Older adults

Older adult defined as ≥ 64 years+

• Muscle strength decreases by more than 10% each decade (Lynch, Metter et al. 1999)
• Weakness is associated with decreased bone mineral density (Bevier, Wiswell et al. 1989)
• Strength training is important to reverse these age-related changes
• Prevention over cure
• Recommended levels of physical activity for ≥ 64 years+
  
• See Blood flow restriction for improvement in physical function and walking in older adults.

Assessment:

• ESSA Adult Pre Exercise Screening Tool
• Aerobic Endurance Test (with normative values for female and male)
  • 2 minute step test 
  • 6 Minute Walk test
  • Borg Scale 

Strength after Sixty:

“Doing squats won’t kill you even if you’re old”

Recommendations:

• Use functional strength training that incorporates balance and co-ordination
• Progressive overload – The muscles of older adults need to be challenged in order to grow just as the muscles of younger adult
• Neuromuscular training – take advantage coordination and complex movements to challenge the brain
• Movement standards refer to Exercise technique guidelines 

Best Exercises:

• Double leg Bridge: neuromuscular training of the pelvic gluteal activation sequence as well as spinal articulation and control.

• Single Leg Bridge: Strength progression as well as isolation, balance and coordination.

• Squats: The Squat is very important movement to get right as it mimics sitting down, jumping and many everyday life movements you need in order to live!
  • When you improve squat strength, you are developing strength in a sequence that the brain can immediately apply to similar movements, such as walking up stairs, because it shares a similar relative timing sequence.

• Deadlift:  how often you would need to bend over in a day? We use this movement all the time and don’t think about it.
  • Performing this exercise in a control environment can improve your everyday ability to pick something off the floor

Resistance program:

• Training program recommendations:
  • 8-10 exercises
  • 2 -3 sets of 6-12 repetitions of each exercise
  • 70-80% of the one repetition maximum (1-RM)
  • 2-3 times per week
  • Program length: for periods ranging from six weeks to two years.

• Dosage and progression as per novices
• Slow progression for those with:
  • Hypertension
  • Arthritis
  • cardiovasular disease
  • other conditions that limit function

• Setting and supervision: initial instruction and performance in a supervised setting are important

Supporting articles/text

1. Marlow, N., Hastings, K., & Hansson, J. (2014). Exercise & Sports Science Australia’s Outcome Measures for Exercise physiologists: Ensuring Evidence Based Practice. Exercise & Sports Science Australia.
2. Mackenzie, B. (2005). 101 Performance Evaluation Tests. London. Jonathan Pye.

• Timed up & Go Test

Balance exercises:

Otago Exercise programme including:

• Assessment
• Resistance program
• Balance program

• ESSA position statement Falls prevention:

• Falls Prevention TREK