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Resistance exercise is medicine: Strength training in health promotion and rehabilitation

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The benefits of aerobic training in health promotion are well documented, and this mode of exercise training continues to be the gold standard for health professionals when prescribing exercise programmes. However, resistance training has a wealth of unique benefits over those of aerobic training. It is these unique benefits that demonstrate the necessary role of resistance training in health promotion. The aim of this article is to demonstrate that resistance training is equally, and in some cases superior, to aerobic training in its health-promoting benefits, such as the increasing and/ or maintenance of lean body mass and bone mineral density. As such, resistance training should be considered an integral component, along with aerobic and flexibility training, in any exercise programme designed to promote health in all populations. However, it is essential for health professionals to understand and differentiate the subtypes of resistance training as these have different impacts on sports performance, health promotion and rehabilitation.
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International Journal of Therapy and Rehabilitation, August 2015, Vol 22, No 8 385
Resistance exercise is medicine:
Strength training in health
promotion and rehabilitation
The benets of aerobic training in health promotion are well documented, and this mode of exercise
training continues to be the gold standard for health professionals when prescribing exercise
programmes. However, resistance training has a wealth of unique benets over those of aerobic
training. It is these unique benets that demonstrate the necessary role of resistance training in health
promotion. The aim of this article is to demonstrate that resistance training is equally, and in some
cases superior, to aerobic training in its health-promoting benets, such as the increasing and/or
maintenance of lean body mass and bone mineral density. As such, resistance training should
be considered an integral component, along with aerobic and exibility training, in any exercise
programme designed to promote health in all populations. However, it is essential for health
professionals to understand and differentiate the subtypes of resistance training as these will have
different impacts on sports performance, health promotion and rehabilitation.
Key words: Health Strength training Weight training Wellness
Submitted 5 May 2015; sent back for revisions 20 May 2015; accepted for publication following double-blind peer review 9 June 2015
Brandon S Shaw, Ina Shaw, Gregory A Brown
Numerous studies have demonstrated
the benefits of aerobic training in
health promotion, and this mode of
exercise training, usually in the form
of walking, continues to be the gold standard
for health professionals when prescribing
exercise programmes for their clientele or
patients (Westcott et al, 2009). Exercise
prescriptions that focus solely on aerobic
exercise are problematic in that resistance
training has been shown to have a wealth of
unique benets over those of aerobic training
(Shaw and Shaw, 2005; Phillips, 2007). In
addition, adherence to exclusively aerobic
exercise results in its own complications, such
as the inability of aerobic training to reverse
or halt the 4–6 pound (1.8–2.6 kg) loss in lean
body mass and conc om itant 2–3% loss in
resting metabolic rate per decade associated
with normal ageing (Westcott et al, 2009).
However, as resistance training has until
recently received little attention for its value in
health promotion, the majority of literature on
the health benefits following aerobic training
has continued to make this mode of exercise
the foremost focus of the physical activity
guidelines governing the majority of major
health organisations (Phillips and Winett, 2010).
These endorsements continue to ensure that
health professionals prescribe evidence-based
programmes of mainly aerobic-type exercise.
This omission and the inferior status awarded
to resistance training in such guidelines is also
usually interpreted as a lack of importance of
resistance training, especially when designing
exercise programmes for health promotion and
rehabilitation. Thus, the aim of this article is to:
Demonstrate that resistance training is equally,
and in some cases superior, to aerobic training
in its health-promoting benets
Motivate health professionals to make use of
resistance training, either alone or in combina-
tion with other modes of exercise.
Types of resistance training
It is typically believed that high loads and low
repetitions are best to increase muscular strength,
while lower loads and higher repetitions are
best to increase muscle endurance. Phillips and
Winett (2010) argue that it is this type of over-
simplication of resistance training programme
design that has depreciated resistance training
as inferior to aerobic training and led to cardio-
centric research in health promotion. A large
number of studies whose results formulate the
basis for current resistance training programmes
were conducted during the 1950s and 1960s
further obscure the potential health benets that
could be attained following resistance training
(Feigenbaum and Pollock, 1999).
In the past, in most cases, training designs
that resulted in improvements in strength,
Brandon S Shaw,
Professor, Department
of Sport and Movement
Studies, Faculty of Health
Sciences, University of
Johannesburg, South Africa;
Ina Shaw,
Research manager,
Monash University
(South Africa Campus)
and visiting full
professor, Department
of Sport and Movement
Studies, Faculty of Health
Sciences, University of
Johannesburg, South Africa;
Gregory A Brown,
Professor, Department
of Kinesiology and Sport
Sciences, University of
Nebraska, Kearney, USA.
Correspondence to:
Brandon S Shaw
Email:
brandons@uj.ac.za
© 2015 MA Healthcare Ltd
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386 International Journal of Therapy and Rehabilitation, August 2015, Vol 22, No 8
© 2015 MA Healthcare Ltd
Analysis
muscle endurance and/or muscle hypertrophy
spread quickly and became accepted globally.
In contrast, programme designs that did not
result in improvements in strength, muscle
endurance and/or muscle hypertrophy were
lost. This is problematic in that such designs
may have proved effective in other contexts, for
example, in the promotion of health. Further,
at the infancy of resistance training studies,
it was not easy to distinguish successful from
unsuccessful training practices, primarily
because it was difficult to clearly define the
parameters of training. Precursors of resistance
training also did not have at their disposal the
sophisticated equipment that is available today
(Stojiljkovic et al, 2013).
While resistance training (or weight training)
is commonly called strength training, this term
is a misnomer. Just as aerobic training can take
the guise of long slow distance training, interval
training and fartlek or ‘speed play’ training,
resistance training can take the guise of strength
training, power training, hypertrophy training,
and/or muscular strength training (Baechle et
al, 2008). As resistance training encompasses
a myriad of subtypes of exercise, it is essential
for health professionals to understand and
differentiate between these subtypes as they
have different impacts on sports performance,
health promotion and rehabilitation, specically
(Baechle et al, 2008):
Strength training requires training at a load
of 85% or more of one repetition maximum
(1RM) for 6 or less repetitions of 2–6 sets with
rest periods of 2–5 minutes
Power (single-effort) training requires training
at a load of 80–90% 1RM performed at
maximum speed for 1–2 repetitions of 3–5sets
with rest periods of 2–5 minutes
Power (multiple-effort) training requires
training at a load of 75–85% 1RM performed
at maximum speed for 3–5 repetitions of
3–5sets with rest periods of 2–5 minutes
Hypertrophy training requires training at
a load of 67–85% 1RM for 6–12 repetitions
of 3–6 sets with rest periods of 30 seconds to
1.5minutes
Muscular endurance training requires
resistance training at a load of 67% or less of
1RM for 12 or more repetitions of 2–3 sets
with rest periods of 30 seconds or less.
It is critical that the health professional utilise
the most recent evidence for effective resistance
training in different populations (i.e. children,
adults, the elderly) and/or different conditions
(i.e. cardiopulmonary disease, cerebral palsy)
when designing resistance training programmes.
However, it must be noted that numerous
other factors can be manipulated within the
resistance training programme design that could
affect its effectiveness. These include, inter
alia, time under tension, order of exercise, total
training volume (Phillips and Winett, 2010),
mode of resistance training (i.e. free weight
vs variable resistance machines), and type of
movement (i.e. isotonic, isokinetic or isometric)
(Feigenbaum and Pollock, 1999).
LITERATURE REVIEW
Until recently, there has been insufficient
evidence to support the role of resistance training
in health promotion or the prevention of disease
(Hurley et al, 2011). While evidence now
exists to support the role of resistance training
in improving risk factors for specic diseases,
no studies have provided a comprehensive
assessment of resistance training, as compared to
aerobic training, as a tool for health promotion.
However, what is clear about the essential and
necessary role of resistance training in health
promotion is that resistance training, compared
with aerobic training, has the ability to decrease
fat mass (especially abdominal and visceral
fat) (Shaw et al, 2010a; Westcott, 2012), while
simultaneously increasing lean body mass. This
can occur even in the absence of changes in the
dietary intake of total kilocalories, carbohydrates,
proteins and fats (Shaw et al, 2008). The increase
in lean body mass is especially important in
the ever-increasing ageing population, which
typically loses 4–6 pounds (1.8–2.6 kg) of lean
body mass per decade (Westcott et al, 2009).
Age-related progressive loss in lean body mass
is also associated with a 2–3% loss in resting
metabolic rate per decade, which results in a
further increase in fat mass and dyslipidemia and
reduced insulin sensitivity (Hunter et al, 2004).
Furthermore, resistance training, and not
aerobic training, may increase bone mineral
density by as much as 1–3% (Westcott et al,
2009). Resistance training has also been shown
to improve cardiovascular health by:
Reducing resting blood pressure (Shaw et al,
2010b)
Improving lipoprotein-lipid profiles and/or
dyslipidemia (i.e. decreasing low-density
lipoprotein cholesterol)
Decreasing triglycerides
Increasing high-density lipoprotein cholesterol
(Shaw et al, 2011; Williams et al, 2011)
Reducing cardiovascular demands to physical
activity (Kraemer et al, 2002a).
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International Journal of Therapy and Rehabilitation, August 2015, Vol 22, No 8 387
© 2015 MA Healthcare Ltd
Resistance training should also form an
integral part of any exercise guideline or
programme for health promotion since this mode
of training has the unique ability to improve
muscle metabolic properties that may assist in
the management and/or prevention of type 2
diabetes by decreasing visceral fat, reducing
HbA1c levels, increasing the density of glucose
transporter type 4, and improving insulin
sensitivity (Bweir et al, 2009; Westcott, 2012).
Resistance training is critical for reducing the
risk of falls, especially in the elderly (Phillips,
2007), and has also been shown to reverse
specific ageing factors in skeletal muscle (i.e.
sarcopenia) and reduce the risk and severity of
musculoskeletal injuries (Shaw and Shaw, 2014).
In terms of musculoskeletal health promotion,
resistance training has proven effective for
reducing low back pain and easing discomfort,
inflammation, muscle weakness and fatigue
associated with arthritis and fibromyalgia
(Hurley et al, 2011; Westcott, 2012).
Resistance training has further proved essential
in improving and promoting (Hunter et al, 2004;
Phillips, 2007; Westcott, 2012):
Physical performance
Movement control
Walking speed
Functional independence
Cognitive abilities
Self-esteem
Participation in spontaneous physical activity.
However, although there is no evidence that
resistance training can reverse any of the major
biological or behavioural outcomes of diseases,
such as cerebral palsy (Verschuren et al, 2011)
or Alzheimer’s disease, there is increasing
evidence to suggest that the prevalence of these
conditions is inversely associated with muscle
mass and strength (Hurley et al, 2007), further
presenting the need for resistance training
in promoting mental health. While it has been
found that increased cardiorespiratory fitness
has been linked to a larger prefrontal cortex,
resistance training may specifically help
individuals who already have a condition known
as mild cognitive impairment delay the onset of
dementia (Liu-Ambrose and Donaldson, 2009).
These researchers highlight an underappreciated
aspect of resistance training in promoting overall
physical and mental health.
A PARADIGM SHIFT
Much as the public health message regarding
aerobic exercise has embraced simple acts of
low-to-moderate intensity activity, there is a need
for resistance exercise to be viewed as essential,
effective, and easy to do.
Due to the ever-mounting evidence for
the use and/or inclusion of resistance training
in holistic exercise programmes, major health
organisations, such as the American College
of Sports Medicine (ACSM), have developed
resistance training guidelines (ACSM, 2009).
In this regard, the ACSM’s minimum exercise
guidelines recommends performing one set of
8–12 repetitions resistance of training exercises
that train the major muscle groups twice weekly
(hypertrophy-type training), in addition to
20 minutes of aerobic training thrice weekly.
However, research on the efficacy of these
recommendations has been minimal (Westcott et
al, 2009) and, as stated earlier, since resistance
training has received little attention, aerobic
training has evidently continued to be the
foremost focus in such guidelines.
Even when resistance training does not prove
superior to that of aerobic training in promoting
health, evidence for at least the equal inclusion
of resistance training along with aerobic training
in health promotion is becoming increasingly
convincing (Pitsavos et al, 2009; Shaw et
al, 2010b). Although it is supposed that an
interference effect exists when combining
aerobic and resistance exercises in athletes,
but not in the general population (Shaw et al,
2009), increasing evidence is becoming available
for the use of comprehensive programmes
that combine aerobic training and resistance
training. Concurrent training has previously been
shown to reduce cardiovascular disease risk in
previously sedentary individuals (Shaw et al,
2010b). However, further research is needed
on the effect of concurrent training on health
promotion since Wallace et al (1997) and Pierson
et al (2001) did not find positive changes in
lipoprotein lipids and blood pressure following
their concurrent training programmes.
Having said this, it seems that the type of
aerobic training performed with resistance
training may result in different effects. For
example, when resistance training is performed
concurrently with running, but not cycling,
significant decrements can be found in both
hypertrophy and strength (Wilson et al, 2012).
When researching the effect of or designing
such concurrent resistance and aerobic exercise
training programmes, both researchers and
health professionals need to be mindful that
the time commitments for these concurrent
programmes, whether performed on the same
day or alternate days, should not exceed single
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388 International Journal of Therapy and Rehabilitation, August 2015, Vol 22, No 8
© 2015 MA Healthcare Ltd
Analysis
modality resistance training or aerobic training
programmes as this may limit the potential
impact of health promotion and adherence rates
to exercise programmes (Bosy-Westphal et al,
2004; Shaw et al, 2009). Interestingly, Heyward
(1997) previously pointed out that individuals
adhere to an exercise programme more readily
when that programme is deemed enjoyable.
The good news is that performing a resistance
training session that meets the ACSM guidelines
should only take 20–30 minutes (Phillips
and Ziuraitis, 2004), which is similar to the
recommended duration for aerobic exercise.
Further, it is critical to note that even though
resistance training benefits can be safely
obtained by most segments of the population
(Hass et al, 2001), resistance training prog-
rammes and guidelines by their very nature
and design have been developed separately to
promote or restore health in:
Healthy adults who are either sedentary or
physically active (Kraemer et al, 2002b)
Young people (Faigenbaum et al, 2009)
The elderly (Willoughby, 2014)
Patients with cardiopulmonary disease
(Pollock et al, 2000).
In many educational and clinical contexts,
resistance training is reputed to be made up of
dangerous activities, such as weightlifting,
especially in special populations such as
children. However, there is no statistically
convincing evidence that resistance training is
particularly hazardous. In fact, the overwhelming
impression from the surveys and literature is
that resistance training is markedly safer than
many other sports, certainly when supervised by
qualied health professionals (Hamill, 1994).
When it comes to resistance training
and health promotion, heavier is not better
(Phillips and Winett, 2010) and the aim
(i.e.improvement in blood pressure) and target
population (youth vs elderly) of the resistance
training programme must be clearly dened. As
such, proper resistance training design that uses
progressive overload, variation, and specicity
is essential to maximise the health benets of
resistance training.
CONCLUSIONS
Given the relative lack of promotion of
resistance training compared with aerobic
training as a mainstream mode of exercise for
health promotion, a central tenet of this article
is that resistance training is equal, and in some
cases superior, in its health-promoting and
cardiopulmonary benets to aerobic training. In
recent years, this tenet has been gaining support
among researchers and health professionals, with
compelling evidence suggesting that resistance
training should assume a position at least equal
to that of aerobic training when designing
exercise programmes and/or developing physical
activity guidelines.
In view of this growing evidence base, it is
hoped that health professionals will be further
motivated to make use of resistance training,
either alone or in combination with other modes
of exercise. In addition, when designing resistance
training programmes, health professionals should
at all times consider the complexity of this mode
of exercise and the population, client or patient
for whom the programme is designed for. IJTR
Conict of interest: none declared.
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Findings unequivocally indicate that resistance training is safe for most
segments of the population, especially when supervised by qualied
healthprofessionals
Health professionals must utilise the most recent evidence for effective
resistance training in different populations and/or different conditions when
designing resistance training programmes
Resistance training is equally, and in some cases superior, to aerobic training
in its health-promoting benets
Health professionals should make use of resistance training, either alone or
in combination with other modes of aerobic exercise to maximise the unique
benets of each for their patients.
Key poInTs
Support and care for patients with long-term conditions
Helen McVeigh
n Each chapter presents learning points, using a re ective approach
n Essential guide to long-term conditions, exploring the key principles of practice,
skills and policy
n Case history examples included to illustrate issues discussed
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Long-Term Conditions
Edited by Helen McVeigh
Fundamental Aspects of Long-Term Conditions
Edited by Helen McVeigh
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ISBN 1-85642-392-1
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About the book
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Research for Nurses
FA LTCs cover.indd 1 18/1/10 12:38:13
... More recently, elevated uric acid and serum creatine phosphokinase (S-CPK) levels have been demonstrated to be a greater risk factor for musculoskeletal damage (7). Also, athletes undergoing changes in response to endurance training may produce more free radicals, resulting in strong physical exertion-induced oxidative stress (8,9). This may, in turn, affect signaling pathways in the muscles, increasing the possibility of musculoskeletal injury (8). ...
... This may, in turn, affect signaling pathways in the muscles, increasing the possibility of musculoskeletal injury (8). While research on endurance training is forthcoming, such research on the association of various sports and even resistance training and biomarkers of oxidative stress are scarce (8,9). Further, exercise of too high an intensity may affect muscle signaling and metabolism (8,9) and the role of some endogenous antioxidants, such as uric acid and lactate, in scavenging free radicals (8,9). ...
... While research on endurance training is forthcoming, such research on the association of various sports and even resistance training and biomarkers of oxidative stress are scarce (8,9). Further, exercise of too high an intensity may affect muscle signaling and metabolism (8,9) and the role of some endogenous antioxidants, such as uric acid and lactate, in scavenging free radicals (8,9). Specifically, uric acid oxidation scavenges oxo-heme oxidants, lipid hydroperoxide radicals, hydroxyl radicals (10), and singlet molecular oxygen (11). ...
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Background: Various training protocols have been used in combat sports including Taekwondo (TKD) to rapidly improve performance and to avoid injury by balancing the exercise intensity and the athletes’ metabolic tolerance and hormonal response. However, little is known about such metabolic responses in previously-trained individuals. Objectives: To investigate the effects of a concurrent TKD plus resistance (RT) training program on post-exercise blood biomarkers of physiological stress in previously-trained individuals. Methods: Twenty-eight (16 males:12 females) previously-trained individuals aged 20-26 years were matched by gender and randomly divided into either moderate- to vigorous-intensity exercising group (MODG) or a high-intensity exercising group (HIG). The MODG performed TKD training at a target training intensity of 55-70% (weeks 1-2) and 70-85% (weeks 3-4) maximum heart rate (HRmax) and RT training for four sets of 10-15 repetitions for each of the 13 whole-body RT exercises. The HIG performed TKD training at a target training intensity of 85-100% (weeks 1-2) and 95-100% (weeks 3-4) HRmax and RT training for five sets of 10-15 repetitions for each of the 13 whole-body RT exercises. A structured taekwondo tasks (sTT) test was conducted before and after the training period. Results: Significant post-exercise improvements were found for total testosterone (p=0.02), free testosterone (p=0.01), C/T ratio (p= 0.03) and lactate (p=0.03) in the mixed gender HIG. With regards to the specific gender effects, post-exercise improvements were found in S-CPK in the male MODG and HIG, with improvements in uric acid only in the male HIG. In turn, post-exercise improvements were found for total testosterone, testosterone binding globulin, free testosterone in the female MODG and HIG, with post-exercise improvements in S-CPK and uric acid in the female HIG only. Conclusion: This study demonstrates that even a short period of concurrent taekwondo and resistance training improves adaptation and post-exercise responses to physiological stress, and such adaptation may even be more marked in previously-trained female athletes. Thus, this mode of training may provide a novel exercise training modality to rapidly improve an individuals’ capacity to exercise, especially in situations of plateau, while avoiding overtraining and an increased concomitant chance of illness and musculoskeletal injury.
... Strength training not only prevents or even reverses the decrease of muscle mass and strength (Fragala et al., 2019), but it also decreases intramuscular adiposity (Goodpaster et al., 2008), improves metabolic health and insulin sensitivity (McLeod et al., 2019), blood pressure, gastrointestinal transit time (Winett and Carpinelli, 2001), muscle quality (Evans, 2002;Goodpaster et al., 2008), bone density (Marques et al., 2012), physical performance (Häkkinen et al., 2002;Fragala et al., 2019), sarcopenia and lower-back pain (Winett and Carpinelli, 2001), psychological well-being (Fisher et al., 2017), as well reduces the risk for falls (Silva et al., 2013) and postpone disability and independent living (Spirduso and Cronin, 2001). The benefits of strength training in decreasing the risk of various chronic diseases such as diabetes, mobility, disability, cardiovascular diseases and cancer in older adults are similar to those of aerobic training (Westcott, 2012;Shaw et al., 2015;McLeod et al., 2019). In addition, strength training provides an effective alternative to aerobic training for older adults who are physically limited or have cardiorespiratory problems such as asthma, and thus are not able to participate in aerobic exercise training such as cycling or jogging (Ouellette et al., 2004;Yerokhin et al., 2012). ...
... To gain the established benefits of strength training (Westcott, 2012;Shaw et al., 2015;Fisher et al., 2017;Fragala et al., 2019;McLeod et al., 2019), older adults are recommended to engage in mild-to high-intensity workouts/trainings, with ≤60min duration, twice a week (Nelson et al., 2007;Fisher et al., 2017;Fragala et al., 2019). ...
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Background Despite functional and cognitive benefits, few adults and older adults do strength training twice per week with sufficient intensity. Exercise-based active video games (exergaming) may amplify the cognitive benefits of exercise and increase adherence and motivation toward training. However, the benefits of a well-defined and monitored dose of strength training, executed simultaneously or sequentially with a cognitive element, has received little attention. In this study we have two aims: First, to systematically gather the available evidence; second, to suggest possible ways to promote strength exergaming innovations. Methods We systematically reviewed randomized controlled trials using simultaneous or sequent combined strength and cognitive training or strength exergaming to improve cognitive or functional outcomes in adults and older adults. Results After screening 1,785 studies (Google Scholar, ACM Digital Library, IEEE Xplore Library, PsycARTICLES, Scopus, Cochrane Library and PubMed) we found three eligible studies. Of the two studies using sequent strength and cognitive training, one showed improved functionality, but the other showed negative effects on cognition. The third study using simultaneous intervention, reported a positive influence on both cognition and function, when compared with either strength training alone or a control group. Moderate level of evidence was showed on GRADE analysis. Conclusion The existing little evidence suggests that strength and cognitive training improves cognition and function in adults and older adults. The following suggestions may help to promote further innovation: (1) ensure minimal dosage of strength training (30–60 min, 2 × /week), (2) use machine-based strength training devices to control volume and intensity (to prevent cognitive components from interfering with strength training), (3) include power training by using cognitive tasks requiring rapid reactions, and (4) add cognitive memory tasks (to extend the cognitive benefits of strength training per se ), and (5) include motivational exergame elements to increase adherence.
... RT attenuates the age-related decrease in muscle mass and strength (19,20), improves healthrelated quality of life (21), and there is an inverse association of muscular strength and fitness with all-cause mortality, even after adjusting for cardiorespiratory fitness or proven risk factors (22)(23)(24)(25). Considering the workplace setting, the "medicine" RT (26,27) shows inter alia positive effects on physical (e.g., pain reduction) and work-related (e.g., productivity) factors of employees (28)(29)(30)(31)(32)(33). ...
... Regardless of the reporting analysis, the included studies illustrate the multifaceted nature of potential workplace-related RT interventions for adult health promotion. RT represents a promising health promotion intervention component in many respects for a wide variety of target populations (27,33,82,94,95) (for employees with, e.g., different gender, age, occupational background, or exercise experience). Most of the included studies used only small equipment such as elastic bands or dumbbells, which basically allows exercise to be performed on site (or at home) without major organizational hurdles. ...
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Background: The workplace is an important setting for adult health promotion including exercise training such as resistance training (RT). Since the reporting of exercise training interventions is generally inconsistent, the objective of this systematic review was to investigate the attention to principles of RT progression and variables of RT exercise prescription in workplace-related RT interventions. Methods: A systematic literature search was conducted in the databases LIVIVO, PubMed, SPORTDiscus, and Web of Science (2000–2020). Controlled trials with apparently healthy “employees” and a main focus on RT were included. RT principles and variables were extracted and rated by two reviewers (reported, not reported, or unclear). Sum scores for each RT intervention and percentages regarding each principle and variable were calculated. Results: Overall, 21 articles were included (18 primary studies, 3 protocols). Summarized narratively, the interventions showed different positive effects on strength- or performance-related and/or health- or complaint-related outcomes. The reporting of the RT principles and variables was varied (progressive overload: 94 % of the studies, specificity: 78 %, variation (periodization): 39 %, muscle action: 94 %, loading: 94 %, volume; 67 %, exercise selection: 89 %, exercise order: 47 %, rest periods between sets: 33 %, rest periods between exercises: 27 %, repetition velocity: 44 %, and frequency: 100 %). Conclusion: Several key RT principles and variables were reported inconsistently, reducing reproducibility and pointing to the need for standardized RT intervention reporting in workplace-related interventions. Exercise science and workplace promotion should be further linked, since accurate reporting is a prerequisite for transferring robust findings into practice.
... Resistance training is a fundamental part of an athlete's conditioning program with clear benefits on health (Shaw, Shaw, & Brown, 2015) and performance (Crewther, Cronin, & Keogh, 2005;Harries, Lubans, & Callister, 2012). Prescribing the proper training intensity to optimize gains requires adequate assessment of muscle strength, which is typically quantified using direct measurements of 1-repetition maximum (Baechle & Earle, 2008) or estimated using predictive equations (LeSuer, McCormick, Mayhew, Wasserstein, & Arnold, 1997). ...
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The purpose of this study was to analyze the validity and reliability of the BEAST™ wearable device to measure movement velocity during the back squat exercise. Eleven national-level female field-hockey players (age: 18.4 ± 1.7 y; back squat 1-RM: 92.7 ± 14.1 kg; height: 158.4 ± 4.6 cm; weight: 54.5 ± 5.5 kg) performed 3 repetitions of the back squat exercise with four loads on a power rack. Movement velocity for each repetition was simultaneously recorded using a linear position transducer (LPT) and the BEAST™ sensor. Results showed excellent agreement between the LPT and the BEAST™ for mean movement velocity and power, with intra-class correlation coefficient (ICC) values of 0.966 and 0.957, respectively; however, a systematic bias was observed with the BEAST™ sensor compared to the LPT device with greater mean velocity (+0.098 m·s-1, p < 0.001, 14.3%) and power (+51.8 W, p < 0.001, 21.9%). For repetitions at a given workload, mean velocity and power measures were highly reproducible for both the BEAST™ (velocity: ICC = 0.935, CV = 7.4%, power: ICC = 0.962, CV = 8.4%) and the LPT (velocity: ICC = 0.929, CV = 8.7%; power: ICC = 0.923, CV = 10.2%). The results support the use of the BEAST™ as a reliable low-cost wearable device to track velocity and power outputs during back squat training. Comparisons between data from the BEAST™ sensor and the LPT device should be made with caution due to the significant systematic bias observed. Wearable devices, such as the one used in this study, have valuable practical applications for athletes, strength and conditioning coaches, and sport scientists attempting to optimize training via feedback or monitor adaptations resultant from the manipulation of training micro-cycles and periodised plans.
... Physical activity can both modify individual risk factors, but it also reduces overall risk of CVD [9]. As such, evidence supports the inclusion of exercise training in a) the primary prevention (preventing the onset of CVD) [10], b) secondary prevention (reducing the impact of CVD prior to any critical or permanent damage to health) [11] and c) tertiary prevention of CVD (slowing, arresting, or reversing CVD to prevent further deterioration, and reduce the risk of subsequent events) [12]. In addition, physical exercise can be employed in low, middle or high income countries [13]. ...
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Cardiovascular disease (CVD) continues to be the leading cause of death and continuous efforts are needed to reduce CVD risk and established CVD. Most exercise training guidelines do not recommend RT as an integral component of an overall CVD prevention and/or rehabilitation programme. This is notwithstanding the increasing evidence of RT’s orthopaedic and hemodynamic safety, its cardioprotec- tive effects and positive effects on mortality, and even its unique role on improving the comorbidities associated with CVD. As with cardiorespiratory fitness, muscular fitness is increasingly being demonstrated to be related to the integrated function of numerous physiological systems and as a reflection of whole-body health and func- tion. As such, ‘“counting reps’” should be as important as ‘“counting steps’” in any CVD prevention and management programme. While many current international recommendations and guidelines are based on the fact that not all health benefits can be achieved through a single type of exercise, emphasis is still placed on aerobic training over RT. This chapter will not only discuss the importance of RT in overall CVD prevention and/or rehabilitation, but will directly inform recommendations and provide guidelines on practical exercise as a safe and foundational component of CVD programmes.
... Albono Santos et al. (2011) reported that combined endurance and strength training within a single exercise session provided more significant results than training on alternate days. Therefore, concurrent exercise training is a practical approach for developing prospective soccer players [20][21][22]. Ethical Clearance: Ethical clearance has been obtained from the Faculty of Physiotherapy, DR.MGR. The Educational and Research Institute, Chennai, will conduct this study with A-017/ PHSIO/IRB/2019-20 dated 07/01/2020. ...
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Background: Football players can sustain repeated muscular effort that requires adequate muscular strength and power and adequately conditioned cardiovascular and respiratory systems. Resistance training improves muscular strength and endurance. Concurrent training involves cardiovascular endurance and resistance training within the same session or closely together within the same day. Concurrent training was promoted as a way promoted to save time while multiple training goals. The study's objective is to compare the effectiveness of resistance exercise and concurrent exercise training on the power and strength of lower limbs in football players. Methods: This was an experimental study design with a convenient sampling method. This was conducted on subjects from the Faculty of physiotherapy, Dr.M.G.R. Educational, and Research Institute and took nearly one month to analyze the study. Based on the inclusion and exclusion criteria, 30 samples were selected and divided into Group A and Group B by convenient sampling method. Group A received Resistance training exercise, and Group B received Concurrent training for two sets of 15 repetitions/twice a week for four weeks. Pre and post-test were measured before and after the study for 1 month, using a vertical jump test. The data were compared and analyzed within and between groups. Result: Comparing the Pre and Post-test scores between Groups (A & B) on maximum Isometric Voluntary Contraction (MIVC) &Vertical Jump Test shows a significant difference in Mean values with P ≤ 0.001. Conclusion: Concurrent exercise training is more effective than resistance exercise on the power and strength of lower limbs.
... Further, many individuals engaging in a weight loss programme fail to utilise RT for fear of "bulking up", "looking manly", or "becoming muscle-bound". While it is true that RT is the exercise of choice for bodybuilders, many individuals, and females in general, lack the hormonal and genetic profile to develop overly large muscles [23]. ...
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In addition to the impact of normal ageing on body composition, increasing levels of sedentariness reduce an individual’s ability to mobilise fat, resulting in an altered body composition characterised by increased fat mass, and more specifically an increased total and abdominal fat, and reduced muscle mass. While exercise, and aerobic exercise in general, has been promoted as a means to maintaining an appropriate body weight, aerobic exercise should not be considered as the golden standard to do so. This is because resistance training (RT) has an unsurpassed ability to improve lean mass along with other simultaneous improvements in multiple body composition parameters. An increased muscle mass is essential in that it is the amount of exercising muscle that determines the magnitude of lipolysis (fatty acid release from adipocytes) during exercise. In addition, an increased muscle mass results in an elevated basal metabolic rate (BMR) and resting metabolic rate (RMR), effectively increasing the amount of energy or calories utilised even at rest. RT is especially useful in the general population for weight management in that the ideal form of RT required for improvements in body composition is of moderate intensity, which reduces the risk of injury and improves adherence.
... It recommended that community residents should gather proactively and designate a place for social interaction in addition to muscle-strengthening exercises. Resistance training is beneficial for enhancing muscle strength, walking speed, heart disease, fall prevention, cognitive function, and self-esteem [10]. Participation in the "lively 100-years-old physical exercise" has been shown to positively impact lower extremity muscle strength, walking speed, and motor fitness scale scores [11]. ...
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Background How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises. Methods We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0–3, 4–7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: <3 times, short-term participation group; 4–6 times; mid-term participation group; and 7–13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51). Results The participants’ mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age ( p <0.001) and changed by − 0.93 points for long-term participate group ( p <0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age ( p =0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term ( p <0.001) and mid-term ( p =0.002) participation groups. Conclusion Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline.
... Strength training usually involves a load of 85% or more of one repetition maximum (1RM) for six or less repetitions of two to six sets with rest periods of two to five minutes. Muscular endurance training, on the other hand, requires resistance training at a load of 67% or less of 1RM for twelve or more repetitions of two to three sets with rest periods of thirty seconds or less [189]. We will discuss both animal and human studies addressing the sex disparities in cardiac structure and function with combined exercise below (please refer to Table 5 for details of the exercise regimens). ...
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Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field.
Article
Objectives To examine the effect of aerobic and resistant exercise intervention on inflammaging in middle-aged and older adults with type 2 diabetes mellitus (T2DM) using inflammatory cytokines, such as interleukin (IL)-1 β, IL-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) as biomarkers. Design Systematic review and meta-analysis. Setting and Participants Middle-aged and older adults with T2DM in the community. Methods Articles were searched from 8 electronic databases. Randomized control trials (RCTs) published in English, from inception to October 31, 2021, were included in this review. Two authors conducted data extraction and quality appraisal independently following guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was conducted using Review Manager. Heterogeneity was investigated using subgroup and sensitivity analysis. Results This review included 14 RCTs. The meta-analysis showed significant improvement in IL-6 (Z = 3.05; 95% confidence interval [CI]: −3.60 to −0.79; P = .002), CRP (Z = 2.44; 95% CI: −0.55 to −0.06; P = .01) and TNF-α levels (Z = 2.96; 95% CI: −2.21 to −0.45; P = .003) post-exercise programs. Subgroup analysis revealed that combined aerobic and resistance exercises and long-term exercises have more significant improvement to the outcomes than usual care. Based on the Grades of Recommendation, Assessment, Development and Evaluation system, considerable risk of bias and low level of certainty were revealed in all biomarker outcomes. Conclusions and Implications Exercise intervention is effective in improving inflammatory, metabolic, and lipid markers in middle-aged and older adults with T2DM. By modifying the levels of these markers with exercise, inflammation and insulin resistance can be improved. Long-term, combined aerobic and resistance exercise interventions have more significant effect on biomarkers. The small sample size of this meta-analysis limited the generalizability of the results. Future studies can consider adopting a more optimized exercise regimen to achieve effective T2DM management in middle-aged and older adults. Similar studies should expand to other populations and larger sample sizes to explore replicability of these effects.
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With regards to obesity-related disease the impact of exercise training on health depends on the ability of exercise to promote a negative energy balance. Exercise's effect on promoting a negative energy balance is more likely to occur if exercise can induce a favourable dietary intake such as a reduced relative fat content in the diet. As such, the aim of this study was to evaluate and compare the effectiveness of aerobic training, weight training and concurrent aerobic and weight training on self-reported dietary intake. The effects of 16 weeks of aerobic (n = 12), weight (n = 13) and concurrent aerobic and weight training (n = 13) on self-reported dietary intakes were compared in previously sedentary males using the computer-based Dietary Manager(®) software programme. Only the concurrent aerobic and weight training group showed significant (p ≤ 0.05) reductions in total kilocalories, carbohydrates, proteins and fats consumed while the aerobic training group showed significant reductions in fat intake at the completion of the experimental period (before: 91.0 ± 42.1g versus after: 77.1 ± 62.1g). However, no changes were observed in self-reported dietary intake in the weight training or non-exercising control groups. It is concluded that concurrent aerobic and weight training is the most effective mode of exercise at promoting a favourable improvement in self-reported dietary intake in the short term. This finding provides support for efforts to promote increases in overall physical activity in an attempt to modify the patterns of dietary intake. Key pointsConcurrent aerobic and weight training can significantly reduce the amount of total kilocalories, carbohydrates, proteins and fats consumed.Aerobic training can significantly reduce fat intake.Weight training resulted in no changes in dietary intake.Concurrent aerobic and weight training is the most effective mode of exercise at promoting a favourable improvement in self-reported dietary intake.
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This paper discusses statistics derived from surveys and competitions. Analyses of previous publications and comparative data from other studies appear to contradict a general view that weight training is safer than weightlifting, when the latter is defined according to the International Weightlifting Federation's rulebook. Both activities appear to be safer than many other sports. The age group considered is largely school age. © 1994 Journal of Applied Sport Science Research. All rights reserved.
Article
SUMMARY In order to stimulate further adaptation toward specific training goals, progressive resistance training (RT) protocols are necessary. The optimal characteristics of strength-specific programs include the use of concentric (CON), eccentric (ECC), and isometric muscle actions and the performance of bilateral and unilateral single- and multiple-joint exercises. In addition, it is recommended that strength programs sequence exercises to optimize the preservation of exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher-intensity before lower-intensity exercises). For novice (untrained individuals with no RT experience or who have not trained for several years) training, it is recommended that loads correspond to a repetition range of an 8-12 repetition maximum (RM). For intermediate (individuals with approximately 6 months of consistent RT experience) to advanced (individuals with years of RT experience) training, it is recommended that individuals use a wider loading range from 1 to 12 RM in a periodized fashion with eventual emphasis on heavy loading (1-6 RM) using 3- to 5-min rest periods between sets performed at a moderate contraction velocity (1-2 s CON; 1-2 s ECC). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 dIwkj1 for novice training, 3-4 dIwkj1 for intermediate training, and 4-5 dIwkj1 for advanced training. Similar program designs are recom- mended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training and 2) use of light loads (0-60% of 1 RM for lower body exercises; 30-60% of 1 RM for upper body exercises) performed at a fast contraction velocity with 3-5 min of rest between sets for multiple sets per exercise (three to five sets). It is also recommended that emphasis be placed on multiple-joint exercises especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (915) using short rest periods (G90 s). In the interpretation of this position stand as with prior ones, recommendations should be applied in context and should be contingent upon an individual's target goals, physical capacity, and training
Article
This paper discusses statistics derived from surveys and competitions. Analyses of previous publications and comparative data from other studies appear to contradict a general view that weight training is safer than weightlifting, when the latter is defined according to the International Weightlifting Federation's rulebook. Both activities appear to be safer than many other sports. The age group considered is largely school age. (C) 1994 National Strength and Conditioning Association
Article
PURPOSE: This study examined the effects of performing combined resistance and aerobic training, versus aerobic training alone, in patients with coronary artery disease. METHODS: Thirty-six patients with coronary artery disease were randomized to either an aerobic-only training group (AE) or a combined aerobic and resistance training group (AE+R). Both groups performed 30 minutes of aerobic exercise 3 days/week for 6 months. In addition, AE+R group performed two sets of resistance exercise on seven different Nautilus® machines after completion of aerobic training each day. Twenty patients (AE: n = 10; AE+R: n = 10) completed the training protocol with > 70% attendance. RESULTS: Strength gains for AE+R group were greater than for AE group on six of seven resistance machines (P < 0.05). VO2peak increased after training for both AE and AE+R (P < 0.01) with no difference in improvement between the groups. Resting and submaximal exercise heart rates and rate-pressure product were lower after training in the AE+R group (P < 0.01), but not in the AE group. AE+R increased lean mass in arm, trunk, and total body regions (P < 0.01), while AE increased lean mass in trunk region only (P < 0.01). Percent body fat was reduced for AE+R after training (P < 0.05) with a between group trend toward reduced body fat (P = 0.09). Lean mass gain significantly correlated with strength increase in five of seven resistance exercises for AE+R. CONCLUSIONS: Resistance training adds to the effects of aerobic training in cardiac rehabilitation patients by improving muscular strength, increasing lean body mass, and reducing body fat.
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Inactive adults experience a 3% to 8% loss of muscle mass per decade, accompanied by resting metabolic rate reduction and fat accumulation. Ten weeks of resistance training may increase lean weight by 1.4 kg, increase resting metabolic rate by 7%, and reduce fat weight by 1.8 kg. Benefits of resistance training include improved physical performance, movement control, walking speed, functional independence, cognitive abilities, and self-esteem. Resistance training may assist prevention and management of type 2 diabetes by decreasing visceral fat, reducing HbA1c, increasing the density of glucose transporter type 4, and improving insulin sensitivity. Resistance training may enhance cardiovascular health, by reducing resting blood pressure, decreasing low-density lipoprotein cholesterol and triglycerides, and increasing high-density lipoprotein cholesterol. Resistance training may promote bone development, with studies showing 1% to 3% increase in bone mineral density. Resistance training may be effective for reducing low back pain and easing discomfort associated with arthritis and fibromyalgia and has been shown to reverse specific aging factors in skeletal muscle.