American Physical Therapy Association
View all recommendations from this societyReleased September 15, 2014
Don’t prescribe under-dosed strength training programs for older adults. Instead, match the frequency, intensity and duration of exercise to the individual’s abilities and goals.
Improved strength in older adults is associated with improved health, quality of life and functional capacity, and with a reduced risk of falls. Older adults are often prescribed low dose exercise and physical activity that are physiologically inadequate to increase gains in muscle strength. Failure to establish accurate baseline levels of strength limits the adequacy of the strength training dosage and progression, and thus limits the benefits of the training. A carefully developed and individualized strength training program may have significant health benefits for older adults.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their health care provider.
How The List Was Created
The American Physical Therapy Association (APTA) invited all 88,000 members to suggest items for the Choosing Wisely® list. Communication of this request was distributed to members via website posting, e-mail blast and social media. APTA convened an expert workgroup of physical therapists representing a broad range of clinical expertise, practice settings and patient populations. A modified Delphi technique was used to rank and prioritize the recommendations based upon the Choosing Wisely criteria. An extensive literature search was conducted on the highest rated strategies. The expert panel reviewed the literature and provided a ranking of recommendations based upon the established criteria. The final list of five strategies was selected through a survey open to all APTA members who were asked to select five items from a list of nine, all of which met the established criteria. The final list was presented to the APTA Board of Directors for final approval.
APTA’s disclosure and conflict of interest policy can be found at www.apta.org.
Sources
Silva NL, Oliveira RB, Fleck SJ, Leon AC, Farinatti P. Influence of strength training variables on strength gains in adults over 55 years old: A meta-analysis of dose-response rela tionships. J Sci Med Sport. 2014;17(3):337–44.
Raymond MJ, Bramley-Tzerefos RE, Jeffs KJ, Winter A, Holland AE. Systematic review of high-intensity progressive resistance strength training of the lower limb compared with other intensities of strength training in older adults. Arch Phys Med Rehabil. 2013;94(8):1458–72.
Valenzuela T. Efficacy of progressive resistance training interventions in ol der adults in nursing homes: a systematic review. J Am Med Dir Assoc. 2012;13(5):418–28.
Mayer F, Scharhag-Rosenberger F, Carlsohn A, Cassel M, Muller S, Scharhag J . The intensity and effects of strength training in the elderly . Dtsch Arztebl Int. 2011;108(21):359–64.
Nicola F, Catherine S. Dose-response relationship of resistance training in older adults: a meta-analysis. Br J Sports Med. 2011;45(3):233–4.
