A new assessment of several clinical trials indicates exercise may raise the spirits of the frail elderly without causing more pain.

"Exercise can improve quality of life in at least one important domain, emotional health, without causing an increase in pain," says lead author Kenneth B. Schechtman, Ph.D., of the Washington University School of Medicine.

Schechtman and his team assessed the effects of exercise interventions on the quality of life of 1733 subjects at four sites across the United States. The mean age of subjects was 73 years. Fifty-five percent were female.

The exercise studies included in this trial were noteworthy for their large sample size and concentration on older persons at risk for fall-related injury.

The study results appear in the August issue of The Annals of Behavioral Medicine.

Training of participants included four types of exercise -- resistance, endurance, flexibility and balance -- at low, medium and high intensity. Researchers assessed how exercise intervention affected four quality of life components -- general health, emotional health, pain and social well being.

Overall, "the quality of life benefits of these exercise interventions in frail elderly adults are modest in size," they found.

The researchers found that exercise produced a small but significant improvement in the emotional health of the frail elderly. Those who exercised scored higher on the emotional health scale than control groups.

These "interventions may have increased self-efficacy and the sense of mastery which help to provide focus and meaning to one's life," Schectman says.

The researchers found that improvements in emotional health could not be explained by measurable physical improvements in parameters such as gait speed. They also report that exercise intervention had little effect on subjects' scores on the general health perception scale, the social scale and on the pain scale.

However, investigators anticipated that vigorous, frequent exercise might cause the fragile oldsters to report more pain in their muscles and joints, which didn't happen. "The absence of such an increase is an important positive finding," says Schectman.

The study was sponsored by the National Institute on Aging and National Center of Nursing Research.

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Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact Robert Kaplan, Ph.D., (858) 534-6058. For copies of the article, contact the Center for the Advancement of Health at 202-387-2829 or e-mail press@cfah.org.