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Ex Phys II > Final Exam Older Adults > Flashcards

Final Exam Older Adults Flashcards

1
Q

Aging and Muscle Strength Loss: UE vs. LE, declines and decades of life, women vs. men

A
  • loss in UE and LE strength, but more severe losses in LE
  • maintained through 5th decade, declines ~15% per decade in 6th and 7th decades, additional 25-30% loss in 8th decade
  • relative losses similar between men and women, but women start at lower absolute strength levels
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2
Q

What type/s of strength is/are maintained for the most part throughout aging?

A

eccentric

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3
Q

Average power vs. average force and aging

A

power reductions substantially greater than force reductions

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4
Q

Summary of Skeletal Muscle Changes Associated with Aging: Decreases (14)

A
  1. gross muscle size
  2. type 2 fiber area
  3. muscle fiber number
  4. muscle density (due to increases in fat & CT)
  5. maximal strength
  6. maximal shortening velocity (speed)
  7. rate of force development
  8. muscle power
  9. specific tension (force/area because decrease density)
  10. capillarity density
  11. activity of oxidative enzymes
  12. mitochondrial density
  13. total number of motor units
  14. steadiness of maintaining submaximal forces
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5
Q

Skeletal Muscle Changes Associated with Aging: Increases (3)

A
  1. intramuscular connective tissue
  2. intramuscular fat
  3. motor unit size
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6
Q

Skeletal Muscle Changes Associated with Aging: Little to No Change (4)

A
  1. fiber type distribution or %
  2. type 1 fiber area
  3. relative muscle endurance (endurance at a specific % max)
  4. glycolytic capacity of muscle
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7
Q

Proposed Mechanisms Leading to Decreases in Muscle Strength and Power with Aging

A
  • altered physical activity level
  • decreased testosterone and GH
  • poor nutrition or disease
  • changes in NS
  • muscle atrophy
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8
Q

Sarcopenia –> decrease strength, power, muscle endurance –> increases in what?

A

increased difficulty with weight bearing tasks
increased risk of falls and fracture
increased fatigability

which decreases PA and increases disability –> (+)

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9
Q

Cardiovascular Changes with Aging

A
  • aerobic capacity decreases about 1% each year
  • max HR decreases 1 bpm each year
  • max SV decreases, but can be maintained with training
  • total blood and plasma volume decrease
  • small reductions in hemoglobin con’t
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10
Q

Respiratory Changes with Aging

A
  • RV increases
  • VC and FEV1.0 decrease linearly with age
  • TLC unchanged
  • RV:TLC increases (less air can be exchanged)
  • minute ventilation decreases
  • elasticity decreases (can be reduced with endurance training)
  • pulmonary ventilation capabilities of endurance trained athletes are only slightly decreased with aging
  • arterial oxygen saturation does not decreased during strenuous exercise for normally active older adults
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11
Q

VO2 and Aging

A
  • prior training offers little advantage to endurance capacity later in life unless you stay active
  • aging along may not necessarily decrease VO2max
  • keeping training intensity and volume high, then rate of decrease in SV and VO2max with aging slows
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12
Q

Did you know? VO2

A

If body comp and physical activity are kept constant, VO2max decreases only 2-5% per decade, rather than the 10% per decade normally attributed to aging.

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13
Q

Effects of Aging vs. Reduced PA

A

Since PA tends to decline substantially as we age, distinguishing between the effects of aging and those of reduced PA is difficult when studying lifelong changes in physiological function

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14
Q

Relationship Between Skeletal Muscle Strength and Functional Status

A
  • In a hierarchy of functional tasks with a strength threshold, strength influences the difficult of a task
  • Once past the threshold, increases or decreases in strength may have no impact depending on how close you are to threshold
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15
Q

Functional Reserve or Reserve Capacity & Independence

A
  • the better you are going into an illness or injury, the better your physiological and functional reserve and therefore the potential for optimal outcome
  • With less reserve, the older person will struggle with an activity that a person with a higher reserve may find easy
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16
Q

Strength vs. Aerobic Training in preventing strength loss

A
  • Strength training is only exercise to prevent reductions in strength
  • Aerobic training does not maintain or increase muscle strength b/c it has little force generation
  • American Guidelines recommend both resistance and aerobic training
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17
Q

Fiatarone et al. Study: baseline –> after resistance training

A
  • old muscle is very responsive to resistance training
  • strength and CSA increases
  • functionality (6 min walk test increased)
18
Q

Fiatarone et al. Follow Up Study: resistance training group, supplement group, control group, exercise + supplement group

A
  • functionality improves
  • nutritional supplementation had no effect on primary outcome measures
  • strength related to function!!!!!!!
  • increased activity levels later in life because of improved strength and/or aerobic capacity
19
Q

Resistance Training Increases what in Independent Older Adults? (7)

A
  1. maximal walking speed
  2. stair climbing speed
  3. dynamic standing balance
  4. leg press strength
  5. knee extensor strength
  6. upper body strength
  7. muscle & fiber CSA
20
Q

Resistance Training Does Not Increase What in Independent Older Adults? (2)

A
  1. self selected walking speed

2. static standing balance

21
Q

Osteopenia, Osteoporosis, Nontraumatic fracture

A
  • Osteopenia: low bone mass (1 to 2 SD below that of a sex matched younger adult)
  • Osteoporosis: development of nontraumatic fractures as a result of low bone mass (BMD
22
Q

Most Common Fractures with Osteoporosis (female to male ratio)

A
  1. distal forearm 1.5:1
  2. thoracic and lumbar verts 7:1
  3. proximal femur 2:1

*annual expenditure on care follow hip fracture alone exceeds $10 billion in the US

23
Q

Resistance Training and BMD

A
  • high intensity strength training has a positive effect on the following risk factors for osteoporotic fractures in women 50-70 yo: bone density, muscle mass, muscle strength, dynamic balance, and overall PA activity
  • nutritional or pharmacological approaches along maintain or slow the loss of bone, but can’t improve the above factors
24
Q

Sarcopenia: effects of aging, RT, aerobics

  • muscular strength
  • muscle mass
  • muscle power
  • muscle quality (less force/area)
A

Aging: decreases all (strength the most)

RT: increases all (strength the most)

Aerobics: does not influence any

25
Q

CHD: effects of aging, RT, aerobics

  • VO2max
  • endurance performance
  • plasma lipoprotein lipid profile
  • hypertension
A

Aging: decrease VO2 max and endurance performance, increase hypertension, decrease/no change in lipid profile

RT: no change VO2max, increase endurance performance, increase/no change lipid profile, decrease hypertension

Aerobics: increase VO2max, endurance performance, lipid profile, decrease hypertension

26
Q

Diabetes: effects of aging, RT, aerobics

  • glucose intolerance
  • insulin resistance
A

Aging: increase both

RT: decrease both

Aerobics: decrease both

27
Q

Changes in height and weight with aging

A
  • height declines 1 cm per decade during 40s and 50s, then accelerates after 60 (women > men) = discs compress, pronounced thoracic curvature
  • less fat free mass, more fat
28
Q

Abdominal Obesity: effects of aging, RT, aerobics

  • total body fat
  • intra abdominal fat
  • RMR
A

Aging: increase in body fat and abdominal fat, decrease in RMR

RT: decrease body and abdominal fat, increase RMR

Aerobics: decrease body and abdominal fat, no effect on RMR

29
Q

Osteoporosis: effects of aging, RT, aerobics

  • BMD
  • risks of falls
  • flexibility or ROM
  • osteoarthritis
A

Aging: decrease BMD and flexibility, increase risk of falls and osteoarthritis

RT: increase BMD, decrease risk of falls, no change in flexibility, decrease osteoarthritis (decrease in pain, increase in fxn)

Aerobics: increase BMD if weight bearing, no change in falls, no change in flexibility, decrease osteoarthritis (decrease pain, increase fxn)

30
Q

Aging and Skeletal Muscle: muscle CSA, type 1 vs. type 2 fiber area and fiber number

A
  • decrease muscle CSA
  • no change in % of type 1 or type 2
  • decrease # of type 1 and type 2 fibers
  • decrease in type 2 fiber area/size
31
Q

Resistance Training Program Design Variables for Older Adults: 7

A
  1. Needs Analysis
  2. Exercise Selection
  3. Training Frequency
  4. Order of Exercises
  5. Training Load and Reps
  6. Volume (sets)
  7. Rest Periods
32
Q
  1. Needs Analysis
A
  • health and performance benefits of exercise for older individuals should be made clear
  • pattern of activities/interests, activity levels in last 2-3 months, barriers or concerns regarding exercise, level of interest/motivation, social preferences
33
Q

Common Contraindications for High Intensity Exercise (5)

A 
recent fractures (unstable)
advanced CHF
unstable CV disorders
cancer in musculoskeletal system
acute illness
34
Q
  1. Exercise Selection (# of exercises, weaknesses)
A
  • safety
  • movement analysis of ADLs, occupation, recreational specific skills
  • technique experience
  • equipment availability
  • 8 to 10 exercises for all major muscle groups
  • hip ADD and extensors and glutes are common weakness
  • machines then free weights
35
Q

Commonly Employed Strength Training Exercises in SNF (5)

A
  1. leg press
  2. rowing
  3. low back extensions
  4. dips
  5. cervical extension
36
Q

Elderly Exercise Precautions (3)

A
  1. leg press and machine squat - shoulder loading
  2. lateral raise - shoulder impingement
  3. cervical - RA, radicular sx
37
Q
  1. Frequency (days/week)
    - the more deconditioned the individual…the
    - generally, more intense and high volume the training, the…
A
  • 2 to 3 days per week for general health and fitness (1 day of rest between); 1 to 2 days per week for strength maintenance
  • more deconditioned the individual, the higher frequency and lower intensity
  • more intense and high volume the training, the lower the frequency
38
Q
  1. Exercise Order
A
  • thought of in terms of major muscle groups or bodyparts

- 1 exercise for each muscle group at least

39
Q
  1. Training Load & Reps (% 1RM and reps recommended)
    - relationship between load and reps (80% 1RM = ? reps)
    - options for determining starting loads
    - what do older adults respond well to
A
  • 60 to 80% 1RM or variation of loads and reps
  • 8 to 12 reps (ACSM recommends 10-15 reps)
  • 80% 1RM = 8 reps
  • options: trial and error, testing 1 RM and using % of 1RM, estimating 1 RM from multiple reps by using prediction equation
  • older adults respond well to higher reps and low loads
40
Q

Momentary Muscle Failure Assessed by: 4 things

A
  1. are last few reps difficult to perform?
  2. speed of last few reps?
  3. look of concentration and/or determination
  4. RPE
41
Q
  1. Volume
A
  • volume tolerated is related to training status

- anywhere from 1-3 set programs

42
Q
  1. Rest Periods
    - general recommendation for older adult beginners
    - strength/power, hypertrophy, endurance
A
  • 2 to 3 minutes rest generally recommended
  • used as variable to vary intensity of training
  • educate them not to stop and rest between REPS
  • strength/power = 2 to 5 min
  • hypertrophy = 20 to 90 sec
  • endurance = less than 30 sec for 12-19 reps, 2 to 3 min for greater than 20 reps

Ex Phys II (5 decks)

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