Progression Models in Resistance Training for Healthy Adults

Nicholas A. Ratamess, Ph.D.; Brent A. Alvar, Ph.D.; Tammy K. Evetoch, Ph.D., FACSM; Terry J. Housh, Ph.D., FACSM (Chair); W. Ben Kibler, M.D., FACSM; William J. Kraemer, Ph.D., FACSM; N. Travis Triplett, Ph.D.


March 01, 2010

In This Article

Progression Models for Resistance Exercise in Healthy, Older Adults

Progression and maintenance (maintenance of physical function in this population may be viewed as progression) in healthy, older adults is brought about by systematic manipulation of the acute program variables. However, caution must be taken with the elderly population as to the rate of progression, particularly those with hypertension, arthritis, cardiovascular disease, or any other debilitating condition that limits physical function. There are other modes of resistance exercise, such as aquatic resistance exercise, that have been shown to be especially beneficial in the older population and to reduce some of the risks of resistance exercise. These studies have shown increased muscular strength, power, and bone mineral density as well as improvements in cardiovascular and psychological function.[13,257,264,266,267] Further, each individual will respond differently based on their current training status and past experience, joint health, and individual response to the training stress. A quality training program should improve the quality of life by enhancing several components of muscular fitness, that is, strength, balance, etc..[61] Programs that include variation, gradual progressive overload, careful attention to recovery and stress, and specificity are warranted. This finding was recently shown in elderly women where peak torque and average power plateaued as a result of a significant increase in volume (at the same intensity).[243]

Muscular strength and hypertrophy training may improve the quality of life and limit sarcopenia. Optimizing strength to meet/exceed performance goals is important to a growing number of older adults. Numerous studies have shown increased muscle strength and size in older adults following RT as long as basic requirements of intensity and volume are met.[31,36,61,69,77,105,106] The basic RT program recommended by the ACSM for the healthy adult[6,7] has been an effective starting point in the elderly population.

When the older adult's long-term goal is progression toward higher levels of strength and hypertrophy, evidence supports the use of variation in program design.[105,106,154] Studies have shown significant improvements in strength in this population.[61,69,77] It is important that progression be introduced gradually. A training frequency of 1-3 d·wk−1 produced similar increases in strength; however, 3 d·wk−1 was superior to 1-2 d for improving LME, coordination, balance, and cardiorespiratory fitness in older women.[193] Some studies have shown similar strength increases between moderate (50-60% of 1 RM) and high (80-85% of 1 RM) training intensities or 6-15 RM[109,265] over 18-24 wk of training. Training 3 d·wk−1 with 50%, 65%, and 80% of 1 RM each day produced similar strength increases to training 3 d·wk−1 with 80% of 1 RM.[128] However, several studies have shown greater strength increases with high-intensity (80-83% of 1 RM) versus moderate-intensity (50-63% of 1 RM) and low-intensity (20-48% of 1 RM) training.[53,65,66,135,136] Thus, a variety of intensities may be effective in this population especially early in training.

Evidence Statement and Recommendation.Evidence Category A. For improvements in strength and hypertrophy in older adults, the use of free-weight and machine multiple- and single-joint exercises with slow to moderate lifting velocity for one to three sets per exercise with 60-80% of 1 RM for 8-12 repetitions with 1-3 min of rest in between sets for 2-3 d·wk−1 is recommended.[31,53,61,65,66,69,77,105,106,109,128,135,136,265]

The ability to develop high muscular power diminishes with age.[107] An increase in strength and power enables the older adult to improve performance in tasks that require a rapid RFD, including a reduced risk of falls.[212] There is support for the inclusion of power training for the healthy older adult.[107,154] Muscle atrophy results from fiber denervation with loss of some fibers and atrophy of others, that is, especially fast twitch, with aging and inactivity.[164] Age-related muscle atrophy is associated with reductions in strength and power,[77,104] and reductions in power exceed decreases in maximal strength.[246] Although most studies in the elderly examined heavy RT programs, power training may optimize functional abilities as well as have secondary effects on other physiological systems, for example, connective tissue.[18]

Since 2001, several studies have examined power training, for example, free-weight and machine exercises with the CON phase performed rapidly with a controlled (2-3 s) ECC phase, in the elderly. Low-to-moderate intensity (20-80% of 1 RM), high-velocity training has been tolerable in this population and consistently shown to enhance power production, strength, and performance of activities of daily living, for example, chair rise, and balance.[29,53,57,107,115,124,199,200,243] In comparison to traditional RT, power training has been shown to produce similar[29,70] and inferior increases[185] in maximal strength, greater improvements in power,[29,70] and greater functional performance enhancement.[29,185] de Vos et al.[53] reported that power training with 50% of subjects' 1 RM led to the highest gains in muscle power, whereas RT with loads corresponding to 80% of subjects' 1 RM led to the highest gains in muscular strength and endurance. On the basis of these data, it appears prudent to include high-velocity, low-intensity movements in progression models for older adults.

Evidence Category B. Increasing power in healthy older adults include 1) training to improve muscular strength and 2) the performance of both single- and multiple-joint exercises for one tot three sets per exercise using light to moderate loading (30-60% of 1 RM) for 6-10 repetitions with high repetition velocity.[29,53,57,70,107,115,124,185,199,200,243]

Improvements in LME in the older adult may lead to an enhanced ability to perform submaximal work and recreational activities. Although studies examining LME training in the older adult are limited, LME may be enhanced by circuit RT,[275] strength training,[125] and high repetition, moderate-load programs[9] in younger populations. Multiple-set training led to 44.3-60.5% increases in LME, whereas single-set training led approxiamtely10% increases in individuals 65-78 yr of age.[81]

Similar recommendations may apply to older adults as young adults, for example, low to moderate loads (40-70% of 1 RM) performed for moderate to high repetitions (10-15 or more).[81]