Pumping a little iron can help elderly nursing home residents and heart failure patients gain strength for everyday life, the American Heart Association says, expanding on earlier advice.

"Those folks are capable of exercise training benefits and certainly resistance training is part of that," said Mark Williams, who led the group that wrote the new guidance published Monday online in the journal Circulation.

Williams said resistance training — whether it's lifting weights or doing sit-ups — should be used as a complement to aerobic exercise.

"A lot of people after having a heart attack or heart failure think they need to 'take it easy,'" said Dr. Amit Khera, director of cardiac rehabilitation at the University of Texas Southwestern Medical Center. He said broader guidance should help reassure doctors and patients that it's probably OK for most people to start exercising after heart trouble.

Khera said cardiac patients using weights are often restricted to 1- to 5-pound weights for the first couple of weeks.

The heart association statement cited one study of a 10-week period of resistance training among nursing home residents with an average age of 87 that resulted in improvements in strength and stair-climbing power. In a study of older women who were heart failure patients, 10 weeks of resistance training resulted in a 43 percent increase in muscle strength and a 49 percent increase in the distance covered in a six-minute walk.

The statement also notes that elderly people and women who suffer from coronary heart disease (a narrowing of the small blood vessels to the heart), or are frail can benefit from workouts including resistance training because they build muscle strength.

Resistance weight training includes using one's body for weight resistance by doing things like abdominal crunches to using resistance-cord exercises, dumbbells, wrist weights or weight machines.

It's been known for some time that resistance training is good for everyone, from those with chronic diseases to healthy people. Resistance training for heart patients has been gaining momentum for the last two decades or so, said Williams, professor of medicine in the cardiology division at Creighton University School of Medicine in Omaha, Neb.

Tom Simerly, 57, of suburban DeSoto, who had a procedure to open a clogged artery seven weeks ago, started rehabilitation a week after he got out of the hospital. Though lackadaisical about exercise before, Simerly said that he's noticed improved strength as he goes to rehab three days a week. He works out on a treadmill, stationary bicycle and has graduated from free weights to weight machines.

"The whole regimen has been really good," said Simerly, who works for a Dallas engineering firm. "My stamina's better. I sleep better. I feel better about myself. I've lost some weight."

Dr. Art Labovitz, cardiology director at St. Louis University School of Medicine, said that despite increasing knowledge about the benefits of resistance training, the public perception is likely that it's largely off-limits for heart patients.

"I think probably the conventional wisdom is that if you have a heart condition, you can't lift weights," Labovitz said.

He added that there may be some circumstances where a heart patient shouldn't do such training.

The statement recommends that those who do resistance training start out slow, setting the resistance or weight load at a moderate level to achieve the prescribed repetition range without straining. Elderly people should start with a low level of resistance. As progress is made, they should first increase the number of repetitions before adding weight or resistance.

Resistance weight training can help heart patients resume activities from their daily life by building muscle strength, said Jenny Adams of the Baylor Heart and Vascular Hospital.

"The truth of the matter is when you ask these patients what their goals are, they want to lift their grandkids, work in the yard," Adams said.