Archives of Physical Medicine and

Rehabilitation
OLEH
MUNA
NIM I4A013220
 The purpose of the research was to evaluate the effect of 2 different
exercise frequencies on multiple risk factors and diseases of the elderly in an
ambulatory group setting.

Summing up, the results verify the hypothesis that bone and muscle
have to be addressed with a frequency of at least 2 sessions/wk, while no
corresponding differences were determined for falls and CHD risk factors.
 The significance of results of present studies is based on
the following strong points:

(a) the results were derived from a randomized controlled trial

with a multicomponent protocol that positively impacted all the
parameters addressed in this study.
(b) Because of the adequate sample size among all groups, the
statistical power of the study is high enough to detect relevant
differences.
(c) The study was longer than most other corresponding exercise
studies. Thus, an effect triggered during the sensitive initial phase
does not guarantee a general long-term effectiveness.
(d) The study cohort was a relatively homogeneous group of
community-living women aged 65 to 80 years with no
medications or diseases affecting bone or muscle metabolism.
(e) Strong emphasis was placed on controlling for
confounders and monitoring the subjects adherence to
the study protocol.
(f) Group sessions were continuously supervised, and
the general intensity of the program was adequately
adapted throughout the study course.
From a statistical point of view, preplanned,
randomized doseresponse studies with subsequent
intention-to-treat analysis would have been preferable.
However, experience shows that the fundamental
weakness of this strategy is that a relevant number of
subjects do not exercise with the prescribed frequency
of the study arm to which they were allocated.
 In summary, the results indicate that a rather
high exercise frequency of 2 sessions/wk (on average
over the year!) has to be applied to relevantly impact
musculoskeletal parameters in the elderly, even if the
exercise intensity is relatively high.
 The strong interaction of exercise parameters
alone (eg, intensity vs duration vs frequency)
irrespective of other confounding factors (eg, exercise
principles, compliance, and status of the study
participants) makes it very likely that the minimum
effective dose of an isolated exercise parameter simply
does not exist.
TERIMAKASIH