Evaluation of a Supervised Exercise Program in a Geriatric Population

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Abstract
Most studies that assess the effects of exercise in the elderly involve subjects who are in good health. The objective of this prospective longitudinal study was to examine the impact of exercise on cardiovascular fitness, flexibility, and strength in an elderly population that included chronically ill individuals. Patients were recruited initially from a population of veterans over 64 years of age who use a VA outpatient clinic as their regular source of care. The exercise intervention consisted of 90 minutes of exercise 3 days per week at 70% of the patient''s maximal capacity. Activities included stationary cycling stretching weight training, and walking. Of 69 patients who began the program, 49 (71%) reached 4-month follow-up. Most patients completing follow-up (76%) had at least one chronic disease, such as arthritis, hypertension, or heart disease. Patients who dropped out were more likely to have multiple chronic illnesses than those who remained in the program. Average weekly attendance was 65% and was stable over time. Improvements in cardiovascular fitness at 4-month follow-up were significant: Metabolic equivalents increased from 7.1 .+-. 2.3 to 8.3 .+-. 2.6 (P < .001), treadmill time increased from 8.5 .+-. 3.8 to 11.2 .+-. 4.2 minutes (P < .001), submaximal heart rate decreased from 123.7 .+-. 18.8 to 118.8 .+-. 19.4 beats per minutes (P < .001) and resting heart rate decreased from 68.1 .+-. 10.6 to 63.3 .+-. 11.6 beats per minute (P = .005). Hip flexibility also increased significantly from 58.5 .+-. 13.8 to 67.7 .+-. 9.9 degrees (P < .001), and abdominal strength increased significantly from 88.8 .+-. 32.4 to 104 .+-. 28.4 foot-pounds (P < .001). No major complications resulted from exercise. This study demonstrates that elderly individuals, including those with chronic diseases, will participate in an exercise program and experience improvements in cardiovascular fitness, strength, and flexibility. Whether these improvements will enable elderly individuals to live independently for a longer period of time and avoid or postpone the need for long-term care requires additional study and follow-up.

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