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The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly
Boshuizen HC, Stemmerik L, Westhoff MH, Hopman-Rock M
Journal of Aging and Physical Activity 2005 Jan;13(1):5-22
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 Nm were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and one unsupervised home session per week, n = 17), a medium-guidance group (MG; one supervised group session and two unsupervised home sessions per week, n = 16), or a control group (C; no exercise, n = 16). Maximal isometric knee strength increased more in HG than in C (p = 0.03) and with increasing guidance (p = 0.03). The effect was mainly the result of participants with low initial strength. Walking speed increased more for HG than for C (p = 0.02) and than for MG (p = 0.06). No statistically significant improvements were seen on other functional tests. In summary, the study shows a trend toward better results with more supervision, but more and larger studies are needed to confirm this.

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