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Exercise In Older Poluations

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Devon Powers

on 12 May 2015

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Transcript of Exercise In Older Poluations

Older Adults/Elderly Populations
Exercise In Older Populations
As of 2009, 39.6 million adults were over the age of 65 in the U.S (12.9% of total U.S. population)
Effects of Aging on Health-Related Variables
Older Adult – Individuals 65 yrs or older or 50-64 yrs with significant conditions or physical limitations that affect movement, physical fitness, or physical activity).
Physiologic aging does not occur uniformly across the population, individuals of similar chronological age may differ dramatically in their response to exercise.
Race and Ethnicity
Only 21% of the total 65+ population were of racial or ethnic populations
Disabilities and Activity Limitations
35% of men and 38% of women age 65+ reported having a disability in 2011
Evan Lloyd & Devon Powers

Older Adults / Elderly Population
Often lack knowledge about the benefits of physical activity or how to setup a personal physical activity program so that health/fitness and clinical exercise professionals need to provide some initial education.
Exercise Testing
Most older adults do not require an exercise test prior to starting a moderate intensity physical activity program.
Geographic Location
Special Considerations
Poor balance
Poor neuromotor coordination
Impaired Vision
Impaired gait patterns
Weight-Bearing limitations
Decreased Muscular Strength
Foot problems
Contraindications to Exercise Testing
FITT-VP: Frequency
Frequency: Aerobic Exercise
≥ 5 days/week moderate intensity or...
≥ 3 days/week vigorous intensity or...
3-5 days/week combination of mod. and vigorous intensity
When unable to meet recommended amounts due to chronic conditions, they should still try to be as physically active as they possibly can.
Frequency: Muscle Strength/Endurance Exercise
≥ 2 days/week
Frequency: Flexibility Exercise
≥ 2 days/week
FITT-VP: Intensity
Intensity: Aerobic Exercise
Healthy adults determined relative to METs.
Older adults defined relative to the individuals fitness level within context of perceived exertion using a 10-point scale.
Effort of sitting: 0
Moderate intensity activity: 5-6
Vigorous intensity activity: 7-8
All out effort: 10
Intensity: Strength/Endurance Exercise
Light intensity (40%-50% 1-RM) for older adults beginning a resistance training program
Progress to moderate intensity (60%-70% 1-RM)
If no measured 1-RM available, intensity can be determined using the 10-point scale of effort with 5-6 being moderate intensity and 7-8 being vigorous intensity.
Intensity: Flexibility Exercise
Stretch to the point of feeling tightness or slight discomfort
Healthy Adults
Older Adults
Time: Aerobic Exercise
Moderate intensity:
At least 30-60 min/day, achieved in bouts of at least 10 minutes each
Total of 150-300 min/week
Vigorous Intensity:
At least 20-30 min/day
Total of 75-100 min/week
Time: Strength/Endurance Exercise
Time: Flexibility Exercise
Hold stretch for 30-60 seconds
Type: Aerobic Exercise
Any modality that does not promote excessive orthopedic stress can be used
Walking is the most common method
Choose methods of exercise which facilitate specific needs of the client (Poor Balance? Limited weight-bearing tolerance?)
Aquatic exercise and Stationary cycle exercise may be helpful to facilitate these specific needs
Type: Stength/Endurance Exercise
Progressive weight-training or weight-bearing calisthenics
Perform 8-10 exercises involving the major muscle groups
≥1 set of 10-15 repetitions of each exercise
Type: Flexibility Exercise
Any activities that help maintain or improve flexibility with slow movements for each major muscle group
Static stretches rather than rapid ballistic movements
FITT-VP: Volume
Benefits of Exercise
Decreased pain from arthritis
Increase bone density
Increase resting metabolism rate
Lower blood pressure in people with hypertension
Can improve lipoprotein profiles
FITT-VP: Progression
Prior to Exercise Testing
Total of 150-300 min/week of moderate intesity aerobic exercise or...
Total of 75-100 min/week of vigorous intensity aerobic exercise
Important to check for:
-Adequate strength
What to Prescribe First
Difficulty rising from a chair:
Strengthening Exercises
Difficulty balance standing:
Balance Exercises
Neither problem:
Endurance Training
Increase the length exercise session time 5-10 minutes every 1-2 weeks over the first 4-6 weeks of an exercise program.
After ≥1 month of regular exercise, Frequency, Intensity, and Time increased gradually over 4-8 months
May be longer than 4-8 months for older adults
Expected to increase to 72.1 million adults by 2030 (19% of total U.S. population)
African Americans: 9%
Asian/Pacific Islander: 4%
Hispanic: 7%
American Indian/Native Alaskan: 1%
Two or more/Mixed: 0.6%
Disabilities included difficulty in hearing, vision, cognition, ambulation, and self-care
Facts about Exercise with Older Adults
Focus on functional movements that will help perform activities of daily living
Older adults who are inactive have a 2 times greater probability for becoming frail than older adults who are active
Older populations represented 12.9% of the U.S. population (about 1 in 8 Americans)

Advice for trainers of older adults
Progression s
hould be individualized & tailored to tolerance and pref
Very frail individuals may need to improve muscle strength/endurance prior to aerobic training
Incorporate behavioral strategies to enhance participation.
Muscular strength decreases rapidly with age, especially those over 50yrs
Exercise Testing Guidelines
Initial workload should be light < 3 METS
May need to make changes for those with poor neuromotor coordination, impaired vision, impaired gait patterns, weight-bearing limitations and or foot problems
May have to extend initial stage for those that have difficulty adjusting to the exercise protocol
Exercise induced dysrythmias are more frequent in older adults
Medications are common and may influence ECG readings
Pescatello, L. S., & American College of Sports Medicine. (2014). ACSM's guidelines for exercise testing and prescription. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.
Administration on Aging (AoA). (2012, December 31). Retrieved April 24, 2015, from http://www.aoa.acl.gov/Aging_Statistics/Profile/2013/8.aspx
Older Adults. (n.d.). Retrieved April 28, 2015, from http://www.cdc.gov/nccdphp/sgr/olderad.htm
Spirduso, W. W., Francis, K. L., & MacRae, P. G. (2005). Physical dimensions of aging. Champaign, IL: Human Kinetics.
Inactivity increases with age. By age 75 about 1 in 3 men and 1 in 2 women engage in no physical activity.
Among adults 65 years and older, walking and gardening or yardwork are by far the most popular activities.
No specific time has been identified for effectiveness. However, good duration is how long it takes to complete 8-10 general exercises at a comfortable pace.
Warm up:
At least 5-10min of light-moderate intensity cardiorespiratory and muscular endurance activities
Same guidelines as warm up
Should also include stretching and flexibility exercises
Elward, K, & Larson, E. B. (1992). Benefits of exercise for older adults. A review of existing evidene and current recommendations for the general population. Clinics in geriactric medicine, 8(1), 35-50.
1.) What percentage of the total 65+ population in the U.S. were of racial or ethnic populations?
A.) 35% B.) 21% C.) 26% D.) 18%

2.) True or False: Older adults have the same contraindications to exercise as young adults?

3.) Short Answer: What should be done if the client cannot meet the minimum amounts of physical activity due to chronic conditions?

4.) List 4 special considerations when working with the Older populations

5.) It's possible for older adults to be considered in what age range?
A.) 50-64yrs B.) ≥ 65yrs C.) ≥ 55yrs D.) ≥ 50yrs

Represents a diverse spectrum of ages and physiologic capabilities.
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