OBJECTIVE -To determine the efficacy of high-intensity progressive resistance training (PRT) on glycemic control in older adults with type 2 diabetes.RESEARCH DESIGN AND METHODS -We performed a 16-week randomized controlled trial in 62 Latino older adults (40 women and 22 men; mean Ϯ SE age 66 Ϯ 8 years) with type 2 diabetes randomly assigned to supervised PRT or a control group. Glycemic control, metabolic syndrome abnormalities, body composition, and muscle glycogen stores were determined before and after the intervention.RESULTS -Sixteen weeks of PRT (three times per week) resulted in reduced plasma glycosylated hemoglobin levels (from 8.7 Ϯ 0.3 to 7.6 Ϯ 0.2%), increased muscle glycogen stores (from 60.3 Ϯ 3.9 to 79.1 Ϯ 5.0 mmol glucose/kg muscle), and reduced the dose of prescribed diabetes medication in 72% of exercisers compared with the control group, P ϭ 0.004 -0.05. Control subjects showed no change in glycosylated hemoglobin, a reduction in muscle glycogen (from 61.4 Ϯ 7.7 to 47.2 Ϯ 6.7 mmol glucose/kg muscle), and a 42% increase in diabetes medications. PRT subjects versus control subjects also increased lean mass (ϩ1.2 Ϯ 0.2 vs. Ϫ0.1 Ϯ 0.1 kg), reduced systolic blood pressure (-9.7 Ϯ 1.6 vs. ϩ7.7 Ϯ 1.9 mmHg), and decreased trunk fat mass (Ϫ0.7 Ϯ 0.1 vs. ϩ0.8 Ϯ 0.1 kg; P ϭ 0.01-0.05).CONCLUSIONS -PRT as an adjunct to standard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes.

Background. Identification of the physiologic factors most relevant to functional independence in the elderly population is critical for the design of effective interventions. It has been suggested that muscle power may be more directly related to impaired physical performance than muscle strength in elderly persons. We tested the hypothesis that peak muscle power is closely associated with self-reported functional status in sedentary elderly community-dwelling women.

Chronic heart failure (CHF) is characterized by a skeletal muscle myopathy not optimally addressed by current treatment paradigms or aerobic exercise. Sixteen older women with CHF were compared with 80 age-matched peers without CHF and randomized to progressive resistance training or control stretching exercises for 10 wk. Women with CHF had significantly lower muscle strength (P < 0.0001) but comparable aerobic capacity to women without CHF. Exercise training was well tolerated and resulted in no changes in resting cardiac indexes in CHF patients. Strength improved by an average of 43.4 +/- 8.8% in resistance trainers vs. -1.7 +/- 2.8% in controls (P = 0.001), muscle endurance by 299 +/- 66% vs. 1 +/- 3% (P = 0.001), and 6-min walk distance by 49 +/- 14 m (13%) vs. -3 +/- 19 m (-3%) (P = 0.03). Increases in type I fiber area (9.5 +/- 16%) and citrate synthase activity (35 +/- 21%) in skeletal muscle were independently predictive of improved 6-min walk distance (r2 = 0.78; P = 0.0024). High-intensity progressive resistance training improves impaired skeletal muscle characteristics and overall exercise performance in older women with CHF. These gains are largely explained by skeletal muscle and not resting cardiac adaptations.