Exercise training as a preventive tool for age-related disorders: a
brief review

Ciolac, Emmanuel Gomes

doi:10.6061/clinics/2013(05)20

Emmanuel Gomes Ciolac

Department of Physical Education, School of Sciences, Universidade Estadual Paulista, Bauru, SP, Brazil

E-mail: ciolac@fc.unesp.br

Figures (4)
Tables (1)

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Figure 1
Schematic representation of the consequences of sarcopenia associated with aging and the feedback from its consequences. Observe that most of the influences are bi-directional. ↓ indicates reduction; ↑ indicates increase.

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Figure 2
Schematic representation of the manner in which exercise and/or physical activity may influence disease incidence and, consequently, mortality during aging. Observe that most influences are bi-directional, indicating that the presence of a risk factor or chronic diseases may alter the exercise/physical activity level, increasing the effects of sedentary behavior on disease and mortality.

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Figure 3
Relative resistance training workload increase curves of young sedentary, older sedentary and older runner (more than 10 years of practice) men submitted to 13 weeks of resistance training (2 sets of 8 to 12 maximal repetitions in 9 exercises). The training workload was increased by 5% to 10% whenever 2 sets of 12 maximal repetitions with the proper form were achieved, without performing Valsalva maneuver, for two consecutive exercise sessions. Observe that there was no significant difference between sedentary young and sedentary older workload increase for almost all exercises performed (except for the greater increase in the calf raise workload of sedentary older), whereas the older runner workload increase was greater than the sedentary young and sedentary older subjects for most of the exercises performed. †: Difference from the sedentary young and sedentary older group (p<0.05). ◊: Difference from the sedentary young group (p<0.05). Reprinted from (⁵5. Ciolac EG, Garcez-Leme LE, Greve JMD. Resistance exercise intensity progression in older men. Int J Sports Med. 2010;31(6):433-8.) Ciolac EG, et al. Resistance exercise intensity progression in older men. Int J Sports Med 2010; 31: 433-8. © Georg Thieme Verlag KG Stuttgart. Used with permission.

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Figure 4
Muscle strength (A) and relative resistance training workload increase curves (B) for older women with total knee arthroplasty and knee osteoarthritis in the contralateral limb (OKG), older women without musculoskeletal limitations (older group) and young women without musculoskeletal limitations (young group) submitted to 13 weeks of resistance training (2 sets of 8 to 12 repetitions of 9 exercises). The training workload was increased by 5% to 10% whenever 2 sets of 12 repetitions with the proper form and avoidance of the Valsalva maneuver were performed for two consecutive exercise sessions. Observe that there was no significant difference between the older group and the young group in terms of the muscle strength or workload increase, whereas the OKG had a greater muscle strength and workload increase for all exercises. ^adenotes a significant difference from the total knee arthroplasty limb muscle strength (p<0.05). ^bdenotes a significant difference from the total knee arthroplasty and osteoarthritic limb muscle strength (p<0.05). ^cdenotes a significant difference from the older group and the young group (p<0.05). ^ddenotes a significant difference from the young group (p<0.05). Adapted from (³³33. Ciolac EG, Greve JMD. Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. Clinics. 2011;66(12):2079-84, http://dx.doi.org/10.1590/S1807-59322011001200013.
http://dx.doi.org/10.1590/S1807-59322011... ) Ciolac EG, et al. Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. Clinics 2011; 66: 2079-84. © Clinics. Used with permission.

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Table 1
Exercise recommendations for health promotion and chronic disease prevention in older adults.

Modality	Resistance	Aerobic	Balance	Flexibility
Frequency	2-3 days per week	3-7 days per week	2-7 days per week	2-7 days per week
Volume	1-3 sets of 8-12 repetitions 1 exercise per major muscle group (8-10 exercises)	20-60 minutes per day (may be divided into sessions of at least 10 min)	No specific recommendation	All major muscle groups should be stressed
Intensity	70 to 80% of 1-maximum repetition (15 to 17 in the 6 to 20 rate of perceived exertion [RPE] scale) (⁴²42. Borg GAV. Psycophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.), ∼1 min recovery between sets	40-80% of reserve heart rate or VO_2MAX (12-15 in the 6-20 RPE scale) (⁴²42. Borg GAV. Psycophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.)	No specific recommendation	12-13 in the 6-20 RPE scale (⁴²42. Borg GAV. Psycophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.)
Observations	Emphasize the use of correct technique. Perform controlled movements and avoid the Valsalva maneuver. Increase workload progressively to maintain relative intensity. Ensure there is at least one day of rest between sessions. If there is equipment available, periodic power training sessions (moderate-intensity, high-velocity movements) will generate muscular power increase.	Moderate-intensity sessions of 30-60 min performed 5 days per week (12-13 in the 6-20 RPE scale) (⁴²42. Borg GAV. Psycophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.) or high-intensity sessions of 20-30 min performed 3 times per week (14-15 in the 6-20 RPE scale) (⁴²42. Borg GAV. Psycophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.) are recommended. Avoid high-impact activities. Walking is the most frequently recommended exercise; however, cycle-ergometer or water-based exercises can be more beneficial for those who do not support weight-bearing activities.	There is no evidence regarding specific frequency, intensity or type of exercise; however, the use of exercises that progressively achieve the following is recommended: 1) reduce the base of support, 2) perturb the center of gravity, 3) stress postural muscle groups and/or 4) reduce sensory input.	Perform sustained stretches rather than ballistic movements.

[1] E-mail: ciolac@fc.unesp.br

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Exercise training as a preventive tool for age-related disorders: a brief review