Efficacy of progressive resistance training interventions in older adults in nursing homes: a systematic review

ObjectiveTo provide a synthesis of the evidence from clinical trials to determine whether progressive resistance training, as a single exercise intervention, improves strength and functional performance in older institutionalized adults.MethodsA comprehensive systematic database search for randomized controlled trials was performed, including AMED, CINAHL, COCHRANE, and all EMB reviews: Cochrane DSR, ACP Journal Club, DARE, MEDLINE, PREMEDLINE, and PsycINFO, completed in July 2011. Studies were then assessed for potential inclusion. Study quality indicators, cohort characteristics, training intervention, muscle strength, and functional performance outcomes were extracted.ResultsThirteen studies were reviewed; the mean cohort age range was 80 to 89 years. In general, the quality of the reviewed studies was moderately robust; an average of 9 of 11 quality criteria were accounted for in the reviewed literature. Significant improvements were found in muscle strength outcomes and functional performance outcomes, including chair to stand time, stair climbing, gait speed, balance, and functional capacity following progressive resistance training interventions.ConclusionsSignificant improvements in muscle strength and functional performance occur in response to progressive resistance training exercise, despite advanced age, presence of chronic diseases, extremely sedentary habits, and functional disabilities in older institutionalized individuals. Therefore, the incorporation of a progressive resistance training exercise program is an effective means to preserve independence levels by maintaining or improving the ability to perform activities of daily living and the implementation of this type of exercise program should be promoted and incorporated into the recreational schedules of long term care institutions.