) , 3 sets of 8 repetitions for the following exercises : knee extension/knee flexion ; bicep curl/tricep extension ; military press ; lat pull down ; seated leg press ; and bench press . Measurements 1 RM for each exercise and measures of lean body mass were assessed prior to and following the 14 week program . Results Each group significantly ( p<0.05 ) increased strength and lean body mass , however , there were no significant group effects or group X trial interactions . Conclusion Resistance training in middle-aged and older men significantly increased muscular strength and added muscle mass with no additional benefits from creatine and /or protein supplementation BACKGROUND Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living , falls , prolonged recovery time after hospitalization , and mortality in older adults . New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence . OBJECTIVE We evaluated the efficacy of fish oil-derived n-3 ( ω-3 ) PUFA therapy to slow the age-associated loss of muscle mass and function . DESIGN Sixty healthy 60 - 85-y-old men and women were r and omly assigned to receive n-3 PUFA ( n = 40 ) or corn oil ( n = 20 ) therapy for 6 mo . Thigh muscle volume , h and grip strength , one-repetition maximum ( 1-RM ) lower- and upper-body strength , and average power during isokinetic leg exercises were evaluated before and after treatment . RESULTS Forty-four subjects completed the study [ 29 subjects ( 73 % ) in the n-3 PUFA group ; 15 subjects ( 75 % ) in the control group ] . Compared with the control group , 6 mo of n-3 PUFA therapy increased thigh muscle volume ( 3.6 % ; 95 % CI : 0.2 % , 7.0 % ) , h and grip strength ( 2.3 kg ; 95 % CI : 0.8 , 3.7 kg ) , and 1-RM muscle strength ( 4.0 % ; 95 % CI : 0.8 % , 7.3 % ) ( all P < 0.05 ) and tended to increase average isokinetic power ( 5.6 % ; 95 % CI : -0.6 % , 11.7 % ; P = 0.075 ) . CONCLUSION Fish oil-derived n-3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults . This study was registered at clinical trials.gov as NCT01308957 Objective : To examine the effectiveness of task-oriented progressive resistance strength training on lower extremity strength and functional performance in chronic stroke subjects . Design : Single-blind , r and omized controlled trial . Setting : Medical centre and district hospital . Subjects : Forty-eight subjects at least one year post stroke . Interventions : Participants r and omly allocated to two groups , control  ( n-/24 ) and experimental  ( n-/24 ) . Subjects in the control group did not receive any rehabilitation training . Subjects in the experimental group were put on a four-week task-oriented progressive resistance strength training . Main measures : Lower extremity muscle strength , gait velocity , cadence , stride length , six-minute walk test , step test , and timed up and go test . Results : Muscle strength significantly improved in the experimental group for strong side muscle groups ( ranged from 23.9 % to 36.5 % ) and paretic side muscle groups ( ranged from 10.1 % to 77.9 % ) . In the control group muscle strength changes ranged from 6.7 % gain to 11.2 % decline . The experimental group showed significant improvement in all selected measures of functional performance except for the step test . In the control group , the number of repetitions of the step test significantly decreased ( -20.3 % ) with no change in other functional tests . There was a significant difference between groups for muscle strength and all functional measures . The strength gain was significantly associated with gain in the functional tests . Conclusions : The task-oriented progressive resistance strength training programme could improve lower extremity muscle strength in individuals with chronic stroke and could carry over into improvement in functional abilities BACKGROUND To study the effects of resistance training on muscle strength and size in older people , we enrolled 8 men and 17 women ( mean age 68.2 + /- 1 SEM ) into a one-year exercise trial . METHODS Subjects were r and omly assigned to exercise or control groups . Muscle biopsies were obtained from 11 subjects ( 8 exercisers/3 controls ) at baseline and after 15 weeks ; exercisers underwent another biopsy at 30 weeks . After testing maximum strength using the 1-RM method , the exercisers began a 12-exercise circuit ( 3 sets of 8 repetitions at 75 % of 1-RM ) , 3 times a week . The controls repeated the strength testing every 15 weeks . They were asked to continue usual activities and not to start any exercise program . RESULTS With exercise , muscle strength increased , average increases ranging from 30 % ( hip extensors ) to 97 % ( hip flexors ) . Strength increased rapidly over 3 months , then plateaued for the duration of the experiment . No strength changes were observed in sedentary controls . Cross-sectional area of type 1 muscle fibers increased in exercisers by 15 weeks ( 29.4 + /- 1 % , p < .02 ) and after 30 weeks ( 58.5 + /- 13.7 % , p < .002 ) compared to baseline . Type 2 fiber area did not change at 15 weeks , but increased by 30 weeks of training ( 66.6 + /- 9.5 % , p < .0002 ) . CONCLUSIONS These results suggest that prolonged moderate to high intensity resistance training may be carried out by healthy older adults with reasonable compliance , and that such training leads to sustained increases in muscle strength . These improvements are rapidly achieved and are accompanied by hypertrophy of both type 1 and type 2 muscle fibers AIM The purpose of the present study was to determine the effects of a water-based exercise program on muscle function compared with regular high-intensity resistance training . METHODS Older women ( n = 87 ) were recruited from the local community . The inclusion criteria were , to be aged 60 years or older , able to walk and able to carry out daily living activities independently . Participants were r and omly assigned to one of the following groups : water-based exercises ( WBG ) , resistance training ( RTG ) or control ( CG ) . The experimental groups carried out 12 weeks of an excise program performed on water or on l and . The dynamic strength , the isometric peak , and rate of torque development for the lower limbs were assessed before and after interventions . RESULTS The water-based program provided a similar improvement in dynamic strength in comparison with resistance training . The isometric peak torque increased around the hip and ankle joints in the water-based group , and around the knee joint in the resistance-training group ( P < 0.05 ) . The rate of torque development increased only in the water-based group around the hip extensors muscles ( P < 0.05 ) . CONCLUSIONS Water-based programs constitute an attractive alternative to promote relevant strength gains using moderate loads and fast speed movements , which were also effective to improve the capacity to generate fast torques Patients who are on hemodialysis commonly experience muscle wasting and weakness , which have a negative effect on physical functioning and quality of life . The objective of this study was to determine whether anabolic steroid administration and resistance exercise training induce anabolic effects among patients who receive maintenance hemodialysis . A r and omized 2 x 2 factorial trial of anabolic steroid administration and resistance exercise training was conducted in 79 patients who were receiving maintenance hemodialysis at University of California , San Francisco-affiliated dialysis units . Interventions included double-blinded weekly n and rolone decanoate ( 100 mg for women ; 200 mg for men ) or placebo injections and lower extremity resistance exercise training for 12 wk during hemodialysis sessions three times per week using ankle weights . Primary outcomes included change in lean body mass ( LBM ) measured by dual-energy x-ray absorptiometry , quadriceps muscle cross-sectional area measured by magnetic resonance imaging , and knee extensor muscle strength . Secondary outcomes included changes in physical performance , self-reported physical functioning , and physical activity . Sixty-eight patients completed the study . Patients who received n and rolone decanoate increased their LBM by 3.1 + /- 2.2 kg ( P < 0.0001 ) . Exercise did not result in a significant increase in LBM . Quadriceps muscle cross-sectional area increased in patients who were assigned to exercise ( P = 0.01 ) and to n and rolone ( P < 0.0001 ) in an additive manner . Patients who exercised increased their strength in a training-specific fashion , and exercise was associated with an improvement in self-reported physical functioning ( P = 0.04 compared with nonexercising groups ) . N and rolone decanoate and resistance exercise produced anabolic effects among patients who were on hemodialysis . Further studies are needed to determine whether these interventions improve survival This study aim ed to evaluate the effectiveness of an innovative exercise program on muscle strength , balance , and gait kinematics in elderly community-dwellers . The exercise program included strength and balance training and the 8-form Tai Chi Chuan . The measurements were carried out at baseline and 12 weeks , and consisted of four physical performance tests , joint isokinetic strength tests , and three-dimensional gait analysis . Fifty-six community-dwelling older adults aged 60–80 years old were r and omly assigned to an intervention or control group . After 12 weeks , the intervention group showed a 17.6 % improvement in the timed up and go test , accompanied by a 54.7 % increase in the 30-second chair st and test score . Significant increases in the score of star excursion balance tests , and the strength of the extensor and flexor muscles at knee and ankle joints were also observed . In addition , the intervention group walked at a faster speed with a longer step length , shorter support phase , and a greater sagittal plane range of motion at the hip and ankle joints . No statistical improvements were seen in the control group . This study provided an effective , evidence -based falls prevention program that can be implemented in community setting s to improve physical fitness and reduce fall risks among community-dwelling older adults .  The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people 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 Background The core components of physical activity , cardiovascular endurance , muscular strength , balance and flexibility can provide many health benefits and potentially slow declines associated with aging . Aerobic exercise message to the public has been widely promoted by national health authorities , although the promotion of resistance training has received far less attention . Objectives n this research , the prevalence of resistance training in a sample of adults living in regional Australia was primarily assessed . Design A computer-assisted telephone interview survey ( n=1230 ) was conducted by the Population Research Laboratory at Central Queensl and University on Queensl and adults in October to November 2006 . Respondents were asked to report the frequency with which they engaged in resistance training . Participants Respondents were 18 years or older that could be contacted by direct-dialled , l and -based telephone service . A telephone data base using a computer program to select , with replacement , a simple r and om sample of phone numbers selected respondents . Results Almost 14 % of the population did some form of  gym-based resistance training  in the week before the survey . There was a significant ( p<0.05 ) reduction in participation levels with age . Participation was highest amongst the youngest 18–34-year-olds ( 23.8 % ) , steadily declining with age to a low of 7 % in the 55 years and older age group . There was no significant association between sexes and participation in resistance training . Conclusions The findings underscore the need to increase overall education on the benefits of resistance training with an emphasis among targeted adult population s to increase participation in resistance training Health in older adults can best be measured in terms of functional status . Skeletal muscle strength has been reported to be a determinant of functional status in older individuals . Two major contributors to the decline in muscle function as a person ages are disuse and physical inactivity . Declining muscle function through a loss of muscular strength may decrease functional independence and mobility and increase the risk for falls and injuries , physical frailty , and disability .  Older individuals lacking an appropriate amount of muscular strength may not be able to perform various activities of daily living , which are important indicators of independence OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity OBJECTIVE To determine the effect of frequency of resistive training on gain in muscle strength and neuromuscular performance in healthy older adults . DESIGN A r and omized controlled trial with subjects assigned either to high-intensity resistance training 1 ( EX1 ) , 2 ( EX2 ) , or 3 ( EX3 ) days per week for 24 weeks or to a control group ( CO ) . SETTING An exercise facility at an academic medical center . SUBJECTS Forty-six community-dwelling healthy men ( n = 29 ) and women ( n = 17 ) aged 65 to 79 years . INTERVENTION Progressive resistance training consisting of three sets of eight exercises targeting major muscle groups of the upper and lower body , at 80 % of one-repetition maximum ( 1-RM ) for eight repetitions , either 1 , 2 , or 3 days per week . MEASURES Dynamic muscle strength ( 1-RM ) using isotonic equipment every 4 weeks , bone mineral density and body composition by dual energy X-ray absorptiometry ( DXA ) , and neuromuscular performance by timed chair rise and 6-meter backward t and em walk . RESULTS For each of the eight exercises , muscle strength increased in the exercise groups relative to CO ( P < .01 ) , with no difference among EX1 , EX2 and EX3 groups at any measurement interval . Percent change averaged 3.9 + /- 2.4 ( CO ) , 37.0 + /- 15.2 ( EX1 ) , 41.9 + /- 18.2 ( EX2 ) , and 39.7 + /- 9.8 ( EX3 ) . The time to rise successfully from the chair 5 times decreased significantly ( P < .01 ) at 24 weeks , whereas improvement in the 6-meter backward t and em walk approached significance ( P = .10 ) in the three exercise groups compared with CO . Changes in chair rise ability were correlated to percent changes in quadriceps strength ( r = -0.40 , P < .01 ) and lean mass ( r = -0.40 , P < .01 ) . CONCLUSIONS A program of once or twice weekly resistance exercise achieves muscle strength gains similar to 3 days per week training in older adults and is associated with improved neuromuscular performance . Such improvement could potentially reduce the risk of falls and fracture in older adults 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 The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise ( PRE ) training on walking ability in children with cerebral palsy ( CP ) . Fifty-one ambulant children with spastic CP ( mean age 10 years 5 months , 29 boys ) were r and omized to an intervention ( n=26 ) or control group ( n=25 , receiving usual care ) . The intervention consisted of 12 weeks functional PRE circuit training , for 3 times a week . Main outcome measures were walking ability and participation . Secondary outcomes were muscle strength and anaerobic muscle power . Possible adverse outcomes were spasticity and passive range of motion ( ROM ) . Muscle strength increased significantly in the training group compared to the control group , but walking ability , participation and anaerobic muscle power did not change . Spasticity and ROM remained unchanged , except for a significant decrease in rectus femoris length in the intervention group . It is concluded that twelve weeks of functional PRE-training does not improve walking ability , despite improved muscle strength 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 Previous studies concerning psychological benefits of exercise among the elderly has focused predominantly on the effects of aerobic exercise . In the present study , psychological and behavioral adaptations in response to 12-weeks of strength training were examined in medically healthy but sedentary 42 older adults ( mean age = 68 years ) . The purpose of this study was to evaluate the effects of high and low intensity resistance training intensity on a ) muscular fitness , b ) psychological affect , and c ) neurocognitive functioning . Subjects were r and omly assigned to high intensity/low volume ( EXH : 2 sets of 8 to 10 repetitions for 75 to 85 % of 1 RM ) , low intensity/high volume ( EXL : 2 sets of 14 to 16 repetitions for 55 to 65 % of 1 RM ) , or no exercise control programs . Prior to and following the 12-week program , subjects underwent comprehensive physiological and psychological evaluations . Physiological assessment included measurements of blood pressure , heart rate , arm and leg muscle strength , body composition , and oxygen consumption ( VO2max ) . Psychological measures included evaluations of mood , anxiety , and physical self-efficacy as well as cognitive functioning . The results of this study indicated that both high and low intensity strength programs were associated with marked improvements in physiological fitness and psychological functioning . Specifically , subjects in the strength training programs increased overall muscle strength by 38.6 % and reduced percent body fat by 3.0 % . Favorable psychological changes in the strength-trained subjects included improvements in positive and negative mood , trait anxiety , and perceived confidence for physical capability . The treatment effects of neurocognitive functioning were not significant . In summary , this study demonstrated that participation in 12-weeks of high or low intensity strength training can improve overall physical fitness , mood , and physical self-efficacy in older adults while cognitive functioning remains constant Frailty has emerged as an important risk factor for disability . Age-related declines in physical and physiological function lead to increased risk of loss of independence and poor quality of life . Recent evidence has shown the effectiveness of physical exercise programmes in preventing or reversing frailty . The aim of this study was to evaluate changes in the functioning of frail elderly individuals after undergoing  resistance training  for 3 days a week for 8 weeks . The effectiveness of exercise training was investigated in 48 frail elderly individuals who were r and omly assigned to the following intervention groups : high-intensity ( HI ; n=16 ; age : 69–96 years ) or low-intensity ( LI ; n=16 ; age : 77–93 years ) strength training groups or a control group ( n=16 ; age : 76–93 years ) with no specific exercise programme . Participants were assessed for muscle strength , physical function , activities of daily living , depression and quality of life . The HI group had significantly better results ( P<0.05 ) on the Short Physical Performance Test than the LI group ; however , the LI group did show a significant improvement in those scores , whereas the scores of the control group worsened . Results for the other evaluations were similarly favourable in both exercise groups ( P>0.05 ) . The study showed that LI exercise was as effective as HI exercise for most parameters tested . Exercise training is useful for the prevention or treatment of frailty , as it improves functioning by contributing positively to muscle strength , gait , balance and quality of life The short-term effects of an accessible exercise intervention on the strength and health-related quality of life ( HRQOL ) among older adult women were evaluated . We conducted an 8-week resistance training intervention utilizing elastic b and s in 62 community-dwelling women with a mean age of 68 years . Participants were r and omly assigned to either an exercise or a control group . Pre- and postintervention assessment s included strength tests and HRQOL . Results revealed significant increases in three major muscles compared to the control group . However , there were no significant changes on either mental or physical health functioning . The elastic b and s provide older adult women with an inexpensive , practical exercise program that effectively increases strength within 8 weeks but may have little effect on self-reported HRQOL Chronic heart failure ( CHF ) is characterized by a skeletal muscle myopathy not optimally addressed by current treatment paradigms or aerobic exercise . Sixteen older women with CHF were compared with 80 age-matched peers without CHF and r and omized to progressive resistance training or control stretching exercises for 10 wk . Women with CHF had significantly lower muscle strength ( P < 0.0001 ) but comparable aerobic capacity to women without CHF . Exercise training was well tolerated and result ed in no changes in resting cardiac indexes in CHF patients . Strength improved by an average of 43.4 + /- 8.8 % in resistance trainers vs. -1.7 + /- 2.8 % in controls ( P = 0.001 ) , muscle endurance by 299 + /- 66 % vs. 1 + /- 3 % ( P = 0.001 ) , and 6-min walk distance by 49 + /- 14 m ( 13 % ) vs. -3 + /- 19 m ( -3 % ) ( P = 0.03 ) . Increases in type I fiber area ( 9.5 + /- 16 % ) and citrate synthase activity ( 35 + /- 21 % ) in skeletal muscle were independently predictive of improved 6-min walk distance ( r2 = 0.78 ; P = 0.0024 ) . High-intensity progressive resistance training improves impaired skeletal muscle characteristics and overall exercise performance in older women with CHF . These gains are largely explained by skeletal muscle and not resting cardiac adaptations UNLABELLED Resistance training ( RT ) is a proven sarcopenia countermeasure with a high degree of potency . However , sustainability remains a major issue that could limit the appeal of RT as a therapeutic approach without well-defined dosing requirements to maintain gains . PURPOSE To test the efficacy of two maintenance prescriptions on muscle mass , myofiber size and type distribution , and strength . We hypothesized the minimum dose required to maintain RT-induced adaptations would be greater in the old ( 60 - 75 yr ) versus young ( 20 - 35 yr ) . METHODS Seventy adults participated in a two-phase exercise trial that consisted of RT 3 d·wk for 16 wk ( phase 1 ) followed by a 32-wk period ( phase 2 ) with r and om assignment to detraining or one of two maintenance prescriptions ( reducing the dose to one-third or one-ninth of that during phase 1 ) . RESULTS Phase 1 result ed in expected gains in strength , myofiber size , and muscle mass along with the typical IIx-to-IIa shift in myofiber-type distribution . Both maintenance prescriptions preserved phase 1 muscle hypertrophy in the young but not the old . In fact , the one-third maintenance dose led to additional myofiber hypertrophy in the young . In both age groups , detraining reversed the phase 1 IIx-to-IIa myofiber-type shift , whereas a dose response was evident during maintenance training with the one-third dose better maintaining the shift . Strength gained during phase 1 was largely retained throughout detraining with only a slight reduction at the final time point . CONCLUSIONS We conclude that older adults require a higher dose of weekly loading than the young to maintain myofiber hypertrophy attained during a progressive RT program , yet gains in specific strength among older adults were well preserved and remained at or above levels of the untrained young Background : Patients receiving high-dose chemotherapy and hematopoietic stem cell transplantation ( HSCT )  experience considerable reductions in physical activity and deterioration of their health status . Objective : The purpose of this pilot study was to test the effects of strength training compared with usual activity on physical activity , muscle strength , fatigue , health status perceptions , and quality of life following HSCT . Methods : Nineteen subjects were r and omized to the  exercise or control group . Moderate-intensity strength training began following discharge from the hospital . Dependent variables included physical activity , muscle strength , fatigue , health status perceptions , and quality of life . Variables were measured prior to admission to the hospital for HSCT , day 8 following HSCT , and 6 weeks following discharge from the hospital . Results : Significant time effects were noted for many variables with anticipated declines in physical activity , muscle strength , fatigue , and health status perceptions immediately after HSCT with subsequent improvements 6 weeks following hospital discharge . One group effect was noted with subjects in the exercise group reporting less fatigue than subjects in the control group . Although no significant interactions were detected , the trends suggest that the exercise group may be more physically active following the intervention compared with the usual-activity group . Conclusions : This study demonstrates the potential positive effects of strength training on physical activity , fatigue , and quality of life in people receiving high-dose chemotherapy and HSCT . Implication s for Practice : Preliminary evidence is provided for using strength training to enhance early recovery following HSCT . Elastic resistance b and s are easy to use and relatively inexpensive 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 BACKGROUND Muscle power ( force x velocity ) recedes at a faster rate than strength with age and may also be a stronger predictor of fall risk and functional decline . The optimal training paradigm for improving muscle power in older adults is not known , although some literature suggests high velocity , low load training is optimal in young adults . METHODS One hundred twelve healthy older adults ( 69 + /- 6 years ) were r and omly assigned to either explosive resistance training at 20 % ( G20 ) , 50 % ( G50 ) , or 80 % ( G80 ) one repetition maximum ( 1RM ) for 8 - 12 weeks or to a nontraining control group ( CON ) . Participants trained twice per week ( five exercises ; three sets of eight rapidly concentric and slow eccentric repetitions ) using pneumatic resistance machines . Repeated- measures analysis of variance and covariance ( ANOVA and ANCOVA ) were used to determine the effects of training . RESULTS Average peak power increased significantly and similarly in G80 ( 14 + /- 8 % ) , G50 ( 15 + /- 9 % ) , and G20 ( 14 + /- 6 % ) compared to CON ( 3 + /- 6 % ) ( p < .0001 ) . By contrast , a positive dose-response relationship with training intensity was observed for relative changes in average strength ( r = .40 , p = .0009 ) and endurance ( r = .43 , p = .0005 ) . Average strength increased in G80 ( 20 + /- 7 % ) , G50 ( 16 + /- 7 % ) , and G20 ( 13 + /- 7 % ) compared to CON ( 4 + /- 4 % ) ( p < .0001 ) . Average muscle endurance increased in G80 ( 185 + /- 126 % , p < .0001 ) , G50 ( 103 + /- 75 % , p = .0004 ) , and G20 ( 82 + /- 57 % , p = .0078 ) compared to CON ( 28 + /- 29 % ) . CONCLUSION Peak muscle power may be improved similarly using light , moderate , or heavy resistances , whereas there is a dose-response relationship between training intensity and muscle strength and endurance changes . Therefore , using heavy loads during explosive resistance training may be the most effective strategy to achieve simultaneous improvements in muscle strength , power , and endurance in older adults BACKGROUND Adequate levels of physical balance and muscular strength are necessary to live independently in old age . The effects of an exercise training program targeting the sensory and muscle systems on balance and strength in a group of older adults were determined in this study . METHODS Static balance ( one-leg balance with eyes closed ) , dynamic balance ( limits of stability [ endpoint excursion [ EPE ] , maximum excursion [ MXE ] ] ) , and strength ( chair st and ) were assessed before and after the intervention . Volunteers were divided r and omly into a  training group ( TR , n = 15 , 76 + /- 4 years ) and a control group ( CN , n = 14 , 76 + /- 7 years ) . TR performed 12-week ( 2 days/week , 60 min/day ) supervised training while st and ing on the floor ( first 4 weeks ) and progressing to st and ing on foam pads of different compliances . Exercises included movements that challenged the sensory and muscle systems . RESULTS After 12 weeks of training , the TR demonstrated significant improvements in static balance ( 82 % ) ; EPE backward ( 72 % ) , right ( 32 % ) , and left ( 33 % ) ; MXE backward ( 74 % ) , right ( 31 % ) , and left ( 18 % ) ; and lower body muscle strength ( 20 % ) with no significant changes in CN . CONCLUSION These results indicate that this training program is very effective in improving balance and lower body strength in older adults BACKGROUND The benefit of protein supplementation on the adaptive response of muscle to exercise training in older people is controversial . OBJECTIVE To investigate the independent and combined effects of a multicomponent exercise program with and without a milk-based nutritional supplement on muscle strength and mass , lower-extremity fatigue , and metabolic markers . DESIGN A sample of 48 healthy sedentary men aged 60.8 ± 0.4 years were r and omly assigned to a 16-week multicomponent exercise training program with a milk-based supplement containing , besides proteins [ total milk proteins 4 or 10 g/day or soluble milk proteins rich in leucine ( PRO ) 10 g/day ] , carbohydrates and fat .  Body composition , muscle mass and strength , and time to task failure , an index of muscle fatigue , were measured . Blood lipid , fibrinogen , creatine phosphokinase , glucose , insulin , C-reactive protein , interleukin-6 , tumor necrosis factor-α soluble receptors , and endothelial markers were assessed . RESULTS Body fat mass was reduced after the 4-month training program in groups receiving 10 g/day of protein supplementation ( P < .01 ) . The training program sustained with the daily 10 g/day PRO was associated with a significant increase in dominant fat free mass ( + 5.4 % , P < .01 ) and in appendicular muscle mass ( + 4.5 % , P < .01 ) . Blood cholesterol was decreased in the trained group receiving 10 g/day PRO . The index of insulin resistance ( homeostasis model assessment -insulin resistance ) and blood creatine phosphokinase were reduced in the groups receiving 10 g/day PRO , irrespective of exercise . The inflammatory and endothelial markers were not different between the groups . Training caused a significant improvement ( + 10.6 % to 19.4 % , P < .01 ) in the maximal oxygen uptake . Increased maximum voluntary contraction force was seen in the trained groups receiving 10 g/day of proteins ( about 3 % , P < .05 ) . Time to task failure was improved in the trained participants receiving a 10 g/day supplementation with PRO ( P < .01 ) . CONCLUSIONS Soluble milk proteins rich in leucine improved time to muscle failure and increase in skeletal muscle mass and strength after prolonged multicomponent exercise training in healthy older men OBJECTIVES This paper describes a videotaped , home-based , strength training program , titled Strong-for-Life and reports on its effectiveness in improving muscle strength , psychological well-being , and health status in a sample of older persons . DESIGN AND SETTING We enrolled 102 nondisabled , community-dwelling older people aged 66 to 87 , identified from the Medicare beneficiary list , into a r and omized , controlled trial . MEASUREMENTS Effectiveness was based on change in isokinetic upper and lower extremity muscle strength , psychologic well-being , and health status . RESULTS Results revealed several statistically significant short-term benefits after 12 to 15 weeks of exercise , especially for men . Younger older adults demonstrated a 10 % improvement in knee extensor strength relative to control subjects . Older male exercisers achieved significant differences relative to controls in perceived anger , tension , and overall social functioning . Male exercisers , in general , achieved significant improvement in perceived vigor . Women did not report psychological benefits following participation in the program . CONCLUSION Study results reveal that the Strong for Life program , design ed to be widely disseminated to the nondisabled older population , has many short-term positive benefits 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 PURPOSE The purpose of this study was to examine the impact of moderate-intensity , progressive , upper-body resistance training ( RT ) on muscle strength and perceived performance of household physical activities ( HPA ) among women in cardiac rehabilitation . METHODS The 10-week , pretest-posttest , experiment r and omized women to either  usual care ( UC ) aerobic exercise or RT . Muscle strength for 5 upper-body RT exercises ( chest press , shoulder press , biceps curl , lateral row , and triceps extension ) was measured using the 1-Repetition Maximum Assessment . The RT group progressively increased weight lifted using 40 % , 50 % , and 60 % of obtained 1-Repetition Maximum Assessment at 3-week intervals . Perceived performance of HPA was measured with the Kimble Household Activities Scale . RESULTS The RT group ( n = 16 , mean age 64 ± 11 ) significantly increased muscle strength in all 5 exercises in comparison with the UC group ( n = 14 , mean age 65 ± 10 ) ( chest press , 18 % vs 11 % ; shoulder press , 24 % vs 14 % ; biceps curl , 21 % vs 12 % ; lateral row , 32 % vs 9 % ; and triceps extension , 28 % vs 20 % , respectively ) . By study end , Household Activities Scale scores significantly increased ( F = 13.878 , P = .001 ) in the RT group ( 8.75 ± 3.19 vs 11.25 ± 2.14 ) , whereas scores in the UC group decreased ( 8.60 ± 3.11 vs 6.86 ± 4.13 ) . CONCLUSION Progressive upper-body RT in women shows promise as an effective tool to increase muscle strength and improve the ability to perform HPA after a cardiac event . Beginning RT early after a cardiac event in a monitored cardiac rehabilitation environment can maximize the strengthening benefit BACKGROUND Aging is associated with reductions in muscle mass and strength , but nutrition and exercise interventions can delay this progression and enhance the quality of life . OBJECTIVE We examined whether the predominant source of protein consumed by older men influenced measures of muscle size and strength , body composition , resting energy expenditure , and skeletal muscle creatine concentrations in response to 12 wk of resistive training . DESIGN After consuming a lactoovovegetarian ( LOV ) diet for 2 wk , 21 men aged 65 + /- 5 y were r and omly assigned to either consume a beef-containing ( BC ) diet ( n = 10 ) or to continue the LOV diet ( n = 11 ) throughout resistive training . The BC diet included 0.6 g protein . kg(-1 ) . d(-1 ) from beef and the LOV diet included 0.6 g protein . kg(-1 ) . d(-1 ) from textured vegetable protein ( soy ) sources . The remaining protein in the diets came from self-selected LOV sources . RESULTS The mean total protein intake for both groups ranged from 1.03 to 1.17 g. kg(-1 ) . d(-1 ) during the intervention . Men in both groups had improvements ( 14 - 38 % ) in maximal dynamic strength of all the muscle groups trained with no significant difference between groups . With resistive training , cross-sectional muscle area of the vastus lateralis increased in both groups ( 4.2 + /- 3.0 % and 6.0 + /- 2.6 % for the LOV and BC groups , respectively ) with no significant difference between groups . Body composition , resting energy expenditure , and concentrations of muscle creatine , phosphocreatine , and total creatine did not differ significantly between groups or change over time . CONCLUSIONS These data suggest that increases in muscle strength and size were not influenced by the predominant source of protein consumed by older men with adequate total protein intake OBJECTIVES To assess the effects of an 8-week exercise training program with a special focus on light- to moderate-intensity resistance exercises ( 30 - 70 % of one repetition maximum , 1RM ) and a subsequent 4-week training cessation period ( detraining ) on muscle strength and functional capacity in participants aged 90 and older . DESIGN R and omized controlled trial performed during March to September 2009 . SETTING Geriatric nursing home . PARTICIPANTS Forty nonagenarians ( 90 - 97 ) were r and omly assigned to an intervention or control group ( 16 women and 4 men per group ) . INTERVENTION Eight-week muscle strength exercise intervention focused on lower limb strength exercises of light to moderate intensity . MEASUREMENTS PRIMARY OUTCOME 1RM leg press . SECONDARY OUTCOMES h and grip strength , 8-m walk test , 4-step stairs test , Timed Up and Go test , and number of falls . RESULTS A significant group by time interaction effect ( P=.02 ) was observed only for the 1RM leg press . In the intervention group , 1RM leg press increased significantly with training by 10.6 kg [ 95 % confidence interval (CI)=4.1 - 17.1 kg ; P=.01 ] . Except for the mean group number of falls , which were 1.2 falls fewer per participant in the intervention group ( 95 % CI=0.0 - 3.0 ; P=.03 ) , no significant training effect on the secondary outcome measures was found . CONCLUSION Exercise training , even of short duration and light to moderate intensity , can increase muscle strength while decreasing fall risk in nonagenarians BACKGROUND AND PURPOSE Exercise programs targeting muscle strength and balance can reduce falls . The study aim ed to compare the Otago Exercise Program ( OEP ) , originally design ed as supervised home training ( HT ) , with the same programme performed as GT , on functional balance and muscle strength , mobility , fall efficacy and self-reported health . METHODS A single-blind r and omized controlled trial with assessment s at baseline ( T1 ) , following the 12-week intervention ( T2 ) , and 3 months following intervention ( T3 ) , was performed . 125 people , mean age 82.5 ( SD = 5.7 ) years , 73 % women , referred to a Falls Outpatient Clinic , participated . 74 % had fallen , and 37 % had a fall-related hospital stay during the previous year .  OEP supervised by physiotherapists was performed as GT twice weekly or as HT three times a week , for 12 weeks . Total exercise time was comparable between groups . The primary outcome was the Berg Balance Scale assessed at T2 . RESULTS From T1-T2 , Berg Balance Scale improved significantly more in the GT group than in the HT group ( mean group difference in change of 3.2 points , 95%CI = 0.7 - 5.8 , p = 0.014 ) . Of the secondary outcomes , the 30-second sit-to-st and test ( p = 0.004 ) , and physical health measured by the Short Form-36 ( p = 0.004 ) , improved significantly more for the GT group . Change in mobility measured by the Timed Up and Go test , mental health by the Short Form-36 , and fall efficacy by the Fall Efficacy Scale International did not differ between groups . The 30-second sit-to-st and test and the Timed Up and Go , but not the Berg Balance Scale , was still better in the GT group at T3 . DISCUSSION In fall-prone home-dwelling older people , the OEP performed as GT is more effective for improving functional balance , muscle strength and physical health , but not fall efficacy and mental health than when performed as HT . The OEP provided as GT should be considered in this population Introduction This study assessed the feasibility and efficacy of a novel resistance training device used within an intradialytic progressive resistance training ( PRT ) intervention BACKGROUND Age-related loss in physiologic capacities contributes to the decline in physical function in the elderly population . Despite the beneficial effects of exercise interventions on maximal physiologic capacity measures , the functional benefits have not been shown in independently living older adults . The objective of this study was to evaluate exercise in independent older adults for significant and meaningful improvements in physical function , not detected by commonly used measures of physical function . METHODS In a r and omized controlled study , 49 independently living men and women were assigned to either a nonexercise control group ( Control ; n = 26 ) or an exercise training group ( Exercise ; n = 23 ) . Participants ( age = 76+/-4 ) in good general health were recruited from retirement communities or apartments . The combined endurance and strength training was performed at 75 % to 80 % intensity ; the groups met 3 times/week for 6 months of supervised sessions . Outcome measures included physical capacity , health status , and physical function using a newly developed performance test -- the Continuous Scale-Physical Functional Performance test ( CS-PFP ) . RESULTS Compared to the Control group , the Exercise group showed significant increases in maximal oxygen consumption ( 11 % ) and muscle strength ( 33 % ) . No significant differences were found between groups for changes in the Sickness Impact Profile , SF-36 scales , or the 6-minute walk . However , the CS-PFP score improved significantly in the Exercise group ( 14 % , effect size 0.80 ) . CONCLUSIONS Independent older adults gain meaningful functional benefits from several months of exercise training . The public health importance of physical activity may relate not just to its role in preventing decline , but also to its role in enhancing physical function Twelve middle-aged men and 12 middle-aged women in the 50-year-old age group ( M50 ; range 44 - 57 years ; W50 ; 43 - 57 ) , and 12 elderly men and 12 elderly women in the 70-year-old age group ( M70 ; 59 - 75 ; W70 ; 62 - 75 ) volunteered as subjects in order to examine effects of 12-week progressive heavy resistance strength training on electromyographic activity ( EMG ) , muscle cross-sectional area ( CSA ) of the quadriceps femoris and maximal concentric force in a one repetition maximum ( 1 RM ) test of the knee extensor muscles . One half of the subjects in each group performed the knee extension ( and flexion ) exercises only bilaterally ( BIL ) , while another half performed the exercises only unilaterally ( UNIL ) . None of the subject groups demonstrated statistically significant changes in any of the 1 RM values during the 2 week control period with no training ( between week -2 and 0 ) preceding the actual experimental training . However , the 12-week training result ed in increases ( P < 0.05 - 0.001 ) in 1 RM values in each group so that the average relative increase of 19 + /- 12 % ( P < 0.001 ) in bilateral 1 RM in all BIL trained subjects was greater ( P < 0.05 ) than that of 13 + /- 8 % ( P < 0.001 ) recorded for all UNIL trained subjects . The average relative increases of 17 + /- 11 % ( P < 0.001 ) and 14 + /- 14 % ( P < 0.001 ) in unilateral 1 RM values of the right and left leg in all UNIL trained subjects were greater ( P < 0.05 ) than those of 10 + /- 18 % ( P < 0.001 ) and 11 + /- 11 % ( P < 0.001 ) recorded for all BIL trained subjects , respectively . The relative average increase of 19 + /- 19 % ( P < 0.001 ) observed in the maximum averaged IEMG of both legs during the bilateral actions in all BIL trained subjects was greater ( P < 0.05 ) than that of 10 + /- 17 % ( P < 0.05 ) recorded for all UNIL trained subjects . The relative increases of 14 + /- 12 % ( P < 0.001 ) and 11 + /- 6 % ( P < 0.001 ) recorded for the CSA in all BIL and UNIL trained subjects did not differ significantly from each others . The present findings suggest that progressive heavy resistance strength training leads to great increases in maximal dynamic strength of the trained subjects accompanied by both considerable neural adaptations and muscular hypertrophy not only in middle-aged but also in elderly men and women . Both bilateral and unilateral exercises are effective to produce functional and structural adaptations in the neuromuscular system , although the magnitude of functional strength increase seems to be specific to the type of exercise used , further supporting the principle of specificity in the design of strength programmes 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 Introduction Aging involves a progressive reduction of respiratory muscle strength as well as muscle strength . Purpose Compare the effects of resistance training volume on the maximum inspiratory pressure ( MIP ) , maximum expiratory pressure ( MEP ) , functional performance , and muscle strength in elderly women . Methods Thirty elderly women were r and omly assigned to a group performing either single sets ( 1-SET ) or three sets ( 3-SET ) of exercises . The sit-to-st and test , MIP , MEP , and muscle strength were assessed before and after 24 training sessions . Progressive resistance training was performed two times per week for a total of 8–12 repetitions , using the main muscle groups of the upper and lower limbs . Results The main results showed that the participants significantly increased their MEP ( P<0.05 ; 1-SET : 34.6 % ; 3-SET : 35.8 % ) and MIP ( P<0.05 ; 1-SET : 13.7 % ; 3-SET : 11.2 % ) . Both groups also improved in the sit-to-st and test ( P<0.05 ; 1-SET : 10.6 % ; 3-SET : 17.1 % ) . After 24 training sessions , muscle strength also significantly increased ( P<0.0001 ; 40%–80 % ) in both groups . An intergroup comparison did not show any statistically significant differences between the groups in any of the parameters analyzed . Conclusion Single- and multiple-set resistance training programs  increased MIP , MEP , muscle strength , and sit-to-st and test performance in elderly women after 24 sessions of training . In conclusion , our results suggested that elderly women who are not in the habit of physical activity may start with single-set resistance training programs as a short-term strategy for the maintenance of health OBJECTIVE To associate changes of body composition , muscle strength ( MS ) and plasma hormones ( PH ) in resistance-training protocol in sedentary postmenopausal women ( PMW ) . DESIGN This r and omized controlled trial , Brazilian 43 PMW ( 45 - 70-year-old ) able for physical exercises were selected after they have accomplished medical and ethical criteria . They were assigned in two groups : RT , resistance training ( n=22 ) ; and CT , not trained control ( n=21 ) ; with supervision sessions of two to three exercise for large and one exercise for smaller groups in three series of 8 - 12 rep . ( 60 - 80%1RM ) for each exercise . The training period lasted 16 weeks and was preceded by low-load exercise ( 40 - 50%1RM ) adaptation period of 4 weeks ( 3/(times week ) ) . Body weight , height , body mass index ( BMI ) , and composition ( BIA ) along with fast-PH ( FSH , LH , estradiol , cortisol , IGF-1 and testosterone ) were assessed before ( M0 ) and after ( M16 ) the 4 weeks period with the MS ( 1RM ) determined also at 8 weeks ( M8 ) . The values were correlated by Person 's test and the means compared by Student 's t-test and ANOVA . RESULTS At baseline both groups were similar in age , time of PMW , body composition , MS and fast-PH . However after 16 weeks , RT presented higher BMI ( 2.1 % ) , IGF-1 ( 37.8 % ) and MM gain ( 1.8+/-0.8 kg ) than CT . MM correlated positively with IGF-1 ( r=0.45 , p<0.05 ) and MS progressively increased in all exercise greater in pectoral than legs and upper arms . CONCLUSION Former sedentary postmenopausal women su bmi tted to resistance training gained MM and MS irrespectively of fat mass changes but significantly associated with IGF-1 increase BACKGROUND Endurance training improves cardiopulmonary fitness in maintenance haemodialysis ( MHD ) . Because many MHD patients are profoundly deconditioned and exhibit significant muscle weakness , endurance training may also improve muscle strength and physical performance in these patients . This study assessed this possibility . METHODS Twelve MHD patients performed incremental and constant work rate cycle exercise tests to determine peak work rate , VO(2)peak and endurance time ( ET ) . Lower extremity strength , power and fatigability , stair-climbing time , 10 m walk time and a timed up- and -go were assessed before and after 8.6+/-2.3 weeks of thrice weekly , progressive , semi-recumbent , leg-cycle training during haemodialysis . Initial training intensity and duration targets were set at 50 % peak work rate ( WR ) and 20 min , respectively , with a goal of progressing to 40 min at the highest WR tolerable .  Non-exercising MHD patients and healthy volunteers with similar age , gender and race/ethnicity served as comparison groups . RESULTS None of the subjects tolerated the initial target intensity . Therefore , WR was reduced to 19+/-9 watts ( 30 % of peak WR ) for 19.9 min/session . At end of training , subjects cycled at 29+/-25 watts ( 46 % initial peak WR ; P = 0.01 ) for 38+/-8 min ( P<0.001 ) . VO(2)peak and ET improved 22 % ( P = 0.018 ) and 144 % ( P = 0.001 ) , respectively . Quadriceps strength , power and fatigability improved 16 % ( P = 0.002 ) , 15 % ( P = 0.115 ) and 43 % ( P = 0.029 ) , respectively . The three measures of physical performance improved by 14 - 17 % ( P<0.031 ) . Total work performed in training increased by 5.5+/-21.1 kJ/week ( 17 % ) ; a 165 % increase during the study period . CONCLUSIONS Nine weeks of leg-cycling during haemodialysis in MHD patients improves not only cardiopulmonary fitness and endurance but also muscle strength , power , fatigability and physical function . These data underscore the value of endurance training in MHD OBJECTIVES This study sought to evaluate the effects of inspiratory muscle training in inspiratory muscle strength , as well as in functional capacity , ventilatory responses to exercise , recovery oxygen uptake kinetics , and quality of life in patients with chronic heart failure ( CHF ) and inspiratory muscle weakness . BACKGROUND Patients with CHF may have reduced strength and endurance in inspiratory muscles , which may contribute to exercise intolerance and is associated with a poor prognosis . METHODS Thirty-two patients with CHF and weakness of inspiratory muscles ( maximal inspiratory pressure [ Pi(max ) ] < 70 % of predicted ) were r and omly assigned to a 12-week program of inspiratory muscle training ( IMT , 16 patients ) or to a placebo-inspiratory muscle training ( P-IMT , 16 patients ) . The following measures were obtained before and after the program : Pi(max ) at rest and 10 min after maximal exercise ; peak oxygen uptake , circulatory power , ventilatory oscillations , and oxygen kinetics during early recovery ( VO2/t-slope ) ; 6-min walk test ; and quality of life scores . RESULTS The IMT result ed in a 115 % increment Pi(max ) , 17 % increase in peak oxygen uptake , and 19 % increase in the 6-min walk distance . Likewise , circulatory power increased and ventilatory oscillations were reduced . The VO2/t-slope was improved during the recovery period , and quality of life scores improved . CONCLUSIONS In patients with CHF and inspiratory muscle weakness , IMT results in marked improvement in inspiratory muscle strength , as well as improvement in functional capacity , ventilatory response to exercise , recovery oxygen uptake kinetics , and quality of life Background Exercise training is effective for improving physical fitness and physical function in people with type 2 diabetes . However , limited research has been conducted on the optimal exercise training intensity for this population . Objective The primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes . Design This was a r and omized clinical trial . Setting The setting was a university campus . Participants Twenty-one people with type 2 diabetes were r and omly allocated to receive either moderate-intensity training ( MOD group ) or high-intensity training ( HIGH group ) . Intervention The MOD group performed resistance training at an intensity of 75 % of the 8-repetition maximum ( 8-RM ) and aerobic training at an intensity of 30 % to 45 % of the heart rate reserve ( HRR ) . The HIGH group performed resistance training at an intensity of 100 % of the 8-RM and aerobic training at an intensity of 50 % to 65 % of the HRR .  Measurements Muscle strength ( peak torque [ newton-meters ] ) , exercise capacity ( grade d exercise test duration [ minutes ] ) , and physical function ( Patient-Specific Functional Scale question naire ) were measured at baseline and 3 months later . Acute exercise-induced changes in glucose levels were assessed immediately before exercise , immediately after exercise , and 1 hour after exercise during the first exercise training session . Results Although both groups showed improvements in physical fitness and physical function , the between-group effect sizes were not statistically significant ( exercise capacity estimated marginal mean [ EMM ] difference=2.1 , 95 % confidence interval [ 95 % CI]=−0.2 , 4.5 ; muscle strength EMM difference=20.8 , 95 % CI=−23.3 , 65.0 ; and physical function EMM difference=0.1 , 95 % CI=−0.6 , 0.9 ) . Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise , immediately after exercise and 1 hour after exercise , and immediately before exercise and 1 hour after exercise for the MOD group were −11.4 % , −5.0 % , and −15.8 % , respectively ; those for the HIGH group were −21.5 % , 7.9 % , and −15.3 % , respectively . Limitations Sample size , lack of outcome assessor masking , and physical function measurement subjectivity were limitations . Conclusions Moderate- and high-intensity exercise training , as defined in this study , may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes BACKGROUND Age-related declines in balance and muscle power are largely responsible for the changes in the various components of gait performance among elderly people . But these can often be remedied with strength training .  People with cognitive impairment frequently demonstrate impaired gait , putting them at increased risks for falls and serious injury . OBJECTIVES This paper reports on the effects of a six-week pilot study of moderate intensity strength training on the gait of elderly individuals with dementia who attend a day-care center . METHODS Twenty-six adults ( 23 female , three male ) , age = 79.2 + /- 6.6 years , completed the study . Each subject completed a baseline assessment of lower extremity strength and gait . Gait was evaluated using free- and fast-gait speed over a 6-meter course , the Tinetti-Gait Assessment scale , the ' Timed-Up- and -Go ' , and the Gait Assessment Rating Scale ( GARS ) . The intervention consisted of moderate-intensity progressive resistance lower extremity exercise using Therab and , for two to three sessions per week over the six weeks . Post-intervention assessment of strength and gait was repeated at the completion of the sixth week . Multiple paired t-tests were calculated for each outcome measure . RESULTS The baseline assessment of gait suggests a high degree of frailty and risk for falls in the sample . Although post-intervention scores reflected improvement on all gait measures , the only statistically significant change observed was in fast-gait time . CONCLUSION A six-week resistance training program proved to be of insufficient duration , intensity or specificity to produce significant change in gait outcome measures , with the exception of fast speed gait Background : Age-related postural misalignment , balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors .  Core instability strength training ( CIT ) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength , spinal mobility and balance performance . Objective : The objective was to investigate the effects of CIT on measures of trunk muscle strength , spinal mobility , dynamic balance and functional mobility in seniors . Methods : Thirty-two older adults were r and omly assigned to an intervention group ( INT ; n = 16 , aged 70.8 ± 4.1 years ) that conducted a 9-week progressive CIT or to a control group ( n = 16 , aged 70.2 ± 4.5 years ) . Maximal isometric strength of the trunk flexors/extensors/lateral flexors ( right , left)/rotators ( right , left ) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program . Dynamic balance ( i.e. walking 10 m on an optoelectric walkway , the Functional Reach test ) and functional mobility ( Timed Up and Go test ) were additionally tested . Results : Program compliance was excellent with participants of the INT group completing 92 % of the training sessions . Significant group × test interactions were found for the maximal isometric strength of the trunk flexors ( 34 % , p < 0.001 ) , extensors ( 21 % , p < 0.001 ) , lateral flexors ( right : 48 % , p < 0.001 ; left : 53 % , p < 0.001 ) and left rotators ( 42 % , p < 0.001 ) in favor of the INT group . Further , training-related improvements were found for spinal mobility in the sagittal ( 11 % , p < 0.001 ) and coronal plane ( 11 % , p = 0.06 ) directions , for stride velocity ( 9 % , p < 0.05 ) , the coefficient of variation in stride velocity ( 31 % , p < 0.05 ) , the Functional Reach test ( 20 % , p < 0.05 ) and the Timed Up and Go test ( 4 % , p < 0.05 ) in favor of the INT group . Conclusion : CIT proved to be a feasible exercise program for seniors with a high adherence rate . Age-related deficits in measures of trunk muscle strength , spinal mobility , dynamic balance and functional mobility can be mitigated by CIT . This training regimen could be used as an adjunct or even alternative to traditional balance and /or resistance training BACKGROUND AND OBJECTIVE Skeletal muscle dysfunction contributes to exercise limitation in patients with chronic obstructive pulmonary disease ( COPD ) .  Strength training increases muscle strength and muscle mass , but there is an ongoing debate on the additional effect concerning the exercise capacity . The purpose of this study was to compare the effects of three different exercise modalities in patients with COPD including endurance training ( ET ) , progressive strength training ( ST ) and the combination of strength training and endurance training ( CT ) . DESIGN A prospect i ve r and omized trial . METHODS Thirty-six patients with COPD were r and omly allocated either to ET , ST , or CT .  Muscle strength , cardiopulmonary exercise testing , lung function testing and quality of life were assessed before and after a 12-week training period . RESULTS Exercise capacity ( Wmax ) increased significantly in all three training groups with increase of peak oxygen uptake ( VO2peak ) in all three groups , reaching statistical significance in the ET group and the CT group . Muscle strength ( leg press , bench press , bench pull ) improved in all three training groups , with a higher improvement in the ST ( + 39.3 % , + 20.9 % , + 20.3 % ) and the CT group ( + 43.3 % , + 18.1 % , + 21.6 % ) compared to the ET group ( + 20.4 % , + 6.4 % , + 12.1 % ) . CONCLUSIONS Progressive strength training alone increases not only muscle strength and quality of life , but also exercise capacity in patients with COPD , which may have implication s in prescription of training modality . CLINICAL TRIALS.GOV IDENTIFIER : NCT01091623 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 AND PURPOSE Patients with hip osteoarthritis have impairments in muscle function ( muscle strength and power ) and hip range of motion ( ROM ) , and it is commonly believed that effective clinical management of osteoarthritis should address these impairments to reduce pain and disability . Therefore , the purpose of this study was to compare the short- and long-term effects of 4 months of physiotherapist-supervised strength training , physiotherapist-supervised Nordic Walking ( NW ) , or unsupervised home-based exercise ( HBE ) on muscle function and hip ROM in patients diagnosed with hip osteoarthritis . METHODS Secondary outcome analyses from an observer-blinded three-armed parallel- design r and omized controlled trial in 60 + -year-old patients with clinical hip osteoarthritis ( American College of Rheumatology criteria ) who were not on a waiting list for hip replacement . One hundred and fifty-two patients were r and omized to either 4 months of physiotherapist-supervised , moderate , progressive , strength training ( n = 50 ) , physiotherapist-supervised NW ( n = 50 ) , or unsupervised HBE ( n = 52 ) . Maximal isometric hip and thigh muscle strength and leg extensor power and active hip ROM were assessed at baseline 2 , 4 , and 12 months . RESULTS Intention-to-treat-analyses did not show any significant between-group differences for improvements in muscle strength and power or ROM at any time points . Short-term significant ( p < .05 ) increases in muscle strength were present in the physiotherapist-supervised exercise groups and in the long-term for muscle power in the NW-group . All exercise modes result ed in significant increases of ROM but long-term improvements were only shown for NW and HBE . DISCUSSION Four months of physiotherapist-supervised , progressive , moderate , and strength training was less effective than hypothesized for improving muscle strength and power in patients with hip osteoarthritis who are not awaiting hip replacement . Our results may indicate that in these patients , improvements in disability are not necessarily dependent on improvements in strength and power or ROM Background Hip muscle weakness in older people seems to be an influencing factor of falls . Currently , it is unclear which muscles out of the hip muscle group play an important role in older people . A validating process in the measurement regarding muscle strength related to falls is necessary before answering that question . Objective Firstly , we aim ed to investigate which hip muscle group strength shows an acceptable level of distinction between older adult fallers and non-fallers compared to a predefined external criterion regarding falling . Secondly , we aim ed to compare the same outcomes and questions for h and -grip strength in relation to the same external criterion . Design This study was a cross-sectional validity study . Methods The  maximum voluntary isometric strength ( MVIS ) and the rate of force generation of hip abductors ( ABD ) , adductors , internal and external rotators , extensors , and flexors were measured with a dynamometer fixed to a custom-made frame as well as h and -grip strength with a Martin Vigorimeter in 60 older people aged over 65 years ( 38 females and 22 males ) . Results The area under the curve ( AUC ) and the results of the mean decrease in Gini index assessed by r and om forest approach show that of all the assessed parameters , hip ABD MVIS showed the highest discriminative value regarding the chosen external criterion in older people ( AUC ABD MVIS 0.825 , 95 % confidence interval : 0.712–0.938 ) . Conclusion Results indicate that ABD MVIS is a useful measure to distinguish between older adult fallers and non-fallers regarding the chosen external criterion Since muscle strength and coordination training in healthy elderly people has been effective in the primary prevention , a program for geriatric patients with falls is presented . Its aim is safer walking by an increase in muscular strength and improved coordination . The exclusion criteria and the size of the training program define a group of over 75 year old patients , who will be compared with a group with light physical exercise in a r and omized fashion . The first results show a remarkable increase in strength and a low complication rate . The functional relevance of our program remains to be proven Background . Aged-related loss of afferent feedback of the feet plays an important role in gait performance . Although strength , balance and gait training can significantly improve the muscle power and functional abilities of older individuals , it remains unclear whether training effects can be enhanced by augmenting afferent feedback from the feet adding shoe insoles complementary to conventional training . Objective . The current study investigated the effect of physical exercise combined with wearing MedReflex ® shoe insoles on the gait performance and muscle power in older adults . Methods . Twenty-eight independent living , older adults aged 65–91 years were r and omly assigned to either an insole group ( IG ; n = 14 ) or a training group ( TG ; n = 14 ) . Further 14 subjects matched to the IG and TG were recruited as a control group ( CG ; n = 14 ) ( no exercise ) . The IG and TG completed the same training program consisting of aerobic exercises , progressive resistance strength training and stretching exercises twice per week for 12 weeks , whereas , the IG wore the insoles during everyday life and during training sessions . Assessment s included the Falls Efficacy Scale – International ( FES-I ) , gait analysis and muscle power measurements of the knee and ankle joint at pre- and post-training . Results . There were significant time × group interactions in walking speed , step length and in several muscle power measurements . The positive effects of gait parameters ranged between 1 % and 12 % and between 1 % and 8 % and the trend to improvements of muscle power ranged between 15–79 % and 20–79 % for the IG and TG , respectively . The IG and TG did not differ significantly in their improvements . The CG showed a trend to deteriorations between 0 % and −5 % for gait parameters and between −4 % and −14 % for muscle power . No significant change in FES-I score occurred in neither groups . Conclusions . The results of this study provide evidence of significant improvements in gait performance and muscle power after a conventional training program in independent living , older adults . However , there is no additional effect of long-term adaptation of gait caused by wearing insoles concurrent to physical training The effects of high-intensity progressive resistance training ( HIPRT ) on cardiovascular function and autonomic neural regulation in older adults are unclear . To investigate this issue , 25 older adults were r and omly divided into two groups : control ( CON , N = 13 , 63 ± 4 years ; no training ) and HIPRT ( N = 12 , 64 ± 4 years ; 2 sessions/week , 7 exercises , 2–4 sets , 10–4 RM ) . Before and after four months , maximal strength , quadriceps cross-sectional area ( QCSA ) , clinic and ambulatory blood pressures ( BP ) , systemic hemodynamics , and cardiovascular autonomic modulation were measured . Maximal strength and QCSA increased in the HIPRT group and did not change in the CON group . Clinic and ambulatory BP , cardiac output , systemic vascular resistance , stroke volume , heart rate , and cardiac sympathovagal balance did not change in the HIPRT group or the CON group . In conclusion , HIPRT was effective at increasing muscle mass and strength without promoting changes in cardiovascular function or autonomic neural regulation Background and aims : The practice of regular physical exercise has been shown to be effective in slowing the age-related progressive functional deterioration . Most exercise trials have been conducted with supervised training programs . The purpose of this study was to investigate the effectiveness of a 4-month home-based strength training on strength , function and personal satisfaction . Methods : Ten elderly men ( mean age 68.5 years ) were enrolled for home-based training  one month after completing a 4-month supervised program ; 12 age-matched men served as the control group . Subjects were asked to perform 3 sessions a week consisting of six resistance exercises with elastic b and s involving the major muscle groups of the upper and lower limbs . We had calculated the correlation between the elongation and resistance of the elastic b and s. The subjects were instructed to keep a diary reporting the execution of the session . We measured dynamic concentric strength of the muscle groups involved in the resistance exercises and maximal isometric strength of the knee extensors and elbow flexors before and after the 4- month home training . The Satisfaction Profile ( SAT-P ) question naire was administered before and one month after the completion of the training program for assessing personal satisfaction . Results : The final to baseline comparison showed a non-significant decrease in mean isometric maximal strength values for knee extensors and elbow flexors in the control group , while the exercise group significantly ( p=0.001 ) improved the average baseline values . Maximal dynamic concentric strength values decreased significantly in the control group , while significant improvements were observed in the exercising subjects . The SAT-P question naire did not show any difference in either group from baseline . The adherence-to- protocol rate based on self-report was 78 % . Conclusions : Home training with elastic b and s appears to be an effective low-cost modality of maintaining strength and function in an elderly population Sullivan DH , Wall PT , Bariola JR , Bopp MM , Frost YM : Progressive resistance muscle strength training of hospitalized frail elderly . Am J Phys Med Rehabil 2001;80:503–509 . Objective To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training . Design Muscle strength ( one repetition maximum ) , functional abilities ( sit-to-st and maneuver and 20-sec maximal safe gait speed ) , and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training . The nonr and omized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home . Participants included 19 recuperating elderly subjects ( 14 male , 5 female ; 13 ambulatory , 6 nonambulatory ) > 64 yr ( mean age , 82.8 ± 7.9 yr ) . Results The one repetition maximum increased an average of 74 % ± 49 % ( median , 70 % ; interquartile range , 38%–95 % , and an average of 20 ± 13 kg ( P = 0.0001 ) . Sit-to-st and maneuver times improved in 15 of 19 cases ( 79 % ) . Maximum safe gait speeds improved in 10 of 19 cases ( 53 % ) . Four of the six nonambulatory subjects progressed to ambulatory status . No subject experienced a complication . Conclusions A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses . A r and omized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages , if any , over routine posthospital care that includes traditional low-intensity physical therapy Objectives : To investigate the effects of progressive resistance training of quadriceps and hamstrings muscles in children with cerebral palsy ( CP ) . Design : Pilot study using a repeated measures design with measurements at baseline , immediately after six weeks training then at four-week follow-up . Setting : The project was undertaken within the physiotherapy department of two special schools in Glasgow . Subjects : A convenience sample of eight children aged between six and 12 years , with hypertonic CP . Intervention : The subjects participated three times per week in a six-week , progressive , free-weight , strengthening programme . Outcome measures : Maximum isometric muscle strength and resistance to passive stretch were measured with a h and -held myometer . The Gross Motor Function Measure and a 10-metre timed walking test , were used to assess function and gait parameters respectively . Results : Muscle strength increased , with the quadriceps to hamstrings strength ratio moving towards normal . These changes were retained at follow-up . Muscle tone decreased and continued to decrease to follow-up . The st and ing ( D ) and walking , running and jumping ( E ) goal areas of the Gross Motor Function Measure showed improvement that continued towards follow-up . Walking speed and step rate increased . Conclusions : A future large-scale r and omized controlled study would be of value to substantiate these results as the small convenience sample and lack of control group limit this study . However , the finding that no adverse effect accompanied the positive outcomes in strength and function may encourage clinicians to consider resistance training alongside st and ard therapeutic interventions Background Frailty is common in older age , and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care .  Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility . Methods / Design The Home-Based Older People 's Exercise ( HOPE ) trial is a two arm , assessor blind pilot r and omised controlled trial ( RCT ) to assess the effectiveness of a 12 week exercise intervention ( the HOPE programme ) design ed to improve the mobility and functional abilities of frail older people living at home , compared with usual care . The primary outcome is the timed-up- and -go test ( TUGT ) , measured at baseline and 14 weeks post-r and omisation . Secondary outcomes include the Barthel Index of activities of daily living ( ADL ) , EuroQol Group 5-Dimension Self-Report Question naire ( EQ-5D ) quality of life measure and the geriatric depression scale ( GDS ) , measured at baseline and 14 weeks post-r and omisation . We will record baseline frailty using the Edmonton Frail Scale ( EFS ) , record falls and document muscle/joint pain . We will test the feasibility of collection of data to identify therapy re sources required for delivery of the intervention . Discussion The HOPE trial will explore and evaluate a home-based exercise intervention for frail older people . Although previous RCTs have used operationalised , non-vali date d methods of measuring frailty , the HOPE trial is , to our knowledge , the first RCT of an exercise intervention for frail older people that includes a vali date d method of frailty assessment at baseline . Trial registration IS RCT N : IS RCT This study investigated the effects of heavy resistance training in elderly males with chronic obstructive pulmonary disease ( COPD ) . 18 Home-dwelling male patients ( age range : 65 - 80 years ) , with a mean forced expiratory volume in the first second ( FEV1 ) of 46 + /- 3.4 % of predicted value , were recruited . Baseline and post-training assessment s included : Cross-sectional area ( CSA ) of quadriceps assessed by MRI , isometric and isokinetic knee extension strength , isometric trunk strength , leg extension power , normal and maximal gait-speed on a 30 m track , stair climbing time , number of chair st and s in 30 s , lung function ( FEV1 ) and self-reported health . Subjects were r and omized to a resistance training group ( RE , n = 9 ) or a control group conducting breathing exercises ( CON , n = 9 ) . RE performed heavy progressive resistance training twice a week for 12 weeks . 6 RE and 7 CON completed the study . In RE the following improved ( P < 0.05 ) : Quadriceps CSA : 4 % , isometric knee extension strength : 14 % , isokinetic knee extension strength at 60 degrees /s . : 18 % , leg extension power : 19 % , maximal gait speed : 14 % , stair climbing time : 17 % , isometric trunk flexion : 5 % and self-reported health . In CON no changes were found . In conclusion , 12 weeks of heavy resistance training twice a week result ed in significant improvements in muscle size , knee extension strength , leg extension power , functional performance and self-reported health in elderly male COPD patients 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 The aim of this study was to enquire whether older adults , who  continue plantar-flexion ( PF ) strength training  for an additional 6-month period , would achieve further improvements in neuromuscular performance , in the ankle PFs , and in the antagonist dorsi-flexors ( DFs ) . Twenty-three healthy older volunteers ( mean age 77.4 ± 3.7 years ) took part in this investigation and 12 of them followed a 1-year strength-training program .  Both neural and muscular factors were examined during isometric maximal voluntary contraction ( MVC ) torques in ankle PF and DF pre-training , post 6 and post 12 months . The main finding was that 6 months of additional strength training of the PFs , beyond 6 months , allowed further improvements in neuromuscular performance at the ankle joint in older adults . Indeed , during the first 6 months of progressive resistance training , there was an increase in the PF MVC torque of 11.1 ± 19.9 N m , and then of 11.1 ± 17.9 N m in the last 6-month period . However , it was only after 1 year that there was an improvement in the evoked contraction at rest in PF ( + 8 % ) . The strength training of the agonist PF muscles appeared to have an impact on the maximal result ant torque in DF . However , it appeared that this gain was first due to modifications occurring in the trained PFs muscles , then , it seemed that the motor drive of the DFs per se was altered . In conclusion , long-term strength training of the PFs result ed in continued improvements in neuromuscular performance at the ankle joint in older adults , beyond the initial 6 months The effects of detraining subsequent to strength training on neuromuscular function were examined in 39 recent-onset rheumatoid arthritis ( RA ) patients . Eighteen age- and sex-matched healthy people ( H ) served as controls . Patients were r and omly allocated either to the experimental group ( PE ) , who carried out progressive strength training for 6 months , or to the control group ( PC ) , who maintained only their habitual physical activities . After 6 months , PE returned to their earlier physical activities and strength training was terminated . At baseline , the maximal strength of the trunk extensors ( not significant ) , grip strength and maximal dynamic strength and the shape of the force-time curve of the knee extensors were lower in PE and PC ( P < 0.05 - 0.001 ) than in H. Strength training in PE led to remarkable increases ( P < 0.05 - 0.001 ) in the maximal strength of all muscle groups without changes in the shape of the force-time curve . The increases in muscle strength in PE obtained by strength training were lost to a great degree during the detraining period for the isometric trunk extension ( P < 0.01 ) and flexion ( P < 0.01 ) strength and for the dynamic knee extension strength ( P < 0.05 ) , but not for the grip strength . In PC , trunk extension and flexion strength decreased significantly throughout the study period . At the post-test , all the strength values in both patient groups were much lower than in H. RA is a chronic disease which seems to need continuous physical exercise with sufficient intensity to minimize/prevent the loss of muscle strength and functional capacity Strength training has been reported as a potentially useful exercise to improve psychological aspects in the elderly , but its effects remain controversial . This study investigated the effectiveness of strength training conducted twice a week for 12 weeks for improving health-related quality of life ( HRQOL ) and executive cognitive function . The study was a single-blind r and omized controlled trial with assessment s before and after intervention . HRQOL and executive function were assessed using the SF-36 Health Status Survey and a computerized neuro-cognitive assessment using task-switch reaction time trials , respectively . Subjects comprised 119 participants > or = 65 years old , r and omized to either strength training ( n=65 ) or health education classes ( controls , n=54 ) . The strength training program was design ed to strengthen the large muscle groups most important for functional activities and to improve balance . The effects of the intervention on the eight dimensions of the SF-36 in the control and training groups were analyzed . Only the mental health scale of the SF-36 was significantly improved for the training group compared with controls after 12 weeks . Task-switch reaction time and correct response rate remained unchanged . Short-term strength training might have modest positive effects on HRQOL , although this training period may not be sufficient to affect executive function in relatively healthy older people Background : Recent guidelines for exercise in patients with heart failure ( HF ) recommended aerobic and resistance exercise as being safe and effective ; however , the clinical and functional significance of these combined training modalities has not been established . In this pilot study , combined aerobic and resistance training was hypothesized to improve physical function , muscle strength , and health-related quality of life ( HRQOL ) compared with an attention control wait list ( ACWL ) . Methods : The 10-item Continuous Scale Physical Functional Performance Test ( CS-PFP10 ) , which simulates common household chores ; muscle strength ( h and grip and knee extension ) ; and HRQOL ( Kansas City Cardiomyopathy Question naire ) were evaluated at baseline ( T1 ) and at 12 weeks ( T2 ) . The home-based moderate-intensity walking and resistance training program was performed 5 days a week . Results : Twenty-four New York Heart Association class II to III HF patients ( mean [ SD ] age , 60 [ 10 ] years ; mean [ SD ] left ventricular ejection fraction , 25 % [ 9 % ] ) were r and omized to a combined aerobic and resistance exercise program or to an ACWL group . Of the total group , 58 % were New York Heart Association class III HF patients , 50 % were white , and 50 % were female . The CS-PFP10 total scores were significantly increased in the exercise group , from 45 ( 18 ) to 56 ( 16 ) . The Kansas City Cardiomyopathy Question naire overall summary score was significantly improved ( P < .001 ) at T2 in the exercise intervention group compared with the ACWL group . Conclusions : Participants provided the home-based , combined aerobic and resistance exercise program had significantly improved physical function , muscle strength , symptom severity , and HRQOL compared with the ACWL group . The findings of this study must be interpreted cautiously owing to the limitations of a small sample , data collection from a single center , and differences between control and interventions groups at baseline . A combined aerobic and resistance exercise approach may improve physical function in stable HF patients , but further study in a larger , more diverse population is recommended . However , in this study , the CS-PFP10 instrument demonstrated its ability to identify functional health status in HF patients and thus warrants further testing in a larger sample for possible use in clinical practice This study identified factors associated with exercise participation  and  adherence  in a sample of 102 sedentary , functionally limited , community-dwelling adults aged 60 to 94 years who participated in a home-based resistance training program .  Stepwise regression analyses revealed that baseline physical factors ( i.e. , higher levels of mobility , weaker muscle strength , and fewer numbers of new medical conditions ) were associated with higher rates of participation in the home program .  Positive attitudes and a sense of control toward exercise , lower levels of confusion and depressive moods , and the development of fewer new medical problems during the program were related to higher levels of adherence to the program . Findings revealed that although physical health variables were the primary indicators of an older person 's overall participation in the program , it was the psychological factors that were most important to adherence to this home-based program Background and Purpose : Muscle strength training is important for people with knee osteoarthritis ( OA ) .  High-resistance exercise has been demonstrated to be more beneficial than low-resistance exercise for young subjects . The purpose of this study was to compare the effects of high- and low-resistance strength training in elderly subjects with knee OA . Subjects and Methods : One hundred two subjects were r and omly assigned to groups that received 8 weeks of high-resistance exercise ( HR group ) , 8 weeks of low-resistance exercise ( LR group ) , or no exercise ( control group ) . Pain , function , walking time , and muscle torque were examined before and after intervention . Results : Significant improvement for all measures was observed in both exercise groups . There was no significant difference in any measures between HR and LR groups . However , based on effect size between exercise and control groups , the HR group improved more than the LR group . Discussion and Conclusion : Both high- and low-resistance strength training significantly improved clinical effects in this study . The effects of high-resistance strength training appear to be larger than those of low-resistance strength training for people with mild to moderate knee OA , although the differences between the HR and LR groups were not statistically significant BACKGROUND Muscle size and strength decrease with aging , and the result ant muscle weakness has been implicated in increased risk of falls in older adults . These falls have large economic and functional costs . METHODS The purpose of this r and omized , controlled study was to determine if an 8-week , 3-day per week intense ( 77.8 + /- 3.4 % of 1-repetition maximum [ 1RM ] ) strength training program could improve functional ability related to the risk of falling in subjects aged 61 - -87 years ( mean 72 , SD 6.3 ) . Twelve strength-training-naive subjects performed two sets of 10 repetitions for six lower body exercises while 12 subjects served as nonintervention controls . Subjects were tested pre- , mid- , and postintervention for strength gain and on three tests of functional ability . RESULTS Postintervention strength was significantly better ( p < .017 ) in all training subjects across all exercises , and no injuries were reported as a result of either training or 1RM testing . After controlling for preintervention differences , repeated measure analysis of covariance ( ANCOVA ) found a significant difference between experimental and nonintervention control subjects for postintervention maximal walking speed [ F(1,19 ) = 5.03 , p < .05 ] . There were no significant between-group differences for 1-leg blind balance time or 5-repetition sit-to-st and performance [ F(1,19 ) = .082 ; F(1,19 ) = .068 , respectively , p > .05 ] . CONCLUSIONS These findings suggest that strength training alone does not appear to enhance st and ing balance or sit-to-st and performance in active , community-dwelling older adults but that it may improve maximal walking speed . The relationship between strength gain and risk of falls remains unclear . The data do reinforce the notion that intense strength training is a safe and effective way to increase muscle strength in this population 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 PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects Background With increasing age neuromuscular deficits ( e.g. , sarcopenia ) may result in impaired physical performance and an increased risk for falls . Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline . Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice . Thus , the objective of the present trial is to assess the effects of a  fall prevention program that was developed by an interdisciplinary expert panel on measures of balance , strength / power , body composition , cognition , psychosocial well-being , and falls self-efficacy in healthy older adults . Additionally , the time-related effects of detraining are tested . Methods / Design Healthy old people ( n = 54 ) between the age of 65 to 80 years will participate in this trial . The testing protocol comprises tests for the assessment of static / dynamic steady-state balance ( i.e. , Sharpened Romberg Test , instrumented gait analysis ) , proactive balance ( i.e. , Functional Reach Test ; Timed Up and Go Test ) , reactive balance ( i.e. , perturbation test during bipedal stance ; Push and Release Test ) , strength ( i.e. , h and grip strength test ; Chair St and Test ) , and power ( i.e. , Stair Climb Power Test ; countermovement jump ) . Further , body composition will be analysed using a bioelectrical impedance analysis system . In addition , question naires for the assessment of psychosocial ( i.e. , World Health Organisation Quality of Life Assessment -Bref ) , cognitive ( i.e. , Mini Mental State Examination ) , and fall risk determinants ( i.e. , Fall Efficacy Scale – International ) will be included in the study protocol . Participants will be r and omized into two intervention groups or the control / waiting group . After baseline measures , participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week , with each training session lasting 30 min . ( actual training time ) . One intervention group will complete an extensive supervised training program , while the other intervention group will complete a short version ( ' 3 times 3 ’ ) that is home-based and controlled by weekly phone calls . Post-tests will be conducted right after the intervention period . Additionally , detraining effects will be measured 12 weeks after program cessation . The control group / waiting group will not participate in any specific intervention during the experimental period , but will receive the extensive supervised program after the experimental period . Discussion It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance , strength / power , body composition , cognitive function , psychosocial well-being , and falls self-efficacy of older adults . In addition , information regarding fall risk assessment , dose – response-relations , detraining effects , and supervision of training will be provided . Further , training-induced health-relevant changes , such as improved performance in activities of daily living , cognitive function , and quality of life , as well as a reduced risk for falls may help to lower costs in the health care system . Finally , practitioners , therapists , and instructors will be provided with a scientifically evaluated feasible , safe , and easy-to-administer exercise program for fall prevention . Trial registration Clinical Trials.gov Identifier : Rationale Strength training and neuromuscular electrical stimulation ( NMES ) improve lower-limb muscle function in dyspnoeic individuals with chronic obstructive pulmonary disease ( COPD ) . However , high-frequency NMES ( HF-NMES ) and strength training have never been compared head-to-head ; and effects of low-frequency NMES ( LF-NMES ) have never been studied in COPD . Therefore , the optimal training modality to improve lower-limb muscle function , exercise performance and other patient-related outcomes in individuals with severe COPD remains unknown . Objectives To study prospect ively the efficacy of HF-NMES ( 75 Hz ) , LF-NMES ( 15 Hz ) or strength training in severely dyspnoeic individuals with COPD with quadriceps muscle weakness at baseline . Methods 120 individuals with COPD ( FEV1 : 33±1 % predicted , men : 52 % , age : 64.8±0.8 years ) were r and omised to HF-NMES , LF-NMES or strength training as part of a comprehensive inpatient pulmonary rehabilitation programme . No treadmill walking or stationary cycling was provided . Measurements and main results Groups were comparable at baseline . Quadriceps muscle strength increased after HF-NMES ( + 10.8 Newton-metre ( Nm ) ) or strength training ( + 6.1 Nm ; both p<0.01 ) , but not after LF-NMES ( + 1.4 Nm ; p=0.43 ) . Quadriceps muscle endurance , exercise performance , lower-limb fat-free mass , exercise-induced symptoms of dyspnoea and fatigue improved significantly compared with baseline after HF-NMES , LF-NMES or strength training . The increase in quadriceps muscle strength and muscle endurance was greater after HF-NMES than after LF-NMES . Conclusions HF-NMES is equally effective as strength training in severely dyspnoeic individuals with COPD and muscle weakness in strengthening the quadriceps muscles and thus may be a good alternative in this particular group of patients . HF-NMES , LF-NMES and strength training were effective in improving exercise performance in severely dyspnoeic individuals with COPD and quadriceps weakness . Trial registration Aim /hypothesisIn people with type 2 diabetes , exercise improves glucose control ( as reflected in HbA1c ) and physical fitness , but it is not clear to what extent these exercise-induced improvements are correlated with one another . We hypothesised that reductions in HbA1c would be related : ( 1 ) to increases in aerobic fitness and strength respectively in patients performing aerobic training or resistance training ; and ( 2 ) to changes in strength and aerobic fitness in patients performing aerobic and resistance training . Methods We r and omly allocated 251 type 2 diabetes patients to aerobic , resistance , or aerobic plus resistance training , or to a sedentary control group .  Peak oxygen consumption ( $ $ \mathop {V}\limits^\cdot { { \text{O}}_{\text{2 peak } } } $ $ ) , workload , treadmill time and ventilatory threshold measurements from maximal treadmill exercise testing were measured at baseline and 6 months . Muscular strength was measured as the maximum weight that could be lifted eight times on the leg press , bench press and seated row exercises . Results With aerobic training , significant associations were found between changes in both $ $ \mathop {V}\limits^\cdot { { \text{O}}_{\text{2 peak } } } $ $ ( p = 0.040 ) and workload ( p = 0.022 ) , and changes in HbA1c . With combined training , improvements in $ $ \mathop {V}\limits^\cdot { { \text{O}}_{\text{2 peak } } } $ $ ( p = 0.008 ) , workload ( p = 0.034 ) and ventilatory threshold ( p = 0.003 ) were significantly associated with changes in HbA1c . Increases in strength on the seated row ( p = 0.006 ) and in mid-thigh muscle cross-sectional area ( p = 0.030 ) were significantly associated with changes in HbA1c after resistance exercise , whereas the association between increases in muscle cross-sectional area and HbA1c in participants doing aerobic plus resistance exercise ( p = 0.059 ) was of borderline significance . Conclusions /interpretationThere appears to be a link between changes in fitness and HbA1c . The improvements in cardiorespiratory fitness with aerobic training may be a better predictor of changes in HbA1c than improvements in strength PURPOSE Aerobic exercise training is a recognized approach for improving functional capacity in COPD . People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity . The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training . METHODS Patients were r and omized to : 1 ) sequential resistance then aerobic training ( RT-then-AT ) ( 8 weeks resistance training followed by 8 weeks aerobic exercise training ) , 2 ) control group ( CE-then-AT + RT ) ( 8 weeks of ' sham ' training followed by 8 weeks concurrent aerobic and resistance training ) , 3 ) control group ( CE-then-AT ) ( 8 weeks ' sham ' training followed by 8 weeks aerobic training ) . Outcomes were assessed at study entry , after week 8 , and after week 16 : aerobic exercise performance ; muscle strength and endurance . RESULTS 75 patients completed training :  FEV1 % pred 40 ± 10 , V˙O(2peak ) % predicted , 71 ± 22 , fat-free mass index 19.5 ± 3.1 . RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT , but improvements in aerobic exercise performance were similar . Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT . Sarcopenia was associated with poorer attendance , and lower aerobic and resistance training volumes . CONCLUSION Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training , other training outcomes were similar between the two groups , thus the sequential approach is not clearly superior to the concurrent approach in severe COPD . Clinical Trials.gov Identifier : NCT01058213 Muscle wasting is a common complication afflicting maintenance hemodialysis ( HD ) patients , and it is associated with decreased muscle function , exercise performance , physical function , and quality of life . Meanwhile , numerous epidemiologic studies have consistently shown that greater muscle mass ( ascertained by body anthropometry surrogates , body composition tests such as dual x-ray absorptiometry , and /or serum creatinine in patients with little to no residual kidney function ) is associated with increased survival in this population . The pathophysiology of muscle wasting in HD patients is complex and may be caused by poor dietary intake , catabolic effects of dialysis therapy , hormonal alterations ( e.g. , decreased levels or resistance to anabolic hormones , increased levels of catabolic hormones ) , inflammation , metabolic acidosis , and concurrent comorbidities . Muscle disuse result ing from low physical activity is an important yet under-appreciated risk factor for muscle wasting . Intra-dialytic resistance exercise training has been suggested as a potential strategy to correct and /or prevent this complication in HD patients , but prior studies examining this exercise modality as an anabolic intervention have shown mixed results . In a recently published 12-week r and omized controlled trial of a novel intra-dialytic progressive resistance exercise training ( PRET ) program vs. control therapy conducted in HD and non-HD patients , PRET result ed in increased muscle volume and strength in both groups . At this time , further study is needed to determine if anabolic improvements imparted by resistance exercise translates into improved physical function and quality of life , decreased hospitalization and mortality risk , and greater cost-effectiveness in HD patients BACKGROUND Older women with coronary artery disease ( CAD ) have reduced peak aerobic power ( Vo(2)peak ) , muscle strength , and quality of life ( QOL ) . Exercise interventions that can improve Vo(2)peak and muscle strength may also result in an improvement in QOL . This study compared the effect of aerobic training ( AT ) or combined aerobic and strength training ( COMT ) on Vo(2)peak , distance walked in 6 min , upper- and lower-extremity maximal strength , and QOL in 18 women ( age range , 60 to 80 years ) with documented CAD . METHODS After baseline testing , subjects were r and omly assigned to AT ( treadmill and cycle exercise , n = 9 ) or COMT ( treadmill and cycle exercise plus upper- and lower-extremity strength training , n = 9 ) , and each group exercised 3 d/wk for 8 weeks . RESULTS Both AT and COMT result ed in a similar increase in Vo(2)peak , distance walked in 6 min , lower-extremity strength , and emotional and global QOL . COMT improved upper-extremity strength , and physical and social QOL , which was unchanged after AT . CONCLUSIONS Older women with CAD should perform aerobic and strength training to attain optimal improvements in overall physical fitness and QOL Objective : To compare the effects of aerobic and resistance exercise on weight , muscle strength , cardiovascular fitness , blood pressure and mood in obese women who were not on an energy-restricted diet . Design : R and omized , prospect i ve , controlled trial . Setting : Department of Physical Medicine and Rehabilitation , University Hospital . Subjects : Sixty obese women were assigned to one of three groups : aerobic exercise ( n=20 ) , resistance exercise ( n=20 ) and control group ( n=20 ) . Interventions : The aerobic exercise group performed both walking and leg cycle exercise with increasing duration and frequency . The resistance exercise group performed progressive weight-resistance exercises for the upper and lower body . Main outcome measures : Before and after a 12-week period , all subjects were evaluated by anthropometric measurement , rating of mood , cardiorespiratory capacity and maximum strength of trained muscles . Results : After a 12-week training period , subjects in the resistance group showed significant improvement in one-repetition maximum test of hip abductors ( 7.95±3.58 kg ) , quadriceps ( 14±7.18 kg ) , biceps ( 3.37± 2.84 kg ) and pectorals ( 8.75±5.09 kg ) compared with those in the control group ( P<0.001 ) . VO2 max increased ( 0.51±0.40 ) and Beck Depression Scale scores decreased ( -5.40±4.27 ) in the aerobic exercise group compared with the control group , significantly ( P<0.001 ) . Only in hip abductor muscle strength was there a significant increase in the resistance exercise group compared with the aerobic exercise group ( P < 0.05 ) . Conclusion : Both aerobic exercise and resistance exercise result ed in improved performance and exercise capacity in obese women .  While aerobic exercise appeared to be beneficial with regard to improving depressive symptoms and maximum oxygen consumption , resistance exercise was beneficial in increasing muscle strength Increased circulating adiponectin and insulin sensitivity are usually observed after body fat loss induced by a weight-loss diet . Progressive resistance training ( PRT ) without a concomitant weight-loss diet significantly decreases visceral fat , thus improving insulin sensitivity . Therefore , the purpose of this study was to ascertain the effects of combined 16-week PRT and weight-loss diet on circulating adiponectin and insulin sensitivity index .  Thirty-four obese ( BMI : 30 - 40 kg/m(2 ) ) women , aged 40 - 60 year , were r and omized to three groups : a control group ( C ; n = 9 ) ; a diet group ( WL ; n = 12 ) with a caloric restriction of 500 kcal/d ; and a diet plus resistance training group ( WL+RT ; n = 13 ) with the same caloric restriction as group WL and a 16-week supervised whole body PRT of two sessions/week . Both WL and WL+RT groups showed similar decreases in body mass ( -6.3 % and -7.7 % ) and visceral fat ( -19.9 % and -20.5 % ) . WL result ed in an expected increase in circulating levels of adiponectin ( P = 0.07 ) and insulin sensitivity . However , circulating total adiponectin decreased ( P < 0.05 ) in WL+RT group , whereas an improvement in different cardiovascular risk factors ( insulin sensitivity , low-density lipoprotein cholesterol ( LDL-C ) , etc . ) was observed . In conclusion , in obese women a 16-week combined PRT and weight-loss diet is accompanied by significant improvements in different cardiovascular risk factors in spite of a significant decrease of circulating adiponectin The purpose of this study was to investigate the effects of a 12-week resistance-training program on muscle strength and mass in older adults . Thirty-three inactive participants ( 60 - 74 years old ) were assigned to 1 of 3 groups : high-resistance training ( HT ) , moderate-resistance training ( MT ) , and control . After the training period , both HT and MT significantly increased 1-RM body strength , the peak torque of knee extensors and flexors , and the midthigh cross-sectional area of the total muscle . In addition , both HT and MT significantly decreased the abdominal circumference . HT was more effective in increasing 1-RM strength , muscle mass , and peak knee-flexor torque than was MT . These data suggest that muscle strength and mass can be improved in the elderly with both high- and moderate-intensity resistance training , but high-resistance training can lead to greater strength gains and hypertrophy than can moderate-resistance training Physical activity ( PA ) helps to prevent osteoporosis , but older women are often sedentary . This study used a pre-post r and omized controlled design to evaluate a 12-week exercise education intervention program based on the stages of change ( SoC ) and processes of change from the transtheoretical change model ( TTM ) to improve adherence with strength and balance training recommendations at levels sufficient to prevent osteoporosis in Iranian women aged 40 - 65 years . The home-based exercise prescription consisted of strength and balance training that was progressive , individually tailored and included a walking program . Individuals in the training group ( n=61 ) had a positive , significant progression in psychological SoC ( P<0.001 ) , whereas no progression in stages occurred in the control group ( n=55 ) . After the intervention , the training group demonstrated significant improvements in PA , lower body muscle strength , static and dynamic balance , with no significant changes in the control group . These results support the applicability of the TTM for a PA intervention and indicate that this training program is very effective in improving balance and lower body strength in older women Aging is associated with lower muscle mass and an increase in body fat . We examined whether creatine monohydrate ( CrM ) and conjugated linoleic acid ( CLA ) could enhance strength gains and improve body composition ( i.e. , increase fat-free mass ( FFM ) ; decrease body fat ) following  resistance exercise training in older adults ( > 65 y ) . Men ( N = 19 ) and women ( N = 20 ) completed six months of resistance exercise training with CrM (5g/d)+CLA ( 6g/d ) or placebo with r and omized , double blind , allocation . Outcomes included : strength and muscular endurance , functional tasks , body composition ( DEXA scan ) , blood tests ( lipids , liver function , CK , glucose , systemic inflammation markers ( IL-6 , C-reactive protein ) ) , urinary markers of compliance ( creatine/creatinine ) , oxidative stress ( 8-OH-2dG , 8-isoP ) and bone resorption ( Ν-telopeptides ) . Exercise training improved all measurements of functional capacity ( P<0.05 ) and strength ( P<0.001 ) , with greater improvement for the CrM+CLA group in most measurements of muscular endurance , isokinetic knee extension strength , FFM , and lower fat mass ( P<0.05 ) . Plasma creatinine ( P<0.05 ) , but not creatinine clearance , increased for CrM+CLA , with no changes in serum CK activity or liver function tests . Together , this data confirms that supervised resistance exercise training is safe and effective for increasing strength in older adults and that a combination of CrM and CLA can enhance some of the beneficial effects of training over a six-month period . Trial Registration . Clinical Trials.gov 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 Evidence suggests that consumption of over-the-counter cyclooxygenase ( COX ) inhibitors may interfere with the positive effects that resistance exercise training has on reversing sarcopenia in older adults . This study examined the influence of acetaminophen or ibuprofen consumption on muscle mass and strength during 12 wk of knee extensor progressive resistance exercise training in older adults . Thirty-six individuals were r and omly assigned to one of three groups and consumed the COX-inhibiting drugs in double-blind placebo-controlled fashion : placebo ( 67 ± 2 yr ; n = 12 ) , acetaminophen ( 64 ± 1 yr ; n = 11 ; 4 g/day ) , and ibuprofen ( 64 ± 1 yr ; n = 13 ; 1.2 g/day ) . Compliance with the resistance training program ( 100 % ) and drug consumption ( via digital video observation , 94 % ) , and resistance training intensity were similar ( P > 0.05 ) for all three groups . Drug consumption unexpectedly increased muscle volume  ( acetaminophen : 109 ± 14 cm(3 ) , 12.5 % ; ibuprofen : 84 ± 10 cm(3 ) , 10.9 % ) and muscle strength  ( acetaminophen : 19 ± 2 kg ; ibuprofen : 19 ± 2 kg ) to a greater extent ( P < 0.05 ) than placebo ( muscle volume : 69 ± 12 cm(3 ) , 8.6 % ; muscle strength : 15 ± 2 kg ) , when controlling for initial muscle size and strength . Follow-up analysis of muscle biopsies taken from the vastus lateralis before and after training showed muscle protein content , muscle water content , and myosin heavy chain distribution were not influenced ( P > 0.05 ) by drug consumption . Similarly , muscle content of the two known enzymes potentially targeted by the drugs , COX-1 and -2 , was not influenced ( P > 0.05 ) by drug consumption , although resistance training did result in a drug-independent increase in COX-1 ( 32 ± 8 % ; P < 0.05 ) . Drug consumption did not influence the size of the nonresistance-trained hamstring muscles ( P > 0.05 ) . Over-the-counter doses of acetaminophen or ibuprofen , when consumed in combination with resistance training , do not inhibit and appear to enhance muscle hypertrophy and strength gains in older adults . The present findings coupled with previous short-term exercise studies provide convincing evidence that the COX pathway(s ) are involved in the regulation of muscle protein turnover and muscle mass in humans Experimental evidence indicates that a lower synthesis rate of muscle contractile protein myosin heavy chain ( MHC ) occurs in age-related muscle wasting and weakness . To determine the molecular mechanism of this lower synthesis of MHC , we measured transcript levels of isoforms of MHC ( MHCI , MHCIIa , and MHCIIx ) in muscle biopsy sample s of 7 young ( 20 - 27 yr ) , 12 middle-aged ( 47 - 60 yr ) , and 14 older ( > 65 yr ) people . We further determined the effect of 3 mo of resistance exercise training ( exercise ) vs. nonintervention ( control ) on transcript levels of MHC isoforms on these subjects and the fractional synthesis rate ( FSR ) of MHC in 39 people aged 46 - 79 yr .  MHCI mRNA levels did not significantly change with age , but MHCIIa decreased 38 % ( P < 0.05 ) from young to middle age and further decreased 50 % ( P < 0.05 ) from middle to old age . MHCIIx decreased 84 % ( P < 0.05 ) from young to middle age and 48 % from middle to old age ( P < 0.05 ) . Exercise increased FSR of MHC by 47 % ( P < 0.01 ) and mixed muscle protein by 56 % ( P < 0.05 ) . Exercise training results in an increase ( 85 % ) in transcript levels of MHCI and a decrease in the transcript levels of MHCIIa and MHCIIx . In conclusion , an age-related lowering of the transcript levels of MHCIIa and MHCIIx is not reversed by exercise , whereas exercise results in a higher synthesis rate of MHC in association with an increase in MHCI isoform transcript levels Objective : The purpose of this study was to compare adaptations in functional and quality of life measures following endurance- and resistance-exercise training in people with multiple sclerosis . Design : Cross-over design with an eight-week washout period . Setting : Community health centre . Subjects : Sixteen individuals with multiple sclerosis . Intervention : Subjects completed both an eight-week endurance- and an eight-week resistance-exercise training programme in a r and omized order . The exercise training comprised individualized progressive programmes that were completed twice weekly in a supervised group setting . Main measures : Grip strength , functional reach , four step square , timed up and go and six-minute walk tests , Multiple Sclerosis Impact and Modified Fatigue Impact Scales , Becks Depression Inventory and the Health Status Question naire Short Form-36 . Results : Sixteen of 21 ( 76 % ) subjects completed the study . Subjects attended 13.2 ± 1.6 endurance- and 15.8 ± 1.9 resistance-exercise training sessions . No adverse events were reported . No significant differences ( P < 0.05 ) in any outcome measures were observed between the two exercise training programmes either at baseline or following the completion of both training programmes . Conclusion : Both endurance- and resistance-exercise training were well tolerated and appear to provide similar effects for people with multiple sclerosis , but larger studies are required to confirm these findings BACKGROUND Considerable discrepancy exists in the literature on the proposed benefits of protein supplementation on the adaptive response of skeletal muscle to resistance-type exercise training in the elderly . OBJECTIVE The objective was to assess the benefits of timed protein supplementation on the increase in muscle mass and strength during prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . DESIGN Healthy elderly men ( n = 26 ) aged 72 + /- 2 y were r and omly assigned to a progressive , 12-wk resistance-type exercise training program with ( protein group ) or without ( placebo group ) protein provided before and immediately after each exercise session ( 3 sessions/wk , 20 g protein/session ) . One-repetition maximum ( 1RM ) tests were performed regularly to ensure a progressive workload during the intervention . Muscle hypertrophy was assessed at the whole-body ( dual-energy X-ray absorptiometry ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . RESULTS The 1RM strength increased approximately 25 - 35 % in both groups ( P < 0.001 ) . Dual-energy X-ray absorptiometry and computed tomography scans showed similar increases in leg muscle mass ( 6 + /- 1 % in both groups ; P < 0.001 ) and in the quadriceps ( 9 + /- 1 % in both groups ) , from 75.9 + /- 3.7 and 73.8 + /- 3.2 to 82.4 + /- 3.9 and 80.0 + /- 3.0 cm2 in the placebo and protein groups , respectively ( P < 0.001 ) . Muscle fiber hypertrophy was greater in type II ( placebo : 28 + /- 6 % ; protein : 29 + /- 4 % ) than in type I ( placebo : 5 + /- 4 % ; protein : 13 + /- 6 % ) fibers , but the difference between groups was not significant . CONCLUSION Timed protein supplementation immediately before and after exercise does not further augment the increase in skeletal muscle mass and strength after prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . This trial was registered at clinical trials.gov as NCT00744094 OBJECTIVE Resistance and endurance training result in gains in fitness in the aged . It is unclear whether the debilitated elderly can perform moderate-intensity training and whether such training results in short-term improvements in strength , endurance , and function in this population . DESIGN R and omized , controlled trial . SETTING S AND PATIENTS Subjects were from a Veterans Affairs nursing home and rehabilitation unit and a community nursing home . They were older than 60 yrs with impairment in at least one physical activity of daily living . Seventy-eight subjects volunteered and 58 ( mean age , 75 yrs ; 9 women , 49 men ) completed the intervention and initial posttest . Only one subject withdrew because of injury or disinterest . INTERVENTION Thrice-weekly resistance training ( using an isokinetic dynamometer ) and twice-weekly endurance training for 4 to 8 weeks . MAIN OUTCOMES Isometric strength in dominant arm and leg , heart rate response to timed endurance test , and activities of daily living score . RESULTS The mean change in isometric strength across the muscle movements tested was 32.8 % in the training group and 10.2 % in the control group ( difference , 22.6 % ; 95 % confidence interval , 6.2 % to 39.0 % ) . No change in heart rate during exercise was seen in the training group . Trained subjects tended to have a greater improvement in functional activity than control subjects , which was statistically significant ( p = .04 ) for those subjects who at enrollment were most dysfunctional ( i.e. , activities of daily living score less than 13 [ maximum score 26 ] ) . CONCLUSION This group of debilitated elderly patients effectively performed resistance training and increased their strength , with the most impaired gaining the most function . Few in the group could effectively perform endurance training BACKGROUND Osteoarthritis is a common musculo-skeletal problem accompanied with muscle weakness . Muscle weakness may be readily improved by resistance training . Greater muscle strength has been associated with a lower knee joint loading rate . METHODS We conducted a single-blind r and omized controlled trial of 54 female patients with osteoarthritis in at least one knee , according to the American College of Rheumatology clinical criteria . Patients were r and omized into a 6-month high intensity progressive resistance training or a sham-exercise program . The primary outcomes were first peak knee and hip adduction moment measured using three-dimensional gait analysis at self-selected habitual and maximal speeds . Secondary outcomes were sagittal plane knee and hip moments , peak muscle strength , gait speed , and self-reported knee osteoarthritis symptoms measured by the Western Ontario and McMaster Osteoarthritis Index ( WOMAC ) . FINDINGS Six months of high intensity resistance training did not change the first peak knee or hip adduction moment at either habitual or maximum walking speeds ( P>0.413 ) compared to the sham-exercise . However , the second peak hip adduction moment ( P=0.025 ) and WOMAC pain score ( P<0.001 ) were reduced significantly in both groups over time , but there was no group effect . The changes in the second peak hip adduction moment were inversely related to the changes in the WOMAC pain score ( r=-0.394 , P=0.009 ) . INTERPRETATIONS Muscle strength training in women with osteoarthritis , while effective for reducing osteoarthritis symptoms , appeared to operate through mechanisms other than improved knee or hip joint loading , as paradoxically , improved symptoms were related to decreases of hip adduction moment in late stance Summary There is no clear consensus on definition , cut-points or st and ardised assessment s of sarcopenia . We found a lower limb strength assessment  was at least as effective in predicting balance , mobility and falls in 419 older people as muscle mass-based measures of sarcopenia . Introduction There is currently no consensus on the definition , cut-points or st and ardised assessment s of sarcopenia . This study aim ed to investigate whether several published definitions of sarcopenia differentiate between older people with respect to important functional and health outcomes . Methods Four hundred nineteen community-living older adults ( mean age 81.2 ± 4.5 , 49 % female ) completed assessment s of body composition ( dual-energy X-ray absorptiometry ) , strength , balance , mobility and disability . Falls were recorded prospect ively for a year using monthly calendars . Sarcopenia was defined according to four skeletal mass-based definitions , two strength-based definitions ( h and grip or knee extensor force ) and a consensus algorithm ( low mass and low strength or slow gait speed ) . Obesity was defined according to percentage fat mass or waist circumference . Results The four skeletal mass-based definitions varied considerably with respect to the percentage of participants classified as sarcopenic and their predictive accuracy for functional and health outcomes . The knee extension strength-based definition was equivalent to or better than the mass-based and consensus algorithm definitions ; i.e. weaker participants performed poorly in tests of leaning balance , stepping reaction time , gait speed and mobility . They also had higher physiological fall risk scores and were 43 % more likely to fall at home than their stronger counterparts . Adding obesity to sarcopenia definitions identified participants with greater self-reported disability . Conclusions A simple lower limb strength assessment was at least as effective in predicting balance , functional mobility and falls in older people as more expensive and time-consuming muscle mass-based measures . These findings imply that functional terms such as muscle weakness or motor impairment are preferable to sarcopenia Background Institutionalized older persons have a poor functional capacity . Including physical exercise in their routine activities decreases their frailty and improves their quality of life . Whole-body vibration ( WBV ) training is a type of exercise that seems beneficial in frail older persons to improve their functional mobility , but the evidence is inconclusive . This trial will compare the results of exercise with WBV and exercise without WBV in improving body balance , muscle performance and fall prevention in institutionalized older persons . Methods / Design An open , multicentre and parallel r and omized clinical trial with blinded assessment . 160 nursing home residents aged over 65 years and of both sexes will be identified to participate in the study . Participants will be central ly r and omised and allocated to interventions ( vibration or exercise group ) by telephone . The vibration group will perform static/dynamic exercises ( balance and resistance training ) on a vibratory platform ( Frequency : 30 - 35 Hz ; Amplitude : 2 - 4 mm ) over a six-week training period ( 3 sessions/week ) . The exercise group will perform the same exercise protocol but without a vibration stimuli platform . The primary outcome measure is the static/dynamic body balance . Secondary outcomes are muscle strength and , number of new falls . Follow-up measurements will be collected at 6 weeks and at 6 months after r and omization . Efficacy will be analysed on an intention-to-treat ( ITT ) basis and ' per protocol ' . The effects of the intervention will be evaluated using the " t " test , Mann-Witney test , or Chi-square test , depending on the type of outcome . The final analysis will be performed 6 weeks and 6 months after r and omization . Discussion This study will help to clarify whether WBV training improves body balance , gait mobility and muscle strength in frail older persons living in nursing homes . As far as we know , this will be the first study to evaluate the efficacy of WBV for the prevention of falls . Trial Registration Clinical Trials.gov : UNLABELLED Power-based resistance training ( PWT ) , using low load and high velocity , can improve physical function and quality of life in older persons . Patients with Parkinson 's disease ( PD ) , exhibiting muscular weakness and reduced movement speed , have been shown to be benefit from resistance training ; however , little is known about the advantages of PWT for PD . PURPOSE To evaluate the effects of PWT on bradykinesia and muscular performance in older patients with PD . METHODS Twenty-six patients with mild to moderate PD were r and omly assigned to a PWT or control group ( CON ) . The PWT program was three months , incorporating two sessions/wk of high-speed resistance training combined balance and agility drills . Outcome measures included : upper and lower limb bradykinesia scores , one repetition maximums ( 1RM ) and peak powers on biceps curl , chest press , leg press , hip abduction and seated calf , and quality of life ( PDQ-39 ) . RESULTS The PWT group produced significant improvement in both upper and lower limbs bradykinesia scores , 1RM and muscle peak power ( p < .05 ) , which surpassed the CON group except for power during the seated calf exercise . No significant correlations between changes in clinical measure of bradykinesia and muscle peak power were observed after training . Significant improvements were seen in the PDQ-39 overall score , subsections for mobility , activities of daily living and social support for the PWT group . CONCLUSION The 3-month PWT program significantly reduced bradykinesia and increased muscle strength and power in older patients with PD . Power training is an effective training modality to improve physical function and quality of life for PD BACKGROUND AND OBJECTIVES Reduced muscle mass and strength are prevalent conditions in dialysis patients . However , muscle strength and muscle mass are not congruent ; muscle strength can diminish even though muscle mass is maintained or increased . This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination ( i.e. , concurrent loss of muscle mass and strength/mobility , here defined as sarcopenia ) . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS This study included 330 incident dialysis patients ( 203 men , mean age 53±13 years , and mean GFR 7±2 ml/min per 1.73 m(2 ) ) recruited between 1994 and 2010 and followed prospect ively for up to 5 years . Low muscle mass ( by dual-energy x-ray absorptiometry appendicular mass index ) and low muscle strength ( by h and grip ) were defined against young reference population s according to the European Working Group on Sarcopenia in Older People . RESULTS Whereas 20 % of patients had sarcopenia , low muscle mass and low muscle strength alone were observed in a further 24 % and 15 % of patients , respectively . Old age , comorbidities , protein-energy wasting , physical inactivity , low albumin , and inflammation associated with low muscle strength , but not with low muscle mass ( multivariate ANOVA interactions ) . During follow-up , 95 patients ( 29 % ) died and both conditions associated with mortality as separate entities . When combined , individuals with low muscle mass alone were not at increased risk of mortality ( adjusted hazard ratio [ HR ] , 1.23 ; 95 % confidence interval [ 95 % CI ] , 0.56 to 2.67 ) . Individuals with low muscle strength were at increased risk , irrespective of their muscle stores being appropriate ( HR , 1.98 ; 95 % CI , 1.01 to 3.87 ) or low ( HR , 1.93 ; 95 % CI , 1.01 to 3.71 ) . CONCLUSIONS Low muscle strength was more strongly associated with aging , protein-energy wasting , physical inactivity , inflammation , and mortality than low muscle mass . Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation Abstract .Falls are a common hazard in the elderly . Orthostatic hypotension ( OH ) is prevalent in older patients and contributes to the high incidence of falls . Our aim was to test whether a home-based resistance-training program ( HBRT ) using elastic resistance b and s could safely and effectively increase muscle strength and functional ability , and attenuate the orthostatic fall in blood pressure .  Eight subjects ( > 60 yrs ) underwent orthostatic provocations ; muscle strength testing ( isometric and dynamic ) , and a functional test of gait and mobility ( Timed Up & Go ) , at baseline and following 8 weeks of training . Ten exercises were assigned and customized to each participant . At 8 weeks , significant increases occurred in dynamic strength in the chest press ( p = 0.017 ) , quadriceps extension ( p = 0.017 ) , and leg press ( p = 0.025 ) ; no significant differences occurred in isometric strength or in blood pressures . Functional mobility increased in 7 of 8 subjects . There were no falls during the investigation period . Conclusion A HBRT program using elastic resistance b and s effectively increases dynamic muscle strength in elderly individuals with OH . Although no changes occurred in orthostatic blood pressures , which could be attributed to the limited length of the program , this therapy may be recognized as a safe method to improve strength , functional ability , and promote physical activity – variables that can reduce the incidence of falls and enhance the quality of life in this population BACKGROUND Progressive loss of muscle and strength with age is often coincident with increases in adiposity , leading to a condition called sarcopenic obesity . Studies have shown sarcopenic obese adults to be at higher risk for declines in physical function . Despite this rising public health concern , no intervention studies currently exist in this population . METHODS A total of 21 sarcopenic obese adults , 60 years or older , were r and omized into two groups , strength/hypertrophy ( SH , n=9 ) and high-speed circuit ( HSC , n=8 ) and were trained for 15 weeks . The primary outcome was the SPPB modified as a measure of physical function , assessed by assessors blinded to r and omization . Secondary outcomes were lower body and upper body power and strength , instrumental activities of daily living ( IADL ) , ratings of perceived exertion ( RPE ) , body fat % ( BF% ) , skeletal muscle index ( SMI ) , and grip strength ( GRP ) . RESULTS For the SPPB results favored HSC over SH ( 1.1 , 95 % CI ( -.1 to 2.4 ) , p=.08 ) and showed a moderate effect size ( Hedge g=0.6 , 95 % CI ( -0.4 , 1.6 ) ) . For secondary outcomes , lower body power ( mean difference=158 W , 95 % CI ( 2 , 315 ) ; p=.01 ) and RPE ( mean difference=-1.5 , 95 % CI ( -2.9 , -0.12 ) ; p=.04 ) also favored HSC . IADL , SMI , BF% , upper and lower body strength and upper body power , showed no statistically significant differences between groups . CONCLUSIONS Considering the moderate effect size , the large treatment effect shown by the upper limit of the 95 % CI , the low perceived exertion , and no adverse effects , HSC training should be further investigated with a larger sample size in sarcopenic obese adults We conducted a 12-wk resistance training program in elderly women [ mean age 69 + /- 1.0 ( SE ) yr ] to determine whether increases in muscle strength are associated with changes in cross-sectional fiber area of the vastus lateralis muscle . Twenty-seven healthy women were r and omly assigned to either a control or exercise group . The program was satisfactorily completed and adequate biopsy material obtained from 6 controls and 13 exercisers . After initial testing of baseline maximal strength , exercisers began a training regimen consisting of seven exercises that stressed primary muscle groups of the lower extremities . No active intervention was prescribed for the controls . Increases in muscle strength of the exercising subjects were significant compared with baseline values ( 28 - 115 % ) in all muscle groups . No significant strength changes were observed in the controls . Cross-sectional area of type II muscle fibers significantly increased in the exercisers ( 20.1 + /- 6.8 % , P = 0.02 ) compared with baseline . In contrast , no significant change in type II fiber area was observed in the controls . No significant changes in type I fiber area were found in either group . We conclude that a program of resistance exercise can be safely carried out by elderly women , such a program significantly increases muscle strength , and such gains are due , at least in part , to muscle hypertrophy BACKGROUND It has been demonstrated that protein ingestion before sleep increases muscle protein synthesis rates during overnight recovery from an exercise bout . However , it remains to be established whether dietary protein ingestion before sleep can effectively augment the muscle adaptive response to resistance-type exercise training . OBJECTIVE Here we assessed the impact of dietary protein supplementation before sleep on muscle mass and strength gains during resistance-type exercise training . METHODS Forty-four young men ( 22 ± 1 y ) were r and omly assigned to a progressive , 12-wk resistance exercise training program . One group consumed a protein supplement containing 27.5 g of protein , 15 g of carbohydrate , and 0.1 g of fat every night before sleep . The other group received a noncaloric placebo . Muscle hypertrophy was assessed on a whole-body ( dual-energy X-ray absorptiometry ) , limb ( computed tomography scan ) , and muscle fiber ( muscle biopsy specimen ) level before and after exercise training . Strength was assessed regularly by 1-repetition maximum strength testing . RESULTS Muscle strength increased after resistance exercise training to a significantly greater extent in the protein-supplemented ( PRO ) group than in the placebo-supplemented ( PLA ) group ( + 164 ± 11 kg and + 130 ± 9 kg , respectively ; P < 0.001 ) . In addition , quadriceps muscle cross-sectional area increased in both groups over time ( P < 0.001 ) , with a greater increase in the PRO group than in the PLA group ( + 8.4 ± 1.1 cm(2 ) vs. + 4.8 ± 0.8 cm(2 ) , respectively ; P < 0.05 ) . Both type I and type II muscle fiber size increased after exercise training ( P < 0.001 ) , with a greater increase in type II muscle fiber size in the PRO group ( + 2319 ± 368 μm(2 ) ) than in the PLA group ( + 1017 ± 353 μm(2 ) ; P < 0.05 ) . CONCLUSION Protein ingestion before sleep represents an effective dietary strategy to augment muscle mass and strength gains during resistance exercise training in young men . This trial was registered at clinical trials.gov as NCT02222415 BACKGROUND Individuals with end-stage renal disease on hemodialysis therapy have reduced aerobic exercise capacity and reduced muscle strength . METHODS This was a single-blind , r and omized , placebo-controlled trial of an exercise intervention in hemodialysis patients administered erythropoietin . The intervention consisted of progressive resisted isotonic quadriceps and hamstrings exercise and training on a cycle ergometer three times weekly for 12 weeks . Individuals in the control group underwent a nonprogressive program of range-of-motion exercises . Both groups were observed for an additional 5 months without intervention . Outcomes were assessed without knowledge of treatment assignment at baseline , 12 weeks , and 5 months . A healthy age- and sex-matched sample provided comparative data . RESULTS Our sample was relatively high functioning , with a mean score on the Physical Function subscale of the Short Form 36 ( SF-36 ) of 76 of 100 . At 12 weeks , there were large and statistically significant differences in favor of the experimental group on the submaximal exercise test ( 14 W ; 95 % confidence interval , 2 to 26 ) and muscle strength ( 45 lb ; 95 % confidence interval , 9 to 81 ) , but not in the 6-minute walk , symptoms question naire , or SF-36 . Differences between the intervention and control groups at 12 weeks were not evident on retesting 5 months after the end of the intervention . Compared with the healthy sample , patients were significantly lower functioning on the submaximal exercise test , muscle strength , and 6-minute walk test at baseline . CONCLUSION In this high-functioning sample , the exercise program improved physical impairment measures , but had no effect on symptoms or health-related quality of life . The impact on patients with a greater degree of physical dysfunction needs to be rigorously studied CONTEXT Poor muscle strength , functional limitations , and disability often coexist , but whether muscle strength during midlife predicts old age functional ability is not known . OBJECTIVE To determine whether h and grip strength measured during midlife predicts old age functional limitations and disability in initially healthy men . DESIGN AND SETTING A 25-year prospect i ve cohort study , the Honolulu Heart Program , which began in 1965 among Japanese-American men living on Oahu , Hawaii . PARTICIPANTS A total of 608945- to 68-year-old men who were healthy at baseline and whose maximal h and grip strength was measured from 1965 through 1970 . Altogether , 2259 men died over the follow-up period and 3218 survivors participated in the  disability assessment  in 1991 through 1993 . MAIN OUTCOME MEASURES Functional limitations including slow customary walking speed ( < or = 0.4 m/s ) and inability to rise from a seated position without using the arms , and multiple self-reported upper extremity , mobility , and self-care disability outcomes . RESULTS After adjustment for multiple potential confounders , risk of functional limitations and disability 25 years later increased as baseline h and grip strength , divided into tertiles , declined . The odds ratio ( OR ) of walking speed of 0.4 m/s or slower was 2.87 ( 95 % confidence interval [ CI ] , 1.76 - 4.67 ) in those in the lowest third and 1.79 ( 95 % CI , 1.14 - 2.81 ) in the middle third of grip strength vs those in the highest third . The risk of self-care disability was more than 2 times greater in the lowest vs the highest grip strength tertile . Adding chronic conditions identified at follow-up to the models predicting disability reduced the ORs related to grip strength only minimally . CONCLUSIONS Among healthy 45- to 68-year-old men , h and grip strength was highly predictive of functional limitations and disability 25 years later . Good muscle strength in midlife may protect people from old age disability by providing a greater safety margin above the threshold of disability OBJECTIVES The prospect i ve relationships between self-efficacy beliefs , in conjunction with measures of knee pain and knee strength , and subsequent decline in both physical performance and self-reported disability among older adults with knee pain were examined . METHODS In this prospect i ve epidemiological trial , 480 men and women aged 65 years and older who had knee pain on most days of the week and difficulty with daily activity were followed for 30 months . RESULTS There was a significant interaction of baseline self-efficacy with baseline knee strength in predicting both self-reported disability and stair climb performance . Participants who had low self-efficacy and low strength at baseline had the largest 30-month decline in these outcomes . DISCUSSION These data underscore the important role that self-efficacy beliefs play in underst and ing functional decline with chronic disease and aging . Self-efficacy beliefs appear to be most important to functional decline in older adults when they are challenged by muscular weakness in the lower extremities OBJECTIVE To evaluate the residual effects of fitness and whole-body vibration ( WBV ) training in older men 1 year after completion of the interventions . DESIGN A 1-year follow-up of a r and omized controlled trial comparing the effects of 1 year of fitness training , including combined resistance and aerobic ( R+A ) training and WBV training , with a control ( CON ) group . SETTING University training center . PARTICIPANTS Adult men ( N=72 ) between 60 and 80 years of age . Response rate was 80 % , 92 % , and 90 % in the R+A training ( n=20 ) , WBV training ( n=23 ) , and CON ( n=29 ) groups , respectively . INTERVENTIONS The intervention groups exercised 3 times weekly during 1 year . The R+A training group performed a st and ard training program , combining resistance exercises and aerobic training , following the American College of Sports Medicine guidelines . The WBV training group performed unloaded static and dynamic leg exercises on a vibration platform . The CON group did not participate in any training program . MAIN OUTCOME MEASURES Muscle volume , isometric and concentric muscle strength , muscle quality , and muscle power . RESULTS Both interventions had result ed in comparable increases in muscle quality characteristics . No significant changes had been found in the CON group . During the 1-year follow-up period , the R+A ( -4.05 % , P=.006 ) and WBV ( -2.45 % , P<.0001 ) training groups had lost most of their gains in muscle volume . However , isometric muscle strength was preserved in the R+A training group ( + 1.65 % , P=.745 ) , result ing in an increase in muscle quality ( + 7.97 % , P=.034 ) . In the WBV training group , muscle power decreased ( -6.10 % , P<.0001 ) but remained significantly higher than at baseline ( P=.038 ) . Except for a strong decrease in muscle power , no significant changes were found in the CON group . CONCLUSIONS One year of R+A and /or WBV training can equally reverse the adverse effects of aging on muscle quality in older men , but their residual impact after follow-up is different Objective This study aim ed to compare the effects of two frequencies of high-speed resistance training ( HSRT ) on physical performance and quality of life of older women . Methods A total of 24 older women participated in a 12-week HSRT program  composed of either two or three sessions/week ( equated for volume and intensity ) . Women were r and omized into three arms : a control group ( CG , n=8 ) , a resistance training group performing two sessions/week ( RT2 , n=8 ) , and a resistance training group performing three sessions/week ( RT3 , n=8 ) . The training program for both experimental groups included exercises that required high-speed concentric muscle actions . Results No baseline differences were observed among groups . Compared with the CG , both training groups showed similar small to moderate improvements ( P<0.05 ) in muscle strength , power , functional performance , balance , and quality of life . Conclusion These results suggest that equated for volume and intensity , two and three training sessions/week of HSRT are equally effective for improving physical performance and quality of life of older women OBJECTIVES To evaluate the effects of elastic b and resistance training in combination with nutrient supplementation on muscular strength and the ability to perform mobility-related activities of daily living in older adults living in retirement care facilities . DESIGN R and omized controlled trial , with a 6-month intervention period . SETTING A retirement care facility , Vienna , Austria . PARTICIPANTS One hundred and seventeen older adults ( 14 males ( 12 % ) and 103 females ( 88 % ) ) , aged 65 to 97 years ( mean age : 82.8 ± 6.0 ) , having a mini-mental state examination score ≥ 23 and no chronic diseases posing a medical contraindication to training therapy . INTERVENTION Participants were r and omly assigned , but stratified by sex , to one of three intervention groups : supervised resistance exercise training ( RT ) , RT in combination with nutrient supplementation ( RTS ) , or cognitive training group ( CT ) . All interventions were performed two times a week for 6 months . RT was design ed to train all major muscle groups using elastic b and s. The nutrient supplement ( rich in proteins , vitamin D , B2 , B12 ) was distributed every morning as well as after each RT session . MEASUREMENTS A battery of motor ability tests and functional test were performed prior to as well as following 3 months and finally after 6 months of intervention . These tests included isokinetic torque measurements of the knee extensors and flexors in concentric mode at 60 and 120 ° /s , isometric h and grip strength , senior arm-lifting test , chair st and test , maximum walking speed and a 6-minute walking test ( 6 MWT ) . RESULTS A repeated- measures ANOVA analysis revealed significant improvements in physical function of lower ( p=0.002 ) and upper extremities ( p=0.006 ) for RT and /or RTS in comparison to CT . For isokinetic measurements , 6 MWT , and gait speed time effects ( p<0.05 ) were detected without any group × time interaction effects . Dropouts showed lower performance in chair st and test ( p=0.012 ) , 6 MWT ( p=0.003 ) , and gait speed ( p=0.013 ) at baseline than that of the finishers of the study . CONCLUSION Six months of a low intensity resistance exercise using elastic b and s and own body weight is safe and beneficial in improving functional performance of institutionalised older people . Multinutrient supplementation did not offer additional benefits to the effects of RT in improving muscular performance Creatine supplementation in close proximity to resistance training may be an important strategy for increasing muscle mass and strength ; however , it is unknown whether creatine supplementation before or after resistance training is more effective for aging adults . Using a double-blind , repeated measures design , older adults ( 50 - 71 years ) were r and omized to 1 of 3 groups : creatine before ( CR-B : n = 15 ; creatine ( 0.1 g/kg ) immediately before resistance training and placebo ( 0.1 g/kg cornstarch maltodextrin ) immediately after resistance training ) , creatine after ( CR-A : n = 12 ; placebo immediately before resistance training and creatine immediately after resistance training ) , or placebo ( PLA : n = 12 ; placebo immediately before and immediately after resistance training ) for 32 weeks . Prior to and following the study , body composition ( lean tissue , fat mass ; dual-energy X-ray absorptiometry ) and muscle strength ( 1-repetition maximum leg press and chest press ) were assessed . There was an increase over time for lean tissue mass and muscle strength and a decrease in fat mass ( p < 0.05 ) . CR-A result ed in greater improvements in lean tissue mass ( Δ 3.0 ± 1.9 kg ) compared with PLA ( Δ 0.5 ± 2.1 kg ; p < 0.025 ) . Creatine supplementation , independent of the timing of ingestion , increased muscle strength more than placebo ( leg press : CR-B , Δ 36.6 ± 26.6 kg ; CR-A , Δ 40.8 ± 38.4 kg ; PLA , Δ 5.6 ± 35.1 kg ; chest press : CR-B , Δ 15.2 ± 13.0 kg ; CR-A , Δ 15.7 ± 12.5 kg ; PLA , Δ 1.9 ± 14.7 kg ; p < 0.025 ) . Compared with resistance training alone , creatine supplementation improves muscle strength , with greater gains in lean tissue mass result ing from post-exercise creatine supplementation To assess muscle remodeling and functional adaptation to exercise and diet interventions , 26 men and women aged 72 - 98 yr underwent a vastus lateralis biopsy before and after placebo control condition , and progressive resistance training , multinutrient supplementation , or both .  Type II atrophy , Z b and , and myofibril damage were present at baseline . Combined weight lifting and nutritional supplementation increased strength by 257 + /- 62 % ( P = 0.0001 ) and type II fiber area by 10.1 + /- 9.0 % ( P = 0.033 ) , with a similar trend for type I fiber area ( + 12.8 + /- 22.2 % ) . Exercise was associated with a 2 . 5-fold increase in neonatal myosin staining ( P = 0.0009 ) and an increase of 491 + /- 137 % ( P < 0.0001 ) in IGF-I staining . Ultrastructural damage increased by 141 + /- 59 % after exercise training ( P = 0.034 ) . Strength increases were largest in those with the greatest increases in myosin , IGF-I , damage , and caloric intake during the trial . Age-related sarcopenia appears largely confined to type II muscle fibers . Frail elders respond robustly to resistance training with musculoskeletal remodeling , and significant increases in muscle area are possible with resistance training in combination with adequate energy intakes 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 An unexplained loss of muscle strength occurs with aging . Vitamin D deficiency can cause myopathy and administration of 1,25-dihydroxyvitamin D3 [ 1,25-(OH2)D3 ] to persons with low serum concentrations can improve strength . To test the hypothesis that the weakness associated with aging is in part due to inadequate serum concentrations of [ 1,25-(OH2)D3 ] , we conducted a r and omized , controlled , double blinded trial in 98 men and women volunteers over 69 yr old . Treatment consisted of 0.25 micrograms 1,25-(OH)2D3 , orally , twice per day or identical placebo for 6 months .  Leg muscle strength of the quadriceps was measured with an isokinetic dynamometer . There was no difference between the two groups at 1 week , 1 month , or 6 months of treatment in any of the measures of muscle strength . We conclude that oral administration of 0.5 micrograms 1,25-(OH)2D3/day does not improve muscle strength in older persons . Further research is needed to determine the etiology of the decline in muscle strength associated with aging BACKGROUND AND RATIONALE Cancer-related fatigue is a common severe symptom in breast cancer patients , especially during chemotherapy . Exercise appears to be promising in prevention or treatment of fatigue .  Resistance training as an accompanying treatment to chemotherapy has been minimally investigated , yet might counteract muscle degradation and inflammation caused by many chemotherapeutics , and thus forestall or reduce fatigue . Previous exercise trials mostly compared the intervention with ' usual care ' . Therefore , it is unclear to what extent the observed effects on fatigue are based on physical adaptations by exercise itself , or rather on psycho-social factors linked to the group support or attention by the trainer . METHODS AND DESIGN The BEATE study is a r and omized , controlled intervention trial comparing a 12-week supervised progressive resistance training program with a supervised group-based progressive muscle relaxation training in 100 patients with breast cancer under adjuvant chemotherapy .  The primary endpoint is cancer-related fatigue ; secondary endpoints include quality of life , depression , and cognitive capacity . In addition , isokinetic and isometric muscle strength , cardiorespiratory fitness , and body composition are measured , and biomarkers , such as inflammatory parameters , cortisol , and oxidative stress are analyzed in blood , saliva and urine . Safety of the resistance training during chemotherapy is monitored . DISCUSSION Strengths of the BEATE study include the investigation of progressive resistance training parallel with chemotherapy , the choice of a control group that enables an evaluation of the physiological effects of exercise beyond potential psycho-social effects , and the comprehensive and high- quality assessment of physiological factors and biomarkers potentially related to fatigue CONTEXT Testosterone in Older Men with Mobility Limitations Trial determined the effects of testosterone on muscle performance and physical function in older men with mobility limitation . Trial 's Data and Safety Monitoring Board recommended enrollment cessation due to increased frequency of adverse events in testosterone arm . The changes in muscle performance and physical function were evaluated in relation to participant 's perception of change . METHODS Men aged 65 years and older , with mobility limitation , total testosterone 100 - 350 ng/dL , or free testosterone less than 50 pg/mL , were r and omized to placebo or 10 g testosterone gel daily for 6 months . Primary outcome was leg-press strength . Secondary outcomes included chest-press strength , stair-climb , 40-m walk , muscle mass , physical activity , self-reported function , and fatigue . Proportions of participants exceeding minimally important difference in study arms were compared . RESULTS Of 209 r and omized participants , 165 had follow-up efficacy measures . Mean ( SD ) age was 74 ( 5.4 ) years and short physical performance battery score 7.7 ( 1.4 ) .  Testosterone arm exhibited greater improvements in leg-press strength , chest-press strength and power , and loaded stair-climb than placebo . Compared with placebo , significantly greater proportion of men receiving testosterone improved their leg-press and chest-press strengths ( 43 % vs 18 % , p = .01 ) and stair-climbing power ( 28 % vs 10 % , p = .03 ) more than minimally important difference . Increases in leg-press strength and stair-climbing power were associated with changes in testosterone levels and muscle mass . Physical activity , walking speed , self-reported function , and fatigue did not change . CONCLUSIONS Testosterone administration in older men with mobility limitation was associated with patient-important improvements in muscle strength and stair-climbing power . Improvements in muscle strength and only some physical function measures should be weighed against the risk of adverse events in this population Background : Regular exercise has been recommended as a potential strategy to counteract the age-related bone loss experienced by men ; however , the optimal exercise prescription is not known . Objective : To perform a pilot study to examine the osteogenic effect , safety and feasibility of a combined program of upper body resistance exercise and two doses of impact-loading exercise on bone mineral density ( BMD ) of middle-aged and older men . Methods : Forty-two community-dwelling men aged 50 - 74 years were r and omly assigned to either an exercise program of combined upper body resistance exercise and either high-dose impact-loading ( HI ; 80 jumps per session ) or moderate-dose impact-loading ( MOD ; 40 jumps per session ) or a control ( CON ) group . The 9-month intervention involved 4 sessions each week : 2 supervised clinic-based and 2 home-based . BMD of the lumbar spine , femoral neck , total hip , trochanter and whole body as well as lean and fat mass were assessed at baseline and 9 months by dual-energy X-ray absorptiometry . Bone turnover markers , hormone levels , physical function and muscle strength were also assessed . Results : Following 9 months of training , significant differences in BMD among groups were found at the total hip ( p = 0.010 ) and trochanter ( p = 0.047 ) with BMD in the MOD group decreasing relative to the HI group . Although not significant , the HI group consistently preserved BMD , whereas BMD of the MOD and CON groups declined at the hip sites . Mean change for all groups at all skeletal sites was approximately within ±1 % . There was no change in bone turnover markers . There were no adverse events as a result of the intervention ; however , overall attendance for the HI and MOD groups was 53 % ( clinic : 68 % , home : 38 % ) and 65 % ( clinic : 74 % , home : 55 % ) , respectively . Conclusions : This study indicates that while impact-loading exercise can be safely undertaken in middle-aged and older men , the current combined program did not elicit significant improvements in BMD Background : Several studies have been carried out in order to evaluate the potential influence of increased physical activity on the health , biological ageing and functional ability of the elderly . However , only limited information is available on the effects of multicomponent training and detraining on functional performance . Objective : The purpose of the present study was to investigate the effect of 8-month multicomponent training and 3-month detraining on the functional fitness of older women . Methods : Fifty-seven women were r and omly assigned to an exercise ( n = 32 ; 68.4 ± 2.93 years ) or a control group ( n = 25 ; 69.6 ± 4.20 years ) . The training program consisted of 2 sessions per week of aerobic , strength , balance and flexibility exercises . The functional fitness test battery was performed to assess the physical parameters associated with independent functioning in older adults . Results : No significant changes were observed in body mass index and cardiovascular endurance as a result of the exercise training . Training induced significant ( p < 0.05 ) improvements in chair st and ( 27.3 % ) , arm curl ( 17.4 % ) , chair sit- and -reach ( 17.4 % ) , up- and -go ( 11 % ) and back scratch ( 14.5 % ) tests . However , both upper and lower body strength and upper and lower flexibility declined significantly after detraining in the exercise group . Conclusion : The results of this study highlight the negative effects of interrupting exercise on several physical parameters of functional fitness INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity BACKGROUND The effect that supervised or unsupervised exercise training has on aerobic capacity ( peak oxygen consumption [ VO2peak ] ) , muscle strength and quality of life in older women with heart failure remains unknown . OBJECTIVE To examine the effect of six months ( three months supervised followed by three months unsupervised ) of aerobic training ( AT ) or combined aerobic and strength training ( CAST ) on VO2peak , muscle strength and quality of life in older women with heart failure . METHODS Twenty older women ( mean age + /- SD , 72+/-8 years ) with clinical ly stable heart failure were r and omly assigned to AT ( n=10 ) or CAST ( n=10 ) . Supervised AT was performed two days per week at 60 % to 70 % heart rate reserve , whereas unsupervised training was performed two days per week at a rate of perceived exertion of 12 to 14 on the Borg scale . The CAST group also performed one to two sets of low-to-moderate intensity strength training two days per week . RESULTS Supervised AT or CAST result ed in an increase in VO2peak ( 12 % ; P<0.05 ) and leg press strength ( 13 % ; P<0.05 ) that returned to baseline after unsupervised training .  Vertical row strength was greater ( + 23 % ; P<0.05 ) after supervised CAST and remained unchanged after supervised or unsupervised AT . Supervised or unsupervised exercise training was not associated with a significant change in quality of life . CONCLUSIONS Supervised AT or CAST are effective modes of exercise to improve VO2peak and muscle strength in older women with heart failure . However , the improvements in VO2peak and muscle strength are not maintained with unsupervised exercise training OBJECTIVE Our aim was to investigate the feasibility of completing an exercise program in patients with advanced cancer and to obtain preliminary data of its impact on physical and quality of life ( QoL ) outcomes . METHODS We conducted a nonr and omized pilot study . Participants were 26 palliative care patients with advanced cancer ( mean age=54.5 years ; st and ard deviation [ SD ] 8.9 years ) of the outpatient clinic of the medical oncology and the urology departments of a medical center in The Netherl and s. Participants followed an individually grade d group exercise program , consisting of resistance training and aerobic exercise , twice a week during 6 weeks . Feasibility of the training program , muscle strength , aerobic fitness , body composition , QoL , fatigue , and physical role , social , and activities of daily living ( ADL ) functioning were assessed at baseline and immediately after the intervention . RESULTS Dropout rate during the training period was 35 % due to disease progression . After the training period , based on intention to treat analysis , muscle strength and aerobic functional fitness had increased significantly ( p≤0.01 ) . A significant decrease in fat percentage ( p≤0.02 ) was observed . QoL had increased significantly ( p≤0.02 ) , as well as social ( p≤0.04 ) , physical role ( p≤0.01 ) , and ADL functioning ( p≤0.05 ) . Fatigue decreased significantly on the Checklist Individual Strength ( CIS ) and R AND -36 question naires ( p≤0.02 ) , however not on the European Organisation for Research and Treatment of Cancer ( EORTC ) QLQ-C30 ( p=0.48 ) . No change in physical functioning was observed with the EORTC QLQ-C30 and R AND -36 ( respectively , p=0.33 and p=0.09 ) . CONCLUSIONS These preliminary results show that physical exercise in patients with advanced cancer is feasible . A significant impact was observed on physical and QoL outcomes . These findings need to be confirmed with a larger-scale , r and omized controlled trial INTRODUCTION Osteoarthritis ( OA ) is a common degenerative joint disease particularly in older subjects . It is usually associated with pain , restricted range of motion , muscle weakness , difficulties in daily living activities and impaired quality of life . To determine the effects of adding two different intensities of low-level laser therapy ( LLLT ) to exercise training program on pain severity , joint stiffness , physical function , isometric muscle strength , range of motion of the knee , and quality of life in older subjects with knee OA . METHODS Patients were r and omly assigned into three groups . They received 16 sessions , 2 sessions/week for 8 weeks . Group-I : 18 patients were treated with a laser dose of 6 J/cm(2 ) with a total dose of 48 J. Group-II : 18 patients were treated with a laser dose of 3 J/cm(2 ) with a total dose of 27 J. Group-III : 15 patients were treated with laser without emission as a placebo . All patients received same exercise training program including stretching and strengthening exercises . Patients were evaluated before and after intervention by visual analogue scale ( VAS ) , the Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) index for quality of life , h and held dynamometer and universal goniometer . RESULTS T test revealed that there was a significant reduction in VAS and pain intensity , an increase in isometric muscle strength and range of motion of the knee as well as increase in physical functional ability in three treatment groups . Also analysis of variance ( ANOVA ) proved significant differences among them and the post hoc tests ( LSD ) test showed the best improvements for patients of the first group . CONCLUSION It can be concluded that addition of LLLT to exercise training program is more effective than exercise training alone in the treatment of older patients with chronic knee OA and the rate of improvement may be dose dependent , as with 6 J/cm(2 ) or 3 J/cm(2 ) BACKGROUND AND PURPOSE Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments . The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities . A second aim was to analyze whether cognitive function was associated with the applicability of the program . SUBJECTS The subjects were 91 older people ( mean age=85.3 years , SD=6.1 , range=68 - 100 ) who were dependent in personal activities of daily living and r and omly assigned to participate in an exercise intervention .  Their mean score for the Mini-Mental State Examination ( MMSE ) was 17.5 ( SD=5.0 , range=10 - 29 ) . METHODS A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists . There were 29 exercise sessions over 13 weeks . Attendance , intensity of lower-limb strength and balance exercises , and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program . RESULTS The median attendance rate was 76 % .  Lower-limb strength exercises with high intensity were performed in a median of 53 % of the attended exercise sessions , and balance exercises with high intensity were performed in a median of 73 % of the attended exercise sessions . The median rate of sessions with adverse events was 5 % . All except 2 adverse events were assessed as minor and temporary , and none led to manifest injury or disease . No significant differences were observed in applicability when comparing participants with dementia and participants without dementia . In addition , there was no significant correlation between applicability and the MMSE score . DISCUSSION AND CONCLUSION The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use , regardless of cognitive function , among older people who are dependent in activities of daily living , living in residential care facilities , and have an MMSE score of 10 or higher Purpose Loss of skeletal muscle strength is commonly seen with chronic obstructive pulmonary disease ( COPD ) . The study aim was to determine the effects of comprehensive upper-body resistance training ( 8 different lifts ) and a self-efficacy enhancing intervention in COPD with respect to muscle strength , symptoms , functional status and exercise adherence . Methods This r and omized trial had 3 groups : upper-body resistance training with an intervention to enhance self-efficacy ( UBR + SE ) , upper-body resistance training and health education ( UBR + HE ) , gentle chair exercises and health education ( CE + HE ) . Subjects performed 16 weeks of supervised training , then 12 months of long-term maintenance at home . Outcomes were : muscle strength , dyspnea , functional status , self-efficacy , and adherence . Results Sixty-four subjects completed 16 wks of training : age 71 ± 8 yr , fat-free mass index 19 ± 3 kg/m2 , forced expiratory volume in one second 58 ± 18 percent predicted .  The UBR + SE intervention produced a 46 % increase in strength compared to a 36 % increase in the UBR + HE group ( P = 0.054 ) . The combined UBR + SE and UBR + HE groups produced a 41 % increase in strength compared to an 11 % increase in the CE+HE ( P < 0.001 ) . The combined UBR groups also demonstrated increases in lean arm mass ( P = 0.003 ) and a trend toward decreased dyspnea ( P = 0.053 ) . There were no group differences in attrition , attendance and training progression . Fifty subjects completed long-term maintenance and the UBR + SE and UBR + HE groups retained some gains in muscle strength , 24 % and 21 % respectively , and the CE + HE group lost 3 % of muscle strength from baseline . Conclusion The study provides strong evidence that comprehensive resistance training increased strength and lean arm mass and that strength can be partially maintained through a simple home program using h and weights . It provides limited evidence that upper-body resistance training improved dyspnea and that the exercise-specific self-efficacy enhancing intervention was beneficial Muscle adaptations can be induced by high-resistance exercise . Despite being potentially more suitable for older adults , low-resistance exercise protocol s have been less investigated . We compared the effects of high- and low-resistance training on muscle volume , muscle strength , and force-velocity characteristics . Fifty-six older adults were r and omly assigned to 12 weeks of leg press and leg extension training at either HIGH ( 2 × 10 - 15 repetitions at 80 % of one repetition maximum ( 1RM ) ) , LOW ( 1 × 80 - 100 repetitions at 20 % of 1RM ) , or LOW+ ( 1 × 60 repetitions at 20 % of 1RM , followed by 1 × 10 - 20 repetitions at 40 % of 1RM ) . All protocol s ended with muscle failure . Leg press and leg extension of 1RM  were measured at baseline and post intervention and before the first training session in weeks 5 and 9 . At baseline and post intervention , muscle volume ( MV ) was measured by CT-scan . A Biodex dynamometer evaluated knee extensor static peak torque in different knee angles ( PT(stat90 ° ) , PT(stat120 ° ) , PT(stat150 ° ) ) , dynamic peak torque at different speeds ( PT(dyn60 ° s)(-1 ) , PT(dyn180 ° s)(-1 ) , PT(dyn240 ° s)(-1 ) ) , and speed of movement at 20 % ( S20 ) , 40 % ( S40 ) , and 60 % ( S60 ) of PTstat90 ° . HIGH and LOW+ result ed in greater improvements in 1RM strength than LOW ( p<0.05 ) . These differences were already apparent after week 5 . Similar gains were found between groups in MV , PT(stat ) , PT(dyn60 ° s)(-1 ) , and PT(dyn180 ° s)(-1 ) . No changes were reported in speed of movement . HIGH tended to improve PT(dyn240 ° s)(-1 ) more than LOW or LOW+ ( p=0.064 ) . In conclusion , high- and low-resistance exercises ending with muscle failure may be similarly effective for hypertrophy . High-resistance training led to a higher increase in 1RM strength  than low-resistance training ( 20 % of 1RM ) , but this difference disappeared when using a mixed low-resistance protocol in which the resistance was intensified within a single exercise set ( 40 % of 1RM ) . Our findings support the need for more research on  low-resistance programs in older age , in particular long-term training studies and studies focusing on residual effects after training cessation OBJECTIVES This investigation examined the effect of 6 months of high- or low-intensity resistance exercise on muscular strength and endurance and stair climbing ability in adults aged 60 to 83 . DESIGN A r and omized controlled trial . SETTING University of Florida Center for Exercise Science . PARTICIPANTS Sixty-two men and women completed the study protocol . Subjects were matched for strength and r and omly assigned to a control ( n = 16 ) , low-intensity ( LEX , n = 24 ) , or high-intensity ( HEX , n = 22 ) group . INTERVENTION Six months of progressive , whole-body resistance training . Subjects trained at 50 % of their one-repetition maximum ( 1RM ) for 13 repetitions ( LEX ) or 80 % of 1RM for eight repetitions ( HEX ) three times per week for 24 weeks using resistance machines . One set each of 12 exercises was performed . MEASUREMENTS One-repetition maximum was measured for eight different exercises . Muscular endurance was measured using leg press and chest press machines . Low back strength was measured using a lumbar extension machine . Stair climbing ability was assessed as the time to ascend one flight of stairs . RESULTS 1RM significantly increased for all exercises tested for the HEX and LEX groups ( P < or = .050 ) . The increases in total strength ( sum of all eight 1RMs ) were 17.2 % and 17.8 % for the LEX and HEX groups , respectively . Muscular endurance improved by 79.2 % and 105.0 % for the leg press , and 75.5 % and 68.0 % for the chest press for the LEX and HEX groups , respectively . The time to ascend one flight of stairs significantly decreased for both the LEX and HEX groups ( P < or = .050 ) . Lumbar extension strength increased by 62.6 % and 39.5 % for the LEX and HEX groups , respectively . CONCLUSIONS These data indicate that significant and similar improvements in strength , endurance , and stair climbing time can be obtained in older adults as a consequence of high- or low-intensity resistance exercise training . These findings may have an effect on how resistance exercise is prescribed to older adults BACKGROUND & AIM Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient . The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than st and ard care . Secondary outcomes were changes in muscle strength , functional ability and body weight . METHODS 29 acutely admitted old ( > 65 years ) patients were r and omly assigned to the intervention ( n = 14 ) or to st and ard care ( n = 15 ) . The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement ( 18.8 g protein ) and resistance training 3 times per week the 12 weeks following discharge .  Muscle mass was assessed by Dual-energy X-ray Absorptiometry . Muscle strength was assessed by H and Grip Strength and Chair St and Test . Functional ability was assessed by the de Morton Mobility Index , the Functional Recovery Score and the New Mobility Score . Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis . RESULTS The intention-to-treat analysis showed no significant effect of the intervention on lean mass ( unadjusted : β-coefficient = -1.28 P = 0.32 , adjusted for gender : β-coefficient = -0.02 P = 0.99 , adjusted for baseline lean mass : β-coefficient = -0.31 P = 0.80 ) . The de Morton Mobility Index significantly increased in the Control Group ( β-coefficient = -11.43 CI : 0.72 - 22.13 , P = 0.04 ) . No other differences were found . CONCLUSION No significant effect on muscle mass was observed in this group of acutely ill old medical patients . High compliance was achieved with the dietary intervention , but resistance training was challenging . Clinical trials identifier NCT02077491 This study compared the effects of a resistance training protocol and a moderate-impact aerobic training protocol on bone mineral density ( BMD ) , physical ability , serum osteoprotegerin ( OPG ) , and receptor activator of nuclear factor kappa B lig and ( RANKL ) levels .  Seventy-one older women were r and omly assigned to resistance exercise ( RE ) , aerobic exercise ( AE ) or a control group ( CON ) . Both interventions were conducted 3 times per week for 8 months . Outcome measures included proximal femur BMD , muscle strength , balance , body composition , serum OPG , and RANKL levels . Potential confounding variables included dietary intake , accelerometer-based physical activity ( PA ) , and molecularly defined lactase nonpersistence . After 8 months , only RE group exhibited increases in BMD at the trochanter ( 2.9 % ) and total hip ( 1.5 % ) , and improved body composition . Both RE and AE groups improved balance . No significant changes were observed in OPG and RANKL levels , and OPG/RANKL ratio . Lactase nonpersistence was not associated with BMD changes . No group differences were observed in baseline values or change in dietary intakes and daily PA . Data suggest that 8 months of RE may be more effective than AE for inducing favourable changes in BMD and muscle strength , whilst both interventions demonstrate to protect against the functional balance control that is strongly related to fall risk The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer . Relevant studies were identified by entering the following search terms into Pubmed : aerobic training ; resistance training ; stretching ; pediatric ; children ; AND cancer . Reference lists in retrieved manuscripts were also review ed to identify additional trials . We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses . Nine included children with an acute lymphoblastic leukemia ( ALL ) diagnosis , and six children with mixed cancer diagnoses . Generally , interventions tested were either in-hospital supervised exercise training or home based programs design ed to promote physical activity . Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness , improved muscle strength and flexibility , reduced fatigue and improved physical function . Generalizations to the entire childhood cancer and childhood cancer survivor population s are difficult as most of the work has been done in children during treatment for and among survivors of ALL . Additional r and omized studies are needed to confirm these benefits in larger population s of children with ALL , and in population s with cancer diagnoses other than ALL BACKGROUND We compared the effects of two uniquely different lower extremity power training interventions on changes in muscle power , physical performance , neuromuscular activation , and muscle cross sectional area in mobility-limited older adults . METHODS Fifty-two subjects ( 78±5 years , short physical performance battery score : 8.1±1 ) were r and omized to either 16 weeks of progressive high velocity resistance training performed at low external resistance ( 40 % of the 1-repetition maximum [ 1-RM ] [ LO ] ) or high external resistance ( 70 % of 1RM [ HI ] ) . Both groups completed three sets of leg and knee extension exercises at maximum voluntary velocity , two times per  week . Neuromuscular activation was assessed  using surface electromyography and muscle cross sectional area ( CSA ) was measured using computed tomography . RESULTS At 16 weeks , LO and HI exhibited significant and similar within-group increases of leg extensor peak power ( ~34 % vs ~42 % ) , strength ( ~13 % vs ~19 % ) , and SPPB score ( 1.4±0.3 vs 1.8±0.3 units ) , respectively ( all P < .03 ) . Improvements in neuromuscular activation occurred in LO ( P = .03 ) while small gains in mid-thigh muscle CSA were detected in LO ( 1.6 % , P = .35 ) and HI ( 2.1 % , P = .17 ) . No significant between-group differences were evident for any measured parameters ( all P > .25 ) . CONCLUSIONS High velocity resistance training with low external resistance yields similar improvements in muscle power and physical performance compared to training with high external resistance in mobility-limited elders . These findings may have important implication s for optimizing exercise interventions for older adults with mobility limitations Objective : To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity , muscle strength , fat-free mass , and systemic inflammation in patients with chronic obstructive pulmonary disease . Design : A prospect i ve , r and omized , eight-week clinical trial . Setting : The study was conducted in a university-based , outpatient , physical therapy clinic . Subjects : A total of 49 patients with moderate chronic obstructive pulmonary disease . Interventions : Participants were r and omly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks . Main measures : The primary outcome measure was functional exercise capacity . The secondary outcome measures were peripheral muscle strength , health-related quality of life assessed by the Chronic Respiratory Disease Question naire ( CRDQ ) , fat-free mass , and cytokine profile . Results : After eight weeks , the mean distance covered during six minutes increased by 73 meters ( ±69 ) in the elastic tubing group and by 42 meters ( ±59 ) in the conventional group ( p < 0.05 ) . The muscle strength and quality of life improved in both groups ( P < 0.05 ) , with no significant differences between the groups . There was a trend toward an improved fat-free mass in both groups ( P = 0.05 ) . After the first and last sessions , there was an increase in interleukin 1β ( IL-1β ) and interleukin 10 ( IL-10 ) in both groups , while tumour necrosis factor alpha ( TNF-α ) was stimulated only in the conventional training group . Conclusion : Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training . Both interventions were equally effective in improving muscle strength and quality of life This study was design ed to investigate the effects of vibration on muscle performance and mobility in a healthy , untrained , older population . Forty-three participants ( 23 men , 20 women , 66 - 85 y old ) performed tests of sit-to-st and ( STS ) , 5- and 10-m fast walk , timed up- and -go test , stair mobility , and strength . Participants were r and omly assigned to a vibration group , an exercise-withoutvibration group , or a control group . Training consisted of 3 sessions/wk for 2 mo . After training , the vibration and exercise groups showed improved STS ( 12.4 % , 10.2 % ) , 5-m fast walk ( 3.0 % , 3.7 % ) , and knee-extension strength ( 8.1 % , 7.2 % ) compared with the control ( p < 0.05 ) . Even though vibration training improved lower limb strength , it did not appear to have a facilitatory effect on functional-performance tasks compared with the exercise-without-vibration group . Comparable mobility and performance changes between the experimental groups suggest that improvements are linked with greater knee-extension strength and largely attributed to the unloaded squats performed by both exercise groups Osteoarthritis ( OA ) is a common chronic and progressive degenerative joint condition . A major consequence of knee OA is physical disability ; especially difficulty with activities requiring ambulation and transfer , which are necessary to maintain independence and a good quality of life . The purpose s of this study were to determine the efficacy of a muscle exercise program along with education about knee care , and investigate the clinical factors which influence its therapeutic efficacy . A prospect i ve study was carried out among elderly Thai people aged 60 years and over , living in an urban community of the Bangkok metropolitan area around Siriraj Hospital , between October 1997 and September 1999 . The number of elderly people with osteoarthritis of the knee was 392 ( male : female=86:306 ) with a mean age of 67.7+/-6 years . They were interviewed for demographic data and information about their symptoms . The range of the knee movement , quadriceps strength and the six-minute walking distance and a knee X-ray were evaluated . Group exercise was arranged twice a week for 8 weeks for the intervention group only . The results of the study revealed that the quadriceps strength in the intervention group had a tendency to increase and the walking distance was significantly improved especially in the first two months but there was a tendency to decline by the sixth and twelfth month after enrollment . On the other h and , there was no statistically significant difference of both important outcomes for the control group when assessed in the second month . The findings at the sixth and twelfth month after enrollment were that the quadriceps strength was slightly increased but the walking distance was decreased when compared with the initial assessment . An exercise frequency of 12 sessions in two months was sufficient to improve muscle strength and walking distance . Group exercise produces a significant improvement in strength and walking ability , especially in the first two months . Deterioration over time could be due to multiple factors , such as lack of regular exercise , lack of motivation , lack of family support or poor economic status , so we should encourage the elderly to exercise regularly Reduction in muscle mass and physical function depends on a variety of interacting factors : age , physical activity level , nutritional state and the type and impact of disease . The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength , balance , mobility , ambulation and activities of daily living ( ADL ) in institutionalized elderly people aged 65 and over with multiple diagnoses . Baseline assessment s consisted of strength , balance , mobility/ambulation , and ADL .  Twenty-one subjects were included in the intervention program . A control group ( 21 subjects ) was first matched in pairs according to gender , age , ADL and mobility , and then by balance , ambulation and strength . The intervention program was individualized and included strength , mobility , balance and endurance training . Follow-up measures were conducted directly after the intervention and 10 weeks later . After drop-out , 20 subjects in the intervention group and 15 subjects in the control group remained for analyses . Balance and mobility improved significantly in the intervention group while declining in the control group . This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses The effects of 52 weeks resistance training at one of two exercise intensities on thigh muscle strength , fiber cross-sectional area ( CSA ) , and tissue composition were studied in healthy 65 - 79-year-old women . Subjects were assigned to either a control ( CO ) , high-intensity ( HI ) or low-intensity ( LO ) training group . Exercise regimens consisted of three sets of leg press , knee extension , and knee flexion exercises , 3 days/week , at either 80 % of one-repetition maximum ( 1-RM ) for seven repetitions ( HI ) or 40 % of 1-RM for 14 repetitions ( LO ) . Dynamic muscle strength was evaluated by 1-RM , thigh lean tissue mass ( LTM ) , fat mass , and bone mineral density ( BMD , g/cm2 ) by dual energy X-ray absorptiometry , and fiber CSA of vastus lateralis m. by histomorphometry . Muscle strength increased , on average ( + /- SEM ) , by 59.4 + /- 7.9 % and 41.5 + /- 7.9 % for HI and LO , respectively , compared to 1.3 + /- 4.8 % in CO ( P = 0.0001 ) . Type I fiber CSA increased over time ( P < 0.05 ) in both exercise groups , with a trend for increased type II area ( HI , P = 0.06 ; LO , P = 0.11 ) . There was no significant effect of either exercise program on thigh tissue composition , except for BMD at the 1/3 site ( middle third of the femur ) , where LO and CO groups experienced a decline ( P < 0.05 ) of -2.2 + /- 0.5 % and -1.8 + /- 0.6 % , respectively , while HI maintained BMD ( + 1.0 + /- 1.0 % ) . Both training programs produced significant gains in thigh muscle strength , which were associated with fiber hypertrophy , although these did not translate into appreciable alterations in thigh tissue composition The purpose of this study was to investigate the influence of a 6-wk ballistic stretching training program on various parameters of the human gastrocnemius medialis muscle and the Achilles tendon . It is known that ballistic stretching is an appropriate means of increasing the range of motion ( RoM ) , but information in the literature about the mechanical adaptation of the muscle-tendon unit ( MTU ) is scarce . Therefore , in this study , a total of 48 volunteers were r and omly assigned into ballistic stretching and control groups . Before and following the stretching intervention , we determined the maximum dorsiflexion RoM with the corresponding fascicle length and pennation angle . Passive resistive torque ( PRT ) and maximum voluntary contraction ( MVC ) were measured with a dynamometer . Muscle-tendon junction ( MTJ ) displacement allowed us to determine the length changes in tendon and muscle , and hence to calculate stiffness . Mean RoM increased significantly from 33.8 ± 6.3 ° to 37.8 ± 7.2 ° only in the intervention group , but other functional ( PRT , MVC ) and structural ( fascicle length , pennation angle , muscle stiffness , tendon stiffness ) parameters were unaltered . Thus the increased RoM could not be explained by structural changes in the MTU and was likely due to increased stretch tolerance We compared the effects of two resistance training ( RT ) programs only differing in the repetition velocity loss allowed in each set : 20 % ( VL20 ) vs 40 % ( VL40 ) on muscle structural and functional adaptations . Twenty-two young males were r and omly assigned to a VL20 ( n = 12 ) or VL40 ( n = 10 ) group . Subjects followed an 8-week velocity-based RT program using the squat exercise while monitoring repetition velocity . Pre- and post-training assessment s included : magnetic resonance imaging , vastus lateralis biopsies for muscle cross-sectional area ( CSA ) and fiber type analyses , one-repetition maximum strength and full load-velocity squat profile , countermovement jump ( CMJ ) , and 20-m sprint running . VL20 result ed in similar squat strength gains than VL40 and greater improvements in CMJ ( 9.5 % vs 3.5 % , P < 0.05 ) , despite VL20 performing 40 % fewer repetitions . Although both groups increased mean fiber CSA and whole quadriceps muscle volume , VL40 training elicited a greater hypertrophy of vastus lateralis and intermedius than VL20 . Training result ed in a reduction of myosin heavy chain IIX percentage in VL40 , whereas it was preserved in VL20 . In conclusion , the progressive accumulation of muscle fatigue as indicated by a more pronounced repetition velocity loss appears as an important variable in the configuration of the resistance exercise stimulus as it influences functional and structural neuromuscular adaptations PURPOSE Determine the independent and combined effects of progressive resistance muscle strength training ( PRMST ) and testosterone on strength , muscle mass , and function in hypogonadal elderly male recuperative care patients . METHODS Between 1999 and 2004 , 71 subjects ( mean age 78.2 + /- 6.4 yr , 86 % white ) were enrolled . After baseline one-repetition maximum ( 1RM ) strength testing and then r and omization to one of four treatment groups ( low-resistance ( 20 % of the 1RM ) exercises and weekly injections of either 100 mg of testosterone enanthate or placebo or high-intensity PRMST ( > or = 80 % 1RM ) and weekly injections ) , each subject received training and injections for 12 wk . RESULTS Ten subjects withdrew from the study before its completion . Based on intent-to-treat analyses , strength improved in all groups , but was greater with high-intensity PRMST compared with low-resistance exercise ( e.g. , leg press , ( mean + /- SE ) , 28 + /- 4 vs 13 + /- 4 % , P = 0.009 ) . Although testosterone led to significantly greater increases in midthigh cross-sectional muscle area compared with placebo ( 7.9 + /- 1.3 vs 2.4 + /- 1.4 % , P = 0.005 ) , it produced only a nonsignificant trend toward greater strength gains ( e.g. , leg press 25 + /- 4 vs 16 + /- 4 % , P = 0.144 ) . Change in aggregate functional performance score ( the sum of 4 functional performance test scores ) did not differ between the four intervention groups nor with high-intensity PRMST compared with low-resistance exercise ( 7 + /- 5 vs 15 + /- 5 % , P = 0.263 ) . There was not a significant interaction between exercise and testosterone for any outcome . CONCLUSION High-intensity PRMST is as safe and well tolerated as a similarly structured low-resistance exercise regimen for very frail elderly patients , but produces greater muscle strength improvements . The addition of testosterone leads to greater muscle size and a trend toward greater strength but did not produce a synergistic interaction with exercise . Neither intervention had a significant effect on functional performance Objective . Arthritis and its associated joint pain act as significant barriers for adults attempting to perform l and -based physical activity . Swimming can be an ideal form of exercise for patients with arthritis . Yet there is no information on the efficacy of regular swimming exercise involving patients with arthritis . The effect of a swimming exercise intervention on joint pain , stiffness , and physical function was evaluated in patients with osteoarthritis ( OA ) . Methods . Using a r and omized study design , 48 sedentary middle-aged and older adults with OA underwent 3 months of either swimming or cycling exercise training . Supervised exercise training was performed for 45 min/day , 3 days/week at 60–70 % heart rate reserve for 12 weeks . The Western Ontario and McMaster Universities Arthritis Index was used to measure joint pain , stiffness , and physical limitation . Results . After the exercise interventions , there were significant reductions in joint pain , stiffness , and physical limitation accompanied by increases in quality of life in both groups ( all p < 0.05 ) . Functional capacity as assessed by maximal h and grip strength , isokinetic knee extension and flexion power ( 15–30 % increases ) , and the distance covered in the 6-min walk test increased ( all p < 0.05 ) in both exercise groups . No differences were observed in the magnitude of improvements between swimming and cycling training . Conclusion . Regular swimming exercise reduced joint pain and stiffness associated with OA and improved muscle strength and functional capacity in middle-aged and older adults with OA . Additionally , the benefits of swimming exercise were similar to the more frequently prescribed l and -based cycling training . Trial registration : clinical trials.gov NCT01836380 Background evidence on the effectiveness of interventions to prevent frailty is scarce . Objective to assess the effect of an intervention in preventing frailty progression in pre-frail older people . Study design a r and omised , open label , controlled trial with two parallel arms . Population community-dwelling pre-frail older people ( ≥70 years ) consulting in primary care .  Intervention nutritional assessment ( and derivation to a Nutritional Unit for usual care in the event of nutritional risk ) and a physical activity programme including aerobic exercise and a set of mixed strengthening , balance and coordination exercises .  Control group patients receiving the usual care . Main outcome measure prevalence of frailty ( Fried criteria ) at 12 months . Secondary outcomes measures functional capacity ( Barthel index ) , falls and nutritional status ( Short-Form Mini Nutritional Assessment ) on follow-up at 12 months . Results one hundred and seventy-two participants were recruited and r and omised ( mean age : 78.3 years ; mean number of Fried criteria : 1.45 ) . Thirty-nine participants ( 22.6 % ) were dropped out during the study . At follow-up , 4.9 % of the intervention group and 15.3 % of the control group had evolved to frailty , for a crude odds ratio ( OR ) of 0.29 ( 95 % confidence interval [ CI ] : 0.08 - 1.08 ; P = 0.052 ) and an adjusted ( by age , gender and number of co-morbidities ) OR of 0.19 ( 95 % CI : 0.04 - 0.95 ; P = 0.044 ) . Intervention group showed a higher outdoors walking hour per day ( 0.97 versus 0.73 ; P = 0.019 ) but no difference was observed in muscle strength , gait speed or other functional indicators . Conclusion an intervention focused on physical exercise and maintaining good nutritional status may be effective in preventing frailty in community-dwelling pre-frail older individuals . Clinical Trials.gov identifier NCT02138968 PURPOSE An open , r and omized , controlled study was design ed to study the effects of exclusive strength training ( ST ) in patients with severe chronic heart failure ( CHF ) in comparison with conventional endurance ( ET ) and combined ET-ST training ( CT ) . The hypothesis was that ST would at least be equal to ET or CT , because peripheral muscle atrophy and weakness play a key role in exercise limitation in CHF patients . METHODS Three groups of 15 patients underwent ST , ET , or CT during 40 sessions , three times a week , for 45 min . Fifteen patients served as control group . Before and after intervention , left ventricular ejection fraction ( LVEF ) , peak oxygen consumption ( VO2peak ) , peak workload , thigh muscle volume , knee extensor strength , endurance , and quality of life ( QoL ) were assessed . RESULTS All measured parameters improved significantly in the three training groups , except for knee extensor strength in ET . Training outcome was superior in all three training groups compared with the control group , but statistical significance was only reached for VO2peak and peak workload , thigh muscle volume , and knee extensor endurance . In contrast , knee extensor strength , LVEF , and QoL did not reach statistical significance . None of the training modalities proved to be superior to any other , although small differences between the three groups were observed . CONCLUSION Independently of the training modality , intensive exercise training is efficient in increasing cardiac function , exercise capacity , peripheral muscle function , and QoL in CHF patients Background Evidence supports the use of educational and physical training programs for people with rheumatoid arthritis ( RA ) . Objective The purpose of this study was to evaluate the effects of a group-based exercise and educational program on the physical performance and disease self-management of people with RA . Design This was a r and omized controlled trial . Setting The study was conducted at a rehabilitation center in the Netherl and s. Participants Thirty-four people diagnosed with RA participated in the study . Participants were r and omly assigned to either an intervention group ( n=19 ) or a waiting list control group ( n=15 ) . Intervention The intervention in this study was an 8-week , multidisciplinary , group therapy program for people with RA , consisting of physical exercise design ed to increase aerobic capacity and muscle strength ( force-generating capacity ) together with an educational program to improve health status and self-efficacy for disease-self-management . Measurements The main outcome measures were maximum oxygen uptake ( V̇o2max ) , muscle strength of the elbow and knee flexors and extensors , health status , and perceived self-efficacy . All data were recorded before intervention in week 1 , after intervention in week 9 , and at follow-up in week 22 . Results The intervention group showed significant improvement ( 12.1 % ) in V̇o2max at week 9 compared with the control group ( −1.7 % ) . Although significant within-group changes were found over time for muscle strength of the upper and lower extremities and health status that favored the intervention group , no between-group changes were found regarding these outcomes . Limitations An important limitation was the small number of participants included in our study , which may have result ed in a lack of power . Conclusions The present group-based exercise and educational program for people with RA had a beneficial effect on aerobic capacity but not on muscle strength , health status , or self-efficacy OBJECTIVE To determine the effects of resistance training on muscular strength , body composition ( percent fat and lean tissue mass ) , and program adherence in active women over 60 years of age . DESIGN This study was design ed as a stratified , r and omized , non-blinded trial . Subjects were stratified into rank-ordered pairs by level of physical activity according to the Blair Seven-Day Recall , then r and omly assigned into either a weight-training ( WT , n = 18 ) or control ( CON , n = 18 ) group . PARTICIPANTS AND SETTING Thirty-six women over the age of 60 ( 67.1 + /- 1.5 , chi + /- SE ) were recruited from the San Diego community . All subjects had to be engaging in some form of aerobic exercise  at least 3 days each week for a minimum of 6 months . MEASUREMENTS AND INTERVENTION : Subjects engaged in isotonic training 3 days/week on Polaris machines at a target intensity of 80 % of the 1 repetition maximum ( 1 RM ) for three sets of seven exercises selected to train major muscle groups of the trunk and upper and lower body . The 1 RM was re-tested every 6 weeks in WT and the workload adjusted to maintain target intensity . The 1 RM was tested at 0 , 12 , and 24 weeks in CON . Body fatness and lean tissue mass , excluding skeletal mass , were assessed at 0 and 24 weeks by dual energy radiography using a total body scan . RESULTS Increases in muscle strength of the weight trainers were significant for all seven exercises ( 5%-65 % ) , with the greatest gains in the shoulder and trunk muscles . Percent body fat of weight trainers decreased significantly ( from 38.8 % to 37.9 % , P < 0.05 ) , while lean tissue mass increased by 1.5 kg ( P < 0.01 ) . No changes in body composition were observed in control subjects . Overall program adherence was 83 % ( 15 weight trainers and 15 control women completed the study ) . Monthly attendance averaged 86.8 + /- 3.3 % , with no incidence of injury during the training sessions . CONCLUSIONS These data indicate that heavy-resistance weight training is safe and enjoyable for older women and that meaningful gains in muscular strength and body composition can be made even in women who are already highly active Muscle strength changes following multi-level surgery in cerebral palsy and the impact of rehabilitation on functional recovery are largely unknown . The aim of this study was to quantify lower limb muscle strength changes in children with spastic diplegia after multi-level orthopaedic surgery  and to compare the efficacy of progressive resistance strengthening ( RS ) versus active exercise ( AE ) .  Twenty children with spastic diplegia ( mean age 12.5 years ) participated in this prospect i ve r and omised controlled trial . Participants underwent multi-level orthopaedic surgery . Routine physiotherapy commenced immediately after surgery . At 6 months post-operatively , children were r and omly assigned to the resistance strengthening RS ( n=11 ) or active exercise AE ( n=9 ) group and received intensive physiotherapy for 6 weeks . Gait , motor function and maximum isometric muscle strength in five lower limb muscle groups were measured pre-operatively and at 6 months ( before and after intensive physiotherapy ) and 12 months . As part of the study , we developed and vali date d a myometry protocol . Despite kinematic improvements , there was significant reduction of muscle strength ( p<0.05 ) in all muscle groups at 6 months post-operatively . Following 6 weeks of intensive physiotherapy , both groups showed significant improvement in muscle strength , GMFM scores and gait parameters . Resistance training showed some advantages over active exercise . At 1 year after surgery , strength did not reach pre-operative values in some muscle groups but the benefit from physiotherapy was maintained . In conclusion , we quantified objective ly the reduction in muscle strength 6 and 12 months following multi-level surgery . Furthermore , we demonstrated significant improvement in muscle strength , gait and function following post-operative strength training OBJECTIVES To examine the association between strength , function , lean mass , muscle density , and risk of hospitalization . DESIGN Prospect i ve cohort study . SETTING Two U.S. clinical centers . PARTICIPANTS Adults aged 70 to 80 ( N=3,011 ) from the Health , Aging and Body Composition Study . MEASUREMENTS Measurements were of  grip strength , knee extension strength , lean mass , walking speed , and chair st and pace . Thigh computed tomography scans assessed muscle area and density ( a proxy for muscle fat infiltration ) . Hospitalizations were confirmed by local review of medical records . Negative binomial regression models estimated incident rate ratios ( IRRs ) of hospitalization for race- and sex-specific quartiles of each muscle and function parameter separately . Multivariate models adjusted for age , body mass index , health status , and coexisting medical conditions . RESULTS During an average 4.7 years of follow-up , 1,678 ( 55.7 % ) participants experienced one or more hospitalizations . Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized ( multivariate IRR=1.47 , 95 % confidence interval (CI)=1.24 - 1.73 ) than those in the highest quartile . Similarly , participants with the weakest grip strength were at greater risk of hospitalization ( multivariate IRR=1.52 , 95 % CI=1.30 - 1.78 , Q1 vs. Q4 ) . Comparable results were seen for knee strength , walking pace , and chair st and s pace . Lean mass and muscle area were not associated with risk of hospitalization . CONCLUSION Weak strength , poor function , and low muscle density , but not muscle size or lean mass , were associated with greater risk of hospitalization . Interventions to reduce the disease burden associated with sarcopenia should focus on increasing muscle strength and improving physical function rather than simply increasing lean mass The plasma levels of dehydroepi and rosterone ( DHEA ) and its sulfated form ( DHEAS ) decline approximately 80 % between the ages of 25 and 75 yr . Muscle mass and strength also decrease with aging . Published data on the effects of DHEA replacement on muscle mass and strength are conflicting . The goals of this study were to determine whether DHEA replacement increases muscle mass and strength and /or enhances the effects of heavy resistance exercise in elderly women and men . We conducted a r and omized , double-blind , placebo-controlled study of the effects of 10 mo of DHEA replacement therapy with the addition of weightlifting exercise training during the last 4 mo of the study  ( DHEA + exercise group , n = 29 ; placebo + exercise group , n = 27 ) .  DHEA alone for 6 mo did not significantly increase strength or thigh muscle volume . However , DHEA therapy potentiated the effect of 4 mo of weightlifting training on muscle strength , evaluated by means of one-repetition maximum measurement and Cybex dynamometry , and on thigh muscle volume , measured by magnetic resonance imaging . Serum insulin-like growth factor concentration increased in response to DHEA replacement . This study provides evidence that DHEA replacement has the beneficial effect of enhancing the increases in muscle mass and strength induced by heavy resistance exercise in elderly individuals Background Inspiratory and peripheral muscle training improves muscle strength , exercise tolerance , and quality of life in patients with chronic heart failure ( HF ) . However , studies investigating different workloads for these exercise modalities are still lacking . Objective To examine the effects of low and moderate intensities on muscle strength , functional capacity , and quality of life . Design A r and omized controlled trial . Methods Thirty-five patients with stable HF ( aged > 18 years , NYHA II/III , LVEF < 40 % ) were r and omized to : non-exercise control group  ( n = 9 ) , low-intensity training group ( LIPRT , n = 13 , 15 % maximal inspiratory workload , and 0.5 kg of peripheral muscle workload ) or moderate-intensity training group ( MIPRT , n = 13 , 30 % maximal inspiratory workload and 50 % of one maximum repetition of peripheral muscle workload ) . The outcomes were : respiratory and peripheral muscle strength , pulmonary function , exercise tolerance by the 6-minute walk test , symptoms based on the NYHA functional class , and quality of life using the Minnesota Living with Heart Failure Question naire . Results All groups showed similar quality -of-life improvements . Low and moderate intensities training programs improved inspiratory muscle strength , peripheral muscle strength , and walking distance . However , only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients . Conclusions The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance , demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients . In addition , the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients OBJECTIVE To evaluate the effects of progressive resistance training on muscle strength , muscle tone , gait performance and perceived participation after stroke . DESIGN A r and omized controlled trial . SUBJECTS Twenty-four subjects ( mean age 61 years ( st and ard deviation 5 ) ) 6 - 48 months post-stroke . METHODS The training group ( n = 15 ) participated in supervised progressive resistance training of the knee muscles ( 80 % of maximum ) twice weekly for 10 weeks , and the control group ( n = 9 ) continued their usual daily activities . Both groups were assessed before and after the intervention and at follow-up after 5 months . Muscle strength was evaluated dynamically and isokinetically ( 60 degrees /sec ) and muscle tone by the Modified Ashworth Scale . Gait performance was evaluated by Timed " Up & Go " , Fast Gait Speed and 6-Minute Walk tests , and perceived participation by Stroke Impact Scale . RESULTS Muscle strength increased significantly after progressive resistance training with no increase in muscle tone and improvements were maintained at follow-up . Both groups improved in gait performance , but at follow-up only Timed " Up & Go " and perceived participation were significantly better for the training group . CONCLUSIONS Progressive resistance training is an effective intervention to improve muscle strength in chronic stroke . There appear to be long-term benefits , but further studies are needed to clarify the effects , specifically of progressive resistance training on gait performance and participation 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 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 Background : The lower limb muscle strength is an important determinant of physical function in older people . However , measurement in clinical and epidemiological setting s has been limited because of the requirement for large-scale equipment . A protocol using a novel , versatile h and -held dynamometer ( HHD ) has been developed to measure the quadriceps strength in a supine position . Objective : The objective of this study was to assess the validity of this new methodology for measuring the lower limb muscle strength compared to the gold st and ard Biodex dynamometer . Methods : The supine quadriceps strength was measured twice with each of the Biodex and the HHD  in 20 men and women , aged 61–81 years , on their non-dominant leg . The agreement between the peak torques obtained by Biodex and HHD was analyzed . Results : The mean peak Biodex and HHD results were 83.4 ± ( SD ) 28.0 Nm and 68.9 ± 19.6 Nm , respectively . The HHD undermeasured the quadriceps strength by an average of 14.5 Nm ( 95 % CI 8.5 , 20.6 ) compared to the Biodex , and this effect was most marked in the strongest participants . Nevertheless , there was a good correlation between the measures ( r = 0.91 , p < 0.0001 ) . Classification of individuals into tertiles of muscle strength showed good agreement between the two methods ( Kappa = 0.69 , p < 0.0001 ) . Conclusions : Our findings suggest that the HHD using a supine positioning offers a feasible , inexpensive , and portable test of quadriceps muscle strength for use in healthy older people . It underestimates the absolute quadriceps strength compared to the Biodex particularly in stronger people , but is a useful tool for ranking muscle strength of older people in epidemiological studies . It may also be of value for quick and objective assessment of physical function in the clinical setting Knee osteoarthritis ( OA ) is associated with quadriceps atrophy and weakness , so muscle strengthening is an important point in the rehabilitation process . Since pain and joint stiffness make it often difficult to use conventional strength exercises , neuromuscular electrical stimulation ( NMES ) may be an alternative approach for these patients . This study was aim ed at ( 1 ) identifying the associations of knee OA with quadriceps muscle architecture and strength , and ( 2 ) quantifying the effects of a NMES training program on these parameters . In phase 1 , 20 women with knee OA were compared with 10 healthy female , asymptomatic , age-matched control subjects . In phase 2 , 12 OA patients performed an 8-week NMES strength training program . OA patients presented smaller vastus lateralis thickness ( 11.9 mm ) and fascicle length ( 20.5 % ) than healthy subjects ( 14.1 mm ; 24.5 % ) , and also had a 23 % smaller knee extensor torque compared to the control group . NMES training increased vastus lateralis thickness ( from 12.6 to 14.2 mm ) and fascicle length ( from 19.6 % to 24.6 % ) . Additionally , NMES training increased the knee extensor torque by 8 % and reduced joint pain , stiffness , and functional limitation . In conclusion , OA patients have decreased strength , muscle thickness , and fascicle length in the knee extensor musculature compared to control subjects . NMES training appears to offset the changes in quadriceps structure and function , as well as improve the health status in patients with knee OA OBJECTIVE To examine whether improvements in glycemic control and body composition result ing from 6 months of supervised high-intensity progressive resistance training could be maintained after an additional 6 months of home-based resistance training . RESEARCH DESIGN AND METHODS We performed a 12-month r and omized controlled trial in 36 sedentary , overweight men and women with type 2 diabetes ( aged 60 - 80 years ) who were r and omly assigned to moderate weight loss plus high-intensity progressive resistance training ( RT&WL group ) or moderate weight loss plus a control program ( WL group ) . Supervised gymnasium-based training for 6 months was followed by an additional 6 months of home-based training .  Glycemic control ( HbA1c ) , body composition , muscle strength , and metabolic syndrome abnormalities were assessed at 0 , 3 , 6 , 9 , and 12 months . RESULTS Compared with the WL group , HbA1c decreased significantly more in the RT&WL group ( -0.8 % ) during 6 months of supervised gymnasium-based training ; however , this effect was not maintained after an additional 6 months of home-based training . In contrast , the greater increase in lean body mass ( LBM ) observed in the RT&WL group compared with the WL group ( 0.9 kg , P < 0.05 ) after the gymnasium-based training tended to be maintained after the home-based training ( 0.8 kg , P = 0.08 ) . Similarly , the gymnasium-based increases in upper body and lower body muscle strength in the RT&WL group were maintained over the 12 months ( P < 0.001 ) . There were no between-group differences for changes in body weight , fat mass , fasting glucose , or insulin at 6 or 12 months . CONCLUSIONS In older adults with type 2 diabetes , home-based progressive resistance training was effective for maintaining the gymnasium-based improvements in muscle strength and LBM but not glycemic control . Reductions in adherence and exercise training volume and intensity seem to impede the effectiveness of home-based training for maintaining improved glycemic control BACKGROUND The performance of daily tasks , such as stair climbing or lifting an object , requires both muscle strength and power . Age-associated reductions in strength and power can affect an older adult 's ability to complete daily tasks such as stair climbing and lifting a child . METHODS The purpose s of this study were to determine whether power training was more efficacious than strength training for improving whole-body physical function in older adults and to examine the relationship between changes in anaerobic power and muscle strength and changes in physical function . Thirty-nine men and women ( mean age + /- SD = 72.5 + /- 6.3 years ) with below-average leg extensor power were r and omly assigned to control ( C , n = 15 ) , strength-training ( ST , n = 13 ) or power-training ( PT , n = 11 ) groups . The ST and PT groups met 3 days per week for 16 weeks ; the C group maintained usual activity and attended three lectures during the course of the study . Primary outcome measures included the Continuous Scale Physical Functional Performance test , maximal strength , and anaerobic power . RESULTS After baseline was controlled for , the Continuous Scale Physical Functional Performance test total score was significantly greater for the PT group than for the ST ( p = .033 ) and C ( p = .016 ) groups . Maximal strength was significantly greater for the ST group than for the C group ( p = .015 ) after the intervention . There was no significant difference between groups for peak anaerobic power . CONCLUSIONS Power training was more effective than strength training for improving physical function in community-dwelling older adults Background Acute decompensated heart failure ( ADHF ) is a leading cause of hospitalization in older persons in the United States . Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF . However , these are not addressed by current heart failure ( HF ) management strategies and there has been little study of exercise training in older , frail HF patients with recent ADHF . Hypothesis Targeting physical frailty with a multi‐domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization . Study design REHAB‐HF is a multi‐center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be r and omized either to a novel 12‐week multi‐domain physical rehabilitation intervention or to attention control . The goal of the intervention is to improve balance , mobility , strength and endurance utilizing reproducible , targeted exercises administered by a multi‐disciplinary team with specific milestones for progression . The primary study aim is to assess the efficacy of the REHAB‐HF intervention on physical function measured by total Short Physical Performance Battery score . The secondary outcome is 6‐month all‐cause rehospitalization . Additional outcome measures include quality of life and costs . Conclusions REHAB‐HF is the first r and omized trial of a physical function intervention in older patients with hospitalized ADHF design ed to determine if addressing deficits in balance , mobility , strength and endurance improves physical function and reduces rehospitalizations . It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients , those with ADHF , frailty , and multiple comorbidities Background : Previous studies in diverse ethnic groups have reported that progressive resistance training is effective for glycemic control . However , it is unknown whether this form of exercise therapy leads to clinical ly meaningful changes in metabolic , cardiovascular and anthropometric parameters in Asian Indians . Aim : The study was design ed to investigate the efficacy of progressive resistance training on glycemic , musculoskeletal , anthropometric and cardiovascular variables in untrained middle-aged type 2 diabetic patients living in North India . Material s and Methods : Forty-eight untrained patients , 35 men and 13 women ( mean ± SD age , 44.7 ± 4.2 years ) , with a diagnosis of type 2 diabetes were r and omly divided into 2 groups : A group receiving progressive resistance training and a control group who provided participative involvement . The primary outcomes were glycemic control and muscle strength . Additionally , anthropometric and cardiovascular risk parameters were evaluated at baseline and after intervention or control program at 8 weeks . Results : Mixed ANOVA revealed a significant group-by-time interaction for the main outcomes of the study . Change in glycosylated hemoglobin was mean ± SD , 0.6 ± 0.5 in progressive resistance training group compared to no change in control group ( P < .001 ) . Progressive resistance training group showed a greater improvement in upper and lower body muscle strength ( P < .001 ) , waist circumference ( P = .008 ) , and high density lipoprotein cholesterol ( P = .004 ) . However , no significant group-by-time interaction was detected on body weight , total cholesterol , triglycerides , low density lipoprotein cholesterol , and systolic and diastolic blood pressure . Conclusions : A short-term progressive resistance training program leads to clinical ly meaningful improvements in glycemic control and muscle strength in untrained middle-aged type 2 diabetic patients of Asian Indian ethnicity While exercise is generally recommended for older adults , the specific role of exercise in preventing falls and frail health is unclear . The Seattle FICSIT/MoveIt study is a population -based , r and omized , controlled trial comparing the effects of three 6-month exercise interventions ( endurance training , strength training , or combined endurance and strength training ) , and three 3-month endurance training interventions ( stationary cycle , walking , or aerobic movement ) . Primary study outcomes are aerobic capacity , strength , gait , balance , and physical functional status . The study enrolls adults age 68 - 85 who have leg weakness and impaired gait . It differs from most previous community-based exercise studies in several respects : recruitment of subjects from a defined population ; eligibility criteria based upon physiologic and functional status deficits ; r and om assignment to exercise groups ; assessment of both physiologic and functional status outcomes ; follow-up beyond the completion of supervised exercise ; and a large sample size ( Total N = 180 ) OBJECTIVES To determine whether a functional-task exercise program and a resistance exercise program have different effects on the ability of community-living older people to perform daily tasks . DESIGN A r and omized , controlled , single-blind trial . SETTING Community leisure center in Utrecht , the Netherl and s. PARTICIPANTS Ninety-eight healthy women aged 70 and older were r and omly assigned to the functional-task exercise program ( function group , n=33 ) , a resistance exercise program ( resistance group , n=34 ) , or a control group ( n=31 ) . Participants attended exercise classes three times a week for 12 weeks . MEASUREMENTS Functional task performance ( Assessment of Daily Activity Performance ( ADAP ) ) , isometric knee extensor strength ( IKES ) , h and grip strength , isometric elbow flexor strength ( IEFS ) , and leg extension power were measured at baseline , at the end of training ( at 3 months ) , and 6 months after the end of training ( at 9 months ) . RESULTS The ADAP total score of the function group ( mean change 6.8 , 95 % confidence interval (CI)=5.2 - 8.4 ) increased significantly more than that of the resistance group ( 3.2 , 95 % CI=1.3 - 5.0 ; P=.007 ) or the control group ( 0.3 , 95 % CI=-1.3 - 1.9 ; P<.001 ) . Moreover , the ADAP total score of the resistance group did not change significantly compared with that of the control group . In contrast , IKES and IEFS increased significantly in the resistance group ( 12.5 % , 95 % CI=3.8 - 21.3 and 8.6 % , 95 % CI=3.1 - 14.1 , respectively ) compared with the function group ( -2.1 % , 95 % CI=-5.4 - 1.3 ; P=.003 and 0.3 % , 95 % CI=-3.6 - 4.2 ; P=.03 , respectively ) and the control group ( -2.7 % , 95 % CI=-8.6 - 3.2 , P=.003 and 0.6 % , 95 % CI=-3.4 - 4.6 ; P=.04 , respectively ) . Six months after the end of training , the increase in ADAP scores was sustained in the function group ( P=.002 ) . CONCLUSION Functional-task exercises are more effective than resistance exercises at improving functional task performance in healthy elderly women and may have an important role in helping them maintain an independent lifestyle Background : Strength training has been shown to benefit the health and function of older adults . Objective : To investigate whether one set of exercises performed once a week was as effective in increasing muscle strength as training twice a week . Methods : 18 subjects ( 7 women and 11 men ) aged 65–79 years were r and omly assigned to two groups . Both groups performed one set of exercises to muscular fatigue ; group 1 trained 1 day/week and group 2 trained 2 days/week on three lower and three upper body exercises for 9 weeks . The data were analysed using a mixed model 2 × 2 analysis of variance . Results : A significant main effect of time ( p<0.001 ) , but not group , on one-repetition maximum scores was observed . No significant interaction was observed between time and group and therefore no difference in strength changes between training once a week versus twice a week after 9 weeks . Conclusions : One set of exercises performed once weekly to muscle fatigue improved strength as well as twice a week in the older adult . Our results provide information that will assist in design ing strength-training programmes that are more time and cost efficient in producing health and fitness benefits for older adults OBJECTIVES To examine the effect of grade d doses of testosterone on physical function and muscle performance in healthy , older men . DESIGN R and omized , double-blind , placebo-controlled clinical trial . SETTING General clinical research center . PARTICIPANTS Community-dwelling healthy men aged 60 to 75 ( N=44 ) . INTERVENTION Monthly treatment with a gonadotropin-releasing hormone agonist plus 25 , 50 , 125 , or 300 mg/wk of intramuscular injections of testosterone enanthate for 20 weeks . MEASUREMENTS Skeletal muscle mass ( SMM ) was estimated using dual-energy X-ray absorptiometry . Leg press strength was measured by one repetition maximum , leg power by Nottingham Leg Rig , and muscle fatigability by repetitions to failure in the leg press exercise .  Stair climbing , 6-meter and 400-meter walking speed , and a timed-up- and -go ( TUG ) test were used to assess physical function . RESULTS Significant testosterone dose- and concentration-dependent increases were observed in SMM ( P<.001 ) and maximal strength ( P=.001 ) but not muscle fatigability . Leg power also increased dose-dependently ( P=.048 ) . In contrast , changes in self-selected normal and fast walking speed over 6 or 400 meters , stair climbing power , and time for the TUG were not significantly related to testosterone dose , testosterone concentrations , or changes in muscle strength or power , or SMM . CONCLUSION Testosterone administration was associated with dose-dependent increases in SMM , leg strength , and power but did not improve muscle fatigability or physical function . The observation that physical function scores did not improve linearly with strength suggests that these high-functioning older men were already in the asymptotic region of the curve describing the relationship between physical function and strength Objective Long-term studies regarding the effect of a structured physical exercise programme ( SPEP )  during haemodialysis ( HD ) assessing compliance and clinical benefit are scarce . Study design A single-centre clinical trial , non-r and omised , investigating 46 patients with HD ( 63.2±16.3 years , male/female 24/22 , dialysis vintage 4.4 years ) performing an SPEP over 5 years . The SPEP ( twice/week for 60 min during haemodialysis ) consisted of a combined resistance ( 8 muscle groups ) and endurance ( supine bicycle ergometry ) training . Exercise intensity was continuously adjusted to improvements of performance testing . Changes in endurance and resistance capacity , physical functioning and quality of life ( QoL ) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years . Average power per training session , maximal strength tests ( maximal exercise repetitions/min ) , three performance-based tests for physical function , SF36 for QoL were assessed in the beginning and every 6 months thereafter . Results 78 % of the patients completed the programme after 1 year and 43 % after 5 years . Participants were divided — according to adherence to the programme — into three groups : ( 1 ) high adherence group ( HA , > 80 % of 104 training sessions within 12 months ) , ( 2 ) moderate adherence ( MA , 60–80 % ) , and 3 . Low adherence group ( LA , < 60 % ) ) with HA and MA evaluated quantitatively . One-year follow-up data revealed significant ( p<0.05 ) improvement for both groups in all measured parameters : exercise capacity ( HA : 55 % , MA : 45 % ) , strength ( HA : > 120 % , MA : 40–50 % ) , QoL in three scores of SF36 subscales and physical function in the three tests taken between 11 % and 31 % . Moreover , a quantitative correlation analysis revealed a close association ( r=0.8 ) between large improvement of endurance capacity and weak physical condition ( HA ) . Conclusions The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence BACKGROUND In patients with intermittent claudication , a supervised walking exercise program increases peak exercise performance and community-based functional status .  Patients with peripheral arterial disease also have muscle weakness in the affected extremity that may contribute to the walking impairment . However , the potential benefits of training modalities other than walking exercise , such as strength training , have not been critically evaluated in this patient population . The present study tested the hypothesis that a strength training program would be as effective as treadmill walking exercise and that combinations of strengthening and walking exercise would be more effective than either alone in improving exercise performance . METHODS AND RESULTS Twenty-nine patients with disabling claudication were r and omized to 12 weeks of supervised walking exercise on a treadmill ( 3 h/wk at a work intensity sufficient to produce claudication ) , strength training ( 3 h/wk of resistive training of five muscle groups of each leg ) , or a nonexercising control group . Grade d treadmill testing was performed to maximally tolerated claudication pain to define changes in peak exercise performance . After 12 weeks , patients in the treadmill training program had a 74 + /- 58 % increase in peak walking time as well as improvements in peak oxygen consumption ( VO2 ) and the onset of claudication pain . Patients in the strength-trained group had a 36 + /- 48 % increase in peak walking time but no change in peak VO2 or claudication onset time . Control subjects had no changes in any of these measures over the 12-week period . After the first 12 weeks , patients in the initial walking exercise group continued for 12 more weeks of supervised treadmill training . This result ed in an additional 49 + /- 53 % increase in peak walking time ( total of 128 + /- 99 % increase over the 24 weeks ) . After the initial 12 weeks , patients in the strength-trained group began 12 weeks of supervised treadmill training , and patients in the control group participated in a 12-week combined program of strengthening and treadmill walking exercise . The combined strength and treadmill training program and treadmill training after 12 weeks of strength training result ed in increases in peak exercise performance similar to those observed with 12 weeks of treadmill training alone . CONCLUSIONS A supervised treadmill walking exercise program is an effective means to improve exercise performance in patients with intermittent claudication , with continued improvement over 24 weeks of training . In contrast , 12 weeks of strength training was less effective than 12 weeks of supervised treadmill walking exercise . Finally , strength training , whether sequential or concomitant , did not augment the response to a walking exercise program The purpose of this study was to investigate the influence of a 6-week proprioceptive neuromuscular facilitation ( PNF ) stretching training program on the various parameters of the human gastrocnemius medialis muscle and the Achilles tendon . Therefore , 49 volunteers were r and omly assigned into PNF stretching and control groups .  Before and after the stretching intervention , we determined the maximum dorsiflexion range of motion ( RoM ) with the corresponding fascicle length and pennation angle . Passive resistive torque ( PRT ) and maximum voluntary contraction ( MVC ) of the musculo-articular complex were measured with a dynamometer . Muscle-tendon junction ( MTJ ) displacement allowed us to determine the length changes in tendon and muscle , and hence to calculate stiffness . Mean RoM increased from 31.1 ± 7.2 ° to 33.1 ± 7.2 ° ( P = 0.02 ) , stiffness of the tendon decreased significantly in both active ( from 21.1 ± 8.0 to 18.1 ± 5.5 N/mm ) and passive ( from 12.1 ± 4.9 to 9.6 ± 3.2 N/mm ) conditions , and the pennation angle increased from 18.5 ± 1.8 ° to 19.5 ± 2.1 ° ( P = 0.01 ) at the neutral ankle position ( 90 ° ) , only in the intervention group , whereas MVC and PRT values remained unchanged . We conclude that a 6-week PNF stretching training program  increases RoM and decreases tendon stiffness , despite no change in PRT OBJECTIVE To test the efficacy of high-velocity training in healthy older persons . DESIGN A 12-week r and omized trial , with subjects blocked for gender and residence , comparing high-velocity resistance training with a self-paced walking program . SETTING Retirement community . PARTICIPANTS Forty-three volunteers over the age of 70 years . INTERVENTION Power group : high-velocity leg exercises 3 times weekly with weekly increases in resistance combined with 45 minutes of moderate , nonresistance exercise weekly . Walking group : moderate intensity exercise 30 minutes daily , 6 days weekly . MAIN OUTCOME MEASURES Variables measured included leg press peak power and leg extensor strength . Functional performance outcomes included : 6-minute walk distance , Short Physical Performance Battery , Physical Performance Test , and Medical Outcomes Study Short-Form Health Survey . RESULTS Peak power improved 22 % ( p = .004 ) in the power group ( 3.7 + /- 1.0 W/kg to 4.5 + /- 1.4 W/kg ) but did not change in the walking group ( 3.99 + /-.76 W/kg to 3.65 + /-.94 W/kg ) . Leg extensor power at resistance of 50 % , 60 % , and 70 % of body weight increased 50 % , 77 % , and 141 % , respectively , in the power group ( p < .0001 , repeated- measures analysis of variance ) . Strength improved 22 % in the power-trained individuals and 12 % in the walkers ( p < .0001 ) . Training did not improve functional task performance in either group . One subject developed a radiculopathy during training . CONCLUSIONS Resistance training focusing on speed of movement improved leg power and maximal strength substantially , but did not improve functional performance in healthy high-functioning older volunteers Objectives Maintaining or improving muscle mass and muscle strength is an important treatment goal in pancreatic cancer ( PC ) patients because of high risk of cachexia . Therefore , we assessed feasibility and effectivity of a 6-month progressive resistance training ( RT ) in PC patients within a r and omized controlled trial . Methods Sixty-five PC patients were r and omly assigned to either supervised progressive RT ( RT1 ) , home-based RT ( RT2 ) , or usual care control group ( CON ) . Both exercise groups performed training 2 times per week for 6 months . Muscle strength for knee , elbow , and hip extensors and flexors and cardiorespiratory fitness and body weight were assessed before and after the intervention period . Results Of 65 patients , 43 patients were analyzed .  Adherence rates were 64.1 % ( RT1 ) and 78.4 % ( RT2 ) of the prescribed training sessions . RT1 showed significant improvements in elbow flexor/extensor muscle strength and in maximal work load versus CON and RT2 ( P < 0.05 ) . Further , knee extensors were significantly improved for RT1 versus CON ( P < 0.05 ) . Body weight revealed no significant group differences over time . Conclusions Progressive RT was feasible in PC patients and improved muscle strength with significant results for some muscle groups . Supervised RT seemed to be more effective than home-based RT There is little evidence that home-based muscle training through exercise improves the muscle strength and QoL of elderly osteoporotic women . The efficacy of home-based daily exercise on muscle strength of the upper and lower extremities and QoL were examined in elderly osteoporotic women by means of a case-controlled study that was design ed and conducted between 2005 and 2006 . Sixty-three osteoporotic women over 60 years of age were r and omly assigned to 12 months of muscle exercise or to no intervention . The outcomes were changes in muscle strength and quality of life ( QoL ) . Ultimately , sixty-two participants completed the 12 months program . Before the start of home-exercise training , the lumbar spine bone mineral density ( BMD ) and femoral neck BMD values in the intervention group were significantly lower than those in the control group ( p<0.05 ) . Grip strength and maximum walking speed increased significantly in the intervention group ( p<0.05 ) . In terms of QoL , physical functioning was improved by home-based exercise in the intervention group ( p=0.05 ) , while there were no improvements in any of the categories of Short-Form 36 in the control group . Our results suggest that home-based training is effective for elderly osteoporotic women in improving not only muscle strength in upper and lower extremities but also physical functioning in The purpose of this study was to investigate the efficacy of , and the adherence to , a 12-week home-based progressive resistance training program for older adults utilizing elastic tubing . Sixty-two adults ( mean age , 71.2 years ) qualified to participate in the study . Subjects were r and omly assigned to either the exercise ( E ) ( n=31 ) or non-exercise ( NE ) group ( n=31 ) . Pre- and post-testing included isokinetic ( 1.05 rad · s −1 ) concentric/eccentric knee extension/flexion strength testing and flexibility measures of the hip , knee , and ankle . The E group trained three times per week , performing one to three sets of 10–12 repetitions for each of 12 resistance exercises . The exercises involved muscles of both the lower and upper body . Within the E group , 25 of the 31 subjects ( 80.6 % ) completed the study . Of the E subjects completing the study adherence to the three training sessions per week was 90 % ( range 72%–100 % ) . Training resistances used during workouts increased significantly with the average estimated increase being 82 % ( P<0.001 ) . The E group also demonstrated significant ( P<0.05 ) increases in isokinetic eccentric knee extension ( 12 % ) and flexion ( 10 % ) strength . No other significant changes were observed between E and NE groups . These results suggest that home-based resistance training programs utilizing elastic tubing can serve as a practical and effective means of eliciting strength gains in adults over the age of 65 Objectives : The study aim ed to investigate the effects of a combined functional and aerobic exercise program on aerobic capacity , muscle strength , and functional mobility in a group of patients with sporadic inclusion body myositis ( IBM ) . Methods : Aerobic capacity , muscle strength , and functional capacity assessment s were conducted on 7 participants with sporadic IBM before and after a 12-week exercise program , which included resistance exercises and aerobic stationary cycling 3 times per week on alternative days . Results : Aerobic capacity of the group increased significantly by 38 % , and significant strength improvements were observed in 4 of the muscle groups tested ( P < 0.05 ) . The exercise program was well tolerated , and there was no significant change in the serum creatine kinase level after the exercise period . Conclusions : An aerobic exercise program can be safely tolerated by patients with sporadic IBM and can improve aerobic capacity and muscle strength when combined with resistance training . These findings indicate that aerobic and functional muscle strengthening exercise should be considered in the management of patients with IBM CONTEXT Skeletal muscle from sedentary older adults exhibits reduced mitochondrial abundance and oxidative capacity . OBJECTIVE The primary objective was to determine whether 8 weeks of combined training ( CT ) has a more robust effect than endurance training ( ET ) or resistance training ( RT ) on mitochondrial physiology in healthy young ( 18 - 30 years ) and older ( ≥ 65 years ) adults . INTERVENTION Thirty-four young and 31 older adults were r and omly assigned to 8 weeks of ET , RT , and control/CT .  Control subjects completed 8 weeks of no exercise ( control ) followed by 8 weeks of CT  . Body composition , skeletal muscle strength , and peak oxygen uptake were measured before and after the intervention . Vastus lateralis muscle biopsy sample s were obtained before and 48 hours after the intervention . Mitochondrial physiology was evaluated by high-resolution respirometry and expression of mitochondrial proteins and transcription factors by quantitative PCR and immunoblotting . RESULTS ET and CT significantly increased oxidative capacity and expression of mitochondrial proteins and transcription factors . All training modalities improved body composition , cardiorespiratory fitness , and skeletal muscle strength . CT induced the most robust improvements in mitochondria-related outcomes and physical characteristics despite lower training volumes for the ET and RT components . Importantly , most of the adaptations to training occurred independent of age . CONCLUSION Collectively , these results demonstrate that both ET and CT increase muscle mitochondrial abundance and capacity although CT induced the most robust improvements in the outcomes measured . In conclusion , CT provides a robust exercise regimen to improve muscle mitochondrial outcomes and physical characteristics independent of age 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 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 : Insufficient vitamin D status , commonly found in older people , has been associated with muscle weakness which , in old age , impairs mobility and is a risk factor for falling . In a r and omized , double-blind placebo-controlled trial , we tested the hypothesis that vitamin D + calcium supplementation improves muscle strength and mobility , compared with calcium mono-therapy in vitamin D-insufficient female geriatric patients . Methods : Seventy female geriatric patients > 65 years of age with serum 25-hydroxyvitamin D3 ( 25OHD ) concentrations between 20 and 50 nmol/L , visiting an outpatient geriatric department , were included . Participants received either cholecalciferol 400 IU/day + calcium 500 mg/day ( D/Cal group ) or a placebo + calcium 500 mg/day ( Plac/Cal group ) for 6 months . At baseline and 6 months , muscle strength , power and functional mobility were tested . Results : At baseline , 25OHD was significantly ( p<0.05 ) associated with knee extension strength ( r=0.42 ) , h and grip strength ( r=0.28 ) , leg extension power ( r=0.34 ) , Timed Get Up and Go ( r=−0.31 ) and Modified Cooper test ( r=0.44 ) . At 6 months , a significant difference in 25OHD ( 77.2 vs 41.6 nmol/L , p<0.001 ) and 1,25OHD was found between the two groups . Significantly improving vitamin D status in the D/Cal group compared with the Plac/Cal group did not result in a significant difference in strength or functional mobility between the two groups . Conclusions : Daily 400IU vitamin D + 500 mg calcium supplementation is not enough to significantly improve strength or mobility in vitamin D-insufficient female geriatric patients
Serious adverse events were rare , and no serious events were reported to be directly related to the exercise programme .
This review provides evidence that PRT is an effective intervention for improving physical functioning in  older people , including improving strength and the performance of some simple and complex activities .
BACKGROUND Muscle weakness in old age is associated with physical function decline .
Progressive resistance strength training ( PRT ) exercises are design ed to increase strength .
OBJECTIVES To assess the effects of PRT on older people and identify adverse events .