Strength exercises require a muscle to produce force, resulting in a feeling of exertion or strain. Strengthening exercises typically improve the ability to lift and move things—including your body. Examples of strength exercises include squats, leg extensions and heel raises.
Older adults are those 65+ years of age. The loss of skeletal muscle is part of the normal aging process and noted as a primary factor in diminished activity of daily living (ADL) performance. Research has consistently shown that older adults can improve strength with adherence to an exercise routine. Additionally, exercises need to be carried out to the point of fatigue in order to show positive changes in strength.
Strength is improved by challenging the body to exert higher amounts of force. This challenge occurs by either lifting the same amount of weight more times or by increasing the amount of weight lifted. Because heavy weights can be dangerous, increasing the number of times a weight is lifted (repetitions) is the preferred way to progress strengthening exercises for novice exercisers.
Strengthening exercises are progressed first by increasing repetitions and sets before increasing the intensity. The following progression sequence is recommended for initial strengthening exercises:
Session 1: One set of each strengthening exercise for 10 repetitions (reps).
Session 2: Increase from 10 reps to 15 reps for each set of strengthening exercises.
Session 3: Increase to two sets of 10 reps for each strengthening exercise.
Session 4: Increase to two sets of 15 reps for each strengthening exercise.
Session 5: Perform one set of 15 reps and second set to muscle fatigue* for each strengthening exercise.
*Muscle fatigue is defined as acceptable levels of pain or strain is the exercising muscle belly following completion of several repetitions – it may be accompanied by a decrease in performance (poor movement quality, lack of full range of motion, etc.).
Secondary progression of strength exercises occurs after the patient has successfully performed 2 sets of each exercise (first set of 15 repetitions and second to muscle fatigue). Secondary progression is dependent on feedback from the patient. Ask him or her if the exercise is easy, hard or somewhere in between. The ideal vigor is medium to medium-high, which balances the need to fatigue the muscle without being overly aggressive. Easy exercises aren’t effective in improving muscle strength. Easy exercises result in undertraining and do not lead to good outcomes. Conversely, hard exercises may be too aggressive and could cause unnecessary joint/muscle strain or pain. Secondary ways to progress strength exercises (beyond increasing repetitions) include the following:
- Increase weight lifted (ankle weights, bands, dumbbells, etc.)
- Increase ROM (long arc quad versus short arc quads, deeper squats, reach higher, reach lower, etc.)
- Reduce rest periods (30 sec. or less between sets instead of 1 minute)
Hopefully this post will help you more effectively and safely build muscle strength. Stronger muscles lead to easier and safer performance of ADLs: transfers, ambulation, entering/exiting home, etc. Easier ADLs in turn lead to increased confidence, socializing and overall quality of life – which, ultimately, is why we care about exercise in the first place. Now go, get strong and enjoy life!