[<< wikibooks] Exercise as it relates to Disease/Concurrent Cardiovascular and Resistance training for health in Older Adults
== What is the background to this research? ==
Exercise for older adults has similar improvements in fitness as young adults. Moderate to vigorous cardiovascular training can enhance their maximal oxygen consumption by 10-30%  and resistance training can have great strength gains. Combining both resistance and cardiovascular training has similar effects on the muscles and cardiac system as resistance and cardiovascular training alone. McCarthy’s study showed endurance training can cause an interference for strength training. This is important in older adults who need resistance training to help with daily activities.The aim is to compare the physical fitness effects of a 12 week resistance and cardiovascular training to a program with a combination of both. Also investigation of the training protocols on functional fitness in older adults. Functional fitness is important for them, as it helps maintain independent living for as long as possible and to delay the onset of disability.

== Where is the research from? ==
Conducted at Department of Kinesiology, Louisiana State University, Baton Rouge, LA. Published in Medicine Science in Sports and Exercise in September 2001. .

== What kind of research was this? ==
This research is qualitative, random control trial based on elderly American's.

== What did the research involve? ==
Experimental procedures
The subjects undertook three sessions to determine their fitness capabilities. These assessments where conducted before the 12 week program started and after.
Session 1 tests functional fitness. Several assessments were carried out, including: body composition, sit and reach, agility, dynamic balance, coordination, cardiovascular endurance and muscular strength.
Session 2 tests submaximal cardiorespiratory. This was done by undertaking a graded exercise test. The grade of the treadmill and the speed is increased every 3 minutes. Heart rate, blood pressure, rate of perceived exertion (RPE), mean arterial pressure and rate pressure product (RPP) is measured.
Session 3 involved resistance exercise. Weight is increased until the participant couldn’t perform more than 5 correct repetitions. Exercises completed were: knee extension, knee flexion, seated row, chest press, lateral raise, seated dip and bicep curl.
Treatment groups
Once the participants completed the three sessions, they were assigned to one of four groups. They then follow the program for 12 weeks.
Cardiovascular training- The participants have to maintain 60-70% of the estimated heart rate for the duration of the exercise. Initially the work duration is 21 minutes per session, with the duration increasing 2 minutes each session until 45 minutes is reached.
Resistance training- Participants are to complete the following exercises: seated leg press, leg extension, seated leg curl, seated row, chest press, lateral shoulder raise, seated dip and bicep curl. Initially they perform 12-15 repetitions at 75% of 5RM. Work load is to increase 5-10% per workout until 8-12RM is achieved. They then progress to 2 sets of 8-12RM.
Combined training- Performed both the cardiovascular and resistance training. They perform a maximum of 30 minutes cardiovascular work and one set of 8-12RM per workout.
Control- participants are to do the exercises explained above with no significant changes in nutritional habits. The intensity, frequency and duration is maintained as above groups.

== What were the basic results? ==
Most exercise groups had an improvement in HR, RPP, lower RPE and were able to continue the graded exercise test for longer.  The muscular strength of all groups showed equal improvements in the 5RM strength for leg extension, leg curl, seated row and lateral raise.  All the treatment groups improved in the flexibility and coordination.
Although the changes were only small, they are considered big for this population as all improvements in the cardiovascular system and strength are important for older adults, no matter how big or small. These changes will help them be able to live independently for longer and have a healthier life, which can lead to living longer.

== How did the researchers interpret the results? ==
They found that there were several group by treatment interactions. These group by treatment interactions resulted in very similar treatment effects, all except the control group. They also found that the interactions were indicative of the difference in response to the exercise treatment group and the training period.
The results showed that it didn’t matter whether the subjects were doing the single training or the combined training, the effects were very similar. This is a very important finding as it shows there is no interference from the cardiovascular training on strength training. From the results, older adults should be encouraged to undertake both resistance and cardiovascular training to improve their overall health and maintain their independence.
Comparing these results to the results achieved by JP McCarthy, there is conflicting evidence. McCarthy’s study showed there is impairments in strength gains when combining strength and endurance training compared to strength training alone. But when the results are compared to M Izquierdo’s study, the results obtained are similar, indicating there is no interference of cardiovascular training on strength gains.

== What conclusions should be taken away from this research? ==
The aim was to investigate the benefits of four training protocols and there effects on physical and functional fitness in adults between 60-84yrs. Results showed that resistance and cardiovascular is beneficial for older adults. It also showed that combinations of both training protocols had the same improvements as resistance and cardiovascular training alone, indicating no interference of the cardiovascular training on strength improvement.
The main aim was to see if after a 12 week training program, the strength gains made would be greater in the resistance training then combinations training. This was proven wrong as the 5RM test was no different in both groups, with improvements between 21-64%.
All training groups had an improvement in cardiovascular efficiency. Evidence of this is lower heart rate and RPP after the training protocol. All participants improved the length of the graded exercise test, showing improvements in cardiovascular endurance.
Another aspect was to investigate the improvements in functional fitness. The results showed that all groups improved functional fitness no matter whether it was the resistance training, cardiovascular training or both.

== What are the implications of this research? ==
The study shows the importance of cardiovascular and resistance training in older adults. Showing that those who do a combination of both training programs, do not jeopardise strength or cardiovascular gains. More importantly it showed combining both training is more effective than doing them alone when it comes to functional fitness. This is important for independent living.

== References ==
WOOD R, REYES R, WELSCH M, FAVALORO-SABATIER J, SABATIER M, MATTHEW LEE C et al. Concurrent cardiovascular and resistance training in healthy older adults. Medicine & Science in Sports & Exercise. 2001;33(10):1751-1758.