PURPOSE: Functional differences between the sexes are well documented. The causes of functional decline are complex, but in general, women report more functional decline and have a greater prevalence of disabling chronic conditions than do men. The role of exercise training in attenuating functional decline has not been studied extensively. Therefore, the purpose of this study was to compare sex differences in adaptations to exercise training in measures of physical function (physical performance and self-report) and symptom reporting. METHODS: Men and women (n = 114, ages 65 to 90) performed purely aerobic exercises (walking or stationary cycling) or a combination of aerobic plus spinal flexibility exercises for 1 hour 3 days a week for 3 months in a supervised, hospital-based setting. Outcome measures assessed in a blinded fashion at baseline and 3 months included physical performance (10-meter walk time, timed bed mobility, 360-degree turn time), self-reported physical function and disability (Nagi and Rosow-Breslau disability questions and SF-36 Physical Function Scale), and symptoms (number of symptoms, pain, shortness of breath, fatigue, and muscle weakness). RESULTS: At baseline, men had better physical performance scores and fewer functional limitations and reported fewer symptoms than women. Following exercise training, women, but not men, improved in most measures of physical function and reported fewer symptoms. The absence of change among the men is most likely due to ceiling effect measures of physical function among the men. CONCLUSIONS: We conclude that among functionally impaired women, exercise training has a positive effect on physical disability and symptom reporting. Exercise training attenuated the gap in self-reported symptoms between men and women in this study.

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