Download - Exercises for Older Adults-2
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Exercises for older adults
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Aerobic Exercise
Measurement: Most clinical applicable measure to determine it is measuring target heart rate
Formula used known as Karvonen method (will yield higher amount than the traditionalmethod)
Subjective measures of perceived exertion: the Borg Rating of Perceived Exertion scalemonitors exercise intensity in older adults (especially usefull if the pt. has a bluntedheart rate response or taking -blockers)
Talk Test: when exercise reaches an intensity where the pt can barely respond inconversation = safe and appropriate
6 min walk test
Table 5.5 pg 75
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Indications for aerobic exercise: Pts who lack ability to sustain an activity for a certain amount of
time due to decreased cardiovascular efficiency
Contraindications and Safety: Pts with joint pain and/or mm. weakness must first be
strengthened prior to aerobic exercise(may prevent multiple
contractions needed)
Resting heart rate > 100bpm
Systolic blood pressure > 200 mmHg
Diastolic blood pressure > 120 mmHg
Unstable cardiac conditions
Monitor blood press and heart rate (instruct pt)
Be knowledgeable ofpts medications
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Equipment and opportunities:
Indoors Treadmil
Elliptical trainer
Stair stepper
Rower
Stationary bike
Outdoors Walking or hiking
Skating
Jogging
Cycling
Remember: individuals preference and ability!!
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Aquatic exercise
Aquatic exercise allows individuals who cannot tolerate land-
based stresses (eg. Joint pathology) to exercise by decreasing
the forces needed to move.
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Measurement: heart rate- same formulas BUT will be lower in the pool
aquatic heart rate reduction should be included in the formula
(-1min in-pool heart rate from 1 min land-based heart rate)
Indications: Painful joints in weight-bearing
Osteoarthritis
Overweight
Recent surgery
Significant balance disorders or fear of falling
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Contraindications and safety:
Monitor patients walking over slippery surfaces and into/ out of
pool
Open wounds not allowed
Emergency communication equipment
Automated external defibrillator
Equipment: Flotation devices (support or resistance)
Devices like underwater treadmill
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Strengthening Exercise
They gain strength same way younger people
do!!
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Measurement:
Muscle dynamometry
Isokinetic dynamometers very expensive
Repetitive maximum test gold standard
Indications: Patients functional activities impaired
Add reserve to protective effect during enforced bed rest
1st line intervention for symptoms of chronic disease eg. COPD
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Contraindications and safety: No absolute contraindications
Care taken to avoid patient holding his breath Monitor proper form, especially during high speed and intensities
Equipment and exercise:
Overload results in strength gains Added resistance
Elastic bands
Weights
Hand-held blades
NB variety and creativity = enthusiasm = results!!
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Stretching Exercises
Older adults adopt certain movement and positioning
patterns, that can lead to muscles and soft tissue being held in
a shortened or lengthened position.
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Measurement:
Age-based normal ranges
Indications:
Painful joint ROM
Abnormal movement patterns
Painful postures
Prevention of future potential problems
NB muscles in older adults that need stretching are:
Suboccipital mm
Pectoralis minor
Extensors of lumbar spine
Hip flexors and external rotators
Ankle plantar flexors
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Contraindications and safety:
Presence of joint instability (would contribute to the instability) Ensure stretching force is only on target muscle or joint
Neural tissue may present as a pins and needles sensation
Table 5.9 and 5.10 pg 82
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Plyometrics
Definition: Plyometric exercise is an attempt to use the
stretch reflex of the muscle spindle and the elastic energy
that is stored in a stretched muscle to enhance the
immediate reciprocal contraction of the muscle. It involves
eccentric contraction followed by a concentric contraction
of the same muscle.
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Measurement:
An isokinetic dynamometer can be used to test for
muscle power Exercise is meant to result in increase in the ballistic ability of
the muscle
Any functional test measuring time taken to complete a
task: Gait speed
Floor transfer
Stair climbing
Roses Fullerton balance test Jumping task indicating muscles capability to produce a
forceful rapid contraction.
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Indications:
Loss of power during activities
Bone formation (Wolffs law)
Decreasing fall risk
Application:
Beginner patients may not have soft tissue and muscle
integrity needed for the exercise
As they progress in their program, the speed of contractionshould be used as a method of overload.
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Tai Chi
Tai Chi originated as a form of marshal arts. It
involves learning multiple poses that are linked
together with slow movements, emphasizing
control and balance.
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Measurement: No direct measurement has been reported
However, balance measurements such as the Berg balance scorehave been used.
Indications:
Chronic conditions:
Arthritis
Cancer
Cardiovascular disease
Diabetes
Stress
Also improves balance and fitness, thus decreasingfalls and lessening the risk.
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It is believed that the slow body movements superimposed on
the ankle musculature that must react rapidly to maintain the
position provides an overload stimulus for ankle power andproprioception
Tai Chi can be taught in schools by experienced teachers, or
can be learnt from books and videos.
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