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The U.S. Department of Health and Human Services (1990) has specified as a key objective the reduction of disability in the performance of activities of daily living (ADL) for persons over the age of 65 years. Many ADL involve combinations of muscular strength, muscular endurance, and flexibility, three components that together have been referred to as "muscular fitness." The capacity of the elderly to remain functionally independent, therefore, may depend less on cardiovascular fitness, which has traditionally been the focus of health related fitness research, than on these components of muscular fitness. This review addresses the issue of muscular fitness and disability in the elderly by considering three questions: Is muscular fitness associated with ADL performance? Can muscular fitness be improved with exercise training? Do improvements in muscular fitness improve ADL performance? Answers to these questions will have important implications for future research and program implementation. Although initial findings are promising, more data are needed on the effect of muscular fitness on functional independence and quality of life in the elderly.

The impact of proprioceptive neuromuscular facilitation (PNF) on physical function in assisted-living older adults (73-94 years old) was studied. A 5-week pretraining period consisting of weekly visits by trainers to participants preceded a 10-week training period of warm-up, PNF exercises, and cool-down. Training progressed from 1 set of 3 repetitions to 3 sets of 3 repetitions. Assessments were conducted at baseline (T1), postpretraining (T2), and posttraining (T3). Eleven of 14 volunteer participants completed the study. Physical function was assessed by range of motion (ROM), isometric strength, and balance and mobility measures. Repeated-measures ANOVA identified 6 measures (sit-to-stand, shoulder- and ankle-flexion ROM, and hip-extension, ankle-flexion, and ankle-extension strength) with statistically significant differences. With the exception of hip-extension strength, these measures were statistically significant from T2 to T3 in post hoc univariate tests. Results indicate that PNF flexibility training can improve ROM, isometric strength, and selected physical-function tasks in assisted-living older adults.