Exercise Prescription for Older Adults Components of Fitness

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Exercise prescription for older adults

Prescribing exercise for older adults depends largely on the individuals level of functionality. The FITT principal should be applied to information gained from the risk stratification and fitness assessment phases to design a macro-cycle. Some general pointers can be used to help guide prescription for certain groups within the older adult population; For older adults considered to be frail, exercise should occur on nonconsecutive days. This allows for adequate recovery. For those with medical conditions the exercise prescription guidelines specific to the condition(s) apply. This includes contraindications. Emphasise activities that aim to improve function and enhance the individuals ability to perform activities of daily living Look to embed incidental exercise Include exercises that target balance and co-ordination Keep in mind that characteristics such as strength and endurance naturally decline with age. Dont view maintenance as a failure. Exercise prescription guidelines and considerations can be further broken down into components of fitness for older adults. These components are listed below and include cardiovascular, strength and flexibility.

Cardiovascular considerations Cardiovascular endurance decreases with age. The extent of this is illustrated in the tables below;

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Female (values in ml/kg/min)

Age

Very Poor

Poor

Fair

Good

Excellent

Superior

13-19

<25.0

25.0 30.9

31.0 34.9

35.0 38.9

39.0 41.9

>41.9

20-29

<23.6

23.6 28.9

29.0 32.9

33.0 36.9

37.0 41.0

>41.0

30-39

<22.8

22.8 26.9

27.0 31.4

31.5 35.6

35.7 40.0

>40.0

40-49

<21.0

21.0 24.4

24.5 28.9

29.0 32.8

32.9 36.9

>36.9

50-59

<20.2

20.2 22.7

22.8 26.9

27.0 31.4

31.5 35.7

>35.7

60+

<17.5

17.5 20.1

20.2 24.4

24.5 30.2

30.3 31.4

>31.4

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Male (values in ml/kg/min)

Age

Very Poor

Poor

Fair

Good

Excellent

Superior

13-19

<35.0

35.0 38.3

38.4 45.1

45.2 50.9

51.0 55.9

>55.9

20-29

<33.0

33.0 36.4

36.5 42.4

42.5 46.4

46.5 52.4

>52.4

30-39

<31.5

31.5 35.4

35.5 40.9

41.0 44.9

45.0 49.4

>49.4

40-49

<30.2

30.2 33.5

33.6 38.9

39.0 43.7

43.8 48.0

>48.0

50-59

<26.1

26.1 30.9

31.0 35.7

35.8 40.9

41.0 45.3

>45.3

60+

<20.5

20.5 26.0

26.1 32.2

32.3 36.4

36.5 44.2

>44.2

Q: Considering the information in the tables above, why is it important to maintain a relatively high VO2 (cardiovascular capacity) into older age? Use the picture on the next page to help. ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ....................................................................................................................................... ......................................................................................................................................

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Taken from McArdle, Katch & Katch (2000). Essentials of Exercise Physiology. 2nd Edn. Lippincott, Williams and Wilkins.

Older adults can achieve the same 10-30% increases in VO2 Max with prolonged endurance exercise training as their younger counterparts. The extent of improvement in VO2 Max remains a function of training intensity with age. That is, light intensity training causes minimal adaptation. However, cardiovascular activity of any intensity can have a positive impact on health factors aside from VO2, including body composition, cholesterol levels, bone strength and psychology.

Cardiovascular exercise can contribute to a number of other benefits for older adults. List some of these in the spaces provided below;

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Strength considerations Loss of muscle mass occurs with age. This loss of contractile tissue is called sarcopenia and generally begins at around age 35. A graph of this process is shown below.

Computed tomography of the knee extensors indicates that after 30 years, there is; A decrease in cross sectional area A decrease in muscle density An increase of intramuscular fat These changes are more evident in women

A loss of muscle mass (cross sectional area) generally corresponds with a decrease in strength. This has wide ranging implications for older adults. For example, there has been found to be a significant correlation between muscle strength and preferred walking speed in older adults. For this reason, strength levels, especially leg strength levels, can be used as a useful predictor of functional capacity. Overall, Lean Body Mass has been reported to be reduced by an average of 15% between the third and eighth decade. As muscle mass decreases so too does metabolic rate. What implications could this have? ................... Document1 Created 28/08/2012 8:43:00 PM Last modified 4/09/2013 3:19:00 PM

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Increased muscular strength and endurance can be achieved through resistance training. This is true for both the general population and older adults. However, when writing resistance training programs for older adults any existing conditions that the individual has must be taken in to account. For example, older adults with osteoporosis will have specific requirements, such as relatively low weights, no bouncing movements and no twisting of the spine. Such medical conditions should be programmed for specific to the individual, whether they are considered an older adult or not. Resistance training can benefit older adults in several ways. Use the space provided below to continue the list; With increased muscular strength and power, older adults often exhibit an increased tendency for spontaneous activity ...... .........................................................................

Flexibility considerations Flexibility training should be encompassed in any training program implemented with an older adult. Flexibility decreases with age with males tending to have poorer flexibility at all ages. For older adults flexibility is important for three significant reasons; It can help reduce the risk of a fall It can help improve the rate of recovery after a fall It can improve functional independence. For example, poor flexibility can make tasks such as getting dressed, driving and putting away the groceries more difficult. The following flexibility guidelines are generally recommended for older adults; Static stretching Regular (5-7x per week) Whole body

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 Incorporate ROM exercises (especially for those with arthritis)

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