The Efficacy and Safety of Lower-Limb Plyometric Training in Older Adults: A Systematic Review

Non invasive techniques for direct muscle quality assessment after exercise intervention in older adults: a systematic review

BACKGROUND

The aging process induces neural and morphological changes in the human musculoskeletal system, leading to a decline in muscle mass, strength and quality. These alterations, coupled with shifts in muscle metabolism, underscore the essential role of physical exercise in maintaining and improving muscle quality in older adults. Muscle quality's morphological domain encompasses direct assessments of muscle microscopic and macroscopic aspects of muscle architecture and composition. Various tools exist to estimate muscle quality, each with specific technical requirements. However, due to the heterogeneity in both the studied population and study methodologies, there is a gap in the establishment of reference standards to determine which are the non-invasive and direct tools to assess muscle quality after exercise interventions. Therefore, the purpose of this review is to obtain an overview of the non-invasive tools used to measure muscle quality directly after exercise interventions in healthy older adults, as well as to assess the effects of exercise on muscle quality.

MAIN TEXT

To address the imperative of understanding and optimizing muscle quality in aging individuals, this review provides an overview of non-invasive tools employed to measure muscle quality directly after exercise interventions in healthy older adults, along with an assessment of the effects of exercise on muscle quality.

RESULTS

Thirty four studies were included. Several methods of direct muscle quality assessment were identified. Notably, 2 studies harnessed CT, 20 utilized US, 9 employed MRI, 2 opted for TMG, 2 adopted myotonometry, and 1 incorporated BIA, with several studies employing multiple tests. Exploring interventions, 26 studies focus on resistance exercise, 4 on aerobic training, and 5 on concurrent training.

CONCLUSIONS

There is significant diversity in the methods of direct assessment of muscle quality, mainly using ultrasound and magnetic resonance imaging; and a consistent positive trend in exercise interventions, indicating their efficacy in improving or preserving muscle quality. However, the lack of standardized assessment criteria poses a challenge given the diversity within the studied population and variations in methodologies.. These data emphasize the need to standardize assessment criteria and underscore the potential benefits of exercise interventions aimed at optimizing muscle quality.

Effects of plyometric training on health-related physical fitness in untrained participants: a systematic review and meta-analysis

Plyometric training (PT) is an effective training method for improving physical fitness among trained individuals; however, its impact on health-related physical fitness in untrained participants remains ambiguous. Therefore, this meta-analysis aimed to evaluate the effects of PT on health-related physical fitness among untrained participants. Six electronic databases (PubMed, CINAHL Plus, MEDLINE Complete, Web of Science Core Collection, SCOPUS, and SPORTDiscus) were systematically searched until March 2024. We included controlled trials that examined the effects of PT on health-related physical fitness indices in untrained participants. Twenty-one studies were eligible, including a total of 1263 participants. Our analyses revealed small to moderate effects of PT on body mass index, muscular strength, cardiorespiratory fitness, and flexibility (ES = 0.27-0.61; all p > 0.05). However, no significant effects were detected for body fat percentage and lean mass (ES = 0.21-0.41; all p > 0.05). In conclusion, the findings suggest that PT may be potentially effective in improving health-related physical fitness indices (i.e., body mass index, muscular strength, cardiorespiratory fitness, and flexibility) in untrained participants. However, the results should be interpreted cautiously due to data limitations in some fitness variables.

Effects of plyometric training on skill-related physical fitness in badminton players: A systematic review and meta-analysis

Skill-related physical fitness significantly correlates with sports performance. Plyometric training (PT) is an effective method for improving physical fitness in athletes. However, its impact on skill-related physical fitness in badminton players remains uncertain. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of PT on skill-related physical fitness in badminton players. Five electronic databases (Web of Science, PubMed, SCOPUS, MEDLINE, and SPORTSDiscus) were searched until February 2024. A PICOS approach was used to identify inclusion criteria, (1) healthy badminton players, (2) a PT program, (3) an active control group, (4) a measure of skill-related physical fitness before and after PT, and (5) randomized controlled studies. The PEDro scale was used to assess the methodological quality of PT studies, while the level of evidence certainty was determined through the GRADE framework. The calculation of effect sizes (ESs) was based on mean values and standard deviations, and heterogeneity was measured with the I2 statistic. The extended Egger's test was employed to check for publication bias. Eleven studies comprising 445 badminton players were eligible for inclusion. The analysis revealed significant small-to-moderate effects of PT on power (ES = 0.60, p < 0.001), agility (ES = 0.96, p < 0.001), speed (ES = 0.63, p = 0.001), and balance (ES = 0.89; p = 0.013). However, no significant effect was observed for reaction time (ES = 0.56; p = 0.189). The certainty of evidence for outcomes was graded as either low or very low. In conclusion, our findings demonstrate that PT improved power, agility, speed, and balance, but not reaction time in badminton players. However, the small number of studies and the very low to low certainty evidence mean that these results need to be interpreted with caution.

Effects of plyometric training on measures of physical fitness in racket sport athletes: a systematic review and meta-analysis

Background

Over the past decade, the popularity of racket sports has surged. Plyometric training (PT) has been the focus of extensive research because of the proven benefits it provides to athletes. However, there is a lack of systematic reviews and meta-analyses specifically evaluating the impact of PT on physical fitness metrics in racket sport athletes. This study aimed to conduct a comprehensive review and analysis of evidence derived from randomized controlled trials (RCTs) to evaluate the effects of PT on measures of physical fitness among racket sports athletes.

Methods

The electronic databases PubMed, Web of Science, SCOPUS, and SPORTDiscus were systematically searched up to June 2023 without placing any restrictions on the publication dates. The PICOS method was adopted to establish the inclusion criteria: (a) healthy athletes who participate in racket sports; (b) a PT program; (c) a control group; (d) assessment of physical fitness components pre- and post-PT; and (e) RCTs. The records' methodological quality was assessed utilizing the Physiotherapy Evidence Database (PEDro) scale. The certainty in the evidence related to each outcome was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. A random-effects model was used to calculate effect sizes (ES; Hedges' g) between experimental and control groups.

Results

There were 14 eligible studies of moderate-to-high-quality, involving 746 athletes in total. The results revealed small-to-moderate effects (p < 0.05) of PT on muscle power (ES = 0.46), muscle strength (ES = 0.50), sprint speed (ES = 0.45), change of direction ability (ES = 0.76), and reaction time (ES = 0.67), while no clear evidence was found on balance and flexibility. The training-induced changes in muscle power showed no significant difference (p > 0.05) between youth (ES = 0.72) and adults (ES = 0.40). There were also similar muscle power improvements (ES = 0.36-0.54 vs 0.38-0.56, all p > 0.05) for a length of ≤7 weeks with ≤14 total PT sessions vs >7 weeks with >14 total PT sessions, and ≤2 weekly sessions vs >2 sessions. No adverse effects were reported in the included studies regarding the PT intervention. The certainty of evidence varied from very low to moderate. Conclusions: Our findings demonstrated that PT has positive effects on important indices of physical fitness among athletes participating in racket sports. Future studies are required to clarify the optimal doses and examine interactions among training variables to further promote the physical fitness of this specific population.

Agility training to integratively promote neuromuscular, cardiorespiratory and cognitive function in healthy older adults: a one-year randomized-controlled trial

BACKGROUND

Exercise training recommendations for seniors include the targeted training of strength, balance, endurance and flexibility domains. Agility training (AT) is conceptualized as a multi-component and time-efficient training framework for older adults to improve physical, functional and cognitive health domains that are relevant for maintaining activities of daily living. The aim of this one-year trial was to comparatively evaluate the effects of agility training on physical and cognitive function.

METHODS

Seventy-nine healthy older adults (AT: 61.5% female, 70.8 ± 4.8 years, 27.7 ± 4.2 kg/m2; CG: 60.5% female, 69.6 ± 4.7 years, 27.5 ± 4.4 kg/m2) took part in this one-year randomized controlled intervention and were either assigned to the agility training group (AT) with two weekly 60 min AT sessions or to the control group (CG), receiving no treatment. Participants were assessed pre, intermediate and post intervention for strength and power, balance, gait speed under multi-task conditions, aerobic capacity as well as cognitive performance. Linear mixed effects models were used to analyze the effect of treatment over time.

RESULTS

Fifty-four participants (AG: 25, CG: 29) were analyzed, most drop-outs attributed to COVID-19 (17/30 dropouts). Adherence was good (75%) of 90 offered sessions. Notable effects in favor of AT were found for gait parameters in single (d = 0.355, Δ = 4.3%), dual (d = 0.375, Δ = 6.1%) and triple (d = 0.376, Δ = 6.4%) task conditions, counter movement jump performance (strength and power) (d = 0.203, Δ = 6.9%), static one leg balance (d = 0.256, Δ = 12.33%) and n-back reaction time (cognitive performance) (d = 0.204, Δ = 3.8%). No effects were found for the remaining outcomes (d < 0.175).

CONCLUSION

AT might serve as an integrative training approach for older adults particularly improving gait and lower limb power parameters. It seems suitable to improve a broad range of seniors' health domains and should replace isolated training of these domains. However, individual variation and progression of exercises should be considered when programming agility training providing adequate challenges throughout a long-term intervention for all participants.

TRIAL REGISTRATION

DRKS, DRKS00017469 . Registered 19 June 2019-Retrospectively registered.

Efficacy of Preoperative Physiotherapy Protocols in a 30-Year-Old Patient With Bilateral Osteoarthritis of Hip Secondary to Avascular Necrosis

Osteoarthritis (OA) of the hip is a rare condition that occurs in adults can be a result of avascular necrosis or a history of steroids that can wear away the articulating cartilage of the hip joint causing friction, pain in the groin region, stiffness, and decreased functional mobility. We present a 30-year-old adult who came with chief complaints of pain in the groin region, stiffness, difficulty in walking, and experiencing pain while walking, which had reduced his activity of daily living. The investigation was done, and the patient was diagnosed with bilateral hip OA secondary to avascular necrosis. To reduce morbidity, preoperative physiotherapy management for eight weeks was planned and started before the operation. The purpose was to educate the patient about the condition, reduce pain, increase the ranges of the hip, improve strength, and provide gait re-education. We added basic proprioception training and plyometric exercises for the hip to improve strength and balance. At the end of the session patient, positive results were achieved. The progress of proprioception or balance training can be improved by using single-leg balance as an outcome measure. Hence, our study aims to use exercise therapy to reduce or postpone the need for hip arthroscopy. However, future research should focus on plyometric exercises for the lower limbs or any abnormalities associated with the lower limbs. However, they should be carried out when some recovery is observed in patients.

Effects of Plyometric Training on Physical Performance: An Umbrella Review

BACKGROUND

Plyometric training can be performed through many types of exercises involving the stretch-shortening cycle in lower limbs. In the last decades, a high number of studies have investigated the effects of plyometric training on several outcomes in different populations.

OBJECTIVES

To systematically review, summarize the findings, and access the quality of published meta-analyses investigating the effects of plyometric training on physical performance.

DESIGN

Systematic umbrella review of meta-analyses.

DATA SOURCES

Meta-analyses were identified using a systematic literature search in the databases PubMed/MEDLINE, Scopus, SPORTDiscus, Web of Science, Cochrane Library and Scielo.

ELIGIBILITY CRITERIA FOR SELECTING META-ANALYSES

Meta-analyses that examined the effects of plyometric training on physical fitness in different populations, age groups, and sex.

RESULTS

Twenty-nine meta-analyses with moderate-to-high methodological quality were included in this umbrella review. We identified a relevant weakness in the current literature, in which five meta-analyses included control group comparisons, while 24 included pre-to-post-effect sizes. Trivial-to-large effects were found considering the effects of plyometric training on physical performance for healthy individuals, medium-trivial effects for the sports athletes' groups and medium effects for different sports athletes' groups, age groups, and physical performance.

CONCLUSION

The available evidence indicates that plyometric training improves most related physical fitness parameters and sports performance. However, it is important to outline that most meta-analyses included papers lacking a control condition. As such, the results should be interpreted with caution. PROSPERO number: CRD42020217918.

Effects of Combined Upper and Lower Limb Plyometric Training Interventions on Physical Fitness in Athletes: A Systematic Review with Meta-Analysis

Objective: We aimed to meta-analyze the effects of combined upper and lower limb plyometric training (ULLPT) on physical fitness attributes in athletes. Methods: A systematic literature search was conducted in Web of Science, SPORTDiscus, PubMed, and SCOPUS, for up to 13 August 2022. Controlled studies with baseline and follow-up measures were included if they examined the effects of ULLPT on at least one measure of physical fitness indices in athletes. A random effects meta-analysis was performed using the Comprehensive Meta-Analysis software. Results: Fifteen moderate-to-high-quality studies with 523 participants aged 12−22.4 years were included in the analyses. Small to large (ES = 0.42−1.66; p = 0.004 to <0.001) effects were noted for upper and lower body muscle power, linear sprint speed, upper and lower body muscle strength, agility, and flexibility, while no significant effects on static and dynamic balance were noted (ES = 0.44−0.10; all p > 0.05). Athletes’ sex, age, and training program variables had no modulator role on the effects of ULLPT in available data sets. Conclusions: ULLPT induces distinct neuro-muscular adaptations in the upper and lower body musculature and is an efficient method for enhancing athletes’ physical fitness.

CHANGES IN LOWER LIMB BONE DENSITY IN YOUNG JUMPERS

ABSTRACT Introduction The research on the exercise effect on the human bone density and skeletal muscle content mainly focuses on the middle-aged and elderly population. However, few studies on different sports’ effects upon bone and muscle density in college students and adolescents. Objective Study the effect of physical training on bone density and lower limb jumping ability in young people. Methods The relationship between bone mineral density and lower limb jumping ability was analyzed by mathematical statistics. Male individuals aged 10-20 years were divided into the early adolescence group (n=26) and late adolescence group (n=37). According to training status, they were divided into preadolescent athletic group (n=11), non-athletic group (n=15); puberty athletic group (n=11) and non-athletic group (n=15). The following indicators were used: bone density, vertical jump test, continuous vertical jump test, RDJ index. Results Athletes’ bone mineral density (BMD) is related to their muscle strength. These results suggest a certain internal connection between the (BMD) of bone tissue and the development of muscle strength. Therefore, there is evidence of differences in lower limb bone mineral density and jumping ability between the two groups. Conclusion Bone mineral density in the lower limbs of adolescents is correlated with jumping ability. Exercise can help improve bone density in adolescents. Evidence level II; Therapeutic Studies - Investigating the results.

Effects of Different Acute Plyometric Training Intensities on Attention and Psychological States

The objective of this investigation was to explore in a sample of female students the effects of several acute plyometric training intensities (low, moderate, and high-55-65%, 70-80%, and 90-100% of maximal vertical jump performance, respectively) on cognition (attention) and psychological states (mood). Thirty-seven female students (mean age = 19.72 ± 0.73 years, mean body mass index = 19.51) participated in the current study. They were randomly allocated to one of three conditions: a high-intensity plyometric exercise (HIPE), a moderate-intensity plyometric exercise (MIPE), and a low-intensity plyometric exercise (LIPE). Before and immediately after each session for the three conditions, all participants underwent a cognitive performance test (d2 test) and filled in a battery of psychological questionnaires (the Rating of Perceived Exertion (RPE), and the Brunel Mood Scale (BRUMS)). The data reported higher concentration performance and a lower number of errors in the MIPE when compared with HIPE (all, p-value < 0.05) groups, whereas no significant difference was found between other conditions (p-value > 0.05). The RPE value was higher in the HIPE (p-value < 0.001) and MIPE (p = 0.01) than in the LIPE, and in the HIPE than in the MIPE (p = 0.001) conditions. Concerning the BRUMS scale, fatigue (p = 0.005) was significantly different among the various conditions, being higher in HIPE with respect to MIPE and LIPE (all, p-value < 0.05) conditions. In conclusion, moderate-intensity plyometric exercise can be considered the best activity to improve visual attention. Practitioners may practice moderate-intensity plyometric exercises to improve concentration performance. However, due to the limitations of the present study (lack of a control group and between-subjects study design), further research in the field is warranted.

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review

BACKGROUND

Physical activity and a healthy diet are important in helping to maintain mobility with aging. This umbrella review aims to identify group-based physical activity and/or nutrition interventions for community-dwelling older adults that improve mobility-related outcomes.

METHODS

Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological Abstracts) were searched from inception to December 2021. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity or structured exercise, alone or combined with nutrition interventions on mobility-related outcomes (aerobic capacity, physical function, balance, falls/safety, muscle strength, health-related quality of life/wellbeing). Interventions must have been delivered in a group setting to community-dwelling older adults aged 55+. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. The GRADE approach was used to reflect the certainty of evidence based on the size of the effect within each mobility-related outcome category. Older adult/provider research partners informed data synthesis and results presentation.

RESULTS

In total, 62 systematic reviews (1 high, 21 moderate, 40 low/critically low quality) were identified; 53 included physical activity only, and nine included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity.

CONCLUSIONS

Group-based physical activity interventions that combine aerobic and resistance, general PA and mind-body exercise can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.

Effect of Plyometric Jump Training on Skeletal Muscle Hypertrophy in Healthy Individuals: A Systematic Review With Multilevel Meta-Analysis

Objective: To examine the effect of plyometric jump training on skeletal muscle hypertrophy in healthy individuals. Methods: A systematic literature search was conducted in the databases PubMed, SPORTDiscus, Web of Science, and Cochrane Library up to September 2021. Results: Fifteen studies met the inclusion criteria. The main overall finding (44 effect sizes across 15 clusters median = 2, range = 1-15 effects per cluster) indicated that plyometric jump training had small to moderate effects [standardised mean difference (SMD) = 0.47 (95% CIs = 0.23-0.71); p < 0.001] on skeletal muscle hypertrophy. Subgroup analyses for training experience revealed trivial to large effects in non-athletes [SMD = 0.55 (95% CIs = 0.18-0.93); p = 0.007] and trivial to moderate effects in athletes [SMD = 0.33 (95% CIs = 0.16-0.51); p = 0.001]. Regarding muscle groups, results showed moderate effects for the knee extensors [SMD = 0.72 (95% CIs = 0.66-0.78), p < 0.001] and equivocal effects for the plantar flexors [SMD = 0.65 (95% CIs = -0.25-1.55); p = 0.143]. As to the assessment methods of skeletal muscle hypertrophy, findings indicated trivial to small effects for prediction equations [SMD = 0.29 (95% CIs = 0.16-0.42); p < 0.001] and moderate-to-large effects for ultrasound imaging [SMD = 0.74 (95% CIs = 0.59-0.89); p < 0.001]. Meta-regression analysis indicated that the weekly session frequency moderates the effect of plyometric jump training on skeletal muscle hypertrophy, with a higher weekly session frequency inducing larger hypertrophic gains [β = 0.3233 (95% CIs = 0.2041-0.4425); p < 0.001]. We found no clear evidence that age, sex, total training period, single session duration, or the number of jumps per week moderate the effect of plyometric jump training on skeletal muscle hypertrophy [β = -0.0133 to 0.0433 (95% CIs = -0.0387 to 0.1215); p = 0.101-0.751]. Conclusion: Plyometric jump training can induce skeletal muscle hypertrophy, regardless of age and sex. There is evidence for relatively larger effects in non-athletes compared with athletes. Further, the weekly session frequency seems to moderate the effect of plyometric jump training on skeletal muscle hypertrophy, whereby more frequent weekly plyometric jump training sessions elicit larger hypertrophic adaptations.

Comparison of Power Training vs Traditional Strength Training on Physical Function in Older Adults: A Systematic Review and Meta-analysis

IMPORTANCE

Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under control) and power training (PT) (lifting weights fast and lowering under control) are associated with improved physical function in older adults is not clear.

OBJECTIVE

To evaluate whether PT vs traditional strength training is associated with physical function improvement in older adults.

DATA SOURCES

Systematic searches of MEDLINE, Embase, Cochrane Central, CINAHL, PsycInfo, PEDro, and SPORTDiscus were conducted from database inception to October 20, 2021.

STUDY SELECTION

Randomized clinical trials (RCTs) that compared strength training with instructions to move the weight as fast as possible in the lifting phase with traditional strength training in healthy, community-living older adults (age ≥60 years).

DATA EXTRACTION AND SYNTHESIS

Two authors independently selected trials, extracted data, assessed the risk of bias using the Cochrane risk-of-bias tool 2, and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Summary effect size measures were calculated using a multilevel random-effects model with cluster robust variance estimation and are reported as standardized mean differences (SMDs). Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline.

MAIN OUTCOMES AND MEASURES

Primary outcomes included physical function and self-reported physical function. Secondary outcomes included power, strength, muscle mass, walk speed, balance, and adverse effects.

RESULTS

A total of 20 RCTs enrolling 566 community-living older adults (mean [SD] age, 70.1 [4.8] years; 368 [65%] women) were included. For the primary outcomes, PT was associated with an improvement in physical function with low-certainty evidence in 13 RCTs (n = 383) (SMD, 0.30; 95% CI, 0.05-0.54) and self-reported function with low-certainty evidence in 3 RCTs (n = 85) (SMD, 0.38; 95% CI, -0.62 to 1.37). The evidence was downgraded by 2 levels for high risk of bias and imprecision for physical function and very serious imprecision for self-reported physical function.

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, PT was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.

Flywheel Training in Older Adults—A Systematic Review

The process of healthy aging might be reconsidered, based on the nonfatal outcomes of falls in older adults. Flywheel training is a relatively new training method used by different age groups, which enables the muscles to contract at maximum force in minimum time. The study aim was to summarize the relevant literature about the effects of flywheel training in older adults and to determine its efficiency and feasibility. PRISMA guidelines were followed for both the search and analysis. Electronic databases (Google Scholar, PubMed, Science Direct, Scopus, Web of Science and SPORTDiscuss) yielded 9915 studies, but we have included studies published in English between 2005 and 2021, cross-sectional and pre-post treatments, with older adults (≥60 years) as the sample, where flywheel training was conducted. A total of nine studies have met the pre-defined criteria and entered the systematic review, with a total of 216 participants, both male and female. After analyzing the obtained results, it can be concluded that flywheel training showed physical, neuromuscular, and functional improvements in older adults. However, the review did not reveal an optimal duration, frequency, intensity, or volume. Furthermore, it can be stated that this training method can be considered as an appropriate form of activity in older adults, as a tool for improving overall health.

Effects of Plyometric Jump Training on Balance Performance in Healthy Participants: A Systematic Review With Meta-Analysis

Background: Postural balance represents a fundamental movement skill for the successful performance of everyday and sport-related activities. There is ample evidence on the effectiveness of balance training on balance performance in athletic and non-athletic population. However, less is known on potential transfer effects of other training types, such as plyometric jump training (PJT) on measures of balance. Given that PJT is a highly dynamic exercise mode with various forms of jump-landing tasks, high levels of postural control are needed to successfully perform PJT exercises. Accordingly, PJT has the potential to not only improve measures of muscle strength and power but also balance. Objective: To systematically review and synthetize evidence from randomized and non-randomized controlled trials regarding the effects of PJT on measures of balance in apparently healthy participants. Methods: Systematic literature searches were performed in the electronic databases PubMed, Web of Science, and SCOPUS. A PICOS approach was applied to define inclusion criteria, (i) apparently healthy participants, with no restrictions on their fitness level, sex, or age, (ii) a PJT program, (iii) active controls (any sport-related activity) or specific active controls (a specific exercise type such as balance training), (iv) assessment of dynamic, static balance pre- and post-PJT, (v) randomized controlled trials and controlled trials. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. This meta-analysis was computed using the inverse variance random-effects model. The significance level was set at p <0.05. Results: The initial search retrieved 8,251 plus 23 records identified through other sources. Forty-two articles met our inclusion criteria for qualitative and 38 for quantitative analysis (1,806 participants [990 males, 816 females], age range 9-63 years). PJT interventions lasted between 4 and 36 weeks. The median PEDro score was 6 and no study had low methodological quality (≤3). The analysis revealed significant small effects of PJT on overall (dynamic and static) balance (ES = 0.46; 95% CI = 0.32-0.61; p < 0.001), dynamic (e.g., Y-balance test) balance (ES = 0.50; 95% CI = 0.30-0.71; p < 0.001), and static (e.g., flamingo balance test) balance (ES = 0.49; 95% CI = 0.31-0.67; p < 0.001). The moderator analyses revealed that sex and/or age did not moderate balance performance outcomes. When PJT was compared to specific active controls (i.e., participants undergoing balance training, whole body vibration training, resistance training), both PJT and alternative training methods showed similar effects on overall (dynamic and static) balance (p = 0.534). Specifically, when PJT was compared to balance training, both training types showed similar effects on overall (dynamic and static) balance (p = 0.514). Conclusion: Compared to active controls, PJT showed small effects on overall balance, dynamic and static balance. Additionally, PJT produced similar balance improvements compared to other training types (i.e., balance training). Although PJT is widely used in athletic and recreational sport settings to improve athletes' physical fitness (e.g., jumping; sprinting), our systematic review with meta-analysis is novel in as much as it indicates that PJT also improves balance performance. The observed PJT-related balance enhancements were irrespective of sex and participants' age. Therefore, PJT appears to be an adequate training regime to improve balance in both, athletic and recreational settings.

The Effectiveness of Aquatic Plyometric Training in Improving Strength, Jumping, and Sprinting: A Systematic Review

CONTEXT

Aquatic plyometric training may provide benefits due to reduced joint loading compared with land plyometric training; however, the reduced loading may also limit performance gains.

OBJECTIVE

To systematically review the effect of aquatic plyometric training on strength, performance outcomes, soreness, and adverse events in healthy individuals.

EVIDENCE ACQUISITION

Five databases were searched from inception to June 2020. Quality assessment and data extraction were independently completed by 2 investigators. When similar outcome measures were used, standardized mean differences were calculated.

EVIDENCE SYNTHESIS

A total of 19 randomized controlled trials with 633 participants (mean age, range 14-30 y) were included. Aquatic plyometric training was most commonly performed in waist to chest deep water (12/19 studies), 2 to 3 times per week for 6 to 12 weeks (18/19 studies), with final program foot contacts ranging from 120 to 550. Meta-analyses were not completed due to the clinical and statistical heterogeneity between studies. Compared with land plyometric training, aquatic plyometric training exercises and dosage were replicated (15/16 studies) and showed typically similar performance gains (3/4 knee extensor strength measures, 2/4 leg extensor strength measures, 3/4 knee flexor strength measures, 7/10 vertical jump measures, 3/3 sprint measures). In total, 2 of 3 studies monitoring muscle soreness reported significantly less soreness following training in water compared with on land. Compared with no active training (no exercise control group or passive stretching), most effect sizes demonstrated a mean improvement favoring aquatic plyometric training (23/32 measures). However, these were not significant for the majority of studies measuring isokinetic knee strength, vertical jump, and sprinting. The effect sizes for both studies assessing leg press strength indicated that aquatic plyometric training is significantly more effective than no training.

CONCLUSION

Aquatic plyometric training appears similarly effective to land plyometric exercise for improving strength, jumping, and sprinting and may be indicated when joint impact loading needs to be minimized. However, the low quality of studies limits the strength of the conclusions.

The Efficacy of Brief School-Based Exercise Programs in Improving Pubertal Bone Mass and Physical Fitness: A Randomized Controlled Trial

PURPOSE

To examine the effects of three types of school-based exercises on bone health and physical fitness function in Chinese boys and girls.

METHODS

One hundred and seventy-four Chinese boys and girls were randomly assigned into four groups: (1) sham exercise (ShEx); (2) high-impact exercise (HiEx); (3) high-impact exercise with various directions (HiExVi); and (4) high-intensity interval exercise (HiInEx). Speed of sound (SOS) and physical fitness parameters were determined before and after six-month intervention.

RESULTS

At the end of six-month intervention, participants in all groups show an increment of SOS compared with the baseline (p < 0.05), and the changes were higher in HiEx (mean: 38.878 m/s, 95% CI: 32.885~44.872, p = 0.001) and HiExVi groups (49.317 m/s, 42.737~55.897, p < 0.001) compared with ShEx group (20.049 m/s, 13.751~26.346). Six-month exercise training generated a reduction of percent of body fat (PBF) and waist-hip ratio (WHR) (p < 0.05). The decrease of PBF was greater in HiExVi (-1.222%, -1.820~-0.624, p = 0.012) and HiInEx groups (-1.395%, -1.809~-0.982, p = 0.003), whereas the reduction of WHR was larger in HiEx (-0.026, -0.039~-0.014, p = 0.009), HiExVi (-0.024, -0.036~-0.012, p = 0.021), and HiInEx groups (-0.035, -0.046~-0.024, p < 0.001) compared with ShEx group. Balance function (BLF), vital capacity (VC), standing long jump (SLJ), and sit up (SU) increased in all intervention groups (p < 0.05). The BLF increased in HiEx (6.332 s, 4.136~8.528, p = 0.001), HiExVi (10.489 s, 8.934~12.045, p < 0.001), and HiInEx groups (9.103 s, 7.430~10.776, p < 0.001) showed a greater change than that of ShEx group (1.727 s, 0.684~2.770). The increment of VC (273.049 mL, 199.510~346.587, p < 0.001) and SU (2.537 times/min, 0.639~4.435, p = 0.017) was higher in HiInEx group, whereas the accrual in SLJ was larger in HiExVi (7.488 cm, 4.936~10.040, p = 0.007) compared with ShEx group (58.902 mL, 7.990~109.814; -0.463 times/min, -2.003~1.077; 1.488 cm, -0.654~3.630).

CONCLUSION

The brief school-based exercises were effective in improving schoolchildren's health, but they showed different effects, with HiEx mostly improving bone health, HiInEx largely benefiting physical fitness function, and HiExVi enhancing both bone and physical fitness.

Effects of plyometric vs. resistance training on skeletal muscle hypertrophy: A review

OBJECTIVE

In this review, we critically evaluate studies directly comparing the effects of plyometric vs. resistance training on skeletal muscle hypertrophy.

METHODS

We conducted electronic searches of PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science to find studies that explored the effects of plyometric vs. resistance training on muscle hypertrophy.

RESULTS

Eight relevant studies were included in the review. Six studies compared the effects of plyometric vs. resistance training on muscle hypertrophy, while 2 studies explored the effects of combining plyometric and resistance training vs. isolated resistance training on acute anabolic signaling or muscle hypertrophy. Based on the results of these studies, we conclude that plyometric and resistance training may produce similar effects on whole muscle hypertrophy for the muscle groups of the lower extremities. Therefore, it seems that plyometric training has a greater potential for inducing increases in muscle size than previously thought. Despite the findings observed at the whole muscle level, the evidence for the effects of plyometric training on hypertrophy on the muscle fiber level is currently limited for drawing inferences. Compared to isolated resistance training, combining plyometric and resistance exercise does not seem to produce additive effects on anabolic signaling or muscle growth; however, this area requires future study. The limitations of the current body of evidence are that the findings are specific to (a) musculature of the lower extremities, (b) short-term training interventions that lasted up to 12 weeks, and (c) previously untrained or recreationally active participants.

CONCLUSION

This review highlights that plyometric and resistance training interventions may produce similar effects on whole muscle hypertrophy, at least for the muscle groups of the lower extremities, in untrained and recreationally trained individuals, and over short-term (i.e., ≤12 weeks) intervention periods.

Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers

Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.

Evaluation of short-term multi-component exercise programming on major variables that directly influence fall risk in older women: a pilot study

Falls are linked to gait and balance inconsistencies influenced by a combination of variables including muscle strength and power. Multicomponent athlete training models that incorporate high-intensity challenging activities have been shown to significantly improve strength, power, and balance. This study evaluated the efficacy of a short-term multi-component dynamic training program on strength, power, and balance in older women. Seventeen women participated in 8-weeks of specialized exercise training. Significant changes were observed in all performance variables from baseline. Results suggest short-term, high intensity multi-component programming can be used safely and effectively to improve major variables that influence falls in older women.

Utilisation of Post-Activation Performance Enhancement in Elderly Adults

With age, many physiological changes occur in the human body, leading to a decline in biological functions, and those related to the locomotor system are some of the most visible. Hence, there is a particular need to provide simple and safe exercises for the comprehensive development of physical fitness among elderly adults. The latest recommendations for the elderly suggest that the main goal of training should be to increase muscle power. The post-activation performance enhancement effect underpinning complex training might be an approach that will allow for the development of both muscle strength and velocity of movement, which will result in an increase in muscle power and improve the ability to perform daily activities and decrease injury risk. This article briefly introduces a complex training model adapted to the elderly with its potential benefits and proposes a direction for further studies.

Morning fatigue and structured exercise interact to affect non-exercise physical activity of fit and healthy older adults

Background

Exercise training is crucial for maintaining physical and mental health in aging populations. However, as people participate in structured exercise training, they tend to behaviorally compensate by decreasing their non-exercise physical activity, thus potentially blunting the benefits of the training program. Furthermore, physical activity of older adults is substantially influenced by physical feelings such as fatigue. Nevertheless, how older people react to day-to-day fluctuations of fatigue and whether fatigue plays a role in non-exercise physical activity compensation is not known. Thus, the purpose of this study was twofold: (1) To explore whether the volume and intensity of habitual physical activity in older adults were affected by morning fatigue. (2) To investigate the effect of attending power and resistance exercise sessions on the levels of non-exercise physical activity later that day and the following day.

Methods

Twenty-eight older adults wore an accelerometer during a 4-week low-volume, low-intensity resistance and power training program with three exercise sessions per week and for 3 weeks preceding and 1 week following the program. During the same period, the participants were prompted every morning, using text messages, to rate their momentary fatigue on a scale from 0 to 10.

Results

Greater morning fatigue was associated with lower volume (p = 0.002) and intensity (p = 0.017) of daily physical activity. Specifically, one point greater on the fatigue scale was associated with 3.2 min (SE 1.0) less moderate-to-vigorous physical activity. Furthermore, attending an exercise session was associated with less moderate-to-vigorous physical activity later that day by 3.7 min (SE 1.9, p = 0.049) compared to days without an exercise session. During the next day, the volume of physical activity was greater, but only in participants with a body mass index up to 23 (p = 0.008).

Conclusions

Following low-volume exercise sessions, fit and healthy older adults decreased their non-exercise physical activity later that day, but this compensation did not carry over into the next day. As momentary morning fatigue negatively affects daily physical activity, we suggest that the state level of fatigue should be monitored during intensive exercise programs, especially in less fit older adults with increased fatigability.

Utilization of Safe Fall Landing Strategies in Physical Therapist Management of Geriatric Populations: A Case Report

OBJECTIVE

Safe fall landing strategies (SFLS) have shown promise to decrease injury during falls but have been examined primarily in young, healthy populations. There is emerging evidence to suggest SFLS can be safe and effective for a geriatric population; however, this intervention has not been examined in a clinical physical therapist practice setting. This case study seeks to determine how SFLS can be incorporated into a physical therapy program with a geriatric population.

METHODS (CASE DESCRIPTION)

A 77-year-old woman reported imbalance and inability to return to her previous active lifestyle. Multiple SFLS were implemented during the course of physical therapist management. Controlled fall heights were gradually progressed over the course of therapy.

RESULTS

Gains in Patient Specific Functional Scale score (initial score = 2.5, discharge score = 8), static balance, and ability to perform floor-to-waist lifting were seen following physical therapist intervention that included SFLS. The patient was able to perform a back fall and a front fall from a standing position and reported no adverse side effects throughout the course of physical therapist care.

CONCLUSION

This case report demonstrates how SFLS were safely and pragmatically progressed for 1 patient in a clinical physical therapy setting. SFLS may have the potential to improve patient outcomes and even decrease the risks associated with falls, though further evaluation is needed.

IMPACT

This case report introduces SFLS as an emerging intervention in the clinical physical therapist practice setting. This case report should encourage future research needed to assess the effectiveness and safety of this treatment strategy in physical therapy.

Effects of Ballroom Dance on Physical Fitness and Reaction Time in Experienced Middle-Aged Adults of Both Genders

Ballroom dance practice might play a pivotal role for successful aging, but its effects could differ depending on dancers' experience level. The aim of this study was to investigate the effects of six months of ballroom dance (three times/w) on physical fitness and reaction time (RT) in 24 middle-aged adults who are experienced dancers (age: 59.4 ± 11.6 years). Body composition, handgrip test (HG), standing long-jump test (SLJ), step test (ST), one-legged stance balance test (OLSB), and RT were assessed before (T0) and after six months (T6) of dance practice. RT was re-evaluated four months later (T10). RT was significantly (p < 0.05) lower at T6 (221.2 ± 20.3 ms) and T10 (212.0 ± 21.9 ms) than T0 (239.1 ± 40,7 ms); no significant differences were found between T6 and T10. No significant differences were observed for all the other parameters between T0 and T6: weight and muscle mass were significantly lower (p < 0.01) in females than in males, and percentage of fat mass was significantly higher (p < 0.01) in females than in males. HG was significantly higher in males than females (p < 0.01). Results suggest that in experienced middle-aged adults of both genders, ballroom dance may positively influence RT, and this result could be maintained for four months.

High-Speed Bodyweight Resistance Training Improves Functional Performance Through Maximal Velocity in Older Females

The authors compared the effects of bodyweight resistance training at moderate- or high-speed conditions on muscle power, velocity of movement, and functional performance in older females. In a randomized, single-blinded noncontrolled trial, participants completed 12 weeks (three sessions/week) of bodyweight resistance training at high (n = 14; age = 70.6 ± 4.3 years) or moderate (n = 12; age = 72.8 ± 4.2 years) speeds. Data were analyzed with an analysis of variance (Group × Time) with α level set at <.05. After the intervention, timed up and go test performance (p < .05) and the rising from a chair test mean (22.4%) and maximal velocity (28.5%), mean (24.4%) and maximal power (27.7%), normalized mean (25.1%), and normalized maximal power (28.5%) increased in the high-speed group (p < .05). However, the moderate-speed group achieved no improvements (Δ6.7-14.4%; p > .2). The authors conclude that high-speed bodyweight resistance training is an effective and economically practical strategy to improve the functional capacity of older women relevant to daily life activities.

Overspeed Stimulus Provided by Assisted Jumping Encourages Rapid Increases in Strength and Power Performance of Older Adults

Following a 4-week control period, 24 older men and women (55-91 years) attended a 4-week progressive jumping program to determine whether assisted jumping could be safely and effectively implemented as a novel stimulus in healthy older adults. Bodyweight countermovement jump performance, isometric and isokinetic strength, postural stability, and exercise enjoyment were assessed before the control period, before the training intervention, and after the training intervention. Following the 4-week intervention, eccentric quadriceps strength increased by 19 N·m (95% confidence interval [2, 36], p = .013), bodyweight countermovement jump height increased by 1.7 cm (95% CI [0.5, 2.9], p < .001), postural sway improved by 2.1 mm/s (95% CI [0.3, 4.0], p = .026), and the participants' perceived exercise enjoyment improved (p = .026). Therefore, using assisted jumping to induce an overspeed training stimulus in a jump training program resulted in similar performance improvements as in previous studies in older populations but with less training volume and a shorter training duration.

Effect of Plyometric Training on Sport Performance in Adolescent Overhead Athletes: A Systematic Review

CONTEXT

Plyometric training has been shown to be beneficial in adolescent overhead athletes. However, existing research on the effects of plyometrics on sport performance has been limited.

OBJECTIVE

To systematically review the current literature to investigate whether plyometric training intervention improves upper- and lower-body sport performance.

DATA SOURCES

Two electronic databases (MEDLINE and Web of Science) were searched using specific Medical Subject Headings (MeSH) terms up to February 2019, and hand-searching was performed by looking to relevant studies that were cited in other studies.

STUDY SELECTION

A total of 932 items were identified and were further assessed for the eligibility in the systematic review. For a study to be eligible, each of the following inclusion criteria had to be met: (1) participants were aged 13 to 18 years and selected from a sports or athletic population and the study (2) involved the evaluation of a plyometric training intervention with an aim to improve sports performance; (3) must have included a control intervention and/or control group; (4) included a quantitative objective measure of sport performance variables concerning throwing, jumping, running, and sprinting; and (5) was published in English.

STUDY DESIGN

Systematic review.

LEVEL OF EVIDENCE

Level 3.

DATA EXTRACTION

A first screening was conducted based on title and abstract of the articles. In the second screening, the full text of the remaining articles was evaluated for the fulfillment of the inclusion criteria.

RESULTS

A total of 14 studies were included in this review. The methodological quality of the included studies ranged from low to moderate. There is moderate evidence that plyometric training intervention improves throwing and jumping performances. There is also preliminary evidence that plyometric training intervention improves sprint performance.

CONCLUSION

The current evidence suggests that sport performance consisting of throwing capacity, jumping ability, and sprint performance significantly improved due to plyometric training interventions in adolescent overhead athletes.

An age-adapted plyometric exercise program improves dynamic strength, jump performance and functional capacity in older men either similarly or more than traditional resistance training

Power declines at a greater rate during ageing and is more relevant for functional deterioration than either loss of maximum strength or muscle mass. Human movement typically consists of stretch-shortening cycle action. Therefore, plyometric exercises, using an eccentric phase quickly followed by a concentric phase to optimize power production, should resemble daily function more than traditional resistance training, which primarily builds force production capacity in general. However, it is unclear whether older adults can sustain such high-impact training. This study compared the effects of plyometric exercise (PLYO) on power, force production, jump and functional performance to traditional resistance training (RT) and walking (WALK) in older men. Importantly, feasibility was investigated. Forty men (69.5 ± 3.9 years) were randomized to 12-weeks of PLYO (N = 14), RT (N = 12) or WALK (N = 14). Leg press one-repetition maximum (1-RM), leg-extensor isometric maximum voluntary contraction (MVC) and rate of force development (RFD), jump and functional performance were evaluated pre- and post-intervention. One subject in RT (low back pain) and three in PLYO (2 muscle strains, 1 knee pain) dropped out. Adherence to (91.2 ± 4.4%) and acceptability of (≥ 7/10) PLYO was high. 1-RM improved more in RT (25.0 ± 10.0%) and PLYO (23.0 ± 13.6%) than in WALK (2.9 ± 13.7%) (p < 0.001). PLYO improved more on jump height, jump power, contraction time of jumps and stair climbing performance compared to WALK and/or RT (p < 0.05). MVC improved in RT only (p = 0.028) and RFD did not improve (p > 0.05). To conclude, PLYO is beneficial over RT for improving power, jump and stair climbing performance without compromising gains in strength. This form of training seems feasible, but contains an inherent higher risk for injuries, which should be taken into account when designing programs for older adults.

Assisted Jumping in Healthy Older Adults: Optimizing High-Velocity Training Prescription

Tufano, JJ, Vetrovsky, T, Stastny, P, Steffl, M, Malecek, J, and Omcirk, D. Assisted jumping in healthy older adults: optimizing high-velocity training prescription. J Strength Cond Res XX(X): 000-000, 2020-Because older adults benefit from power training, training strategies for athletes such as supramaximal velocity-assisted jumping could also be useful for older adults. However, optimizing-assisted exercise prescription in older adults remains uninvestigated. Therefore, the purpose of this study was to determine the effects of different bodyweight (BW) assistance levels on jumping force and velocity in healthy older adults. Twenty-three healthy older adults (67.6 ± 7.6 years, 167.0 ± 8.8 cm, 72.7 ± 14.3 kg, and 27.1 ± 6.9% body fat) performed 5 individual countermovement jumps at BW, 90, 80, 70, and 60% of BW. Jumps were performed on a force plate, which provided peak take-off force (TOF), flight time, and peak impact force. A linear position transducer measured peak concentric velocity (PV). The rating of perceived exertion (RPE) was also assessed after each condition. Take-off force was greater during BW than all other conditions, 90 and 80% were greater than 70 and 60%, but there were no differences between 80 and 90% or between 70 and 60%. The FT progressively increased at all assistance levels, and PV was faster for all assistance levels than BW, with no differences between assistance levels. Impact force was greater during BW than 80, 70, and 60% and was greater during 90% than 60%. The RPE was less than BW during all assistance conditions but was the least during 70%. Implementing assisted jumping between 70 and 80% of BW in older adults likely provides the ideal combination of force, velocity, and RPE.

Agility-based exercise training compared to traditional strength and balance training in older adults: a pilot randomized trial

BACKGROUND

In addition to generally high levels of physical activity, multi-component exercise training is recommended for the maintenance of health and fitness in older adults, including the prevention of falls and frailty. This training often encompasses serial sequencing of balance, strength, endurance and other types of exercise. Exercise training featuring integrative training of these components (i.e. agility training) has been proposed, as it more likely reflects real life challenges like stop-and-go patterns, cutting manoeuvers, turns and decision-making. In this study, we compared the efficacy of an agility-based training to the traditional strength and balance training approach with regard to selected risk factors for falls and frailty.

METHODS

We trained twenty-seven community-dwelling healthy seniors (16♂; 11♀; age: 69.5 ± 5.3 y; BMI: 26.4 ± 3.7 kg/m2) for 8 weeks in a group setting with 3 sessions per week, each lasting 50 minutes. Participants were randomized into either the agility group (AGI; n = 12), that used the integrative multi-component training, or the traditional strength and balance group (TSB; n = 15). TSB performed balance and strength exercises separately, albeit within the same session. The training of both groups progressively increased in difficulty. Outcomes were static and dynamic balance (single leg eyes open stand, Y-balance test, reactive balance), lower limb (plantar flexion and dorsal extension) and trunk flexion and extension maximum strength and rate of torque development (RTD). In addition, we tested endurance by the six-minute walk test (6MWT). We calculated linear mixed effects models for between-groups comparisons as well as effect sizes (ES) with 95 % confidence intervals.

RESULTS

Small ES in favor of AGI were found for plantar flexion strength (ES > 0.18[-0.27;0.89]) and RTD (ES > 0.43[-0.19;1.36]) as well as trunk extension RTD (ES = 0.35[-0.05;0.75]). No other parameters showed notable between group differences. Compliance was high in both groups (AGI: 90 ± 8% of sessions; TSB: 91 ± 7% of sessions).

DISCUSSION

Agility-based exercise training seems at least as efficacious as traditional strength and balance training in affecting selected physical performance indicators among community-dwelling healthy seniors. In particular, lower limb and trunk extension explosive strength seem to benefit from the agility training.

Assisted jumping: A possible method of incorporating high-velocity exercise in older populations

In the past, older adults were traditionally deemed too weak or fragile to participate in high-intensity exercise, but more recent research indicates that not only is high-intensity exercise not dangerous in this population, but it may in fact be a preferable form of exercise over other, less-intense alternatives. However, many seniors still do not participate in high-intensity exercise despite the mounting evidence that it can improve a number of physiological functions and ultimately increase quality of life. As health, sport, and medical professionals, we must continuously ask ourselves how we can apply our lab-based findings in real-life scenarios, and in the case of older adults, we must find a way to circumvent some of their most common reasons for not exercising, which can include a lack of time, a lack of know-how, a lack of motivation, a fear that high-intensity exercise is unsafe, and a perception that high-intensity exercise is too difficult. Therefore, introducing quick, simple, safe, and perceptually easy exercises may result in immediate health and functional benefits and may serve as a gateway exercise to usher older adults into the realm of high-intensity training. Specifically, assisted jumping could serve this purpose. In this article, the ideas behind the theory and practice of assisted jumping are set forth, providing an evidence-based hypothesis from which future researchers can build on to implement high-speed, high-power, high-intensity exercise in older populations in both research and practical settings.