Transcript To your Chair Based Exercise Leadership Course Tutor Simon Hanna

Welcome to Day 2
“Sit Tall, Stand Strong”
Chair-Based Exercise Course
for
Frailer, Older Adults
& Disabled Adults
Any Questions?
Recap of class structure:
Warm-up
Circulation Boosting 1
Mobility
Circulation Boosting 2
Stretches
Circulation Boosting 3
Endurance
Strength
Cool down
How ageing, inactivity, disease,
functional impairment and
disability affect bones, joints,
muscles, nerves, heart and
lungs….
Bones
Functions of the
Skeleton
Shape
Protection
Storage of minerals
Production of blood cells
Movement through joints
Knowledge
Base
Page 43
Possible changes to Bone
associated with ageing, disability
and inactivity:
 Reduced bone mineral density
 Increased risk of osteoporosis
 Loss in height
 Postural problems
What is Osteoporosis?
Skeletal disorder characterised
by low bone mass and
deterioration of bone
with increase in bone
fragility and susceptibility to fracture
(Consensus Department Conference 1993)
Bone becomes thinner and more fragile
Osteoporosis
Osteoporosis
40 years
60 years
70 years
JOINTS
Structure of a synovial joint
Knowledge
Base
Page 48
Possible changes to joints
associated with ageing, disability
and inactivity:
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Less synovial fluid
Synovial fluid more viscous
Cartilage wear and tear
Reduced joint stability
Reduced range of movement
Ligament less flexible
Joints more stiff
MUSCLES
Structure of Skeletal
Muscle
Possible changes to Muscles
associated with ageing, disability
and inactivity:
Reduction in muscle mass
Reduction in number of muscle fibres
Increased connective tissue
Increased size of motor units
Reduced elasticity of tendons
Active, strength-trained
70 yr old
female
Sedentary
The same size difference is seen between 30 yr old and 80 yr old
(Adapted from Sipilä & Suominen
Muscle Nerve 1993;16:294)
Potential consequences
• Reduced:
– Power
– Strength
– Endurance
– Fine control
– Heat production
– Immune function
Nervous System
Knowledge
Base
Page 59
Nervous System
Possible changes to Nerves
associated with ageing, disability
and inactivity:
• Reduces number of nerves
• Reduced speed of transmission
• Slower information processing
Potential consequences:
Slower movement speed
Impaired short term memory
Reduced reaction time
Slower pace of learning
Reduced balance
Increased falls
Slower response to instructions
Poorer coordination
Reduced sight and hearing
HEART AND
LUNGS AND
BLOOD VESSELS
The Lungs
Knowledge
Base
Page 56
Gaseous Exchange in the
Alveoli
Diaphragm and
Intercostals Muscles
Possible changes to the lungs
associated with ageing, disability
and inactivity:
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Decreased elasticity of the lungs
Weaker breathing muscles
Less flexible rib cage
Reduced gaseous exchange
Increased breathlessness
Reduced maximal inspiration and reduced expiration
Blood Vessels….
Arteries
Veins
Capillaries
Possible changes to the blood
vessels associated with ageing,
disability and inactivity:
• Increased furring and hardening of the arteries
• Increased blood pressure and risk of hypertension
• Reduced number of capillaries in muscles
• Reduced oxygen delivery to muscles, reduced
ability to sustain activity
ATHEROMA
The heart ….
Possible changes to the heart
associated with ageing, disability
and inactivity:
• Decreased cardiac muscle
• Decreased blood pumped out
• Decreased maximal heart rate
Consequences…
• Reduced ability to work at high intensity
•Tasks require greater percentage of max heart rate
• Reduced ability to sustain activity
Leading Workshop
Warm-up
CB1
Mobility
CB2
Stretches
Warm-Up Component
CB1
1. Alternate heel raises, Arm Swings, Leg Marches,
Tap & Clap
Mobility
2. Shoulder Lifts and Circles
3. Side Bends
4. Ankle Activators
5. Trunk Twists
CB2
Stretches
6. Back of Thigh Stretch
7. Chest Stretch
8. Calf Stretch
9. Upward Side Stretch
The Functional Model
Practice Workshop…….
Safety First…
• This session will cover:
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PARQ screening
Contraindications to exercise
Exercise cautions
Medication effects on safe exercise
participation
PARQ…
See pages 5 & 6 of your learner file
Absolute contraindications
• Unstable and uncontrolled health conditions as follows:
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Uncontrolled pain or feeling unwell on arrival
Lasting, increased pain following previous session
Suspected acute injury
Recent injurious fall without medical assessment
Severe breathlessness or dizziness
Recently diagnosed cardiovascular events
Recent medication changes
Uncontrolled pulmonary problems
Inability to follow simple instructions placing themselves or
others at risk of injury
– RA flare up or acute systemic illness/infection
– Unexplained lethargy
Cautions
• Known current injury/wound that is
identified and/or protected
• Observable pain of known origin
• Problems understanding instructions
• Unable to safely maintain balance while
seated
• Infection control
• Latex allergy
Common effects of medication
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Reduced alertness
Postural hypotension
Reduced balance
Reduced proprioception
Difficulties with exercise intensity monitoring
Urinary urgency/frequency
Slowed reaction time
Poor coordination
Session Plans
Why?
They will assist you in your exercise
session
What should it contain?
Include relevant information to deliver a
safe and effective exercise session!
Session Plans
 Name of exercise and planned rests
 Repetitions and/or Time
 How to perform the exercise safely and
effectively (teaching points/key safety
considerations)
 Purpose of the exercise
 Alternatives and adaptations
See page 23 of your learner file
SAMPLE SESSION PLAN
Posture/Teaching Points/or Instructions?
Exercise Name
& Planned Rest
Shoulder Lifts
Shoulder Rolls
Exercise
purpose &
ADL’s
Reps
and/or
Time
Teaching Points
(Key safety considerations)
• Sit tall, feet flat on floor
• Knees hip width apart
• Knees above ankles
• Smooth continuous
movements
• Lower with control
• Lift shoulders up
• Avoid poking chin
• Roll shoulders back
• Avoid arching the back
• Breathe normally
• Keep tummy in
Adaptations
and/or
Alternatives
What makes a COMPETENT and
SUCCESSFUL Chair-Based
Exercise Leader?
Prepare to lead a small group on day 3
Use the “how to be even better” info sheet
to help with the leading sequence
Complete all 3 worksheets ready to hand in
on day 3 for marking