Exercise strategies to improve neuromuscular and cardiovascular parameters and functional performance in frail elderly individuals should include the following:

Resistance-training programs should be performed 2 to 3 times per week, with 3 sets of 8 to 12 repetitions at an intensity that starts at 20-30% and progresses to 80% of 1RM.

• To optimize the functional capacity of individuals, resistance training programs should include exercises in which daily activities are simulated, such as the sit-to-stand exercise.

High-speed resistance training should be conducted because this type of training is associated with greater improvements in functional performance.

Endurance training should include walking with changes in pace and direction, treadmill walking, step-ups, stair climbing, and stationary cycling. Endurance exercise may start at 5-10 minutes during the first weeks of training and progress to 15-30 minutes for the remainder of the program.

• The Rate of Perceived Exertion scale is an alternative method for prescribing the exercise intensity, and an intensity of 12 to 14 on the Borg scale (Borg 1982) appears to be well tolerated.

• Balance training should include several exercise stimuli, such as tandem foot standing, multidirectional weight lifts, heel-toe walking, line walking, stepping practice, standing on one leg, weight transfers (from one leg to the other), and modified Tai Chi exercises. 

• Multicomponent training programs should include gradual increases in the volume, intensity and complexity of the exercises, along with the simultaneous performance of resistance, endurance and balance exercises.