Adverse Events Reported in Progressive Resistance Strength Training Trials in Older Adults: 2 Sides of a Coin

doi:10.1016/j.apmr.2010.06.001

Archives of Physical Medicine and Rehabilitation

Volume 91, Issue 9, September 2010, Pages 1471-1473

Presented to the Gerontological Society of America, November 22, 2008, National Harbor, MD.

https://doi.org/10.1016/j.apmr.2010.06.001 Get rights and content

Abstract

Liu C, Latham N. Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin.

Objectives

To summarize adverse events reported in randomized controlled trials that applied progressive resistance strength training in older adults and to examine factors that might be associated with these events.

Design

After systematic searches of databases, 2 reviewers independently screened and extracted adverse event–related information from identified trials.

Setting

Not applicable.

Participants

Older adults 60 years of age and above (N = 6700).

Intervention

Muscle strength training exercise that increases load gradually.

Main Outcome Measures

Adverse events and reasons for dropout. Adverse events include any undesirable outcomes that may be directly related or unrelated to the intervention.

Results

Among 121 trials identified, 53 trials provided no comments about adverse events, 25 trials reported no adverse events occurred, and 43 trials reported some types of adverse events. Most adverse events reported were musculoskeletal problems such as muscle strain or joint pain. Adverse events were reported more often in trials that recruited participants with certain health conditions, functional limitations, or sedentary lifestyle; in trials that applied high intensity; and in trials that were published after the 2001 Consolidated Standards of Reporting Trials statement had been published. Reasons reported for dropout in 58 trials might be related to adverse events. The most frequent reasons for dropout were illness or medical problems.

Conclusions

Adverse events may be underreported because there is no consensus on the definition. Reporting adverse events associated with progressive resistance strength training in older adults is informative for practitioners to translate clinical research to clinical practice by knowing both the benefits and risks. Future trials should clearly define adverse events and report them in the published article.

Section snippets

Methods

The following electronic databases were searched to identify qualified trials: CINAHL—Cumulative Index to Nursing and Allied Health Literature (1982 to July 1, 2007), the Cochrane Central Register of Controlled Trials (1800 to February 1, 2007), Digital Dissertations (1905 to February 1, 2007), Embase (1980 to February 1, 2007); Medline (1966 to July 1, 2007), PEDro—The Physiotherapy Evidence Database (1929 to February 1, 2007), and SPORTDiscus (1948 to February 1, 2007). Text search terms

Results

One hundred twenty-one trials were identified (completed references were published elsewhere).³ Twenty-one trials (17%) had sample size larger than 50 in total; 71 trials (59%) had participants with certain chronic conditions (ie, osteoarthritis, stroke, congestive heart failure), functional limitations, or sedentary lifestyle; and 37 trials (31%) had a mean age of the sample older than 75 years. Additionally, the intervention program tended to be at high intensity—above 65% of 1 repetition

Discussion

Two issues emerged from the results. One was that AEs might be underreported given that only 68 (56%) of 121 trials provided comments on whether AEs occurred. Most AEs are musculoskeletal problems that may be related to improper exercise form or an underlying health condition. Trial investigators who did not provide comments might have followed data and safety monitoring policy in each individual research performance site but failed to report AE-related information in the publication if the

Conclusions

Reporting AEs that happen in an exercise intervention trial should be regarded as a standard in published articles, although the causality between the intervention and events often cannot be established. Instead of following a fixed intervention protocol from a clinical trial, practitioners need to tailor the intervention program to individual clients. To reap the benefits of progressive resistance strength training, information about AEs can help practitioners monitor and modify the

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: Supported by the National Institute on Disability and Rehabilitation Research (postdoctoral fellowship grant no. H133P001) to Boston University.

: No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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Brief reportAdverse Events Reported in Progressive Resistance Strength Training Trials in Older Adults: 2 Sides of a Coin

Abstract

Objectives

Design

Setting

Participants

Intervention

Main Outcome Measures

Results

Conclusions

Section snippets

Methods

Results

Discussion

Conclusions

Arch Phys Med Rehabil

The Framingham Disability Study: IIPhysical disability among the aging

Am J Public Health

Progressive resistance strength training for improving physical function in older adults

Cochrane Database of Systematic Reviews

Benefits of exercise for community-dwelling older adults

Arch Phys Med Rehabil

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium

Ann Behav Med

Brief report
Adverse Events Reported in Progressive Resistance Strength Training Trials in Older Adults: 2 Sides of a Coin