Lecture 12 Flashcards
primary goals for exercise prescription
-Improve basic fitness components with emphasis on aerobic and muscle
strengthening activity
-Functional (relevant) approach with emphasis on flexibility, balance and
coordination
-Prevent or slow chronic disease progression and associated limitations
-Ensure symptom free exercise
-Some older adults want to train but most want to keep what they have
remember population can be
- Physically elite
- Physically fit
- Physically independent
- Physically frail
- Physically dependent
remember exercise can be
- Daily tasks
- Recreational activities
- Hobbies and social interactions
- Active transportation
- Active living
first steps
- Consent
- History – learn “the story of the client”
- Assess their functional level
- Write down two of THEIR goals
- Determine exercise program based on needs and goals
- Evaluate after four sessions
cardiovascular training
- HRmax = 208 - 0.7 x age
- Inactive client may start at 40-50% MHR(RPE of 10 or 11)
- 3 x 10 minute bouts daily for the least fit
- 30 min/day minimum for health maintenance
- High fitness level may be around 70—85% MHR
- 60-90 minutes per day to maximize health and fitness
musculoskeletal training
-Intensity and duration is low to begin – increase reps before resistance
-Machines or bands better to start especially if balance is an issue
-Proper technique is essential as is pain free range of movement
-Provide adequate rest
-Reduce volume during arthritic flare-ups, hot and humid weather or during
acute phase of injury
-Once 1 x 15 reps is achieved, add second set and reduce to 2x 8-12 reps
-Train eccentrically (2-3 sec lift, 3-4 sec lower)
-FOCUS LOWER: hip extensors, hip abductors and adductors, knee extensors
and ankle plantar and dorsiflexors
-FOCUS UPPER: bicep, tricep, shoulder stabilizers and movers
-FOCUS TRUNK: all abdominal muscles and extensors
balance and flexibility
Balance:
-Performed 3 days a week for 10-15 minutes each session for older adults and those with most chronic conditions
-Walk on uneven surface, hiking, tandem walking, side step etc. Good evidence supporting Tai Chi and balance
-Reps and rest depend on client (ex: independent client: sit on foam pad, disc to physioball; fit client: standing with progression: both hands, one hand, one finger, no fingers, eyes closed to dynamic)
Flexibility:
-Stretches – all joints – 2-4 reps held for 10-30 seconds – muscle pull not pain
-Done daily and with activity session ideally
functional exercises
-Activities designed to make activities of daily living easier, safer and more
efficient
-Up and down activities: lower body
-Locomotor activities
-Carry-push-reach activities that focus on upper body and core
-Remember to include these elements:
-Dynamic stabilization
-Reactive movements to maintain posture
-Functional range of motion
-Progression of challenge that mimics speed, power and agility of ADLs
daily dose
-Habit or routine where physical activity occurs on a relatively regular
schedule every week
-Can you make everyday activities a bit more challenging? (work in some
squats, stand or walk while on phone, stretch after shower (safely), dance
during housework)
when to progress RT
- When they can complete a full number of reps and sets in good form
- They feel the exercise is too easy
- There is no pain or undue discomfort
when to progress cardio
- Be able to breathe comfortably and able to talk but not sing
- Feel refreshed and not exhausted
- No undue fatigue, soreness or injury the day after the session
exercise principles still apply to seniors
- Overload – increase: 1. frequency, 2. intensity, 3. duration, 4. type
(typically) - Specificity – in this case related to function
-Basic ADL – hygiene, transfer, mobility, feeding and toileting
-Instrumental ADL – food prep, shopping, finances, medication
management, house work and transportation
-Advanced ADL – working, hobbies, socializing - Challenge – change the task or the environment (walk outdoors not on
treadmill)
general assumptions for most seniors
-Glutes, quads, core and calves tend to be weak
-Ankle dorsiflexor weakness risk for falls – wrists and ankles in general
-Assume low bone density and avoid spinal flexion, exercise choices with fall
risk
-Balance poor
-Range of motion will be affected
-Build a basic strength base before prescribing power, plymetric, or other
exercises that are outside a slow, safe range of motion
-Use devices that reduce momentum first – tubes, bands, pneumatic machines
potentially inappropriate exercises for seniors
- Neck hyperextension and full neck rotation
- Straight leg sit ups or double leg lift in supine
- Full sit up and sit up with feet anchored
- Feet apart twisting alternating toe touches
- Seated, legs straight out reading for toes
- Deep knee bends or duck walks
- Hurdler’s stretch
- Rapid torso twisting
- Side bends with weights and lateral flexion beyond 20 degrees
- High impact activities
