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High-Load Resistance Training for At-Risk Older Adults

With our global aging population, low muscular strength and function significantly impact an older adult’s capacity to remain independent. Older adults experience gradual declines in physical function and mobility leading to difficulty completing activities of daily living. These difficulties are conceptualized as an expression of mobility disability or through diagnoses of clinical geriatric syndromes such as frailty. Aging physiology in the musculoskeletal system clinically translates into declines in physical function due to losses in muscular strength. Preventative interventions may be appropriate as failing to intervene until critical thresholds are reached will increase healthcare expenditure.
Resistance training is a highly beneficial, cost-effective, conservative strategy for community-dwelling older adults to optimize physical resiliency through increasing muscular strength and function lost due to aging, sedentary behaviour and/or physical inactivity. Resistance training needs to be dosed appropriately for function to improve, but clinicians rarely prescribe high-load resistance training with older adults, especially those at risk for mobility decline and frailty.
The overarching goal of this thesis was to evaluate the role of resistance training in managing mobility disability and prefrailty. This thesis is comprised of three studies to address this goal:
(1) The role of resistance training to improve or prevent mobility disability in community-dwelling older adults: a systematic review and meta-analysis.
(2) The use of High- Intensity Enhanced Resistance Training (HEaRT) to optimize independence and quality of life in older adults with or at-risk of mobility disability: a pilot randomized controlled trial.
(3) An Ounce of Prevention: a substudy of pre-frail older adults from the HEaRT pilot randomized controlled trial. / Thesis / Candidate in Philosophy / As people get older, the amount of muscle they have, and their strength start to decrease. When too much strength is lost, individuals can begin to have difficulties completing tasks around their home or can be at risk for developing health issues such as disability and frailty. Strength training has been one way proposed to increase strength and physical function for those at risk for mobility disability and those at risk for frailty (prefrailty). This strength training is often of low intensity despite guidelines advocating for higher-intensity exercise. This thesis evaluates the benefit of strength training, specifically using high-load, for those with mobility disability and the safety and feasibility of high-intensity resistance training for those with prefrailty and those at risk for or with established mobility disability.

Identiferoai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/29015
Date January 2023
CreatorsPrevett, Christina
ContributorsTang, Ada, Rehabilitation Science
Source SetsMcMaster University
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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