Just four minutes of daily strengthening exercise dramatically increases key factors in quality of life for aging adults, according to a new study led by researchers at Penn State College of Medicine. Results published in PLOS One showed that strength - which impacts fall risk, longevity, independent living and more - significantly improved for adults aged 65 and older in as little as 12 weeks.
Mobility, or physical fitness, is a critical indicator of quality of life for adults ages 65 and above, allowing for completion of daily tasks and movement. Unintentional injuries such as tripping or falling are among the top leading causes of death among adults ages 65 and over, according to the Centers for Disease Control and Prevention. A lack of physical fitness in aging persists because people believe that they can only reap the benefits of exercise with more extensive resistance training workouts - but that's not the case, according to lead author Christopher Sciamanna, professor of medicine and of public health at Penn State College of Medicine. He said a short four-minute workout is enough to improve upon several factors of critical mobility indicators.
"The human body is designed to improve very quickly," Sciamanna said. "And just a few repetitions of an exercise performed regularly can lead to huge improvements. Exercise is about forward thinking - think about what you want to be able to do and train for it."
While resistance training can greatly increase strength in just a few months, less than one in five older adults exercise for the recommended two days per week of muscle-strengthening activity, partially due to routine length, pain and other limitations.
"Exercise is actually really complicated, because you have to decide how many repetitions, how far, how many sets, how much rest and how many times per week," said co-author Smita Dandekar, associate professor of pediatrics at Penn State College of Medicine. "It's hard work, so there's huge problems with people wanting to do exercise. If we can make it short, we're part way there."
Previously, the team had conducted a study called FAST (Functional Activity Strength Training)-1, a smaller scale experiment where 24 older adults performed 30 seconds of push-ups and squats daily, resulting in improved squat performance over six months. Other studies have also shown that a few sets of exercise per week can lead to nearly the same improvements as longer-length routines. Building off of those findings, Sciamanna's team decided to test the efficacy of a shorter routine.
In the current study, researchers from Penn Statue tested the effects of a program, called FAST-2, to see if it improved mobility and physical capability in adults older than 65. A total of 97 participants with an average age of 74 years old were randomly assigned to receive either the exercise regimen treatment or no intervention. Prior to the study, participants reported performing an average of about 18 minutes of total exercise each week, which is much lower than the recommended amount of at least 150 minutes moderate or 75 minutes vigorous exercise for adults, Sciamanna explained.
The FAST-2 program included four exercises: push-ups, chair stands, two-arm rows and stair stepping. Participants performed each movement for 30 seconds followed by a 30-second rest. Participants received four elastic resistance bands and a stepper with an adjustable height. Written explanations and modifications were provided for the exercises, such as performing pushups with hands on a countertop or wall, or chair stands with hands on the knees.
As participants improved, they were encouraged to progress to higher levels of difficulty, like performing the original version of the exercise if they were doing a modified version or increasing step height on the stepper. To measure participants' progress, the researchers assessed the participants' ability and speed at standing up and ability to stand on one leg at the beginning, middle and end of the study.
The tests mimic the movements required in everyday activities, making them useful predictors of potential risks and future need for care, the researchers said.
The authors found that this exercise regimen, which included only 60 seconds of lower body resistance training, was enough to give significant improvements in functional performance: 4.2 more repetitions in a 30 second chair stand, 3.6 more seconds in one-legged stand time and a decrease of 2.3 seconds in sit-to-stand time. These changes point to related improvements in daily life fitness, such as standing up from a chair, climbing stairs and walking, Sciamanna explained.
"These indicators predict your future ability to go into a nursing home, your future likelihood of falling and of developing difficulty walking," Sciamanna said. "They give you a sense of whether or not you're going to be able to be active in the future."
One of the additional benefits of a shorter program like FAST-2, Sciamanna explained, is a higher chance that people will stick to the routine. Participants completed the exercise on 81% of days during the study period, demonstrating that the program can fit into days even with time constraints or other concerns that may keep people from continuing an exercise program, even though it could lead to improvements in everyday life.
The findings are a promising indication that resistance training regimens do not have to be long to make a big difference in strength, mobility and quality of life, Sciamanna explained.
"Exercise is the key to freedom," he said. "Freedom is the ability to be able to do what you want to do, and I would say that if you can't do what you want to do, you're not free. I approach exercise by thinking of what I want to be able to do in 20 years, and then I train to do that."
Other Penn State co-authors include Smita Dandekar of the Department of Pediatrics, Division of Hematology and Oncology at Penn State Health Children's Hospital; Jordan Kurth, Liza S. Rovniak, Noel Ballentine and Natalia Pierwola-Gawin of the Department of Medicine, Division of General Internal Medicine at Penn State College of Medicine; Yimeng Shang and Shouhao Zhou of the Department of Public Health Sciences, Division of Biostatistics and Bioinformatics at Penn State College of Medicine; and Jonathan G. Stine of the Department of Medicine, Division of Gastroenterology and Hepatology at Penn State Health Milton S. Hershey Medical Center, with an additional appointment in the Department of Public Health Sciences at Penn State College of Medicine. Additional contributors include Matthew Silvis of the Departments of Orthopedics and Rehabilitation and Family and Community Medicine at Penn State Health Milton S. Hershey Medical Center; Matthew A. Ladwig of Purdue University Northwest; David E. Conroy of the University of Michigan; Kathryn H. Schmitz of the University of Pittsburgh School of Medicine; and Margaret Danilovich of Northwestern University Feinberg School of Medicine.
