New W Flashcards
Resistance Training for Older Adults
Part 1: Resistance Training Program Variables
Statement 1
Statement: A properly designed resistance training program with appropriate instructions for exercise technique and proper spotting is safe for healthy older adults.
To maintain safety, proper program design is required, with special care and attention needed for some older adults to reduce the risks associated with their specific condition. For example, when working with an older adult with uncontrolled hypertension, exercise prescription should consider acute elevations in blood pressure, which occur with resistance training.
Resistance Training for Older Adults
Part 1: Resistance Training Program Variables
Statement 2
Statement: A properly designed resistance training program for older adults should include an individualized and periodized approach working toward 2–3 sets of 1–2 multijoint exercises per major muscle group, achieving intensities of 70–85% of 1 repetition maximum, 2–3 times per week, including power exercises performed at higher velocities in concentric movements with moderate intensities (i.e., 40–60% of 1 repetition maximum).
The number of repetitions is dependent on the intensity, or load, used and should be adjusted accordingly. Repetitions to failure are not needed to optimize neuromuscular adaptations. One multijoint exercise should be prescribed for major muscle groups, although lower limbs may respond better to two exercises.
Part 2: Positive Physiological Adaptations to Resistance Exercise Training in Older Adults
Statement:1
Statement: A properly designed resistance training program can counteract the age-related changes in contractile function, atrophy, and morphology of aging human skeletal muscle.
- Higher training volume is associated with greater increases in lean body mass.
Part 2: Positive Physiological Adaptations to Resistance Exercise Training in Older Adults
Statement:2
Statement: Resistance exercise training can increase muscle strength and power, and improve functional capacity in older adults.
- Increases in strength and power can translate to improved functional capacity, such as performing activities of daily living (ADLs) independently and with greater ease and confidence, as well as enhanced mobility (e.g., gait speed, stair climbing ability, and balance).
Part 3: Functional Benefits of Resistance Training in Older Adults
Statement:1
Statement: Resistance exercise training can improve physical function and health-related quality of life in older adults.
Research has shown that older adults who participate in progressive resistance training should begin resistance training at an individualized level appropriate to their abilities and progress toward the recommended daily amounts of activity.
Part 3: Functional Benefits of Resistance Training in Older Adults
Statement:2
Statement: Resistance exercise training can reduce the age-related decline in cognitive function in older adults.
- Most studies that have investigated the psychological benefits of resistance exercise in older adults have provided supervised sessions three times a week.
Part 4: Considerations for Frailty, Sarcopenia, or Other Chronic Conditions
Statement: 1
Statement: Resistance training programs can be adapted for older adults with frailty, mobility limitations, cognitive impairment, or other chronic conditions.
- Studies that included resistance training either alone or as part of multicomponent exercise programs revealed greater strength gains in older adults with physical frailty or severe functional declines.
Part 4: Considerations for Frailty, Sarcopenia, or Other Chronic Conditions
Statement: 2
Statement: Resistance training programs can be adapted (with portable equipment and seated exercise alternatives) to accommodate older adults residing in assisted living and skilled nursing facilities.
Describe the participants included in this study (what were some of the group’s characteristics?).
Golightly 2021
●A total of 29 participants were included in the study.
○The average age was 63 years old.
○66% of the participants were women, and 66% were obese.
○To be included in the study, participants had to be between 40 and 75 years old, have a BMI between 18.5 and 50 kg/m2, and report both a physician diagnosis of knee osteoarthritis and current knee symptoms. Knee osteoarthritis symptoms had to be severe enough to score at least a six out of 20 on the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
○ Individuals were excluded from the study if they had a number of conditions, such as fibromyalgia, rheumatoid arthritis, severe dementia, psychosis, uncontrolled substance abuse, a recent stroke, heart attack, or heart failure, recent knee surgery, an upcoming knee replacement, or an intra-articular injection in the past three months. Pregnant women and people with conditions that would prevent safe participation were also excluded.
Describe the exercise intervention (i.e. the high intensity interval training program).
●The exercise intervention was a high-intensity interval training (HIIT) program that participants completed twice a week for 12 weeks. Participants could choose to complete their HIIT program on a bicycle or treadmill.
○Each session consisted of a warm-up followed by 10 repetitions of one minute of exercise at 90% of the participant’s peak oxygen consumption (VO2peak), with one minute rest periods between each repetition. A full rest period was used, rather than low- to moderate-intensity exercise, to maximize effort and metabolite accumulation, with the goal of supporting greater adaptations.
○All training sessions were supervised by trained research personnel.
Which physical function measures showed improvements at the end of the study (after 12 weeks)?
●At the end of the 12-week study, participants showed improvement in all four performance-based physical function measures, which were the 20-meter fast-paced walk test, 30-second chair-stand test, stair-climb test, and the timed up and go test. Participants also showed improvement in their WOMAC score, single leg stand time, isometric knee extensor strength, VO2peak, time to exhaustion, and maximum heart rate.
How did the participants tolerate the high intensity interval training? Any adverse events reported?
The HIIT program was well-tolerated, and no adverse events related to the program were reported. Adherence was 70%, and most participants reported high enjoyment of the program. The eight participants who discontinued participation cited reasons such as knee swelling and pain from work, family circumstances, medication changes for unrelated conditions, scheduling conflicts, and a sprained ankle.
What are the exercise guidelines targeting most: an increase in bone mineral density in older adults with osteoporosis?
Why is this the target of the guidelines?
Modest Effects on Bone Mineral Density: Exercise has been shown to have a modest positive effect on BMD, particularly at the lumbar spine and trochanter. However, the clinical significance of these changes in preventing fractures remains unclear. Additionally, the studies primarily focused on postmenopausal women without osteoporosis, making the evidence indirect for individuals with osteoporosis. The quality of evidence for exercise’s impact on BMD is rated as low for those with osteoporosis and very low for those with vertebral fractures
What are the exercise guidelines targeting most: a reduction of fall riskin older adults with osteoporosis?
Why is this the target of the guidelines?
High Quality of Evidence for Fall Reduction: Two meta-analyses showed that exercise, especially programs that include balance training and a higher overall exercise dose, can significantly reduce falls in older adults. This evidence is considered high quality by the panel for individuals with osteoporosis.
● Falls Lead to Fractures: A significant proportion of fractures in older adults, particularly hip fractures, result from falls. Reducing falls, therefore, is a direct way to lower the risk of fractures.
What are the exercise guidelines targeting most: a reduction of fracture risk in older adults with osteoporosis?
Why is this the target of the guidelines?
Limited Evidence for Fracture Risk Reduction: While exercise may reduce fracture risk, the research is less conclusive. Current randomized controlled trials haven’t been specifically designed to investigate fracture as a primary outcome, leading to limitations in the available data. Existing studies show inconsistent effects on fracture incidence, with some even suggesting a potential increase in specific types of fractures with higher physical activity levels. The evidence for exercise’s effect on fracture risk is rated as very low quality for both individuals with osteoporosis and those with a history of vertebral fractures
