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Traditional Versus Functional Strength Training: Effects on Muscle Strength and Power in the Elderly

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The aim was to determine whether strength training with machines vs. functional strength training at 80% of one-repetition maximum improves muscle strength and power among the elderly. Sixty-three subjects (69.9 ± 4.1 yr) were randomized to a high-power strength group (HPSG), a functional strength group (FSG), or a nonrandomized control group (CG). Data were collected using a force platform and linear encoder. The training dose was 2 times/wk, 3 sets × 8 reps, for 11 wk. There were no differences in effect between HPSG and FSG concerning sit-to-stand power, box-lift power, and bench-press maximum force. Leg-press maximum force improved in HPSG (19.8%) and FSG (19.7%) compared with CG (4.3%; p = .026). Bench-press power improved in HPSG (25.1%) compared with FSG (0.5%, p = .02) and CG (2%, p = .04). Except for bench-press power there were no differences in the effect of the training interventions on functional power and maximal body strength.
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51
Journal of Aging and Physical Activity, 2013, 21, 51-70
© 2013 Human Kinetics, Inc.
Lohne-Seiler and Torstveit are with the Faculty of Health and Sport Sciences, University of Agder,
Kristiansand, Norway. Anderssen is with the Dept. of Sport Medicine, Norwegian School of Sport
Sciences, Oslo, Norway.
Traditional Versus Functional Strength
Training: Effects on Muscle Strength
and Power in the Elderly
Hilde Lohne-Seiler, Monica K. Torstveit,
and Sigmund A. Anderssen
The aim was to determine whether strength training with machines vs. functional
strength training at 80% of one-repetition maximum improves muscle strength and
power among the elderly. Sixty-three subjects (69.9 ± 4.1 yr) were randomized
to a high-power strength group (HPSG), a functional strength group (FSG), or a
nonrandomized control group (CG). Data were collected using a force platform
and linear encoder. The training dose was 2 times/wk, 3 sets × 8 reps, for 11 wk.
There were no differences in effect between HPSG and FSG concerning sit-to-stand
power, box-lift power, and bench-press maximum force. Leg-press maximum force
improved in HPSG (19.8%) and FSG (19.7%) compared with CG (4.3%; p = .026).
Bench-press power improved in HPSG (25.1%) compared with FSG (0.5%, p = .02)
and CG (2%, p = .04). Except for bench-press power there were no differences in the
effect of the training interventions on functional power and maximal body strength.
Keywords: weight training, high velocity, force, seniors
Human aging leads to a progressive loss of muscle strength, mostly because of
atrophy of muscle mass and loss of muscle bers (Lexell, 1997; Lexell, Taylor, &
Sjöström, 1988). Age-related reductions in muscle mass are primarily a consequence
of losses of alpha motor neurons in the spinal cord and secondary denervation of
their muscle bers (Lexell, 1993, 1997). A reduction of muscle bers is associated
with motor-unit loss, mainly after 60 years of age (Lexell, 1993). Fast-twitch motor
units are the most affected. In addition, qualitative changes in muscle cross-sectional
area are reported with increasing age, which results in a dramatic loss in the abil-
ity to produce force rapidly (De Vito et al., 1998; Izquierdo, Aguado, Gonzalez,
Lopez, & Häkkinen, 1999). Muscle power, dened as the product of force and
velocity (Power = force × velocity), therefore declines more than muscle strength
(Skelton, Greig, Davies, & Young, 1994). Muscle power has been shown to be
positively associated with the ability to perform activities of daily living and may
be a stronger predictor of functional dependency than muscle strength is (Bean et
al., 2003; Foldvari et al., 2000).
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ORIGINAL RESEARCH
52 Lohne-Seiler, Torstveit, and Anderssen
A signicant correlation between leg-extensor power and performance mea-
sures, such as the ability to rise from a chair, climb stairs, and walk quickly, has been
shown (Bassey et al., 1992; Foldvari et al., 2000). Muscle power is also related to
dynamic balance (Bean et al., 2002) and postural sway (Izquierdo et al., 1999) and
may be a stronger predictor of fall risk than muscle strength is (Skelton, Kennedy,
& Rutherford, 2002). Furthermore, increased muscle power may lead to improve-
ments in functional capacity, fall prevention, dependency, and disability later in
life (de Vos, Singh, Ross, Stavrinos, Orr, & Fiatarone Singh, 2005).
It is not clear what form of strength training is most benecial for the elderly.
There are different views concerning strength-training protocols where the goal
is to maintain or attain an adequate level of physical function, to perform activi-
ties of daily living successfully and independently. High-intensity (Fiatarone et
al., 1990), low-intensity (Skelton, Young, Grieg, & Malbut, 1995), high-velocity
in combination with high-intensity (Henwood & Taaffe, 2005; Macaluso, Young,
Gibb, Rowe, & De Vito, 2003), high-velocity versus traditional low-velocity resis-
tance training at the same training intensity (Fielding et al., 2002), high-velocity
versus traditional low-velocity resistance training at different training intensities
(Miszko et al., 2003), and functional task-oriented strength training (de Vreede,
Samson, van Meeteren, Duursma, & Verhaar, 2005; Helbostad, Sletvold, & Moe-
Nilssen, 2004) have all been investigated. A traditional protocol for the elderly
focuses on high-intensity and low-velocity strength training (Fiatarone et al., 1990).
High-intensity strength training, equivalent to ~80% of one-repetition maximum
(1RM), is effective for increasing muscle size and strength (Fiatarone et al., 1990;
Frontera, Meredith, O’Reilly, Knuttgen, & Evans, 1988; Taaffe, Duret, Wheeler,
& Marcus, 1999). However, this training regimen, because of the slow speed of
muscle contraction, may lead to lack of muscle power. Using heavy loads (80% of
1RM) during explosive resistance training may be the most effective strategy to
achieve simultaneous improvements in muscle strength and power in older adults
(de Vos et al., 2005). Power-training studies in the elderly have mostly focused on
lower body power (de Vos et al., 2005; Fielding et al., 2002; Henwood & Taaffe,
2005; Macaluso et al., 2003). However, if the goal is to elicit improvements in
functional movement capacity among older adults, it is also necessary to integrate
the upper body in the training program and improve peak power in the upper body
musculature. Furthermore, exercise strategies for the elderly should be designed to
increase muscle power in functional movements. However, little is known about the
functional adaptive responses of elderly subjects to power training (Evans, 2000).
The aim of the current study was to test the hypothesis that functional strength
training performed at 80% of 1RM at a maximal intended concentric velocity would
improve strength and power in functional strength tasks among elderly subjects
more than traditional strength training at the same intensity and velocity.
Methods
Study Design and Participants
The subjects were recruited through advertisement in the local newspaper. A total
of 110 people showed their interest after the rst information meeting. Because
of limited capacity, 70 volunteers (35 men, 35 women) were randomly stratied
Traditional vs. Functional Training 53
by sex out of the total number of 110. The subjects were randomized into two
intervention groups: a high-power strength group (HPSG, n = 25) and a functional
strength group (FSG, n = 30). Based on the capacity of the tness center and the
number of instructors available, the size of the HPSG was necessarily smaller than
FSG. Finally, 15 subjects volunteered to be nontraining controls (CG) and were
therefore a nonrandomized group (Figure 1).
Before participation, all subjects reported their health history and physical
activity level through a questionnaire. In addition, they received medical clearance
from their medical doctor, either in written or oral form. Inclusion criteria were being
65 years or older, physically active less than 30 min/day at moderate intensity, and
healthy enough to participate. Exclusion criteria were being physically active more
than 30 min/day at moderate intensity, participating in strength training, or involved
in other studies interfering with the current study or having cognitive impairment,
acute or terminal illness, or severe cardiovascular, respiratory, musculoskeletal, or
neurological diseases disturbing voluntary movement. During the study period,
the participants were encouraged to maintain their normal activity and dietary
patterns.
The study was approved by the Regional Committee for Medical Research
Ethics in Norway and the Data Inspectorate, and all subjects provided informed
consent before the study.
Figure 1 A owchart showing the study design.
54 Lohne-Seiler, Torstveit, and Anderssen
Measures
On the rst test day, participants completed a 20- to 30-min warm-up on a cycle
ergometer (Monark, 818 E, Ergomed) before undergoing the traditional strength
tests (leg-press, Smith-machine bench-press, and isometric dead-lift tests). On
the second test day, approximately 1 week after the rst test day, the participants
completed a 20- to 30-min warm-up including fast walking and stair climbing
before the functional strength tests (sit-to-stand power and box-lift power tests).
This warm-up procedure was chosen because of the specicity of the functional
movements. In the traditional strength tests, the muscle recruitment was as isolated
as possible, in contrast to the functional strength tests where the muscle recruitment
was as integrated as possible.
Leg-Press Tests. 1RM leg-press force and 80% of 1RM leg-press power were
determined using a linear encoder and load cell connected to an integrated data-
analysis program (Muscle Laboratory, Ergotest Technology AS, Norway). The
subjects were encouraged to exert maximal force during the bilateral 1RM testing,
after the same test procedure as described in Taaffe, Pruitt, Pyka, Guido, and
Marcus (1996). To measure 80% of 1RM leg-press power, the subjects were asked
to complete the concentric phase of the movement as rapidly as possible and then
return through the eccentric phase at a slow and controlled pace over 2–3 s. The
average of the two best attempts of ve was recorded as the result. The same load
lifted at 80% of 1RM at preintervention testing was used on the postintervention
testing to reveal possible power changes for a given load.
Bench-Press Tests on the Smith Machine. 1RM bench-press force and 80%
of 1RM bench-press power were determined using a linear encoder and load cell
connected to the same integrated data-analysis program described earlier. Similar
test procedures were followed as during the leg-press tests.
Isometric Dead-Lift Test. 1RM isometric dead-lift force was determined using a
tension load cell connected to the integrated data-analysis program. The subjects
were encouraged to exert maximal force during the 1RM testing. The better of
two attempts was recorded. A total of 10% for women and 15% for men of the
“average” maximum loads were calculated and then used during the box-lift test.
Sit-to-Stand Power Test. The sit-to stand power test, which is a test of lower
extremity muscle power, was performed on a force platform (Figure 2[a]) connected
to the integrated data-analysis program. The test is based on a validity and reliability
study of the 30-s chair stand by Jones, Rikli, and Beam (1999; Lohne-Seiler,
Anderssen, Blazevich, & Torstveit, 2012). After a given signal the subjects were
encouraged to work as fast as possible and exert maximal power (a combination
of fast speed and explosive work) while standing from a chair without handrails
(height 46.0 cm, depth 44.5 cm). The average of the two best trials of ve was
recorded as the result. Five trials were necessary to ensure that the best sit-to-stand
power result was achieved.
Box-Lift Power Test. The box-lift power test, which is a test of total-body lifting
power, was performed using a linear encoder and load cell (Figure 2[b]) connected
to the integrated data-analysis program. The test is based on a validity and reliability
study of a version of the progressive isoinertial lifting test (Mayer et al., 1988)
Traditional vs. Functional Training 55
performed by Lohne-Seiler et al. (2012). During the box-lift test, 10% for women
and 15% for men of the “average” maximum load achieved during the isometric
dead-lift test were used. The subjects were encouraged to work as fast as possible
and exert maximal power (a combination of fast speed and explosive work) during
the box lifting. The average of the two best trials of ve was recorded as the
result. Five trials were necessary to ensure that the best box-lift power result was
achieved.
Anthropometric Data. Body height and mass were measured using a measuring
tape and body-mass monitor (Seca opima) twice per subject (wearing a T-shirt,
shorts, and no shoes) ahead of the traditional and functional strength and power
testing. The results are given as a mean of two measurements.
Exercise Intervention
The two intervention groups exercised twice a week for 11 weeks, with at least 48
hr between the two training sessions. The exercise program in the two intervention
groups consisted of a 10-min warm-up including instructed aerobic and stretching
exercises, followed by 50 min of instructed strength training using machines (HPSG)
or functional strength training (FSG). Finally, a 10-min cooldown consisting of
lower back, abdominal, and stretching exercises was completed under supervision
in both the intervention groups.
HPSG subjects completed the following strength-training exercises in each
training session: seated row, lat pull-down, shoulder press, leg press, and multipower
(a) (b)
Figure 2 — Photos showing (a) sit-to-stand power test performed on a force platform and
(b) box-lift power test performed using linear encoder and load-cell devices.
56 Lohne-Seiler, Torstveit, and Anderssen
bench press on a Smith machine (Figure 3). The exercises were performed on
TechnoGym equipment (Silver Line/Selection, Italy).
FSG subjects completed the following functionally based exercises in each
training session: stair climbing using a backpack lled with training weights as
the external load, box lifting using 2.25-kg bottles lled with sand as the external
load, shoulder press and one-arm ies using dumbbells as the external load, and
“rubber band rowing” using three different-resistance rubber bands as the external
load. In addition, the participants in the FSG worked in an obstacle course consist-
ing of sit-to-stand from a chair, hurdles, balance, and slalom challenges (Figure
4). They were asked to complete the obstacle course as correctly and quickly as
possible.
All participants worked in pairs and were supervised by an instructor whose
responsibility was to maintain set protocols and to establish a standard of security
and motivation. Five instructors were engaged throughout the 11-week interven-
tion, and each was responsible for the same exercises in the training period. The
focus in the rst 2 weeks (equivalent to four training sessions) of the intervention
period was for the subjects to learn how to do the exercises, establish good training
routines for the couples who worked together, get used to the training environment,
and gain muscle conditioning.
In our study, the same training protocol was used as described in Jozsi,
Campell, Joseph, Davey, and Evans (1999) and Henwood and Taaffe (2005). The
rst four training sessions had the following training procedure: For each exercise
Figure 3 — Photos showing the machine-based strength-training exercises.
Traditional vs. Functional Training 57
the participants completed three sets of six to eight repetitions at 60% of 1RM
(maximal weight an individual can lift one time) in the rst set and 70% of 1RM
in the second and third sets. Concentric and eccentric movements were performed
in 2–3 s each. For the rest of the intervention period (equivalent to 18 training ses-
sions) the training aimed specically at increasing muscle power by using rapid
concentric movements and increasing resistance intensities. Three sets of eight
repetitions were performed at 60% of 1RM in the rst set and 80% of 1RM in the
second and third sets. The participants were instructed to perform the concentric
phase of the movement as rapidly as possible, then return through the eccentric phase
at a slow and controlled pace of 2–3 s. In the third set of exercises on the second
training day each week, the subjects were asked to work past the eighth repetition
until failure. If they managed to do 10 repetitions, the 1RM was increased by 5%.
If they managed to do 12 repetitions, the 1RM was increased by 10%. The 1RM
training percentages were then recalculated accordingly.
Subject participation was recorded at every training session, and those whose
adherence was less than 84% were excluded from the study. This allowed them to
be absent three times during the 21-session intervention period.
Figure 4 — Photos showing a selected sample of the functionally based exercises.
58 Lohne-Seiler, Torstveit, and Anderssen
Data Analysis
All analyses were conducted using SPSS statistical software (version 13.0, SPSS
Inc., Chicago, IL). One-way ANOVA with Bonferroni’s post hoc test was used to
analyze differences between groups at baseline. Within-group comparisons were
made using Student’s paired-sample t tests. Differences in the change in perfor-
mance from pre- to postintervention testing between the three groups (HPSG,
FSG, and CG) were analyzed by using one-way ANOVA with Bonferroni’s post
hoc test (three-group comparison). All the tests were two-tailed, and a p level of
.05 was chosen for statistical signicance. Results are given as M ± SD. A power
calculation was conducted in advance of the current study based on the work by
Henwood and Taaffe (2005), looking at the changes in functional muscle strength.
The analysis was based on an effect size of 1.0, where the size of the change in
functional muscle strength was 10% and the standard deviation of the mean change
was 10%. The power analysis gave a statistical power of 81% and alpha error level
or condence level of 5%, giving a sample size in each intervention group of 20
subjects and a sample size in the control group of 15 subjects.
Results
Seven subjects dropped out of the study, 2 from the HPSG for medical reasons and
5 subjects from the CG—4 for medical reasons and 1 due to a failure to complete
the required number of testing sessions. The average attendance rate was 18 of
21 sessions in both intervention groups during the 11-week intervention period.
The mean age of the total sample (N = 63) was 69.9 ± 4.1 years (range 65–87).
All the participants in this study lived at home, with no help or assistance from the
health care system. They all reported a physical activity level less than 30 min/day
of moderate-intensity activity. None of the subjects had any previous experience
in weight lifting or strength training. Common activities among the elderly were
walking/strolling, swimming, gardening, and household activities. No signicant
differences in the subject characteristics were found between the three groups at
baseline (Table 1).
Functional Strength Tests
No signicant differences were found between the groups at baseline for the func-
tional strength tests (Table 2).
Table 1 Baseline Characteristics in the High-Power Strength Group
(HPSG), the Functional Strength Group (FSG), and the Control
Group (CG), M (SD)
HPSG,
n
= 23 FSG,
n
= 30 CG,
n
= 10
p
Age, years 69.4 (4.0) 70.4 (4.3) 69.3 (4.2) .7
Height, cm 172.1 (8.8) 172.6 (9.8) 174.3 (10.0) .8
Mass, kg 75.6 (14.8) 79.2 (11.0) 79.3 (18.0) .6
Body-mass index, kg/m
2
25.4 (3.7) 26.4 (2.9) 25.9 (4.3) .6
59
Table 2 Pre- and Postintervention Test Results in Functional Muscle-Strength Tests in the High-Power Strength
Group (HPSG), the Functional Strength Group (FSG), and the Control Group (CG), M (SD)
HPSG FSG CG
Pre Post
n
Pre Post
n
Pre Post
n
Sit-to-stand
power test, W 814.1 (305.4) 909.5 (364.5) 23 841.4 (240.7) 909.0 (243.4)* 27 708.0 (336.7) 648.8 (240.2) 9
Box-lift
power test, W 222.3 (151.7) 255.6 (167.3)* 23 260.0 (113.6) 282.9 (121.0)* 27 266.7 (192.1) 272.3 (198.8) 9
*Signicant changes from pre- to postintervention were found (within-group comparison), p .05.
60 Lohne-Seiler, Torstveit, and Anderssen
Sit-to-Stand Power. Signicant improvements from pre- to postintervention in the
sit-to-stand power test were only found in FSG, t = –3.168, df(26), p = .004 (Table
2; 67.6 ± 110.8 W, 9.7%), although this change was not signicantly different, F
= 2.388, df(2, 56), p = .101, from HPSG (95.4 ± 247.0 W, 14.5%) or CG (–59.2 ±
155.8 W, –4.1%). The effect size was η
2
= .50.
Box-Lift Power. Both HPSG and FSG signicantly improved their box-lift power,
t = –6.404, df(22), p = .000, and t = –2.999, df(26), p = .006, respectively (Table
2; 33.3 ± 24.9 W, 19.2%, and 23.0 ± 39.8 W, 9.7%, respectively), although no
differences between the groups were found, F = 2.074, df(2, 56), p = .135, change
in CG = 5.5 ± 41.4 W (3.3%). The effect size was η
2
= .50.
Traditional Strength Tests
No signicant differences were found between the groups at baseline for the tra-
ditional strength tests (Table 3).
Leg-Press Force (1RM). Both HPSG and FSG signicantly improved their
leg-press maximum force, t = –4.240, df(22), p = .000, and t = –5.096, df(27), p =
.000, respectively (Table 3; 203.4 ± 191.7 N, 19.8%, and 196.8 ± 200.7 N, 19.7%,
respectively). Average force output during the leg-press maximum-force test
signicantly increased, F = 3.978, df(2, 44), p = .026, from pre- to postintervention
in both the intervention groups compared with CG (Table 3; change in CG = 14.2
± 123.7 N, 4.3%, p .05). The effect size was η
2
= .50. The subjects in HPSG
and FSG managed to lift 24.8 ± 27.7 kg and 23.2 ± 24.4 kg, respectively, more at
postintervention than CG (2.0 ±11.4 kg).
Leg-Press Power (80% of 1RM). CG signicantly improved leg-press power
from pre- to postintervention, t = –2.386, df(9), p = .041 (Table 3; 39.4 ± 52.3 W,
16.6%), although this change was not different, F = 1.792, df(2, 55), p = .176, from
HPSG (0.04 ± 40.1 W, 0.3%) or FSG (4.1 ± 68.3 W, 2.9%). The effect size was
η
2
= .50.
Bench-Press Force (1RM). Both HPSG and FSG signicantly improved their
bench-press maximum force, t = –4.502, df(22), p = .000, and t = –4.024, df(27),
p = .000, respectively (Table 3; 51.0 ± 52.0 N, 15.2%, and 33.5 ± 46.9 N, 12.9%,
respectively), although there were no differences in the changes among the groups,
F = 0.698, df(2, 47), p = .502; change in CG = 28.5 ± 59.9 N (14.7%). The effect
size was η
2
= .50. The subjects in the HPSG and the FSG managed to lift 6.8 ±
5.6 kg and 4.1 ± 5.4 kg, respectively, more at postintervention than CG (3.0 ±
6.2 kg).
Bench-Press Power (80% of 1RM). HPSG signicantly improved bench-press
power from pre- to postintervention, t = –3.324, df(21), p = .003 (Table 3; 27.6
± 39.0 W, 25.1%). Otherwise, no signicant changes were detected (Table 3).
Average power output in the bench-press power test signicantly increased, F =
4.684, df(2, 54), p = .013, in HPSG (27.6 ± 39.0 W, 25.1%) compared with both
FSG (–1.2 ± 33.5 W, 0.5%, p = .02) and CG (–0.4 ± 23.4 W, 2.0%, p = .04). The
effect size was η
2
= .50.
61
Table 3 Pre- and Postintervention Test Results in Traditional Muscle-Strength Tests in the High-Power Strength
Group (HPSG), the Functional Strength Group (FSG), and the Control Group (CG), M (SD)
HPSG FSG CG
Pre Post
n
Pre Post
n
Pre Post
n
Leg-press force test
1RM, N 1,117.6 (459.9) 1,359.2 (664.7)
a,b
23 1,195.3 (370.5) 1,430.9 (524.8)
a,c
28 1,142.3 (502.6) 1,156.5 (439.3) 10
Leg-press power test
80% of 1RM, W 314.6 (129.8) 314.6 (133.8) 21 338.9 (122.3) 343.0 (128.6) 27 282.9 (122.6) 322.3 (132.5)
a
10
Bench-press force
test 1RM, N 343.2 (131.2) 402.4 (166.6)
a
23 353.9 (108.2) 393.8 (113.2)
a
28 377.3 (188.5) 405.8 (168.6) 10
Bench-press power
test 80% of 1RM, W 139.6 (71.4) 167.2 (86.5)
a,d
22 141.7 (47.7) 140.5 (48.8) 25 143.8 (81.0) 143.4 (80.4) 10
Note. 1RM = one-repetition maximum.
a
Signicant changes from pre- to postintervention (within-group comparison), p .05.
b
HPSG compared with CG, p = .05.
c
FSG compared with CG, p = .04.
d
HPSG
compared with FSG, p = .02, and CG, p = .04.
62 Lohne-Seiler, Torstveit, and Anderssen
Discussion
A main nding of the current study was that there was no difference in the effect on
functional power and maximal body strength between the two training regimens,
machine-based strength training versus functional strength training. However, a
signicant difference in effect was seen in traditional upper body power between
the two intervention groups and the control group. Thus, higher speed strength
training seems to be effective for the development of upper body strength and
power in elderly subjects.
The intention of this study was to examine the difference in effect between
strength training with machines and functional strength training, where both train-
ing regimens included work at a heavy load with maximal intended concentric
velocity. This is different from other studies (Helbostad et al., 2004; Skelton et al.,
1995) where the functional training regimes were completed at lower intensity and
slower movement speeds. Few studies have compared these two training regimens,
although one compared the effect of traditional resistance training versus functional
strength training (de Vreede et al., 2005), and other studies have evaluated the effect
of strength-training regimens at different movement speeds (Henwood, Riek, &
Taaffe, 2008; Henwood & Taaffe, 2006).
Muscle Power Measured Functionally
Only FSG signicantly improved in the sit-to-stand power test from pre- to postint-
ervention. Similar results have previously been reported by Helbostad et al. (2004),
who showed an effect of functional strength training on chair-stand performance,
measured as the time an older adult takes to rise from a chair as fast as possible.
No signicant increase was seen in the current study in HPSG and FSG compared
with CG in functional lower body power over the 11-week intervention period. Our
result is not consistent with those of Henwood & Taaffe (2005, 2006), who found a
signicant improvement in chair-rise ability after a high-velocity resistance-training
program. Their study had a low training specicity, only an 8-week intervention
period, and a smaller number of participants in the training group (n = 15), so their
results might be connected to the use of a combination of high-intensity and high-
velocity movements. At least for the lower body musculature, it is possible that the
use of separate high-intensity and high-speed sessions might be more effective than
consistently using a single-session design where the concentric phase is performed
as rapidly as possible. This hypothesis should be tested in future research.
In the box-lift power test both HPSG and FSG signicantly improved from
pre- to postintervention. These ndings differ from those of Skelton et al. (1995),
who found no change in bag-lifting performance after functional strength train-
ing. de Vreede et al. (2005) demonstrated that functional strength training had a
signicantly greater inuence on activities of daily living than traditional strength
training in a group of elderly subjects. This result might be explained by a high
training specicity in the functional group and, based on this, we probably should
have prevented FSG from doing box lifting, as it was too specic to the pre- and
postintervention test. In our study, we found no signicant differences in functional
lower and upper body power between HPSG and FSG.
The signicant improvement in functional power in FSG might be explained
by a high training specicity, where the training and testing tasks were identical.
Traditional vs. Functional Training 63
Conversely, the lack of functional body-power improvements in HPSG is probably
due to a low training specicity. This is in agreement with Henwood and Taaffe
(2005), as mentioned earlier, who found that the proportional change in functional
strength was less than the change in “traditional” strength after higher velocity
machine-based strength training.
The relative increase in functional-test performance in our study was greater
in HPSG than in FSG, which might be explained by a better control of the speed
of contraction (movement) and the greater training load used by HPSG than by
FSG. Our subjects in both intervention groups were reminded on a regular basis
to work at a high speed in the concentric phase, but slow and controlled (2–3 s) in
the eccentric phase, although movement speed was not specically measured. To
control for the speed of contraction performed by the intervention groups, using
timers or metronomes might be a solution. This would probably be helpful for
researchers or practitioners interested in developing power-training protocols for
their elderly subjects or clients.
Since we could not detect any difference between the two exercise groups, we
combined the subjects and compared them with CG to increase statistical power.
A signicant improvement in sit-to-stand power was found in the combined inter-
vention group (80.3 ± 184.7 W, equivalent to 11.9%) compared with CG (–59.2
+ 155.8 W, equivalent to –4.1%; p = .03). A signicant improvement in leg-press
maximum force was also found in the combined intervention group (199.5 ±
194.4 N, equivalent to 20.2%) compared with CG (14.2 ± 123.7 N, equivalent to
4.3%; p = .001). This result shows that strength training with high intensity and
high velocity, per se, might appear to have a substantial effect on both lower body
strength and functional performance in older individuals, which is in agreement
with previous research (Bottaro, Machado, Nogueira, Scales, & Veloso, 2007;
Henwood et al., 2008; Henwood & Taaffe, 2005, 2006). Surprisingly, our result
showed no signicant increases in upper body performance when comparing the
combined group with CG.
In our study, the functional abilities (sit-to-stand power and box-lift power)
were measured objectively. Our ndings are therefore difcult to compare with
those of other studies where the power outcome in functional-tasks performance and
abilities among the elderly were often measured indirectly in the eld (de Vreede
et al., 2005; Helbostad et al., 2004; Henwood & Taaffe, 2005; Miszko et al., 2003;
Skelton et al., 1995). It is a methodological challenge to compare results based on
two different test methods, eld-based and objective-based tests. In addition, studies
using functional-training regimens as interventions are hard to compare with our
study, since those studies were not concerned with showing the intent to maintain
the high intensity and the high velocity of the training but instead focused more
on adapting the training exercises similar to activities of daily living (de Vreede et
al., 2005; Helbostad et al., 2004).
According to de Vos et al. (2008), explosive resistance training in older adults
results in their ability to produce higher peak power outputs with heavier loads with-
out loss of movement velocity. The lack of signicant improvements in functional
power in our study may be connected to the estimated intensity and velocity. The
high intensity was easier to control for in HPSG than in FSG. To ensure that the
subjects in both intervention groups exerted maximal power during the tests, they
were asked to work as fast as possible and at the same time think of the movement
as being very explosive. It was important for the test leaders to ensure that the
64 Lohne-Seiler, Torstveit, and Anderssen
subjects fully understood the importance of this concept to exert maximal power.
The velocity was more related to each individual’s intention to work at high speeds.
To ensure that this happened, both intervention groups were constantly reminded by
the instructors to work fast in the concentric phase of the movement. The training
intensity used in our study is in accordance with de Vos et al. (2005), who looked
at the optimal load for increasing muscle power during explosive resistance training
in elderly participants and found that heavy loads equal to 80% of 1RM may be
the most effective strategy to achieve improvements in muscle strength and power.
The training specicity in FSG was high, and therefore we had an expectation to
inuence the subjects’ functional strength abilities. The lack of signicant improve-
ment is probably related to the issues we have explained, including controlling for
the correct speed of movement and the training intensity.
Muscle Strength and Power Measured Traditionally
Leg-press maximum force signicantly improved in HPSG and FSG compared with
CG, and a signicant increase in traditional upper body strength was seen in both
HPSG and FSG from pre- to postintervention. However, no signicant differences
in the magnitude of change were found in bench-press maximum force among the
groups after 11 weeks of training. Studies evaluating the effects of high-power
strength training using machines showed positive results in both upper and lower
maximal body strength (Bottaro et al., 2007; Henwood et al., 2008; Henwood &
Taaffe, 2005, 2006). An important explanation for some of the strength gains in our
study is the specicity of the training, which also might explain the outcomes of
the studies cited. The participants in HPSG trained on the same machines on which
they were tested. This might explain the outcome from the high-power strength
training on the machines. An interesting issue in this regard is the effect we found
on lower body maximum force (leg-press strength) after 11 weeks of functional
strength training. The FSG subjects did not train using the test exercises, resulting
in a low training specicity. The stair-climbing activity with external load on the
back might have elicited enough of a strength adaptation to result in the increases
in traditional lower body strength, even though the training exercise was unilateral
while the testing was completed bilaterally.
Differences in the responses of men and women might partly explain the lack
of signicant differences in change among the groups in upper body strength. We
reexamined the HPSG data, split by sex, and found a signicant improvement in
bench-press maximum force in men (23.2% compared to 1.5% in CG, p < .02)
but not in women. Previous data (Janssen, Heymseld, Wang, & Ross, 2000) have
shown that men have more skeletal-muscle mass than women do and that these
sex differences are greater in the upper body, which might be related to our results.
Because the sample sizes are smaller when divided by sex, these data have not been
presented in the Results section, but a more detailed between-sexes examination
might be an important focus of future research.
No signicant changes were found in leg-press power in HPSG and FSG after
11 weeks of training, and no change was noticed when the two training groups
were combined—2.3 ± 57.1 W (1.8%), compared with 39.4 ± 52.3 W (16.6%) for
CG. Henwood et al. (2008), on the other hand, demonstrated enhanced lower body
muscle power after a period of high-velocity resistance training, which might be
Traditional vs. Functional Training 65
explained by their longer intervention period of 24 weeks. The small improvement
in CG is difcult to explain but may indicate a possible learning effect in CG that
might have been greater than in the intervention groups because they did not perform
weekly training and therefore had no interference after learning the test. Similar
results have been reported in another study (Henwood & Taaffe, 2005) that found
small (nonsignicant) increases in average knee-extension power after 8 weeks
of high-velocity resistance training. In upper body power, on the contrary, only
HPSG signicantly improved bench-press power from pre- to postintervention,
with this increase being statistically greater than in FSG and CG. These results
are probably due to the high-intensity and high-velocity movements that HPSG
subjects completed during the 11-week intervention. Few studies (Bottaro et al.,
2007) have demonstrated the effects of power training on upper body power. Muscle
power, or the ability to produce force rapidly, has emerged as an important predic-
tor of functioning in older men and women (Sayers, 2007). The conclusion of a
review detailing the functional benets of power training for the elderly was that
standard resistance training is effective in increasing strength in older adults, but
power training incorporating high-velocity contractions might be more optimal
when the emphasis is on enhancing the performance of activities of daily living
(Hazell, Kenno, & Jakobi, 2007). If it is possible to maintain high intensities and
high velocities when using functional movements, like the FSG did in our study,
this might lead to higher strength and power outcomes and increased functional
benets. Unfortunately, the results from the current study are not able to prove it.
Overall, strength training with machines produced a greater outcome in tra-
ditional strength and power tests than did functional strength training, despite the
fact that both groups had the intention to work at both a high training intensity and
a high training velocity.
Physiological Adaptations
The precise neurological adaptations resulting from high-intensity and high-velocity
strength training, and in particular whether changes are greater at the spinal-cord
level or the degree of ring rates within the motor units (Carroll, Riek, & Carson,
2001), are not completely known. It is possible to speculate that this specic strength
training leads to an increase in the number and diameter of motor neurons in the
ventral root in the spinal cord, and faster nerve impulses in both afferent and efferent
nerve cells would arise, leading to improved neuromuscular adaptation. Overall, this
would lead to increased motor responses. These physiological adaptations are not
well documented in the literature (Reeves, Maganaris, & Narici, 2003). However,
increased muscle cross-sectional area in elderly subjects as a result of high-intensity
strength training is well documented (Harridge, Kryger, & Stensgaard, 1999; Patten
& Kamen, 2000; Reeves et al., 2003), and it probably inuenced the performance
adaptations seen in the current study.
Strengths and Limitations of the Study
The strengths of the current study are randomized intervention groups, use of objec-
tive validated functional tests, and high training compliance of the participants.
There are some limitations to the study that need to be addressed. One of them is
66 Lohne-Seiler, Torstveit, and Anderssen
the nonrandomized CG. There were, however, no differences between the three
groups at baseline, indicating homogeneous groups based on age, height, weight,
and body-mass index. Another limitation is the moderate dropout rate in CG. The
fact that 5 of 15 controls dropped out of the study, 4 for medical reasons and 1 due
to a failure to complete the required number of testing sessions, makes the sample
size in the CG small. In an attempt to prevent dropouts in the CG, we could have
established a social arena for the controls during the intervention period and invited
them to be involved with an activity—a exibility-training program—of the same
duration and frequency as the intervention groups, but not related to the interven-
tion, which would affect the outcome measures. Another issue in this regard is the
signicant improvement in leg-press power from pre- to postintervention in the
CG. The low number of controls and a possible learning effect may explain this
outcome, and as mentioned earlier similar results have been reported by Henwood
et al. (2008), where the CG had a signicant increase in average leg-curl power.
Nonetheless, the fact that there were only 2 dropouts in HPSG (medical reasons)
and none in FSG is a strength of the current study.
The lack of statistically signicant ndings may be related to the high vari-
ability (SD) of the changes. To minimize this variability, an even better control of
the participants’ training status, by measuring their physical tness level, could
have been carried out before inclusion. However, in the recruitment phase of the
study the goal was to make sure the participants were quite homogeneous according
to their activity level and health status, based on a questionnaire. In addition, all
participants were community-dwelling people and were able to get to the training
facilities and back home without any assistance. This effort was taken to ensure that
the participants were as homogeneous as possible. Since no signicant differences
were found between the groups at baseline based on age, height, body mass, and
body-mass index, it is likely that their training status was quite similar.
In addition, the participants could have been invited to the gym to practice in
advance of the preintervention testing, to ensure that they were more familiar with
the test and exercise environment. There is some consideration with conducting
only one session of strength testing at baseline that could be addressed in future
studies. When we started the intervention, we intended to complete two testing
sessions for both the traditional and the functional strength tests, as part of the
baseline measures, to reduce a possible learning effect. Unfortunately, based on a
limited ability to use the laboratories for testing, we were not able to complete more
than one testing session for each test at baseline. However, to ensure that all the
participants felt comfortable with the different tests, they also got an extra attempt,
meaning a practice run, before the testing started. Another possible explanation
for the lack of statistical signicance is the training volume and the duration of
the intervention period. Maybe an 11-week intervention period is too short, and
a training frequency of two sessions per week is too low. Both the duration and
the frequency of training might be increased in future studies to provide a greater
training stimulus. However, most previous studies have used twice-weekly train-
ing and an intervention period of 8–24 weeks (de Vos et al., 2008; Henwood et al.,
2008; Henwood & Taaffe, 2005).
Studies in the area of power training designed for the elderly have mostly
focused on lower body power (de Vos et al., 2005; Fielding et al., 2002; Henwood
& Taaffe, 2005; Macaluso et al., 2003). To investigate the combination of high-
Traditional vs. Functional Training 67
intensity and high-velocity training and the effect on both traditional and functional
muscle strength and power involving upper and lower extremities, as in our study,
is novel. We found that there might be a practical value from high-power strength
training using machines to power gains in activities of daily living, measured as box
lifting and sit-to-stand. These are bilateral activities, similar to the way the partici-
pants trained on the machines, which may be part of the reason for the increases
in performance. However, the training specicity was low. From this perspective,
it is interesting to see that traditional power training might have an application to
functional power. Further research should be undertaken to dene the mechanisms
underlying this adaptation and to develop test regimens measuring muscle power
and strength in functional task-oriented activities in an objective way. A measure-
ment of muscle hypertrophy would probably have increased the scientic impact
of this study and might have explained the limited effect of high-power strength
training on muscle strength and power.
Conclusion
The current study revealed no difference in the effects of strength training with
machines and functional strength training on functional power and traditional
maximal upper body strength. Both intervention groups signicantly improved
maximal strength measured in the leg press compared with the CG. A signicant
difference in effect was found in traditional upper body power between the two
intervention groups and the control group. HPSG signicantly improved bench-press
power compared with both FSG and CG. Both intervention groups signicantly
increased functional upper body power and traditional maximal upper body strength
from pre- to postintervention. Based on our results, there seems to be a transfer
from high-power strength training to functional power gains in the elderly. Future
studies should therefore investigate the effect of different power-training protocols
to improve functional ability in the elderly and, in this way, determine the most
effective power-training regimen.
Acknowledgment
We would like to thank the staff at the University of Agder, Faculty of Health and Sport
Science, for their help in this study: master students Bodil Fischer Breidablik, Kathrine
Thorstensen Stangeland, Jørg Inge Stray-Pedersen, Kristine Kaasin, and Stig-Runar Bakke
for their assistance during the testing and training period; Professor Stephen Seiler for his
methodological advice; and Tommy Haugen for his statistical support. We would also like to
thank Associate Professor in Biomechanics Anthony Blazevich at Edith Cowan University,
Perth, Australia, for his exhaustive proofreading and text editing, which we very much appre-
ciate. A special thanks also to all the participants who were involved in this intervention study.
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... Complete strength data were extracted from 20 studies (Bellew, 2002;Beurskens et al., 2015;Caserotti et al., 2008;De Vos et al., 2005;Earles et al., 2001;Gurjão et al., 2012;Henwood and Taaffe, 2005;Hortobagyi et al., 2001;Hvid et al., 2016;Jiang et al., 2016;Judge et al., 1994;Kalapotharakos et al., 2010;Laidlaw et al., 1999;Lixandrao et al., 2016;Lohne-Seiler et al., 2013;Marsh et al., 2009;Tracy et al., 2004;Unhjem et al., 2020;Walker and Häkkinen, 2014;Wolfson et al., 1996) that measured maximum strength post-strength-training in older adults (n = 312) compared to age-matched controls (n = 280). The pooled data indicated that, following strength-training, the older trained group exhibited a moderate increase in strength (25.49%; ...
... Eleven out of 20 studies (Bellew, 2002;Beurskens et al., 2015;Caserotti et al., 2008;Earles et al., 2001;Gurjão et al., 2012;Hortobagyi et al., 2001;Judge et al., 1994;Lixandrao et al., 2016;Tracy et al., 2004;Unhjem et al., 2020;Wolfson et al., 1996) trained the lower-body to assess strength gains whereas only two studies trained the upper-body (Jiang et al., 2016;Laidlaw et al., 1999). The remaining seven studies (De Vos et al., 2005;Henwood and Taaffe, 2005;Hvid et al., 2016;Kalapotharakos et al., 2010;Lohne-Seiler et al., 2013;Marsh et al., 2009;Walker and Häkkinen, 2014) trained both the upper-and lower-body for examination but kept the focus on the lower-body. ...
... Complete strength data were extracted from 20 studies (Bellew, 2002;Beurskens et al., 2015;Caserotti et al., 2008;De Vos et al., 2005;Earles et al., 2001;Gurjão et al., 2012;Henwood and Taaffe, 2005;Hortobagyi et al., 2001;Hvid et al., 2016;Jiang et al., 2016;Judge et al., 1994;Kalapotharakos et al., 2010;Laidlaw et al., 1999;Lixandrao et al., 2016;Lohne-Seiler et al., 2013;Marsh et al., 2009;Tracy et al., 2004;Unhjem et al., 2020;Walker and Häkkinen, 2014;Wolfson et al., 1996) that measured maximum strength post-strength-training in older adults (n = 312) compared to age-matched controls (n = 280). The pooled data indicated that, following strength-training, the older trained group exhibited a moderate increase in strength (25.49%; ...
... Eleven out of 20 studies (Bellew, 2002;Beurskens et al., 2015;Caserotti et al., 2008;Earles et al., 2001;Gurjão et al., 2012;Hortobagyi et al., 2001;Judge et al., 1994;Lixandrao et al., 2016;Tracy et al., 2004;Unhjem et al., 2020;Wolfson et al., 1996) trained the lower-body to assess strength gains whereas only two studies trained the upper-body (Jiang et al., 2016;Laidlaw et al., 1999). The remaining seven studies (De Vos et al., 2005;Henwood and Taaffe, 2005;Hvid et al., 2016;Kalapotharakos et al., 2010;Lohne-Seiler et al., 2013;Marsh et al., 2009;Walker and Häkkinen, 2014) trained both the upper-and lower-body for examination but kept the focus on the lower-body. ...
Article
There are observable decreases in muscle strength as a result of ageing that occur from the age of 40, which is thought to occur as a result of changes within the neuromuscular system. Strength-training in older adults is a suitable intervention that may counteract the age-related loss in force production. The neuromuscular adaptations (i.e., cortical, spinal and muscular) to strength-training in older adults is largely equivocal and a systematic review with meta-analysis will serve to clarify the present circumstances regarding the benefits of strength-training in older adults. 20 studies entered the meta-analysis and were analysed using a random-effects model. A best evidence synthesis that included 36 studies was performed for variables that had insufficient data for meta-analysis. One study entered both. There was strong evidence that strength-training increases maximal force production and rate of force development and muscle activation in older adults. There was limited evidence for strength-training to improve voluntary-activation, the volitional-wave and spinal excitability, but strong evidence for increased muscle mass. The findings suggest that strength-training performed between 2-12 weeks increases strength, rate of force development and muscle activation, which likely improves motoneurone excitability by increased motor unit recruitment and improved discharge rates.
... The Sit-to-stand power test was based on principles by Lohne-Seiler, et al. [31]. The test was performed on a force platform (MuscleLab; Ergotest, Langesund, Norway) connected to an integrated data analysis program (MuscleLab; Ergotest, Langesund, Norway). ...
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Background: It is well-established that cross-sectional measurements of poor body composition are associated with impaired physical function and that power training effectively enhances total lean mass and physical function in older adults. However, it is unclear if power training-induced changes in body composition are associated with improved physical function in older adults. Aim: The present study investigated associations between body composition and physical function cross-sectionally and with power training-induced changes in older men. Methods: Forty-nine older men (68 ± 5 yrs) completed a 10-week biweekly power training intervention. Body composition was measured using dual-energy X-ray absorptiometry. Physical function was assessed as a composite Z-score combining measures from Sit-to-stand power, Timed up-and-go time, and loaded and unloaded Stair-climbing time (15 steps). Linear and quadratic regression analyses were performed to assess associations between body composition and physical function. Results: At baseline, total (R2 = 0.11, p < 0.05) and percentage body fat (R2 = 0.15, p < 0.05) showed a non-linear relationship with physical function. The apex of the quadratic regression for body composition was 21.5% body fat. Furthermore, there was a non-linear relationship between changes in body fat percentage and physical function from pre- to post-intervention (R2 = 0.15, p < 0.05). Conclusion: The present study's findings indicate that participants with a body composition of ~20% body fat displayed the highest level of physical function at baseline. Furthermore, despite small pre-post changes in body fat, the results indicate that those who either preserved their body fat percentage or experienced minor alterations observed the greatest improvements in physical function.
... Linear encoders are widely accepted in sports science to measure sports performance using displacement over time [24]. However, authors such as [25] have described that they are rarely used to assess physical performance in older people. Nevertheless, power has become an essential predictor of functionality in older men and women [26,27]. ...
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Background: With the increasing number of older adults and their declining motor and cognitive function, it is crucial to find alternative methods for assessing physical functionality. The Short Physical Performance Battery (SPPB), the Time Up and Go (TUG) test, the 4 MeterWalk Test and the Barthel Index (BI) have been used to evaluate mobility and fragility and predict falls. But some of these functional test tasks could be difficult to perform for frail older adults or bedridden patients that cannot ambulate. This study aimed to evaluate the relationship between these functional tests and the power elbow flexion (PEF test). Material and methods: A correlation study was designed with 41 older adults over 65 years of age. The upper limb muscle power was measured using a linear encoder (VITRUBE VBT) with the flexion of the elbow. Results: Strong correlations were found between the PEF test and the 4mWT (rho = 0.715, p = 0.001) and TUG (rho= - 0.768, p = 0.001), indicating that the greater the upper limb muscle power is, the greater physical performance will be. Moderate correlations were also found between the PEF and Barthel Index (rho = 0.495, p = 0.001) and SPPB (rho = 0.650, p < 0.001). Conclusions: There is a strong correlation between PEF and the functional tests, proving that older adults that have greater upper limb muscle power have better physical performance. Upper limb muscle power and PEF could be an interesting tool for the assessment of physical performance in bedridden older adults.
... After 3 min, they performed 3-5 repetitions at maximum concentric speed for each mentioned load. The repetition with the highest power produced was chosen as the final result (Lohne- Seiler et al., 2013). These measurements were used systematically in our research group's studies and showed excellent reliability (Aragão-Santos et al., Vasconcelos et al., 2020). ...
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Introduction: Aging can be associated with reduced muscle power, functional decline, and increased plasma concentrations of proinflammatory cytokines. Functional training (FT) can improve muscle power, functional fitness and reduce plasma cytokines. However, the functional training optimal volume required to produce these adaptations must be clarified. Our study analyzed the effects of multiple–set functional training (MSFT) and single–set functional training (SSFT) on postmenopausal women’s muscle power, functional fitness, and inflammatory profile. Methods: Forty–three women were randomly allocated into three groups: multiple–set functional training ( n = 16, age 64.13 ± 5.17), single–set functional training ( n = 14, age 63.79 ± 4.88), and control group (CG, n = 13, age 64.62 ± 5.44). The bench press and squat exercises evaluated upper and lower limb muscle power. The following tests assessed functional fitness: putting on and taking off a T–shirt, gallon–jug shelf–transfer, standing up and walking around the house, five times sit–to–stand, and 400–m walk. Plasma cytokine (TNF–α, IL–6, and IL 10) concentrations were measured by flow cytometry. Results: Single–set functional training and multiple–set functional training increased upper and lower limbs muscle power and improved functional fitness, except for the putting on and taking off a T–shirt test. Multiple–set functional training reduced TNF–α and IL–6, while single–set functional training reduced only TNF–α. IL–10 was unaffected by exercise. Discussion: Single–set functional training and multiple–set functional training, therefore, promoted similar muscle power and functional fitness improvements over 24 weeks. Multiple–set functional training was more effective than single–set functional training, reducing both TNF and IL–6, while single–set functional training only decreased TNF–α.
... The European Working Group on Sarcopenia in Older People (EWGSOP [17]) recommends that therapeutic approaches targeting sarcopenia treatment should aim to restore muscle strength since its reduction is the central element of this disease [17]. Therefore, exercise programs, especially RET, are highly recommended for this population [45][46][47][48]. We demonstrated that a RET protocol improved all muscle strength markers (handgrip and 1RM test) and increased peak torque in concentric, isokinetic, and isometric muscular actions. ...
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Unlabelled: Sleep and exercise have an important role in the development of several inflammation-related diseases, including sarcopenia. Objective: To investigate the effects of 12 weeks of resistance exercise training on sleep and inflammatory status in sarcopenic patients. Methods: A randomized controlled trial comparing resistance exercise training (RET) with a control (CTL) was conducted. Outcomes were obtained by physical tests, polysomnography, questionnaires, isokinetic/isometric dynamometry tests, and biochemical analysis. Results: Time to sleep onset (sleep latency) was reduced in the RET group compared to the CTL group (16.09 ± 15.21 vs. 29.98 ± 16.09 min; p = 0.04) after the intervention. The percentage of slow-wave sleep (N3 sleep) was increased in the RET group (0.70%, CI: 7.27-16.16 vs. -4.90%, CI: 7.06-16.70; p = 0.04) in an intention to treat analysis. Apnea/hour was reduced in the RET group (16.82 ± 14.11 vs. 7.37 ± 7.55; p = 0.001) and subjective sleep quality was improved compared to the CTL (-1.50; CI: 2.76-6.14 vs. 0.00; CI: 1.67-3.84 p = 0.02) in an intention-to-treat analysis. Levels of interleukin-10 (IL-10) (2.13 ± 0.80 vs. 2.51 ± 0.99; p < 0.03) and interleukin-1 receptor antagonist (IL-1ra) (0.99 ± 0.10 vs. 0.99 ± 0.10 ng/mL; p < 0.04; delta variation) were increased in the RET group. Conclusions: RET improves sleep parameters linked to muscle performance, possibly due to an increase in anti-inflammatory markers in older sarcopenic patients.
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ABSTRACT Aims: To determine the effect of functional strength training (FST) and strength training (ST) on sit-to-stand (STS) performance and functional-autonomy (FA) in older adults. Methods: A total of 30 subjects participated in the study, which were randomly allocated to two groups—ST group (control N=15) and FST group (experimental N=15) with pre and post experimental design. Outcome Measures: Time taken for STS performance which was assessed by 5 time STS test and FA which was assessed by Latin American Development Group for Maturity (GDLAM) protocol. Results: Both FST and ST significantly improved STS performance and FA in older adults (p=0.001), but FST was found to be more effective tool on STS performance and FA for older adults in between group analysis. Conclusion: Our results provide evidence that FST is more beneficial for older adults than ST. This helps in early rehabilitation of the patient
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PURPOSE: This study aimed to investigate the effects of plyometric training (PT) with elastic bands on the physical fitness and isokinetic function in fencing foil athletes.METHODS: The study participants were 16 male and female foil fencers aged 20–35 who were selected as the national team in 2019 and classified into the PT with band (PTB) group (n=8) and PT group (n=8). The participants performed PT according to their elastic band status three times a week for four weeks. Both groups participated in the measurement of physical fitness and isokinetic function factors of the knee joint after 0 and 4 weeks.RESULTS: Hand grip strength decreased significantly after 4 weeks versus 0 week in both groups (respectively, p <.05), and the changestep jump increased significantly after 4 weeks compared with 0 week in both groups (respectively, p <.05). The number of front and back steps increased more significantly after 4 weeks in the PT group than in the PTB group ( p <.05). The right flexor strength of the knee joint increased significantly after 4 weeks compared to that at 0 week in both groups (respectively, p <.05).CONCLUSIONS: Regardless of the use of elastic bands, the fencing-specific PT program improved agility factor and isokinetic function of knee joint.
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O novo coronavírus causador da Síndrome Respiratória Aguda Grave (SARS-CoV-2), se expandiu rapidamente no Brasil e no mundo. Os serviços de saúde apontam que o grupo de maior vulnerabilidade à infecção grave pelo COVID-19 são os idosos. Medidas de isolamento social embora protegerem contra o contágio, acarretam impactos diretos na funcionalidade de idosos, principalmente em variáveis psicológicas e físicas como força, equilíbrio, marcha e capacidade cardiorrespiratória, fundamentais para a realização de atividades diárias. Objetivo do estudo foi descrever os impactos do isolamento social na funcionalidade de idosos durante a pandemia da COVID-19 numa perspectiva baseada na Classificação Internacional de Funcionalidade (CIF). Trata-se de uma revisão integrativa. Foram incluídos estudos que mencionassem os descritores “idosos” e “COVID-19” e que abordassem o tema isolamento social e/ou funcionalidade e/ou comorbidades. Não houve restrição do desenho de estudo, idioma e ano de publicação. As bases de dados consultadas foram PubMed, Scopus, Science Direct e Google Scholar. Foram identificados 5057 estudos, 42 elegidos pelo título e resumo. Após leitura rigorosa na íntegra, 7 atenderam aos objetivos e foram sintetizados em tabela. O isolamento social apresentou implicações psicológicas, comportamento sedentário e redução da funcionalidade de idosos. O isolamento social em virtude da pandemia da COVID-19 tornou a população idosa com hábitos sedentários, alterações psicológicas e funcionais que interferem nas Atividades cotidianas. A atividade física orientada pode ser uma alternativa importante para minimizar impactos funcionais de idosos e auxiliar nos aspectos biopsicossociais preconizados pela Classificação Internacional de Funcionalidade.
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Objective: Functional resistance training (FRT) during walking is an emerging approach for rehabilitating individuals with neuromuscular or orthopedic injuries. During FRT, wearable exoskeleton/braces can target resistance to a weakened leg joint; however, the resistive properties of the training depend on the type of resistive elements used in the device. Hence, this study was designed to examine how the biomechanical and neural effects of functional resistance training differ with viscous and elastic resistances during both treadmill and overground walking. Methods: Fourteen able-bodied individuals were trained on two separate sessions with two devices that provided resistance to the knee (viscous and elastic) while walking on a treadmill. We measured gait biomechanics and muscle activation during training, as well as kinematic aftereffects and changes in peripheral fatigue and neural excitability after training. Results: We found the resistance type differentially altered gait kinetics during training-elastic resistance increased knee extension during stance while viscous resistance primarily affected swing. Also, viscous resistance increased power generation while elastic resistance could increase power absorption. Both devices resulted in significant kinematic and neural aftereffects. However, overground kinematic aftereffects and neural excitability did not differ between devices. Conclusion: Different resistance types can be used to alter gait biomechanics during training. While there were no resistance-specific changes in acute neural adaptation following training, it is still possible that prolonged and repeated training could produce differential effects. Significance: Resistance type alters the kinetics of functional resistance training. Prolonged and repeated training sessions on patients will be needed to further measure the effects of these devices.
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We employed a whole body magnetic resonance imaging protocol to examine the influence of age, gender, body weight, and height on skeletal muscle (SM) mass and distribution in a large and heterogeneous sample of 468 men and women. Men had significantly ( P < 0.001) more SM in comparison to women in both absolute terms (33.0 vs. 21.0 kg) and relative to body mass (38.4 vs. 30.6%). The gender differences were greater in the upper (40%) than lower (33%) body ( P < 0.01). We observed a reduction in relative SM mass starting in the third decade; however, a noticeable decrease in absolute SM mass was not observed until the end of the fifth decade. This decrease was primarily attributed to a decrease in lower body SM. Weight and height explained ∼50% of the variance in SM mass in men and women. Although a linear relationship existed between SM and height, the relationship between SM and body weight was curvilinear because the contribution of SM to weight gain decreased with increasing body weight. These findings indicate that men have more SM than women and that these gender differences are greater in the upper body. Independent of gender, aging is associated with a decrease in SM mass that is explained, in large measure, by a decrease in lower body SM occurring after the fifth decade.
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Muscle power diminishes with increasing age and inactivity. The capacity for older adults to increase muscle power with resistance exercise has not been examined; therefore, we examined the influence of progressive resistance training (PRT) on muscle power output in 17 men and women aged 56-66 years, and compared their responses to 15 men and women aged 21-30 years. All subjects performed 12 weeks of PRT at a workload equivalent to 80% of the one repetition maximum (1RM). All training and assessments of 1RM and power were made on Keiser pneumatic resistance machines. Subjects performed five exercises, three sets per exercise, twice weekly. Muscle power was measured (isotonically) at resistances equivalent to 40, 60, and 80% of the 1RM, on the knee extension and arm pull machines. All subjects increased arm pull power similarly at 40 and 60% of 1RM, independent of age or sex. There was not a significant increase in arm pull power at 80% of 1RM. Older and younger subjects also had similar absolute increases in leg extensor power at 40 and 60% of 1RM, but men responded with greater absolute gains than women at these percentages (p < .05). The increase in leg extensor power at 80% of 1RM was similar in all groups. Older and younger subjects increased strength similarly in all exercises except the left knee extension. Independent of age, men increased strength more than women in all exercises except the double leg press. These data demonstrate that individuals in their sixth decade can still improve muscle power (and strength); however, men may realize greater absolute gains than women.
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The purpose of this study was to assess the influence of leg power and leg strength on the physical performance of community-dwelling mobility-limited older people. Cross-sectional analysis of baseline data from a 12-week randomized controlled exercise-intervention study. Exercise laboratory within the Department of Health Science of an urban university. Forty-five community-dwelling mobility-limited people (34 women, 11 men), aged 65 to 83. Health status, depression, cognition, physical activity, and falls efficacy; physiological measures of lower extremity strength and power; and measures of physical performance. Through bivariate analyses, leg power was significantly associated with physical performance as measured by stair-climb time, chair-stand time, tandem gait, habitual gait, maximal gait, and the short physical performance battery describing between 12% and 45% of the variance (R2). Although leg power and leg strength were greatly correlated (r = .89) in a comparison of bivariate analyses of strength or power with physical performance, leg power modeled up to 8% more of the variance for five of six physical performance measures. Despite limitations in sample size, it appeared that, through quadratic modeling,the influence of leg power on physical performance was curvilinear. Using separate multivariate analyses, partial R2 values for leg power and leg strength were compared, demonstrating that leg power accounted for 2% to 8% more of the variance with all measures of physical performance. Leg power is an important factor influencing the physical performance of mobility-limited older people. Although related to strength, it is a separate attribute that may exert a greater influence on physical performance. These findings have important implications for clinicians practicing geriatric rehabilitation.
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To determine the effect of training intensity on the contributions of force and velocity to improvements in peak power (PP) after explosive resistance training in older adults. 112 healthy older adults (69 +/- 6 yr) were randomized to explosive resistance training at 20% (G20), 50% (G50), or 80% (G80) maximal strength (1-repetition maximum) for 8-12 wk (twice weekly, 5 exercises, 3 sets of 8 explosive concentric/slow eccentric repetitions) using pneumatic resistance machines or a nontraining control group (CON). Force at peak power (FPP) increased significantly and similarly among training groups compared with CON. Velocity at peak power (VPP) did not improve significantly and remained similar between all groups. Force contributed significantly more to PP production in G80 and G50 than in CON. The change in PP was independently predicted by changes in fat-free mass in G80 and by changes in both FPP and VPP in G50 and G20. Explosive resistance training in older adults results in the ability to produce higher PP outputs with heavier loads without loss of movement velocity. Moderate- to high-intensity training induced a greater relative contribution of force to PP production in this cohort.
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Muscle dysfunction and associated mobility impairment, common among the frail elderly, increase the risk of falls, fractures, and functional dependency. We sought to characterize the muscle weakness of the very old and its reversibility through strength training. Ten frail, institutionalized volunteers aged 90 ± 1 years undertook 8 weeks of high-intensity resistance training. Initially, quadriceps strength was correlated negatively with walking time (r= -.745). Fat-free mass (r=.732) and regional muscle mass (r=.752) were correlated positively with muscle strength. Strength gains averaged 174% ±31% (mean ± SEM) in the 9 subjects who completed training. Midthigh muscle area increased 9.0%± 4.5%. Mean tandem gait speed improved 48% after training. We conclude that high-resistance weight training leads to significant gains in muscle strength, size, and functional mobility among frail residents of nursing homes up to 96 years of age. (JAMA. 1990;263:3029-3034)
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It has long been believed that resistance training is accompanied by changes within the nervous system that play an important role in the development of strength. Many elements of the nervous system exhibit the potential for adaptation in response to resistance training, including supraspinal centres, descending neural tracts, spinal circuitry and the motor end plate connections between motoneurons and muscle fibres. Yet the specific sites of adaptation along the neuraxis have seldom been identified experimentally, and much of the evidence for neural adaptations following resistance training remains indirect. As a consequence of this current lack of knowledge, there exists uncertainty regarding the manner in which resistance training impacts upon the control and execution of functional movements. We aim to demonstrate that resistance training is likely to cause adaptations to many neural elements that are involved in the control of movement, and is therefore likely to affect movement execution during a wide range of tasks. We review a small number of experiments that provide evidence that resistance training affects the way in which muscles that have been engaged during training are recruited during related movement tasks. The concepts addressed in this article represent an important new approach to research on the effects of resistance training. They are also of considerable practical importance, since most individuals perform resistance training in the expectation that it will enhance their performance in related functional tasks.
Article
Objectives: To determine whether a functional-task exercise program and a resistance exercise program have different effects on the ability of community-living older people to perform daily tasks. Design: A randomized, controlled, single-blind trial. Setting: Community leisure center in Utrecht, the Netherlands. Participants: Ninety-eight healthy women aged 70 and older were randomly assigned to the functional-task exercise program (function group, n=33), a resistance exercise program (resistance group, n=34), or a control group (n=31). Participants attended exercise classes three times a week for 12 weeks. Measurements: Functional task performance (Assessment of Daily Activity Performance (ADAP)), isometric knee extensor strength (IKES), handgrip strength, isometric elbow flexor strength (IEFS), and leg extension power were measured at baseline, at the end of training (at 3 months), and 6 months after the end of training (at 9 months). Results: The ADAP total score of the function group (mean change 6.8, 95% confidence interval (CI)=5.2-8.4) increased significantly more than that of the resistance group (3.2, 95% CI=1.3-5.0; P=.007) or the control group (0.3, 95% CI=-1.3-1.9; P<.001). Moreover, the ADAP total score of the resistance group did not change significantly compared with that of the control group. In contrast, IKES and IEFS increased significantly in the resistance group (12.5%, 95% CI=3.8-21.3 and 8.6%, 95% CI=3.1-14.1, respectively) compared with the function group (-2.1%, 95% CI=-5.4-1.3; P=.003 and 0.3%, 95% CI=-3.6-4.2; P=.03, respectively) and the control group (-2.7%, 95% CI=-8.6-3.2, P=.003 and 0.6%, 95% CI=-3.4-4.6; P=.04, respectively). Six months after the end of training, the increase in ADAP scores was sustained in the function group (P=.002). Conclusion: Functional-task exercises are more effective than resistance exercises at improving functional task performance in healthy elderly women and may have an important role in helping them maintain an independent lifestyle.
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1. Residents of a chronic care hospital (13 men of mean age 88.5 ± 6 sd years and 13 women of mean age 86.5 ± 6 sd years) who had multiple pathologies were assessed for leg extensor capability in several ways. 2. A custom-built rig was used to assess leg extensor power, that is, maximal power output over less than 1 s in a single extension of one leg. Performance measures were obtained by timing chair rises (from a standard chair 0.43 m high), stair climbing (four risers, total height 0.635 m) and a walk (6.1 m). For each measurement the best of several trials were recorded as definitive. 3. Leg extensor power was significantly correlated with all performance measures, but the performance measures were not related to each other except for chair rising and walking speed. 4. Women had significantly less extensor power than men, but their power explained more of the variance in performance, e.g. power accounted for 86% of the variance in walking speed. 5. There was no relation within the group between age and any of the variables measured. 6. Measurement of leg extensor power in frail elderly people may prove useful in focusing effective rehabilitation programmes.
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Dynamic tests of trunk strength and lifting capacity have become more popular in recent years, offering certain advantages over static isometric tests in measuring patient progress in functional restoration programs for spinal disorders. However, equipment for performing such tests is expensive to buy, complex to run, and requires technical expertise and clinical volume unavailable in most physician offices. In this study, a new dynamic test known as Progressive Isoinertial Lifting Evaluation (PILE) is described, which draws upon prior psychophysical and isoinertial methods. An industrial sample of 61 male and 31 female incumbent workers were tested using the PILE, and a variety of anthropometric normalizing factors were evaluated. The isolation of an "Adjusted Weight" (AW) normalizing factor is documented, after which normative data are presented for male and female workers utilizing lumbar (0-30 inches) and cervical (30-54 inches) dynamic protocols.