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Effects of Progressive Resistance Training on Body Composition in Frail Older Adults: Results of a Randomized, Controlled Trial

¹ Department of Internal Medicine, ² Program in Physical Therapy, and ³ Division of Biostatistics, Claude Pepper Older Americans Independence Center, Washington University School of Medicine, St. Louis, Missouri.
⁴ Physical Therapy Program, School of Health Professions, University of Missouri–Columbia.

Address correspondence to Ellen F. Binder, MD, Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, 4488 Forest Park Blvd., Suite 201, St. Louis, MO 63108. E-mail: ebinder{at}im.wustl.edu

Background. Progressive resistance exercise training (PRT) has been shown to increase muscle strength and fat-free mass (FFM) in elderly persons. Limited information is available regarding the effects of PRT on lean and fat mass in frail elderly persons.

Methods. Ninety-one community-dwelling sedentary men and women, 78 years and older with physical frailty (defined using standardized objective criteria) were enrolled in a 9-month trial of exercise training (ET). Physical frailty was defined as having 2 of the 3 following criteria: modified Physical Performance Test score between 18 and 32, peak aerobic power between 10 and 18 ml/kg/min, or self-report of difficulty or assistance with two instrumental activities of daily living or one basic activity of daily living. Participants were randomly assigned to either a control (CTL) group that performed a low intensity home exercise program or a supervised ET group that performed 3 months of low intensity exercise and 3 months of PRT.

Results. After completion of PRT, ET participants had greater improvements than did CTL participants in maximal voluntary force production for knee extension (mean +5.3 ± 13 ft/lb vs +1.1 ± 11 ft/lb, p =.05), measured using isokinetic dynamometry. Total body FFM (measured using dual energy x-ray absorptiometry) increased in the ET group, but not in the CTL group (mean +0.84 ± 1.4 kg vs +0.01 ± 1.5 kg, p =.005). Total, trunk, intra-abdominal, and subcutaneous fat mass (measured using dual energy x-ray absorptiometry and ¹H-magnetic resonance imaging) did not change in response to PRT.

Conclusions. Three months of supervised PRT induced improvements in maximal voluntary thigh muscle strength and whole body FFM in frail, community-dwelling elderly women and men. This supervised exercise program may not be sufficient to reduce whole-body or intra-abdominal fat area in this population.