Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial.
OBJECTIVE
To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults.


METHODS
Randomized, controlled trial.


METHODS
Retirement village.


METHODS
Thirty-eight subjects (14 men and 24 women) aged 76.6 +/- 6.1.


METHODS
A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week.


METHODS
Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level.


RESULTS
Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39+/-31% in exercise, versus 21+/-24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3+/-15%, P=.002) and chair stand time (-7.1+/-15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=-0.568, P=.009, PRT progression in loading r=-0.587, P=.02, and total volume of aerobic training r=-0.541, P=.01), as well as improvements in muscle strength (r=-0.498, P=.002).


CONCLUSIONS
Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults.
Baker
Michael K
MK
School of Exercise and Sport Science, University of Sydney, Lidcombe, NSW, Australia. michael_baker@usyd.edu.au
Kennedy
David J
DJ
Bohle
Philip L
PL
Campbell
Deena S
DS
Knapman
Leona
L
Grady
Jodie
J
Wiltshire
James
J
McNamara
Maria
M
Evans
William J
WJ
Atlantis
Evan
E
Fiatarone Singh
Maria A
MA
D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D017408:Guidelines as Topic; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology; D016037:Single-Blind Method