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On the Benefits of Strength Training in “Older Adults”

18 August 2009 5 Comments
We’ve previously looked at the effects of exercise on reducing the risk of falls in the elderly (HYPERLINK), following on from that I’d like to look at a couple of studies that examine the role of weight/resistance training on improving the physical function of “older adults” and then a study which has shown that having good physical function will reduce the risk of an “older adult” being hospitalised (HYPERLINK).
First up, the article on the benefits of resistance training. This was a Cochrane Review (http://www.cochrane.org/reviews/en/ab002759.html), and for those who don’t know what that is, it’s a very high quality critical review of all of the previous research into a topic. They look at all the top studies and then summarise the results, so rather than you just getting the results of one study, you get the conclusions that can be drawn from a large number of studies (in this case 121 studies), and this is clearly more reliable.
The authors found a number of benefits from strength training:
Gait/Walking Speed Improved
Ability to get out of a chair Improved (“Moderate to Large Improvement”)
Muscle Strength Improved (“A Large Positive Effect”)
Decreased pain after exercise was noted in some but not all studies – most notably it improved in groups of people with arthritis.
Side effects of resistance training were pretty much the same as you would expect for any group – muscle and joint pain, but “serious adverse events were rare overall, and none were directly attributed to the exercise program”. It’s almost like “older adults” are very similar to adults in general – they get stronger when they train, get muscle pain after exercise, but, on the whole, the benefits seem worth it for most people.
This is important because as people age, they get weaker, and this affects their ability to perform normal everyday functions and can even increase their risk of hospitalisation, such as when it increases their risk of falling. The conclusions of this review indicate that resistance/weight training helped people improve their strength and the performace of simple and complex everyday activities.

We’ve previously looked at the effects of exercise on reducing the risk of falls in the elderly (http://www.chrisjonesosteo.com.au/?p=127), following on from that I’d like to look at a couple of studies that examine the role of weight/resistance training on improving the physical function of “older adults” and then a study which has shown that having good physical function will reduce the risk of an “older adult” being hospitalised (http://www.chrisjonesosteo.com.au/?p=353).

First up, the article on the benefits of resistance training. This was a Cochrane Review (http://www.cochrane.org/reviews/en/ab002759.html), and for those who don’t know what that is, it’s a very high quality critical review of all of the previous research into a topic. They look at all the top studies and then summarise the results, so rather than you just getting the results of one study, you get the conclusions that can be drawn from a large number of studies (in this case 121 studies), and this is clearly more reliable.

The authors found a number of benefits from strength training:

  • Gait/Walking Speed Improved
  • Ability to get out of a chair Improved (“Moderate to Large Improvement”)
  • Muscle Strength Improved (“A Large Positive Effect”)
  • Decreased pain after exercise was noted in some but not all studies – most notably it improved in groups of people with arthritis.

Side effects of resistance training were pretty much the same as you would expect for any group – muscle and joint pain, but “serious adverse events were rare overall, and none were directly attributed to the exercise program”. It’s almost like “older adults” are very similar to adults in general – they get stronger when they train, get muscle pain after exercise, but, on the whole, the benefits seem worth it for most people.

This is important because as people age, they get weaker, and this affects their ability to perform normal everyday functions and can even increase their risk of hospitalisation, such as when it increases their risk of falling. The conclusions of this review indicate that resistance/weight training helped people improve their strength and the performace of simple and complex everyday activities.

Cochrane Database Syst Rev. Published online July 8, 2009.

Progressive resistance strength training for improving physical function in older adults

Abstract

Background
Muscle weakness in old age is associated with physical function decline. Progressive resistance strength training (PRT) exercises are designed to increase strength.
Objectives
To assess the effects of PRT on older people and identify adverse events.
Search strategy
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized Register (to March 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 2), MEDLINE (1966 to May 01, 2008), EMBASE (1980 to February 06 2007), CINAHL (1982 to July 01 2007) and two other electronic databases. We also searched reference lists of articles, reviewed conference abstracts and contacted authors.
Selection criteria
Randomised controlled trials reporting physical outcomes of PRT for older people were included.
Data collection and analysis
Two review authors independently selected trials, assessed trial quality and extracted data. Data were pooled where appropriate.
Main results
One hundred and twenty one trials with 6700 participants were included. In most trials, PRT was performed two to three times per week and at a high intensity. PRT resulted in a small but significant improvement in physical ability (33 trials, 2172 participants; SMD 0.14, 95% CI 0.05 to 0.22). Functional limitation measures also showed improvements: e.g. there was a modest improvement in gait speed (24 trials, 1179 participants, MD 0.08 m/s, 95% CI 0.04 to 0.12); and a moderate to large effect for getting out of a chair (11 trials, 384 participants, SMD -0.94, 95% CI -1.49 to -0.38). PRT had a large positive effect on muscle strength (73 trials, 3059 participants, SMD 0.84, 95% CI 0.67 to 1.00). Participants with osteoarthritis reported a reduction in pain following PRT(6 trials, 503 participants, SMD -0.30, 95% CI -0.48 to -0.13). There was no evidence from 10 other trials (587 participants) that PRT had an effect on bodily pain. Adverse events were poorly recorded but adverse events related to musculoskeletal complaints, such as joint pain and muscle soreness, were reported in many of the studies that prospectively defined and monitored these events. Serious adverse events were rare, and no serious events were reported to be directly related to the exercise programme.
Authors’ conclusions
This review provides evidence that PRT is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.

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