High-Load Resistance Training for At-Risk Older Adults

Abstract

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.