Abstract
The use of progressive strength training among the elderly has become an accepted part of evidence-based practice for preventive and rehabilitative care. Exercise is undoubtedly one of the pillars for resilient aging. While research has shown impressive outcomes from strength training, the challenge remains to get elderly persons to exercise. Here we describe a Finnish-Singaporean cross-national project that provides a unique opportunity to evaluate the implementation of strength training in settings where it had previously not been applied. We report from the first 2 years of implementation using assessment data and surveys directed to frontline therapists responsible for the implementation. The strength training concept was progressively implemented in 24 elder care locations in Singapore including residential homes, day rehab/care centers, and senior activity centers. Each location was provided with training, support, gym equipment and technology solutions. It remained for individual sites to enroll elderly to the program, to perform assessments, and to direct the progressive strength training. Based on data from the first 2 years of implementation, improvements in lower body muscle strength were found in Leg Curl (ave 11.1–48.8%), Leg Extension (ave 10.2–24.0%) and Hip Abduction/Hip Adduction (ave 7.0–15.8%). Of the trained therapists, 95% strongly agreed or agreed to some extent that the implementation had been successful. The practice-based evidence from the project has demonstrated that it is feasible to implement progressive strength training in real life settings, using technology. While the implementation initially required handholding and support, the approach yielded consistent improvement rates in muscle strength comparable to results from randomized clinical trials (meta-analysis studies). Significant improvement rates in muscle strength were found in all three types of sites, demonstrating that gym training can be employed broadly in elder care. The Senior Activity Centers offer an interesting model for reaching seniors with preventive actions at an early stage. The data support a 3-month training as an effective intervention of introducing strength training in elder care settings, promoting healthy aging.
Highlights
The aging population presents a global challenge
This specific data set gives a profile of the clients recruited into the gym training groups, how the participants trained, and the effectiveness of the training in terms of improvement rates
The improvement rates in muscle strength were comparable to those reported in meta-analysis of research studies by for example, Lopez et al, observing increases of 6.6– 37% in maximal strength of strength training and multimodal training [40], and Peterson reporting an average of 33%
Summary
The aging population presents a global challenge. Old age is often associated with limitations of physical function, frailty, chronic diseases, and a consequent increase in the need for health services which translate into a higher economic burden for the society. The decline in physical functions and onset of chronic diseases affect the elderly’s quality of life. Supervised intensive training has, according to the studies, clinically significant effects on strength and physical function [9,10,11,12,13]. Global initiatives such as “Exercise is medicine” [14] demonstrates the awareness of the importance of exercise as a complement of the clinical treatments. WHO [22] has recently introduced the concept of intrinsic capacity (IC) to emphasize the potential of healthy aging and combatting frailty though modifiable factors such as physical activity
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