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\ltrch \dbch \af0 \hich \af0 \loch \f0 \lang9 \langnp9 \par }\pard \plain \ql
\li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum
\adjustright \lin0 \rin0 \itap0 \fs21 \kerning2 \rtlch \ltrch \dbch \af2 \hich \af0
\loch \af0 {\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang9
\langnp9 Exercise or physical activity provides a myriad of health benefits in
young and elderly alike. Compared to the resting state, exercise poses a
substantial increase in demand for the body and causes changes in various organs as
a result of a coordinated response generated by musculoskeletal, cardiovascular and
respiratory systems. This topic attempts to discuss the above mentioned responses
to exercise in elderly.}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0
\loch \f0 \lang9 \langnp9 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0
\fs21 \kerning2 \rtlch \ltrch \dbch \af2 \hich \af0 \loch \af0 {\fs32 \kerning2
\rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang9 \langnp9 \par }\pard \plain
\ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum
\loch \af0 {\b1 \fs36 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0
\lang9 \langnp9 CARDIAC ADAPTATIONS TO EXERCISE}{\b1 \fs36 \kerning2 \rtlch
\langnp9 Increased levels of physical activity and exercise are not only associated
with a significant reduction in cardiovascular mortality and morbidity in later
life, but also have substantial impact on the rate of aging in the absence of
disease. Conditioning in elderly leads to changes both at central and at peripheral
levels. Central adaptations with exercise training include changes in cardiac
output, blood volume and arterial oxygen-carrying capacity whereas skeletal muscle
blood flow and capillarization are the peripheral adaptations. }{\fs32 \kerning2
\langnp9 One of the most important physiological changes that occur in response to
advanced aging is a decline in maximal aerobic capacity (i.e. cardiorespiratory
fitness) represented by peak exercise oxygen consumption. It has been shown that
with conditioning, elderly can manifest training adaptations similar to young
people. A
12-week exercise training program on cycle ergometer at an intensity of 70 percent
of heart rate reserve with a frequency of three times/week, increased max VO2 from
26.6 to 31.9 ml/kg/min in 60-year-old men and women, compared with an increase from
45.6 to 51.1 ml/kg/min in a group of 20-year-olds. This indicates a similar
improvement of maximal aerobic capacity in the older in comparison with young
people. In comparison to age-matched sedentary individuals, trained elderly have
twice the max VO2.}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch
\f0 \lang9 \langnp9 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276
\ltrch \dbch \af0 \hich \af0 \loch \f0 \lang9 \langnp9 Furthermore, in a community-
based population free of clinically apparent cardiovascular disease, higher
physical activity levels were associated with proportionally greater left
ventricular mass and end-diastolic volume and lower resting heart rate. Peak
exercise cardiac function is improved after exercise training in older people as
demonstrated with increase in peak cardiac output, stroke volume, ejection fraction
and left ventricular contractility.}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich
\af0 \loch \f0 \lang9 \langnp9 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200
\loch \af0 {\b1 \fs36 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0
\lang9 \langnp9 RESPIRATORY ADAPTATIONS TO EXERCISE}{\fs32 \kerning2 \rtlch
\langnp9 There is initially a drop in end-expiratory lung volume (EELV) in both
young and old subjects to optimi}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich
\af0 \loch \f0 \lang1033 \langnp1033 z}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0
\hich \af0 \loch \f0 \lang9 \langnp9 e inspiratory muscle function. Increased EELV
during exercise results in }{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0
\loch \f0 \lang1033 \langnp1033 decreased}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0
\hich \af0 \loch \f0 \lang9 \langnp9 inspiratory muscle length, increas}{\fs32
\kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 ed }
{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang9 \langnp9 work
of breathing and potentially }{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich
\af0 \loch \f0 \lang1033 \langnp1033 reduced}{\fs32 \kerning2 \rtlch \ltrch
\dbch \af0 \hich \af0 \loch \f0 \lang9 \langnp9 inspiratory muscle endurance. In
line with these effects, inspiratory reserve volume is consistently lower in the
elderly at rest, and remains lower, along with inspiratory capacity, likely
contributing importantly to the greater sensation of breathlessness in the elderly}
{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033
\langnp1033 , which is shown to reduce in trained older individuals as compared to
the untrained, who experience a greater perceived exertion in relation to
exercise.}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0
\lang1033 \langnp1033 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0
\rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 In terms of
pulmonary vascular function, older people display similar changes, yet again, to
those of younger individuals namely increased mean pulmonary arterial pressure, as
a consequence of increased pulmonary vascular resistance and elevated left
ventricle filling, due to age-related diastolic dysfunction.}{\fs32 \kerning2
\rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 \par }\pard
\plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin0 \rin0 \itap0 \fs21 \kerning2 \rtlch \ltrch \dbch \af2
\hich \af0 \loch \af0 {\b1 \fs36 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0
\loch \f0 \lang1033 \langnp1033 MUSCULOSKELETAL ADAPTATIONS TO EXERCISE}{\b1
\fs36 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033
\par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar
\aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \fs21 \kerning2 \rtlch \ltrch
\dbch \af2 \hich \af0 \loch \af0 {\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich
\af0 \loch \f0 \lang1033 \langnp1033 Training-induced adaptations in skeletal
muscle depend on the intensity, frequency, duration, and mode of exercise.
Appropriate exercise can alter, slow, or even partially reverse some of the age-
related physiological changes that occur in skeletal muscle, including sarcopenia,
reduced lean muscle mass and decreased force production.}{\fs32 \kerning2 \rtlch
\langnp1033 Skeletal muscle adaptations to exercise occur in the following ways:}
\langnp1033 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276
\ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 - Muscle
capillarization and oxidative capacity are 2 measures of skeletal muscle adaptation
to training (both endurance and strength training). According to a study, muscle
capillarization increased by 20-25% in older individuals (60\uc1 \u8211 ?70 years
of age) who engaged in an endurance training program that consisted of walking or
jogging for 45 minutes per day, 3 times per week, for 10 months at 80% of their
age-adjusted maximal heart rate. In another study that examined peripheral effects
of endurance training, oxidative capacity of older men increased by 125%. }
\langnp1033 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276
\ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 In terms of body
composition, it is common to see that most normal individuals grow fatter with
increasing age, individuals who engage in heavy resistance training increase their
lean body mass and decrease fat. This hugely improves the quality of life of
elderly and optimizes their health. }{\fs32 \kerning2 \rtlch \ltrch \dbch \af0
\hich \af0 \loch \f0 \lang1033 \langnp1033 \par }\pard \plain \ql \li0 \ri0
\lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lin0 \rin0 \itap0 \fs21 \kerning2 \rtlch \ltrch \dbch \af2 \hich \af0 \loch \af0
\langnp1033 Osteoporosis is a common health disorder in older people. It can
drastically weaken the bones of elderly in the absence of mechanical stress which
contributes to bone health. Aerobic exercises that load the lower extremities
substantially (e.g, running) and strength training help to prevent or slow
osteoporosis because of the observed relationship between sarcopenia and bone
mineral density as well as the effects of weight bearing on bone. In addition,
because bone mass, muscle mass and and muscle strength correlate with each other,
strength training may result in fewer fractures in older people.}{\fs32
\kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033
\af0 \loch \f0 \lang1033 \langnp1033 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200
\rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033 Conclusion}{\b1
\fs36 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0 \lang1033 \langnp1033
\af0 \loch \f0 \lang1033 \langnp1033 Changes due to aging can be detrimental in
sedentary individuals. Exercise induced physiological changes in elderly can help
optimize health and preserve bodily functions. Aerobic exercise and strength
training help maintain various aspects of cardiopulmonary function similar to those
that occur in youth. Furthermore,
the loss in muscle and bone mass can be counterbalanced by the effects of strength
training.}{\fs32 \kerning2 \rtlch \ltrch \dbch \af0 \hich \af0 \loch \f0
\lang1033 \langnp1033 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0
\langnp9 \par }\pard \plain \ql \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1
\ltrch \dbch \af2 \hich \af0 \loch \af0 {\fs22 \kerning2 \rtlch \ltrch \dbch
\af0 \hich \af0 \loch \f0 \lang9 \langnp9 \par }}

Geriatric PT

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