Community-based Training Program Research Articles

Local and National Trends in General Surgery Residents’ Operative Experience: Do Work Hour Limitations Negatively Affect Case Volume in Small Community-Based Programs?

The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

Evaluating Community-Based Public Health Leadership Training

Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

Evaluation of a resistance training program for adults with or at risk of developing diabetes: an effectiveness study in a community setting

BackgroundTo examine the effects of a community-based resistance training program (Lift for Life®) on waist circumference and functional measures in adults with or at risk of developing type 2 diabetes.MethodsLift for Life is a research-to-practice initiative designed to disseminate an evidence-based resistance training program for adults with or at risk of developing type 2 diabetes to existing health and fitness facilities in the Australian community. A retrospective assessment was undertaken on 86 participants who had accessed the program within 4 active providers in Melbourne, Australia. The primary goal of this longitudinal study was to assess the effectiveness of a community-based resistance training program, thereby precluding a randomized, controlled study design. Waist circumference, lower body (chair sit-to-stand) and upper body (arm curl test) strength, and agility (timed up-and-go) measures were collected at baseline and repeated at 2 months (n = 86) and again at 6 months (n = 32).ResultsRelative to baseline, there was a significant decrease in mean waist circumference (-1.9 cm, 95% CI: -2.8 to -1.0) and the timed agility test (-0.8 secs, 95% CI: -1.0 to -0.6); and significant increases in lower body (number of repetitions: 2.2, 95% CI: 1.4-3.0) and upper body (number of repetitions: 3.8, 95% CI: 3.0-4.6) strength at the completion of 8 weeks. Significant differences remained at the 16 week assessment. Pooled time series regression analyses adjusted for age and sex in the 32 participants who had complete measures at baseline and 24-week follow-up revealed significant time effects for waist circumference and functional measures, with the greatest change from baseline observed at the 24-week assessment.ConclusionsThese findings indicate that an evidence-based resistance training program administered in the community setting for those with or at risk of developing type 2 diabetes, can lead to favorable health benefits, including reductions in central obesity and improved physical function.

Abstract 1813: Implementation and outcomes of a community-based educational program in colorectal cancer prevention

Abstract Background: Cancer is the second most common cause of death in Puerto Rico (PR) after heart disease. Colorectal cancer (CRC) is the second most commonly diagnosed cancer among both men and women. The cancer screening guidelines given by the American Cancer Society indicate that adults should begin CRC screening at the age of 50. Although self-reported CRC screening from 1997 to 2006 have showed an increase in PR, CRC screening trends are lower than in the United States. With low screening rates and high CRC mortality in PR, health promotion programs aimed at education and prevention are needed. Methods: The purpose of this study was to evaluate a community-based educational program (Train-the-Trainer – TTTP) to increase knowledge and awareness of prevention about CRC in PR. The TTTP consisted of a formal didactic and hands-on seminar where participants were given didactic information and were trained to become trainers in CRC prevention. The TTTP was open to any adult, who was willing to become a trainer and committed to present the information in another forum using the materials provided at the TTTP. For the evaluation of this project, three main components were measured: (1) the Train the Trainers’ sessions; (2) the Participants’ Community Educational Sessions; and (3) the participant's experience delivering the training intervention. A total of five different questionnaires were design for the evaluation process of each component. Both qualitative and quantitative methods were used to collect data. Evaluations of outcomes were measured within 60-days of the TTT session. Results: Pre- and post-tests were given to the participants of the Train-the-Trainer session (N=115). There was a significant difference in the scores for the pre-test (mean=10.56, SD=2.57) and the post-test (mean=11.43, SD=1.83); t(96)=−4.68, p&amp;lt; 0.001); suggesting an augmentation in knowledge. Overall the participants from the community educational sessions (N=680) evaluated the program to be a success indicating that it provided them with knowledge, resources, and motivation to be screened for colorectal cancer, with 69.9% indicating their willingness to obtain a colonoscopy in the future. The trainer-to-trainee ratio was 1:6, with each participant of the TTTP training an average of 6 individuals from their own community within a 60-day period. Conclusion: The Puerto Rico CRC TTTP was effective in capacitating individuals to become trainers in their respective communities. The TTTP was effective in increasing knowledge of CRC prevention strategies and successfully reached members of the community. Implementation of a community-based program designed to develop trainers in CRC prevention demonstrated to be feasible and effective. Community based training programs are an alternative to promote CRC education and awareness in PR and may impact CRC screening rates, with subsequent decreases in mortality. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1813. doi:10.1158/1538-7445.AM2011-1813

Dissemination and Adoption of Efficacious Parenting Intervention Programs

In addition to a study of drug resistant skills amongunderstudied adolescents in Mexico, this issueincludes three articles on parenting interventionprograms. These studies go beyond whether or notparenting programs work to include specific factorsrelated to their efficacy. Together, this compilation ofarticles spans geography (Australia, Europe, and theUnited States), settings (community, daycare centers,and primary healthcare facilities), and interventions(Triple P: Positive Parenting Program and PACE:Parenting our Children to Excellence). In addition,these studies use a range of state-of-the-art analytictechniques and methodology including HierarchalLinear Modeling, Structural Equation Modeling, andtechnique utilization.Through research and clinical evidence, we knowhow critically important parenting practices are in thedevelopment of a healthy child. Children who growup in families characterized by positive affectiverelationships where adaptive behaviors are supportedand maladaptive behaviors are discouraged generallyexhibit better psychosocial outcomes than youthraised in less functional households. We also knowthat parenting intervention programs can and do work(Eyeberg et al. 2008; Sandler et al. 2011). Theirshort- and long-term benefits include decreased riskof child abuse and participation in risky behaviors,improved academic performance, and improvedmental health, to name a few. However, like manyefficacious programs designed to promote publichealth, dissemination, adoption, and utilizationremain a struggle. Moreover, increased understandingof how parenting prevention programs affect change,who they work for, and what conditions are optimalfor implementation would advance the field.Begal and Dumas examine the efficacy of a group-administered behavioral intervention program (i.e.,PACE) administered to parents of preschoolersrecruited from daycare centers. Their hypothesis thathigher levels of parental engagement in the interven-tion (i.e., session attendance, quality participation)would predict better parent and child outcomes isgenerally supported. Specifically, more activelyengaged parents evidenced less stress and moresatisfactionthanlessengagedparents.Further,activelyengaged high-risk parents had less stress, more satis-faction, and a lower risk of child abuse potential thantheir less engaged high-risk counterparts.The remaining two studies in this issue examinefactors related to the uptake of and engagement inanother behaviorally oriented parenting interventionprogram (i.e., Triple P: Positive Parenting Program).Because of the low participation and high attritionrates of community-based parent training programs,Eisner and Meidert sought to examine factorsimportant to participation at each stage of engage-ment. Interestingly, they found that parents who were

佐久総合病院における地域医療研修の有用性と必要性

佐久総合病院における地域医療研修の有用性と必要性

The Effects of the Community-based Training Program on Daily Living Skills of a High School Student with Intellectual Disability

The Effects of the Community-based Training Program on Daily Living Skills of a High School Student with Intellectual Disability

Dual-Energy X-Ray Absorptiometry to Measure the Influence of a 16-Week Community-Based Swim Training Program on Body Fat in Children and Adolescents With Intellectual Disabilities

Casey AF, Rasmussen R, Mackenzie SJ, Glenn J. Dual-energy x-ray absorptiometry to measure the influence of a 16-week community-based swim training program on body fat in children and adolescents with intellectual disabilities. Objective To use dual-energy x-ray absorptiometry (DXA) to measure the effects of a 16-week community-based swim training program on percent body fat in children and adolescents with intellectual disability (ID). Design Convenience sample. Setting University sport complex and exercise science laboratory. Participants Children and adolescents (n=8; mean age ± SD, 13.1 ± 3.4y), 2 girls and 6 boys with ID, of varying fat levels (11%–35%). Intervention A swim training program lasting for the duration of 16 weeks with three 1-hour sessions held at a 25-m pool each week. Main Outcome Measure Assessing percent body fat at pretest and posttest through the use of DXA. Results After the 16-week exercise training program, we observed a 1.2% median increase in body fat percentage with a range from –0.3% to 4.5%. Wilcoxon matched-pairs signed-ranks tests suggest that these results are statistically significant ( P=.039; exact). Conclusions Exercise training alone proved ineffectual in reducing percent body fat in 8 children and adolescents with ID. Further research should consider implementing a combined diet and exercise program. To gauge the effectiveness of intervention programs, valid methods and complex measurement tools such as DXA should be used to assess changes in percent body fat in such a heterogeneous population.

Effects of a Community-Based Intensive Motor Training Program Combined With Early Supported Discharge After Treatment in a Comprehensive Stroke Unit

Increased amount of therapy seems to be beneficial for motor recovery after stroke. The primary aim of the present study was to evaluate the effect of a 4-week community-based intensive motor training program combined with early supported discharge after initial treatment in a comprehensive stroke unit on balance. Secondary aims were to evaluate the effect on other functional outcome measures. This was a single-blind, randomized, controlled trial with a 26-week follow-up. Sixty-two patients were recruited within 14 days after stroke and were randomly allocated to a standard treatment group (n=32) or to an intensive motor training group (n=30) receiving 3 sessions of physical therapy and a structured home exercise program in addition to standard treatment every week for the first 4 weeks after discharge from hospital. Primary outcome measure was Berg Balance Scale. Secondary measures were Barthel Index, Motor Assessment Scale, Step Test, 5-meter Walk Test, and Stroke Impact Scale. The mean (SD) minutes of physical therapy per week was 171.0 (65.8) in the intensive motor training group vs 85.6(69.9) in the standard treatment group. There were no statistical significant differences between the groups on any measure at end of follow-up except for a trend toward higher Motor Assessment Scale score (P=0.059) and gait speed (P=0.095) in the intensive motor training group. In this randomized, controlled trial, a community-based intensive motor training program, doubling the amount of physical therapy during the first 4 weeks after discharge, did not show significant improvement of balance or any other functional outcomes.

An exploratory survey of malaria prevalence and people's knowledge, attitudes and practices of mosquito larval source management for malaria control in western Kenya

A large proportion of mosquito larval habitats in urban and rural communities in sub-Saharan Africa are man-made. Therefore, community-based larval source management (LSM) could make a significant contribution to malaria control in an integrated vector management approach. Here we implemented an exploratory study to assess malaria prevalence and people's knowledge, attitudes and practices on malaria transmission, its control and the importance of man-made aquatic habitats for the development of disease vectors in one peri-urban lowland and two rural highland communities in western Kenya. We implemented monthly cross-sectional malaria surveys and administered a semi-structured questionnaire in 90 households, i.e. 30 households in each locality. Malaria prevalence was moderate (3.2–6.5%) in all sites. Nevertheless, residents perceived malaria as their major health risk. Thirty-two percent (29/90) of all respondents did not know that mosquitoes are responsible for the transmission of malaria. Over two-thirds (69/90) of the respondents said that mosquito breeding site could be found close to their homes but correct knowledge of habitat characteristics was poor. Over one-third (26/67) believed that immature mosquitoes develop in vegetation. Man-made pools, drainage channels and burrow pits were rarely mentioned. After explaining where mosquito larvae develop, 56% (50/90) felt that these sites were important for their livelihood. Peri-urban residents knew more about mosquitoes’ role in malaria transmission, could more frequently describe the larval stages and their breeding habitats, and were more likely to use bed nets even though malaria prevalence was only half of what was found in the rural highland sites ( p < 0.05). This was independent of their education level or socio-economic status. Hence rural communities are more vulnerable to malaria infection, thus calling for additional methods to complement personal protection measures for vector control. Larval source management was the most frequently mentioned (30%) tool for malaria control but was only practiced by 2 out of 90 respondents. Targeting the larval stages of malaria vectors is an underutilized malaria prevention measure. Sustainable elimination or rendering of such habitats unsuitable for larval development needs horizontally organized, community-based programs that take people's needs into account. Innovative, community-based training programs need to be developed to increase people's awareness of man-made vector breeding sites and acceptable control methods need to be designed in collaboration with the communities.

A study protocol of a randomised controlled trial to investigate if a community based strength training programme improves work task performance in young adults with Down syndrome

BackgroundMuscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome.MethodsA randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates.DiscussionThis paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels.Clinical trial registration numberAustralian New Zealand Clinical Trials Registry ACTRN12609000938202

Training and consultation in evidence-based psychosocial treatments in public mental health settings: The access model.

We present a model of training in evidence-based psychosocial treatments (EBTs). The ACCESS (assess and adapt, convey basics, consult, evaluate, study outcomes, sustain) model integrates principles and findings from adult education and training literatures, research, and practical suggestions based on a community-based clinician training program. Descriptions of the steps are provided as a means of guiding implementation efforts and facilitating training partnerships between public mental health agencies and practitioners of EBTs.

The Lift for Life community-based strength training program for people with or at risk of developing type 2 diabetes—A snapshot evaluation

The Lift for Life community-based strength training program for people with or at risk of developing type 2 diabetes—A snapshot evaluation

Similarities and Differences Between International Medical Graduates and U.S. Medical Graduates at Six Maryland Community-Based Internal Medicine Residency Training Programs

Approximately 25% of practicing physicians in the United States are graduates of medical schools in other countries; they are called international medical graduates (IMGs). Their transition into the U.S. health care system may be difficult and challenging. This study sought to identify the similarities and differences between IMGs and U.S. medical graduates (USMGs) working together in residency training programs. In 2006, the authors conducted a cross-sectional survey study of house officers (interns and residents) at six internal medicine (IM) community-based residency programs in Baltimore, Maryland. The survey asked about demographics, relocation for residency training, practice experience, and career plans and included four previously validated instruments: the Iowa Fatigue Scale, Cohen's Perceived Stress Scale, Rosenberg's Self-Esteem Scale, and the Personal Growth Scale. Of 225 potential house officers, 176 (78%) responded. In multivariable modeling, independent characteristics that differentiated IMGs from USMGs were that IMGs had (1) a native language other than English (odds ratio [OR] 18.3, 95% CI: 5.8-57.3), (2) less debt (<$50K) upon graduation from medical school (OR 7.3, 2.5-21.2), and (3) experiences practicing medicine before residency training (OR 41.02, 1.6-1017). With modeling to control for these three differences, the authors found IMGs to have lower fatigue (OR 2.7; 1.2-6.0), higher self-esteem (OR 3.0; 1.2-7.5), and greater personal growth scores (OR 3.6; 1.6-8.2). Differences exist between the IMGs and USMGs who are working together in community-based IM residency training programs. Considering such differences may help educators and program directors trying to support and train this diverse cadre of trainees.

Development, feasibility and efficacy of a community‐based exercise training program in pediatric cancer survivors

The aim of this study was to develop a 12-week exercise training program (comprising aerobic and strength exercises), and to study the feasibility and efficacy of this exercise program in children who survived acute lymphoblastic leukemia. A 12-week exercise program was developed and tested for feasibility in nine children who survived cancer. From the 16 eligible children for the intervention, 9 participated, while 4 were able to complete the entire program. Feasibility of the program was scored by five children, two of them reported the program as being too demanding. The participating physiotherapists were satisfied with training methodology and training progress. The efficacy of the program on muscle strength, exercise capacity, functional mobility and fatigue showed no significant differences between pre and post training. In designing a community-based exercise training program, not only the stage of the disease needs to be considered, but more so the age of the children, the variety of exercises, the location of implementation and even more importantly the views and motivation of the parents concerning the execution of an exercise training program. A careful balance between these parameters could lead to a greater adherence and by that, to a better outcome of these programs.

Staying alive, staying strong: pilot evaluation of a once-weekly community-based strength training program for older adults

Little is known about the effectiveness of once-weekly strength training programs for older adults based in community settings. This pilot study evaluated such a program to assess changes in the functional fitness of participants. A pre-test/post-test within subjects study design was used with new participants in the 10-week Staying Active, Staying Strong (SASS) program (all aged 50+ years). The Seniors Fitness Test (SFT) and SF-36 were used to assess functional fitness and health-related quality of life respectively. Perception of physical ability was assessed using a study-specific questionnaire. Pre- and post-test SFT and SF-36 scores were compared using paired t-tests. Frequency of responses was used to describe participant perceptions. 110 evaluation participants (mean age 68.2 years; 85% female), 49% of those who completed the pre-test, also completed the post-test. Evaluation participants significantly improved their strength (assessed using arm curls and sit-to-stand); endurance (two-minute step test); flexibility (sit and reach, back scratch); and agility/dynamic balance (eight-foot up and go). SF-36 physical-functioning domain scores also significantly improved. Most participants reported improved strength, fitness, mobility, general well-being and confidence in performing daily activities. Weekly, community-based strength training programs show promise in improving the functional capacity, including the strength, of older adults. More thorough evaluation is now required to confirm these findings.

The regional campaign for women on awareness of neural tube defects and folic acid in Narlidere, Izmir: a community-based intervention

Objectives To create an awareness among women and to update the knowledge of health personnel about neural tube defects (NTDs) and folate in order to reduce the incidence of NTD in Narlidere, İzmir.Methods In 2006, a regional campaign was organized in Narlidere, Izmir that aimed at informing women of child-bearing age on folic acid and prevention of NTD. Nearly 4400 women participated in the study. By means of questionnaires the level of knowledge before and after the intervention was evaluated.Results Before the campaign was carried out, 18% of women had heard of folic acid. Their level of knowledge increased after the campaign (p < 0.0001). Post-intervention scores of high school and university graduates and women with high or middle income, as well as those having a friend or kin with spina bifida were found to have significantly improved.Conclusions The pilot community-based training programme was very successful. Similar programmes, integrated within routine health care services, promoting the use of folic acid will be fostered in the whole country.

Successful Dissemination of a Community‐Based Strength Training Program for Older Adults by Peer and Professional Leaders: The People Exercising Program

The objective of this longitudinal study was to determine the feasibility of a model for disseminating community-based strength training programs for older adults through leadership training of laypersons or "peers" and health and fitness professionals. The intervention consisted of a progressive strength training, balance, and flexibility exercise program and a leader training and certification workshop. Feasibility was defined as 75% or more of individuals who completed leader training establishing or teaching at least two 12-week strength training classes within 1 year. Program dissemination was quantified as the number of classes established between January 2005 and December 2006. Demographic characteristics and health status of leaders and program participants were evaluated. Two hundred forty-four leaders (peers, n=149; professionals, n=95) were trained and certified. Seventy-nine percent of all leaders (n=193) met the feasibility criteria of establishing or teaching strength training classes. There was no difference in the percentage of peer leaders (80%, n=119) and professional leaders (78%, n=74) who established or taught classes (P5.71) despite significant differences in their demographic and health profiles. Ninety-seven self-sustaining strength training classes were established in senior and community centers, and 2,217 older adults (women, n=1,942; men, n=275) aged 50 to 97 with multiple chronic medical conditions enrolled. In conclusion, training peer and professional leaders is a feasible and successful model for disseminating a community strength training program for older adults. Widespread dissemination of this program has significant public health implications for increasing physical activity participation by older adults.

Regenerate: assessing the feasibility of a strength‐training program to enhance the physical and mental health of chronic post stroke patients with depression

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. Participants were screened for depressive status using the PHQ-9 and confirmed by psychiatric assessment. Eligible people (n = 45) were randomised 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. 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. 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.

Effects of a Community-Based Progressive Resistance Training Program on Muscle Performance and Physical Function in Adults With Down Syndrome: A Randomized Controlled Trial

Shields N, Taylor NF, Dodd KY. Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial. Objective To determine whether progressive resistance training improves muscle strength, muscle endurance, and physical function in adults with Down syndrome. Design Single-blind randomized controlled trial. Setting General community. Participants Adults (N=20) with Down syndrome (13 men, 7 women; mean age, 26.8±7.8y) were randomly assigned through a concealed allocation block randomized 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, 8.6kg; 95% CI, −1.3 to 18.5kg) 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.)