The effect of strength training on functional fitness in older patients with chronic lung disease enrolled in pulmonary rehabilitation.

The purpose of this study was to compare the effects of a strength training-enhanced program and a traditional pulmonary rehabilitation (PR) program on functional fitness (FF) in older patients with chronic obstructive pulmonary disease (COPD), using the Senior Fitness Test. Twenty patients were recruited from an outpatient PR program. After completing baseline measures, including muscular strength and the Senior Fitness Test, patients were randomly assigned to the strength training program (TR+ST, n = 10) or traditional PR program (TR, n = 10). Patients completed 16 exercise sessions that were conducted twice a week for 8-10 weeks, after which patients repeated outcome measurements. Independent t tests were conducted to determine whether groups differed between measures. Both the TR+ST and TR groups improved on all FF measures. Moderate effect sizes were found for two of the FF measures when the groups were compared. The addition of strength training to PR may have a favorable impact on FF in older patients with COPD.

The effect of single set resistance training on strength and functional fitness in pulmonary rehabilitation patients.

PURPOSE: The primary goal of pulmonary rehabilitation (PR) is for patients to achieve and maintain their maximum level of independence and functioning in the community. Traditional PR uses a predominantly aerobic/endurance approach to rehabilitation with little or no inclusion of exercises to increase strength. Few studies have investigated the impact of resistance training on PR despite growing evidence supporting its efficacy to improve physical function (functional fitness) in both healthy individuals and those with chronic disease. The purpose of this study was to investigate the effect of single-set resistance training on strength and functional fitness outcomes in PR patients. METHODS: Twenty PR patients, 60 to 81 years old, were randomly assigned to an 8-week endurance-based PR program (ET) or an ET plus resistance training program (RT). RESULTS: Strength increased in RT (P < .05) and decreased in ET for both upper and lower body. Functional fitness improved (P < .05) in 5 of 7 tests for RT compared with 2 tests for ET. CONCLUSIONS: Single set RT can elicit significant improvements in both strength and functional fitness, which is not obtained by traditional PR alone. Our results are comparable to other studies with similar outcomes using multiple-set RT protocols. These findings may have important implications for program design, application, and adherence in PR.

The best warm-up for the vertical jump in college-age athletic men.

The purpose of this study was to determine the effectiveness of specific and nonspecific warm-ups on the vertical jump test performed by athletic men. Twenty-nine men (18-23 years) in athletics (speed positions in football) performed vertical jump tests on 4 separate days after completing 4 different warm-up protocols. The 4 warm-up protocols were (a) submaximal jump warm-up, (b) weighted jump warm-up, (c) stretching warm-up, and (d) no warm-up. The weighted jump warm-up protocol required 5 countermovement jumps onto a box, with the athletes holding dumbbells equaling 10% of their body weight. The submaximal jump warm-up protocol required the athletes to perform 5 countermovement jumps at 75% intensity of their past maximum vertical jump score. The stretching warm-up protocol required the athletes to perform 14 different stretches, each held for 20 seconds. The no warm-up protocol required the athletes to perform no activity prior to being tested. Three vertical jumps were measured following each warm-up; the score for analysis was the best jump. The data were analyzed with a repeated measures analysis of variance and Bonferroni post hoc tests. The Bonferroni post hoc tests showed a significant difference (p < 0.001) between the weighted jump warm-up and all other warm-ups. The effect size was 0.380 and the power was 1.00 for the statistical analyses. We concluded that utilizing a weighted resistance warm-up would produce the greatest benefit when performing the vertical jump test.

Energy cost of single-set resistance training in older adults.

The purpose of this study was (a) to assess the intensity and energy cost of a single-set resistance training (RT) protocol as recommended by the recent American College of Sports Medicine (ACSM) guidelines for older adults and (b) to compare obtained values to those recently reported as eliciting health benefits via endurance-based physical activity (PA). Five males and 5 females (73.1 +/- 5.5 years) performed 1 set of 15 repetitions of 8 RT exercises while connected to a portable metabolic unit (CosMed K4b2). The RT intensity (metabolic equivalents [METs]) was 3.3 +/- 0.7 (males) and 3.0 +/- 0.6 (females). Energy cost (kcal) was 84.2 +/- 14.6 (males) and 69.7 +/- 17.4 (females). We conclude that a single-set 8-exercise RT protocol may be a feasible alternative for achieving moderate intensity (3-6 METs) for older adults but that additional sets and/or repetitions appear to be necessary to accumulate moderate amounts (150-200 kcal) of PA.

Reliability of maximal strength testing in older adults.

OBJECTIVES: To determine (1) the reliability of a maximal strength test (1 repetition maximum) [1-RM] in older adults and (2) the impact of differing periods of familiarization. DESIGN: Within-subject, repeated trials of maximal strength. SETTING: Community-based senior center. PARTICIPANTS: Forty-seven independently living men (n=16) and women (n=31), with a mean age of 75.4+/-4.7 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Systematic error (shift in mean) and random error (% coefficient of variation [%CV]) was assessed between consecutive pairs of 1-RM trials. RESULTS: For the bench press, systematic error was virtually eliminated for men between trials 2 and 3 (0.7%; 95% confidence interval [CI], -2.7% to 4.3%). The CV was stable (4.7%-7.3%) across all trials in both genders. For the leg press, a significant but clinically small systematic error (3.6%, P<.05; 95% CI, 0.8-6.6) was evident for women between trials 2 to 3. The CV was reduced across trial pairs by 3.3% for men and 0.9% for women. Three versus 6 or more sessions of familiarization produced small clinical differences in systematic error (< or =4.1%) and CV (< or =0.2%) between trials 2 and 3 for both lifts. CONCLUSIONS: Reliability is an indispensable requirement for valid test outcomes. Our results show that, in this group of older adults, 3 familiarization sessions and 2 to 3 test trials produced highly reliable 1-RM measures. Additional periods of familiarization added little to test reliability. Effective reliability testing for 1-RM is a practical and attainable goal for outcomes based practitioners.

Cardiac rehabilitation patient versus proxy quality-of-life perceptions.

Spousal perceptions and/or attitudes to their patient partners' capabilities have been shown to affect the effectiveness of the cardiac rehabilitation (CR) process. The purpose of this study was (a) to assess differences between patient and proxy responses to the Medical Outcomes Survey-Short Form 36 (SF36)and (b) suggest how such information may contribute to enhancing rehabitation outcomes. Fifty-eight patients completed the SF36 prior to entering Phase II CR. Patient spouses completed a proxy version of the same questionnaire. The authors found that spouses' perceptions of their patient partners physical functioning (PF) was approximately 10% lower than patients' perceptions of their own PF (p < .04). Implications for the appropriate application of such data are discussed.

Energy cost of the ACSM single-set resistance training protocol.

The purpose of this study was (a) to assess the energy cost and intensity of a single-set resistance training (RT) protocol conducted according to the recent ACSM guidelines and (b) to compare obtained values to those recently reported as eliciting health benefits via endurance-based physical activity (PA). Twelve subjects, mean age 26.7 +/- 3.8 years, performed 1 set of a 15 repetition maximum (15 RM) for each of 8 RT exercises. Metabolic data were collected via a portable calorimetric system. Training intensity in metabolic equivalents (METS) was 3.9 +/- 0.4 for men and 4.2 +/- 0.6 for women (not significant). Total energy was 135.20 +/- 16.6 kcal for men and 81.7 +/- 11.1 kcal for women (p < 0.008). We concluded that the ACSM single-set, 8-exercise RT protocol is a feasible alternative for achieving moderate-intensity (3-6 METS) PA, but it is not sufficient to achieve a moderate amount (150-200 kcal) of PA.

A comparison of linear and daily undulating periodized programs with equated volume and intensity for local muscular endurance.

The purpose of this study was to compare linear periodization (LP), daily undulating periodization (DUP), and reverse linear periodization (RLP) for gains in local muscular endurance and strength. Sixty subjects (30 men, 30 women) were randomly assigned to LP, DUP, or RLP groups. Maximal repetitions at 50% of the subject's body weight were recorded for leg extensions as a pretest, midtest, and posttest. Training involved 3 sets (leg extensions) 2 days per week. The LP group performed sets of 25 repetition maximum (RM), 20RM, and 15RM changing every 5 weeks. The RLP group progressed in reverse order (15RM, 20RM, 25RM), changing every 5 weeks. The DUP group adjusted training variables between each workout (25RM, 20RM, 15RM repeated for the 15 weeks). Volume and intensity were equated for each training program. No significant differences were measured in endurance gains between groups (RLP = 73%, LP = 56%, DUP = 55%; p = 0.58). But effect sizes (ES) demonstrated that the RLP treatment (ES = 0.27) was more effective than the LP treatment (control) and the DUP treatment (ES = -0.02) at increasing muscular endurance. Therefore, it was concluded that making gradual increases in volume and gradual decreases in intensity was the most effective program for increasing muscular endurance.

Community-based senior health promotion program using a collaborative practice model: the Escalante Health Partnerships.

Recent research demonstrates that, although the risk of disease and disability clearly increases with age, poor health need not be an inevitable consequence of aging. A healthy lifestyle is more influential than genetic factors in assisting older adults avoid the decline and deterioration traditionally associated with aging. Many effective strategies for reducing disease and disability are widely underused. The Escalante Health Partnerships is a community-based, nurse-managed health promotion and chronic disease care management program for community-residing older adults. The program base supports a multidisciplinary, collaborative practice model, which has responded to the health needs of members of a community at high risk of having or developing chronic conditions. Preliminary comparisons of the health status of program participants with national norms demonstrate that these seniors report better general health, performance of roles, and social functioning, with the strongest correlations occurring between general health and vitality and between general health and role-physical. In addition, these participants have 4.2 doctor visits per year, in comparison with 7.1 office visits for a national comparison group and 1.6 hospital days per year, in comparison with 2.1 hospital days in the same referenced population. This collaborative partnership is a model that can be replicated cost-effectively in other communities.

A comparison of linear and daily undulating periodized programs with equated volume and intensity for strength.

The purpose of this study was to compare linear periodization (LP) and daily undulating periodization (DUP) for strength gains. Twenty men (age = 21 +/- 2.3 years) were randomly assigned to LP (n = 10) or DUP (n = 10) groups. One repetition maximum (1RM) was recorded for bench press and leg press as a pre-, mid-, and posttest. Training involved 3 sets (bench press and leg press), 3 days per week. The LP group performed sets of 8 RM during weeks 1-4, 6 RM during weeks 4-8, and 4 RM during weeks 9-12. The DUP group altered training on a daily basis (Monday, 8 RM; Wednesday, 6 RM; Friday, 4 RM). Analysis of variance with repeated measures revealed statistically significant differences favoring the DUP group between T1 to T2 and T1 to T3. Making program alterations on a daily basis was more effective in eliciting strength gains than doing so every 4 weeks.