Resistance Training [Neurosurgery Wiki]

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====== Resistance Training ======

**Resistance [[training]]** (also called strength or weight training) involves exercises that cause muscles to contract against external resistance. It is a cornerstone intervention for preventing and reversing age-related musculoskeletal decline.

===== 💡 What Is Resistance Training? =====
  * Uses **weights**, **elastic bands**, **body weight**, or **machines** to provide resistance.
  * Aims to increase **muscle strength**, **endurance**, **bone density**, and **functional capacity**.
  * Can be adapted to all age groups and fitness levels.

===== 🧓 Benefits in Older Adults =====
  * Prevents and treats **sarcopenia** (muscle loss).
  * Improves **bone mineral density**, reducing risk of **osteoporosis** and fractures.
  * Enhances **balance**, **gait speed**, and **postural control**.
  * Reduces incidence of **falls**, **disability**, and **frailty**.
  * Supports **glucose metabolism**, **lipid profile**, and **mental health**.

===== 🏋️ Basic Principles =====
  * **Progressive overload**: Gradually increase resistance to stimulate adaptation.
  * **Specificity**: Target major muscle groups—legs, hips, back, chest, arms, abdomen.
  * **Frequency**: At least **2–3 non-consecutive days per week**.
  * **Volume**: 1–3 sets of 8–12 repetitions per exercise.
  * **Rest**: 48 hours between sessions of the same muscle group.

===== 📋 Sample Routine for Older Adults =====
**Warm-up (5–10 min)**: light cardio and dynamic stretches.

**Core exercises:**
  * Chair squats
  * Wall push-ups
  * Seated rows (resistance band)
  * Step-ups
  * Shoulder press (light dumbbells)
  * Heel raises
  * Core: seated knee lifts or bird-dog

**Cool-down**: static stretching for major muscle groups.

===== ⚠️ Safety Considerations =====
  * Start under supervision (e.g., physiotherapist or trainer).
  * Monitor for **pain**, **dizziness**, or **joint instability**.
  * Adjust loads for **osteoporosis**, **arthritis**, or **cardiovascular disease**.
  * Avoid **Valsalva maneuver** (holding breath during lifts).

===== 🧬 Biological Effects =====
  * ↑ Muscle protein synthesis (via mTOR activation).
  * ↑ Insulin sensitivity and glucose uptake.
  * ↑ Myokines (e.g., irisin) with systemic anti-inflammatory effects.
  * ↓ Myostatin (muscle growth inhibitor).

===== 📚 Evidence-Based Guidelines =====
  * **WHO (2020)**: ≥150 min of moderate activity/week + muscle strengthening 2x/week.
  * **EWGSOP2 (2019)**: Resistance training is **first-line intervention** in [[sarcopenia]].
  * **ACSM (2011)**: Recommends **multicomponent programs** for older adults (strength + balance + flexibility).