EFFECTIVENESS OF HIGH-LOAD VERSUS LOW-LOAD RESISTANCE TRAINING ON MUSCLE STRENGTH AND FUNCTIONAL PERFORMANCE IN GERIATRIC PATIENTS: A COMPARATIVE STUDY

Abstract

Background
Age-related declines in skeletal muscle strength and functional performance are major contributors to
frailty, impaired mobility, falls, and loss of independence among geriatric patients. Progressive
resistance training is recognized as one of the most effective non-pharmacological interventions for
preserving muscle function; however, the optimal training intensity for maximizing functional
recovery remains uncertain. High-load resistance training (HLRT) has traditionally been recommended
for improving maximal muscle strength, whereas low-load resistance training (LLRT) has emerged as
a feasible alternative for geriatric patients with reduced exercise tolerance. Comparative evidence
regarding the effectiveness of these two training strategies in geriatric rehabilitation remains limited.
Objective
To compare the effectiveness of high-load resistance training and low-load resistance training in
improving muscle strength, functional mobility, and balance among geriatric patients.
Methods
A randomized comparative study was conducted at the Department of Physiotherapy, Pacific College
of Physiotherapy, Pacific Medical University, Udaipur. Sixty participants aged 60–75 years were
recruited using convenience sampling and randomly allocated into two groups: HLRT (n = 30) and
LLRT (n = 30). Both groups underwent supervised resistance-training sessions three times per week
for eight weeks. The HLRT group trained at 70–85% of one-repetition maximum (1RM), whereas the
LLRT group trained at 30–40% of 1RM with higher repetitions. Muscle strength, functional mobility
using the Timed Up and Go (TUG) test, and balance using the Berg Balance Scale (BBS) were
assessed before and after the intervention. Paired t-tests were used for within-group comparisons and
independent t-tests for between-group comparisons. Statistical significance was set at p< 0.05.
Results
Both intervention groups demonstrated statistically significant improvements in muscle strength,
functional mobility, and balance following the eight-week training programme (p< 0.001). Baseline
characteristics did not differ significantly between groups. Post-intervention analysis revealed
significantly greater improvements in the HLRT group compared with the LLRT group. Mean muscle
strength increased to 27.84 ± 2.48 in the HLRT group and 23.96 ± 2.31 in the LLRT group (p = 0.001).
Mean TUG time decreased to 10.92 ± 1.12 seconds in the HLRT group and 12.74 ± 1.28 seconds in the
LLRT group (p = 0.002). Mean BBS scores improved to 50.21 ± 2.75 in the HLRT group compared
with 45.68 ± 2.62 in the LLRT group (p = 0.001). The HLRT group also demonstrated greater overall
improvements in muscle strength (+9.42 vs. +5.81), TUG performance (−4.90 vs. −3.02 seconds), and
BBS scores (+11.97 vs. +7.56) than the LLRT group.
Conclusion
Both high-load and low-load resistance training significantly enhanced muscle strength, functional
mobility, and balance in geriatric patients. However, high-load resistance training produced superior
improvements across all outcome measures, suggesting that it may be more effective for maximizing
functional recovery in medically stable geriatric patients. Low-load resistance training remains a
clinically valuable alternative for individuals who are unable to tolerate higher mechanical loads.
These findings support individualized resistance-training prescriptions based on patient characteristics,
rehabilitation goals, and exercise tolerance.