About 5% of the older adults in the

About 5% of the older adults in the US (Karmarkar et al.,
2011) and 2.7% in Taiwan (Yang et al., 2011) live in
institutional settings. The number of older adults using
wheelchairs in nursing homes is over 50% of that
population (Kaye et al., 2002), and many of them use
wheelchairs due to muscle weakness in the lower
extremities caused by previous falls, strokes, or inactivity
(Karmarkar et al., 2011). Wheelchair use is one of the
barriers to physical activity (Rimmer, 2005), which might
lead to further disability and mortality in older adults
(Hirvensalo et al., 2000). Shore (2008) has reported that
12.3% of older adults in wheelchairs experienced worsening
health. Muscle strength is essential in completing the
activities of daily living (Topp et al., 1994), and the muscles
of older adults are as trainable as those of younger adults.
Progressive resistance exercises, including those using
elastic bands, can increase muscle strength and size in
older adults (Brown et al., 1990).