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 Strength Training in Senior Living Facilities  
The following is one in an ongoing series of columns entitled Keeping Fit by . View all columns in series
Dr. Westcott Between early October 1998 and mid-January 1999, a rather unusual strength training study was conducted at the John Knox Village Nursing Home in Orange City, Florida. In conjunction with my professional colleagues, Gary Reinl and Donna Califano, I served as the research director for this special project. Gary Reinl designed the six-exercise Nautilus strength training program called Vigor¨, which has been implemented in 120 senior living centers nationwide. John Knox Village Nursing Home is one of these facilities, and Donna Califano, a physical therapy assistant, served as the on-site director for the strength training research program.

Donna and her staff personally trained 19 physician-referred nursing home patients (14 women and 5 men) for a period of 14 weeks. The patients were elderly (average age 88.5 years), and most were confined to wheelchairs at the start of the study.

The program participants performed one set of each exercise, using a weightload that they could lift between 8 and 12 repetitions. Whenever they completed 12 repetitions, the resistance was increased by five percent for the following workout. Every repetition was executed through a full range of joint movement in approximately six seconds (two seconds for the lifting phase and four seconds for the lowering phase). The subjects averaged two training sessions per week.

Although each training session took 15 to 20 minutes, much of that time was spent assisting patients on and off the Nautilus machines. The actual exercise time was about six minutes per session, as each strength training set required about one minute for completion.

The six training exercises were designed specifically for older individuals who have difficulty standing up and walking, and also suffer from poor posture. Consider how the following Nautilus exercises can effectively address these problems:

Leg Press
The leg press exercise strengthens the lower body muscles used to rise from a chair or wheelchair, namely the front thigh (quadriceps), rear thigh (hamstrings), and buttocks (gluteus maximus). It does so with full support of the back and no loading forces on the spine, which are important safety considerations for senior men and women.

Triceps Press
The triceps press exercise strengthens the upper body muscles used to rise from a chair or wheelchair, namely the rear arms (triceps), front shoulders (anterior deltoids), and chest (pectoralis major). These pushing muscles produce force against the arm rests to assist the legs when moving from a sitting to standing position.

Compound Row
Because it is essential to develop muscle strength in a balanced manner, the compound row exercise complements the triceps press. This exercise strengthens the upper body pulling muscles, namely the front arms (biceps), rear shoulders (posterior deltoids), and upper back (latissimus dorsi, middle trapezius, rhomboids). These muscles counteract the roundshoulderness characteristic of many older adults.

Lower Back
The low back exercise is perhaps the most important component in the training program. Strong low back muscles maintain erect posture and reduce the risk of problems/pain in this vulnerable area of the body. In fact, a 12-year research study at the University of Florida Medical School has reported an 80 percent success rate in relieving low back discomfort by strengthening the low back muscles.

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 About The Author
Wayne L. Westcott, Ph.D., is fitness research director at the South Shore YMCA in Quincy, MA. He is strength training consultant for numerous national organizations, such as the American Council on Exercise, the......moreWayne Westcott PhD
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