Abstract
Objective
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.
Data Sources
Online databases were searched from their inception to July 2012.
Study Selection
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.
Data Extraction
Two reviewers independently completed quality assessment using the Physiotherapy Evidence
Database (PEDro) scale and data extraction using a prepared checklist.
Data Synthesis
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.
Conclusions
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.
Keywords
List of abbreviations:
CI (confidence interval), GDS (Geriatric Depression Scale), HIPRST (high-intensity progressive resistance strength training), LIPRST (low-intensity progressive resistance strength training), MIPRST (moderate-intensity progressive resistance strength training), 1RM (1 repetition maximum), PEDro (Physiotherapy Evidence Database), POMS (Profile of Mood States), PRST (progressive resistance strength training), QOL (quality of life), SMD (standardized mean difference), WMD (weighted mean difference)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Lower extremity function in persons over the age of 70 years as a predictor of subsequent disability.N Engl J Med. 1995; 332: 556-561
- Strength training and detraining effects on muscular strength, anaerobic power, and mobility of inactive older men are intensity dependent.Br J Sports Med. 2005; 39: 776-780
- The impact of resistance exercise on the cognitive function of the elderly.Med Sci Sports Exerc. 2007; 39: 1401-1407
- Randomised controlled trial of an exercise intervention to reduce functional decline and health service utilisation in the hospitalised elderly.Australas J Ageing. 2006; 25: 126-133
- A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities.Aging Clin Exp Res. 2008; 20: 67-75
- High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial.Aust J Physiother. 2006; 52: 105-113
- Randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults.J Am Geriatr Soc. 2000; 48: 1545-1552
- Resistance training and detraining effects on flexibility performance in the elderly are intensity-dependent.J Strength Cond Res. 2006; 20: 634-642
- The American College of Sports position stand. Progression models in resistance training for healthy adults.Med Sci Sports Exerc. 2002; : 364-380
- High-intensity strength training in nonagenarians: effects on skeletal muscle.JAMA. 1990; 263: 3029-3034
- Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders.J Gerontol A Biol Sci Med Sci. 2004; 59: 503-509
- Effects of muscle strength training and testosterone in frail elderly males.Med Sci Sports Exerc. 2005; 37: 1664-1672
- Exercise training and nutritional supplementation for physical frailty in very elderly people.N Engl J Med. 1994; 330: 1769-1775
- A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults.J Gerontol A Biol Sci Med Sci. 2005; 60: 768-776
- Dose-response relationship of resistance training in older adults: a meta-analysis.Med Sci Sports Exerc. 2010; 42: 902-914
- Resistance exercise and physical performance in adults aged 60 to 83.J Am Geriatr Soc. 2002; 50: 1100-1107
- Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women.Clin Physiol. 1996; 16: 381-392
- Systematic review of progressive resistance strength training in older adults.J Gerontol A Biol Sci Med Sci. 2004; 59: 48-61
- Effects of moderate-to-high intensity resistance training in patients with chronic heart failure.Heart. 2009; 95: 1399-1408
- Comparison of high and moderate intensity of strength training on mood and anxiety in older adults.Percept Mot Skills. 1998; 87: 1003-1011
- Resistance training effects on muscular strength of elderly are related to intensity and gender.J Sci Med Sport. 2005; 8: 274-283
- Effect of resistance-training intensity on strength-gain response in the older adult.J Strength Cond Res. 2004; 18: 833-838
- Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial.Phys Ther. 2008; 88: 427-436
- The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.Med Sci Sports Exerc. 1998; 30: 975-991
- Muscle hypertrophy response to resistance training in older women.J Appl Physiol. 1991; 70: 1912-1916
- Effects of progressive resistance training on immune response in aging and chronic inflammation.Med Sci Sports Exerc. 1996; 28: 1356-1365
- Effects of resistance training on selected indexes of immune function in elderly women.J Appl Physiol. 1999; 86: 1905-1913
- Effects of high-intensity resistance training on untrained older men. I. Strength, cardiovascular, and metabolic responses.J Gerontol A Biol Sci Med Sci. 2000; 55: B336-B346
- Low- or high-intensity strength training partially restores impaired quadriceps force accuracy and steadiness in aged adults.J Gerontol A Biol Sci Med Sci. 2001; 56: B38-B47
- Effects of a one- year high-intensity versus low-intensity resistance training program on bone mineral density in older women.J Bone Miner Res. 1995; 10: 1788-1795
- Randomized controlled trial of progressive resistance training in depressed elders.J Gerontol A Biol Sci Med Sci. 1997; 52: M27-M35
- Leptin and adiponectin responses in overweight inactive elderly following resistance training and detraining are intensity related.J Clin Endocrinol Metab. 2005; 90: 5970-5977
- Reliability of the PEDro Scale for rating quality of randomized controlled trials.Phys Ther. 2003; 83: 713-721
- Statistical power analysis for the behavioral sciences.Academic Pr, New York1969
- The effects of high- and moderate-resistance training on muscle function in the elderly.J Aging Phys Act. 2004; 11: 131-143
- Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women.Arch Intern Med. 2002; 162: 673-678
- Effects of a heavy and a moderate resistance training on functional performance in older adults.J Strength Cond Res. 2005; 19: 652-657
- Effects of muscle strength training and megestrol acetate on strength, muscle mass, and function in frail older people.J Am Geriatr Soc. 2007; 55: 20-28
- Physical fitness and psychological benefits of strength training in community dwelling older adults.Appl Human Sci. 1997; 16: 257-266
- Muscle strength and qualitative myosin heavy chain isoform mRNA expression in the elderly after moderate- and high-intensity weight training.J Aging Phys Act. 1998; 6: 327-339
- High-resistance versus variable-resistance training in older adults.Med Sci Sports Exerc. 2001; 33: 1759-1764
- Musculoskeletal impairments and physical disablement among the aged.J Gerontol. 1990; 45: M203-M208
- Functional consequences of joint impairment at age 79.Scand J Rehab Med. 1985; 17: 183-190
- Reduced hip extension during walking: healthy elderly and fallers versus young adults.Arch Phys Med Rehab. 2001; 82: 26-30
- Flexibility and strength training.J Strength Cond Res. 1987; 1: 74-75
- Resistance training vs. static stretching: effects on flexibility and strength.J Strength Cond Res. 2011; 25: 3391-3398
- The effects of strength training, cardiovascular training and their combination on flexibility of inactive older adults.Int J Sports Med. 2002; 23: 112-119
- Exercise for depression.Cochrane Database Syst Rev. 2008 Oct 8; : CD004366
- The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials.BMJ. 2001; 322: 763-767
- A meta-analysis to determine the dose response for strength development.Med Sci Sports Exerc. 2003; 35: 456-464
- Ann Readapt Med Phys. 2003; 46 ([French]): 545-552
- Effects of a short-term resistance program using elastic bands versus weight machines for sedentary middle aged women.J Strength Cond Res. 2008; 22: 1441-1448
- Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance.Phys Ther. 2010; 90: 538-549
Article info
Publication history
Published online: March 11, 2013
Footnotes
Supported by the Caulfield Research Trust, Alfred Health.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
