Evaluating the Impact of Focused Muscle Contraction Therapy in U.S. Veterans

The study will consist of 94 visits (4 study testing visits and 90 exercise visits). Subjects will come to UIC for study testing visits at baseline (prior to starting the exercise program), at 6 months, 12 months, and 18 months (after ending the exercise program). Each of those visits will take about 2-3 hours. After the initial baseline visit, subjects will come twice weekly, for roughly 1 hour each session, for 6 months (52 visits). From 6-12 months, subjects will come once a week, for roughly 1 hour each session (26 visits). From 12-18 months, subjects will come twice a month, for roughly 1 hour sessions (12 visits).

Methods:

Study Testing Visits

If subjects agree to be in the study, subjects will be asked to do the following procedures at baseline, 6 months, 12 months, and 18 months:

* Subjects will be asked to confirm their employment status each visit. * Height and weight will be measured and body mass index (BMI) will be calculated.

Additionally, the investigators will measure the body fat composition and lean body mass using a DEXA scan.

* The investigators will ask subject's their age, race, number of injuries, number of fractures, surgical history, medical history, areas of pain, list of pain medications and allergies. * Blood pressure will be measured for general health markers. * Exercise limit will be measured with a timed 8 foot walk down the hallway (if applicable), a timed sit to stand test (sitting and standing 5 times in a row-if applicable), maximum sit to stands, and a balance test (standing in 3 different positions for 10 seconds each). These three tests combine to form a score called a short performance battery score. * Strength and frailty will be measured using a grip dynamometer (squeezing a hand held device as hard as possible in their dominant hand three times. * To evaluate general health, mental health (e.g. depression, post-traumatic stress disorder, etc.) and pain intensity, quality of life, measure of pain and disability, and fatigue, questionnaires will be administered. * Subjects will be asked to disclose the number of hospital visits they have had in the last 18 months. * Total weight lifted during training session will also be recorded.

Exercise Training Visits

After the initial baseline visit, subjects will begin their exercise training intervention which involves:

* Two days a week of exercise trainings for the first 6 months, and one day a week, from 6-12 months. From 12-18 months, subjects will then complete two days a month of exercise training. Each visit will last roughly one hour and will incorporate approximately 5-10 minute light warm-up plus stretching and then the exercises. * At least twice weekly, GH Fitness staff will follow-up with subjects via text message, email or a phone call to evaluate subjects physical progress and overall health and energy. * On Weeks 6, 13, 18, 25, 41, and 52 subjects will focus on cardio and endurance exercises. These exercises may include running in place, or using a recumbent (stationary) bike. All other weeks consist of basic strength training/resistance workouts.

List of All Possible Strength/Resistance Exercises

Exercise Chest: Smith Bench Press/Incline Glutes: Abductor Biceps: Cable Easy Curl/Free Bar Quads: Leg Extension Calves: Calf Machine Biceps: Preacher Quads: Leg Press Abs: Decline Back: Pull Down Behind Hamstring: Curl Machine Shoulders: Dumbbell Press / Smith Press Back: Low Roll Hamstring: Good Morning with Dumbbell/ 1 Leg Hamstring Curl Shoulders: Side Rise with Dumbbells Triceps: Push Down / Kick Back Abs: Sit Ups Triceps: Close Grip

• Rate at which subjects will see changes in their physical abilities [Time frame: 18 months]
• Rate at which subjects enrolled in the exercise intervention will have an overall changed sense of well-being. [Time frame: 18 months]
• Rate at which subjects enrolled in the exercise intervention will have an overall changed in fatigue. [Time frame: 18 Months]
• Rate at which subjects enrolled in the exercise intervention will have an overall changed in their quality of life. [Time frame: 18 months]
• Rate at which subjects enrolled in the exercise intervention will have an overall decreased change in PTSD. [Time frame: 18 months]
• Rate at which subjects enrolled in the exercise intervention will have an overall decreased change in depression. [Time frame: 18 months]
• Rate at which subjects enrolled in the exercise intervention will have an overall change in pain intensity. [Time frame: 18 months]