Exercise Training and Nutritional Supplementation for Physical Frailty in Very Elderly People

By Ty Sevin, Sep 01, 2021

< Back to Benefits of Strength Training on Physical Frailty in Older Adults

Maria A Fiatarone, M.D., Evelyn F. O'Neill, C.T.R.S., Nancy Doyle Ryan, D.T., Karen M. Clements, M.P.H., Guido R. Solares, Ph.D., Miriam E. Nelson Ph.D., Susan B. Roberts, Ph.D., Joseph). Kehayias, Ph.D., Lewis A. Lipsitz, M.D.,& William J. Evans, Ph.D. Hebrew Rehabilitation Center for Aged, Roslindale, MA; and the Department of Agriculture Human Nutrition Research Center on Aging, Tufts University; the Division on Aging, Harvard Medical School; the Department of Medicine, Beth Israel Hospital; the Gerontology Division, Brigham and Women's Hospital; the Division of Medical Physics, Department of Radiation Oncology, New England Medical Center all in Boston, MA.


The researchers randomly placed 100 frail nursing home residents aged 72-98 years into 4 separate groups for 10 weeks. They compared subjects engaged in: 1) strength training, 2) multi-nutrient supplementation, 3) both interventions, and 4) no intervention. Total energy intake was significantly increased only in the subjects who received both interventions (i.e. exercise & nutritional supplementation).


Ninety-four percent of the subjects (63 women and 37 men) completed the study. Muscle strength increased by about 113% in the subjects engaged in resistance training, as compared with about 3% in the non-exercising subjects. Gait velocity increased by about 11.8% in the exercisers but declined by about 1% in the non-exercisers. Stair climbing power also improved in the exercisers when compared with the non-exercisers (by ≈ 28% vs. ≈ 3.6%), as did the level of spontaneous physical activity. Cross-­sectional thigh-muscle increased ≈ 2.7% in the exercisers but declined by ≈ 1.8% in the non-exercisers. The nutritional supplement had no effect on any primary outcome measure (i.e. strength, gait, etc.).


High-intensity strength training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people. In contrast, multi-nutrient supplementation without exercise does not reduce muscle weakness or physical frailty. Nutritional supplementation has often been used to help prevent physical frailty among dependent & frail older adults. This research clearly demonstrates that providing strength training opportunities for the very frail would be a much more effective use of resources than supplementation to prevent frailty.

Keiser Equipment Used

Leg press

Published in The New England Journal of Medicine 330:1769-1775 June 23), 1994.

Link to Original Research

About the author

Ty Sevin

Director of Human Performance, Education and Research

Articles by Ty Sevin >

With over 25 years of coaching experience at both the collegiate and Olympic levels, Ty Sevin is one of the most influential track and field coaches in the country. Ty has worked for the United States Olympic Committee, serving as the Director of the Track and Field Residency Program at the USOC Olympic Training Center in Chula Vista, CA. He has also served as an assistant coach for Team USA on three separate occasions, for both the men’s and women’s teams. Ty himself was a four-time U.S. Olympics Trials qualifier in javelin. Ty most recently spent four years as the Associate Head Coach at the University of Texas at Austin for both the men’s and women’s track and field teams. Prior to that, he led the men’s and women’s track and cross-country teams at the University of New Orleans and McNeese State.

Currently, Ty applies his vast industry experience to the role of Director of Human Performance, Research and Education for Keiser Corporation, where he consults with college and professional sports teams regarding the utilization of Keiser strength equipment. He is also responsible for creating educational curriculum relating to human performance and overseeing Keiser research projects