Velocity training induces power-specific adaptations in highly functioning older adults.

OBJECTIVE: To test the efficacy of high-velocity training in healthy older persons. DESIGN: A 12-week randomized trial, with subjects blocked for gender and residence, comparing high-velocity resistance training with a self-paced walking program. SETTING: Retirement community. PARTICIPANTS: Forty-three volunteers over the age of 70 years. INTERVENTION: Power group: high-velocity leg exercises 3 times weekly with weekly increases in resistance combined with 45 minutes of moderate, nonresistance exercise weekly. Walking group: moderate intensity exercise 30 minutes daily, 6 days weekly. MAIN OUTCOME MEASURES: Variables measured included leg press peak power and leg extensor strength. Functional performance outcomes included: 6-minute walk distance, Short Physical Performance Battery, Physical Performance Test, and Medical Outcomes Study Short-Form Health Survey. RESULTS: Peak power improved 22% (p =.004) in the power group (3.7 +/- 1.0 W/kg to 4.5 +/- 1.4 W/kg) but did not change in the walking group (3.99 +/-.76 W/kg to 3.65 +/-.94 W/kg). Leg extensor power at resistance of 50%, 60%, and 70% of body weight increased 50%, 77%, and 141%, respectively, in the power group (p <.0001, repeated-measures analysis of variance). Strength improved 22% in the power-trained individuals and 12% in the walkers (p <.0001). Training did not improve functional task performance in either group. One subject developed a radiculopathy during training. CONCLUSIONS: Resistance training focusing on speed of movement improved leg power and maximal strength substantially, but did not improve functional performance in healthy high-functioning older volunteers.

Exercise at midlife: how and why to prescribe it for sedentary patients.

Moderate exercise for middle-aged and older adults is emerging as an important adjuvant to the treatment of many diseases. These include cardiovascular disease, diabetes, osteoporosis, osteoarthritis, insomnia, deconditioning, and (to a degree) obesity. A recent report from the United States Surgeon General recommends that most adults exercise most if not all days of the week, accumulating 180 minutes of moderate intensity exercise weekly. If your patients have been previously sedentary, encourage them to start a slow, stepwise exercise program. Ongoing support, encouragement, and follow-up can help them commit to and maintain a program of regular exercise.