Progressive Strength Training Research Articles

Testosterone and resistance training improved physical performance and reduced fatigue in frail older men: 1 year follow-up of a randomized clinicaltrial.

To improve health conditions among hypogonadal men ≥70 years of age using testosterone undecanoate (TU) injections, progressive strength training, and oral supplements of vitamin D, calcium, and protein. This study is a 1-year follow-up of a double-blind RCT lasting 20 weeks, including 148 older men ≥70 years old with low testosterone levels and mobility problems. During 52 weeks, 4 groups received either testosterone therapy (TU) or progressive resistance training (Training), both (Combo), or no intervention (Controls). Physiotherapists supported the training groups until week 20, while these participants continued trained on their own during weeks 21 to 52. The main outcome measure was the 30-s chair stand test. The following numbers of participants completed the trial: 20 (Combo), 20 (Controls), 24 (TU), and 14 (Training). When examining 30-s chair stand test performance within each group at baseline, and at weeks 4, 20 and 52, only the Combo group improved (p = 0.001, Friedman Test). Compared to controls, only the Combo group experienced reduced fatigue and tiredness (p < 0.05). Fifty-two weeks of testosterone supplementation combined with progressive resistance training may enhance physical performance, alleviate fatigue, and had no notable detrimental impacts among males aged ≥70 suffering from mobility issues and testosterone insufficiency.Trial registration - Clinical Trials NCT02873559.

Increased knee-extension strength and steps per day after a novel post-hospitalization rehabilitative program in older adults (65+): Secondary analyses of a randomized controlled single-blinded trial using an expanded sample size

IntroductionOlder adults are at risk of developing new or worsened disability when hospitalized for acute medical illness. This study is a secondary analysis of the STAND-Cph trial on the effect of a simple strength training intervention initiated during hospitalization and continued after discharge. We investigated the between-group difference in change in functional performance outcomes, the characteristics of patients who experienced a relevant effect of the intervention, and the characteristics of those who were compliant with the intervention, using an expanded sample size as protocolized. MethodsThe STAND-Cph was a randomized controlled trial conducted at a major Danish university hospital. Acutely admitted older adult patients (65+) from the Emergency Department were randomized to the intervention group receiving progressive strength training and a protein supplement during and after hospitalization (12 sessions over 4 weeks) or control group receiving usual care. The primary outcome was the de Morton Mobility Index assessed at baseline and 4 weeks after discharge. The secondary outcomes were 24-h mobility (assessed by ActivPAL accelerometers), isometric knee-extension strength, 30 s. sit-to-stand performance, and habitual gait speed. ResultsBetween September 2013 and September 2018, a total of 158 patients were included and randomized to either the intervention group (N = 80; mean age 79.9 ± 7.6 years) or the control group (N = 78; mean age 80.8 ± 7.4 years). We found no significant between-group difference in change in our primary outcome (p > 0.05). Both the intention-to-treat (difference in change 0.14 Nm/kg (95 % CI 0.03;0.24), p = 0.01) and the per protocol (difference in change 0.16 Nm/kg (95 % CI 0.04;0.29), p = 0.008) analyses showed that between baseline and 4 weeks, knee-extension strength increased significantly more in the intervention group than in the control group. Also, the per protocol analysis showed that the intervention group increased their daily number of steps significantly more than the control group (difference in change 1088 steps (95 % CI 44; 2132); p = 0.04). When examining subgroups of patients, we found no significant differences neither between those who experienced a clinically relevant improvement in the de Morton Mobility Index and those who did not, nor between those who were compliant and those who were not. ConclusionThis exploratory analysis indicates that while simple progressive strength training and protein supplementation does not improve functional performance assessed by the de Morton Mobility Index, it can benefit specific facets of physical activity and muscle strength among geriatric patients.

Can general exercise training and pelvic floor muscle training be used as an empowering tool among women with endometriosis? Experiences among women with endometriosis participating in the intervention group of a randomized controlled trial

BackgroundThe potential benefit of exercise in alleviating symptoms of endometriosis is unclear. Still, exercise may be used to empower women and manage disease symptoms. The purpose of this study was to explore how regular supervised group- and individual exercise training, including pelvic floor muscle training (PFMT), is experienced among women with endometriosis after participating in a randomized controlled trial (RCT).MethodsAmong 41 women randomized to exercise training for four months, ten women were interviewed about their experiences with exercise training after participation in the trial. The weekly group training was led by women’s health physiotherapists and included individualized and progressive muscular strength training of large muscle groups and the pelvic floor muscles, in addition to endurance-, flexibility, and relaxation training. An individual training program followed the same principles as the group training and was to be performed 3–5 times per week, depending on the level of intensity. PFMT was recommended daily. The women also received a group pain management course emphasizing exercise training as self-management. Using inductive reflexive thematic analysis, responses to the question “Did participation in the study change your view of exercise as part of the treatment for endometriosis?“ were analyzed.ResultsThe women brought forward the importance of knowledge about the benefits of exercise to make informed decisions in disease management. Further, the women described how exercise training was perceived as less frightening and manageable when exposed to various intensities, dosages, and types of exercises in a safe and supportive environment. PFMT was especially brought forward as something new and appreciated, and for some of the women, to be performed on days when their bodies could not handle the general exercise training. They also expressed that the supervised exercise brought an extra dimension of belonging through group participation.ConclusionsIndividualization and regular supervision seem important to empower women with knowledge about exercise training as self-management and to experience exercise training as safe and non-threatening. Further, creating a sense of belonging through group training may improve social support and build active coping strategies that are essential for disease management of endometriosis.Trial registrationNCT05091268 (registered 23.09.2021).

Beneficial effects of exercise, testosterone, vitamin D, calcium and protein in older men-A randomized clinical trial.

Due to increasing older populations worldwide, injuries, disabilities and deaths caused by falls among the elderly represent a growing human and societal problem. We aimed to improve health among men of at least 70years of age with low-normal to low testosterone and mobility problems by using testosterone undecanoate (TU) injections, progressive strength training, and oral supplements of vitamin D, calcium and protein. This was a single-centre, randomized, placebo-controlled, double-blind trial with 148 older men with a median age of 77 (73-81) years, testosterone levels at median 8 (5-9) nmol/L (full range from 1.1 to 12.9nmol/L) and mobility problems, recruited at University Hospital of Copenhagen, Herlev Hospital, Denmark. Participants were randomized into four arms for 20weeks: (1) TU therapy (n=37); (2) progressive resistance training with supplements of calcium, vitamin D and protein (n=36); (3) both interventions combined (n=36); or (4) no intervention (n=39). The main outcome measure was the 30-s chair stand test, due to test performance correlating with the risk of serious fall injuries and lower extremity muscle strength. Outcome measurements were performed at baseline and after 20weeks. After the intervention, the combination group receiving progressive resistance training, TU and supplements achieved a median score of 13 (11-15) compared to the control group at 10 (0-14) in the 30-s chair stand test (P=0.003). This median improvement of 3.0 was clinically important. Compared to the control group, participants in the combination group also increased quality of life (P<0.05) and reduced both tiredness (P<0.05) and leg fat (P<0.05) and had higher variability in the RR interval (P<0.01). The group receiving TU reduced gynoid and leg fat compared to the control group (both P<0.05). Blood tests improved for several variables, especially in the combination group. There was no statistically significant increase in adverse effects from either the supplements or training. In men ≥70years old with low-normal to low testosterone and mobility problems, supplements of testosterone, calcium, vitamin D and protein combined with progressive resistance training improved 30-s chair stand test performance, muscle strength and quality of life. Both tiredness and leg fat were reduced, and RR interval variability was increased. Significant adverse effects were not observed.

Frailty evidence-practice gaps in acute care hospitals.

Frailty is common in hospitalised older people. Clinical practice guidelines for the management of frailty provide recommendations for identification and management; however, adoption into practice in hospitals is limited. This study identified and quantified the evidence-practice gap between frailty guidelines and clinical practice in two hospitals using an audit tool. A cross-sectional audit of medical records of frail older patients admitted to two hospitals was conducted. Data were collected using an audit tool based on the Asia Pacific Clinical Practice Guidelines for frailty management. Data were analysed using descriptive statistics and inter-rater reliability of the tool was assessed. Auditing of n = 70 electronic medical records showed that assessment of frailty in the acute setting did not regularly occur (17%). Few participants received guideline-recommended interventions. Physiotherapy treatment was limited, with 23% of participants receiving progressive resistance strength training. Gaps exist in provision of nutritional supplementation (26%) with limited recordings of weight during the admission for 10% of participants. Pharmacy review of medications was consistently documented on admission (84%) and discharge (93%). Vitamin D was prescribed for 57% of participants. Inter-rater reliability showed a high level of agreement using the audit tool. An audit tool was feasible to assess frailty evidence-practice gaps in the hospital setting. Further understanding of the contextual barriers is needed to inform implementation strategies (dedicated staffing, education and training and ongoing audit of practice cycles) for the uptake of frailty guidelines in hospital settings.

The feasibility of a 12-week progressive strength training program in patients with femoroacetabular impingement syndrome

The feasibility of a 12-week progressive strength training program in patients with femoroacetabular impingement syndrome

Progressive strength training can reverse sarcopenia stage in middle-aged and older adults regardless of their genetic profile

The aim of this study was to verify the association of the ACTN3-R577X polymorphism with sarcopenia stage, according to the Revised European Consensus on the Definition and Diagnosis of Sarcopenia, in middle-aged and older adults, pre- and post- ST. In the 12-week longitudinal study, 71 middle-aged and older adults were evaluated; the participants were assigned to either control or intervention group. The intervention group underwent progressive ST three times a week. All participants underwent blood collection, DNA extraction, genotyping of the ACTN3-R577X polymorphism, anthropometric evaluations, and diagnostic tests for sarcopenia. The last two tests were repeated after 12 weeks. No association of the ACTN3-R577X polymorphism with sarcopenia stage was observed before and after 12 weeks. However, the intervention group remained non-sarcopenic (n = 25, p <0.05) or achieved changes in sarcopenia stage (from sarcopenic to non-sarcopenic) (n = 13, p <0.05). Our study demonstrates that progressive ST performed regularly can reverse or prevent sarcopenia regardless of genotype for the ACTN3-R577X polymorphism.

Rehabilitation after Hip Fracture Surgery: A Survey on Italian Physiotherapists’ Knowledge and Adherence to Evidence-Based Practice

The average life expectancy of the Italian population has increased over the last decades, with a consequent increase in the demand for healthcare. Rehabilitation after hip fracture surgery is essential for autonomy, recovery, and reintegration into the social context. The aim of this study was to determine the level of knowledge and adherence to the recent treatment recommendations of the Italian physiotherapists. A web-based survey, composed of 21 items, was conducted and the frequencies and percentages of the responses were analyzed to evaluate if there was an integration and adherence to the recommendations of greater than 70%, with respect to the desired response. A total of 392 responses were collected and analyzed. Recommendations regarding the multidisciplinary approach, early mobilization, and progressive muscle strength training, achieved the desired value in the inpatient setting. Intensive rehabilitation and full weight bearing did not reach the threshold values. The results of this survey show a partial integration of the recommendations for rehabilitation after hip fracture surgery by Italian physiotherapists. Adherence seems to be better in the inpatient setting and with physiotherapists with higher levels of education.

Impact of Exercises on Bone Health of Pre-Menopausal Female

The process of bone resorption and creation, in which osteoclasts destroy old bone and osteoblasts produce new bone, causes the living tissue of bone to continually degrade. Bone is a dynamic tissue that adjusts to the accompanying mechanical forces that are put on it, such as exercise. In order to lower the risk of osteoporosis and resultant fractures during the postmenopausal years, with relative-risk rises, it is crucial to maintain appropriate bone mineral density (BMD) levels throughout the premenopausal years. Pre-menopausal women have been found to have osteopenia and osteoporosis at prevalence rates of 15% and 0.6%, respectively [1]. In addition, it has been found that premenopausal women lose between 0.25 and 1% of their bone mineral density per year [2]. In Pakistan, the long-life expectancy after menopause, multiparity, lack of a calcium-rich diet, vitamin D deficiency, physical inactivity, as well as socio-demographic factors, all contribute to an increase in the prevalence of primary, type II osteoporosis and its associated complications. According to a local survey, it affects postmenopausal women 20-49.3% of the time [3]. Although pre-menopausal women are often unsuitable for pharmaceutical treatment, relying on lifestyle factors is virtually always advised. Exercise, a low-cost, non-pharmacologic intervention that is accessible to the great majority of the population, is one potentially successful lifestyle strategy for accomplishing this aim. During youth, exercise improves bone growth and increases BMD, and it may help older people avoid osteoporosis and fractures. Regular exercise, particularly weight-bearing and high-impact exercises, helps the body build high peak bone mass and may lower the risk of falls and osteoporotic fractures in later life. Regarding femoral neck BMD, high-impact exercise was shown to be most beneficial, and it has also been hypothesized that gains brought on by high-impact exercise are retained after intervention. In healthy pre-menopausal women, high-impact exercise increases the bone mineral density in the upper femur and the lumbar spine. This kind of exercise could be an effective, secure, and affordable strategy to prevent osteoporosis later in life if done regularly. Progressive resistance strength training for the lower limbs is the kind of exercise that have the greatest impact on BMD for the neck of the femur and should be taken into consideration in clinical practice. The multicomponent training exercise programme has been recommended as the most effective intervention for BMD at the spine. Aerobic exercises involving weight bearing and training on vibrating platforms may also improve BMD.

INFLUÊNCIA DO TREINAMENTO PROGRESSIVO DE FORÇA NOS MEMBROS SUPERIORES EM ATLETAS DE TÊNIS DE MESA

ABSTRACT Introduction Progressive strength training can help athletes improve their strength levels quickly and safely. By controlling the frequency and amplitude of vibrations, muscles can produce unconscious and voluntary contractions that help prevent diseases such as osteoporosis. Objective To explore the change in sports performance caused by progressive upper limb muscle strength training in table tennis players. Methods 12 table tennis players with a minimum experience of 5 years were randomly divided into experimental and control groups. The control performed traditional strength training methods while the experimental group used the progressive directed strength training method developed by the research team for nine weeks. Tests were performed on ISOMED 2000 equipment at the conditions of 60°/s and 450°/s. Results Circumference, muscle strength, and relative upper limb strength increased. In addition, a difference in the rate of the maximum elbow flexion moment of the athletes in the experimental group in the 60°/s test conditions was observed. At 450°/s, the maximum flexion and extension elbow moment showed a significant difference (P&lt;0.05). Conclusion The progressive strength training method significantly affects the athletes’ maximum elbow flexion moment and maximum elbow extension moment than traditional strength training methods. Muscle strength progress was noted mainly in the elbow and wrist joints, with less intensity in the shoulders. Evidence Level II; Therapeutic Studies – Investigating the results.

Resting Myokine Concentrations Are Reduced With Resistance-exercise Training But Blood Flow-restricted Resistance-exercise Response Is Unchanged.

Myokines are proteins and peptides produced and secreted by skeletal muscle; some are postulated to contribute to skeletal muscle hypertrophy. PURPOSE: To evaluate systemic myokine concentrations following acute blood-flow restricted resistance-exercise (BFR-RE) after a twelve-week traditional strength-training protocol in younger and older males. METHODS: Untrained males (younger: 24.7 ± 3.9 yrs, n = 8; older: 68.3 ± 4.6 yrs, n = 7) performed full-body BFR-RE before and after 12 weeks of progressive full-body strength training. At rest, immediately after, and 3, 6, 24 and 48 hours following each BFR-RE session, venous blood was collected and analyzed in duplicate to determine concentrations of interleukin-4 (IL-4), IL-6, IL-7, irisin, Leukemia Inhibitory Factor (LIF) and nitrate/nitrite. Area under the curve was calculated and a 2-way (age × training status) repeated measures ANOVA was conducted. RESULTS: For older males, IL-4 (untrained = 6996.9 ± 9260.2 AUC vs. trained = 5681.2 ± 8133.6 AUC; p = 0.038) and IL-6 (untrained = 819.2 ± 1104.5 AUC vs. trained = 636.5 ± 952.8 AUC; p = 0.016) were higher in the untrained condition than trained but did not differ for younger males. A significant age effect was identified for irisin, as younger males had higher concentrations than older (mean difference = 9423.8 ± 12546.8 AUC; p = 0.012). However, when AUC was calculated with baseline values subtracted, participants had higher IL-7 in the untrained condition compared to trained (mean difference = 33.5 ± 56.9 AUC; p = 0.04). Other myokines showed no training differences. CONCLUSION: Younger males had higher circulating irisin, and strength training decreased IL-4 and IL-6 in older males. The disappearance of age-related changes in IL-4 and IL-6 after baseline subtraction suggests those differences were due to lower baseline concentrations following the strength training program. Thus, IL-4 and IL-6 levels did not respond differently to BFR-RE in the untrained and trained conditions. Also, the lower response of IL-7 to BFR-RE in the trained vs. the untrained condition indicates that myokine secretion is affected by an individual’s level of training. Funding: This project was supported by grants (SMC & JEA) from the University Collaborative Research Program and Faculty of Science Collaborative - University of Manitoba.

Modern Approaches to Rehabilitation of Patients with Osteoporotic Hip Fracture: the Role of Pathogenetic Therapy with Zoledronic Acid

The article gives literature data systematic analysis (20 Russian and 47 foreign literature sources) on the issue of rehabilitation of patients with hip fracture (HF) against the background of osteoporosis (OP) and the role of pathogenetic therapy with zoledronic acid in the complex rehabilitation of such patients. Literature data testify to the high prevalence and medical and social significance of osteoporotic HF in Russia and abroad. The need to develop effective methods for the rehabilitation of patients with OP is due to the demand for patient’s life quality recovery in short terms, treatment cost reduction and death risk reduction, the highest during the first year after a pathological HF. The main objective of rehabilitation measures after osteoporotic HF is to reduce the likelihood of disability and death of the patient that is extremely high in the first months after the fracture – about 10% of elderly patients die in the first 3 months after HF. The effectiveness of medical rehabilitation of patients with HF depends on the surgical treatment and mobilization time frames. Exercises are recommended to strengthen the muscles – knee extensors in the first 2–5 days after surgical treatment of osteoporotic HF. After 3 weeks, progressive strength training should be included in rehabilitation programs to improve the functional capabilities of patients. Conclusion. Given the high risk of recurrent fractures in patients with osteoporosis undergoing rehabilitation after HF, the appointment of pharmacological therapy for OP, primarily zoledronic acid at a dose of 5 mg once a year, should be a mandatory addition to physical therapy procedures.

Does Strength training improve quality of life and balance related confidence in older adults?

Background: Individual above the age of 60 years belong to the rapidly raising proportion in Indian population. Aging results in decline in the performance of daily activities that rely on the mobility and balance represent a solemn drip in the functional status leading to the risk of institutionalization. Adopting a regular physical activity and targeting the muscle weakness through resistance training would produce greater benefits in this population. Objective: The purpose of this study was to analyze the effects of progressive strength training on balance related confidence and health related quality of life. Study design – Quasi experimental study. Method: This study was conducted in elderly between 60 to 75 years from residential care homes. Nearly 23 participants received progressive strengthening exercises for 8 weeks. The effect of strength training on balance confidence and quality of life were analysed using activity specific balance confidence (ABC) scale and Euro quality of life questionnaire (EQL-5D-5L) respectively. Result: Progressive strength training showed significant improvements in quality of life and balance related self confidence measure in elderly with impaired balance. Conclusion: Engagement of older adults in strengthening activities involving major muscle groups are essential component in elderly rehabilitation to maintain and control the age related wane in physical activity.

Older patients’ perspectives on participating in multimodal rehabilitation including anabolic steroids following hip fracture: a qualitative study embedded within a pilot RCT

Purpose To explore patient perspectives of participating in a pilot RCT evaluating feasibility and effect of anabolic steroid, physiotherapy and nutritional supplement following hip fracture. Methods Semi-structured telephone-based interviews of 16 women and three men (average age 73 years) were conducted at baseline and after a 12-week intervention. Qualitative content analysis was performed. Results Two main categories were identified: (1) Trust and hope for a positive change with three sub-categories; reflections on anabolic steroids, anticipation of extra attention, lack of energy. (2) Curiosity, care, and commitment with four sub-categories; a sense of anabolic steroids, feeling of exclusivity and privileges, challenges and sense of obligation, and perspectives on personal gain. Conclusions Findings suggest high acceptability of the intervention. Participants motivated their participation on a trust that the intervention would “do more good than harm”. They found the randomization and possibility of receiving anabolic steroids intriguing, and especially valued trial participation because of their experience of getting extra care and “deluxe” rehabilitation including close contact and support by health professionals. Our findings may help inform future research recruiting older patients and generally considered relevant for health professionals in rehabilitation, emphasizing the impact of professional guidance and social support to encourage self-efficacy. Implications for rehabilitation With muscle enhancing medicine being suggested as a supplement in rehabilitation following hip fracture, exploring patients’ perspectives is warranted and may help inform future trials in this area. Factors reported as important by older adults for engaging in rehabilitation trials are: simple but thorough information, friendly and trustful relation with study staff and opportunities of extra care and attention. Older patients with hip fracture highly valued professional guidance and support by health professionals during the rehabilitation intervention. High acceptability was identified for the supervised outpatient rehabilitation, where especially the individually structured progressive strength training was highlighted as the “active ingredient” accelerating recovery and potentially promoted self-efficacy.

Progressive Upper Compartment Functional Strength Training on Postural Muscle Force: In Volleyball Players

Postural muscle force leads to a increase in functional movement and associated ability of strength. The author examined changes in shoulder and humerus strength, maximum isometric joint angular degree force after functional upper strength training in volleyball players. They evaluated isometric joint angular force degree as predictors of functional strength.

Association of the Psychological Response to the ACL-SPORTS Training Program and Self-reported Function at 2 Years After Anterior Cruciate Ligament Reconstruction

Background: Psychological readiness to return to sport has emerged as an important factor associated with outcomes after anterior cruciate ligament reconstruction (ACLR). Psychological factors are potentially modifiable during the course of rehabilitation, and improving them may lead to better outcomes. Purpose: To determine whether athletes with a positive psychological response after participation in a neuromuscular training and second injury prevention program had better self-reported function and activity outcomes compared with athletes who did not have a meaningful change. Study Design: Cohort study; Level of evidence, 3. Methods: After ACLR and the completion of formal rehabilitation, 66 level I/II athletes completed the following self-reported measures at enrollment (pretraining): the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale, the International Knee Documentation Committee (IKDC) subjective knee form, and the 5 subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS). Participants completed these measures after 10 sessions of agility, plyometric, and progressive strength training and at 1 and 2 years after ACLR. Participants who displayed an increase in the ACL-RSI score from pretraining to posttraining that exceeded the minimal clinically important difference (≥10 points) were defined as having a positive psychological response (responders) to training, and those who did not were defined as nonresponders. A mixed-model analysis of variance was used to determine if group differences in IKDC and KOOS scores existed over the 4 time points (pretraining, posttraining, and the 1- and 2-year follow-ups). Results: The responders reported better self-reported function compared with the nonresponders, regardless of time, on the IKDC form (P = .001), KOOS–Sport and Recreation (P = .014), KOOS-Pain (P = .007), and KOOS-Symptoms (P = .002) but not on the KOOS–Quality of Life (P = .078). Overall, 77% of responders and 67% of nonresponders returned to their previous level of sport by 1 year after ACLR (P = .358), and 82% of responders and 78% of nonresponders returned to their previous level of sport by 2 years after ACLR (P = .668). Conclusion: Ultimately, 59% of the athletes in this study displayed a meaningful improvement in their psychological outlook over the course of the training program. Responders demonstrated persistently better self-reported function at posttraining and at 1 and 2 years after ACLR, but there were no between-group differences in return-to-sport rates.

Effects of StrongPeople Strong Bodies on Functional Fitness: A Community-Based Randomized Trial

ABSTRACT Purpose Despite the established benefits of strength training among older adults, access to strength training facilities in rural communities is limited. Local community educator–led classes using affordable equipment that can be easily stored and moved (e.g., handheld weights) offer a feasible approach for improving strength training access among older rural adults; however, very few studies have examined the effects of these types of community-based classes led by nonexercise specialists. The objective of this study was to evaluate the effects of a community-based progressive strength training program led by Cooperative Extension county educators on functional fitness and physical activity among older rural adults. Methods Adults 50 yr and older recruited from rural Montana counties were randomized to a 12-wk, 1-h, twice-weekly, progressive strength training program, or a delayed intervention control group. Data were collected at baseline and postintervention via accelerometry, functional fitness tests, and questionnaires about physical activity, social support, and exercise attitudes. Linear mixed models and general additive models, adjusted for sex and age, were used to assess pre–post changes in outcomes between groups. Results Intervention participants (n = 83) experienced significantly greater improvements in aerobic endurance, upper body strength, lower body strength, exercise-related social support from friends, and attitudes toward exercise (all P &lt; 0.01) compared with control participants (n = 84); improvements were both statistically significant and functionally meaningful. Conclusions The present study provides strong evidence in support of strength training for older adults in community settings, led by nonexercise professionals, to improve cardiorespiratory fitness, strength, social support for physical activity, and attitudes toward exercise. Trial Registration The study was registered at ClinicalTrials.gov (Identifier: [NCT04203563]).

Introducing Progressive Strength Training Program in Singapore's Elder Care Settings.

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.

A long-term community gym program for people with Parkinson’s disease: a feasibility study of the Monash Health “Health and Fitness” model

Purpose To investigate the feasibility and acceptability of the Health and Fitness Program (HFP), a long-term community gym program for people with mild to moderate Parkinson’s disease (PD). Methods Physiotherapists, with PD expertise, developed individualised exercise programs for new HFP members in consultation with them. Gym instructors, with PD training, supervised the HFP sessions. Exercises included progressive strength training, aerobic, balance, and stretching. Participants who had been enrolled in the HFP for 12 months, were recruited to a single group pre/post design study to test the program’s feasibility and acceptability. Feasibility included safety, retention, attendance, and compliance data and acceptability measured using a customised questionnaire. Results 17 of the 20 HFP members enrolled maintained membership for 12 months and participated in this study. The program was shown to be feasible with no falls reported during sessions, only one participant reported pain from exercising lasting more than 48 h, retention was high (85%) and most members complied with their program. Overall satisfaction with the program was high, with seven somewhat satisfied and 10 very satisfied. Conclusion The HFP demonstrated that a PD community gym program is feasible and acceptable when physiotherapists and PD-trained instructors collaborate to provide individualized exercise programs. IMPLICATIONS FOR REHABILITATION People with Parkinson’s disease need support to maintain long-term adherence to regular exercise which can be achieved with supervised community-based gym programs. A community-based PD-specific exercise program can be safe and acceptable to people with PD when PD specialist physiotherapists are involved in planning participants’ exercise programs and PD-trained gym instructors supervise the exercise sessions. Members are satisfied with programs that have strategies in place to minimise barriers to participation, such as keeping costs to members low, providing a quality service, having supportive trained staff, and creating opportunities for social interaction between members. Evidence-based community exercise programs may result in improved strength and aerobic fitness and maintain quality of life in people with mild to moderate PD however further research using an RCT study is needed.

Effect of Progressive Resistance Strength Training on Body Mass Index, Quality of Life and Functional Capacity in Knee Osteoarthritis: A Randomized Controlled Trial.

PurposeThis study aimed to investigate the effectiveness of progressive resistance strength training of the lower limb rehabilitation protocol (LLRP) on body mass index (BMI), quality of life, and functional capacity in patients with knee osteoarthritis (OA) who were overweight and obese.Patients and MethodsFifty-six patients were allocated into either the Rehabilitation Protocol Group (RPG) or the Control Group (CG) by a computer-generated random number. The patients in the RPG performed the strengthening exercises of the LLRP and followed the instruction of daily care (IDC). The patients in the CG only followed the IDC as a usual care. Gait Speed Test, quality of life, and BMI were taken at pre-test and post-test measurements. Paired samples t-test and two way mixed analysis of variance were used to analyze the change of BMI within and compare the difference of BMI between the groups, respectively. Wilcoxon signed ranked test and Mann–Whitney U-test were used to analyze the changes of quality of life and functional capacity within and compare the differences of quality of life and functional capacity between the groups, respectively.ResultsThe patients in the RPG reported a significant reduction in BMI (p = 0.025), improvement in quality of life (p ≤ 0.001), and functional capacity (p ≤ 0.001) within group. The patients in the CG also reported a significant improvements in quality of life (p < 0.05). The improvement in quality of life score was greater in the patients with RPG than the CG (p = 0.053).ConclusionThe progressive resistance strength training of LLRP is effective in terms of reducing BMI, improving quality of life and functional capacity.Trial RegistrationName: Iranian Registry of Clinical Trials. Number: IRCT20191221045846N3. Enrollment of first participant: 27-07-2020.