exercises for older adults-2

7/29/2019 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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