title: Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial.
abstract: 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.
authors.affiliation: School of Exercise and Sport Science, University of Sydney, Lidcombe, NSW, Australia. michael_baker@usyd.edu.au
authors.forename: Michael K
authors.initials: MK
authors.lastname: Baker
authors.forename: David J
authors.initials: DJ
authors.lastname: Kennedy
authors.forename: Philip L
authors.initials: PL
authors.lastname: Bohle
authors.forename: Deena S
authors.initials: DS
authors.lastname: Campbell
authors.forename: Leona
authors.initials: L
authors.lastname: Knapman
authors.forename: Jodie
authors.initials: J
authors.lastname: Grady
authors.forename: James
authors.initials: J
authors.lastname: Wiltshire
authors.forename: Maria
authors.initials: M
authors.lastname: McNamara
authors.forename: William J
authors.initials: WJ
authors.lastname: Evans
authors.forename: Evan
authors.initials: E
authors.lastname: Atlantis
authors.forename: Maria A
authors.initials: MA
authors.lastname: Fiatarone Singh
mesh_terms: 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