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PubMed1993

A low-level strength training exercise program for frail elderly adults living in an extended attention facility.

Little is known about low-level, mildly progressive, strength training programs for frail elderly adults who live in extended attention housing. To study the effects of a low-level strength training program, a group of 12 frail elderly adults, aged 70 to 93 years, residing in an extended attention facility, participated in a strength training exercise program using ankle and wrist weights. Baseline measurements of elbow and knee flexor and extensor muscle strength were taken with a handheld dynamometer prior to initiation of the strength training program, and every three weeks during the 12-week period of exercise with weights. Muscle strength of elbow and knee flexors improved significantly by the end of the 12-week period (p < 0.05). Elbow and knee extensors did not show significant increases in muscle strength, but were maintained. It is concluded that muscle strength can be maintained or improved in adults over 70 who live in an extended attention facility using a low-level, mildly progressive, resistive exercise program. The program is safe, inexpensive, practical and can be used in clinical as well as community settings.

Aged↗
PubMed1994

Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response.

BACKGROUND: In patients with intermittent claudication, a supervised walking exercise program increases peak exercise performance and community-based functional status. Patients with peripheral arterial disease also have muscle weakness in the affected extremity that may contribute to the walking impairment. However, the potential benefits of training modalities other than walking exercise, such as strength training, have not been critically evaluated in this patient population. The present study tested the hypothesis that a strength training program would be as effective as treadmill walking exercise and that combinations of strengthening and walking exercise would be more effective than either alone in improving exercise performance. METHODS AND RESULTS: Twenty-nine patients with disabling claudication were randomized to 12 weeks of supervised walking exercise on a treadmill (3 h/wk at a work intensity sufficient to produce claudication), strength training (3 h/wk of resistive training of five muscle groups of each leg), or a nonexercising control group. Graded treadmill testing was performed to maximally tolerated claudication pain to define changes in peak exercise performance. After 12 weeks, patients in the treadmill training program had a 74 +/- 58% increase in peak walking time as well as improvements in peak oxygen consumption (VO2) and the onset of claudication pain. Patients in the strength-trained group had a 36 +/- 48% increase in peak walking time but no change in peak VO2 or claudication onset time. Control subjects had no changes in any of these measures over the 12-week period. After the first 12 weeks, patients in the initial walking exercise group continued for 12 more weeks of supervised treadmill training. This resulted in an additional 49 +/- 53% increase in peak walking time (total of 128 +/- 99% increase over the 24 weeks). After the initial 12 weeks, patients in the strength-trained group began 12 weeks of supervised treadmill training, and patients in the control group participated in a 12-week combined program of strengthening and treadmill walking exercise. The combined strength and treadmill training program and treadmill training after 12 weeks of strength training resulted in increases in peak exercise performance similar to those observed with 12 weeks of treadmill training alone. CONCLUSIONS: A supervised treadmill walking exercise program is an effective means to improve exercise performance in patients with intermittent claudication, with continued improvement over 24 weeks of training. In contrast, 12 weeks of strength training was less effective than 12 weeks of supervised treadmill walking exercise. Finally, strength training, whether sequential or concomitant, did not augment the response to a walking exercise program.

Aged↗
PubMed2001

Protein nutrition and resistance exercise.

Strength conditioning will result in an increase in muscle size and this increase in size is largely the result of increased contractile proteins. The mechanisms by which the mechanical events stimulate an increase in RNA synthesis and subsequent protein synthesis are not well understood. Lifting weight requires that a muscle shorten as it produces force (concentric contraction). Lowering the weight forces the muscle to lengthen as it produces force (eccentric contraction). Eccentric contractions produce ultrastructural damage that may stimulate increased muscle protein turnover and a cascade of metabolic events which is similar to an acute phase response and includes complement activation, mobilization of neutrophils, increased circulating and skeletal muscle interleukin-1 and macrophage accumulation. While endurance exercise increases the oxidation of essential amino acids and increases the requirement for dietary protein, resistance exercise results in a decrease in nitrogen excretion, lowering dietary protein needs. Research has indicated that increased dietary protein intake (up to 1.6 g protein x kg(-1) x d(-1)) may enhance the hypertrophic response to resistance exercise. It has also been demonstrated that in very old men and women the use of a protein-calorie supplement was associated with greater strength and muscle mass gains than did the use of placebo.

Aging↗
PubMed2006

[Relationship between walking capacity and maximal exercise capacity, strength and motor deficiency in adult hemiplegic stroke patients].

OBJECTIVE: To evaluate the relation between walking capacity and maximal exercise capacity, strength and motor deficiency in hemiplegic stroke patients. DESIGN: Uncontrolled observational study. SETTING: Physical medicine and rehabilitation unit in a teaching hospital. PARTICIPANTS: Twenty hemiplegic stroke patients (17 men and 3 women) aged 18-70 years, whose stroke occurred more than 3 months before the study and who could walk independently with or without walking aids. MAIN OUTCOME MEASURES: Peak oxygen uptake (VO(2peak)), maximal power output walking capacity (6-min walk test) and motor deficiency (Fugl-Meyer scale). RESULTS: Walking capacity was correlated with both VO(2peak) and maximal power output (Pmax) [r=0.609, P<0.003 and r=0.868, P<0.0001, respectively] but also with strength (from r=0.640 to r=0.734; P=0.0018 to P=0.0001) and motor deficiency (r=0.6; P=0.004). CONCLUSIONS: Aerobic capacity and walking capacity are correlated and decreased in hemiplegic stroke patients. These results underscore the need for future studies to confirm the role of fitness in relation to walking capacity and to evaluate the benefit of integrating aerobic training into more traditional rehabilitation programs after stroke.

Adolescent↗
PubMed2004

[The stakes of force perseverance training and muscle structure training in rehabilitation. Recommendations of the German Federation for Prevention and Rehabilitation of Heart-Circulatory Diseases e.v].

While aerobic endurance training has been a substantial part of international recommendations for cardiac rehabilitation during the last 30 years, there is still a rather reserved attitude of the medical community to resistance exercise in this field. Careful recommendations for resistance exercise in cardiac patients was only published a few years ago. It has been taken for granted that strength exercise elicits a substantial increase in blood pressure and thus imposes, especially in cardiac patients, a risk of potentially fatal cardiovascular complications. Results of the latest studies show that the existing recommended overcaution is not justified. Strength exercise can indeed result in extreme increases of blood pressure, but this is not the case for all loads of this kind. The actual blood pressure response to strength exercise depends on the isometric component, the exercise intensity (load or resistance used), muscle mass activated, the number of repetitions in the set and/or the duration of the contraction as well as involvement of Valsalva maneuver. Intra arterially performed blood pressure measurements during resistance exercise in patients with heart disease showed that strength training carried out at low intensities (40-60% of MVC) and with high numbers of repetitions (15-20) only evokes a moderate increase of blood pressure comparable with blood pressure measures induced by moderate endurance training. If used properly and performed accurately, individually dosed, medically supervised and controlled through experienced sport therapists, a dynamic resistance exercise is-at least for a certain group of patients-not associated with higher risks than an aerobic endurance training and can in addition to endurance training improve muscle force and endurance, have a positive influence on cardiovascular function, metabolism, cardiovascular risk factors as well as psychosocial well-being and overall quality of life. However, with respect to currently available data, resistance exercise cannot be generally recommended for all groups of patients. The appropriate kind and execution of training is highly dependent on current clinical status, cardiac capacity as well as possible accompanying diseases of the patient. Most of the studies carried out up to date included small samples of middle-aged male patients with almost normal levels of aerobic endurance performance and good left ventricular function. Data is missing for risk groups, older patients and women. Therefore, an integration of dynamic resistance exercises in cardiac rehabilitation can only be recommended without hesitation for CHD patients with high physical capacity (good myocardial function, revascularized). Since patients with myocardial ischemia and/or low left ventricular functioning might develop wall motion disturbances and/or dangerous ventricular arrhythmia when performing resistance exercises, prevalence of the following conditions is recommend: moderate to high LV-function, high physical performance (>5-6 metabolic equivalents= >1.4 watts/kg body weight) in absence of angina pectoris symptoms or ST-depression, by maintained current medication. In the proposed recommendations, a classification of risks for resistance training in cardiac rehabilitation is being made based on current data and is complemented by specific recommendations for particular groups of patients and detailed guidelines for setup and completion of the therapy program.

Blood Pressure↗
PubMedDate not supplied

Aminophylline, respiratory muscle strength and exercise tolerance in chronic obstructive airway disease.

Fourteen patients with chronic obstructive airway disease participated in a randomized, double-blind, placebo controlled, cross-over study to assess the effect of acutely administered aminophylline on respiratory muscle strength and exercise tolerance. An increase in the distance walked in 6 min occurred following aminophylline (p less than 0.01). There was no improvement in respiratory muscle strength, assessed by maximal static mouth pressures, and no increase in maximal ventilation or oxygen uptake during a progressive exercise test. The ventilatory response to inhaled CO2 was increased (p less than 0.02), suggesting a central stimulatory effect of aminophylline. The mean increase in walking distance was 5.7%. In most cases, the change was small and unlikely to be of practical benefit.

Aminophylline↗
PubMed1998

The effect of a specific strength-development exercise on bone mineral density in perimenopausal and postmenopausal women.

The objective of this study was to assess the effect of physical activity on bone density at the distal radius in healthy perimenopausal (23) and postmenopausal (60) women. The 83 women, aged 40-62 years, were randomized into two groups. The women participated in an exercise program of 40 minutes of jogging and 20 minutes of gymnastics three times a week for 1 year (group 1, n = 46) or 6 months (group 2, n = 37), respectively. Subjects in group 2 served as controls during the first 6 months. They were introduced to exercise classes after the first 6 months of the study and wore wrist weights (0.8 kg on each arm) during the gymnastics session. None of the women were on hormone replacement therapy (HRT). Results show a decrease in bone mineral density (BMD) during the first 6 months of the study in group 1 (2%, p < 0.01) and group 2, although this was not significant for the latter group (1.2%, n.s., p = 0.045). There was no significant change in osteocalcin serum concentration, fasting urinary calcium excretion, and calcium serum concentration during the first half of the study. After an additional 6 months, it was possible to stop BMD loss in both groups. Osteocalcin serum concentration significantly increased, and calcium serum concentration significantly decreased in groups 1 and 2. Fasting urinary calcium excretion decreased in both groups, although this was significant only in group 2 during the 1-year study. In conclusion, it proved possible to prevent BMD loss at the distal radius by our exercise program in perimenopausal and postmenopausal women. The effects of exercise may be general as well as localized. According to our results, additional localized benefits from a specific strength-development exercise may be seen.

Adult↗
PubMed2003

Strength training vs. aerobic training: cardiovascular tolerance in elderly adults.

The aim of the present study was to evaluate cardiovascular tolerance to two different types of exercise (strength training vs. aerobic training) in healthy elderly subjects. Nineteen healthy elderly subjects aged 65-81 were studied. All the subjects participated in a 6-month combined physical activity program of gymnastics (2 times/week; 50 min.) and strength training (2 times/week; 40-50 min.). The gymnastics sessions consisted of general physical activity that is usually offered to elderly people and included warm-up, aerobic exercises, strength training, some balance and coordination exercises, recreational games and cool-down. The strength training consisted of two sets of 10 to 12 repetitions at 70% of one repetition maximum (1 RM) for "women's double chest"; "leg extension"; "overhead press; "seated leg curl"; "lateral raise"; "leg press" and "abdominal machine". Cardiovascular tolerance was evaluated both by measuring heart rate (HR) continuously (Polar Vantage NV) during the sessions and by measuring systolic (SBP) and diastolic blood pressure (DBP) with an electronic sphygmomanometer at five different times (baseline, after warm-up, 15-20 min., 30-40 min. and after cool-down). Moreover, in order to measure the response according to the type of exercise, in strength training sessions, SBP and DBP were also evaluated in different machines (legs vs. arms). Comparison between the two different types of exercise (gymnastics vs. strength training) and between different machines was performed by an unpaired Student's t test. The level of significance was set at p < 0.05. The results showed no significant differences in HR, SBP and DBP values between the two training types. Both sessions were performed at appropriate intensity without exaggerated cardiovascular response. In strength training, exercises that involved the legs presented higher rises in SBP and DBP values than those performed with the arms. These data suggest that, if appropriate techniques are used, strength training as well as gymnastics can be performed by healthy older subjects so long as basic rules for exercise in this population are followed. Furthermore, the data indicate a greater cardiovascular hemodynamic response after strength exercises with the legs than with the arms.

Age Factors↗
PubMed2002

Gender and age differences in plasma carnitine, muscle strength, and exercise tolerance in haemodialysis patients.

BACKGROUND: Haemodialysis patients have impaired exercise tolerance that may be related to impaired carnitine availability and/or alterations in carnitine metabolism. As carnitine metabolism is sex- and age-related, we examined plasma free and esterified carnitine concentrations, muscle strength, and estimated exercise tolerance in female (n=51) and male (n=63) patients of different ages (18-86 years). METHODS: Concentrations of free carnitine and acetylcarnitine were determined in the plasma of patients. Isometric handgrip strength was measured using a dynamometer while exercise tolerance was predicted from scores for self-reported walking distance on the level and on an incline. RESULTS: Plasma total carnitine concentration in the females was significantly lower than that of males (35.4+/-1.3 and 42.4+/-1.4 micro mol/l, respectively, P<0.01). This was almost entirely due to the lower plasma free carnitine concentration of females when compared with the males (20.6+/-0.9 and 26.3+/-1.1 micro mol/l, respectively, P<0.05). Furthermore, plasma free carnitine concentrations were negatively correlated with age in females (r=-0.45, P<0.001) even when the linear effects of haemoglobin, albumin, body weight, time on dialysis, and muscle strength were removed from the regression analysis (partial correlation coefficient; pcc=-0.43, P=0.018), but not in the males (r=0.03, P>0.05). Isometric handgrip strength and estimated exercise tolerance on the level were lower in females than males (138.9+/-10.9 and 259.0+/-15.2 N, P<0.001; and 3.5+/-0.2 and 4.3+/-0.2, P<0.05, respectively). Isometric handgrip strength and estimated exercise tolerance (walking distance on the level and on an incline) were positively correlated with plasma free carnitine concentrations in females, but not in the males. CONCLUSIONS: There was a strong relationship between plasma free carnitine concentrations and age in female patients, but not in males. It is unlikely that the reduction in plasma free carnitine in females was a direct causative factor in their reduced exercise tolerance, but probably reflects greater muscle de-conditioning/atrophy with age in female patients.

Adult↗
PubMed2004

Acute hormonal responses to heavy resistance exercise in strength athletes versus nonathletes.

The aim of the present study was to investigate acute hormonal and neuromuscular responses and recovery in strength athletes versus nonathletes during heavy resistance exercise performed with the forced and maximum repetitions training protocol. Eight male strength athletes (SA) with several years of continuous resistance training experience and 8 physically active but non-strength athletes (NA) volunteered as subjects. The experimental design comprised two loading sessions: maximum repetitions (MR) and forced repetitions (FR). MR included 12-RM squats for 4 sets with a 2-min recovery between sets. In FR the initial load was higher than in MR so that the subject could lift approximately 8 repetitions by himself and 4 additional repetitions with assistance. Before and after the loading protocols, blood samples were drawn to determine serum testosterone, free testosterone, cortisol and growth hormone concentrations, and blood lactate. Maximal voluntary isometric force and EMG activity of the leg extensors was measured before and after the loading as well as 24 and 48 hrs after the loading. The concentrations of the hormones measured increased significantly (p < .01-.001) after both loadings in both groups. The responses tended to be higher in FR than the MR loading and the increases of testosterone concentrations were significantly (p < .01) greater in both loadings in SA than in NA. Both loading protocols in both groups also led to neuromuscular fatigue observable with significant acute decreases in isometric strength by 32-52% (p < .001) and in maximal iEMG (p < .05-01) associated with large increases in blood lactate. These data suggest that, at least in experienced strength athletes, the forced-repetition protocol is a viable alternative to the more traditional maximum-repetition protocol and may even be a superior approach.

Adult↗
PubMed1996

A comparison of the effects of strength and aerobic exercise training on exercise capacity and lipids after coronary artery bypass surgery.

BACKGROUND: Coronary artery surgery improves symptoms and prognosis in patients with angina. Aerobic exercise rehabilitation improves exercise capacity and prognosis in cardiac patients. Strength exercise training has not been extensively studied. DESIGN: We studied the effects of 6 months aerobic and strength exercise training after coronary artery surgery in 81 men, mean age 57 years. RESULTS: Treadmill time(s) increased by 130.3 (95% confidence interval 46.4 to 214.2) in the aerobic group; by 83.1 (0.9 to 165.3) in the strength group, and by 34.3 (-1 to 69.6) in the control group (P = 0.04, control versus aerobic) after 3 months; and by 196.4 (112.2 to 280.7) in the aerobic group, by 122.7 (37.7 to 207.6) in the strength group and by 27 (-40.4 to 94.4) in the control group (P = 0.002, control versus aerobic, and P = 0.03 control versus strength) after 6 months. The level of fitness improved more in the strength-trained group, and there was a minor reduction in body weight and degree of fatness. There were no changes in lipoprotein levels. Aerobic exercise training causes early and sustained benefit in treadmill exercise capacity, while the effects of strength exercise training are later in onset. Exercise training alone did not influence lipid levels. CONCLUSION: Cardiac rehabilitation programmes should be comprehensive, including advice on diet and other risk factor modifications in addition to exercise sessions involving aerobic and strength training elements.

Aged↗
PubMed1997

The effect of dynamic strength back exercise and/or a home training program in 57-year-old women with chronic low back pain. Results of a prospective randomized study with a 3-year follow-up period.

STUDY DESIGN: A prospective, randomized investigation. OBJECTIVES: To compare the effect of dynamic strength back muscle training with that of a home training program and to evaluate the long-term effect of the home training program in patients with chronic low back pain. SUMMARY OF BACKGROUND DATA: In a health survey of 57-year-old women, those with chronic low back pain were selected using the Nordic Questionnaire. Of 172 women with low back pain, 74 participated in the study. METHODS: The participants were randomly assigned to either dynamic strength back exercises at a fitness center and a home training program or to the home training program for the first 3 months, after which both groups continued to pursue the home training program. Follow-up observation was by examination at 3 and 12 months and by mailed questionnaire after 3 years. The primary effect variables were disability, sick-leave, and use of health care services. RESULTS: Both training groups manifested significant improvement at the 3- and 12-month follow-up examinations, yet the adherence rate was much better in the group assigned to the fitness center. Those who adhered to the training program for the first year manifested significant improvement according to the 3-year follow-up questionnaire. There was a significant reduction in the number of women on sick-leave and in use of health care services after 1 year, but not after 3 years. CONCLUSIONS: The home training program was as effective as the supervised dynamic strength muscle training program and yielded lasting improvement after at least 1 year of adherence. The adherence rate was much better, however, when the training was supervised at the start.

Back↗
PubMed2002

Differences in electromyographic activity in the multifidus muscle and the iliocostalis lumborum between healthy subjects and patients with sub-acute and chronic low back pain.

The present study was carried out to examine possible mechanisms of back muscle dysfunction by assessing a stabilising and a torque-producing back muscle, the multifidus (MF) and the iliocostalis lumborum pars thoracis (ICLT), respectively, in order to identify whether back pain patients showed altered recruitment patterns during different types of exercise. In a group of healthy subjects (n=77) and patients with sub-acute (n=24) and chronic (51) low back pain, the normalised electromyographic (EMG) activity of the MF and the ICLT (as a percentage of maximal voluntary contraction) were analysed during coordination, stabilisation and strength exercises. The results showed that, in comparison with the healthy subjects, the chronic low back pain patients displayed significantly lower (P=0.013) EMG activity of the MF during the coordination exercises, indicating that, over the long term, back pain patients have a reduced capacity to voluntarily recruit the MF in order to obtain a neutral lordosis. In contrast, during the stabilisation exercises, no significant differences between patients and controls were found for the normalised EMG activity of the two muscles. These findings indicated that, during low-load exercises, no insufficiencies in back muscle recruitment were evident in either subacute or chronic back pain patients. During the strength exercises, the normalised activity of both back muscles was significantly lower in chronic low back pain patients (P=0.017 and 0.003 for the MF and ICLT, respectively) than in healthy controls. Pain, pain avoidance and deconditioning may have contributed to these lower levels of EMG activity during intensive back muscle contraction. The possible dysfunction of the MF during coordination exercises and the altered activity of both muscles during strength exercises may be of importance in symptom generation, recurrence or maintenance of low back pain.

Acute Disease↗
PubMed1989

Long-term follow-up of symptoms, pulmonary function, respiratory muscle strength, and exercise performance after botulism.

Respiratory muscle weakness occurs commonly at presentation in patients with botulism. Although clinical improvement occurs over several months, symptoms such as fatigue and dyspnea persist in many patients in the long term. To determine whether continued respiratory muscle weakness might contribute to these symptoms, we compared lung function tests, respiratory muscle strength, and exercise performance in 13 patients 2 years after type B botulism. We found that residual symptoms including dyspnea and fatigue were common in botulism patients at 2 years postintoxication. Lung function tests had returned to normal in all patients. Maximal inspiratory and expiratory pressures were similar between botulism patients and control subjects. Evaluation of individual results showed evidence of inspiratory muscle weakness in four of 13 patients with botulism (Plmax less than 65% predicted). Maximal oxygen consumption and maximal workload during exercise were reduced in botulism patients in comparison to control subjects. During exercise, botulism patients had a more rapid and shallow breathing pattern and a higher dyspnea score at a given minute ventilation in comparison to control subjects. Reasons for premature exercise termination in botulism patients were multifactorial. Although respiratory muscle weakness may have been contributory in some patients, most appeared to be limited by reduced cardiovascular fitness, leg fatigue, or reduced motivation.

Adult↗
PubMed1986

[Effect of intensive, strength-building exercise training on the fine structure of human skeletal muscle capillaries].

The effects of a five-weeks training programme and of long-term strenuous exercise on capillary endothelial cells (E), basement membranes (B), and pericytes (P) of m. vastus lateralis were studied morphometrically in 2 groups of healthy young men. The five-weeks training programme was performed by 7 sports students, whereas the long-term effect of strength type exercise was investigated on 6 top level athletes. As a result of the five-weeks training period we found a swelling of the E (23%, p less than 0.05), an increase in number and cross-sectional areas of P (33%, p less than 0.05) as well as signs of endomysial connective tissue stimulation. With the exception of connective tissue reaction this post-training data corresponds to the structural features of the top level athletes. The mean B-thickness (132 +/- 32 nm) was almost the same in both groups and was not affected by the five-weeks training period.

Adult↗
PubMed2005

How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction.

BACKGROUND: Physical exercise is an important component of respiratory rehabilitation because it reverses skeletal muscle dysfunction, a clinically important manifestation of COPD associated with reduced health-related quality of life (HRQL) and survival. However, there is controversy regarding the components of the optimal exercise protocol. A study was undertaken to systematically evaluate and summarise randomised controlled trials (RCTs) comparing different exercise protocols for COPD patients. METHODS: Six electronic databases, congress proceedings and bibliographies of included studies were searched without imposing language restrictions. Two reviewers independently screened all records and extracted data on study samples, interventions and methodological characteristics of included studies. RESULTS: The methodological quality of the 15 included RCTs was low to moderate. Strength exercise led to larger improvements of HRQL than endurance exercise (weighted mean difference for Chronic Respiratory Questionnaire 0.27, 95% CI 0.02 to 0.52). Interval exercise seems to be of similar effectiveness as continuous exercise, but there are few data on clinically relevant outcomes. One small RCT which included patients with mild COPD compared the effect of high and low intensity exercise (at 80% and 40% of the maximum exercise capacity, respectively) and found larger physiological training effects from high intensity exercise. CONCLUSIONS: Strength exercise should be routinely incorporated in respiratory rehabilitation. There is insufficient evidence to recommend high intensity exercise for COPD patients and investigators should conduct larger high quality trials to evaluate exercise intensities in patients with moderate to severe COPD.

Exercise Therapy↗
PubMed1993

Balance, reaction time, and muscle strength in exercising and nonexercising older women: a pilot study.

Twenty-one women, aged 57 to 75 years, who had been taking part in exercise programs for periods of 12 months or more underwent tests of muscle strength, reaction time, proprioception, and body sway. The performance of these women in the tests was compared with 21 women of the same age who were not taking part in any organized physical activity and were not exercising more than 30 minutes a day. The women who had been taking part in the exercise program performed significantly better in the tests of quadriceps strength, reaction time, and sway on a compliant surface than the nonexercising women. The exercisers also had lower body mass index scores. These pilot results suggest that exercise may play a role in improving a number of sensori-motor systems that contribute to stability, and that exercise of this nature may help prevent falls in older women.

Accidental Falls↗