Combination training and resistance training as effective interventions to improve functioning in elders. Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. Concurrent cardiovascular and resistance training in healthy older adults. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge A controlled trial of a nursing-centered intervention in hospitalized elderly medical patients: the Yale Geriatric Care Program. Effectiveness of a multicomponent exercise program in the attenuation of frailty in long-term nursing home residents: study protocol for a randomized clinical controlled trial Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial. Effects of elastic band resistance training and nutritional supplementation on physical performance of institutionalised elderly — A randomized controlled trial Exercise dosing to retain resistance training adaptations in young and older adults. The efficacy of counseling and progressive resistance home-exercises on adherence, health-related quality of life and function after discharge from a geriatric day-hospital. Effects of a targeted multimodal exercise program incorporating high-speed power training on falls and fracture risk factors in older adults: a community-based randomized controlled trial.
The purpose of the study was to determine whether resistance training ( RT ) or a combination of resistance and aerobic training ( CT ) result ed in the most improvement in measures of functional ability in functionally limited elders . Elderly adults who exhibited some limits in functional ability were r and omly assigned to either a CT , RT , or control ( C ) group . Both RT and CT exercised three times per week for 16 weeks . At Weeks 0 and 17 , participants completed six measures of strength and six functional tests . A 3 ( group ) x 3 ( time ) ANOVA with repeated measures on the time factor was used to analyze the results . CT and RT scored significantly better than C at Week 17 for biceps curl , elbow extension , chair st and , and time up the stairs . These findings demonstrate that RT and CT are both effective at increasing measures of strength and functional ability in elderly adults who begin exercise with functional limitations INTRODUCTION Increased physical activity ( PA ) is a crucial factor in the prevention of physical deterioration , and resistance training ( RT ) is also a common and effective intervention for older adults . However , the effects of PA as an adjunct to RT on frailty status remains unclear ; therefore , we clarified the effect of a PA intervention with feedback , as an adjunct to resistance strength training , on the physical and mental outcomes of frail older adults . MATERIAL S AND METHODS We employed a r and omized controlled trial . Community-dwelling frail older adults in Japan were recruited to participate . Forty-one participants ( mean age 81.5 ) were r and omly assigned to engage in a resistance training with PA ( RPA group ) or RT group for six months . Frailty status and frailty scores , which were measured according to the Cardiovascular Health Study criteria -muscle strength , mobility , instrumental activities of daily living , and health-related quality of life-were assessed . RESULTS Participants in the RPA group exhibited a significant increase in light-intensity PA , the number of steps taken daily ( p < 0.05 ) , and lower-limb muscle strength ( p < 0.05 ) and a significant decrease in frailty scores . However , pre- and postintervention frailty status , instrumental activities of daily living , and health-related quality of life did not differ significantly . CONCLUSIONS Implementation of a PA intervention as an adjunct to RT is feasible , as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms Frailty has emerged as an important risk factor for disability . Age-related declines in physical and physiological function lead to increased risk of loss of independence and poor quality of life . Recent evidence has shown the effectiveness of physical exercise programmes in preventing or reversing frailty . The aim of this study was to evaluate changes in the functioning of frail elderly individuals after undergoing  resistance training  for 3 days a week for 8 weeks . The effectiveness of exercise training was investigated in 48 frail elderly individuals who were r and omly assigned to the following intervention groups : high-intensity ( HI ; n=16 ; age : 69–96 years ) or low-intensity ( LI ; n=16 ; age : 77–93 years ) strength training groups or a control group ( n=16 ; age : 76–93 years ) with no specific exercise programme . Participants were assessed for muscle strength , physical function , activities of daily living , depression and quality of life . The HI group had significantly better results ( P<0.05 ) on the Short Physical Performance Test than the LI group ; however , the LI group did show a significant improvement in those scores , whereas the scores of the control group worsened . Results for the other evaluations were similarly favourable in both exercise groups ( P>0.05 ) . The study showed that LI exercise was as effective as HI exercise for most parameters tested . Exercise training is useful for the prevention or treatment of frailty , as it improves functioning by contributing positively to muscle strength , gait , balance and quality of life OBJECTIVES Although deficits in skeletal muscle strength , gait , balance , and oxygen uptake are potentially reversible causes of frailty , the efficacy of exercise in reversing frailty in community-dwelling older adults has not been proven . The aim of this study was to determine the effects of intensive exercise training ( ET ) on measures of physical frailty in older community-dwelling men and women . DESIGN R and omized controlled trial . SETTING Medical school research center . PARTICIPANTS One hundred fifteen sedentary men and women ( mean age + /- st and ard deviation = 83 + /- 4 ) with mild to moderate physical frailty , as defined by two of the following three criteria : Modified Physical Performance Test ( modified PPT ) score between 18 and 32 , peak oxygen uptake ( VO2 peak ) between 10 and 18 mL/kg/min , and self-report of difficulty or assistance with one basic activity of daily living ( ADL ) , or two instrumental ADLs . INTERVENTION Participants were r and omly assigned to a control group that performed a 9-month low-intensity home exercise program ( control ) or an exercise-training program ( ET ) . The control intervention primarily consisted of flexibility exercises . ET began with 3 months of flexibility , light-resistance , and balance training . During the next 3 months , resistance training was added , and , during the next 3 months , endurance training was added . MEASUREMENTS Modified PPT score , VO2 peak , performance of ADLs as measured by the Older Americans Re sources and Services instrument , and the Functional Status Question naire ( FSQ ) . RESULTS ET result ed in significantly greater improvements than home exercise in three of the four primary outcome measures . Adjusted 95 % confidence bounds on the magnitude of improvement in the ET group compared with the control group were 1.0 to 5.2 points for the modified PPT score , 0.9 to 3.6 mL/kg/min for VO2 peak , and 1.6 to 4.9 points for the FSQ score . CONCLUSIONS Our results show that intensive ET can improve measures of physical function and pre clinical disability in older adults who have impairments in physical performance and oxygen uptake and are not taking hormone replacement therapy better than a low-intensity home exercise program PURPOSE The recommendations for exercise training and physical activity for older adults include cardiovascular and resistance training components ( CVT and RT , respectively ) . The purpose of the present investigation was to compare the fitness benefits of concurrent CVT and RT with those attained through an equivalent duration of CVT or RT alone . METHODS Thirty-six participants ( ages 60 - 84 ) were assigned to a control group or to one of three exercise treatment groups . The treatment groups exercised three times per week for 12 wk using RT ( N = 11 ) , CVT ( N = 10 ) , or CVT and RT ( BOTH , N = 9 ) . Pre- and post-training , participants performed a submaximal exercise test ( GXT ) , five repetition-maximum strength tests ( 5RM ) , and the AAHPERD functional fitness test for older adults . RESULTS All exercise treatment groups revealed lower resting heart rate and rate-pressure product ; lower exercise diastolic blood pressure and rating of perceived exertion ; increased GXT duration ; increased leg , back , and shoulder 5RM scores ; and improved AAHPERD flexibility , coordination , and cardiovascular endurance scores . The exercise treatment groups responded differently on the following : RT and BOTH enhanced arm and chest strength more than CVT ; and BOTH enhanced AAHPERD strength and agility scores more than CVT or RT . CONCLUSIONS Concurrent CVT and RT is as effective in eliciting improvements in cardiovascular fitness and 5RM performance as CVT or RT , respectively . Moreover , incorporating both CVT and RT in exercise programs for older adults may be more effective in optimizing aspects of functional fitness than programs that involve only one component This r and omized controlled trial examined the effects of multicomponent training on muscle power output , muscle mass , and muscle tissue attenuation ; the risk of falls ; and functional outcomes in frail nonagenarians . Twenty-four elderly ( 91.9 ± 4.1 years old ) were r and omized into intervention or control group . The intervention group performed a twice-weekly , 12-week multicomponent exercise program composed of muscle power training ( 8–10 repetitions , 40–60 % of the one-repetition maximum ) combined with balance and gait retraining .  Strength and power tests were performed on the upper and lower limbs . Gait velocity was assessed using the 5-m habitual gait and the time-up- and -go ( TUG ) tests with and without dual-task performance . Balance was assessed using the FICSIT-4 tests . The ability to rise from a chair test was assessed , and data on the incidence and risk of falls were assessed using question naires . Functional status was assessed before measurements with the Barthel Index . Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography . The intervention group showed significantly improved TUG with single and dual tasks , rise from a chair and balance performance ( P < 0.01 ) , and a reduced incidence of falls . In addition , the intervention group showed enhanced muscle power and strength ( P < 0.01 ) . Moreover , there were significant increases in the total and high-density muscle cross-sectional area in the intervention group . The control group significantly reduced strength and functional outcomes . Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made The aim of this r and omized controlled trial was to investigate the effect of a 4- to 6-week multimodal program of exercise , relaxation and psychoeducation on physical capacity , functional performance and quality of life ( QOL ) in allogeneic hematopoietic cell transplantation ( allo-HSCT ) adult recipients . In all , 42 patients were r and omized to a supervised multimodal intervention or to a control group receiving usual care .  The primary end point was on aerobic capacity measured in VO2 max . Secondary end points were muscle strength , functional performance , physical activity level , QOL , fatigue , psychological well-being and clinical outcomes . The multimodal intervention had a significant effect on physical capacity : VO2 max ( P<0.0001 ) and muscle strength : chest press ( P<0.0001 ) , leg extension ( P=0.0003 ) , right elbow flexor ( P=0.0009 ) , right knee extensor ( P<0.0001 ) and functional performance ( stair test ) ( 0.0008 ) . Moreover , the intervention group showed significantly better results for the severity of diarrhea ( P=0.014 ) and fewer days of total parenteral nutrition ( P=0.019 ) . Longitudinal changes in QOL , fatigue and psychological well-being favored the intervention group , but did not reach statistical significance . Assignment of a multimodal intervention during allo-HSCT did not cause untoward events , sustained aerobic capacity and muscle strength and reduced loss of functional performance during hospitalization OBJECTIVES To determine the effects of moderate intensity group-exercise programs on falls , functional performance , and disability in older adults ; and to investigate the influence of frailty on these effects . DESIGN A 20-week , multicenter r and omized controlled trial , with 52-week follow-up . SETTING Fifteen homes for the elderly . PARTICIPANTS Two hundred seventy-eight men and women ( mean age + /- st and ard deviation , 85+/-6y ) . INTERVENTIONS Two exercise programs were r and omly distributed across 15 homes . The first program , functional walking ( FW ) , consisted of exercises related to daily mobility activities . In the second program , in balance ( IB ) , exercises were inspired by the principles of Tai Chi . Within each home participants were r and omly assigned to an intervention or a control group . Participants in the control groups were asked not to change their usual pattern of activities . The intervention groups followed a 20-week exercise program with 1 meeting a week during the first 4 weeks and 2 meetings a week during the remaining weeks . MAIN OUTCOME MEASURES Falls , Performance Oriented Mobility Assessment ( POMA ) , physical performance score , and the Groningen Activity Restriction Scale ( GARS ) ( measuring self-reported disability ) . RESULTS Fall incidence rate was higher in the FW group ( 3.3 falls/y ) compared with the IB ( 2.4 falls/y ) and control ( 2.5 falls/y ) groups , but this difference was not statistically significant . The risk of becoming a faller in the exercise groups increased significantly in the subgroup of participants who were classified as being frail ( hazard ratio [ HR ] = 2.95 ; 95 % confidence interval [ CI ] , 1.64 - 5.32 ) . For participants who were classified as being pre-frail , the risk of becoming a faller decreased ; this effect became significant after 11 weeks of training ( HR = .39 ; 95 % CI , .18-.88 ) . Participants in both exercise groups showed a small , but significant improvement in their POMA and physical performance scores . In the FW group , this held true for the GARS score as well . Post hoc analyses revealed that only the pre-frail participants improved their POMA and physical performance scores . CONCLUSIONS Fall-preventive moderate intensity group-exercise programs have positive effects on falling and physical performance in pre-frail , but not in frail elderly Background and aims : An acute illness may place older frail people at increased risk of losing independence in functional abilities . Physical exercise may reduce the risk by improving muscle strength and balance . However , the effects of physical training on functional abilities have not been studied among frail , very old people recovering from an acute illness . The aim of this study was to determine the effects of a group-based exercise program on their ability to carry out self-care ( ADL ) and instrumental activities ( IADL ) relevant to daily life after discharge from hospital . Methods : This r and omized controlled trial examined 68 community-dwelling women aged 75 years or older ( mean age 83.0 , SD 3.9 ) who were hospitalized due to an acute illness , and were mobility-impaired at admission . Participants were recruited from the geriatric ward of a primary -care health-center hospital , and were r and omized into group-based strength training ( n=34 ) and control ( n=34 ) groups . The 10-week group-based intervention included strength training and functional exercises . The control group received instructions for a home exercise training program , including functional exercises but no further encouragement to exercise . The level of independence in ADL and IADL was evaluated , using a 13-item scale with stepwise grading from fully independent to fully dependent . Measurements took place immediately before and after the intervention , and three and nine months later . Results : The intervention did not have any significant main effect ( p=0.407 ) , nor was there any significant interaction between follow-up time and intervention ( p=0.854 ) . Conclusions : The multi-component outpatient strength training program did not improve autonomy in expert-evaluated ADL/IADL functions OBJECTIVE To test the effectiveness of a nursing-centered intervention to prevent functional decline among hospitalized elderly medical patients . DESIGN Prospect i ve cohort study with stratified and matched cohort analyses . SETTING General medicine wards of a university teaching hospital . PATIENTS Two hundred sixteen patients aged > or = 70 years ( 85 intervention and 131 control patients ) . INTERVENTION The intervention included identification and surveillance of frail older patients , twice-weekly rounds of the Geriatric Care Team , and a nursing-centered educational program . MAIN OUTCOME MEASURE Functional decline , defined as a net decline in five activities of daily living ( ADLs ) . RESULTS In stratified analyses , the intervention result ed in a beneficial effect with a relative risk of 0.82 ( 95 % confidence interval [ CI ] 0.54 to 1.24 ) in patients ( n = 106 ) with one of four geriatric target conditions at baseline ( eg , delirium , functional impairment , incontinence , and pressure sores ) . The intervention had no effect in patients without target conditions at baseline ( n = 110 ) ; thus , this subgroup was excluded from further analyses . When patients were matched on number of target conditions and risk for functional decline at baseline ( n = 66 ) , the intervention result ed in a significant beneficial effect , with a reduction in functional decline from 64 % in controls to 41 % in the intervention group , for a relative risk of 0.64 ( 95 % CI , 0.43 to 0.96 ) . The intervention group had significantly less decline in ADL score and in individual ADLs than control subjects . Specific interventions aim ed at maximizing function , such as physical therapy , were received more often by intervention patients ; however , the beneficial effects of the intervention were achieved without increasing per-day hospital costs . CONCLUSIONS The intervention appears effective to decrease functional decline in targeted elderly hospitalized medical patients Background There is increasing evidence suggesting that cognition and physical frailty interact within a cycle of decline associated with aging which has been called cognitive frailty . Exercise programs have demonstrated to be an effective tool to prevent functional and cognitive decline during aging , but little is known about their potential to restore or maintain functionality in individuals that require long-term nursing care . Besides , WHO has recently highlighted the importance of introducing systematic musculoskeletal health programs for older people living in residential care , as they represent a particularly vulnerable group for the development of noncommunicable diseases . Methods This is a multicentre r and omized controlled trial . 114 participants will be r and omly allocated to a  usual care group or to an  intervention group .  Inclusion criteria are as follows : ≥ 70 years , ≥ 50 on the Barthel Index , ≥ 20 on MEC-35 who are capable to st and up and walk independently for 10 m. Subjects in the intervention group will add to the activities scheduled for the control group the participation in a 6 months long multicomponent exercise program design ed to improve strength , balance and walking retraining . Study assessment s will be conducted at baseline and at 3 and 6 months . The primary outcome is change in function assessed by Short Physical Performance Battery and secondary outcomes include other measurements to assess all together the condition of frailty , which includes functionality , sedentary behaviors , cognitive and emotional status and biological markers . The present study has been approved by the Committee on Ethics in Research of the University of the Basque Country ( Humans Committee Code M10/2016/105 ; Biological Sample s Committee Code M30/2016/106 ) . Discussion Results from this research will show if ageing related functional and cognitive deterioration can be effectively prevented by physical exercise in institutionalized elders . It is expected that the results of this research will guide clinical practice in nursing home setting s , so that clinicians and policymakers can provide more evidence -based practice for the management of institutionalized elder people . Trial registration The protocol has been registered under the Australian and New Zeal and Clinical Trials Registry ( ANZCTR ) with the identifier : ACTRN12616001044415 AIM To compare the effect of multicomponent and resistance training and detraining on cognition and depressive symptoms in oldest-old community-dwelling people . METHODS A total of 69 sedentary older adults aged older than 80 years were assessed and r and omized into three groups ( control , multicomponent and resistance training ) . The multicomponent group performed protocol consisting of aerobic , strength and balance exercises . The resistance group participated in strength exercises using six machines . The control group did not perform any intervention . The training sessions had progressive intensity , lasted 16 weeks and included three sessions per week . The volunteers were assessed at baseline , at the end of the 16-week training sessions and after the 6-week detraining period . The assessment consisted of anamneses , Geriatric Depression Scale and cognition ( Montreal Cognitive Assessment , Clock Drawing Test , verbal fluency and dual task ) . RESULTS There were no significant differences between groups and times in any of variables ; however , the adherence to training was low , mainly in the multicomponent group . CONCLUSIONS R and omized controlled trials using adherence strategies and longer times comparing training variations are required to verify which training protocol s are more effective and consistent on cognition and depression in oldest-old people OBJECTIVES To evaluate the effects of elastic b and resistance training in combination with nutrient supplementation on muscular strength and the ability to perform mobility-related activities of daily living in older adults living in retirement care facilities . DESIGN R and omized controlled trial , with a 6-month intervention period . SETTING A retirement care facility , Vienna , Austria . PARTICIPANTS One hundred and seventeen older adults ( 14 males ( 12 % ) and 103 females ( 88 % ) ) , aged 65 to 97 years ( mean age : 82.8 ± 6.0 ) , having a mini-mental state examination score ≥ 23 and no chronic diseases posing a medical contraindication to training therapy . INTERVENTION Participants were r and omly assigned , but stratified by sex , to one of three intervention groups : supervised resistance exercise training ( RT ) , RT in combination with nutrient supplementation ( RTS ) , or cognitive training group ( CT ) . All interventions were performed two times a week for 6 months . RT was design ed to train all major muscle groups using elastic b and s. The nutrient supplement ( rich in proteins , vitamin D , B2 , B12 ) was distributed every morning as well as after each RT session . MEASUREMENTS A battery of motor ability tests and functional test were performed prior to as well as following 3 months and finally after 6 months of intervention . These tests included isokinetic torque measurements of the knee extensors and flexors in concentric mode at 60 and 120 ° /s , isometric h and grip strength , senior arm-lifting test , chair st and test , maximum walking speed and a 6-minute walking test ( 6 MWT ) . RESULTS A repeated- measures ANOVA analysis revealed significant improvements in physical function of lower ( p=0.002 ) and upper extremities ( p=0.006 ) for RT and /or RTS in comparison to CT . For isokinetic measurements , 6 MWT , and gait speed time effects ( p<0.05 ) were detected without any group × time interaction effects . Dropouts showed lower performance in chair st and test ( p=0.012 ) , 6 MWT ( p=0.003 ) , and gait speed ( p=0.013 ) at baseline than that of the finishers of the study . CONCLUSION Six months of a low intensity resistance exercise using elastic b and s and own body weight is safe and beneficial in improving functional performance of institutionalised older people . Multinutrient supplementation did not offer additional benefits to the effects of RT in improving muscular performance UNLABELLED Resistance training ( RT ) is a proven sarcopenia countermeasure with a high degree of potency . However , sustainability remains a major issue that could limit the appeal of RT as a therapeutic approach without well-defined dosing requirements to maintain gains . PURPOSE To test the efficacy of two maintenance prescriptions on muscle mass , myofiber size and type distribution , and strength . We hypothesized the minimum dose required to maintain RT-induced adaptations would be greater in the old ( 60 - 75 yr ) versus young ( 20 - 35 yr ) . METHODS Seventy adults participated in a two-phase exercise trial that consisted of RT 3 d·wk for 16 wk ( phase 1 ) followed by a 32-wk period ( phase 2 ) with r and om assignment to detraining or one of two maintenance prescriptions ( reducing the dose to one-third or one-ninth of that during phase 1 ) . RESULTS Phase 1 result ed in expected gains in strength , myofiber size , and muscle mass along with the typical IIx-to-IIa shift in myofiber-type distribution . Both maintenance prescriptions preserved phase 1 muscle hypertrophy in the young but not the old . In fact , the one-third maintenance dose led to additional myofiber hypertrophy in the young . In both age groups , detraining reversed the phase 1 IIx-to-IIa myofiber-type shift , whereas a dose response was evident during maintenance training with the one-third dose better maintaining the shift . Strength gained during phase 1 was largely retained throughout detraining with only a slight reduction at the final time point . CONCLUSIONS We conclude that older adults require a higher dose of weekly loading than the young to maintain myofiber hypertrophy attained during a progressive RT program , yet gains in specific strength among older adults were well preserved and remained at or above levels of the untrained young Loss of function and low exercise adherence is common among older people after hospitalization . The aim of this r and omized-controlled trial was to evaluate the effects of a combined counseling- and exercise program on changes in health-related quality of life ( HRQL ) and physical function in patients attending a day hospital and continuing exercise at home . The exercise program consisted of counseling , balance- and progressive resistance training and support from the physical therapist at Geriatric Day-Hospital ( GDH ) and home for the Intervention-group . The  Control-group received counseling , balance-training and support from the physical therapist .  The sample was recruited from a GDH in Norway . 108 participants were r and omized into the Intervention group ( IT ) ( n=53 ) or the Control group ( CT ) ( n=55 ) . After 3 months 77 participants were tested . The intention to treat analysis showed that the program had significant benefits in terms of Health Related Quality of Life , measured by SF-36 , on the domains vitality and bodily pain , in favor of the IT-group who performed the combined resistance exercises and balance program . All participants increased their scores on physical function , measured by Berg Balance Scale , Timed Up and Go , 5 times Sit-to-St and , 6 Min Walk Test and Activities Balance Confidence Scale , no group differences . Both groups were adherent to the  home exercise program The results show that it is possible to facilitate older people to increase their HRQL , physical function and level of physical activity through counseling , exercise and support from physical therapists Multimodal exercise programs incorporating traditional progressive resistance training ( PRT ) , weight-bearing impact training and /or balance training are recommended to reduce risk factors for falls and fracture . However , muscle power , or the ability to produce force rapidly , has emerged as a more crucial variable to functional decline than muscle strength or mass . The aim of this 12-month community-based r and omized controlled trial , termed Osteo-cise : Strong Bones for Life , was to evaluate the effectiveness and feasibility of a multimodal exercise program incorporating high-velocity (HV)-PRT , combined with an osteoporosis education and behavioral change program , on bone mineral density ( BMD ) , body composition , muscle strength and functional muscle performance in older adults . Falls incidence was evaluated as a secondary outcome . A total of 162 older adults ( mean ± SD ; 67 ± 6 years ) with risk factors for falls and /or low BMD were r and omized to the Osteo-cise program ( n = 81 ) or a control group ( n = 81 ) . Exercise consisted of fitness center-based HV-PRT , weight-bearing impact and challenging balance/mobility activities performed three times weekly . After 12 months , the Osteo-cise program led to modest but significant net gains in femoral neck and lumbar spine BMD ( 1.0 % to 1.1 % , p < 0.05 ) , muscle strength ( 10 % to 13 % , p < 0.05 ) , functional muscle power ( Timed Stair Climb , 5 % , p < 0.05 ) and dynamic balance ( Four Square Step Test 6 % , p < 0.01 ; Sit-to-St and , 16 % , p < 0.001 ) relative to controls . There was no effect on total body lean mass or mobility ( timed-up- and -go ) , and no difference in falls rate ( incidence rate ratio [ IRR ] , 1.22 ; 95 % confidence interval [ CI ] , 0.72 - 2.04 ) . In conclusion , this study demonstrates that the Osteo-cise : Strong Bones for Life community-based , multimodal exercise program represents an effective approach to improve multiple musculoskeletal and functional performance measures in older adults with risk factors for falls and /or low BMD . Although this did not translate into a reduction in the rate of falls , further large-scale trials are needed to evaluate the efficacy of this multimodal approach on reducing falls and fracture
Conclusion Frequency of 1–6 sessions per week , training volume of 1–3 sets of 6–15 repetitions and intensity of 30–70%1-RM promoted significant enhancements on muscle strength , muscle power , and functional outcomes .
Therefore , in agreement with previous studies , we suggest that supervised and controlled RT represents an effective intervention in frailty treatment
Aim Exercise is one of the most important components in frailty prevention and treatment .
Therefore , we systematic ally review ed the effect of resistance training ( RT ) alone or combined with multimodal exercise intervention on muscle hypertrophy , maximal strength , power output , functional performance , and falls incidence in physically frail elderly .