Efficacy and Feasibility of a Novel Tri‐Modal Robust Exercise Prescription in a Retirement Community: A Randomized, Controlled Trial

Baker, Michael K.; Kennedy, David J.; Bohle, Philip L.; Campbell, Deena S.; Knapman, Leona; Grady, Jodie; Wiltshire, James; McNamara, Maria; Evans, William J.; Atlantis, Evan; Fiatarone Singh, Maria A.

doi:10.1111/j.1532-5415.2006.01031.x

Journal of the American Geriatrics Society

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Efficacy and Feasibility of a Novel Tri-Modal Robust Exercise Prescription in a Retirement Community: A Randomized, Controlled Trial

Authors

Michael K. Baker BAppSc,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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David J. Kennedy PhD,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Philip L. Bohle PhD,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Deena S. Campbell MAppSc,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Leona Knapman GradDipAppSc,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Jodie Grady BAppSc,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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James Wiltshire MCom,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Maria McNamara MA,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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William J. Evans PhD,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Evan Atlantis PhD,
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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Maria A. Fiatarone Singh MD
1. From the ^*School of Exercise and Sport Science, University of Sydney, Lidcombe, Australia^†School of Organization and Management, University of New South Wales, Sydney, Australia^‡Nutrition, Metabolism, and Exercise Laboratory, University of Arkansas for Medical Sciences, Little Rock, Arkansas^§Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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First published: 16 January 2007Full publication history
DOI: 10.1111/j.1532-5415.2006.01031.x View/save citation
Cited by (CrossRef): 26 articles Check for updates
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This work was submitted in part to the 2006 Congress of the Australian Association of Exercise and Sport Science, Sydney, Australia, September 2006, and to the Gerontological Society of America's 59th Annual Scientific Meeting, Dallas, Texas, November 2006.

Address correspondence to Michael Baker, School of Exercise and Sport Science, PO Box 170, Lidcombe NSW, Australia 1825. E-mail:michael_baker@usyd.edu.au

Abstract

OBJECTIVES: To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults.

DESIGN: Randomized, controlled trial.

SETTING: Retirement village.

PARTICIPANTS: Thirty-eight subjects (14 men and 24 women) aged 76.6 ± 6.1.

INTERVENTION: A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week.

MEASUREMENTS: Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level.

RESULTS: Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39±31% in exercise, versus 21±24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3±15%, P=.002) and chair stand time (−7.1±15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=−0.568, P=.009, PRT progression in loading r=−0.587, P=.02, and total volume of aerobic training r=−0.541, P=.01), as well as improvements in muscle strength (r=−0.498, P=.002).

CONCLUSION: Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults.

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