STRENGTH TRAINING FOR SENIORS’
Seniors respond positively to resistance and strength training with a little encouragement and reinforcement.
As people age, their physical abilities decrease and their susceptibilities to illnesses and injuries increase. Many degenerative diseases (coronary artery blockage, adult onset diabetes, osteoporosis, etc.) and physical problems (low-back pain, falls, frailty, etc.) are related to the muscle loss and low strength levels associated with the aging process.6 Unfortunately, most seniors are unaware of this link and are therefore unable to change the course of progressive physical deterioration.
The basic problem
The basic problem is that approximately 90 percent of the adult population does not participate in a strength program.3 Sedentary men and women lose approximately 5 pounds of muscle and add about 15 pounds of fat every decade during their midlife years, thereby entering their senior years with too little muscle and too much fat (Table 1).19
While these undesirable body composition changes should be obvious, most adults are much more aware of the fat gain than the muscle loss. They typically diet to lose excess weight, which further reduces their muscle mass, as about 25 percent of the weight lost through dieting is muscle tissue.1 The loss of muscle tissue leads to a lower metabolic rate, which results in less energy used and more calories stored as fat. In turn, less muscle and more fat makes it more difficult to perform physical activities, and consequently, accelerates degenerative processes.
A sensible solution
If the basic problem is a lack of muscle-building exercises, the logical solution is a sensible program of strength training. Researchers at Tufts University found that previously sedentary seniors who completed 12 weeks of standard strength training (about 30 minutes per session, three days per week) added 3 pounds of muscle, lost 4 pounds of fat, raised their resting metabolism by 7 percent and increased their daily energy expenditure by 15 percent.2 A study conducted at the South Shore YMCA produced similar results. After two months of basic strength training, 341 men and women between 61 and 80 years of age added 2.5 pounds of muscle and lost 4 pounds of fat.
In addition to replacing muscle, reducing fat and revving up metabolic rate, research reveals many health-related reasons for performing regular strength exercise. These include lower resting blood pressure, better blood lipid levels, greater glucose usage, increased bone mineral density, less low-back pain, reduced arthritic discomfort, faster gastrointestinal transit and improved psychological profiles.9,10,12,13,15-18 Although it is sometimes assumed that seniors are less responsive to strength training than younger adults, this is not the case. Research has shown similar improvements in body composition and blood pressure after eight weeks of strength training for young (21 to 40 years), middle-aged (41 to 60 years) and older (61 to 80 years) adults.
Seniors can participate safely and productively in well-designed and carefully supervised strength-training programs, contingent upon their physician’s approval. This is good news, since older adults have much to gain from regular strength exercise, including increased physical capacity, enhanced personal appearance, improved athletic performance and reduced injury risk.22
For example, 77 golfers (average age 57 years) who completed an eight-week strength program experienced a 4-pound increase in muscle, a 4-pound decrease in fat, a 56-percent improvement in strength, a 5-percent increase in club head speed (driving power) and an injury-free golf season.5 These excellent results were achieved from performing just 25 minutes of strength training and five minutes of stretching exercise, three days a week.
Program requirements
Program design. In addition to being essential for health and fitness, effective senior strength-training programs are relatively easy to perform. Generally speaking, a basic workout addressing all of the major muscle groups requires only 10 to 12 exercises, each of which can be completed in about one minute. Given a one-minute rest between exercises, a standard strength-training session should take only 20 to 24 minutes.
Training frequency. Research has demonstrated that two strength workouts a week produce almost as much physiological improvement as three weekly sessions, further reducing the time commitment necessary for obtaining muscle-building benefits.23,4
Training sets. Participants may perform more than one set of each exercise, but single-set training appears to be equally effective for strength development and is certainly more time-efficient.7 Previously inactive individuals should begin with one set of strength exercise for each major muscle group.
Training repetitions. Perhaps a more important training consideration for senior exercisers is the number of repetitions performed per set. Although research indicates no adverse effects associated with eight-repetition exercise sets, the American College of Sports Medicine recommends 10 to 15 repetitions per set for older adults.7,8,14
A recent study examined the heart-rate response to lower- and higher-repetition strength training.24 When using 85 percent of maximum resistance, the subjects completed about seven repetitions and reached a peak heart rate of approximately 70 percent of maximum. When using 70 percent of maximum resistance, the subjects completed about 13 repetitions and also reached a peak heart rate of approximately 70 percent of maximum. The difference was in the rate of cardiovascular response. On a repetition-by-repetition basis, heart rate increased almost twice as quickly with the seven repetition maximum weightload as with the 13 repetition maximum weightload. It would therefore seem prudent for unfit older adults to begin strength training with higher repetition protocols.
Training progression. Because the rate of strength development varies considerably from person to person and from muscle to muscle, it is not advisable to increase resistance on a particular time schedule. That is, raising the weightload by 5 pounds per week may be too little for John and too much for Jane, or too little in the leg press and too much in the bicep curl. For this reason, seniors should increase resistance only when they reach the high end of their repetition range. For example, seniors training with 10 to 15 repetitions per set should not increase the resistance until they can complete 15 repetitions in good form. To prevent doing too much too soon, the resistance should be increased by less than 5 percent at a time.
Training speed. There is general consensus that older adults should use controlled movement speeds when performing strength exercise. One study showed excellent and almost equal strength gains for subjects training with four-second, six-second and eight-second repetitions, all of which represent relatively slow exercise movements.20 Because six-second repetitions have a long and successful history, this training speed should be appropriate for senior exercisers. The preferred cadence is two seconds for the more demanding lifting phase (concentric muscle action) and four seconds for the less demanding lowering phase (eccentric muscle action).
Training range. An unpleasant aspect of the aging process is gradual loss of joint flexibility and functional movement range. Because strength improvement occurs only in the exercised part of the movement range, full-range strength exercise is essential for full-range strength.11 Seniors should therefore be encouraged to perform full-range strength training, working the muscles from positions of full stretch to complete contraction. However, if any aspect of the exercise action causes discomfort, the movement range should be adjusted accordingly.
Training technique. Controlled movement speed and full movement range are important aspects of training technique. In addition, older adults should always practice proper posture when performing strength exercise. Particular attention should be given to position stability and back support.
To avoid unnecessary increases in blood pressure, senior exercisers should never hold their breath (Valsalva effect) or hold the resistance in a static position (isometric effect). The best breathing pattern is to exhale during the more demanding lifting movement and to inhale during the less demanding lowering movement.
Getting started
More than 90 percent of the previously sedentary seniors who completed the South Shore YMCA basic strength-training program continue to perform strength exercises.22 In just two months, they experienced enough physical improvements to make regular strength exercise a permanent part of their lifestyles.
Nonetheless, during the initial training period, seniors respond more positively when instructors provide plenty of encouragement, attention and reinforcement.21 They also seem to appreciate concise exercise explanations and precise exercise demonstrations. Close supervision during the early stages is critical for helping older adults develop confidence and competence in their strength-training programs.
An important consideration during the first few teaching sessions is the order in which new exercises are presented. Participants rate some of the standard strength exercises harder to perform than others (Table 2). Using the Borg Scale of Perceived Exertion, 83 new trainees (average age 49 years) consistently ranked the leg extension, decline press, bicep curl and tricep extension exercises as the most challenging. It therefore makes sense to delay training on these machines until the participants master the less challenging exercises. Based on the responses in this study, you can introduce standard resistance machines in the following progressions:
Week 1: Low back, abdominal curl, neck flexion, neck extension
Week 2: Leg curl, lateral raise, super pullover, chest cross
Week 3: Leg extension, decline press, bicep curl, tricep extension
Summary
To replace the muscle loss, bone loss and metabolic rate reduction associated with the aging process, older adults must perform regular strength exercises. In addition to positive physiological adaptations, strength training is beneficial for blood pressure, blood lipid levels, glucose utilization, low-back pain, arthritic discomfort, gastrointestinal transit and psychological profiles.
Seniors should strength train two or three days a week, with about 10 to 12 exercises that address all of the major muscle groups. One set of 10 to 15 repetitions is recommended for the initial training program. Weight-load progressions should be less than 5 percent upon completing 15 repetitions in good form. Older adults are advised to use controlled movement speeds and full movement ranges, as well as proper posture and continuous breathing.
Instructors should provide concise explanations and precise demonstrations of all training exercises, which should be introduced in order from less challenging to more challenging. With ample levels of encouragement, attention and reinforcement, approximately 95 percent of the seniors who complete a standard strength-training program may be expected to make strength exercise an integral part of their personal lifestyles.
Table 1. Typical changes in bodyweight and body composition for a sedentary woman during the midlife years.
| Age 25 | Age 35 | Age 45 | Age 55 | |
| Bodyweight | 125 lbs. | 135 lbs. | 145 lbs. | 155 lbs. |
| Percent Fat | 25% | 34% | 42% | 49% |
| Fat Weight | 31 lbs. | 46 lbs. | 61 lbs. | 76 lbs. |
| Muscle Weight | 47 lbs. | 42 lbs. | 37 lbs. | 32 lbs |
Table 2. Perceived exertion ratings on Borg Scale for 12 Nautilus exercises during the third, sixth and ninth weeks of training (N = 56). (Higher numbers indicate greater effort.)
| Week | Leg | Leg | Chest | Decline | Super | Lateral | Biceps | Triceps | Low | Abd. | Neck | Neck |
| Ext. | Curl | Cross | Press | Pullover | Raise | Curl | Ext. | Back | Curl | Flexion | Ext. | |
| 3 | 13.3 | 12.1 | 12.9 | 13.7 | 12.3 | 12.5 | 13.0 | 13.0 | 11.3 | 12.4 | 11.3 | 11.3 |
| 6 | 14.1 | 12.9 | 14.3 | 14.1 | 13.5 | 13.4 | 14.1 | 14.1 | 12.3 | 13.6 | 12.8 | 12.4 |
| 9 | 14.5 | 13.3 | 14.3 | 14.5 | 14.1 | 13.8 | 14.7 | 14.4 | 12.6 | 13.4 | 13.2 | 12.8 |
REFERENCES
1. Ballor, D., and E. Poehlman. Exercise training enhances fat-free mass preservation during diet-induced weight loss: A meta analytic finding. International Journal of Obesity 18: 35-40, 1994.
2. Campbell, W., M. Crim, V. Young and W. Evans. Increased energy requirements and changes in body composition with resistance training in older adults. American Journal of Clinical Nutrition 60: 167-175, 1994.
3. Centers for Disease Control. Physical activity, physical fitness, and health: Time to act. Journal of the American Medical Association 262: 2437, 1989.
4. DeMichele, P., M. Pollock, J. Graves, et al. Isometric torso rotation strength: Effect of training frequency on its development. Archives of Physical Medicine and Rehabilitation 78: 64-69, 1997.
5. Draovitch, P., and W. Westcott. Complete Conditioning for Golf. Human Kinetics: Champaign, Ill., 1999.
6. Evans, W., and I. Rosenberg. Biomarkers. Simon and Schuster: N.Y., 1992.
7. Faigenbaum, M., and M. Pollock. Prescription of resistance training for health and disease. Medicine and Science in Sports and Exercise 31(1): 38-45, 1999.
8. Fiatarone, M., E. Marks, N. Ryan, et al. High intensity strength training in nonagenarians. Journal of the American Medical Association 263(22): 3029-3034, 1990.
9. Harris, K., and R. Holly. Physiological response to circuit weight training in borderline hypertensive subjects. Medicine and Science in Sports and Exercise 19: 246-252, 1987.
10. Hurley, B. Does strength training improve health status? Strength and Conditioning Journal 16: 7-13, 1994.
11. Jones, A., M. Pollock, J. Graves, et al. Safe, Specific Testing and Rehabilitative Exercise for Muscles of the Lumbar Spine. Sequoia Communications: Santa Barbara, Calif., 1988.
12. Koffler, K., A. Menkes, W. Redmond, et al. Strength training accelerates gastrointestinal transit in middle-aged and older men. Medicine and Science in Sports and Exercise 24: 415-419, 1992.
13. Menkes, A., S. Mazel, R. Redmond, et al. Strength training increases regional bone mineral density and bone remodeling in middle-aged and older men. Journal of Applied Physiology 74: 2478-2484, 1993.
14. Nelson, M., M. Fiatarone, C. Morganti, et al. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. Journal of the American Medical Association 272(24): 1909-1914, 1994.
15. Risch, S., N. Nowell, M. Pollock, et al. Lumbar strengthening in chronic low back pain patients. Spine 18: 232-238, 1993.
16. Singh, N., K. Clements and M. Fiatarone. A randomized controlled trial of progressive resistance training in depressed elders. Journal of Gerontology 52A(1): M27-M35, 1997.
17. Stone, M., D. Blessing, R. Byrd, et al. Physiological effects of a short term resistive training program on middle-aged untrained men. National Strength and Conditioning Association Journal 4: 16-20, 1982.
18. Tufts University Diet and Nutrition Letter. Never too late to build up your muscle. 12: 6-7, Sep. 1994.
19. Westcott, W. Building Strength and Stamina. Human Kinetics: Champaign, Ill., 1996.
20. Westcott, W. Exercise speed and strength development. American Fitness Quarterly 3(3): 20-21, 1994.
21. Westcott, W. Transformation: How to take them from sedentary to active. IDEA Today 13(7): 46-54, 1995.
22. Westcott, W., and T. Baechle. Strength Training for Seniors. Human Kinetics: Champaign, Ill., 1999.
23. Westcott, W., and J. Guy. A physical evolution. IDEA Today 14(9): 58-65, 1996.
24. Westcott, W., and S. O’Grady. Strength training and cardiac post rehab. IDEA Personal Trainer 9(2): 41-46, 1998.
Wayne L. Westcott, Ph.D., is fitness research advisor at the South Shore YMCA in Quincy, Mass., and author of 21 books on strength training.