High-intensity progressive resistance strength training (HIPRST) improves lower limb strength more than lesser training intensities in older adults, although it may not be required to improve functional performance, say authors of a systematic review published this month in Archives of Physical Medicine and Rehabilitation. They note that training volume also is an important variable, and HIPRST appears to be a safe mode of exercise in this population.  

For this systematic review, the authors searched online databases from their inception to July 2012. Randomized controlled trials of HIPRST of the lower limb compared with other intensities of PRST in older people (mean age ≥ 65 years) were identified. Two reviewers independently completed quality assessment using the PEDro Scale and data extraction using a prepared checklist.

The authors included 21 trials. Study quality was fair to moderate (PEDro Scale range 3 to 7). Studies had small sample sizes (18 to 84) and participants were generally healthy. Meta-analyses revealed HIPRST improved lower limb strength greater than moderate- and low-intensity PRST, SMD 0.79 and 0.83, respectively. Studies where groups performed equivalent training volumes resulted in similar improvements in leg strength, regardless of training intensity. Similar improvements were found across intensities for functional performance and disability. The effect of intensity of PRST on mood was inconsistent across studies. Adverse events were poorly reported; however, no correlation was found between training intensity and severity of adverse event.

The authors call for further research into HIPRST's effects in older people with chronic health conditions across the care continuum.