Resistance Exercise Training in Older Adults

Introduction

Older adults, especially those over the age of 60, need to maintain optimum health standards and preserve adequate vigor for their daily functioning. It is of vital need that the effect of resistance training in older adults be studied further. This owes to the fact that there has been countless documentation that speak to the usefulness of resistance exercise training in improving people's quality of life but very little that exclusively address that issue with respect to older adults. It is important that the specifics of such an exercise training program for adults. There are a number of resistance training methods that physical therapists are utilizing in the rehabilitation setting of elderly who are over 60 years of age as part of their therapy treatment to help them increase their muscle mass and strength. Consequently, the focus of this research will be on identifying the effect of resistance training program on the elderly.

Literature review

According to Henwood and Taaffe, it is inevitable for older adults to lose adequate muscle functioning as they age thus; they are unable to fulfill their daily functioning optimally (2006). Resistance training is an effective way to ensure that older adults can deal with this problem as best as they can. Resistance training has proved to be instrumental in facilitating changes in the functioning of muscles. Home based, community and gymnasium training have been identified as each having differing results with older adults achieving limited ability to function, witnessing significant amplification of functioning and having limited strength in their muscles respectively (Henwood & Taaffe, 2006). The exercises that are constituent of the resistance training programs have been made so that they simulate the movements that individuals commonly exhibit in their daily living.

To further provide evidence as to the effectiveness of resistance training, Japan has shown a progressive increase in the number of elderly individuals with their population accounting for 21.5% of the total (Katsura et al, 2010). As people grow older, the strength they previously had in their lower extremities is reduced and they become weaker. Katsura et al write that studies have led to the deduction that resistance training effectively leads to the improvement of balance, knee extensors and overall isometric strength which in turn lead to the reduction of the number of falls in adults (2010).

Savvas et al mentions that the intensity that a person trains with is quite influential in predicting the end result where older adults who train more intensely see better results than their counterparts who employ lesser training intensity (2009). Resistance training should be kept consistent as studies have shown that cessation results in regression to prior muscular problems. Muscle strength is maintained by consistent resistance exercises of high intensity (Tokmakidis et al, 2009). Achieving positive results in resistance training of older adults requires adequate knowledge of the appropriate intensity that will be directly proportional to increase in muscle mass and strength. In addition, Hunter, McCathy & Bamman in a review of the advantages of resistance training in improving the general health of older adults, the quality of an individual's life is affected by the reduction of endurance and strength that they possess both of which can be significantly advanced through resistance training (2004).

Resistance training is useful in various facets of the body of an older adult. Other than being useful in improving muscle functioning, it helps in improving cardiac functions. Brochu et al report that older women who are disabled and suffering from coronary heart disease (CHD) showed significant improvement in physical functioning after being part of a resistance training program at adequate intensity levels (2001). CHD has been occurring in higher frequency in older women with little intervention available to make the situation better. According to Maiorana et al, exercise training in older adults improves both muscular and heart functions with the inclusion of individuals with chronic heart failure (CHF) (2000). The improvement of the functioning of muscles in the forearm leads to better blood flow consequently improving the functioning of the heart.

Another beneficiary of resistance training is the metal health of older adults. Blumenthal et al reported that interventional and observational studies that have been done before yielded results from which it can be deduced that consistent physical exercise in older adults is associated with reduction in depression (1999). However, direct correlation between the level of reduction of depression and resistance exercise has not been evaluated methodically so as to come up with the exact type of exercise leads to good mental health in older adults. Pollock and Vincent cite resistance training as a major determinant in decreasing the risk and intensity of chronic diseases in older adults (1999).

Purpose

Following the review of previous literature on resistance training, this research will embark to fill in gaps in the research as well as emphasize on the useful areas. The purpose of this study will be to identify the most effective resistance training program for an older adult as part of their therapy treatment especially after illness or injury thus putting it in the rehabilitation setting. The research question that will guide the study will be what is the most effective resistance training program for older adults in rehabilitation? The hypothesis is that resistance training in older adults has a direct correlation to the improvement of their quality of life especially in the rehabilitation setting by improving muscle mass and strength. By conducting research in then specified areas of the subject, gaps as to the specifics of resistance training in older adults will be filled as well as highlighting the most useful areas of resistance training in rehabilitating older adults.

Methodology

Design

The study will be designed in an experimental way that will utilize quantitative collection of data. In addition, sampling of data will be random. The advantage of this type of design in studying resistance exercise training in older adults is that it will have a provision for comparative analysis of the effectiveness or the program as well as the benefits of going through the program, against not going through one at all. Experimenting will offer a chance to control the variables of the study thus making it easier to know the exact result of different components of each variable. As a result, it will be simpler to make conclusions as to the specific type of resistance exercise that leads to the required result.

The choice of utilizing quantitative methods in the collection of data is best for acquiring knowledge of the exact change that occurs in an individual during the course of the program. Changes or alterations to the independent variables in the program will be more easily implemented with the results presenting themselves without confusion as to cause and effect. By knowing the exact change that occurs in an individual, the measurements can then be tested for the overall improvement and rehabilitation of the older adult's functioning. For instance, the result of the increase in muscle mass can be measured against the required mass that a person needs to function.

Two groups of people will be instruments in this study; there will be a control group that will have older adults who are not in the resistance exercise program and an experimental group that will be going through the resistance training. Every experiment needs a comparative counterpart; the control group will serve this purpose. The result that is acquired from the experiment will be compared to the control group's constant result. Muscle mass will be the dependent variable as it is present in both groups and resistance exercise will be the independent variable since it is being introduced to one of the groups.

Participants

The target populations of this study are older adults who are above 60 years of age and are currently in rehabilitation centers of 2 hospitals. The participants will be randomized in participation. Older adults are the target of the stud while rehabilitation is the point of the resistance exercise thus the choice of the population. Participants will be asked to consent to the study as their data will be publicized for purposes of coming up with the results as such studies should adhere to ethical considerations (Katsura et al, 2010). Those who have chronic muscular and physical problems will be excluded from the experiment since the experiments needs to get results on older adults whose problems are caused by their age. In addition, those who exercise regularly will be excluded as the result, in this case, will be biased.

The participants will be introduced to resistance training in at the hospitals they are in regularly with consistent timelines and customized intensity based on the extent of their illness or injuries. The participants in the control group will have similar illnesses and injuries to those in the experimental group. The experiment will take place for 24 weeks which is suggested to be an adequate period for this type of study (Henwood & Taaffe, 2006).

Assessment/ instrumentation

The two variables that will be utilized for this study, muscle strength and the effect of resistance exercise will be measured using different tools for specific parts of the body. In measuring muscle strength; forearm blood flow which is influenced by muscle strength of the arms and in turn influences vascular function in cases of heart failure will be measured using a strain-gauge plethysmography (Moriana et al, 2000). In addition, extension forces in the legs as well as the knee will be measured using a hand held dynamometer which will help to determine the muscle strength in the lower extremities of the body which in turn influence the flexibility of the lower body (Katsura et al, 2010).

Resistance exercise will be measures using real time results. Using a five meter maximum test for walking speed, the speed at which the participants function in daily will be determined (Katsura et al, 2010). In addition, cycling will be done for about five minutes to stretch muscles of the lower body followed by repetitions with loads that were 40% of the maximum that was perceived then 5 repetitions with 65%, followed by single repetitions with 80% till the participants were incapable of fully flexing their knees (Tokmakidis et al, 2009). Intervals of about 4 minutes were included between the extensions.

Procedure

The samples for the study will be acquired from two hospitals that have the highest number of older adults in their rehabilitation programs. They will be divided into two various groups according to their injuries and illnesses. After exclusions and consent, a final sample size of about 50 individuals will be obtained with ten in each group. There will a group of those with physical injuries to their lower body, those with injuries to their upper body, those with heart diseases, those recovering from stokes and those with circulation problems. From this, customized resistance exercises will be easier to design. The intensity of the exercises will be customized according to the needs of each group and functionality. The exercises will be on a daily basis with results being entered to each participant's chart. The control group will have the same number of people with similar problems but without the program.

Data analysis

So as to conduct a comparative analysis of results from the control and experimental groups, separate but similar tests will be conducted on the two groups to measure the independent variable, muscle strength, before and after the introduction of the dependent variable, resistance exercise has been introduced. This will be done so as to calculate the exact difference in muscle strength that the exercises will make on the experimental group over the control group. Statistical techniques will be used for analyzing the data. The expectation of the initial results is that there will be little difference in the initial stages of the study but at the end of 24 weeks, there will be significant differences witnessed in the experimental groups which will be better than the control group. Statistical data will allow the study to have numbers that back up its findings.

Potential Limitations

The study will have certain vital limitations to its validity. One limitation is that by excluding participants who had prior problems, there will be no consensus that the results of the study present an optimal training program (Hunter, McCathy & Bamman, 2004). In addition, there are individual factors that are a major influence to muscle strength that were not considered like genetic predisposition and the level of fitness of each individual and their gender (Hunter, McCathy & Bamman, 2004). In addition, the settings that are evident in the hospital have been arranged for the purpose of the experiment. Consequently, the results that are obtained will be based on that setting making it difficult to determine whether the same will be attained if the experiment is applied to a different environment or whether they are representative of the population being represented.