Objectives. This randomized controlled trial studied the effects of a low-to moderate-intensity group exercise program on strength, endurance, mobility, and fall rates in fall-prone elderly men with chronic impairments.Methods. Fifty-nine community-living men (mean age ϭ 74 years) with specific fall risk factors (i.e., leg weakness, impaired gait or balance, previous falls) were randomly assigned to a control group ( n ϭ 28) or to a 12-week group exercise program ( n ϭ 31). Exercise sessions (90 minutes, three times per week) focused on increasing strength and endurance and improving mobility and balance. Outcome measures included isokinetic strength and endurance, five physical performance measures, and self-reported physical functioning, health perception, activity level, and falls.Results. Exercisers showed significant improvement in measures of endurance and gait. Isokinetic endurance increased 21% for right knee flexion and 26% for extension. Exercisers had a 10% increase ( p Ͻ .05) in distance walked in six minutes, and improved ( p Ͻ .05) scores on an observational gait scale. Isokinetic strength improved only for right knee flexion. Exercise achieved no significant effect on hip or ankle strength, balance, self-reported physical functioning, or number of falls. Activity level increased within the exercise group. When fall rates were adjusted for activity level, the exercisers had a lower 3-month fall rate than controls (6 falls/1000 hours of activity vs 16.2 falls/1000 hours, p Ͻ .05).Discussion. These findings suggest that exercise can improve endurance, strength, gait, and function in chronically impaired, fall-prone elderly persons. In addition, increased physical activity was associated with reduced fall rates when adjusted for level of activity.

A common belief among many clinicians and trainers is that intensive simultaneous training for muscle strength and cardiovascular endurance is counterproductive. To test this premise, 14 healthy, untrained men trained four days per week for 20 weeks on a bicycle ergometer for endurance (END Group, n = 4), on an isokinetic device for increased torque production (ITP Group, n = 5), or on both devices (COMBO Group, n = 5). The ITP and COMBO groups had equal torque gains throughout the study (234 +/- 45 and 232 +/- 23 N.m, respectively). After 11 weeks, both END and COMBO groups had similar gains in maximal oxygen consumption (VO2max) (in milliliters per kilogram of body weight per minute). During the last half of the study, however, the END Group had a significant gain in VO2max (p less than .05) of 4.7 +/- 1.2 mL.kg-1.min-1, whereas the COMBO Group had a nonsignificant gain (p greater than .05) of 1.8 +/- 0.6 mL.kg-1.min-1. In harmony with this finding, the END Group showed a significant increase (p less than .05) in citrate synthase activity (15.5 +/- 7.9 mumol.g-1.min-1), whereas the COMBO Group had no significant increase. The authors concluded that simultaneous training may inhibit the normal adaptation to either training program when performed alone. The extent of the interference probably depends on the nature and intensity of the individual training program. [Nelson AG, Arnall DA, Loy SF, et al: Consequences of combining strength and endurance training regimens.

Two-hundred and ninety-four male and 224 female randomly selected recreational cyclists responded to a mail questionnaire. Significant differences were observed between male and female cyclists' training characteristics. Overall, 85% of the cyclists reported one or more overuse injury, with 36% requiring medical treatment. The most common anatomical sites for overuse injury/complaints reported by the male and female cyclists combined were the neck (48.8%), followed by the knees (41.7%), groin/buttocks (36.1%), hands (31.1%), and back (30.3%). For the male cyclists, effect upon back and groin/buttocks overuse injuries/complaints were miles/week, lower number of gears, and less years of cycling. For female cyclists, training characteristics which had the most significant effect upon groin/buttocks overuse injury/complaints were more non-competitive events/year and less stretching before cycling. The odds of female cyclists developing neck and shoulder overuse injury/complaints were 1.5 and 2.0 times more, respectively than their male counterparts.

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