[Health-related strength and power training in seniors: Purpose and recommendations]. / Grundlagen gesundheitsorientierten Krafttrainings im Alter: Ziele und Umsetzung.

The proportion of older people in western societies rapidly increases. Aging-induced disease conditions accompanied with declines in cardiocirculatory and neuromuscular performance constitute a major individual and economic health burden. Besides decreasing vascular and cardiac function during the process of aging, a loss of skeletal muscle mass, muscle structure and function seem to mainly account for decreasing maximal strength, strength development and strength endurance. These findings adversely interfer with static and dynamic postural control and may lead to an increased risk of falling with impairments of autonomy and quality of life. Traditional strength training recommendations basing on health-related exercise prescriptions for elderly people have been proven to counteract or at least attenuate aging-induced declines of neuromuscular muscular function. Multimodal and combined strength and balance training deliver additional improvements of neuromuscular capacity. Recent evidence additionally underpin the need of trunk muscle training and claimed for regimes considering explosive and high-velocity strength training in seniors. High quality RCTs revealed notable strength training effects on mobility, autonomy, quality of life and the reduction of the risk of falling (up to 50%). Available evidence also indicates that various strength training regimes elicit preventive and therapeutic effects on osteoporosis, diabetes type 2 and other chronic diseases, with effect sizes comparable to medication intake. Thus, health care providers, health insurances, Employers' Liability Insurance Associations and politicians should promote infrastructural developments that enable feasible and cost-effective access to health-related fitness centers or other sport facilities (e. g. sport clubs). These environmental requirements should be embedded in multi-centric education programs and campaigns that might enable regularly conducted strength and endurance training perceived as beneficial and valuable from an individual health care perspective.

Neuromuscular training in construction workers: a longitudinal controlled pilot study.

OBJECTIVE: Many accidents at construction sites are due to falls. An exercise-based workplace intervention may improve intrinsic fall risk factors. In this pilot study, we aimed at evaluating the effects of neuromuscular exercise on static and functional balance performance as well as on lower limb explosive power in construction workers. METHODS: Healthy middle-aged construction workers were non-randomly assigned to an intervention [N = 20, age = 40.3 (SD 8.3) years] or a control group [N = 20, age = 41.8 (9.9) years]. The intervention group performed static and dynamic balance and strength exercises (13 weeks, 15 min each day). Before and after the intervention and after an 8-week follow-up, unilateral postural sway, backward balancing (on 3- and 4.5-cm-wide beams) as well as vertical jump height were assessed. RESULTS: We observed a group × time interaction for postural sway (p = 0.002) with a reduction in the intervention group and no relevant change in the control group. Similarly, the number of successful steps while walking backwards on the 3-cm beam increased only in the intervention group (p = 0.047). These effects were likely to most likely practically beneficial from pretest to posttest and to follow-up test for postural sway (+12%, standardized mean difference (SMD) = 0.65 and 17%, SMD = 0.92) and backward balancing on the 3-cm beam (+58%, SMD = 0.59 and 37%, SMD = 0.40). CONCLUSIONS: Fifteen minutes of neuromuscular training each day can improve balance performance in construction workers and, thus, may contribute to a decreased fall risk.

An exercise sequence for progression in balance training.

Compared with resistance training, information concerning the progressive configuration of balance training (BT) is rare and lacks scientific validation. Therefore, a study was designed to determine participants' ability to perform balance exercises with increasing level of difficulty. The task required the participants (N = 20) to stand as stable as possible on a computerized balance platform. The experiment was performed on 3 testing days using different stance and sensory conditions. On each day, bipedal, step, tandem, and monopedal stands were performed 3 times while sensory conditions changed from firm ground, eyes opened (day 1) over foam ground, eyes opened (day 2) to firm ground, eyes closed (day 3). The results showed that total center of pressure displacements significantly increased when the use of sensory information (comparison between testing days: all p < 0.001) or when the base of support (comparison within testing days: all p < 0.001) was gradually reduced. Based on the observed pattern of increased postural sway across all testing conditions and the levels of trial variability, exercises were categorized into several stages of training. Findings indicate that balance performance decreased in response to an increased level of task difficulty introduced by narrowing the base of support and by limiting the use of sensory information. Practitioners can use the derived exercise ranking to select exercises for BT appropriate to the level of participants' balance ability and to implement progression in balance training.