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However, the magnitude of the improvements in back function found in this study were in line with those reported in other studies, which used more extended (multimodal) exercise programs.
Despite minimal information about consistent areas of balance deficits, some researchers have found improvements in Romberg's test (eyes opened, closed or ratio) or one-legged stance in response to multimodal exercise programs with a significant strength training element for patients with FM [ 39- 41].
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It is unknown, however, what effect eccentric training may have on IMAT as compared to traditional resistance exercise as part of a multimodal exercise program for older adults.
Second, we plan to evaluate the effects of an 8-month multimodal exercise program on the FF of the same IL population.
Cantarero-Villanueva et al. [ 26] reported discomfort or low-intensity pain/stiffness in 3 patients; however, these patients completed the multimodal exercise program.
These observations suggest that the benefits of exercise for skeletal muscle composition may be greater for older adults with poorer muscle composition upon initiation of a multimodal exercise program.
Kim et al. [ 42] found a significant group by time interaction for preferred walking speed (F = 13.03, p < 0.01), three months after the completion of a multimodal exercise program, with significantly greater increase in the exercise group.
In one of these studies, Goodpaster et al. [ 18] demonstrated that a 12-month, multimodal exercise program prevented the age-associated increase in IMAT observed in an inactive control group during the intervention period.
Several studies [ 18– 20] have examined the effects of resistance training on IMAT as part of a multimodal exercise program in older adults, though only one has reported on the exclusive use of eccentric resistance training [ 2].
A multimodal exercise program that combined aerobic and resistance training was effective in improving all FF components related to daily living activities in all age groups except for flexibility of lower limbs in the age group 70 74 years.
Additionally, since some have reported a differential muscle function response to exercise in those with high versus low initial levels of IMAT [ 23], it is curious if a differential gross muscle structure (change in IMAT) response occurs upon completion of a multimodal exercise program.
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