Positive Effects of Physical Training in Activity of Daily Living–Dependent Older Adults Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study. Effects of a combined physical training and nutrition intervention on physical performance and health-related quality of life in prefrail older women living in the community: a randomized controlled trial. Physical fitness and psychological benefits of strength training in community dwelling older adults. Effects of physical exercise for elderly patients with physical impairments. Effects of traditional physical training and visual computer feedback training in frail elderly patients. A randomized intervention study. Exercise training in elderly patients with chronic heart failure Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study. Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial. Benefits of physical exercise training on cognition and quality of life in frail older adults. Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly Effects of a physical and nutritional intervention program for frail elderly people over age 75. A randomized controlled pilot treatment trial Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults Physical training improves motor performance in people with dementia: a randomized controlled trial.
The goal of this study was to determinate the effects of physical training in older adults with mobility limitations . Thirty frail women ( 84 ± 6 years ) were r and omly assigned to a training or control group for 12 weeks of upper body physical training ( UBT ) performed sitting on wheelchairs . Trained subjects showed a significant improvement in arms strength ( + 29 % ) , and shoulder flexibility ( + 10 cm ) but did not improve in arms circumference . The activities of daily living ( ADLs ) were improved ( + 77 % ) , cognitive function as defined by the Mini-Mental State Examination ( MMSE ) was maintained in the trained group ( + 3 % ) and declined in the control group ( −21 % ) . These results demonstrate that UBT in dependent older women with mobility limitations can increase strength and improve ADLs Reduction in muscle mass and physical function depends on a variety of interacting factors : age , physical activity level , nutritional state and the type and impact of disease . The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength , balance , mobility , ambulation and activities of daily living ( ADL ) in institutionalized elderly people aged 65 and over with multiple diagnoses . Baseline assessment s consisted of strength , balance , mobility/ambulation , and ADL .  Twenty-one subjects were included in the intervention program . A control group ( 21 subjects ) was first matched in pairs according to gender , age , ADL and mobility , and then by balance , ambulation and strength . The intervention program was individualized and included strength , mobility , balance and endurance training . Follow-up measures were conducted directly after the intervention and 10 weeks later . After drop-out , 20 subjects in the intervention group and 15 subjects in the control group remained for analyses . Balance and mobility improved significantly in the intervention group while declining in the control group . This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses OBJECTIVES The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life ( HRQOL ) among prefrail elderly women living in the community . DESIGN This was a r and omized controlled trial in which participants were recruited and r and omly assigned to the exercise and nutrition group ( EN , n = 30 ) , exercise only group ( E , n = 28 ) , and control group ( C , n = 31 ) . SETTING Group training classes were held at a research center in Itabashi Ward , Tokyo , Japan . PARTICIPANTS Eighty-nine prefrail women aged 70 years or older . INTERVENTION The EN group participated in an exercise training and nutritional program ( cooking class ) once a week , and the E group participated in the exercise training program only . MEASUREMENTS Outcome measures that included physical performance ( h and grip strength , balance , walking speed ) and HRQOL ( Medical Outcomes Study 36-Item Short Form Health Survey ) were obtained at entry , the end of the 12-week intervention , and 6 months after completion of the intervention program . RESULTS At the end of the 12-week intervention , significant improvements in the physical component summary score and 3 ( role physical , bodily pain , role emotional ) of the 8 domains of the Medical Outcomes Study 36-Item Short Form Health Survey were observed in the EN group . The E group exhibited a significantly increased h and grip strength at postintervention . The positive effects , however , were not maintained at 6-month follow-up , but were reduced . CONCLUSIONS The combined physical exercise training and nutritional intervention program has beneficial effects on several domains of HRQOL and h and grip strength in prefrail elderly women living in the community . However , further studies are needed to examine approaches that facilitate maintenance of the improved outcomes by combined exercise training and nutritional intervention Previous studies concerning psychological benefits of exercise among the elderly has focused predominantly on the effects of aerobic exercise . In the present study , psychological and behavioral adaptations in response to 12-weeks of strength training were examined in medically healthy but sedentary 42 older adults ( mean age = 68 years ) . The purpose of this study was to evaluate the effects of high and low intensity resistance training intensity on a ) muscular fitness , b ) psychological affect , and c ) neurocognitive functioning . Subjects were r and omly assigned to high intensity/low volume ( EXH : 2 sets of 8 to 10 repetitions for 75 to 85 % of 1 RM ) , low intensity/high volume ( EXL : 2 sets of 14 to 16 repetitions for 55 to 65 % of 1 RM ) , or no exercise control programs . Prior to and following the 12-week program , subjects underwent comprehensive physiological and psychological evaluations . Physiological assessment included measurements of blood pressure , heart rate , arm and leg muscle strength , body composition , and oxygen consumption ( VO2max ) . Psychological measures included evaluations of mood , anxiety , and physical self-efficacy as well as cognitive functioning . The results of this study indicated that both high and low intensity strength programs were associated with marked improvements in physiological fitness and psychological functioning . Specifically , subjects in the strength training programs increased overall muscle strength by 38.6 % and reduced percent body fat by 3.0 % . Favorable psychological changes in the strength-trained subjects included improvements in positive and negative mood , trait anxiety , and perceived confidence for physical capability . The treatment effects of neurocognitive functioning were not significant . In summary , this study demonstrated that participation in 12-weeks of high or low intensity strength training can improve overall physical fitness , mood , and physical self-efficacy in older adults while cognitive functioning remains constant Exercise is known to preserve many physiological responses in the healthy elderly , yet those with physical impairments are often discouraged from exercising . The authors studied the effects of a closely supervised exercise program design ed specifically for elders with health problems and functional limitations . Tests , selected for their relevance to clinical patient management , included the Self Evaluation of Life Function question naire , treadmill performance , and tests of autonomic nervous system and neuromotor functions .  Ambulatory volunteers , aged 64 to 83 years , with noncardiac health problems , were r and omly assigned to a control group ( CG ; n = 17 ) or a 16-week exercise group ( EG ; 3 hr/wk , n = 18 ) . Nine of the control and 13 of the exercise subjects completed the study . All EG dropouts were due to illness . EG attendance averaged 87 % , and subjects trained at a heart rate ( HR ) of 103 + /- 5 beats/min ( SD ) ( 98 % of prescription HR ) . Though EG test responses showed a tendency to improve , none reached statistical significance . This result was affected by the small number completing the study and the variability inherent in such a sample . Though these impaired elderly subjects enthusiastically and safely participated with high attendance and at an exercise intensity adequate to expect benefit , measurable training effects were not demonstrated BACKGROUND Physical training to increase muscle strength and balance is considered useful for prevention of falls in older people . AIM This study compares conventional balance training with visual computer feedback training . DESIGN This was a r and omized controlled 12-week intervention trial with pre- and post-training evaluations . SETTING Out- patients referred to a geriatric falls and balance clinic . POPULATION Thirty-five patients were r and omized into two training groups . METHODS Both groups received progressive resistance muscle strength training and physical fitness training . Additionally , one group received traditional balance training and the other group received computer feedback balance training .  Strength , physical endurance , balance and falls efficacy scale scoring were assessed before and after end of training . RESULTS Twenty-seven patients ( 77 % ) were available for the evaluation ; mean compliance was 71 % . In the combined group , significant mean improvement was observed in knee extension ( 19 % ) , ankle dorsiflexion ( 16 % ) , sitting to st and ing ( 16 % ) , and in the six-minute walk test ( 8 % ) . In the traditional balance training group , the static balance in the Modified Clinical Test of Sensory Interaction and Balance st and ing on a foam mat with closed eyes showed a significant increase ( 80 % ) . No increase occurred in the computer balance training group . However , the computer feed-back training group showed a marked improvement that was up to 400 % in the training specific performance . CONCLUSION Elderly frail patients were able to increase muscle strength and physical endurance . A limited improvement was seen in the static balance tests . The computer feedback group showed a remarkable increase in training specific performance . Clinical Rehabilitation Impact Background Physical training currently constitutes an important part of treatment of heart failure patients . So far , no data are available on the effects of regular exercise in elderly ( aged > 65 years ) heart failure patients . Methods In a prospect i ve trial , patients with chronic heart failure ( New York Heart Association class II and III ) were r and omly assigned to a training group and a control group . Patients in the training group performed additional exercises three times a week , while patients in the control group continued regular treatment . To analyse the influence of age , both groups were subdivided into subjects younger than and older than 65 years . The effect of training on exercise parameters was evaluated by means of a treadmill test . Quality of life aspects were evaluated with the help of the Heart Patients Psychological Question naire and a single- question Self Awareness of General Well-Being test . Results Comparison of changes between groups revealed that training increased the duration of the exercise test and improved aspects of quality of life in the trained patients aged both younger than and older than 65 years . Conclusion Exercise training is equally effective in patients aged younger than and older than 65 years AIMS Cardiac rehabilitation including exercise training is of proven value in ischaemic heart disease . However , elderly patients frequently are not encouraged to participate in such programmes . This study evaluates the physiological effects and self-reported quality of life after an aerobic outpatient group-training programme in subjects above the age of 65 years . METHODS AND RESULTS A consecutive series of 101 patients ( males 80 % ) aged 65 - 84 ( mean 71 ) years recovering from an acute coronary event were r and omized to either a supervised out patient group-training programme ( n=50 ) or to a control group ( n=51 ) . The two groups were well balanced as regards clinical characteristics . The compliance in the training group was 87 % . Exercise tolerance increased in the trained group from 104 to 122 and 111 W after 3 and 12 months respectively . The corresponding values were 102 , 105 and 105 W among controls . Parameters , such as quality of life , self-estimated level of physical activity , fitness and well-being were grade d higher by the trained patients than those who served as controls on the two occasions of follow-up . CONCLUSIONS Aerobic group-training of elderly patients recovering from an acute coronary event beneficially influences physical fitness and several parameters expressing quality of life . Great care has to be taken to preserve the initial effects by continued training 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 Frailty is a state of vulnerability associated with increased risks of fall , hospitalization , cognitive deficits , and psychological distress . Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life . Whether frail older adults can show such benefits remains to be documented . METHOD A total of 83 participants aged 61 - 89 years were assigned to an exercise-training group ( 3 times a week for 12 weeks ) or a control group ( waiting list ) . Frailty was determined by a complete geriatric examination using specific criteria . Pre- and post-test measures assessed physical capacity , cognitive performance , and quality of life . RESULTS Compared with controls , the intervention group showed significant improvement in physical capacity ( functional capacities and physical endurance ) , cognitive performance ( executive functions , processing speed , and working memory ) , and quality of life ( global quality of life , leisure activities , physical capacity , social/family relationships , and physical health ) . Benefits were overall equivalent between frail and nonfrail participants . DISCUSSION Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults 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 Background and aims : There are few studies published that combine the interventions of physical training and nutrition . The aim of the present study was to describe the impact of a physical and nutritional intervention program for frail community-dwelling elderly people over the age of 75 . Methods : Ninety-six community-dwelling elderly people ( 58 women ) were r and omized to four different groups : i ) a physical training program ( aerobic , muscle strength , balance ) , ii ) a nutritional intervention program ( individually targeted advice and group sessions ) , iii ) a combination of these interventions , and iv ) a control group . At baseline subjects were screened for physical performance such as muscle strength , balance , mobility and activities of daily living , as well as nutritional aspects such as energy intake , body weight and fat-free mass . These measurements were repeated immediately after the intervention , which lasted for 12 weeks , and after another 6 months . Results : The intention-to-treat analysis indicated significant improvements in lower-extremity muscle strength in both training groups compared with the nutrition group at 1st follow-up . There were small significant changes for some of the balance measurements in the training group without nutrition treatment . The nutrition intervention did not show any significant results . Conclusions : This study shows the positive effect on lower-extremity muscle strength directly after the intervention . Balance training most probably needs to be more individualized in order to be effective for frail elderly people . Further studies are needed , with larger sample sizes , to investigate the effects of these types of interventions before any further conclusions can be drawn OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline Background and aims : The aim of the study was to assess the effect of structured strength and balance training on cognitive function in frail , geriatric , long-term care facility residents , aged 75 years or older , and additionally to evaluate the influence of training on various functional , physical and psychological parameters . Methods : Participants were r and omly assigned to a  training group or a control group . Physical training was performed three times a week for ten weeks in the training group . Muscle function was assessed by manual examination on a scale of 0–5 . Cognitive function was tested with the Mini Mental State Examination ( MMSE ) . In addition , scores for activities of daily living , mobility and depression were assessed . Results : 30 subjects with a mean age of 86.8 years completed the study . After 10 weeks of intervention in the training group , muscle strength increased from a mean of 3.75 to 4.44 points ( p<0.001 ) and the mean MMSE score increased from 20.9 to 23.9 points ( p=0.023 ) . In the training group , the change in the MMSE score correlated significantly with change in muscle function , with a Pearson correlation coefficient of 0.750 ( p=0.002 ) . An increase in mean BMI from 23.8 to 25.0 kg/m2 ( p=0.013 ) was also found in the training group , but no significant changes in scores for activities of daily living , mobility or depression . Compared with the control group , the change in the mean scores over the ten-week training period was significantly higher for the trained group with regard to muscle scores , BMI and lean body mass , but not for MMSE scores . Conclusions : Our findings reinforce the recommendation that structured strength and balance training should be implemented in long-term care facilities . Besides the well-known benefits of physical training , our findings showed that an improvement in cognitive function may also be possible Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed . However , it is unknown whether these are effective in this particular population . This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization . Methods The systematic search included PubMed , EMBASE , Cinahl , the Trials data base of The Cochrane Library and SPORTd iscus from inception to 22 November 2017 . Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on  physical performance or physical activity  was evaluated during hospitalization . Results Fifteen r and omized controlled trials met the inclusion criteria . Overall , the effect of physical interventions on physical performance was inconsistent . Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not . Physical activity as outcome measure was not addressed . Reporting of intensity of the interventions and adherence were frequently lacking . Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain . Further research on the efficacy of the intervention is needed , comparing types of intervention with detailed reporting of frequency , intensity and duration Purpose Physical exercise and cognitive training have been shown to enhance cognition among older adults . However , few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study . Prior trials on combined training have led to interesting yet equivocal results . The aim of this study was to examine the effects of combined physical and cognitive interventions on physical fitness and neuropsychological performance in healthy older adults . Methods Seventy-six participants were r and omly assigned to one of four training combinations using a 2 × 2 factorial design . The physical intervention was a mixed aerobic and resistance training program , and the cognitive intervention was a dual-task ( DT ) training program . Stretching and toning exercises and computer lessons were used as active control conditions  . Physical and cognitive measures were collected pre- and postintervention . Results All groups showed equivalent improvements in measures of functional mobility . The aerobic – strength condition led to larger effect size in lower body strength , independently of cognitive training . All groups showed improved speed of processing and inhibition abilities , but only participants who took part in the DT training , independently of physical training , showed increased task-switching abilities . The level of functional mobility after intervention was significantly associated with task-switching abilities . Conclusion Combined training did not yield synergetic effects . However , DT training did lead to transfer effects on executive performance in neuropsychological tests . Both aerobic-resistance training and stretching-toning exercises can improve functional mobility in older adults OBJECTIVES To determine whether a specific , st and ardized training regimen can improve muscle strength and physical functioning in people with dementia . DESIGN Double-blinded , r and omized , controlled trial with 3-month intervention and 3-month follow-up period in 2006 to 2009 . SETTING Outpatient geriatric rehabilitation . PARTICIPANTS Individuals with confirmed mild to moderate dementia , no severe somatic or psychological disease , and ability to walk 10 m. Most participants were still living independently with or without supportive care . INTERVENTION Supervised , progressive resistance and functional group training for 3 months specifically developed for people with dementia ( intervention , n = 62 ) compared with a low-intensity motor placebo activity ( control , n = 60 ) . MEASUREMENTS Primary outcome measures were one-repetition maximum in a leg press device for maximal strength and duration of the five-chair-st and test for functional performance . Secondary outcome measures were assessed for a number of established parameters for maximal strength , physical function , and physical activity . RESULTS Training significantly improved both primary outcomes ( percentage change from baseline : maximal strength , intervention group ( IG ) : + 51.5 ± 41.5 kg vs control group ( CG ) : -1.0 ± 28.9 kg , P < .001 ; functional performance , IG : -25.9 ± 15.1 seconds vs CG : + 11.3 ± 60.4 seconds , P < .001 ) . Secondary analysis confirmed effects for all strength and functional parameters . Training gains were partly sustained during follow-up . Low baseline performance on motor tasks but not cognitive impairment predicted positive training response . Physical activity increased significantly during the intervention ( P < .001 ) . CONCLUSION The intensive , dementia-adjusted training was feasible and substantially improved motor performance in frail , older people with dementia and may represent a model for structured rehabilitation or outpatient training
There was a large heterogeneity in the studies concerning sample size , types of interventions and types of assessment s. There is strong evidence for a positive effect of  physical training  on muscle strength and mobility ; moderate evidence for an effect on range of motion ; and contradictory evidence regarding gait , activities of daily living , balance and endurance .
OBJECTIVE the positive effect of physical training in healthy elderly people is well documented .
The aim of this systematic review was to describe the effect of physical training on physical performance in institutionalised elderly patients with multiple diagnoses .