Squats, Lunges and Rows; Oh, My!
RESISTANCE TRAINING is vital to a healthy body. It’s something we hear from health professionals regularly. Resistance training creates stronger muscles and increased muscle flexibility. But are there other benefits that come with resistance training, such as increased range of motion in joints, specifically in older adults?
This is what Joshua Guggenheimer, assistant professor of nutrition and exercise sciences, and two St. Kate’s students, Christina Ramsdell ’15 and Alexis Barrett ’14, set out to learn last summer. They worked with 20 women, all residents of the Carondelet Village senior living community that neighbors the University’s St. Paul campus. The research participants’ average age was 83.
“I had done some doctoral work at the University of Idaho with a similar population,” says Guggenheimer, who joined St. Kate’s in 2013. “I really enjoyed working with that age group, and I had a desire to do more research with them here. Older adults are often an under-represented and, sometimes, misunderstood cohort.”
THE PLAN AND THE INTERVENTION
The team developed a set of exercises aimed at increasing range of motion, specifically in the ankle, knee, hip and shoulder joints. These areas of the body were targeted because they are used often in daily tasks — such as walking, rising from a chair, climbing stairs and even carrying groceries. Guggenheimer and his students theorized that greater range of motion would help make these tasks easier and safer for the research participants, allowing them to remain independent longer and prevent falls.
“There’s a pretty complete body of literature showing that if you do resistance training, you’re going to get stronger, regardless of your age,” he explains. “An 80-year-old who does resistance training is going to get stronger; we already know that. So, that wasn’t the intent of our study. Instead, we really wanted to focus on range of motion.”
Range of motion is the full movement potential of a joint, its range of flexion and extension. If an ankle or hip joint moves freely, raising the leg and foot to climb stairs becomes easier. A shoulder joint that can rotate farther means an arm can reach a little higher.
“Older adults don’t necessarily care if they can squat 100 pounds,” says Guggenheimer. “They care if they can get out of a chair comfortably, or take the stairs, or get a can of soup out of the cupboard.”
His research team, funded by St. Kate’s Summer Scholars program, looked to positively impact those activities.
Over a six-week period, Ramsdell, Barrett and Guggenheimer visited Carondelet Village twice per week. They supervised the study participants doing six different strength exercises: squat, lunge, press, step up, bent-over row and shoulder flexion (lifting the arms out in front of the body and overhead). The exercises were chosen because they all include multiple joints; yet are low-impact and safe for older adults.
The participants’ range of motion was measured using a digital inclinometer at the beginning and end of the research. While the results didn’t show significant change in range of motion, anecdotal evidence suggests that the exercises did help the women more easily complete daily living tasks. Most of the participants reported feeling more comfortable and more confident, and all of them felt stronger.
Guggenheimer notes that not finding much in the way of measurable changes wasn’t surprising, given the limited six-week time frame. Many factors affect range of motion, he says. An important one is “compliance of the connective tissues around a joint.” That’s when tissues stretch enough to allow for full flexion and extension of the joint. Change in the pliancy of connective tissues doesn’t happen quickly.
The researchers initially wondered if their exercise plan would be too taxing on the women. Turns out, it wasn’t. Some study participants found the exercises too easy. In fact, they asked to do more. Guggenheimer and his team encouraged the women to continue with resistance training exercises after the study ended, as long as they’re doing so in a supervised and safe setting. Carondelet Village has a wellness center and an expert staff that works with residents.
Changes in mindset — the reports of study participants feeling more comfortable and more confident — weren’t measured in this study, which means follow-up research is in the works.
Guggenheimer has proposed a project this spring, working again with residents at Carondelet Village. The study will be longer in duration and will measure both physical and psychological results.
“I’m interested to know more about what they’re getting out of this psychologically,” he says. “I had some participants tell me after a few weeks that they were taking the stairs for the first time in a long time. I think the psychological change is resulting in a better quality of life for these people.”
In November, the research team shared its findings at Carondelet Village. “Of the 20 participants we started with, 17 attended the follow-up presentation, which says a lot about how receptive they were,” says Guggenheimer. So, he won’t have trouble recruiting for future research.
Guggenheimer, Ramsdell and Barrett will present their study and results in several venues over the next few months, including the April 2015 National Conference on Undergraduate Research in Cheney, Washington.