Functional vs. strength training in disabled elderly outpatients.
OBJECTIVE
To determine whether high-intensity functional training (FT) or strength training (ST) better enables impairment, disability, and functional gains among disabled community-dwelling elders.


METHODS
Randomized, blinded, prospective clinical trial in a large, tertiary care outpatient rehabilitation department. Fifteen elders (62-85 yrs old) referred for physical therapy with one or more impairments, including lower-limb arthritis, participated in 6 wks of FT (weekly outpatient and three to five times per week of home practice in rapid and correct execution of locomotor activities of daily living, including gait, stepping, and sit to stand) or progressive resistive ST using elastic bands with intensity, therapist contact, and home practice similar to those of FT.


RESULTS
Both groups significantly improved their combined lower-extremity strength (hip abduction, ankle dorsiflexion, knee flexion, ankle plantarflexion, and knee extension) (P = 0.003), but no statistical difference between the ST and FT group gains (P = 0.203) was found. Subjects in both interventions improved their gait speed, but the FT group improved more than the ST group (P = 0.001). During chair rise, the FT group improved their maximum knee torque more than the ST group (P = 0.033), indicating that they employed a more controlled and efficient movement strategy.


CONCLUSIONS
These data suggest that an intensive FT intervention results in strength improvements of comparable magnitude as those attained from ST and that FT also confers greater improvements in dynamic balance control and coordination while performing daily life tasks.
Krebs
David E
DE
MGH Institute of Health Professions, Boston, Massachusetts 02129-4557, USA.
Scarborough
Donna Moxley
DM
McGibbon
Chris A
CA
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D016330:Frail Elderly; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D010044:Outpatient Clinics, Hospital; D004856:Postural Balance / Q000502:physiology; D011795:Surveys and Questionnaires