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February 26, 2026Journal of Clinical Medicine0 citationsOpen Access

Can Progressive Strength Training Counteract Frailty and Improve Short-Term Autonomic Compensatory Responses During Active Standing Orthostatic Stress? A Pilot Study

DMDihogo GAMA de MatosJSJefferson Lima de SantanaFAFelipe J. Aidar

Key Result

Progressive strength training reduced the frailty index score by 78% from 0.18 to 0.04 after 12 weeks in pre-frail and frail older adults.

Key Points

  • This research aimed to evaluate the impact of progressive strength training on frailty and autonomic responses during active standing in older adults.
  • Participants underwent a 12-week progressive strength training program.
  • Physical activity levels, handgrip strength, and gait speed were measured at multiple time points.
  • Heart rate variability, cardiac parasympathetic modulation, and cardiac baroreceptor gain were assessed before and after training.
  • Frailty index scores decreased significantly by 78%.
  • Participants showed improvements in physical activity levels (152%), handgrip strength (13%), and gait speed (11%).
  • No autonomic response enhancements were observed despite improved frailty and physical function.

Structured PICO

Does a 12-week progressive strength training program improve frailty status and short-term autonomic compensatory responses in pre-frail or frail older adults?

P
Population
8 older adults (60–79 years) classified as pre-frail or frail according to the frailty index (FI)
I
Intervention
12-week progressive strength training (PST) program
O
Outcome
Frailty status (frailty index) and short-term autonomic compensatory responses (heart rate variability, cardiac parasympathetic modulation, and cardiac baroreceptor gain) during postural transitions at 8 and 12 weekssurrogate

A 12-week progressive strength training program significantly reduced frailty and improved physical function in older adults, though it did not alter short-term autonomic responses to orthostatic stress.

Main Result

Effect estimate: 78% reduction in Frailty Index score

Absolute Event Rate: 0.04% vs 0.18%

p-value: p=<0.001

Limitations

  • Small sample size (n=8) limits generalizability and statistical precision
  • No control group limits causal inference
  • Cardiac baroreceptor gain was measured at discrete time points, possibly missing transient changes
  • Short duration of 12 weeks may be insufficient for autonomic adaptations

Abstract

Background: Frailty is a multifactorial condition that significantly impacts older adults’ health and independence, which can be mitigated through training. This study examined the effects of a 12-week progressive strength training (PST) program on frailty status and short-term autonomic compensatory responses during postural transitions. Methods: Eight older adults (60–79 years) classified as pre-frail or frail according to the frailty index (FI) participated in a 12-week PST program. Time and frequency-domain heart rate variability (HRV) in the supine position, cardiac parasympathetic modulation (CPM) determined from the HR 30:15 ratio (longest RR interval around the 30th heartbeat divided by the shortest RR interval around the 15th heartbeat after standing), and cardiac baroreceptor gain (CBG) assessed as the ratio of heart rate change to systolic blood pressure drop (ΔHR/ΔSBP) at 30, 60, 180, and 420 s after standing were assessed at pre-test, 8 weeks and 12 weeks (autonomic function outcomes). Physical activity levels (PAL), handgrip strength (HGS), and gait speed (GS) were assessed, and orthostatic intolerance (OI) symptoms were self-reported at pre-test, 8 weeks, and 12 weeks. Results: After 12 weeks of PST, FI scores decreased from 0.18 to 0.04 (78% reduction). PAL, HGS, and GS improved by 152%, 13%, and 11%, respectively. Three of eight participants reported OI symptoms at pre-test, with no reported symptoms at week 12. Despite this, PST did not enhance short-term autonomic responses. Conclusions: PST counteracted frailty and improved physical and muscular function but did not enhance indices of short-term autonomic regulation in frail older people.

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Cite This Study

Matos et al. (2026) studied pre-frail or frail older adults (n=8). progressive strength training was evaluated on Frailty Index score change after 12 weeks of progressive strength training (78% reduction in Frailty Index score, p=<0.001). Progressive strength training reduced the frailty index score by 78% from 0.18 to 0.04 after 12 weeks in pre-frail and frail older adults.

synapsesocial.com/papers/699fe3af95ddcd3a253e7c6bhttps://doi.org/10.3390/jcm15051679
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Prospective Observational Study of Frailty in Geriatric Revitalization Aimed at Community-Dwelling Elderly2024 · 2 citations
  2. 2Effect of Strength Training on Orthostatic Hypotension in Older Adults1998 · 26 citations
  3. 3Cardiovascular regulation during active standing orthostatic stress in older adults living with frailty: a systematic review2025 · 3 citations
  4. 4A structured hybrid exercise programme for pre-frail older adults in primary care: A feasibility and pilot study2026
  5. 5Integrated Dynamic Autonomic and Cardiovascular Regulation during Postural Transitions in Older Adults Living with Frailty: A Systematic Review Protocol2022 · 1 citations