Exercise training guidelines for the elderly

EVANS, WILLIAM J.

Section Editor(s): Pollock, Michael L.

Medicine & Science in Sports & Exercise: January 1999 - Volume 31 - Issue 1 - pp 12-17
Clinical Sciences: Symposium: Resistance Training For Health And Disease

Exercise training guidelines for the elderly. Med. Sci. Sports Exerc., Vol. 31, No. 1, pp. 12-17, 1999. The capacity of older men and women to adapt to increased levels of physical activity is preserved, even in the most elderly. Aerobic exercise results in improvements in functional capacity and reduced risk of developing Type II diabetes in the elderly. High-intensity resistance training (above 60% of the one repetition maximum) has been demonstrated to cause large increases in strength in the elderly. In addition, resistance training result in significant increases in muscle size in elderly men and women. Resistance training has also been shown to significantly increase energy requirements and insulin action of the elderly.

Purpose: We have recently demonstrated that resistance training has a positive effect on multiple risk factors for osteoporotic fracture in previously sedentary postmenopausal women.

Methods: Because the sedentary lifestyle of a long-term care facility may exacerbate losses of muscle function, we have applied this same training program to frail, institutionalized elderly men and women.

Results: In a population of 100 nursing home residents, a randomly assigned high-intensity strength-training program resulted in significant gains in strength and functional status. In addition, spontaneous activity, measured by activity monitors, increased significantly in those participating in the exercise program whereas there was no change in the sedentary control group. Before the strength training intervention, the relationship of whole body potassium and leg strength was seen to be relatively weak (r2 = 0.29, P < 0.001), indicating that in the very old, muscle mass is an important but not the only determining factor of functional status.

Conclusions: Thus, exercise may minimize or reverse the syndrome of physical frailty, which is so prevalent among the most elderly. Because of their low functional status and high incidence of chronic disease, there is no segment of the population that can benefit more from exercise than the elderly.

Nutrition, Metabolism and Exercise Program, Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72114

Submitted for publication June 1997.

Accepted for publication February 1998.

Support for this project was received from National Institutes of Health Grant RO1-AG-11811.

Address for correspondence: William J. Evans, Ph.D., Director, Nutrition, Metabolism and Exercise Program, Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, VA Medical Center, 2200 Fort Roots Drive Slot NMEL/NLR, North Little Rock, AR 72114. E-mail: evanswilliamj@exchange.uams.edu.

© 1999 Lippincott Williams & Wilkins, Inc.