Effects Of Progressive Resistance Training Research Articles

149 Power-agers: the effect of Progressive Resistance Training (PRT) on sarcopenia status of community dwelling older adults

Abstract Background The primary aim of this study is to establish whether the sarcopenia status of community-dwelling older adults could be improved using Progressive Resistance Training (PRT) in a gym-based, physiotherapy-led intervention for 7 weeks. Methods This is a non-randomised study, all participants completed the intervention. 24 participants attended the programme, n = 2 lost to follow up. Participants attended twice weekly for 7 weeks; 2 assessment sessions and 12 exercise sessions. The assessment consisted of Bioelectrical Impedance Analysis, Timed Up and Go (TUAG), five time Sit-to-Stand (5 x STS), 10 metre walk test, grip strength and Short Physical Performance Battery (SPPB). Each group had 5–7 participants complete 6 exercises in circuit; (1) weighted sit-to-stand, (2) modified deadlift, (3) farmer walks, (4) overhead press, (5) cable row, and (6) cable chest press. Results Data were analysed using SPSS. Pre-intervention 87.5% (n = 21) were identified as ‘probable sarcopenic’; post-intervention this decreased to 77.3% (n = 17). Sarcopenia status was not found to be significantly associated with the intervention by Chi-squared tests. No participants were classified as ‘confirmed sarcopenia’, as all were above the cut off scores for muscle mass. There was a statistically significant change in the SPPB and TUAG scores (p < 0.0041), with large effect sizes; Eta squared = 0.481 (SPPB), and 0.341 (TUAG). Improvements in 5xSTS and right grip strength had alpha values of less than p < 0.05, with large effect sizes, however they did not reach statistical significance. Conclusion The improvements in physical performance measures (SPPB & TUAG) are encouraging and may indicate that PRT can play a role in the long-term management of sarcopenia and promotion of independence in older adults. However, due to the lack of a control, it is difficult to ascribe the changes to the intervention itself. Further research with suitable controls and follow-up is needed to gain insights into which PRT interventions are the most effective in managing sarcopenia in older community dwellers.

The long-term burden of a symptom cluster and association with longitudinal physical and emotional functioning in breast cancer survivors

Background Fatigue, insomnia and pain are some of the most common and distressing symptoms experienced during breast cancer (BC) treatment and survivorship. The symptoms have been found to impact one another and to form a symptom cluster, and greater severity of the symptoms may be negatively associated with physical and emotional functioning in survivorship. In exploratory analyses from a randomized controlled trial examining the effect of progressive resistance training on the development of lymphedema after BC, we aimed to examine the burden of the symptom cluster fatigue-pain-insomnia, and its prognostic value for long-term symptom severity as well as emotional and physical functioning Material and Methods Latent profile analysis was used to identify groups with similar severity of pain, fatigue and insomnia among 158 patients with BC two weeks after surgery. Mixed effects Tobit regression models were used to estimate fatigue, pain, insomnia, and physical and emotional functioning 20 weeks, 1 year and 3.5 years after surgery. Results Two symptom burden groups were identified: 80% of women had a low severity while 20% of women had a high severity of the three symptoms after BC surgery. 3.5 years later, the women with high symptom burden post-surgery still had higher pain, insomnia and fatigue scores than women with low symptom burden. High symptom burden post-surgery was associated with worse physical functioning 3.5 years later, while emotional functioning was only negatively impacted during the first year. Discussion These findings warrant larger studies investigating if symptom burden early in BC trajectory can be used for risk stratification for persistent symptoms and diminished physical functioning with the purpose of developing and implementing targeted interventions.

Effects of Resistance Training on Pain Control and Physical Function in Older Adults With Low Back Pain: A Systematic Review With Meta-analysis.

Low back pain (LBP) has a high prevalence in older adults and is associated with elevated health care costs. This systematic review and meta-analysis examines the effects of progressive resistance training (PRT) interventions on physical function (PF) and pain control in community-dwelling older adults with chronic LBP. A meta-analysis applying the quality effect method was performed by calculating the effect sizes (ESs) using the Cohen d with a 95% CI. A subgroup analysis was performed according to the participant and intervention characteristics. The statistical significance of differences between subgroups was calculated using a Z -test. Study bias was estimated using the version 2 of the Cochrane risk of bias tool for randomized trials (RoB 2.0) and quality of evidence (Qi) index. Small study effect/publication bias was estimated using the Doi plot and Luis Furuya-Kanamori (LFK) index. The systematic search was conducted in major databases for clinical trials published between January 1, 1990, and January 9, 2021. The inclusion criteria were articles that (1) were peer-reviewed; (2) had participants' mean age of more than 60 years; (3) studied PRT interventions; (4) had participants with LBP; (5) measured LBP or PF outcomes; (6) measured PF in terms of functionality; (7) were randomized controlled trials; (8) and non-randomized controlled trials. The exclusion criteria were (1) articles not written in English, (2) nonexperimental studies, and (3) repeated publications. Twenty-one studies were included (n = 1661). Clear improvements were found in PF (ES = 0.32 [95% CI, 0.05-0.58]; I2 = 75.1%; P < .001), but results on LBP decrease were inconclusive (ES = 0.24 [95% CI, -0.05 to 1.10]; I2 = 75.7%; P < .001). The overall evidence of this aggregated data meta-analysis of clinical trials is level C+. Main limitations are the use of aggregated data and the large heterogeneity between studies. The Qi of this meta-analysis is level I (C+). We concluded that PRT interventions are useful for PF improvement in older adults with generalized LBP, LBP not arising from lumbar spinal stenosis, and having body mass index less than 27. In older adults with LBP not arising from lumbar spine stenosis, PRT interventions also decrease LBP. Interventions should have a frequency of at least 3 sessions per week. In addition, at a lower level of evidence IV (C+), we recommend that interventions with a duration of more than 12 weeks should be considered, whenever possible.

Effectiveness of progressive resistance training in improving muscle strength in myasthenia gravis: a single subject study design

Effectiveness of progressive resistance training in improving muscle strength in myasthenia gravis: a single subject study design

Effectiveness of Progressive Resistance Training in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Introduction: The aim of this study was to systematically explore progressive resistance training (PRT) effects in Parkinson’s disease (PD). Methods: Eligible literature was systematically searched from five electronic databases (PubMed, Web of Science, Ovid, Wanfang, and China National Knowledge Infrastructure) from their inception to February 2022. Included studies were selected based on strict eligibility criteria. RevMan 5.3 software was used for statistical analysis. Results: A total of 14 studies with 761 PD patients were selected for eligibility in this systematic review and meta-analysis. A total of 383 performed trunk or upper or lower extremity PRT and 378 underwent balance training, modified fitness counts, or did not change their lifestyle. The results demonstrated positive PRT effect on freezing of gait (standardized mean difference [SMD] = −0.55, 95% CI = −0.95 to −0.16, p = 0.006), muscular strength (SMD = 1.9, 95% CI = 0.55–3.24, p = 0.006), and quality of life (SMD = −0.86, 95% CI = −1.66 to −0.06, p = 0.04) in adults with PD compared with other training programmes but not for gait velocity, stride length, timed up and go test, and Berg Balance Scale. Conclusions: This meta-analysis revealed that PRT had positive effects on freezing of gait, muscle strength, and improved quality of life during rehabilitation in PD patients.

Effect of progressive resistance training with weight loss compared with weight loss alone on the fatty liver index in older adults with type 2 diabetes: secondary analysis of a 12-month randomized controlled trial

IntroductionNon-alcoholic fatty liver disease (NAFLD) is highly prevalent (~75%) in people with type 2 diabetes (T2D). Since exercise and weight loss (WL) are recommended for the management of both NAFLD...

L-Carnitine Combined with Leucine Supplementation Does Not Improve the Effectiveness of Progressive Resistance Training in Healthy Aged Women

ObjectivesTo evaluate the effect of L-carnitine (LC) in combination with leucine supplementation on muscle strength and muscle hypertrophy in aged women participating in a resistance exercise training (RET) program.Design/Setting/ParticipantsThirty-seven out of sixty (38.3% dropout) healthy women aged 60–75 years (mean 67.6 ± 0.7 years) completed the intervention in one of three groups. One of the supplemented groups received 1 g of L-carnitine-L-tartrate in combination with 3 g of L-leucine per day (LC+L group; n = 12), and the second supplemented group received 4 g of L-leucine per day (L group; n = 13). The control group (CON group; n = 12) received no supplementation.InterventionAll three groups completed the same RET protocol involving exercise sessions twice per week for 24 weeks.MeasurementsBefore and after the experiment, participants performed isometric and isokinetic muscle strength testing on the Biodex dynamometer. The cross-sectional areas of the major knee extensors and total thigh muscles were assessed using magnetic resonance imaging. Fasting serum levels of insulin-like growth factor-1 (IGF-1), myostatin and decorin, and plasma levels of total carnitine (TC) and trimethylamine-N-oxide (TMAO) levels were measured.ResultsThe 24-week RET significantly increased muscle strength and muscle volume, but the group and time interactions were not significant for the muscle variables analyzed. Plasma total carnitine increased only in the LC+L group (p = 0.009). LC supplementation also caused a significant increase in plasma TMAO, which was higher after the intervention in the LC+L group than in the L (p < 0.001), and CON (p = 0.005) groups. The intervention did not change plasma TMAO concentration in the L (p = 0.959) and CON (p = 0.866) groups. After the intervention serum decorin level was higher than before in both supplemented groups combined (p = 0.012), still not significantly different to post intervention CON (p = 0.231). No changes in serum IGF-1 and myostatin concentrations and no links between the changes in blood markers and muscle function or muscle volume were observed.ConclusionsLC combined with leucine or leucine alone does not appear to improve the effectiveness of RET.

Effect of progressive resistance training on post prostatectomy stress urinary incontinence: A randomized controlled study

Purpose. The aim of this study was to investigate the effectiveness of progressive resistance training on post prostatectomy stress urinary incontinence. Materials and Methods. Sixty male patients who complaint from post prostatectomy stress urinary incontinence were participated in this study, their ages were ranged from 40 to 75 years and they were randomly assigned into two equal groups. Group (A) (Study group): This group included 30 patients who had post prostatectomy stress urinary incontinence and they received progressive resistance training in addition to interferential current stimulation and routine medical treatment three sessions per week for 12 weeks. Group (B) (Control group): This group included 30 patients who had post prostatectomy stress urinary incontinence and they received interferential current stimulation and routine medical treatment three sessions per week for 12 weeks. Pre- and post-treatment assessment using DANTIC UD 5000/5500 Urodynamic investigation system &amp; Severity index scale were done for all patients. Results. The obtained results of the present study indicated significant difference of all measured variables when comparing between pre and post- treatment values of the groups (A and B) and revealed significant difference when comparing between post- treatment values of the groups (A and B) in favor of group (A). Conclusion. Progressive resistance training had an effect on reducing post prostatectomy stress urinary incontinence and there was significant difference when comparing between post-treatment values of the groups (A and B) in favor of group (A).

Effect of 4 Weeks of Progressive Resistance Training on Plasma Levels of Omentin-1 and Metabolic Factors in Diabetic Male Rats

Background and Objectives Omentin-1 is a new adipokine with a potential to increase insulin sensitivity, and is associated with lipid profile. There are limited studies on the effect of exercise on the serum level of Omentin-1. The present study aims to investigate the effect of progressive resistance training (PRT) on plasma level of omentin-1 and glycemic control in diabetic male rats. Subjects and Methods In this study, 24 male Wistar rats were randomly divided into three groups: Control, diabetic, and diabetic+PRT. The training group performed a PRT program using a ladder (three days a week, for 4 weeks). Body weight, glucose level, amentin-1 level, insulin level, and lipid profile were measured. Results The PRT significantly increased plasma levels of omentin-1 and triglycerides in the diabetic + PRT group compared to the diabetic group (P=0.017). There was no significant difference in high-density lipoprotein (F=0.318, P&gt;0.05), low-density lipoprotein (F=0.612, P&gt;0.05) and cholesterol (F=0.049, P&gt;0.05) levels between the study groups. Conclusion The PRT improves omentin-1 and insulin resistance in diabetic rats.

The Effect of Progressive Resistance Training on Functionality and Handgrip Strength in the Older Individuals of a Community: A Quasi-Experimental Study.

Muscle weakness is associated with negative outcomes, in addition to being related to the pathogenesis of frailty and functional disability in the older individuals. Muscle strength and functionality are considered biomarkers of aging. Progressive resistance training (PRT) is a type of training that has been the subject of studies as it presents itself as a therapeutic option to fight the reduction of muscle strength and functionality in older individuals. However, few studies have assessed the clinically relevant gains in the levels of muscle strength and functionality of older individuals after PRT, in addition to the need of testing new PRT approaches, including individualization and periodization in training programs. Therefore, this article aims to assess the effect of an individual and periodized PRT protocol on handgrip strength (HS) and functionality in older individuals. Thus, the study sample included 69 older individuals, divided into 2 groups: case (n = 41) and control (n = 28). The case group participated in a PRT protocol for 12 weeks, with two weekly sessions. When compared to the control group, which received only health education, the individuals in the case group had a greater magnitude of improvement in all variables related to the assessed functionality (Timed up and go test, gait speed, and HS), proving the applicability of the assessed protocol to improve strength and functionality in the older individuals of a community.

Effects of progressive resistance training in individuals with type 2 diabetic polyneuropathy: a randomised assessor-blinded controlled trial.

The aim of this study was to evaluate the effects of progressive resistance training (PRT) on muscle strength, intraepidermal nerve fibre density (IENFD) and motor function in individuals with type 2 diabetic polyneuropathy (DPN) and to compare potential adaptations to those of individuals with type 2 diabetes without DPN and healthy controls. This was an assessor-blinded trial conducted at the Neurology department, Aarhus University Hospital. Adults with type 2 diabetes, with and without DPN and healthy control participants were randomised to either supervised PRT or non-PRT for 12 weeks. Allocation was concealed by a central office unrelated to the study. The co-primary outcomes were muscle strength in terms of the peak torque of the knee and ankle extensors and flexors, and IENFD. Secondary outcome measures included the 6 min walk test (6MWT), five-time sit-to-stand test (FTSST) and postural stability index obtained by static posturography. A total of 109 individuals were enrolled in three groups (type 2 diabetes with DPN [n = 42], type 2 diabetes without DPN [n = 32] and healthy control [n = 35]). PRT resulted in muscle strength gains of the knee extensors and flexors in all three groups using comparative analysis (DPN group, PRT 10.3 ± 9.6 Nm vs non-PRT -0.4 ± 8.2 Nm; non-DPN group, PRT 7.5 ± 5.8 Nm vs non-PRT 0.6 ± 8.8 Nm; healthy control group, PRT 6.3 ± 9.0 Nm vs non-PRT -0.4 ± 8.4 Nm; p<0.05, respectively). Following PRT the DPN group improved the 6MWT (PRT 34.6 ± 40.9 m vs non-PRT 2.7 ± 19.6 m; p=0.001) and the FTSST (PRT -1.5 ± 2.2 s vs non-PRT 1.5 ± 4.6 s; p=0.02). There was no change in IENFD following PRT in any of the groups. PRT improved muscle strength of the knee extensors and flexors and motor function in individuals with type 2 diabetic polyneuropathy at levels comparable with those seen in individuals with diabetes without DPN and healthy control individuals, while no effects were observed in IENFD. ClinicalTrials.gov NCT03252132 FUNDING: Research reported in this paper is part of the International Diabetic Neuropathy Consortium (IDNC) research programme, supported by a Novo Nordisk Foundation Challenge Program grant (grant no. NNF14OC0011633) and Aarhus University.

The Effect of Progressive Resistance Training on Fatigue in Multiple Sclerosis Patients: A Systematic Review

The Effect of Progressive Resistance Training on Fatigue in Multiple Sclerosis Patients: A Systematic Review

The effects of progressive resistance training on muscle strength and volume in children with cerebral palsy: A randomized controlled trial

The effects of progressive resistance training on muscle strength and volume in children with cerebral palsy: A randomized controlled trial

INERTIA: A pilot study of the impact of progressive resistance training on blood pressure control in older adults with sarcopenia

Sarcopenia, and high blood pressure are highly prevalent, preventable conditions that pose significant burden for older adults and on the healthcare system. Current prevention and treatment of high blood pressure in sarcopenia, by non-pharmacological approaches remain limited and are far from optimal. Clinical trials and mechanistic studies provide encouraging evidence of a plausible therapeutic effect of progressive resistance training (PRT) on blood pressure in younger, and pre-hypertensive and hypertensive older adults. The impact of PRT on blood pressure has not been empirically tested in older adults with sarcopenia. This pilot study aims to provide effect size confidence intervals, clinical trial and intervention feasibility data, and procedural materials for a full-scale randomized controlled trial that will determine the efficacy of PRT intervention as a therapeutic strategy for blood pressure control in older adults with sarcopenia. Participants (N = 90) will be randomized to receive exercise educational materials or the PRT intervention consisting of 24 supervised exercise sessions over 12-weeks. Follow-up assessments will occur at 12-weeks and one-year later. The primary outcome is systolic blood pressure and diastolic blood pressure, analyzed separately. Microvascular mechanisms linking muscle (perfusion, strength, function) to changes in blood pressure will be explored at baseline and 12-weeks. This study will provide new evidence for the therapeutic effect of PRT as a non-pharmacological strategy for improving blood pressure. Insights gained may also inform of the potential role of muscle strength as a novel target for blood pressure control, and future exercise prescription guidelines related to muscle strengthening in high-risk older adults.

The effect of Progressive Resistance Training and High Intensity Interval Training on TRAF6 gene expression of the heart muscle and serum TNF-α levels in male diabetic rats

Background: The most common causes of mortality in diabetic patients are cardiovascular disorders, one of the reasons being inflammatory factors. Given that physical activity can reduce inflammation, the present study was to investigate the effects of two types of Progressive Resistance Training (RT) and High Intensity Interval (HIIT) on the expression of TRAF6 gene and serum levels of TNF-α in male diabetic rats. Methods: In this experimental study, 72 male rats were divided into 6 groups of 12 diabetic rats (n=12), control (n=12), diabetic High Intensity Interval Training (n=12), High Intensity Interval Training(n=12), diabetic Progressive Resistance Training(n=12) and Progressive Resistance Training(n=12). Progressive Resistance Training was performed in a 6-weekly 3-session, climbing the vertical ladder, with 50%, 75%, 90% and 100% the body weight of the animals. After successful completion, 30 gr were added to the weights, to the extent that the rats cannot carry the ladder. High Intensity Interval Training were also performed at 6-weekly 3-session, with an intensity of 50 to 110% of the VO2max. 24 hours after the completion of the training, the functional test was taken and the animals were autopsy 48 hours after the test. Finally, the expression of TRAF6 gene was evaluated using Real Time PCR and serum TNF-α level by ELISA method. Results: TRAF6 levels increased significantly after the two Training in the diabetic group, which was higher in the HIIT group and serum TNF-α levels decreased significantly after both types of training, which was more prominent in the HIIT group. Conclusion: HIIT and RT can play an important role in reducing the inflammatory factor of TNF-α in diabetic patient that HIIT is more effective in this regard. Increasing the gene expression of the mediating agent TRAF6 can be induced in inflammatory pathways, which may require a reduction in exercise intensity or in anti-inflammatory routes indicating a positive effect of training on diabetes.

Reshaping the path of vascular cognitive impairment with resistance training: a study protocol for a randomized controlled trial

BackgroundSubcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention.MethodsEighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression.DiscussionThe burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care.Trial registrationClinicalTrials.gov NCT02669394. Registered on February 1, 2016

Progressive resistance training in a post-acute, older, inpatient setting: A randomised controlled feasibility study

Objectives:Progressive resistance training can successfully target functional decline in healthy older community-dwelling adults. There are concerns about the safety and acceptance of its use in frail older populations. The aim of this study was to evaluate the feasibility of using progressive resistance training in an older, post-acute, inpatient setting.Methods:A randomised controlled feasibility study was conducted. Appropriate older inpatients undergoing post-acute rehabilitation were recruited. Feasibility measures examined were safety, recruitment, outcome measurement, adherence and retention rates and satisfaction. A range of clinical measures were used to capture changes in body structure and function, activity and participation. Assessments were performed on admission to the study and six weeks later.Results:A sample of 33 patients were included and randomised to the treatment group (n=16) or the control group (n=17). There were no serious adverse events, adherence rates were 63% and retention rates were 82%. While both groups improved between time 1 and 2, there were no significant differences in clinical measures between the groups.Conclusion:Progressive resistance training is a safe and acceptable intervention for use with this population. Further work on the effectiveness of progressive resistance training in this setting is now required.

Observations of Performance and Body Composition Following 8-weeks of Progressive Resistance Training in Participants With Cerebral Palsy

Purpose: To observe the effects of progressive resistance training on performance and body composition in participants with cerebral palsy. Methods: Four quadriplegic (3 male, 1 female) and two hemiplegic (2 female) participants (22 ± 5 yr, mean ± SD) completed moderate to high intensity resistance training 2-3 days a week for 8-weeks. Strength training programs were developed for each participant based on their physical ability. Measurements of exercise performance and body composition (InBody 270 &amp; S10) were collected prior to and following training. Data from all participants was pooled, and samples with 5-6 subjects were analyzed using a paired t-test with significance set at p &lt; 0.05. Results: Measurements of muscular fitness improved, including plank performance (pre: 64 ± 40, post: 95 ± 61 s, n = 6), supine sled leg press 1RM (pre: 225 ± 69, post: 378 ± 124 lb, n = 6) and bench/sled press 1RM (pre: 92 ± 54, post: 115 ± 58 lb, n = 5). There was no change in peak sprint capacity (pre: 89 ± 32, post: 96 ± 29 W, n = 5) or peak aerobic capacity (pre: 303 ± 136, post: 370 ± 246 s, n = 4). Measurements of body weight (pre: 151 ± 40, post: 151 ± 42 lb, n = 6) and skeletal muscle mass (pre: 53 ± 8, post: 54 ± 9 lb, n = 6) were unchanged following training. Conclusion: Preliminary data is encouraging that the unique and challenging strength training program employed with these participants can be utilized to gain meaningful improvements in muscular fitness. However, a larger sample size and longer training period may be necessary to significantly increase muscle mass.

Resistance band training after triamcinolone acetonide injection for subacromial bursitis: A randomized clinical trial.

ObjectiveTo investigate the effect of progressive resistance training using resistance (elastic) bands on subacromial bursitis following triamcinolone acetonide injection.DesignRandomized clinical trial.PatientsA total of 68 patients with subacromial bursitis were randomized to a triamcinolone acetonide group or a triamcinolone acetonide plus resistance band training group.MethodsVisual analogue scale, Constant scores, range of motion, proprioception, and muscle strength were evaluated at pretreatment and at 3, 12 and 24 weeks’ follow-up. Re-treatment ratio was calculated at one-year follow-up.ResultsAt 3 and 12 weeks, both the triamcinolone acetonide group and triamcinolone acetonide plus resistance band training group showed a significant improvement in Visual analogue scale score, Constant score, range of motion, proprioception and muscle strength. Although the scores in the triamcinolone acetonide group had not increased at 24 weeks compared with baseline, the scores in the triamcinolone acetonide plus resistance band training group showed continued improvement at 24 weeks. A lower proportion of patients in the triamcinolone acetonide plus resistance band training bands group than in the triamcinolone acetonide group had received re-treatment at one-year follow-up (12.1% vs 82.9%).ConclusionProgressive resistance training with resistance (elastic) bands has the advantages of extending the benefits of corticosteroid injection and maintaining long-term effects on shoulder function in patients with subacromial bursitis.LAY ABSTRACTSubacromial bursitis is characterized by pain and stiffness of the shoulders. Corticosteroid injection is widely used in treating subacromial bursitis; however, with differing views on its long-term effects in preventing shoulder symptoms. Resistance (elastic) band training is commonly used to promote muscle activation during shoulder rehabilitation. The aim of this study was to investigate the effect of progressive resistance training with elastic bands on subacromial bursitis following triamcinolone acetonide injection. Patients with subacromial bursitis were randomized to a triamcinolone acetonide group or a triamcinolone acetonide plus resistance band training group. The triamcinolone acetonide group received triamcinolone acetonide injection only. Meanwhile, the triamcinolone acetonide plus resistance band training group received triamcinolone acetonide injection and resistance band training. At 3 and 12 weeks, both the triamcinolone acetonide group and triamcinolone acetonide plus resistance band training group showed a significant improvement in pain relief, mobility, and muscle strength. A lower proportion of patients in the triamcinolone acetonide plus resistance band training group than in the triamcinolone acetonide group had received re-treatment at the oneyear follow-up (12.1% vs 82.9%). Thus, training with resistance (elastic) bands has the advantages of extending the benefits of corticosteroid injection and maintaining long-term effects on shoulder function in subacromial bursitis.

Progressive Resistance Training for Improving Health-Related Outcomes in People at Risk of Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Osteoporosis clinical practice guidelines recommend exercise to prevent fractures, but the efficacy of exercise depends on the exercise types, population studied, or outcomes of interest. The purpose of this systematic review was to assess the effects of progressive resistance training (PRT) on health-related outcomes in people at risk of fracture. Multiple databases were searched in October 2019. Eligible articles were randomized controlled trials of PRT interventions in men and women ≥50years with low bone mineral density (BMD) or fracture history. Descriptive information and mean difference (MD) and SD were directly extracted for included trials. A total of 53 studies were included. The effects of PRT on the total number of falls (incidence rate ratio [IRR] = 1.05; 95% CI = 0.91 - 1.21; 7 studies) and on the risk of falling (risk ratio [RR] = 1.23; 95% CI = 1.00 - 1.51; 5 studies) are uncertain. PRT improved performance on the Timed "Up and Go" test (MD=-0.89seconds; 95% CI=-1.01 to -0.78; 13 studies) and health-related quality of life (standardized MD=0.32; 95% CI=0.22-0.42; 20 studies). PRT may increase femoral neck (MD=0.02g/cm2; 95% CI=0.01-0.03; 521 participants, 5 studies) but not lumbar spine BMD (MD=0.02g/cm2; 95% CI=-0.01-0.05; 4 studies), whereas the effects on total hip BMD are uncertain (MD=0.00g/cm2; 95% CI=0.00-0.01; 435 participants, 4 studies). PRT reduced pain (standardized MD =-0.26; 95% CI=-0.37 to -0.16; 17 studies). Sensitivity analyses, including PRT-only studies, confirmed these findings. Individuals at risk of fractures should be encouraged to perform PRT, as it may improve femoral neck BMD, health-related quality of life, and physical functioning. PRT also reduced pain; however, whether PRT increases or decreases the risk of falls, the number of people experiencing a fall, or the risk of fall-related injuries is uncertain. Individuals at risk of fractures should be encouraged to perform PRT, as it may have positive effects on femoral neck BMD, health-related quality of life, physical functioning, and pain, and adverse events are rare. Exercise is recommended for people at risk of osteoporotic fractures. Our study showed that progressive resistance training improves physical functioning, quality of life, and reduces pain. The effects of progressive resistance training on the risk of falling are unclear. Adverse events are rare, and often minor (eg, soreness, pain, musculoskeletal injury). Considering the benefits and safety, people at risk of fractures should engage in progressive resistance training interventions.