1. Methods Inclusion Criteria –60 years of age –Community dwelling –Willingness to participate –Prior medical screening –Completion of survey & consent forms

2. Methods –Enlarging or non-operable AA –Ventricular arrhythmias –Aortic stenosis (severe) –End-stage CHF –Behavioral agitation exacerbated by exercise –Severe dyspnea –Abnormal EKG or hemodynamic response associated with exercise –Contraindicated ejection fraction –Popliteal cyst –Uncontrolled arrhythmia –Resting HR >120 BPM –Resting BP >200/115 mmHg –Retinal hemorrhage –Recent eye surgery –Fever or infection –BG 250 mg/dL –Unstable angina –Resting RR >30 BPM –Fracture –Severe joint instability Exclusion Criteria: contraindications to resistance training

3. Methods Exclusion Criteria –Joint problems or pain precluding participation –Acute or terminal illness –Moderate to severe cognitive impairments –Unstable or ongoing cardiovascular or respiratory issues –Neurological or musculoskeletal impairment –Inability to commit to time of study –Use of medication interfering with participation and safety –Inability to attain testing positions

4. Methods Survey & Consent Forms –Short From (36) Health Survey (SF-36) –Self-Efficacy for Exercise Scale (SEE) –Activities Based Confidence (ABC) Scale –Center for Epidemiologic Studies Depression Scale (CES-D) –Medical Outcomes Study Social Support Scale (MOS-SSS) –Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire

5. Methods-Strength Random Assignment –1 of 4 groups Cardiovascular training (CVT) Resistance training (RT) Combination CVT & RT (COMBO) Control (CONRTOL)

6. Methods-Strength Testing –Before intervention –0-3 days post-intervention –5 weeks post-intervention

7. Methods-Strength Testing Measurements – VO 2max Astrand Rhyming Cycle Ergometer Test –50 RPM, 6-minutes –Pulse rate last 10 seconds of final 2 minutes –Nomogram to predict VO 2max –Age adjusted

8. Methods-Strength Testing Measurements –Hand Held Dynamometry (HHD) 1RM –Hip extensors, hip abductors, knee extensors, ankle dorsiflexors, ankle plantar flexors, abdominals, paraspinals Measurement at muscle weakest point per length tension curve 2 trials, 3 second hold, 15-30 second rest between

9. Methods-Strength Testing Measurements –5 Time Sit to Stand Arms across chest Timed –Command “Go” –Time ended when back touched chair

10. Methods-Strength RT Group –n = 21 –1st session 2x8 repetitions, 60% 1RM - to learn correct technique –Remaining 8 weeks 3x8 repetitions, 80% 1RM, 2x/week Concentric <1 second Eccentric 2-3 seconds –Exercise Sequence Paraspinals, R hip ABD, PF, L hip ABD, knee extensors, R hip extensors, DF, L hip extensors, abdominals –1RM recalculated at 4-weeks Lander’s Prediction Equation –Participants encouraged to perform exercises 1 additional day/week

11. Methods-Strength CVT Group –n = 21 –2x/week, 8-weeks –Stationary Bike or Treadmill –10-minute warm-up –Exercise 30-minutes, 65-75% Hr max Encouraged to complete continuously, allowed breaks as needed –5-minute cool down –HR, BP, and RPE recorded every 3-5 minutes –Participants encouraged to perform CVT outside of intervention whenever possible

12. Methods-Strength COMBO Group –n = 21 –RT 1x/week –CVT 1x/week –Participants encouraged to perform CVT and RT exercise minimum of 1 additional day/week outside of intervention No RT for 2 consecutive days CONTROL group –n = 21 –Maintain usual activity for 8-weeks