EFFECT OF RESISTANCE TRAINING ON SELECTED GAIT VARIABLES AND RISK- FACTORS OF PERIPHERAL V, High school final essays of Physical education

Download EFFECT OF RESISTANCE TRAINING ON SELECTED GAIT VARIABLES AND RISK- FACTORS OF PERIPHERAL V and more High school final essays Physical education in PDF only on Docsity! EFFECT OF RESISTANCE TRAINING ON SELECTED GAIT VARIABLES AND RISK- FACTORS OF PERIPHERAL VASCULAR DISORDER AMONG ADULTS IN ZARIA, KADUNA STATE, NIGERIA JANUARY, 2022 CHAPTER ONE INTRODUCTION 1.1 Background to the Study The use of loads, machines, or own body weight explains the concept of resistance training; the main aim of resistance training is to increase the ability to overcome load and increase muscle mass and in terms of supporting bone health, making aerobic exercise more productive, preventing injury, and facilitating healthy ageing. Resistance training (RT) also known as strength training improves muscular strength and fitness by exercising a specific muscle or muscle group against external resistance, including free-weights, weight machines, or your own body weight. It has been shown by various studies that regular strength or resistance training is good for people of all ages and fitness levels to help prevent the natural loss of lean muscle mass that comes with ageing process (Kraemer, & Ratamess, 2010). The current view of resistance training (RT) is that it benefits people with chronic health conditions, like obesity, arthritis, or a heart condition, improves gait parameters including knee range of motion, step length, velocity and step width and promote neural adaptations such as improved motor unit activation and synchronization of firing rates, which may deteriorate with periods of inactivity. Additionally, it has a positive effect on both gait and balance in an elderly population, specifically straight-line walking speed in older adults and it is an adequate training method to improve balance in an aging population and improvements in strength, attributed to RT, may allow for greater autonomy and independence to carry out activities (Christopher, José & Juan, 2021). It has been reviewed that RT in the elderly could be an effective and safe method of participating in physical activities that are capable of reversing the effects of sarcopenia and 1.2 Statement of the Problem Majority of the older adults are living with abnormal gait resulting from some risk factors of peripheral vascular disorder and spatiotemporal gait parameters abnormality which have impaired quality of life, and as a consequence, activities of daily life are hindered greatly. The step length of older adults is reduced due to decrease in lean muscle mass which slows down the biomechanical power of muscles, with the inherent muscle artrophy accompanying ageing, the muscle responses do not equal the neural stimulations and as a result there is reduced step length during walking which affects the time and energy for execution of short distances. Speed is one of the parameters of gait needed to carryout activities of daily living. As one ages, there is a progressive reduction in speed during walking due to decreasing bone mineral density and muscle mass which are associated with increased risk of slips and falls Body weight increases as one advances in age due to hormonal changes that bring about ageing. This is associated with a decrease in growth hormone secretions, reduced responsiveness to thyroid hormone, decline in serum testosterone and resistance to leptin, and as a result activity level is greatly reduced. As one gets older, blood vessels changes in diameter to volume ratio, and arteries get stiffer causing blood pressure to go up. This causes rupture of smaller vessels like capillaries which in turn leads to tissue damages in older adults with severe consequences like cardiovascular accident (CVS) and gangrene induced amputations. Studies revealed that many intervention programmes such as aerobic exercise, combined aerobic and resistance exercise, use of controlled diet methods and drug therapy have been adopted in improving these gait variables and the risk factors of peripheral vascular disorder, but none of these methods has proved very effective in the improvement of these variables (Institute on Ageing, 2021). This needs more scientific exploration, therefore, this study will assess the effect of resistance training on selected gait Variables and risk factors of peripheral vascular disorder among older adults in Zaria, Kaduna State, Nigeria 1.3 Purpose of the Study The purpose of this study is to assess the effect of resistance Training on selected gait Variables and risk factors of peripheral vascular disorder among older adults in Zaria, Kaduna State- Nigeria. The specific purpose of this study is to find out whether: 1. Resistance training has effect on step length among older adults in Zaria, Kaduna State, Nigeria. 2. Resistance training has effect on speed among older adults in Zaria, Kaduna State, Nigeria. 3. Resistance training has effect on overweight among older adults in Zaria, Kaduna State, Nigeria. 4. Resistance training has effect on hypertension among older adults in Zaria, Kaduna State, Nigeria. 1.4 Research Questions Based on the purpose of the study, the following research questions are stated: 1. Does resistance training has effect on step length among older adults in Zaria, Kaduna State, Nigeria? 2. Does resistance training has effect on speed among older adults in Zaria, Kaduna State, Nigeria? 3. Does resistance training has effect on overweight among older adults in Zaria, Kaduna State, Nigeria? 4. Does resistance training has effect on hypertension among older adults in Zaria, Kaduna State, Nigeria? 1.5 Major Hypothesis There is no significant effect of resistant training on the selected gait variables and risk factors of peripheral vascular disease among older adults in Zaria, Kaduna State, Nigeria Sub- Hypotheses Based on the research questions, the following sub-hypotheses are stated: 1. There is no significant effect of resistance training on step length among older adults in Zaria, Kaduna State, Nigeria 2. There is no significant effect of resistance training on speed among older adults in Zaria, Kaduna State, Nigeria 3. There is no significant effect of resistance training on overweight among older adults in Zaria, Kaduna State, Nigeria 4. There is no significant effect of resistance training on hypertension among older adults in Zaria, Kaduna State, Nigeria. 1.6 Basic Assumption Based on the research hypotheses, the following basic assumptions are stated: CHAPTER TWO REVIEW OF RELATED LITERATURE 2.0 Introduction This study will assess the effect of resistance training on selected gait variables and risk factors of peripheral vascular disorder among older adult in Zaria, Kaduna State, Nigeria. Review of related literature to this study will be reviewed under the following sub-headings: 2.1 Concept of Resistance Training 2.2 History and Basics of Resistance Training 2.2.1. Basic of Resistance Trainig 2.2.2 Resistance Training Selection 2.3 Resistance Exercise Order and workout Structure 2.3.1. Loading 2.3.2. Training Volume 2.3.3. Repetition Velocity 2.3.4. Resistance Training Frequency 2.3.5 Basic Principles of Progression 2.3.6. Effects of Training States and Progression 2.3.7. Warm-up Sub-maximal Resistance Training Drills 2.3.8. Considerations for Older adults in Resistance Training 2.4. Gait in Older Adults 2.4.1. Detecting Changes in Gait in Older Adults 2.4.2 Age-related Changes in Gait of Older Adults 2.4.3 Kinematics of Gait 2.4.4 Peripheral Vascular Disorder in Older Adults (peripheral arterial disoder) 2.5. Effects of Resistance training on Selected Gait Variables and Risk factors of Peripheral Vascular Disorder 2.5.1 Overweight 2.5.2 Speed 2.5.3 Step length 2.5.4 Hypertension 2.6 Empirical Review 2.6.1 Step length 2.6.2 Speed 2.6.3 Overweight 2.6.4 Hypertension 2.7 Summary 2.1 Concept of Resistance Training Resistance training is a term that implies the use of load, machinery, or own body weight while exercising the muscles. It’s used to increase the ability to overcome load and increase muscle mass (Nenad, Aleksandar, Zvezdan , Živorad & Sandra, 2016). From its beginning until today the resistance training largely has been evolved and training always targets at development of muscle mass through the use of external increasing loads; also the development for the most part are based on the method of trial and error and on the experience, and only in the last fifty years has attracted interest of prominent scientists in the field of sport science. Good resistance training practice that would result in progress in strength, muscle endurance and muscle hypertrophy has always been the accepted, whereas the training that did not give the desired results and progress may be used as a pre-resistance exercise (warm up). Through the knowledge of prominent individuals, a period of development, events and training practice in the past has contributed to a better understanding of today’s stage of development and resistance training has continued to undergo analysis concerning the optimum program design to achieve a desired outcome; as an example, strength development requires explicit combinations of lifting intensity, frequency, and a number of sets performed. Resistance training, where muscles are required to contract against an opposing load, has been shown to be a beneficial form of rehabilitation in clinical populations prone to muscle wasting, providing stimuli to increase protein synthesis and muscle mass and proved effective in reducing the advancement of conditions such as HIV, cancer, rheumatoid arthritis, chronic renal impairment and bed rest and as a mode of exercise to promote several health benefits, including improvements in the muscle mass and strength of healthy adult (Garber , Blissmer , Deschenes , Franklin , Lamonte, & Lee , 2011). Strength training programs utilizing mild to moderate intensity are commonly prescribed to address many of the deficits found in MS. Studies applying mild to moderate intensity strengthening programs to PwMS provided inconsistent results regarding the exercise programs’ effects on their gait and balance (DeBolt & McCubbin, 2014). To achieve maximum benefit and make training ideal, the various components of resistance training such as sets, repetition maximum, intensity and frequency must be specifically defined in any training regimen. 2.2 History and basics of Resistant Training The mythical story of Milo of Croton and his training method is well known as his principle of training is considered as a beginning of training with progressive load. Initially, Precursors of the effectively in Olympic sport like the clean and jerk and snatch lifts and body building which involves using resistance training to optimize muscle hypertrophy, and symmetry while reducing body fat to optimize appearance; other reasons include strongman/woman competitions such as ones involving numerous events that exemplify muscle strength, power, and local muscular endurance, and strength training to improve athletic performance. The act of resistance training, itself, does not ensure optimal gains in muscle strength and performance, but it is the magnitude of the individual effort and systematic structuring of the training stimulus that ultimately determines the outcomes associated with resistance training (Kraemer, & Ratamess, 2010). To reap the benefits of resistance training program, progression is a key factor that requires an exercise prescription process, evaluation of training progress, and careful development of target goals which starts with the determination of individual needs and training goals and involves decisions regarding questions as to what muscles must be trained, injury prevention sites, metabolic demands of target training goals; the single workout must then be designed reflecting these targeted program goals including the choice of training, order of training, amount of rest used between sets and training, number of repetitions and sets used for each training, and the intensity of each training. For progression, these variables must then be varied over time and the training prescription altered to maintain or advance specific training goals and to avoid overtraining. A careful system of goal targeting, exercise testing, proper training technique, supervision, and optimal training prescription all contribute to the successful implementation of a resistance training program (Kraemer, & Ratamess, 2010). 2.2.2 Resistant Training Selection Two general types of free weight or machine training may be selected in resistance training: single and/or multiple-joint. Single-joint training stress one joint or major muscle group, whereas multiple joint training stress more than one joint or major muscle group; single- and multiple- joint training have been shown to be effective for increasing muscular strength in the targeted muscle groups (Fleck, 2014). Single-joint training for example, leg extension and leg curl, have typically been used to target specific muscle groups and are thought to pose less risk of injury due to the reduced level of skill and technique involved (Fleck, 2014). Multiple-joint training such as bench press, squat, hang pulls, and power clean involve a more complex neural activation and coordination, and due to the larger muscle mass involvement and subsequent amount of weight used, these training have generally been regarded as the most effective for increasing muscular strength and power and stressing multiple or large muscle groups have shown the greatest acute metabolic responses; for example, those such as the squat, leg press, leg extension, and bent-over row have been shown to elicit greater rates of oxygen consumption than ones such as the behind-the-neck shoulder press, upright row, and arm curl (Ballor, Becque & Katch, 2011). 2.4 Resistance Training Order and Workout Structure The order and number of muscle groups trained during a workout significantly affect the acute expression of muscular strength, for example, there are three basic workout structures: total- body workouts, upper/lower body split workouts, and muscle group split routines; total-body workouts involve performance of training stressing all major muscle groups as obtained among general fitness enthusiasts, athletes, and Olympic weightlifters. Upper/lower body split workouts involve performance of upper-body training during one workout and lower-body training during another and these are common among general fitness enthusiasts, athletes, power lifters, and body builders while muscle group split routines involve performance of training for specific muscle groups during the same workout as in chest/triceps workout where all training for the chest are performed first then followed by training for the triceps. These types of workouts are most popular among body builders or individuals striving to maximize muscle hypertrophy, but three workout structures are effective for improving muscular fitness; and it appears that individual goals, time/frequency, and personal preferences often determines which type of workout will be used (Sforzo & Touey, 2012). The major differences between these structures are the magnitude of specialization observed during each workout for example, three to four trainings for a specific muscle group may be performed during a muscle group split routine workout as opposed to one to two exercises for a muscle group in a total-body workout and the amount of recovery between workouts, like a major muscle group may be trained 1 to 2 wk for a split routine, 2 to 3 wk for an upper/lower- body split, and 3 or more times per week for a total-body workout during most typical lifting programs. Only one study has compared workout structures and similar improvements in previously untrained women between total-body and upper/lower-body split workout (Calder, Chilibeck, Webber & Sale, 2014). Other studies have compared total-body resistance training to either upper-body-only or lower-body-only training. A study have shown the importance of the total-body resistance training in women for improving overall muscular strength, hypertrophy, power, and physical performance; in the elderly, similar improvements have been observed in lower body strength between total-body and lower body workouts of equal volume and intensity (Campbell, Trappe, Kruskall, Wolfe & Evans, 2012). Upon determination of the workout structure like the muscle groups trained, general recommendations can be made depending on whether one is training for strength, hypertrophy, diseases that prevent from doing lower leg training in the older adult (Elder CHron newsllet, 2018), and assist in evaluation of an athlete's overall lower body strength from the gluteus Maximus to the lower leg muscles. A stronger muscle is usually a faster muscle, according to strength coach Charles Poliquin, sprint speed is directly related to muscle mass and when a muscle is bigger and stronger it can apply more force; so being able to apply more force into the ground means one moves faster (increase speed) ( Bubins, 2020; Much, 2018). When leg presses build lower-body strength and mass, one moves faster and squat strength is improved (Dewar, 2020), if performed correctly, the inclined leg press can help develop knees to manage heavier free weights (Di Jensen, 2020), and it can be performed in variations, for example with one leg, or attaching bands to the leg press (Dewar, 2020). The leg press works the following muscle groups:  Quadriceps  Hamstring  Gluteus maximus  Calves  (partially) (Di Jensen, 2020). c. Leg Extension The leg extension is a resistance weight training that targets the quadriceps muscle in the legs and it consists of bending the leg at the knee and extending the legs, then lowering them back to the original position. Leg extension is used to predict step length (Fitness volt, 2020) d. Leg curl Leg curl also known as the hamstring curl, is an isolation training that targets the hamstring muscles (Di Jensen, 2020), it involves flexing the lower leg against resistance towards the buttocks. It is performed in variations such as seated leg curls, lying leg curls, and standing leg curls. Leg curl improves range of motion during ambulation. e. Pull down The pull-down is a strength training designed to develop the latissimus dorsi muscle and it performs the functions of downward rotation and depression of the scapulae combined with adduction and extension of the shoulder joint. The standard pull-down motion is a compound movement that requires dynamic work by muscles surrounding the three joints which move during the training such as the elbow in conjunction with the glenohumeral and scapulothooracic joints in the shoulder girdle. f. Wall push also known as wall press By pushing against the wall, it reduces some of the load caused by gravity, allowing the training to be performed more easily (Bubnis, 2021). Additionally, wall push ups also known as wall presses may be useful for people with mild wrist pain, as there’s less load on the wrist joints and also benefits those with lower back pain or elbow pain as in older adults. The main muscles used during a wall pushup include:  The chest muscles e.g., the pectoralis major and pectoralis minor  The serratus anterior  The triceps  The deltoids  The upper and lower back muscles e.g., the trapezius and rhomboids, as well as the spinal stabilizers  The core muscles e.g., the transversus abdominis, multifidus, obliques, and rectus abdominis i. Bicep curl The biceps curl mainly targets the biceps brachii, brachialis and brachioradialis muscles; biceps are stronger at elbow flexion when the forearm is supinated (palms turned upward) and weaker when the forearm is pronated and usually starts with the arm in a fully extended position, holding a weight with a supinated (palms facing up) grip. A full repetition consists of bending or curling the elbow until it is fully flexed, then slowly lowering the weight to the starting position. The torso should remain upright instead of swinging back and forth, as doing so transfers the load away from the biceps onto other muscles, reducing the effectiveness of the training. The elbows are also usually kept stationary at the side of the torso, as allowing the elbows to move in front of the weight's centre of gravity removes tension before full contraction is achieved. j. Leg raise Leg raise is done while lying on a flat surface with the whole body straight at 180o in a supinated position and the hip joint is flexed to a range of motion that works the iliopsoas muscle group properly. The leg raise is a strength training  which targets the iliopsoas  e.g., the anterior hip flexors because the abdominal muscles are used isometrically to stabilize the body during the motion; it is also often used to strengthen the rectus abdominis muscle and the internal and external oblique (Spark, 2021) 2.3.1 Loading Loading describes the amount of weight lifted or the resistance one is subjected to and is highly dependent upon other variables such as training order, volume, frequency, muscle action, repetition speed, and rest interval length (kraemer & Ratamess, 2011). Altering the training load can significantly affect the acute metabolic, hormonal, neural, and cardiovascular responses to Given that both force and time components are relevant to maximizing power, training to increase muscular power requires two general loading strategies: first, moderate-to-heavy loads are required to recruit high-threshold fast-twitch motor units that are needed for strength, but as depicted by the force-velocity curve, higher loads are accompanied by slower velocities such that performing heavy resistance training will potentially increase force production but not speed. Thus, the second strategy is to incorporate light-to-moderate loads performed at an explosive lifting velocity which depending on the training in question, this loading range may encompass 30–60% of 1 RM. Wilson, Newto, Murphy & Humpheries, (2013) reported that 30 % of 1 RM was the optimal loading that produced the greatest power output during ballistic jump squat training but, Baker, Nance & Moore (2011) reported that a higher loading range (45–60% of 1 RM) was necessary to optimize power during jump squats and the ballistic bench press for power-trained athletes. A recent study has shown that jump squat training with 30% of one repetition maximum was more effective for increasing peak power than jump squat training with 80% of one repetition maximum; with ballistic resistance training, the load is maximally accelerated either by jumping e.g., jump squats or by releasing the weight using specialized equipment e.g., Plyo Power System (Newto, Kraemer & Hakkinen, 2016). However, traditional repetitions result in a deceleration phase that limits power development throughout the complete range of motion and during traditional weight training exercises performed at an explosive velocity, a recent study has shown that 40–60% of 1 RM may be most beneficial for the bench press and 50–70% for the squat, thereby demonstrating that a slightly higher load is necessary for power training when nonballistic repetitions are performed. Thus, training for maximal power requires various loading strategies performed at high velocity (Siegel, Gilders, Staron & Hagerman, 2012). 2.3.2 Training volume Training volume is generally estimated from the total number of sets and repetitions performed during a training session and everal systems including the nervous, metabolic, hormonal, and muscular have been shown to be sensitive to training volume (Hakkinen, Komi, Alen & Kauhanen, 2012). Altering training volume can be accomplished by changing the number of training performed per session, the number of repetitions performed per set, or the number of sets performed per training; typically, heavy loads with low repetitions using moderate-to-high number of sets such as characteristic of strength and power training are generally considered low-volume programs due to the low number of repetitions performed per set (Hakkinen, Komi, Alen & Kauhanen, 2015). Without altering the intensity of these programs, volume may be increased by either increasing the number of sets and/or training performed or by increasing training frequency and however, care must be taken because intensity and volume are inversely related. Increases in training volume with low repetition programs should be closely monitored and intensity possibly reduced in order to lower the risk of overtraining (Fry & Kraemer, 2013). Moderate-to-heavy loads, moderate-to high repetitions, and multiple sets per exercise are characteristic of hypertrophy training although strength and local muscle endurance are also enhanced with these programs and are generally regarded as high-volume programs when several training are performed per workout for example, at least six to eight trainings. Total work, in addition to the forces developed, has been implicated for gains in muscular hypertrophy (Moss, Refsnes, Abildgaard,Nicolaysen &Jensen, 2014). This has been supported, in part, by greater hypertrophy associated with high-volume, multiple-set programs compared with low volume, single-set programs in resistance-trained individuals (Kraemer, 2015). Traditional strength training like high load, low repetition, and long rest periods) has produced significant hypertrophy however, it has been suggested that the total work involved with traditional strength training may not maximize hypertrophy (Fleck & Kraemer, 2013). Very light-to-moderate loads performed for multiple sets of high repetitions (characteristic of local muscular endurance training) are considered to be very high in total volume but not optimal for hypertrophy. Thus, the overall volume selected for the program should be based on individual training status and goals as numerous possibilities exist for effective progression. Although training volume has been examined in many facets, one facet that has received less attention is the number of sets per muscle group or workout and there are few data that directly compare resistance training programs of varying total sets, thus leaving numerous possibilities for the strength and conditioning professional when designing programs. Much of the resistance training literature has examined the number of sets performed per training and it has generally been found that two to six sets per training produce significant increases in muscular strength in both trained and untrained individuals (Luecke,Wendeln, 2012). However, similar strength increases have been found in novice individuals who trained using 2 and 3 sets, and 2 and 4 sets ; 3 sets have also been reported as being superior to one and two (Berger, 2013). Thus, the number of sets selected per exercise should vary depending on the training goals and typically, three to six sets are most common during resistance training. Another related issue to training volume that has received considerable attention is the comparison of single and multiple-set resistance training programs; in most of the studies to date, one set per training performed for 8–12 repetitions at an intentionally slow lifting velocity has been compared with both periodized and non periodized multiple-set programs. A common criticism of these investigations is that the number of sets per training was not separated from other variables such as intensity, frequency, and repetition velocity, therefore making it difficult fatigue, the resultant velocity is slow. One study has shown that during a 5 RM bench press, the concentric phase for the first three repetitions was approximately 1.2–1.6 s in duration, whereas the last two repetitions were approximately 2.5 and 3.3 s, respectively, due to fatigue (Mookerjee & Ratamess, 2017). These data demonstrate the impact of loading and fatigue on repetition velocity in individuals performing each repetition with maximal effort. Intentional slow-velocity repetitions are used with sub-maximal loads where the individual has greater control of the velocity and it has been shown that concentric force production was significantly lower (e.g., 771 versus 1167 N) for an intentionally slow velocity (5-s CON: 5-s ECC) of lifting compared with a traditional (moderate) velocity with a corresponding lower neural activation (Keogh, Wilson & Weatherby, 2015). This suggests that motor unit activity may be limited when intentionally contracting at a slow velocity, although intentionally slow repetition velocity may provide some benefit for local muscular endurance and hypertrophy training, the lighter loads may not provide an optimal stimulus for improving 1 RM strength in resistance trained individuals and it has recently been shown that when performing a set of 10 repetitions using a very slow velocity such as 10-s CON: 5-s ECC compared with a slow velocity like 2-s CON: 4-s ECC, 30 % reduction in training load resulted and that this led to significantly less strength gains in most of the training tested after 10 weeks of training. Compared to slow velocities, moderate (1- to 2-s CON: 1- to 2-s ECC) and fast (1-s CON: 1-s ECC) velocities have been shown to be more effective for enhanced muscular performance, for example, number of repetitions performed, work and power output, volume, and for increasing the rate of strength gains (Hay, Andrews & Vaughan, 2013). Recent studies examining training at fast velocities with moderately high loading have shown this to be more effective for advanced training than traditionally slower velocities (Jones, Hunter, Fleisig &, Escamilla & Lemak, 2012). This technique requires the individual to accelerate the load maximally throughout the range of motion during the CON action to maximize bar velocity, for instance, the attempt to maximize velocity throughout the movement stresses areas of the range of motion where momentum minimizes the effort needed by the individual to complete the training. A major advantage is that this technique can be used with heavy loads, like with small deceleration phases and is considered effective, especially for multiple-joint training (Jones, Hunter, Fleisig &, Escamilla & Lemak, 2012). The repetition velocity is very important for power training and power production is increased when the same amount of work is completed in a shorter period of time, or when a greater amount of work is performed during the same period of time. The neuromuscular contributions to the development of maximal muscle power may include: maximal rate of force development, muscular strength at slow and fast repetition velocities, stretch shortening cycle performance and coordination of movement pattern and skill (Hakkinen & Komi, 2015). In order to maximize power training, heavy resistance training needs to be accompanied by explosive training (Bobbert & Soest, 2014) as one limitation to performing high-velocity repetitions with free weights is the deceleration phase which is that point near the end of the CON phase in which bar velocity decreases before completion of the repetition. The length of this phase depends upon the load used and the average velocity as the load is decelerated for a considerable proportion (24– 40%) of the concentric movement (Elliott, Wilson & Kerr, 2014) and this percentage increases to 52% when performing the lift with a lower percentage (81%) of 1 RM lifted or when attempting to move the bar rapidly in an effort to train more specifically near the movement speed of the target activity (Newton, Kraemer, Hakkinen, Humphries & Murphy, 2016). Thus, power increases may be most specific only to the initial segment of the range of motion as power or speed development throughout the full range of motion is limited because the load cannot be maximally accelerated throughout and safely released. Ballistic resistance training such as explosive movements which enable acceleration throughout the full range of motion has been shown to limit this problem (Mcbride, Triplett-Mcbride, Davie Newton, 2012). Examples of ballistic resistance training include the loaded jump squat, bench throw, and shoulder throw (Baker, Wilson & Carlyon, 1994). Loaded jump squats with 30% of 1 RM according to Moss, Refnes, Abildgaard, Nicolaysen & Jense (2014); Mcbride, Triplett-Mcbride, Davie& Newton (2010) have been shown to increase vertical jump performance more than traditional back squats, plyometrics, and jump squats performed at 80% of 1 RM, and it has been reported that peak power was significantly greater for the shoulder throw than the shoulder press at both 30 and 40% of 1 RM. These studies indicate the importance of minimizing the deceleration phase when maximal power is the training goal and that explosive lifting velocities are critical for developing maximal power. Training for local muscle endurance, and in some aspects hypertrophy, may require a range of velocities with various loading strategies; studies examining isokinetic training have shown that a fast training velocity like 180°·s1, is more effective than a slow training velocity like 30°·s1 for improving local muscular endurance (Crews & Meadors, 2013). Therefore, fast contraction velocities are recommended for isokinetic training and it appears that fast, moderate, and slow velocities are effective for improving local muscular endurance during dynamic constant external resistance training, depending on the number of repetitions performed (Campos, Luecke, Wendeln, 2012). The important component to local muscle endurance training is to prolong the duration of the set and two effective strategies used to prolong set duration are: 1) Moderate repetition number using an intentionally slow velocity and reduced fatigue during exercise performance. One study reported greater increases in muscle cross-sectional area and strength when training volume was divided into two sessions per day rather than one (Hakkinen & Kallinen, 2014). Elite power lifters typically train 4–6 days/week (Fleck & Kraemer, 2012), and it is important to note that not all muscle groups are trained specifically per workout using a high frequency, rather, each major muscle group may be trained 2 to 3 weeks despite the large number of workouts. A recent study examined training frequency with a particular focus on resistance training overreaching (Ratamess, Kraemer & Volek, 2013). Overreaching is a short-term training phase in which the volume, frequency, and/or the intensity of resistance exercise is increased above normal and the rationale is to overwork in order to suppress performance and build up tolerance and then taper to produce a subsequent “rebound” in performance (Fry & Kraemer, 2012). Ratamess, Kraemer & Volek (2013) trained experienced participants for 4 weeks using total- body resistance training consisting of two 2-weeks phases of overreaching such as phase 1: 3 8– 12 RM, eight training; phase 2: 5 3–5 RM, five training and verreaching was achieved by training each major muscle group on consecutive days for 5 days/week; the participants had just completed a 4-week base training phase of 2 days/week and the overreaching program resulted in a large increase in frequency and volume. After the first week, 1 RM squat and bench press significantly decreased (5.2 and 3.4 kg, respectively) in one group of participants who did not ingest an amino acid supplement. However, significant increases in 1 RM squat and bench press were observed after the second, third, and fourth weeks of training. In addition, further increases in strength were observed following a 2-week reduced volume/frequency phase. These results supported the concept of overreaching and indicated that a large short-term increase in training volume and frequency can produce significant increases in performance, therefore, it is important to note that overreaching for an extended period of time may lead to overtraining in which significant declines in performance may be observed. 2.3.5 Basic Principles of Progression Majorly, the goal of a resistance training program is to improve some component of fitness or health until a certain level has been attained and for improvements to occur, the program used must be systematically altered so that the human body is forced to adapt to the changing stimuli. Thus, progression may be defined as the act of moving forward or advancing toward a specific goal (American College of Sports Medicine, 2012). Although it is impossible to continually improve at the same rate over long-term training, the proper manipulation of program variables can limit training plateaus, that is, that point in time where no further improvements takes place, and consequently enable achievement of a higher level of muscular fitness. Three general principles of progression are: 1) Progressive overload 2) Variation 3) Specificity. Progressive overload This describes the gradual increase of stress placed upon the body during resistance training, tolerance of increased stress-related overload is of particular concern for the practitioner and clinician monitoring program progression. In reality, the adaptive processes of the human body will only respond if continually required to exert a greater magnitude of force to meet higher physiological demands and considering that physiological adaptations to a standard resistance training protocol such as a protocol with no variation in any program variable may occur in a relatively short period of time, a systematic increase in the demands placed upon the body is necessary for further improvement. There are several ways in which overload may be introduced during resistance training. For strength, hypertrophy, local muscular endurance, and power improvements, either: 1) Load (resistance) may be increased 2) Repetitions may be added to the current load 3) Repetition speed with sub-maximal loads may be altered according to goals 4) Rest periods may be shortened for local muscular endurance improvements or lengthened for strength and power training 5) Volume may be increased within reasonable limits 6) Any combination of the above. It has been suggested that only small acute increases in training volume (2.5–5%) should be imposed initially until adaptation has occurred according to Fleck & Kraemer (2012). The importance of progressive overload can be observed when examining the interplay between neural and muscular adaptations during strength and power training, the nervous system plays a significant role in the strength increases observed in the early stages of adaptation to training (Sale, 2013). That is, improvements in motor unit recruitment, firing rate, and synchronization take place and account for early increases in strength and subsequent increases in training loads. Within a short period of time (i.e., 4–8 wk of training), muscle hypertrophy becomes evident according to Kraemer, Patton, Gordon (2015), although changes in the quality of proteins, fibre types and protein synthetic rates take place much earlier. From this initial phase onward there appears to be an interplay between neural adaptations and hypertrophy in the acute expression of muscular strength (Sale, 2013). Systematic variation has been used as a means of altering program design to optimize both performance and recovery, however, the use of periodization is not limited to elite athletes or advanced training but has been used successfully as the basis of training for individuals with diverse backgrounds and fitness levels. In addition to athletics and older adults, periodized resistance training has been shown to be effective for health and recreational training goals (Stone, O’bryant & Garhammer, 2011). Although numerous ways exist in which programs may be varied, two general models have been examined, one model is the classic model, which is characterized by high initial training volume and low intensity (Garhammer, 2011) and as training progresses, volume decreases and intensity increases in order to maximize strength, power, or both (Fleck, 2016). Typically, each training phase is designed to emphasize a particular physiological adaptation, for example, hypertrophy is stimulated during the initial high volume phase, whereas strength and power are maximally developed during the later high-intensity phase; in comparisons of classic strength/power periodized models to non-periodized models have been previously reviewed. These studies have shown classic strength/ power periodized training superior for increasing maximal strength, e.g., 1 RM squat, cycling power, motor performance, and jumping ability. However, a short-term study e.g., 12 wk has shown similar performance improvements between periodized and multiple-set nonperiodized models in resistance-trained individuals (Bker, Nance & Carlyon, 2014). It has been shown that longer training periods are necessary to underscore the benefits of periodized training compared with non periodized training, the results of these studies demonstrate that both periodized and non periodized training are effective during short-term training, whereas variation is necessary for long-term resistance training progression. A second examined model is the undulating model. The undulating program enables variation in intensity and volume within each 7- to 10-days cycle by rotating different protocols over the course of the training program; undulating methods attempt to train the various components of the neuromuscular system within the same 7- to 10-days cycle and during a single workout only one characteristic is trained in a given day, e.g., strength, power, local muscular endurance. For example, in loading schemes for the core exercises in the workout, the use of heavy, moderate, and lighter resistances may be randomly rotated over a training sequence, for example, 3–5 RM loads, 8–10 RM loads, and 12–15 RM loads may be used in the rotation. Significant improvements in various parameters of muscle fitness using a similar 3 days/week undulated program with each workout dedicated to either power, strength, or hypertrophy in young and older men has been reported and this model compares favourably with the classical model and non periodized multiple-set programs (Fleck, 2016). Recently, this model has been shown to be more effective for increasing 1 RM bench press and leg press after 12 weeks of training compared with the classic model and have distinct advantages in comparison with non periodized, low-volume training in women (Fleck, 2016). The principles of resistant training are summarized in the table below. Principle Technical Term Individuality: Optimal benefits occur when programs meet the individuals needs & capacities of participants  Trainability: Each person responds differently to the same training stimulus Specificity: The training stimulus must be specific to the clients desired outcomes Overload: For adaptation to occur the volume of exercise must overload the body in some way in line with the capacity of the individual to cope with that overload Progressive Overload: For continual adaptation overload must be progressive, that is the dose of exercise must increase Variety: For optimal adaptation and to avoid stagnation, overuse, and injury the exercise stimulus must be varied (this does not simply mean changing exercises all the time). Rest: Optimal adaptation requires rest periods to be interspersed with training sessions sufficient that the adaptations caused by the exercise dose can take place. Reversibility: All beneficial effects of exercise are reversible if exercise ceases Maintenance: Current fitness levels can be maintained by exercising at the same intensity while reducing volume (frequency and/or duration) by 1/3 to 2/3 Ceiling: As fitness increases the relative & absolute improvements in fitness will decrease, even with continual overload Interference: When training several components at once (e.g. strength & endurance) the stimuli may interfere with each other, thereby slowing adaptation in one or both components FITT (FREQUENCY, INTENSITY, TIME, TYPE) Each of the fitness components has an ideal training frequency (how often), intensity (how hard), time (duration, rest intervals) and type of exercise to be used.  The ‘FITT’ principle is largely a practical ‘amalgamation’ of all the other exercise principles Source: Adopted from Physiotherapy Direct 2.3.6 Effect of Training Status and Progression Initial training status plays an important role in the rate of progression during resistance training and training status reflects a continuum of adaptations to resistance training such that level of fitness, training experience, and genetic endowment each make a contribution. Untrained individuals, for example, those with no resistance training experience or who have not trained for several months to years respond favourably to most protocols, thus making it difficult to evaluate the effects of different training programs. The rate of strength gain differs considerably between untrained and trained individuals; trained individuals have shown much slower rates of improvement. A review has it that muscular strength increases approximately 40% in “untrained, 20% in moderately trained, 16% in “trained,” 10% in “advanced,” and 2% in elite over periods ranging from 4 weeks to 2 years, although the training programs, durations, and testing procedures of these studies differed, it is shown that a specific trend toward slower rates of progression with training experience. This has recently been shown through meta-analysis of 140 example, greater range of motion in your hips and knees will allow you to sink deeper into a squat. Ultimately, having a greater ROM will make it so you're able to do more exercises and do them properly (Winderl, 2018). c. Hip circle drill rotations are a great way to loosen up the hips, Burrell (2018) says, "If your hips are tight, like mine, these are so important to help with preparing for lower body training." Tight hips can inhibit the muscles around them from firing properly, specifically the glues, which can cause other body parts to compensate and become strained. d. Lunge drills work the glutes, quads, and hamstrings, and going straight from lunge to lift requires some serious core strength and stability. Lunges provides strength and flexibility needed that protects from injury. This can benefit resistance activities like leg extension, squat and leg curl (Winderl, 2018) 2.3.8. Considerations for Older Adults in Resistance training Resistance training is a strength demanding training and the key factor to successful resistance training at any level of fitness or age is appropriate program design. Program design entails proper training instruction like technique, breathing, correct use of equipment, goal setting (so the program can target specific areas of interest), a method of evaluation of training progress toward training goals, the correct prescription of the acute program variables, and the inclusion of specific methods of progression targeting particular areas of muscular fitness (William & Nicholas, 2014) . The needs and training goals of older adults differ greatly from those of teens or young and middle adults. Generally, the most common reason for a young or middle- aged adult to hire a personal trainer is weight loss (Melton et al., 2015), however, that goal is not always appropriate for older adults or youth. The current recommendations for training prescription in older adults indicate that the exercise program should include strength (resistance) training at least twice weekly (Ann, Yelmokas, McDermott & Mernitz, 2013). A study has shown that Completing assessments in conjunction with appropriate training prescription guidelines can help the trainer and client develop SMART (specific, measurable, attainable, realistic and timely) goals together, as goals related to strength gains, increases in lean body mass, increases in VO2 max, ease of performing activities of daily living (ADLs), improvement in lipid levels and insulin sensitivity and training compliance are appropriate for this population. The consideration will be looked into with following headings: a. Physical activity Readiness Questionnaire  It is critical that the potential client complete a Physical Activity Readiness Questionnaire (PAR-Q). Older adults are more prone to special conditions such as diabetes, hypertension, dyslipidemia, cancer, coronary artery disease, osteoporosis, severe muscle atrophy and other orthopedic issues. A careful medical history including medication usage should help the fitness professional screen for these special conditions. Postural assessment can help the trainer identify abnormalities such as forward head position, lordosis or kyphosis. Forward head posture can be associated with respiratory distress and individuals with kyphosis can have difficulty with ADLs and have an increased risk of falls, vertebral fractures and premature death. Likewise, postural deviations can indicate the presence of other disease processes such as osteoporosis, proprioceptive deficits, and muscle degradation (Roghani et al., 2017) b. Baseline Movement Baseline movement dysfunction can be assessed by overhead squat movement. However, many older adults may not be comfortable squatting or may not have the ability to complete the test. Instructing the client to assume the overhead squat assessment positioning (toes pointed forward, arms straight up overhead) while proceeding to sit in a chair is a reasonable modification for these clients. Oftentimes, without the modification, the OHSA may yield false results (such as an inadequate forward lean) as the client may not be able to attain low enough squat depth to adequately screen for movement dysfunction. The OHSA can detect specific flexibility limitations based on the movement compensations identified (Clark, Lucett & Sutton, 2014). c. Balance The recommended assessment when working with older adults is the assessment of balance deficit. The gold standard assessment for balance in older adults is the Berg Balance Scale which is also used in clinical settings. The BBS assessment requires the participant to perform several balance related tasks under the supervision of a fitness professional. A score of 0-20 indicates a high fall risk, a score of 21-40 indicates a medium fall risk and a score of 41-56 indicates a low fall risk. Clients that are at high fall risk, especially if they have co-morbidities, may warrant referral to a physical therapist (Sanders, 2014). d. Cardiovascular Integrity A study has shown that cardio consideration is vital for older adults. The Rockport Walk test is vital for this (Enright, 2013). Rock test is a 6-minute walk test which is reliable alternative in this population that can provide baseline information on functional and cardio-respiratory status. e. Muscle Strength Muscle strength is another consideration for weight selection in older adults. Two tests that are easy to perform in the fitness facility setting are the Chair Stand Test and the Arm Curl Test. The Chair Stand test requires the client to stand up from a seated position without using their arms and return to a seated position. The goal of the test is to complete as many repetitions as possible research shows that especially the asymmetry of the vertical GRF between the limbs can, as a result of long-term asymmetry, lead to degenerative changes within all joints of the healthy lower limb; particularly prone to degeneration is the knee joint, in which the range of motion is limited first, which then leads to arthrosis (Harandi, ackland, Haddara, Lizama, Graf, Galea & Lee, 2020). This is because patients are not able to load the compromised involved limb similarly to an unimpaired leg, which leads to load asymmetries and an increased weight transfer to the uninvolved limb. Another manifestation of compromised gait’s asymmetry is an 8% shorter stance on the involved side and a 4 cm wider step length when compared to controls (Hof, Bockel, Schoppen, Postema, 2016). Asymmetry in gait is manifested at various times during the gait phases throughout the whole walking cycle. Various formulas were previously adopted to evaluate side differences in an impaired gait, considering the classification proposed by (Viteckova, Kutilek, Svoboda, Krupicka, Kauler & Szabo, 2018), symmetry assessment approaches can be divided into discrete, complete gait cycle, nonlinear or statistically-based methods. Although commonly used scalar indicators and symbol- based characteristics are an effective measure of temporal and spatial asymmetry, they still do not provide a comprehensive assessment of gait symmetry. (Roerdink, Roeles, Van der pas, Bosboom & Beek, 2012) noticed that step length asymmetry for people after limb compromise assessed using the symmetry index differed between participants and that some of them showed symmetry even though their gait were asymmetrical. A normal gait depends upon normal functioning of the nervous, muscular, skeletal, circulatory and respiratory systems in a highly co-ordinated and integrated manner; the cerebellum regulates the cognitive and automatic processes of posture-gait control by acting on the cerebral cortex via the thalamocortical projection and on the brainstem, respectively. Both the feed forward information from the cerebral cortex via the cortico-ponto-cerebellar pathway and real-time sensory feedback via the spinocerebellar tract to the cerebellum may play major roles in these operations. The basal ganglia may also contribute to the modulation of each process though its gamma-aminobutyric acid (GABA)-ergic projections to the cerebral cortex and brainstem (Takakusaki, 2012). The degree of GABA-ergic influence from the basal ganglia is regulated by the midbrain dopaminergic neurons (DeLong, Wichmann, 2014) and muscles bring about the force that is required to move the limbs in a coordinated manner, the circulatoy system provides the required amount of oxygen that is nedded to fuel the fibres and the skeletal system brings attachment to the muscles and provides increase in forward propulsion by virtue of its mass (momentum effect). Injury or disease of one or more of these systems may lead to impairment of the gait and consequently reduce the patient's mobility and independence. In recent years, attempts have been made to quantify such pathological changes, for instance, following fractures of the lower limb (Imms &.MacDonald, 2016) and strokes in patients with Parkinson's disease (Imms, 2011) and following joint replacement; it is becoming increasingly clear that studies of both gait and mobility may have an important role in the objective assessment of recovery from conditions directly and indirectly affecting the locomotor system. Since such conditions have an increasing incidence with age, it follows that disturbances of gait are likely to be more prevalent in the older adult. Most previous studies of gait have shown that older peoples gait are used for assessing the effects of disease or for quantifying progress during recovery 2.4.1 Detecting Changes in Gait in the Older Adults Most gait disturbances can be diagnosed and classified after obtaining a good history and performing a detailed physical and neurological exam including watching the gait. For many, the diagnosis can be straightforward due to specific patterns of stepping, such as the wide base and varied step length and speed in ataxic gait, slow, small shuffling steps with decreased arm swing in parkinsonian gait and those due to spasticity, weakness and sensory loss. However, in some the cause is not clear and appears to take on features of several types of problems and anatomic origins (multifactorial gait disorders) or is bizarre in character, and the diagnosis is not clear. Some of those with bizarre features may be of a functional etiology. Changes in motor skills that occur with aging vary widely and it is generally accepted that many bodily functions decline with age, including the ability to walk; for older individuals, walking is one of the most important factors in maintaining an independent lifestyle and remaining in the community. As aging occurs, there can be distinct changes in gait patterns. There is some controversy in the field as to whether change occurs as a result of aging or as a result of pathology (Imms & Edholm, 2011). There is tremendous heterogeneity in the process of aging and in the functional changes that occur in gait as one ages, older adults can be divided into three sectors: the young-old (55-75 yr), the middle-old (76-84 yr), and the oldest-old (85+ yr) (Guccione & Baltimore, 2013); various changes and challenges occur at each stage and all healthcare practitioners should be aware of the changes in gait as they may be indicative of subtle changes in multiple systems. Early identification and early intervention can be important in prevention of deterioration or secondary deficits, therefore, it is important to examine the cardiovascular, neuromuscular, and musculoskeletal systems associated with age related changes in gait. Are the changes affecting gait due to abnormalities in all bodily systems, or are certain systems more involved than others and in different timing sequences? Careful periodic assessment may help to identify changes as they occur and provide appropriate intervention to prevent dysfunction and loss of independence. Intervention to prevent dysfunction and/or (2) Decreased stride and step length with increased stride frequency observed are average speed declines of 12% to 16% per decade for free gait speed and up to 20% decline for maximum gait speed (Newstead, Walden & Gitte, 2014) Several researchers have identified a variety of gait characteristics observed to change in community-dwelling adults as a result of aging and the manifestations of acute and chronic disease. These changes include increased double limb support from 18% in the young to 26% in the elderly and in addition, there is a mild decrease in push-off with flat-foot heel strike; forward trunk flexion increases as a result of osteoporotic processes, postural control, core weakness, or a combination of these factors. There is increased elbow and knee flexion and smaller toe clearances, smaller toe clearances may be a contributory factor in falling, especially during turning; gait variability, defined as the stride-to-stride fluctuations in walking, are unchanged in healthy older adults and impairment in the ability to avoid obstacles was attributed to both delayed onsets and reduced response amplitudes of motor units detected through electromyography (EMG) results in a recent study of community-dwelling adults who participated in some type of sports (Weerdesteyn, Neinhuis, Geurts & Duysens, 2014) In a group of less-fit older persons, one might expect to find an even greater difficulty with obstacle avoidance due to even poorer EMG activity also physiologic factors that affect gait dynamics include neural control, muscle function, and posture control, which are impaired by aging and/or neurodegenerative diseases. Changes in the cardiovascular system and mental health can also affect the variability of gait and one can look at changes in the physiologic and neuromuscular systems as contributory to the gait changes with aging, specifically the loss of cross-sectional muscle mass (10-40%), decrease in type I and typeII muscle fibres, prolonged contraction time and one-half relaxation time, and a decrease in conduction velocity in sensory and motor nerves in both the central and peripheral nervous system (Kauffman, 2011). Furthermore, within the articular cartilage, there is formation of cross links and loss of elastic fibres, resulting in stiffer joint capsules and ligaments that affect the quality of movement and gait. The resultant movement pattern will be slower, more uncertain and uncoordinated, and lacking full range of motion. 2.4.3. Kinematics of Gait Kinematics describes movement in terms of displacement, velocity, and acceleration. This dissertation reviews the kinematics of gait only in terms of displacement, including the distance and temporal (time duration) characteristics of gait followed by a description of the discrete movement patterns of individual joints during gait. Kinematics will be discussed under the following headings: a. Time and Distance Characteristics of Gait Step length is the linear distance measured from the heel strike, or initial ground contact, of one foot to the next heel strike of the contralateral foot and step width represents the base of support and is measured as the perpendicular distance between similar points on both feet, measured during two consecutive steps whereas foot angle is the angle measured between the long axis of the foot and the line of forward progression. Although there is much variation in these parameters among individuals, within an individual there is usually side-to-side symmetry, thus, asymmetric step length, width, or foot angle should key the observer to look for the cause of the asymmetry. Asymmetric step length is often observed in individuals who has a unilateral limb compromise, although there are many causes for asymmetrical step lengths, individuals who has unilateral limb compromise often spend less time in stance phase on the involved side, which shortens swing time and thus step length on the non- involved side (May & Lockard, 2011). The primary temporal characteristics of the gait cycle are walking speed and cadence and walking speed is the distance covered in a period of time, usually reported in research studies as meters per second (m/sec); treadmills in the United States, however, usually show speed as miles per hour (10 meters equals 0.006 mile). Most sources report typical step time for an unimpaired adult as about 1 second and normal walking speed as about 3 to 4 miles per hour (mph) or about 1.3 m/sec. Cadence is the number of steps per minute and walking speed is a function of cadence and step length and increasing either or both cadence and step length will increase walking speed and, as a result, reduce stance time and swing time. Although both stance and swing time are reduced as walking speed increases, stance time is reduced more; thus, as walking speed increases, the swing-to-stance-time ratio normally about 0.6 approaches unity. Similarly, gait speed decreases when either step length or cadence is reduced and a commonly observed effect of aging on gait is a reduction of gait speed, typically caused by decreased step length, rather than reduced cadence (Gailey, 2011). Slower gait speed is also common among individuals with impairments that require the use of prosthetic or orthotic devices (May & Lockard, 2011). b. Angular Displacement of Joints during Gait The joints of the upper and lower extremity and trunk go through repetitive movement patterns of joint excursions during the gait cycle, because joint movements in the lower limb occur under closed chain conditions during stance, insufficient joint ROM in one joint requires compensation at another joint or joints. These compensations produce abnormal movement patterns called gait abnormalities or deviations, and as a result, these joint measurements also represent the joint passive ROM requirements for normal joint movement patterns to occur during gait; joint excursions in the frontal and transverse planes during gait are much smaller and more variable, adduction continues until late stance and the beginning of double support, when limb loading begins on the contralateral side (double support), hip abduction begins ipsilaterally in response to lateral pelvic shift to the new weigh bearing limb. The knee has little frontal plane movement as long as there is good ligamentous stability and frontal plane movement of the foot reflects the calcaneal inversion and eversion component of closed chain supination and pronation. The general pattern of movement in the foot during gait includes subtalar pronation (frontal plane eversion) during early stance/weight acceptance and subtalar supination (frontal plane inversion) during mid- and late-stance phase, this pattern of movement helps to keep the plantar aspect of the foot in contact with the ground through stance phase, allows the foot to be flexible during weight acceptance to absorb or give out the impact of limb loading, and makes the foot more rigid to facilitate push-off during late stance (Lockard, 2011). iii. Transverse Plane Movement Pattern Like movement in the frontal plane, transverse plane movements are also very small and variable and transverse plane movements at the hip joint (internal and external rotation) are a function of transverse plane motion of the pelvis and the femur in the closed chain. Forward rotation of the pelvis about the stance limb accompanies hip flexion during swing and reaches maximum forward rotation at foot initial contact and this forward pelvic rotation that occurs with hip flexion produces a greater step length than is possible from hip flexion alone. The forward pelvic advancement also contributes to lateral rotation of the advancing leg, at the same time the opposite hip (of the stance limb) is in maximum extension, the pelvis is in relative backward rotation and the femur is rotated medially. Independent femoral rotation about its long axis also contributes to the rotation movement that occurs at the hip joint. At initial contact, the femur is oriented close to neutral and it rotates internally (medially) during weight acceptance and midstance then begins to rotate laterally, which continues through midswing when medial rotation resumes. Despite considerable variability, the direction of the movement pattern at the hip in the transverse plane is medial rotation from initial contact through mid to late stance followed by lateral rotation through late swing (Lockard, 2011). During the closed-chain conditions of stance phase, transverse plane movement at the knee is influenced by motions occurring at the foot and sagittal plane motion at the knee. Pronation of the foot is linked to tibial medial rotation and knee flexion, which together facilitate shock absorption during loading response, and later in stance as the foot supinates, the tibia rotates laterally and the knee extends, allowing the body to roll forward, smoothly transferring weight onto the opposite limb (Michael, 2014) iv. Movement Patterns of the Trunk The head and trunk also participate in the cyclic movement patterns that occur during the gait cycle. In the sagittal plane, the trunk displays slight flexion (forward lean) and extension during the gait cycle; the trunk is more erect during single limb support and is slightly flexed during double-limb support. In the frontal plane, the trunk leans slightly toward the stance limb with each step in order to keep the centre of mass (COM) over the stance foot and maintain balance and also in the transverse plane, trunk forward rotation is concomitant with forward pelvic rotation on the opposite side. Additionally, the shoulder flexes with forward trunk rotation on the same side and the linked but opposite rotation that occurs between the trunk and pelvis is necessary for efficiency of movement during gait. Individuals who are unable to rotate their trunk and pelvis separately due to back pain, muscle rigidity, or restrictions caused by fitted devices expend more energy during walking (Begerow, 2014). c. Muscle Activity during Gait Muscle activity during gait has been studied extensively with electromyography (EMG) (Ehde & Smith, 2014). During gait, muscles contract primarily in short bursts of activity, most often at times of transition between phases: swing to stance or stance to swing and typically, muscles first contract eccentrically to decelerate the limb or a limb segment, followed by a concentric contraction, which initiates the affected joint’s forward movement or movement in the opposite direction. Most often, the joint affected by a concentrically contracting muscle continues to move after active muscle contraction has ceased due to the kinetics or momentum of the movement. Illustrations of these principles of muscle activity during gait are presented in the following descriptions of the muscular control of the joints of the lower limb during walking. At the transition from swing to stance, several muscles have a burst of activity: these include the gluteus maximus, the hamstrings, the gluteus medius, the quadriceps, and the dorsiflexor muscles; the gluteus maximus and hamstrings contract eccentrically to decelerate the flexing hip at the end of swing phase and their continued contraction helps to initiate hip extension in early stance and additionally, the effect of the gluteus maximus on the femur during early single limb support helps to fix the femur and accelerate the knee into extension. Individuals who have difficulty maintaining knee extension during midstance due to quadriceps weakness can compensate by maximizing this effect of the gluteus maximus in contributing to knee stability. The gluteus medius also has a burst of activity during this same time frame. It begins contracting just before initial contact, peaks during weight acceptance, and continues to contract at a lower level until loading begins on the opposite leg and it provides frontal plane stability to the pelvis through stance phase. Muscle activity at the knee demonstrates contraction of the quadriceps and hamstring muscles during loading response and early midstance and the quadriceps is essential in controlling the knee during the early part of stance. During late stance, however, quadriceps PVD is characterised by atherosclerosis of lower extremity arteries causing occlusive disease, it is strong predictive factor for atherothrombotic disease in other vascular beds and PAD involvement is mostly diffuse and particularly is more severe in tibial vessels. It usually involves long segment occlusions and in a non-diabetic individual, collateral vessels develop in response to occlusion of a major artery and this collateral formation is impaired in diabetes rendering the distal tissue more prone to severe ischemia. Patient with PVD most commonly presents with a cramping pain in the calves, thighs or buttocks known as intermittent claudication and this pain is relieved by rest and reappears with walking and movement (Premalatha, Shanthirani , Deepa , Markovitz & Mohan, 2010). 2.5 Effects of Resistance training on Selected Gait Variables and Risk Factors of Peripheral Vascular Disorder 2.5.1 Overweight A new systematic review and meta-analysis shows we can lose around 1.4 per cent of our entire body fat through resistance training alone, which is similar to how much we might lose through cardio or aerobics (Wewege, 2021). Resistance training has proven to be effective in reducing excess adiposity in older adult. In this research body weight will be measured by body mass index. Body mass index is simple index of weight with the square of the height has been used as a tool for estimating the body fat collection and thus an indirect means of cardiovascular and metabolic risk estimation, and classify overweight and obesity. It’s defined a person’s weight in kilograms divided by squares of his or her height in meters (kg/m2) (World Health Organization, 2019). Researchers have recommended diagnosing a child weight as from the age of two and above as overweight if the child’s body mass index is greater than or equal ≥85th percentile but less than < 95th percentile for age and sex, then as obese if the body mass index is equal to or greater than ≥ 95 th percentile and as extremely obese, if the body mass index is equal to or greater than ≥ 120% of the 95th percentile or greater than ≥ 35kg/m2 (Styne, Arslanian, Connor, Afrooqi, Murad, Silverstein,etal, 2017). Body fat can be assessed with both tissue measurements and calculations from body dimensions. Body mass index (BMI) is a common calculation, although it does not measure body fat (Blackburn & Jacobs, 2014). Body Mass Index (BMI) is a value that is calculated by dividing an individual’s weight in kilograms by the square of his/ her height in meters. Although this value does not measure body fat directly, it is correlated with more direct measure of body fat composition (Centres for Disease Control and Prevention, 2013). 2.5.2 Speed Research has shown that the main reason to do undergo resistance drills is to help athlete build functional power to generate faster accelerations and attain high maximum speed; resistance training helps athletes increase their speed-to-strength ratio which improves their ability to generate great force during splint. Building functional strength, power and speed requires an athlete to use the same muscle in the same movement patterns as during their sport (Quinn, 2019). Lee, Son & Kim (2013) in their study confirmed that resistance training contributes with the improvement of the gait speed. In another study by Papa & Hassan (2016), resistance training can attenuate age -related in muscle function and improve activities of daily living such as gait speed and walking endurance. 2.5.3 Step length Resistance training has been seen to enhance step length, and step length seems to be more influenced by RT than flexibility training. Gregory, Gutierrez, Chow,Tillman, McCoy, Castellano, Lesley & White, (2015) in their study on Resistance training confirmed that after 2 months, there were significant increases (P.05) in percentage of step length. 2.5.4 Hypertension By definition, blood pressure refers to the force of the blood against the walls of the arteries and veins created by the heart as it pumps blood to every part of the body. It is reported as a fraction of systolic over diastolic pressure, systolic blood pressure is the highest arterial pressure reached during contraction of the heart. Diastolic blood pressure is the lowest pressure, found during the heart’s relaxation phase. Blood Pressure is typically expressed in millimetres of Mercury, mmHg, and it’s a dynamic variable. The arterial, heart-level blood pressure is the one typically measured at rest and during exercise (Gaurav, Dureja, Sukanya & Bardhan, 2014). In other word the ratio of systolic blood pressure to the diastolic blood pressure give rise to the blood pressure of an individual while systolic blood pressure is the maximum pressure in the arteries when the ventricles contract during a heartbeat. The term derives from systole, or contraction of the heart. The systolic blood pressure occurs late in ventricle systole. Systolic blood pressure is thought to represent the overall functioning of the left ventricle and is important indicator of cardiovascular function during exercise (Gaurav, Dureja, Sukanya & Bardhan, 2014) However systolic blood pressure is typically measured from the brachial artery at heart level and is expressed in units of millimetres of Mercury (mmHg) (Gaurav Dureja, Sukanya Bardhan, 2014). However, diastolic blood pressure is the minimum pressure in the arteries when the ventricles relax. The term is derived from diastole, or relaxation of the heart. The diastole is the blood pressure occurs late in ventricular diastole and reflects the peripheral resistance in the arterial vessels to blood flow. Diastolic blood pressure is typically measured from the brachial artery at heart level and is expressed in units of millimetres of Mercury (mmHg) (Dwyer and Davis, 2013). required less than 9.2 (range 8.2 to 10.2) seconds are identified as independent. about falls had average scores ranging from 7.1 to 9.4 seconds, with the mean score slightly higher in the group with high concern about falls than in the group with low concern about falls (8.4 and 8.1 seconds, respectively). Everitt & Dunn (2011), In a cohort study involving 597 elderly individuals over 70 years of age. found that a reduction in step length leads to instability of the head and pelvis in the vertical andanterior–posterior directions, thereby affecting the stability of the gait cycle. Deluzio & Stephen (2014). Thus, although it may be a normal reaction, high concern about falls leads to a reduction in step length which contributes towards a more unstable gait and an even greater risk of falling. The step length difference found between the two groups was 6.0 cm, which could clearly affect gait stability found that a reduction in gait velocity of 0.1 m/second increases the risk of falls by 7%, and that participants with a gait velocity equal to or less than 0.7 m/second had a 1.5- fold greater chance of falling than those with a normal velocity. Fried (2011). In one study, differences in double support time between a group with low concern about falls and another with high concern about falls were only found when walking was performed in elevated walkway conditions. In the present study, the intensity of the fear of falling was assessed using the FES-I [7]. The FES-I is an expanded version of the original FES designed and involves different activities of daily living, thereby portraying the concern an individual has upon performing these activities. The self-report of falls was used as the classification variable for the cut- off point of the FES-I, which, although it has been considered to have poor sensitivity for the degree of concern an individual has when performing particular activities, reflects a specific fear to some extent. The result was a cut-off point of 20. Sixteen of the 81 elderly women who reported not being afraid of falling were included in the high concern group. Podsiadlo & Richardson (2011). Another study investigated if gait parameters and the Timed Up and Go mobility test could discriminate between elderly women with low and high concern about falls. As gait parameters are highly correlated variables, the application of multivariate analysis is appropriate for Gait velocity is directly proportional to step length in the gait cycle. A reduction in step length, and consequently stride, is one of the strategies used to reduce gait velocity. determination of the independent effect of these parameters on concern about falls. The discriminant model revealed that step length had greater power to discriminate than either gait velocity or the Timed Up and Go test score. This reduction in step length has been observed in elderly individuals concerned about falls Winter (2012) suggest that, under conditions of normal gait, the primary cause of a reduction in gait velocity among elderly individuals is physical limitation. It has recently been demonstrated in a group of elderly individuals (adjusting for age) that the factors most strongly associated with a reduction in gait velocity are reaction time and quadriceps muscle strength. Speed in Gait Thal (2014), A cross-sectional population based on a sample of 1112 older adults aged 60 years and over from Health, Wellbeing and Aging. Usual gait speed (s) to walk 3 meters was stratified by sex and height into quartiles. Multiple regression analysis was performed to investigate the independent effect of each factor associated with a slower usual gait speed. The average walking speed of the elderly was 0.81 m/s – 0.78 m/s among women and 0.86 m/s among men. In the final model, the factors associated with lower gait speed were age (OR = 3.56), literacy (OR = 3.20), difficulty in one or more IADL (OR =  2.74), presence of cardiovascular disease (OR =  2.15) and sedentarism. When considered the 50% slower, one can add the variables handgrip and the fourth quartile includes faster gait speed values. For the descriptive analysis, mean and standard error values were calculated for the continuous variables, and proportions were calculated for the categorical variables. Differences between groups were estimated using the Wald test of mean equality and the Chi-Square Rao-Scott correction, which considers sample weights for estimates with population weights. We adapted the significance level for the tests a p value <0.05. Most elderly subjects were women (60.3%), white ethnicity (self-declared) (58.4%), had between four and seven years of study (38.1%), lived with someone else (56.7%), self- reported regular health (51%), were inactive (59.6%), had two or more chronic diseases (54.4%) and 48.3% were overweight. Prevalence values found were 7.5% for cognitive impairment and 17.6% for depressive symptoms. Regarding disability, 33% were dependent in at least one IADL and 24.7% in at least one ADL. The average walking speed of the subjects was 0.81 m/s – 0.78 m/s among women, and 0.86 m/s (30.0%), bad or very bad self- reported health (43%), and cognitive impairment (60.4%). Lower handgrip strength of the dominant hand, higher TUG, having some kind of inability, at least one ADL or IADL, and having 2 or more chronic diseases such as AVC or DCV composed the first quartile  among men. Teixeira (2012), in his study in a developing country with special focus on the social determinants of health showing that poor socioeconomic conditions, together with modifiable factors, play an important role in gait speed. Being older, illiterate, having difficulty in one or more instrumental activities of daily living, the presence of cardiovascular disease and being sedentary are independent factors associated with lower walking speed among the elderly. The results of his study were similar to those found worldwide. They indicated that gait speed decreased with older age. Our older adults, however, were significantly slower than foreign populations and their gait speed was slower than the overall fast gait speed of participants who were 70 and older with mobility limitations living in community. Studenski &Perera (2011) found that for healthy women and men aged 70– 79, the usual gait speed was 1.13 m/s and 1.26 m/s, respectively, and for those aged 80–89, the values were 0.94 and 0.97 m/s respectively both higher values compared to our result. The gait speed of older adults in our study were similar to the elderly aged 80–89 living in community in Dublin(Ireland), 30 percent of whom needed more assistance to walk and longer TUG, 14.2 s (versus 5.6) compared to the Brazilian sample showed in this study. Guralnik (2011) The FIBRA study included subjects from different Brazilian cities with different Human Development Indexes, at an increased average age of 71.4. Besides that, the percentage of illiterate older adults was smaller and the methodology was different from our research. Unlike the FIBRA study, which used a convenience sample, ours used a weighting sample in which a weight is attributed to each individual, which indeed makes it a representative sample of the city of Sao Paulo. Other studies included volunteer subjects or only women. compared his results with those obtained from another sample of Brazilian elderly subjects – FIBRA network study (Frailty among Brazilian Older Adults), our average gait speed value was slower than the average of (1.11 m/s) that study. Anderson (2012), This study was based on data from the Umeå 85+/GErontological Regional DAtabase (GERDA) population-based cohort study by Umeå University, Sweden. Half of inhabitants aged 85 years (selected from a randomized starting point) and all of those aged 90 and 95 years or older in 8 municipalities of northern Sweden and western Finland were selected from national tax and population registers for In the total sample and slower- walking subcohort, systolic BP appeared to be inversely associated with mortality, although not independent of adjustments. Among faster- walking participants, mortality risk after adjustment was more than 2 times higher in those Correlations were tested between all baseline covariates, and the ADL score covariate was removed from the analyses due to strong (r > 0.6) correlations with the care facility residency, MMSE score, diagnosis of dementia, and gait speed covariates. The diagnosis of dementia covariate was removed due to strong correlation with MMSE score. The antidepressant prescription covariate was removed to reduce the risk of an overlapping effect with the diagnosis of depression covariate. Associations between all-cause mortality and categorized systolic and diastolic BP, respectively, were analyzed using Cox proportional hazard regression models. Bell (2010) Showed the baseline characteristics of the study population with respect to survival status and gait speed subcohort. In the study population (n = 806), the mean age was 89.6 years. A total of 490 (61%) participants died within 5 years (mean, 3.34 years) after study inclusion. Approximately two-thirds (n = 561) of participants were women, most (63%) of whom had gait speeds slower than 0.5 m/s (slower-walking subcohort, also including habitually nonwalking participants). The slower- walking subcohort included 3 times as many women as men. Almost two-fifths (39%) of study participants were living in a residential care facility, and few (16%) of these participants were assigned to the faster-walking subcohort. BP- lowering drugs were prescribed to 70% of participants. ACE inhibitor and diuretic prescriptions were significantly more prevalent in the slower- walking subcohort (20% and 54%, respectively) and among those who died within 5 years of study inclusion (21% and 52%, respectively) than in other groups. High age, care facility residency, living alone, congestive heart failure, atrial fibrillation, cerebrovascular disease, dementia, hip fracture, depression, and angina pectoris also were significantly more prevalent among those who died within 5 years of study inclusion and those in the slower-walking subcohort. Gait speed and BP were lower among those who died within 5 years than among those who lived (gait speed [mean ± standard deviation], 0.46 ± 0.20 vs 0.58 ± 0.21 m/s, P < .001; systolic BP, 142.7 ± 23.9 vs 153.3 ± 22.4 mm Hg, P < .001; diastolic BP, 73.7 ± 11.3 vs 76.5 ± 10.4 mm Hg, P < .001). Cereatti (2013)  in non-institutionalized people with a mean age of 74 years, the results indicate that greater gait speed at usual pace is likely to also identify people in the multimorbid very old population, including care facility residents, with increased mortality risk due to high BP. Despite substantial differences in disease burden, these results in the faster-walking subcohort are analogous to those of the HYVET intervention study, in which treatment of hypertension to a target systolic BP of 150 mm Hg reduced mortality rates in comparatively healthy people aged 80 years or older. In contrast, BP was not independently associated with mortality in the slower-walking These findings indicate that this threshold was suitable for the present study population of very old individuals. Moreover, mean gait speeds of those who lived and those who died within 5 years after study inclusion fell on either side of this threshold, further supporting its relevance. elsewhere. Briefly, participants were instrumented with 20 reflective markers in anatomical landmarks: anterior and posterior superior iliac spines, medial and lateral knees, medial and lateral ankles, toe (second metatarsal head), heel, and lateral wands over the mid-femur and mid-tibia. To avoid excessive errors in hip joint calculation due to the adipose tissue of over- weight and obese participants, tie band was used in pelvic area, and the distance between left and right anterior superior iliac spines (ASIS) was measured manually. A Vicon 3D motion capture system with a 10-digital camera (Vicon 612 system, Oxford Metrics Ltd., Oxford, U.K.) measured the 3D locations of all markers on the landmarks of lower extremity segments (60 Hz sampling frequency). During the gait test, ground reaction forces were measured with two staggered AMTI force platforms (Advanced Mechanical Technologies, Inc., Watertown, MA, USA; 1080 Hz sampling frequency). After all markers were positioned on the skin and non-reflective firm fitting spandex pants, participants were asked to walk across a 10-m long gait laboratory walkway at preferred speed and maximum speed. Participants were first asked to walk at their self- selected walking speed (like “walking in the street”) and to repeat the same task walking as fast as possible. Participants were not informed about the presence or location of force platforms on the walking path. Trials were performed until at least three complete gait cycles for both left and right sides with complete foot landing on the force platform for both the preferred speed and maximum speed tasks were obtained. The raw coordinate data of marker positions were digitally filtered with fourth-order zero-lag Butterworth filter with a cutoff at 6 Hz. Three dimensional (3D) kinematic and kinetic gait parameters measured and calculated in our gait laboratory protocol have been described in detail elsewhere. Briefly, mechanical joint powers of lower extremity rotations in the anterior-posterior (AP) and medial-lateral (ML) planes were calculated by using Visual3D (C-motion, Inc., Germantown, MD, USA). Bell pelvic model (using the left and right ASISs and PSISs) was used for hip joint calculation. Inertial properties of lower segments were estimated based on the anthropometric measurements (height and weight) and landmark locations. Based on kinematic measurements, ground reaction forces, and the paradigm of inverse dynamics, gait parameters in kinetics including joint moment and joint power were calculated. The characteristics of the study population are reported by BMI groups as mean values and standard deviations for continuous variables and proportions for categorical variables. The differences in characteristics as well as gait parameters at preferred and maximum gait speed across BMI categories were examined with generalized linear models (GLM). All the models were adjusted for gait speed (except gait speed itself), age, sex, and knee OA. To test for trend, categorical variables were entered in the GLM as ordinal variables. Statistical significance was defined with p value less than 0.05. Statistical analyses were performed with SAS 9.1 Statistical platforms (AMTI, Watertown, USA) system. Three-marker triads of infrared light-emitting diodes were placed on the pelvis, thigh, shank, and foot body segments. Individual markers on sacrum, the greater trochanter, the lateral epicondyle, the lateral malleolus, the posterior heel and the tip over the second metatarsal were identified during quiet standing and their positions were used together with four virtual markers to define anatomical coordinate systems. These measurements were obtained on the right side of the body. All signals were captured at 100Hz sample frequency during 10s. The force platforms were mounted in series at the middle of a 10- meters walkway and covered with a gray carpet. Each subject was required to walk barefoot on the walkway at his or her self-selected comfortable walking speed. Participants performed warm-up trials prior to data collection to establish a starting point so that each foot hit one of the force platforms during walking trials. Data collection continued until the subject completed at least five successful trials. The normality of the datasets variance. However, only the first PC score from the sagittal plane presented a statistical difference between groups. This PC presented the highest loading factors (values far from zero) during pre-swing phase where signal epochs presented a marked difference between group averages. Such result pointed to a reduced ankle plantarflexion at toe-off in overweight subjects. PC scores from frontal and transverse range of motion at the ankle presented no statistical difference between the groups, indicating that there is no difference between OG and CG in these planes of motion. containing gait velocity and PC scores was tested by the Kolmogorov-Smirnov test which presented non-normal distribution. Therefore, the Mann Whitney test was applied to compare PC scores between groups. Hypertension Lai (2010) examine whether the association between increased blood pressure and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it. The participants consists of 2,733 with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included. Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, The results indicated a higher systolic BP associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors. diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results. Lewis & Ferris (2015) Investigated the association between increased blood pressure and the decline in gait speed among older adults, and whether other health- related factors may explain the link. A total of 643 well-functioning participants with an average age of 73.6 years, drawn from the Cardiovascular Health Study, were followed over 18 years. Study participants had MRI scans at baseline and follow-up, and repeated blood pressure measures and gait speed measurements. Multiple factors, including incidence of stroke and dementia, and use of antihypertensives during follow-up, were tested as potential explanatory factors for the link The researchers found that gait speed declined faster among people with higher systolic blood pressure. Participants with hypertension had a significantly faster rate of gait speed decline than people with baseline blood pressure of less than 140/90 mm Hg and no history of hypertension. The correlation was similar regardless of whether participants' hypertension was mobility limitation (HR, 0.92; 95% CI, 0.77-1.10), although participants in the intensive treatment group with no mobility limitation had a lower risk for death than those in the standard treatment group (HR, 0.62; 95% CI, 0.43-0.90). 2.7 Summary Based on the various literature reviewed by the researcher, resistance training had significant effect on selected gait variables and risk factors of peripheral vascular disorder (Step length, speed, body weight and high blood pressure)among older adults, and this type of exercise was found to be effective in promoting gait and health of older adults. More so, from the literature reviewed, resistance training can also be used by clinicians, physical Educators and trainers to train older adults to improve gait variable parameters for complete independence. The literature reviewed showed a positive relationship between resistance training and gait variables and risk factors of peripheral vascular disorder among older adults. The improvement in gait variables and risk factors of peripheral vascular disorder among older adults following resistance training could be due to the ability to increase muscle mass, reduction in visceral fat and increase bioavailability of NO (The more RPE in the execution of the resistance activity, the more hypertrophy to increase strength and the more production of NO, and increase in post exercise oxygen consumption to burn fat. The positive role of plyometric training in improving gait variables and risk factors of PAD in older adults proved that resistance exercise can be considered as an important component to gait and therapy for some Vascular dysfunctions like PAD for older adults. CHAPTER THREE RESEARCH METHODOLOGY 3.0 Introduction The main purpose of this study is to assess the effect of resistance training on selected gait variables and risk factors of peripheral vascular disorder among older adults in Zaria, Kaduna State, Nigeria. This chapter will examine research design, population of the study, sample and sampling procedure, instrumentation, procedure for data collection, and procedure for data analysis. 3.1 Research Design In this study, experimental research design of Pre-test–Post-test will be adopted for this study. The main strength of this research is the initial randomization which ensures that the two groups are equally treated (AAPHERD, 2014). Pre-test and post-test measurement of speed, step length, weight, height and blood pressure of the group will be administered before the commencement of training and immediately at the end of the training duration. The average difference between pre-test and post-test will be used to determine the effectiveness of the resistance training on speed, step length, overweight and blood pressure at the end of 12weeks of the study(Vossen,2014). 3.2 Population of the Study The population of this study will comprise of only the overweight and high blood pressure patients attending Ahmadu Bello University Teaching Hospital, Zaria (Shika and Tudunwada). Therefore, due to the heterogeneous nature of the population, the researcher will make use of patients attending physiotherapy and Geriatrics clinics in Shika and Tudunwada which is estimated to be 105 respondents (ABUTH Physical Medicine Record Department, 2021). 3.3 Sample and Sampling Procedure Eighty (80) Patients attending physiotherapy and Geriatrics clinics in Shika and Tudunwada will be used as sample for this study. The sample of the study was guided by research Advisors, (2006) which opined that for a population of one hundred and five (105), Eighty (80) is an adequate sample. Based on the confidence level of 95% with a marginal error of 0.05, the sample gotten for the study from the population of one hundred and five (105), will be Eighty (80). Purposive sampling technique will be used to select only respondents that are within the older adult age (55-85years) attending physiotherapy and Geriatrics clinics of Ahmadu Bello University Teaching hospital, Shika and Tudunwada in Zaria Local Government Area of Kaduna State. To ensure equal representative of older adults from the population of the patient in the hospital, simple random sampling technique will be used to select 60 males and 20 females older adult which will constitute the sample size for the study. 3.4 Instrumentation The instrument for data collection in this study will consists of the following instruments: (a) Stop Watches: Five (5) professional digital sports timers will be used to time the duration of subject workouts to the nearest seconds on each training day, performances in the muscular strength, leg extension and shuttle run for speed.