Progressive resistance training reduces pain and improves mobility in people with osteoarthritis in their hips and knees.
Specific resistance training before and after joint replacement improves recovery and functional outcomes.
There is no evidence to suggest that progressive resistance training will exacerbate knee osteoarthritis.
References
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- Foroughi N, Smith RM, Lange AK, et al. Progressive resistance training and dynamic alignment in osteoarthritis: A single-blind randomised controlled trial. Clin Biomech. 2011;26(1):71-77. DOI: 10.1016/j.clinbiomech.2010.08.013
- Liao CD, Chen HC, Kuo YC, et al. Effects of muscle strength training on muscle mass gain and hypertrophy in older adults with osteoarthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2020;72(12):1703-1718. DOI: 10.1002/acr.24097
- Moyer R, Ikert K, Long K, et al. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty. JBJS Rev. 2017;5(12): e2-e2. DOI: 10.2106/JBJS.RVW.17.00015
- Turner MN, Hernandez DO, Cade W, et al. The role of resistance training dosing on pain and physical function in individuals with knee osteoarthritis: a systematic review. Sports Health. 2020;12(2):200-206. DOI: 10.1177/1941738119887183
- Wen Z, Chai Y. Effectiveness of resistance exercises in the treatment of rheumatoid arthritis: A meta-analysis. Medicine. 2021;100(13):e25019. DOI: 10.1097/MD.0000000000025019
Progressive resistance training prevents and treats coronary artery disease and treats chronic heart failure.
References
- Hollings M, Mavros Y, Freeston J, et al. The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials. Eur J Prev Cardiol. 2017;24(12):1242-1259. DOI: 10.1177/2047487317713329
- Jewiss D, Ostman C, Smart NA. The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis. Int J Cardiol. 2016;221:674-681. DOI: 10.1016/j.ijcard.2016.07.046
- Lee J, Lee R, Stone AJ. Combined aerobic and resistance training for peak oxygen uptake, muscle strength, and hypertrophy after coronary artery disease: a systematic review and meta-analysis. J Cardiovasc Transl Res. 2020;13(4):601-611. DOI: 10.1007/s12265-019-09922-0
- Ruku DM, Tran Thi TH, Chen HM. Effect of center-based or home-based resistance training on muscle strength and VO2 peak in patients with HFrEF: A systematic review and meta-analysis. Enferm Clin (Engl Ed). 2021;S1130-8621(21)00040-1. DOI: 10.1016/j.enfcli.2021.01.011.
- Vincent KR, Vincent HK. Resistance training for individuals with cardiovascular disease. J Cardiopulm Rehabil. 2006;26(4):207-218. DOI: 10.1097/00008483-200607000-00002
- Williams MA, Haskell WL, Ades PA, et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2007;116(5):572-584. DOI: 10.1161/CIRCULATIONAHA.107.185214
Progressive resistance training maintains or increases bone density. Along with balance training, it may prevent falls and fractures in people living with osteoporosis.
Progressive resistance training improves recovery, independent living and reduces mortality after hip fracture as part of a multidisciplinary program targeting frailty components.
References
- Beck BR, Daly RM, Singh MA, et al. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport. 2017;20(5):438-445. DOI: 10.1016/j.jsams.2016.10.001
- Kitsuda Y, Wada T, Noma H, et al. Impact of high-load resistance training on bone mineral density in osteoporosis and osteopenia: a meta-analysis. J Bone Miner Metab. 2021;39(5):787-803. DOI: 10.1007/s00774-021-01218-1
- Ponzano M, Rodrigues IB, Hosseini Z, et al. Progressive resistance training for improving health-related outcomes in people at risk of fracture: a systematic review and meta-analysis of randomized controlled trials. Phys Ther. 2021;101(2):pzaa221. DOI: 10.1093/ptj/pzaa221
- Singh NA, Quine S, Clemson LM, et al. Effects of high-intensity progressive resistance training and targeted multidisciplinary treatment of frailty on mortality and nursing home admissions after hip fracture: a randomized controlled trial. J Am Med Dir Assoc. 2012;13(1):24-30.
Progressive resistance training can be performed at home with minimal, inexpensive equipment, such as resistance bands, ankle weights and dumbbells or by using your own body weight as resistance.
To get the best strength and mobility outcomes, participate in some level of in-person or remotely supervised resistance exercise. Also, use equipment that allows you to progress and increase the intensity of your exercise.
References
- Billany RE, Vadaszy N, Lightfoot CJ, et al. Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials. J Sports Sci. 2021;39(10):1174-1185. DOI: 10.1080/02640414.2020.1861741
- Mañas A, Gómez-Redondo P, Valenzuela PL, et al. Unsupervised home-based resistance training for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev. 2021;69:101368. DOI: 10.1016/j.arr.2021.101368
We should all lift weights, no matter our age.
Advancing age and muscle weakness can lead to frailty. They are some of the most important reasons to start progressive resistance training. The weaker you are when you start, the greater your relative benefits will be from strength training.
References
- Fragala MS, Cadore EL, Dorgo S, et al. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019-2052. DOI: 10.1519/JSC.0000000000003230
- Nagai K, Miyamato T, Okamae A, et al. Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Arch Gerontol Geriatr. 2018;76:41-47. DOI: 10.1016/j.archger.2018.02.005
- Talar K, Hernandez-Belmonte A, Vetrovsky T, et al. Benefits of Resistance training in early and late stages of frailty and sarcopenia: a systematic review and meta-analysis of randomized controlled studies. J Clin Med. 2021;10(8):1630. DOI: 10.3390/jcm10081630
- Valenzuela T. Efficacy of progressive resistance training interventions in older adults in nursing homes: a systematic review. J Am Med Dir Assoc. 2012;13(5):418-428. DOI: 10.1016/j.jamda.2011.11.001
Progressive resistance training can be performed safely and effectively whilst seated.
Strength training, particularly when combined with balance exercise, decreases falls and reduces fear of falling.
References
- Fragala MS, Cadore EL, Dorgo S, et al. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019-2052. DOI: 10.1519/JSC.0000000000003230
- Hewitt J, Goodall S, Clemson L, et al. Progressive resistance and balance training for falls prevention in long-term residential aged care: a cluster randomized trial of the Sunbeam program. J Am Med Dir Assoc. 2018;19(4):361-369. DOI: 10.1016/j.jamda.2017.12.014
- Howe TE, Rochester L, Neil F, et al. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;(11):CD004963. DOI: 10.1002/14651858.CD004963.pub3
- Keating CJ, Cabrera-Linares JC, Párraga-Montilla JA, Let al. Influence of resistance training on gait & balance parameters in older adults: a systematic review. Int J Environ Res Public Health. 2021;18(4):1759. DOI: 10.3390/ijerph18041759
- Lacroix A, Hortobágyi T, Beurskens R, et al. Effects of supervised vs. unsupervised training programs on balance and muscle strength in older adults: a systematic review and meta-analysis. Sports Med. 2017;47(11):2341-2361. DOI: 10.1007/s40279-017-0747-6
Progressive resistance training is effective in treating virtually all chronic diseases, including those contributing to frailty, such as depression, cognitive decline, mobility impairment, cardiometabolic disease, pulmonary disease, cerebrovascular disease and degenerative neurological conditions.
References
- Fragala MS, Cadore EL, Dorgo S, et al. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019-2052. DOI: 10.1519/JSC.0000000000003230
- Izquierdo M, Merchant RA, Morley JE, et al. International exercise recommendations in older adults (ICFSR): expert consensus guidelines. J Nutr Health Aging. 2021;25(7):824-853. DOI: 10.1007/s12603-021-1665-8
Your muscles will only get significantly stronger with specific resistance exercises at an intensity that challenges them more than your usual day-to-day activities.
Walking is great for general mobility, but that will not help frailty if it is related to weakness. Walking will not increase your muscle strength or muscle mass.
Exercise programs combining resistance and balance training help to treat symptoms associated with frailty, help to reduce falls and maintain health benefits.
References
- American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510-1530. DOI: 10.1249/MSS.0b013e3181a0c95c
- Dent E, Lien C, Lim WS, et al. The Asia-Pacific Clinical practice guidelines for the management of frailty. J Am Med Dir Assoc. 2017;18(7):564-575. DOI: 10.1016/j.jamda.2017.04.018
- Kidd T, Mold F, Jones C, et al. What are the most effective interventions to improve physical performance in pre-frail and frail adults? A systematic review of randomised control trials. BMC Geriatr. 2019;19(1):184. DOI: 10.1186/s12877-019-1196-x
Muscles will only get stronger with specific, targeted, resistance training at an intensity that challenges them more than your usual daily activities.
References
- Dent E, Lien C, Lim WS, et al. The Asia-Pacific Clinical practice guidelines for the management of frailty. J Am Med Dir Assoc. 2017;18(7):564-575. DOI:10.1016/j.jamda.2017.04.018
Fatigue related to sleep apnoea or depression can be addressed with resistance exercise.
Fatigue can be improved through exercises.
While long periods of aerobic exercise may cause fatigue, resistance training only requires a small amount of time. It only takes a few minutes to train each muscle group.
References
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Progressive resistance training refers to a progressive resistance that challenges your muscles to make them become stronger.
The term ‘strength training’ is more commonly used, but ‘resistance training’ is preferred.
Progressive resistance training refers to progressively adding resistance to your muscles so that they become stronger.
It’s important to do progressive resistance training throughout your life, especially as we get older as our muscles start to lose their strength.
References
- Fragala MS, Cadore EL, Dorgo S, et al. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019-2052. DOI:10.1519/JSC.0000000000003230
The ‘Healthy Eating to Stay Strong and Independent’ document recommends that older adults:
- have about 1-1.2g of protein per kg of body weight, per day
- eat at least 20-30g of protein by including protein-rich foods at each mealtime
- eat a high protein meal or snack 20-30 minutes after your exercise.
References
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- NSW Agency for Clinical Innovation. Healthy eating to stay strong and independent [internet]. Sydney: ACI; 2022.
If you have protein-energy malnutrition, adequate energy and protein intake combined with progressive resistance training will help.
It is important to do progressive resistance training because it can help increase your appetite and prevent you from losing muscle (which is called sarcopenia) that occurs from malnutrition.
Your nutrition needs and your appetite are linked to how much muscle mass you have, so maintaining or increasing your muscle mass with progressive resistance training can encourage you to eat more.
There is some evidence that the benefits of progressive resistance training are increased with protein or nutrition supplementation, particularly if you are undernourished, but further studies are required.
References
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Progressive resistance training has proven efficacy and safety in the treatment of virtually all chronic diseases, including those contributing to frailty, such as depression, cognitive decline, mobility impairment, cardiometabolic disease, pulmonary disease, cerebrovascular disease and degenerative neurological conditions. Low rates of adverse events have been reported in clinical trials of progressive resistance training. Walking has been associated with increased falls and fractures, whereas progressive resistance training combined with balance exercises is protective. Progressive resistance training is associated with a lower risk of cardiovascular events than aerobic exercise.
To be most effective, exercise should be prescribed for the underlying impairment being addressed (e.g. sarcopenia, balance or neurological impairment). It is important to ensure the specificity of practice is evidence-based and to prescribe progressive muscle overload to ensure adaptation occurs. Prescribing functional type exercises may not be the most appropriate. Prescribe progressive muscle overload to address the sarcopenia, and prescribe balance training for the balance deficits.
Get up (resistance training). Stay up (balance training). Keep moving (aerobic training).
Three times per week of progressive resistance training is optimal and 1-2 days per week is also beneficial. Progressive resistance training can be delivered in ways other than just clinician-supervised, provided that the specificity of prescription is appropriate (e.g. semi-supervised, independent or group exercise).
Progressive resistance training can be prescribed in any healthcare or community setting (e.g. hospital, outpatient clinic, residential aged care, dialysis units, community centres or homes) using machines, free weights, elastic bands or simply body weight. The best outcomes are achieved when resistance is measurable, high intensity, and progressive with training supervised.
Low intensity, non-progressive exercise does not cause the adaptations needed to improve strength, function, mobility, or any chronic diseases. These outcomes are the motivational reasons to promote evidence-based modalities and dosages of exercise. The outcomes can motivate people patients to move out of their comfort zone and progress their exercise from mobility and gentle exercises.
There is no evidence that gentle or range of motion exercises prevent or treat any chronic diseases or geriatric syndromes such as sarcopenia or frailty. Using medications that have been shown to be ineffective would be considered inappropriate and below clinical standard of care. The same principle applies to exercise prescription.
References
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