PAGA & Strengthening for Adults and Older Adults

What populations should strength train?

All populations should include resistance training:

Healthy adults

Older adults

People with disease or disability

People with limited range of motion

People in recovery or rehabilitation

Some may need medical clearance or supervision.

PAGA muscle-strengthening recommendations

For adults and older adults:

Do muscle-strengthening activities 2 or more days per week

Work all major muscle groups

Include exercises for muscular strength, power, endurance, and mass

No exact duration is given; sessions depend on the program and goals.

bone strengthening recommendations

Adults and older adults should include activities that place load or impact on bones, such as:

Walking

Jogging

Dancing

Resistance training

Weightlifting

This helps maintain bone density, reduce fall risk, and support independence

What should be evaluated before leading exercises?

Fitness professionals should consider:

Age

Training history

Goals

Disease or disability

Range of motion

Technique

Ability to move through full ROM

Intensity/load level

Need for medical clearance

Whether the person needs a certified/licensed professional

How can very frail elderly benefit from lifting heavy?

With proper supervision, heavy resistance training can help very frail older adults:

Increase strength

Improve muscle mass

Improve power

Reduce fall risk

Maintain independence

Improve ability to do daily tasks

What does FITT-VP stand for in general programming considerations?

Frequency, Intensity, Time, Type, Volume, Progression

What is the recommended frequency for exercise in adults?

2+ days/week

How should intensity be determined in adult programming?

Based on RPE, RIR, or rep max tests

What does the time of exercise depend on?

Goals

What types of exercises should be included in adult programming?

Resistance and bone-loading exercises

How is volume calculated in exercise programming?

Sets × reps × load

What should be ensured before progressing in exercise difficulty?

Technique is good and the person can move through the full range of motion

Recommendations for resistance training sessions

Fitness professionals should:

Start with foundational movement skills

Use proper technique first

Match exercises to goals

Include all major muscle groups

Use progressive overload

Adjust load, reps, sets, and rest

Provide modifications for limited ROM

Exceed PAGA minimums for athletes or sport goals

What is the foundational movement for the squat?

Bodyweight squat

What are the adult progressions for the squat?

Goblet squat, back squat

Which muscles are primarily used in the squat?

Quads, glutes, hamstrings

What is the foundational movement for the hinge?

Hip hinge drill

What are the adult progressions for the hinge?

Deadlift, kettlebell swing

Which muscles are primarily used in the hinge?

Glutes, hamstrings, back

What is the foundational movement for the push?

Wall push-up

What are the adult progressions for the push?

Push-up, bench press

Which muscles are primarily used in the push?

Chest, shoulders, triceps

What is the foundational movement for the pull?

Band row

What are the adult progressions for the pull?

Dumbbell row, pull-up

Which muscles are primarily used in the pull?

Back, biceps

What is the foundational movement for the lunge?

Step-back lunge

What are the adult progressions for the lunge?

Walking lunge, split squat

Which muscles are primarily used in the lunge?

Quads, glutes, hamstrings

What is the foundational movement for the carry?

Light object carry

What is the adult progression for the carry?

Farmer's carry

Which muscles are primarily used in the carry?

Grip, core, shoulders

What is the foundational movement for rotation/core?

Medicine ball twist

What are the adult progressions for rotation/core?

Cable rotation, plank variations

Which muscles are primarily used in rotation/core?

Core, obliques