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Am Fam Physician. 2000;62(4):849

Studies of the effects of exercise in the elderly have mainly included healthy persons. Whether exercise training is beneficial in debilitated elderly persons is unclear. Meuleman and colleagues studied the effects of resistance and endurance training on strength, endurance and functional status in debilitated elderly patients.

The randomized controlled trial included 78 patients 60 years or older from two nursing homes and one rehabilitation center. Patients were qualified to enter the study if they had at least one impairment in physical activities of daily living. The exercise program consisted of resistance training three times a week and endurance training twice a week for four to eight weeks. Outcome measures included strength in the dominant arm and leg, heart rate response to exercise and a score for activities of daily living.

Resistance training resulted in significant increases in strength, particularly in those who were the most debilitated. Increases in the mean training load between the first resistance session and the last session ranged from a 78 percent increase for knee extension exercise to a 268 percent increase for dorsiflexion exercise. The mean change in isometric strength across all of the muscle movements was 32.8 percent in the training group and 10.2 percent in the control group. No change in heart rate occurred during exercise. The exercise group also showed improvement in the activities of daily living scores. Endurance training led to no demonstrable improvement in aerobic fitness.

The authors conclude that debilitated elderly patients can participate in resistance training, leading to increased strength and functional status. The authors state that additional studies are needed to confirm these short-term results and to assess cost-benefit and survival data.

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