Exercise and Physical Functional Performance in Independent Older Adults

Age-related loss in such physiologic capacities as oxygen consumption and strength contributes to the decline in physical function in the elderly population. Exercise is widely recognized for its beneficial effects on these physiologic capacities. Until now, research on exercise intervention has failed to demonstrate that increasing strength and endurance affects older adults'functionality, making it easier for them to climb stairs, board a bus, or do laundry, for example. Investigators speculate that the benefits of exercise on older adults may not be evident or are not being detected. This study developed an exercise intervention and specialized scale called the Continuous Scale-Physical Functional Performance test (CS-PFP) that was developed to detect functional benefits of this exercise protocol.

The exercise program is designed to train multi-joint muscles in order to train all muscle groups important to performing daily tasks efficiently. Activities include use of various Stairmaster machines for lower body endurance and strength training. Free weights and rowing machines are used to increase upper body strength.

For the study, supervised, 60-minute sessions were conducted 3 times per week for 6 months.

The exercise program is to be followed 3 times per week for 60 minutes a session, with 10 minutes allotted for warm-up and cool-down and 40 minutes for training.

Participants were men and women, 70 years of age or older and in relatively good health, living in a retirement community or an apartment.

This intervention is suitable for implementation in a community setting.

Required resources include strength-training machines and free weights.  Costs associated with the program's implementation are not provided.

Participants were randomly assigned to either the exercise group or the control group. Over a sixth month period, participants in the exercise group had supervised, 60-minute workout sessions, three times per week. Training sessions included a 10-minute warm-up and cool-down and 40 minutes of training on machines and with free weights. Strength training intensity was set at 75% - 80% of an estimated one repetition maximum and endurance training intensity was 75% - 80% of heart-rate reserve. The CS-PFP test was administered in a neighborhood facility. Participants were asked to complete such tasks as carrying groceries on and off a bus platform, making a bed, putting on and removing a jacket, and getting down and up from the floor.

Results indicated:

• Scores on the Continuous Scale - Physical Functional Performance test increased in the exercise group compared to the control group, with an increase of 13% in upper body and 14% in lower body strength (p = 0.008 and 0.001, respectively) and a 20% increase in endurance (p = 0.02).
• Compared to the control group, participants in the exercise group had a 33% increase in skeletal muscle strength and an 11% increase in aerobic capacity.
• The exercise program increased isolated measures of maximalleg strength. Knee flexion strength increased by 9%, isotonic leg and hip strength (leg press) increased by 33% and aerobic capacity increased by 10.5%, while the control group remained unchanged.