Which of the following is a benefit of resistance training in older adults?

T here are currently 33 million Americans aged ≥65 living in the United States; over the next century, that number will more than double, with the greatest increase occurring among individuals aged ≥85.1 The implications of extended years of life often involve increased incidence of chronic disease as well as the development of functional limitations. Despite the recent reduced prevalence of disability, 7 million older adults still are chronically disabled.2 Physiologically, there is a loss of muscle mass and strength as age increases. Observational studies indicate that approximately 1% of muscle mass is lost per year after the fourth decade of life.3, 4 This age-related loss of muscle mass is known as sarcopenia.5 Sarcopenia can result from or be exacerbated by certain medical conditions, yet it remains an issue of concern for the aging population regardless of chronic disease presence. Moreover, the loss of muscle mass and strength with age can increase an individual's risk for developing certain chronic conditions, such as osteoporosis.6

Often concurrent with increased physical impairment is the decreased ability to perform functional tasks such as climbing stairs, standing up from a chair, and doing basic household chores, all tasks that require a threshold of muscular strength. In some instances, it is the underlying presence of chronic disease that causes physical impairments; in other cases, it is simply age-related decrements, such as the loss of muscle mass and strength, that lead to these functional limitations. Regardless, this series of events can lead to disability, dependence, and increased morbidity and mortality for older adults.7

Research in the last several decades has shown that many of the age-related physiologic decrements older adults experience are not inevitable. The primary components of physical fitness are cardiorespiratory endurance, flexibility, body composition, power, balance/coordination, muscular endurance, and muscular strength. Each component has a role in preserving function, reducing risk for chronic health conditions, and averting disability with age.8, 9, 10 Specifically, studies have now shown that targeted exercise referred to as strength training (also known as weight lifting or progressive resistance training) has the power to combat weakness and frailty and their debilitating consequences.6 Functionally, strength training is an activity in which muscles move dynamically against weight (or other resistance) with small but consistent increases in the amount of weight being lifted over time.

Although it has yet to be determined whether the muscle mass, strength, and other benefits gained through strength training can actually prevent disability in older adults, scientific research and community implementation of strength-training programs have shown that it is a safe and effective means by which to improve physical capabilities, reduce risk for falls, prevent functional limitations, and avert the development of certain chronic diseases or their symptoms in older adults.

Cited by (240)

• A scoping review to map the evidence of physical activity interventions in post-treatment adolescent and young adult cancer survivors

  2022, Critical Reviews in Oncology/Hematology

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  This scoping review describes and synthesizes previously reported data to document physical activity (PA) interventions in adolescents and young adult (AYA) cancer survivors and to explore whether PA interventions tested to date improve survivors’ health outcomes.

  A search of the literature was conducted in PubMed, CINAHL, EMBASE, Web of Science and Cochrane Library following the PRISMA-ScR statement. We included all original studies (n = 8) investigating PA interventions in AYA cancer survivors.

  This review showed that PA interventions were feasible and acceptable in AYA cancer survivors. PA interventions were individualized and mainly aerobic in nature. Studies examining the effects of PA interventions on survivors’ health evaluated physical and mental health outcomes.

  Our scoping review maps the current evidence of PA interventions and highlights the paucity of data in this area of investigation, obviating how much work remains to be done to demonstrate the potential benefits of PA on AYA cancer survivors' health outcomes.

• Leg press and chest press strength normative values by half-decades in older persons

  2021, Experimental Gerontology

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  Evaluating muscular strength is vital to the application of effective training protocols that target quality of life and independence in older individuals. Resistance training is a valuable tool to improve functional capacity, strength, and power in this population; however, the lack of normative values for common lifts such as the leg press (LP) and chest press (CP) reduce its utility. This study developed age- and sex-specific normative strength values for older individuals. LP and CP 1-repetition maximum (1RM) values on Keiser A420 pneumatic machines were compiled from 445 older adults, ages 60-85y. Descriptive statistics and quartile rankings are reported, and two-way ANOVAs were conducted to determine differences between sex and age groups. There were significant sex x age group interactions for LP and CP. Men were significantly stronger than women across all age groups for both exercises (p < .01); however, the mean difference decreased with age. For men, no differences were seen among the 60–64 (237 ± 39 kg), 65–69 (223 ± 43 kg) and 70–74 (219 ± 50 kg) age groups; but the 60–64 group showed higher strength values than the 75–79 group (193 ± 52 kg) and all three groups contained higher strength values than the 80–85 group (172 ± 40 kg). Similarly, for relative strength, the 60–64 group (2.80 ± 0.53 kg·kgBM) surpassed values for all groups but the 65–69, and the 65–69 (2.70 ± 0.54 kg·kgBM) produced greater strength values than the 70–74 (2.45 ± 0.47 kg·kgBM), 75–79 (2.09 ± 0.37 kg·kgBM) and 80–85 (2.19 ± 0.38 kg·kgBM) groups. In contrast, no significant differences in absolute or relative strength were seen among age groups for the women. Our study establishes absolute and relative age- and sex-specific normative values for the LP1RM and CP1RM in older individuals. These values allow practitioners and researchers to interpret the results of various interventions, and evaluate their importance to evaluation of sarcopenia, injury risk, functional mobility and quality of life. Additionally, our results reveal that age-related declines in strength are prominent for male LP and CP, but not female CP or LP.

• Comparison of blood flow restriction devices and their effect on quadriceps muscle activation

  2021, Physical Therapy in Sport

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  Blood flow restriction training (BFRT) provides an alternative approach to traditional strength training. The purpose of this study was to determine differences in quadriceps muscle activation, subject reported pain, and perceived exertion between three exercise conditions: low-load resistance BFRT with (1) regulated and (2) standardized devices, and (3) high-load resistance exercise without BFRT.

  Randomized cross over study.

  XX University Biomechanics laboratory.

  Thirty-four healthy subjects (18 male/16 female) each completed three randomized sessions of knee extensions using Delfi’s Personalized Tourniquet System (R) at 30% of 1 repetition maximum (1RM), the B-Strong™ device (S) at 30% 1RM, and high-load resistance exercise (HL) at 80% 1RM.

  Quadriceps EMG activity, numeric pain rating scale (NPRS), and perceived exertion (OMNI-RES) were recorded.

  Average and peak EMG were greater in HL sessions than both S and R (p < .001). NPRS was greater in the R sessions compared to both S (p < .001) and HL (p < .001). OMNI-RES was greater in the R sessions compared to S (p < .02) and HL (p < .001). No differences (p > .05) in average or peak EMG activation were found between S and R sessions.

  Quadriceps EMG amplitude was greater during high-load resistance exercise versus low-load BFR exercise and there were no differences in EMG findings between BFRT devices.

• Mapping of the contraction-induced phosphoproteome identifies TRIM28 as a significant regulator of skeletal muscle size and function

  2021, Cell Reports

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  Mechanical signals, such as those evoked by maximal-intensity contractions (MICs), can induce an increase in muscle mass. Rapamycin-sensitive signaling events are widely implicated in the regulation of this process; however, recent studies indicate that rapamycin-insensitive signaling events are also involved. Thus, to identify these events, we generate a map of the MIC-regulated and rapamycin-sensitive phosphoproteome. In total, we quantify more than 10,000 unique phosphorylation sites and find that more than 2,000 of these sites are significantly affected by MICs, but remarkably, only 38 of the MIC-regulated events are mediated through a rapamycin-sensitive mechanism. Further interrogation of the rapamycin-insensitive phosphorylation events identifies the S473 residue on Tripartite Motif-Containing 28 (TRIM28) as one of the most robust MIC-regulated phosphorylation sites, and extensive follow-up studies suggest that TRIM28 significantly contributes to the homeostatic regulation of muscle size and function as well as the hypertrophy that occurs in response to increased mechanical loading.

• ‘There's a difference between tolerance and acceptance’: Exploring women's experiences of barriers to access in UK gyms

  2021, Wellbeing, Space and Society

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  Weight-bearing and moderate intensity exercise are increasingly recognised as important to wellbeing, yet women have been shown to participate in these activities at lower rates than men. With gym training a primary means of engaging in these health-promoting activities, one way in which disparities in exercise participation may be addressed is through understanding of women's experiences accessing gym spaces, and barriers to participation experienced in these environments. Drawing on 18 in-depth qualitative interviews with female gym staff and gym users, and ethnographic fieldwork conducted in four commercial gyms in the South & South-West of England, this article explores the experiential realities of women seeking to access gym training and the barriers they identify to equal access in these spaces.

  Findings examine four key ways in which gyms environment and the gendering of this space create barriers to women's access: through the sharp gender segregation of weights areas and emotional barriers crossing into this ‘male space’ creates; through insufficient equipment provision for women's needs and how this raises costs to women's participation; issues with the performance of masculinities in gym space and associated intimidation and harassment in increasingly (hetero)sexualised gym space; and how gym structures create the impression one is always ‘on show’, and subject to scrutiny. This research offers insights into the experiential realities of women regarding how these barriers are felt and perceived, and in doing so offers understanding which can help direct gym policies toward more equitable outcomes, contributing to this important area for health and social research.

• Factors contributing to functional dependence among older adults in Ile–Ife, Nigeria

  2021, International Journal of Africa Nursing Sciences

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  Old age presents myriads of challenges particularly in the dimension of dependence in the performance of activities of daily living and those contributing to maintenance of health. This study therefore, assessed factors contributing to functional dependence among older adults attending care in a Nigerian Teaching Hospital.

  A cross-sectional correlational design was employed to study 400 respondents 60 years and above attending care in the hospital. Data regarding the respondents’ sociodemographic attributes, their degree of dependence in instrumental activities of daily living (IADLs) as well as health maintenance practices were collected with a validated interviewer-administered questionnaire and were analysed descriptively and inferentially using Stata 12 statistical package.

  Results revealed that almost a quarter (24.5%) of the respondents were dependent (moderate) on others in all the dimensions of IADLs measured, while majority (83.0%) had moderate health maintenance practices. Furthermore, respondents age (Β = −0.124, p < 0.001), health maintenance practice (Β = 0.180, p < 0.001) sex (Β = 1.181, p < 0.001), Income level (Β = 0.551, p < 0.001), level of education (Β = 0.723, p < 0.001) significantly predicted functional dependence among the older adults.

  In conclusion, this study showed that functional dependence is prevalent among the residents in this setting. Therefore, there is a need for nurses to carry out a periodic health assessment among the older adults and also educate the general geriatric cohort on the need to scale up the performance of health maintenance practices which will in turn increase their functional capacity and promote better quality of life.

Recommended articles (6)

• Research article

  Strength training at high versus low external resistance in older adults: Effects on muscle volume, muscle strength, and force–velocity characteristics

  Experimental Gerontology, Volume 48, Issue 11, 2013, pp. 1351-1361

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  Muscle adaptations can be induced by high-resistance exercise. Despite being potentially more suitable for older adults, low-resistance exercise protocols have been less investigated. We compared the effects of high- and low-resistance training on muscle volume, muscle strength, and force–velocity characteristics. Fifty-six older adults were randomly assigned to 12 weeks of leg press and leg extension training at either HIGH (2 × 10–15 repetitions at 80% of one repetition maximum (1RM)), LOW (1 × 80–100 repetitions at 20% of 1RM), or LOW + (1 × 60 repetitions at 20% of 1RM, followed by 1 × 10–20 repetitions at 40% of 1RM). All protocols ended with muscle failure. Leg press and leg extension of 1RM were measured at baseline and post intervention and before the first training session in weeks 5 and 9. At baseline and post intervention, muscle volume (MV) was measured by CT-scan. A Biodex dynamometer evaluated knee extensor static peak torque in different knee angles (PTstat90°, PTstat120°, PTstat150°), dynamic peak torque at different speeds (PTdyn60°s− 1, PTdyn180°s− 1, PTdyn240°s− 1), and speed of movement at 20% (S20), 40% (S40), and 60% (S60) of PTstat90°. HIGH and LOW + resulted in greater improvements in 1RM strength than LOW (p < 0.05). These differences were already apparent after week 5. Similar gains were found between groups in MV, PTstat, PTdyn60°s− 1, and PTdyn180°s− 1. No changes were reported in speed of movement. HIGH tended to improve PTdyn240°s− 1 more than LOW or LOW + (p = 0.064). In conclusion, high- and low-resistance exercises ending with muscle failure may be similarly effective for hypertrophy. High-resistance training led to a higher increase in 1RM strength than low-resistance training (20% of 1RM), but this difference disappeared when using a mixed low-resistance protocol in which the resistance was intensified within a single exercise set (40% of 1RM). Our findings support the need for more research on low-resistance programs in older age, in particular long-term training studies and studies focusing on residual effects after training cessation.

• Research article

  Optimizing the Benefits of Exercise on Physical Function in Older Adults

  PM&R, Volume 6, Issue 6, 2014, pp. 528-543

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  As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area.

• Research article

  Influence of strength training variables on strength gains in adults over 55 years-old: A meta-analysis of dose–response relationships

  Journal of Science and Medicine in Sport, Volume 17, Issue 3, 2014, pp. 337-344

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  The importance of strength training to elderly individuals is well established. However, the dose–response relationship of the benefits of strength training in this population is unclear. The purpose of the study was to use meta-analysis to investigate the dose–response of the effects of strength training in elderly individuals.

  Fifteen studies with a total of 84 effect-sizes were included. The analyses examined the dose–response relationships of the following training variables ‘intensity’, ‘number of sets’, ‘weekly frequency’, and ‘training duration’ on strength improvement.

  The studies selected met the following inclusion criteria: (a) randomized controlled trials; (b) trained healthy subjects of both genders; (c) trained subjects aged 55 years or older; (d) strength increases were determined pre- and post-training; (e) use of similar strength evaluation techniques (strength determined by a repetition maximum test) and training routine (dynamic concentric–eccentric knee extension exercise to train the quadriceps muscle group). The effect-sizes were calculated using fixed and random effect models with the main effects determined by meta-regression.

  Many combinations of training variables resulted in strength increases. However meta-regression indicated only “training duration” had a significant dose–response relationship to strength gains (p = 0.001). Over durations of 8–52 weeks, longer training durations had a greater effect on strength gains compared to shorter duration protocols.

  Resistive training causes strength gains in elderly individuals, provided the training duration is sufficiently long, regardless of the combination of other training variables.

• Research article

  Systematic Review of High-Intensity Progressive Resistance Strength Training of the Lower Limb Compared With Other Intensities of Strength Training in Older Adults

  Archives of Physical Medicine and Rehabilitation, Volume 94, Issue 8, 2013, pp. 1458-1472

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  To examine the effect of high-intensity progressive resistance strength training (HIPRST) on strength, function, mood, quality of life, and adverse events compared with other intensities in older adults.

  Online databases were searched from their inception to July 2012.

  Randomized controlled trials of HIPRST of the lower limb compared with other intensities of progressive resistance strength training (PRST) in older adults (mean age ≥65y) were identified.

  Two reviewers independently completed quality assessment using the Physiotherapy Evidence Database (PEDro) scale and data extraction using a prepared checklist.

  Twenty-one trials were included. Study quality was fair to moderate (PEDro scale range, 3–7). Studies had small sample sizes (18–84), and participants were generally healthy. Meta-analyses revealed HIPRST improved lower-limb strength greater than moderate- and low-intensity PRST (standardized mean difference [SMD]=.79; 95% confidence interval [CI], .40 to 1.17 and SMD=.83; 95% CI, −.02 to 1.68, respectively). Studies where groups performed equivalent training volumes resulted in similar improvements in leg strength, regardless of training intensity. Similar improvements were found across intensities for functional performance and disability. The effect of intensity of PRST on mood was inconsistent across studies. Adverse events were poorly reported, however, no correlation was found between training intensity and severity of adverse events.

  HIPRST improves lower-limb strength more than lesser training intensities, although it may not be required to improve functional performance. Training volume is also an important variable. HIPRST appears to be a safe mode of exercise in older adults. Further research into its effects on older adults with chronic health conditions across the care continuum is required.

• Research article

  High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women

  Experimental Gerontology, Volume 58, 2014, pp. 51-57

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  To examine the effects of 12 weeks of high-speed resistance training (RT) versus low-speed RT on muscle strength [one repetition of maximum leg-press (1RMLP) and bench-press (1RMBP), plus dominant (HGd) and non-dominant maximum isometric handgrip], power [counter-movement jump (CMJ), ball throwing (BT) and 10-m walking sprint (S10)], functional performance [8-foot up-and-go test (UG) and sit-to-stand test (STS)], and perceived quality of life in older women.

  45 older women were divided into a high-speed RT group [EG, n = 15, age = 66.3 ± 3.7 y], a low-speed RT group [SG, n = 15, age = 68.7 ± 6.4 y] and a control group [CG, n = 15, age = 66.7 ± 4.9 y]. The SG and EG were submitted to a similar 12-week RT program [3 sets of 8 reps at 40–75% of the one-repetition maximum (1 < RM), CMJ and BT] using slow, controlled (3 s) concentric muscle actions for the SG and using fast, explosive (< 1 s) concentric muscle actions for the EG (20% less work per exercise without CMJ and BT).

  Over the 12-week training period, both RT groups showed small to large clinically significant improvements in the dependent variables; however, a significant difference was found between the EG and SG for the performance changes in BT, S10 and UG (20% vs. 11%, p < 0.05; 14% vs. 9%, p < 0.05; 18% vs. 10%, p < 0.01; respectively). No significant changes were observed for the CG.

  Both RT interventions are effective in improving functional capacity, muscle performance and quality of life in older women, although a high-speed RT program induces greater improvements in muscle power and functional capacity.

• Research article

  Long-Term Impact of Strength Training on Muscle Strength Characteristics in Older Adults

  Archives of Physical Medicine and Rehabilitation, Volume 94, Issue 11, 2013, pp. 2054-2060

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  To evaluate the long-term preventive impact of strength training on muscle performance in older adults.

  A 7-year follow-up on a 1-year randomized controlled trial comparing the effects of combined resistance training and aerobic training and whole-body vibration training on muscle performance.

  University training center.

  Men and women (N=83; control [CON] group, n=27; strength-training intervention [INT] group, n=56) between 60 and 80 years of age.

  The INT group exercised 3 times weekly during 1 year, performing a combined resistance training and aerobic training program or a whole-body vibration training program. The former training program was designed according to American College of Sports Medicine guidelines. The whole-body vibration training program included unloaded static and dynamic leg exercises on a vibration platform. The CON group did not participate in any training program.

  Static strength (STAT), dynamic strength at 60°/s (DYN60) and at 240°/s (DYN240), speed of movement at 20% (S20).

  From baseline to postintervention, muscle performance did not change in the CON group, except for S20 (+6.55%±2.88%, P<.001). One year of strength training increased (P≤.001) STAT (+11.46%±1.86%), DYN60 (+6.96%±1.65%), DYN240 (+9.25%±1.68%), and S20 (+7.73%±2.19%) in the INT group. Between baseline and follow-up, muscle performance decreased (P<.001) in both groups. However, STAT and DYN60 showed a significantly lower loss in the INT group (−8.65%±2.35% and −7.10%±2.38%, respectively) compared with the CON group (−16.47%±2.69% and −15.08%±2.27%, respectively). This positive impact might be due to the preservation of the training-induced gains, given the similar annual decline rates in both groups from postintervention to follow-up. Additionally, in trained participants, aging seems to impact velocity-dependent strength and power more compared with basic strength, as the total losses in DYN240 (CON, −15.93%±2.64%; INT, −11.39%±1.95%) and S20 (CON, −14.39%±2.10%; INT, −13.16%±1.72%) did not differ significantly between the groups.

  A 1-year strength-training intervention results in an improved muscle performance in older adults 7 years after their enrollment in the intervention. However, an extensive exercise program cannot attenuate the age-related decline once the intervention stops.