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Impact of training modality on strength and physical function in older adults
Misic MM, Valentine RJ, Rosengren KS, Woods JA, Evans EM
Gerontology 2009 Jul;55(4):411-416
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The importance of maintaining strength in older adults is well documented and various training modalities have been recommended; however, the effectiveness of various interventions with high translation to public health practice has not been completely characterized. Additionally, the interrelations among mode, strength, and lower extremity physical function (LEPF) changes in older adults warrant further investigation. PURPOSE: The primary aims were to examine the effectiveness of cardiovascular endurance training (CVE) compared with balance and flexibility training (FLEX) and to explore the relationship of muscle strength to LEPF. METHODS: Fifty-five adults (69.1 +/- 5.6 years, 35 female) were randomly assigned to 10 months of CVE or FLEX. Knee extension and flexion at 60 and 120 degrees/s were measured using an isokinetic dynamometer. LEPF was measured using a battery of tasks. The CVE group exercised using treadmills, cycles, and elliptical trainers. The FLEX group participated in a group exercise class that incorporated flexibility and balance activities. RESULTS: The CVE training group significantly improved peak oxygen consumption by 6% (p = 0.03), while the FLEX training group showed no change (p = 0.47). Participants significantly improved peak torque at both speeds and muscle actions by 21 to 65% (p <= 0.05), with no group effect (p > 0.05). Both groups also significantly improved performance on all LEPF tasks included in this study (4 to 7%, p <= 0.05). Significant correlations (all p = 0.00) were found between improvements in strength and improvements in LEPF including timed walk and peak torque extension and flexion at 60 degrees/s (r = 0.40 and 0.27, respectively), obstacle walk and peak torque extension and flexion at 60 and 120 degrees/s (r range 0.27 to 0.40), and stair ascent and peak torque extension at 120 degrees/s (r = 0.37). CONCLUSIONS: Sedentary older adults achieve similar improvements in strength and LEPF with either CVE or FLEX training with the latter being related to improvements in leg strength.

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