Transcript Exercise Programs for Older Adults

Exercise Programming for
Older Adults
40 years old
on 50 mile
run
60 years old finishing
4300 mile ride
Important Considerations
 The goal is to maintain the basic and advanced
activities of daily living (ADL) for as long as
possible to allow for independent functioning
as long as possible.
 The key is to accentuate the movements they
CAN do rather than to dwell on what they can’t
do.
 Consider what activities they might enjoy doing
– let them pick!
Demographics
 Those age 65+ represent the fastest growing
segment of the US population.
 By the year 2030 the population of those over
age 65 will have doubled (to over 63 million).
 1 out of every 8 Americans is > 65
 In US in 1998, there were:
 34 m people over age 65
 20 m older women
 14 m older men
 Ratio of 10 women to 7 men BUT…
 As reach age 85, the ratio changes to 10:5
Demographics - Future
 The dramatic growth of seniors is expected to
continue.
 The ranks of the oldest-old will swell five-fold to
more than 19 million people in the year 2050.
 Greater need for exercise programs and
professionals to lead them.
Rate of Decline
 Data collected from the Masters Track & Field Org
and US Masters Swimming Congress found the
average aging-related rate of decline was 0.5% per
year for older exercisers (12.5% over 25 years).
 In sedentary people, the rate of decline was 2%
per year  50% over 25 years.
 Those seniors who are only at 30% of their
functional capacity are considered “frail”.
 Those seniors who remain engaged in an exercise
program will likely remain highly functional.
Leadership Tips
 Motivating seniors
 Understand chronic conditions
 Accommodate programs to meet needs
 Adjust FITT principle accordingly
 Purchase resources to learn more
Incentives & Motivators
 Ambiance should be inviting to elders
 Consider music selection
 Social opportunities
 Intergenerational exercise programs
 Awards
 On-going fitness assessments
Safety & Guidelines
 Obtain medical clearance
 First Aid & CPR certifications
 Before developing a program, get a
complete lists of client’s
medications…know side effects
 Knowledge of intensity levels: target
training zone, rated perceived exertion,
Talk
 Group formations – circles and semis
Safety & Guidelines
Encourage immediate notification if feeling
ill
 Breathing techniques
 Clothing and shoes
 Include warm up and cool down
segments
 Include flexibility program
 Reducing fear and anxiety
When Does Old Age Begin?
 Chronologically considered ~ 65 y.o.
 50+ is often referred to as an older adult
or senior.
 Inactivity and sedentary lifestyle influence
this number greatly.
 Regard the aging process as one of
function  what is the older client
capable of doing?
Activities of Daily Living (ADL)
 Basic ADL:
 Advanced ADL:
Dressing
Shopping
Eating
Housework
Ambulating
Accounting
Toileting
Food Prep
Hygiene
Transportation
Categories for Physical Functioning
Physically:
Elite
Fit
Independent
Frail
Dependent
The Senior Fitness Test
(Developed by Rikli & Jones, Scanned from Health Fitness Instructor’s Handbook,
Howley & Franks)
Effects of Aging on the MS
 Loss of muscle mass, strength and mobility is
associated with aging.
 Adults lose ~ ½ pound of muscle per year during
30’s & 40’s
 As a rule, strength remains relatively intact until ~
age 40-50.
 Muscle mass decreases ~ 10% between ages
24-50.
 There is an accelerated decline of muscle mass
of ~ 30% between ages 50-60.
 Sedentary folks between 50-70 y.o. experience
strength declines of ~ 15% per decade.
Effects of Aging on the MS
 Muscle mass is better maintained in the upper
body vs. lower body.
 Aging is also associated with a decline in
testosterone and human growth hormone.
 Some studies have shown increased atrophy in
fast twitch type IIb fibers in those over 70.
 Due to a loss of motor units and a regrouping of
muscle fiber, there is an enlargement of the
motor unit size, but less distinction between
muscle fiber types.
Effects of Aging on the musculoskeletal
system
 Peak muscle strength in females occurs
~ age 20; males age 30.
 Surveys conducting in the US indicate
that 28% of older men and 66% of older
women cannot lift objects weighing 10
lbs.
Strength Training for
Older Adults
Benefits of Strength Training
 Increased Strength
 Increased Lean mass
 Improved Mobility & Independence
 Reduced Bone Loss
 Prevent or Modify Chronic Disease
 Fall Prevention
 Improved Mood
Benefits – Increased Strength
 Older adults gain strength at ~ same rate as
younger adults
 Strength increases as great as 40% have been
seen with high-intensity strength training up to
age 96.
 Some studies have shown that in the 3-4
months following the start of a strength training
program for the older client that as much as 3
decades of functional decline can be reversed.
Benefits – Increased Lean Mass
 RMR decreases with aging
 ST increases lean mass  increases basal
metabolic rate
 Muscle hypertrophy resulting from resistance
training has been documented in folks 90+ y.o.
 Study found that men in their 70’s who started
and continued strength training before age 50
had strength and muscle cross sectional areas
similar to sedentary 28 y.o. (Yound & Skelton, 1994)
 An increase in body fat with age is attributed
more to a decrease in physical activity than an
increase in caloric intake.
Benefits – Reduced Bone Loss
 Increased bone density through strength
training and weight bearing exercises.
 Especially a concern of post-menopausal
women.
 The type of exercise DOES matter  see next
slides!
Types of Exercise
(Dr. Ginger Schirmer, PH.D, RD, Med 2000 Inc., Version 7,
Women’s Health & Stress Management. 2001)
Weight Bearing / High Impact
 Stair Climbing
 Aerobic Dancing
 Hiking
 Volleyball
 Dancing
 Basketball
 Jogging
 Gymnastics
 Downhill Skiing
 Strength Training –
can be high/low
impact
Types of Exercise
(Dr. Ginger Schirmer, PH.D, RD, Med 2000 Inc., Version 7,
Women’s Health & Stress Management. 2001)
 Wt Brg/Low-Impact
 Non Wt Brg/Non-Impact
 Walking
 Lap Swimming
 Cross-Country Skiing
 Indoor Cycling
 Ski Machine
 Stair Step Machine
 Rowing
 Water Aerobics
 Deep Water Walking
 Low Impact Aerobics
 Stretching
ACSM Exercise Guidelines for
ST Programs for Seniors
 Thorough health screening and medical exam
needed.
 Frequency of strength training  2 days/week
 Rest  Minimum of 48 hours between
sessions
 Seniors tend to have more soreness and may need
a longer recovery up to 3-4 days.
ACSM Exercise Guidelines for
Strength Training Programs for
Seniors
 Sets/Reps 
Start with 1 of 10-15 reps.
Gradually increase to 2 or 3 sets
 Intensity 
Start with 40-60% of 1 rep max
Gradually increase to 70-80% of 1 rep max
 Rated Perceived Exertion 
12-13 (mild to moderate)
ACSM Exercise Guidelines for
Strength Training Programs for
Seniors
 Include at least one exercise for all major
muscle groups. Which are?
 Focus upon functional, multi-joint exercises.
Examples are?
 For many clients, you many need to start with
single joint exercises / machine exercises 
perceived as easier by the client.
 Progress them from machine to functional
when they become accustomed to the
exercise.
ACSM Exercise Guidelines for
Strength Training Programs for
Seniors
 Complete session within 30 minutes
 1st 8 wks should use only minimal
resistance to allow for connective tissue
adaptation.
 1st few sessions should be supervised.
 Emphasize proper technique within a
painfree range of motion
 Encourage normal breathing pattern.
ACSM Exercise Guidelines for
Strength Training Programs for
Seniors
 Initial overload should be achieved by
increasing the number of reps then the
weight.
 When returning from a layoff, use a
resistance of 50% of the previous
intensity.
 Should be a year-round program.
ACSM Exercise Guidelines for
Strength Training Programs for
Seniors
 Avoid isometrics and other exercises that
may increase blood pressure.
 Work large muscle groups first and
opposing muscle groups in succession.
 Machines preferred over free weights
initially.
Risk of Injury
 Consider the learning curve.
 Watch form and technique.
 Use caution when performing any eccentric
contractions due to the potential for increased
muscle soreness and longer recovery period.
 Consider any pre-existing conditions or illnesses
the older client may have.
 Consider medications effect during exercise
session.
Strength Programming Guidelines
 Be aware that the senior will tend to
move and progress slower.
 Design program to emphasize function.
 Work only through the pain-free range of
motion  No Pain!
Program Structure
 Should consist of exercise to improve the
ability to:
Stabilize the torso
Push
Pull
Grip
Get up & down
Move
Stabilizing The Torso
 Activities: All activities of daily living involve the
torso.
 Muscles: Erector Spinae, Rectus Abdominus,
Obliques.
 Exercises: Stability Ball
 Sitting
 Marching
 Arm/Leg lifts
 Catching drills
Pushing
 Activities: Need to move furniture, kitchen
activities, putting things away, shopping cart.
 Muscles: Triceps, Pects, Anterior Deltoid
Coracobrachialis, Serratus Anterior.
 Exercises:
 Wall push ups
 Fwd/overhead med ball press
 Squeezing a balloon
 Seated chest press
 Shoulder press
 Push up
Pulling
 Activities: Need to rake leaves, open doors,
laundry, groceries from trunk, picking up the
cat!
 Muscles: Lats, teres major, post. delt., biceps,
traps, rhomboids.
 Elastic tubing exercises:
 Rowing
 Vary Angles
 Seated Row
 Reverse Flys
Grip Strength & Dexterity
 Activities: Need to open lids, use tools, writing,
eating, sewing, buttoning, etc.
 Muscles: Forearm and intrinsic muscles of the
hand.
 Exercises: Towel rolls, ball squeezes, rubber
band exercises, dexterity drills, progressively
tighter jar lids (series).
Getting Up & Down
 Activities: Needed to climb stairs, getting in/out
of chair/car, toileting.
 Muscles: Quads, gluts, hams, torso.
 Functional Exercises:
 Ball Squats, chair squats
 Lunges
 Step ups
 Traditional Gym Exercises:
 Leg press
 Hack squat
 Smith Machine Squat
 Abduction/Adduction exercises
 Avoid:Leg extension due to shear forces
Improve Mobility
 Walking is the most popular and is highly
functional.
 Strength Training will improve the client’s ability
to walk.
 Take note of the muscles around the ankle –
note strength and flexibility.
 Treadmill walking with a slight incline can help to
improve strength & endurance in the leg
muscles. Also improves speed and balance.
 Consider age appropriate obstacle courses.
 Low step ups  holding on or carrying
something. Do forward, backward, laterally.
In A Nutshell
 Strength training benefits for seniors is
well documented.
 Should be a long-term part of client’s life.
 Remind seniors that strength training will
improve their cardio program as well.
 Greatly increases the client’s quality of
life and adds “life to their years.”