Efficacy of 12-Week Handgrip Strength Training Program Amongst Older Adults: A Pilot Study 

ABSTRACT 

Handgrip strength is indicative of overall health and longevity. The significance of a strong grip increases with age as it relates to lower mortality rates and improved functional capacity.

PURPOSE: To evaluate the effectiveness of a 12-week handgrip strength training program amongst older adults. METHODS: A total of 12 participants (mean age = 82.7 ± 4.8 years; height = 160.7 ± 7.4 cm; body mass = 64.2 ± 13.9 kg; 2 males; 10 females) completed the 12-week exercise intervention. The participants engaged in a twice-weekly, 45-minute suspension training regimen that incorporated a range of exercises targeting upper body strength and stability. Handgrip strength was assessed via a handgrip dynamometer at baseline and post-intervention. A paired samples t-test was employed to assess differences between pre-and post-intervention grip strength. A Bonferroni correction was applied to mitigate the risk of Type I error due to multiple comparisons, setting the adjusted alpha level at p = 0.025. Effect sizes were calculated using Cohen’s d to assess the practical significance of the findings. RESULTS: The analysis revealed a statistically significant improvement in right-handgrip strength, with values increasing from 21.5 ± 1.3 kg in Week 1 to 23.0 ± 1.4 kg in Week 12 (p = 0.006). No significant improvement was observed in left-handgrip strength (20.2 ± 1.2 kg to 21.1 ± 1.5 kg; p = 0.12). The right handgrip strength demonstrated a large effect (d = 0.99), whereas the left handgrip strength exhibited a moderate effect (d = 0.48). CONCLUSION: Findings from this study suggest that the 12-week suspension training and handgrip strength exercise regimen was both statistically and practically effective in increasing HGS in older adults. PRACTICAL APPLICATIONS: Allied healthcare professionals should educate older adults on the importance of HGS and incorporate targeted exercises into their regimens to mitigate age-related functional decline and promote better outcomes.

KEYWORDS: Suspension Training, Longevity, Handgrip Strength

INTRODUCTION 

By the year 2050, the global population of older adults is projected to reach 2.1 billion (10). As this demographic shift occurs, various risks associated with aging, including falls, cognitive decline, and impaired longevity and quality of life, become increasingly concerning (8, 14, 45). A crucial yet frequently underappreciated factor contributing to falls and other age-related risks is diminished handgrip strength (HGS), which impairs an individual’s capacity to stabilize themselves and prevent injuries (16, 19). Research suggests that HGS is representative of overall body strength (1). Handgrip strength is defined as the maximum amount of force the hand generates when gripping an object. Thresholds for HGS required to perform functional tasks in older adults are estimated at greater than 18.5 kg for females and 28.5 kg for males (2). Beyond serving as a measure of physical strength, HGS is also a strong predictor of longevity and overall quality of life, making it especially relevant in the context of aging (1). Comprehending the relationship between HGS and other fitness components is essential for devising effective strategies to preserve functional independence and enhance quality of life, particularly as the global population experiences unprecedented aging trends.

According to the Centers for Disease Control and Prevention (CDC), falls represent the leading cause of mortality among individuals aged 65 years and older. Annually, approximately 36 million older adults experience falls, with 32,000 cases resulting in fatal outcomes (4). Falls impact the quality of life by jeopardizing health, mobility, and independence. Although multiple factors influence fall risk, prioritizing interventions to improve HGS may offer a practical and impactful approach to reducing the incidence of falls among older adults (24).

In 2016, Szulc and colleagues examined 890 men aged 50 and older, assessing appendicular skeletal muscle mass (ASM), physical function, and HGS (42). Over a 5-year follow-up period, 813 participants aged 60 and above were monitored, of whom 144 experienced multiple falls. Findings from this research investigation revealed that those who sustained Grade 2 or Grade 3 vertebral fractures and multiple fractures had reduced HGS, decreased physical function, and an increased risk of multiple falls (42).

The number of global dementia cases is expected to almost triple from 57.4 million cases in 2019 to 152.8 million in 2050 (17). That said, aging significantly elevates the risk of cognitive decline, potentially leading to a loss of independence and other adverse outcomes. Although many factors are involved in preventing and treating cognitive decline and related illnesses, HGS may play a key role in determining who is at risk for these diseases. Physical impairments, such as diminished HGS, can interact with other factors to amplify the risk of age-related cognitive decline (7, 18). Consequently, investigating the relationship between HGS and cognitive function is essential for addressing the challenges of an aging global population.

In 2022, Orchard et al. evaluated both gait speed and HGS as predictors of cognitive decline and dementia (36). The participants were community-dwelling older adults who were cognitively intact at the onset of the study. Researchers assessed each participant’s 3-meter walk time and measured their HGS. A 4.7-year median follow-up was used to gather data on the prevalence of cognitive decline and dementia among participants. Slower walking gait and low HGS were independently related to an increased incident risk of dementia and cognitive decline. When these variables were combined, slow walking gait and low HGS were associated with a 79% increase in the risk of dementia development and a 43% increased risk of cognitive decline (36).

Precursory research has revealed that a culmination of exercise methods, including resistance training, Vitality Acupunch training program, multi-modal training, and suspension training (ST), can impact the HGS of older adults (2, 3, 10, 21, 23, 25, 26, 44). Among these, ST programs, such as total resistance exercise (TRX), stand out as accessible and adaptable methods. Due to the nature of ST, users possess the unique opportunity to train in several different facets of fitness at differing scalable resistances in a single bout of exercise (27). The suspension training system enables individuals to perform strength exercises adapted to their unique capabilities, offering progressive resistance to facilitate individualized strength development (15, 27).

In 2018, Campa, Silva, and Toselli conducted a study to determine the effects of a 12-week ST intervention on the phase angle and HGS of female older adults. Thirty older women were randomly assigned to either a control or training group. Participants in the control group continued their usual activities throughout the study, while those in the training group underwent a 12-week ST program. Both groups were assessed on various fitness parameters, including HGS. At the conclusion of the study, researchers found that ST promoted improvements in HGS in older women (3).

In 2022, Pierle and associates conducted a study to examine the efficacy of a 6-week ST program on a sample of 11 older individuals (37). The fitness parameters of interest were functional reach, overall balance, body fat, body mass, and HGS. While this study demonstrated improvements in functional reach and overall balance, body fat, body mass, and HGS showed no significant changes. These findings suggest that ST may be an effective exercise modality for enhancing certain aspects of fitness in older adults. However, further investigation is crucial to understand its impact on HGS better and determine whether ST can optimize strength outcomes in this population (37).

Against this backdrop, given the dearth of research examining the effects of ST protocols on HGS and the relationship between HGS and fall prevention, further investigation is imperative to elucidate the potential benefits of ST, especially amongst the older adult population. Therefore, the primary purpose of this study is to fill this critical gap by evaluating the efficacy of a 12-week ST and HGS exercise program in enhancing handgrip strength in this population. The apriori hypothesis posits that significant improvements in HGS will be observed between pre- and post-assessment measurements, underscoring the potential of ST and HGS as a targeted intervention to improve strength and reduce fall risk among older adults.

METHODS 

Participants

Prior to participating in this study, participants were screened using inclusionary and exclusionary criteria. The inclusion requirements included participants who currently exercise, are older than 55 years of age, and are independent of assistive walking devices (e.g., walker, rollator, wheelchair, etc.). The exclusionary criteria included participants not having a medical release form on record, being overwhelmed by the exercise routine, specifically, mild increases in heart rate and blood pressure during exercise, or possessing a pacemaker or other internally implanted device. All participants, therefore, were required to have a medical release to participate. This study was approved by the university’s institutional review board and adhered to the practice of ethical research standards.

All participants were recruited from a local retirement community and were required to report to the Wellness Center onsite for 24 sessions over 12 weeks. Flyers were posted, and those interested were instructed to sign up for an appointment with the principal investigator (PI) to complete the protocol requirements. Participants were encouraged to contact the PI or co-PI by phone or email if any question(s) arose or if any of the requirements remained unclear.

Upon arrival for the pre-assessment session, participants read/signed/dated an informed consent form approved by the University’s Institutional Review Board (IRB) for human subject use (IRB#: H24-0565). Ten females and 2 males (Age = 82.7 ± 4.8 years; Height = 160.7 ± 7.4 cm; Body Mass = 64.2 ± 13.9 kg), completed the 12-week exercise intervention.

Protocol

Once the informed consent was obtained, pre-assessment data was collected. All participants were instructed to remove footwear, socks, and stockings before stepping onto the scale. Height (cm) and body mass (kg) were assessed via Seca 217 Mobile Stadiometer (Model Number 2171821009, USA). The participant’s height and body mass results were displayed and recorded via a data collection sheet. Grip strength was assessed via the Smedley Creative Health Products III Analog Grip Strength Dynamometer (T.K.K. 5001, Japan). Participants were instructed to maintain the standard bipedal position during the entire test with the arm in complete extension and to avoid touching any part of the body with the handgrip dynamometer except the hand being measured. Participants comfortably grasped the handgrip dynamometer and were encouraged to exert maximal grip.

Three trials, with brief pauses, were allowed for each hand alternately. The sum of the highest left and right values was recorded on the data collection sheet. The PI was the lead exercise instructor of the 12-week exercise intervention. The PI took attendance, organized, and provided corrective feedback/instructions during each exercise session. A team of fitness instructors at the retirement community and a research assistant also led these classes by providing feedback to participants and keeping each session organized. The exercise intervention required participants to attend two sessions per week for 12 weeks, with each class being 45 minutes. Attendance was recorded at the start of each class to keep track of the adherence rate. Every session consisted of seven strength training exercises in a circuit style (Table 1), followed by a grip strength series consisting of four exercises (Table 2).

Strength training exercises were advanced every 4 weeks, specifically, progressing from 30-second intervals (first micro-cycle) to 35 seconds (second micro-cycle) to 40 seconds (final micro-cycle). The Farmer’s Carry exercise specifically intensified each micro-cycle, starting with holding one dumbbell each set, then holding one dumbbell each set vertically upright by the head of the weight, and finally holding the head of a dumbbell in each hand. The grip strength series progressed throughout the 12-week intervention, starting with one set of each exercise for 15 seconds per hand in the first 4 weeks and followed by 8 weeks of performing each exercise for two sets of 15 seconds. Each session started with a 5-minute warm-up, followed by 35 minutes of exercise, and concluded with a 5-minute cooldown. The 12-week exercise training intervention took place as a group fitness class in the fitness center of a local retirement community, giving participants the advantage of working with partners for each exercise, increasing accountability and motivation. The TRX suspension training (ST) allowed users to exercise in a customizable and scalable capacity that fits their personal specifications, comfort, and intensity levels (27). Additionally, the PI used a timed-circuit style class versus measuring each exercise based on repetition, allowing participants to perform at their own intensified pace.

Statistical Analysis

A paired samples t-test was employed to assess differences between pre-and post-intervention grip strength. To mitigate the risk of Type I error due to multiple comparisons, a Bonferroni correction was applied, setting the adjusted alpha level at p = 0.025. Effect sizes were calculated using Cohen’s d to assess the practical significance of the findings. 

RESULTS 

The primary objective of this study was to evaluate the efficacy of a 12-week exercise intervention on handgrip strength (HGS) in a population of community-dwelling older adults. Sixteen participants were initially recruited; however, four withdrew during the study, resulting in a final sample size of 12 participants (Age = 82.7 ± 4.8 years; Height = 160.7 ± 7.4 cm; Body Mass = 64.2 ± 13.9 kg; 2 males and ten females). Attendance was monitored at each session, yielding an average adherence rate of 83%. The adherence rate remained consistent throughout this study.

A paired-sample t-test was conducted to assess differences between pre- and post-intervention measurements. A Bonferroni correction was applied to mitigate the risk of Type I errors due to multiple comparisons, resulting in an adjusted alpha level of p = 0.025. Effect sizes were quantified using Cohen’s d, with thresholds of 0.2, 0.5, and >0.8 representing small, medium, and large effects, respectively.

The analysis revealed a statistically significant improvement in right-hand grip strength, which increased from 21.5 ± 1.3 kg at baseline (Week 1) to 23.0 ± 1.4 kg post-intervention (Week 12, p = 0.006). In contrast, no statistical improvement was observed for left-hand grip strength (20.2 ± 1.2 kg to 21.1 ± 1.5 kg, p = 0.12). The effect size for right-hand grip strength was large (d = 0.99), whereas the left-hand grip strength demonstrated a moderate effect (d = 0.48). Detailed results are presented in Table 3.

DISCUSSION 

Limited research exists with respect to investigating sustained strength training (ST) programs and handgrip strength (HGS) in older adults (12, 23). Therefore, the primary purpose of this study was to determine the efficacy of a 12-week ST and HGS exercise program in a community-dwelling older adult population. The researchers hypothesized a statistically significant improvement in HGS between pre- and post-assessment data. At the conclusion of the 12-week ST and HGS exercise program, right-HGS improved significantly and demonstrated a large effect size, while the left hand showed a moderate but non-significant change. These findings suggest that a 12-week suspension training exercise program may enhance grip strength and potentially improve functional independence and reduce fall risk in older adults. However, additional research is needed to fully understand these effects and any differences between dominant and non-dominant hands.

 In 2018, a research study was conducted by Campa and colleagues in which the participants were divided into two groups: 1) 12-week ST exercise group and 2) control group that maintained their usual daily activity (3). Both groups of participants underwent pre-and post-tests, evaluating several fitness components, including HGS. Findings from the current research study and the study by Campa et al. (3) revealed both shared and contrasting results in how structured exercise interventions affect HGS in older adults. More precisely, both studies reported statistically significant HGS improvements following their 12-week interventions. The current research study observed an increase in right-hand grip strength from 21.5 ± 1.3 kg to 23.0 ± 1.4 kg, equating to an approximate 7.0% improvement. Similarly, Campa et al. (3) reported an increase in dominant-hand HGS from 38.2 ± 9.7 kg to 40.1 ± 9.0 kg, reflecting a significant 4.97% improvement. Both findings confirm the efficacy of a 12-week exercise program in promoting upper-body strength among older adults. Notably, both studies targeted older adults, with the current study involving a mixed-gender cohort (mean age 82.7 years) and Campa et al. (3) focusing on men with a mean age of 67.4 years. Despite this approximate 15-year age difference, the consistency in outcomes underscores the adaptability of exercise interventions across different subsets of older adults. Both research studies spanned 12 weeks, suggesting that this time frame is sufficient to elicit measurable improvements in muscular strength. Given these similarities, improvements in HGS in both studies align with broader health and functional benefits. Because HGS is a well-established predictor of overall physical health (29, 35), these findings highlight the role of resistance-based interventions in enhancing the quality of life and functional independence among older adults.

While both studies displayed shared findings, it was noted that the baseline mean HGS of the current study was strikingly lower (21.5 ± 1.3 kg) compared to Campa et al.’s (3) sample group (38.2 ± 9.7 kg). This discrepancy may be due to the age difference of about 15 years, which more than likely contributed to variations in baseline physical fitness and adaptive capacity. Older adults often experience diminished neuromuscular responsiveness and muscle plasticity (7, 32).

To summarize, the current research study and Campa et al.’s (3) study demonstrate significant improvements in HGS following 12-week exercise programs, reinforcing the utility of structured ST in mitigating age-related strength decline. Both studies provide compelling evidence that targeted interventions can yield functional strength gains in older populations regardless of modality. However, the differences in participant demographics highlight the influence of baseline fitness levels and age on HGS outcomes.

The results from a study by Gaedtke and Morat (16) also revealed results like those of the current study. Eleven older adults (Mean Age = 66.0 ± 4.0 yrs) participated in a 12-week TRX-OldAge training program, composed of seven exercises progressing through multiple stages of difficulty. The intervention method utilized TRX equipment, shared by Gaedtke and Morat (16) and the current study. Both studies also had similar sample sizes and durations, spanning 12 weeks. The results displayed within Gaedtke and Morat’s (16) research study share thematic similarities with the current research in demonstrating improvements in HGS. Both studies emphasize the potential of targeted programs to enhance functional strength, which is critical for maintaining independence and reducing the risk of falls in aging populations. Specifically, the current research reported a 7.0% increase in right-hand grip strength, showcasing the tangible benefits of a 12-week intervention. Similarly, participants in Gaedtke and Morat’s (16) study subjectively reported strength gains as the most notable improvement following the TRX-OldAge program. However, Gaedtke and Morat (16) did not provide quantifiable pre- and post-assessment metrics for HGS, which limits direct comparisons. While participant feedback highlights strength improvements, the lack of quantifiable data undermines the ability to assess the efficacy of the intervention, specifically on grip strength. This limitation in Gaedtke and Morat’s (16) study underscores the importance of incorporating quantifiable assessments in future investigations to validate self-reported outcomes and to draw more substantial comparisons with similar studies. Regardless, given the vast similarities between the two research studies, it is evident that a TRX-related exercise regime conducted for 12 weeks does enhance muscular strength in older individuals.

In a study conducted by Skelton et al. (41), a 12-week progressive ST intervention was implemented to assess its effects on the strength, power, and functionality of women aged 75 and older (41). The intervention included three exercise sessions per week, with two sessions conducted at home and one in a group setting. The additional day of exercise, as well as the inclusion of home exercise sessions, differs from the current study, which took place twice a week in a group fitness class setting. While the exercises did not mimic the functional tests entirely, each session was tailored to work the specific muscles relevant for functional tasks. Exercises were performed in three sets of four to eight repetitions, using rice bags and elastic bands for resistance. An assortment of pre- and post-assessments were conducted, including a HGS test, resembling the current study.

Despite these methodological differences, Skelton and colleagues (41) demonstrated increases in HGS, which aligns with the improvements observed in the current research study. In Skelton et al.’s (41) 12-week progressive resistance training program, participants experienced a significant 4% increase in HGS, from a pre-training mean of 21.6 ± 3.4 kg to a post-training mean of 22.3 ± 3.9 kg. This outcome parallels findings from the current research study, whereby a significant 7% improvement in HGS was observed. This supports the notion that 12 weeks of functional resistance training may improve HGS amongst a sample of older individuals.

A potential explanation for the greater improvement in HGS observed in the current study may be the focused, grip-specific training regimen utilized. Skelton et al.’s (41) training program, while progressive and resistance-based, did not include exercises that mimicked or directly engaged the musculature required for grip strength improvement. Instead, the program targeted broader functional movements, such as knee extensors, elbow flexors, and other large muscle groups. This specificity likely contributed to the larger improvement in grip-related performance observed in the current study.

Because the current study partially mimicked and addressed some of the limitations of Pierle and colleagues (37), detailed comparative results will be described. Pierle et al. (37) evaluated the efficacy of a 6-week ST intervention on multiple fitness components of older adults (37). This intervention consisted of 1-2 sets of 8 ST exercises performed twice a week. At the conclusion of this study, participants showed improvements in several fitness and functional areas. In contrast to the current study, Pierle et al. (37) did not observe improvements in HGS.

In the current study, participants demonstrated a statistically significant improvement in right-HGS following a 12-week intervention. Pre-assessment HGS for the right hand was 21.5 ± 1.3 kg, which increased to 23.0 ± 1.4 kg, reflecting a 7.0% improvement and a large effect size (d = 0.99). Conversely, left-hand HGS exhibited a smaller, non-significant increase from 20.2 ± 1.2 kg to 21.1 ± 1.5 kg (4.5% improvement, d = 0.48). Comparatively, Pierle et al. (37) observed no statistically significant changes in HGS, with pre-assessment values averaging 22.4 ± 1.9 kg and post-assessment values averaging 22.8 ± 1.8 kg. The effect size (d = 0.03) was minimal, indicating negligible gains in grip strength.

The differences in duration and intervention may explain this disparity in findings. For instance, the intervention in Pierle et al.’s (37) study lasted for 6 weeks, with two sessions per week, totaling 12 training sessions. This short duration may have limited the time available for participants to experience significant neuromuscular adaptations, such as improved motor unit recruitment and muscle hypertrophy, which are crucial for strength gains (6, 33). In contrast, the current study required participants to exercise for 12 weeks, providing twice the intervention time, therefore allowing for a more progressive overload and adaptation. The longer program likely facilitated more robust changes in muscle strength, particularly in the dominant hand. Previous research documents that strength improvements, particularly in older adults, rely on consistent and prolonged exposure to resistance-based stimuli to elicit meaningful neuromuscular adaptations (9, 20).

Another potential reason for the difference in findings is the modality and specificity of exercises. Pierle and colleagues’ study (37) focused on general ST, which emphasized functional movements, overall balance, core stability, and flexibility but did not prioritize grip-intensive exercises. In contrast, the current study employed targeted resistance and isometric exercises specifically designed to enhance HGS, ensuring a more direct focus on grip-related adaptations. Previous research has shown that exercise modality plays a critical role in the specificity of adaptations (15, 21). The lack of direct HGS training in Pierle et al.’s (37) protocol likely limited the magnitude of HGS improvements compared to the current research study.

The current study displayed a statistically significant improvement in right-HGS. While no statistically significant improvement was observed in left-HGS. While said findings were unanticipated, previous research investigations have displayed similar asymmetrical findings (22, 30, 43). In 2008, Thomas & Sahlberg recruited 41 college-aged males and females to complete an 8-week resistance training protocol with the aim of enhancing HGS. Data revealed by Thomas and Sahlberg (2008) align closely with the current investigation in demonstrating significant improvements in right-hand HGS, while no significant changes were observed in the left-hand HGS. In Thomas and Sahlberg’s (43) study, participants in the training group exhibited a statistically significant increase in right-hand HGS (32.9 ± 8.6 kg to 35.5 ± 7.6 kg) over an 8-week general resistance training intervention. However, the left-hand HGS showed no significant changes (30.7 ± 8.4 kg and 30.2 ± 6.0 kg). Similarly, the current research reported a statistically significant improvement in right-hand HGS (21.5 ± 1.3 kg to 23.0 ± 1.4 kg) but observed no significant change in left-hand HGS, which increased only marginally from 20.2 ± 1.2 kg to 21.1 ± 1.5 kg.

The consistency between these studies highlights the tendency for dominant-hand HGS to exhibit greater responsiveness to resistance training interventions. Both studies emphasize the role of hand dominance in determining training outcomes, with dominant hands showing significant strength gains due to frequent daily use and greater neuromuscular efficiency (5, 39). Conversely, the non-dominant hand may require more targeted stimuli to achieve comparable improvements, as evidenced by the lack of significant HGS gains in the left hand in both studies (13, 40). These findings emphasize the importance of tailoring training programs to address asymmetries and maximize bilateral strength development.

In 2019, Labott and colleagues conducted a comprehensive meta-analytical review to evaluate the effects of various exercise interventions on HGS in older adults. The review analyzed 24 research articles involving 3,018 participants with a mean age of 73.3 years (22), focusing on interventions ranging from resistance training to multimodal programs. While the findings revealed small but statistically significant improvements in HGS overall, the results emphasized a common trend across studies to the extent that greater responsiveness in right-hand HGS compared to the left-hand HGS. These authors concluded that task-specific and multimodal training interventions often yielded measurable gains in dominant hand strength, as this hand benefits from more frequent use and neuromuscular efficiency in daily activities. In contrast, left-hand HGS frequently displayed minimal or no significant change, reflecting the need for targeted stimuli to elicit comparable adaptations in the non-dominant hand. The review highlights this asymmetry as a recurring observation in HGS research, reinforcing the importance of tailored interventions to address disparities between dominant and non-dominant hand strength (5,22).

Although no statistically significant improvement was observed in left-hand HGS among participants in the current study, the practical implications of the findings should not be overlooked. A mean increase of 1.1 kg (4%) represents a meaningful real-world difference, particularly within aging populations. For older adults, even modest improvements in HGS can translate into enhanced functional capacity, better mobility, fall mitigation, greater independence in activities of daily living, and improved overall quality of life (11, 22, 28, 31, 38, 46). Moreover, from an applied perspective, a 4% increase in left-hand HGS may provide critical support in scenarios requiring quick reflexive actions, such as maintaining balance or catching oneself during a fall (28, 34). This seemingly minor improvement could make a significant difference in preventing injury and maintaining mobility, highlighting the value of targeted interventions to enhance HGS, even in cases where statistical significance is not achieved.

There were several limitations to this study that may have impacted the results. The small sample size (n = 12) and the low male participation in this study may have stifled the results from reaching their full expression. Future studies would benefit from a larger and more gender-balanced sample to enhance the generalizability of findings. Additionally, an increased sample size would allow for a control group to be utilized, bolstering the findings of future studies. Adherence to the 12-week intervention proved difficult as it slowly declined by 17% throughout the study, as many participants had busy schedules and prior commitments that interfered with consistent session attendance. Future studies may consider methods to improve adherence, such as scheduling flexibility or at-home modifications. Longer intervention durations may yield more robust findings, as 12 weeks might not have allowed the intervention to reach its full potential. Confounding variables, such as diet, sleep, and baseline activity levels, were not accounted for and may have influenced the results. Tracking these variables in future studies could provide additional insights into their potential impact.

As individuals age, their priorities often shift toward improving quality of life, extending longevity, and maintaining functional independence. Because HGS directly impacts these aspects of healthy aging, its maintenance, or better yet, improvement, should remain a priority in interventions targeting older adults. The intention of this study was to discover the efficacy of a 12-week ST exercise intervention on the HGS of older adults and underscore its importance for healthy aging. The current study revealed a statistically significant improvement in right-HGS, whereas no significant improvement was observed in left-HGS. Future research should evaluate asymmetrical HGS, as this was not an anticipated finding. Additionally, further research should investigate ST in older adult populations, addressing the limited existing evidence on its efficacy in this demographic.

CONCLUSION 

Findings from this study suggest that the 12-week ST and HGS exercise regime was statistically and practically effective in increasing overall HGS in older adults. These findings may serve as valuable guidance for fitness instructors, physical therapists, and other allied healthcare professionals working with older adults. Integrating ST exercises and HGS-specific exercises results in improved HGS, an essential component of maintaining functional independence as individuals age. Utilizing the TRX system for this intervention provided unique advantages, as the exercises were simple to perform and customizable to each participant.

PRACTICAL APPLICATIONS

Implementing an exercise program focusing on HGS has broader implications, as HGS correlates with improved quality of life, longevity, and reduced risk of falls. Allied healthcare professionals working with older adult populations should educate their patients on the importance of HGS and adopt intentional HGS-focused exercises into their regimens. In doing so, they can help mitigate age-related functional decline and promote better outcomes for aging individuals.

ACKNOWLEDGMENTS

The author would like to personally thank the health and wellness team at Carolina Bay at Autumn Hall: Shannon Hardy and Madison Norris.

The author would also like to thank the Center for the Support of Undergraduate Research and Fellowships for their generous contributions.