Gym Tonic: 3-month progressive strength training potent for ageing well

Progressive weight training for 3 months is an effective intervention to introduce strength training to older people, which in turn builds muscle strength and promotes successful ageing, according to a study from Singapore.

Named Gym Tonic, the programme applied gym technology for strength training, as well as standardized assessment instruments for evaluating an older person’s physical condition and capacity to train on a continuous basis.

The gym technology comprised six pneumatic machines, namely leg extension/curl, leg press, chest press, lat pull, abdomen/back, and hip abduction/adduction. These pieces of equipment were based on air pressure technology to reduce the impact on the joints and make exercise safer for the elderly.

Elderly participants who underwent the training intervention at Gym Tonic sites were advised to perform progressive strength training (two sets of exercises at each machine, adjusted in terms of the maximum repetition) two times a week for 12 weeks. Each session lasted around 30–45 minutes. The assessments were performed at the start and at the end of the training period, with follow-ups at 3-month intervals if the training continued.

A total of 399 participants completed the 12-week training and the pre- and postassessments. Over the first 2 years of implementation, gains in lower body muscle strength were achieved with leg curl (11.1–48.8 percent), leg extension (10.2–24.0 percent), and hip abduction/hip adduction (7.0–15.8 percent) equipment. [Front Med 2021;8:515898]

Gym Tonic was set up in 24 elderly care locations in Singapore, including residential facilities, day rehab or senior care centres, and senior activity or community centres. Frontline staff were successfully trained in the use of the technology for gym training and assessments, with 95 percent of the therapists strongly agreeing or agreeing to some extent that the implementation had been successful.

“The study data showed significant improvements in muscle strength in each of the three settings including those living in the community and those residing in facilities,” the investigators said.

“In terms of outcomes, the improvement rates in muscle strength were comparable to those reported in [a] meta-analysis of research studies … observing increases of 6.6–37 percent in maximal strength of strength training and multimodal training … [and] an average of 33 percent increase in muscle strength on resistance training for muscular strength in older adults,” they added. [Aging Clin Exp Res 2017;30:889-899; Ageing Res Rev 2010;9:226-237]

Adopting a behavioural change strategy—such as allowing the elderly to exercise in everyday clothes, keeping training simple and short, preprogrammed exercises using RFID smart card to activate each machine—was also effective at spurring the participants to continue exercising.

“To make it simple and easy, training intervention was also kept short, around 30–45 min, and the elderly were only expected to exercise twice a week. During the training period, the therapists and specialists were encouraged to update the elderly on their progress,” the investigators pointed out.

Taken together, the data indicate that a 3-month training intervention may help promote healthy ageing, they said, noting its value for policy makers looking for practical solutions in the war against frailty.