Effects of a partially supervised training program in subjects over 75 years of age

Background and aims: Partially supervised training programs may be preferable than class-based ones in older subjects because the adherence rate is more likely to be good and they cost less. The main purpose of this investigation was to provide some evidence of the effectiveness of a 4-month partially supervised training program. We compared it with a class-based program focusing on the knee extensor (KE) and ankle plantar flexor (APF) muscles. Methods: We selected for the study 14 subjects over 75 years of age (75+), age range 75 to 83 years with a mean age of 77.8, and 14 subjects over 65 years of age (65+), age range 65 to 72 years, mean age 66.3 years. They were moderately physically active subjects, free from neurological, cardiovascular, metabolic or inflammatory diseases. The two groups underwent two 4-month training sessions 3 days a week, including: warm-up, aerobics, strength training, cool-down exercises. 65+ subjects underwent a class-based program three times a week. 75+ subjects underwent a partially supervised program consisting of two supervised sessions and one session at home. Strength training was carried out bilaterally with the "Leg Press" and "Sitting Calf" variable-resistance machines (Technogym, Italy). The subjects performed one set of 10 repetitions with a 2-min rest in between. At home, 75+ subjects were instructed to carry out the strength exercises with graded elastic bands (Theraband). Subjects were tested immediately before and after the 4-month training. In addition to weight-lifting ability (1RM), we measured the isometric maximum strength values of KE and APF with a Cybex Norm dynamometer at various angles. Results: Significant baseline differences between 75+ and 65+ were found at all KE angles except 30 degrees and -20 degrees APF. A significantly increased maximum load (1RM) was observed over the 4-month period. The baseline and post-training torque-angle relationships for APF and KE in the two groups showed higher post-training gains in 75+ at all angles except at -20 degrees APF, although a statistically significant difference (p < 0.005) between the groups was only found at 30 degrees KE. Conclusion: Our baseline data confirm the decay in torque capacity in subjects aged 75+ compared with 65+. The partially supervised training for 75+ subjects showed better responses in terms of relative strength gain than for 65+ subjects, and it appears effective in counteracting the age-related physiological and functional decay which appears to be particularly evident around that age.