How to program exercise for aging and elderly people.

Introduction

Exercise programming for aging and elderly people falls under the special population category because they all suffer from chronic and temporary health conditions. An effective exercise program provides guidance to help clients achieve their personal health and fitness goals. Exercise programming generally consists of four major components: strength, endurance, balance, and flexibility.

Examples for special population:

Aging and the elderly people

Individuals with disabilities

Children and teens

Pregnancy

Asthma

Diabetes mellitus

Obesity

Osteoporosis

Hypertension

Amputation

FUNCTION THAT DECLINE AS WE AGE:

Hormone production

Maximum oxygen uptake

Bone rigidity and porosity

Neurological capabilities

Muscle mass and strength

Balance and co-ordination

Attention and memory

Language processing

CHARACTERISTIC THAT INCREASE AS WE AGE:

Fat, body mass

Resting and training heart rate.

Blood pressure

Disability

CVA associated weakness

COMMON CONDITION IN OLD AGE:

Refractive errors decision

Back and neck pain

Osteoarthritis

Diabetes

Chronic obstructive

Pulmonary disease

Depression

EXERCISE ROUTINE:

Exercise routine is for elderly people it should be able to incorporate 150 minute of moderate endurance activity in a week. Including: walking, swimming and cycling a little bit of time every day to improve strength, flexibility and balance

EXERCISE RECOMMENDATION FOR OLDER ADULT PATIENTS:

Strength Training:

Strength is defined as the instantaneous maximal force generated by a muscle at a given velocity of movement.

High intensity progressive resistance exercise has been demonstrated to be safe in older adults up to 96 years of age.

The exercise may need to be modified due to medical conditionu such as osteoporosis.

Physiology and the effects of aging on strength:

Advance age is associated with decreasing strength and decline in the physiological properties of muscle.

Decline muscle mass

Quadriceps muscle weakness predisposes to osteoarthritis of the knee

Decrease body and muscle mass is leads to osteoporosis facture after falls

Benefits:

Improve daily function

Reduce blood pressure

Reduce arthritis pain

Reduce disability

Increase aerobic capacity in congestive heart failure.

Prescription:

Moderate to high intensity strength training 2to3 times in week. May start with low intensity progressive resistance Training (PRT) in a or poorly compliant patients

Precaution:

Monitor vital sign in patients with known coronary artery disease

Pulmonary dysfunction.

Monitor patient with neurological insult for fatigue

The patient with osteoarthritis, ensure the patent begin with reduced weight- bearing

Exercises:

Abdominal contraction

Pelvic tilts

Heel raise

Knee lifts

Ankle rotation

Toe taps

Wall push-ups

ENDURANCE TRAINING:

Endurance is the ability to work for prolonged periods of time and the ability to resist fatigue. That prevent further such activity namely air exchange in the lung, heart function, blood circulation.

PHYSIOLOGY AND THE EFFECT OF AGING ON ENDURANCE

Aging itself is associated with decline skeleton muscle mass and capillary blood flow.

Poor nutrition intake

Impaired Oxygen uptake.

BENEFITS:

Reduce BP level

Reduce cardiac Fatality

Improve insulin secretion

Improve energy expenditure

Decrease cerebrovascular accidents associated weakness

promotes function in osteoarthritis and rheumatoid arthritis

PRESCRIPSION:

5-6 Mets or more for 30 min 5 times in week heart rate 60% - 70% of projected maximum or Borg scale of perceived exertion level 11 – 13

PRECAUTION:

Monitor vital signs in patients with cardiac and pulmonary impairment

Monitor saturation by pulse oximetry (SPO2) In patients with pulmonary disease and use supplemental oxygen

EXERCISE:

Brisk walking

Jogging

dancing

swimming

Biking

BALANCING TRAINING

Balance is defined as the ability to control the body mass or center of gravity to the base support in ordered to maintain an upright posture or functional equilibrium in dynamic activities.

BENEFITS:

Reduce the risk of fall

Improve functionality

PRESCRIPTION:

Tai chi or weighted vest exercise or ankle start age exercise perform 3to4 times in week in combination with other mode of exercises.

EFFECTS OF AGING ON BALANCING:

Deterioration in one or more aspect of the postural control system may occur naturally with age.

Fall are the leading cause of accidental death in older people.

Additionally, vascular disease, diabetes, neurologic disorders

PRECAUTION:

Consider dual emission x-ray

Control pain where needed

Prescribe appropriate

EXERCISES:

Shifting weight

Single leg balance

Core exercises

Back leg raises

Tree pose

Heel-to-toe walk

FELXIBILITY:

Flexibility describe the range of motion around a joint in the body A low intensity, long duration stretch is the safest and most effectiveform of stretch

EFFECTS OF AGING ON FLEXIBILITY:

Decrease collages synthesis in skin, ligament, tendons which may lead to (slower healing and adaptation to change movement pattern )

Blood flow to tissue and muscle decreased

Spasticity

BENEFITS

Improve blood supply

Improve Range of Motion

Decrease muscle spasticity

PRESCRIPTION:

4-5 repetition, held for 30s, both static and dynamic exercise combined routinely with other modes.

PRECAUTION:

Observe the patient have any recent fracture, or wound healing

Antiunion racture

EXERCISES:

Shoulder and upper backstretch

Neck stretch

Ankle rotation

CONTRAINDICATIONS TO PARTICIPATION IN ON EXERCISE PROGRAM:

Unstable angina

Congestive heart failure

Unstable arrhythmias of malignant

Elevated resting BP (systolic >200mmhg diastolic > 110 MMH)

Large aortic aneurysm

Recent intracranial bleed

Recent ophthalmologic surgery

Behavioral disorders

CORONARY DISEASE EXERCISE PLANE FOR AGING AND ELDERLY PEOPLE:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

15-minute walk x 2

30-minute cycling swimming Zumba etc.

Rest

30 minute walk or 15-minute walk x 2

30 minutes cycling swimming

Rest

Strength

rest

Strength

Rest

Strength

Rest

Balance

Flexibility

REFERENCE:

Exercise in the elderly: Research and clinical practice, Author: Jonathan F Bean

Exercise plan for senior by Nana, Sullivan Kilroy

Text book of rehabilitation by Sunder

Therapeutic exercise foundation and technique (carolyn kisner)