Post by carruthersjam on Sept 22, 2008 8:59:34 GMT -8
Here are some relevant extracts from David Sandler's (StrengthPro)
presentation regarding the training of seniors:
*We are living longer
• Older population will require wider range and expansion of existing
health and rehab services
• Services need to help older persons maintain functional independence
• Greater need for well-educated practitioners, as well as educational
programs about aging
• Demand of personnel to help elderly people will greatly exceed
future supply
--------------
* 40% of people over 65 are functionally limited
• 42% have arthritis, 39% hypertension, 27% heart disease, 12%
arteriosclerosis, 8% diabetes
• 33% of Seniors are prone to falling
– 30% of those lose independence
• Many cannot perform Activities of Daily Living (ADLs) because they
lack physical strength and stamina
• Longer recoveries and hospital stays and more help is needed
--------------
Exercise and Aging
• Loss of muscle mass decreases exercise capacity bringing the
elderly closer to their physical activity threshold
• Physical activity delays disease and restores functional mobility
• We need to convince aging people that they need to exercise by
changing their beliefs
• Data shows the value of exercise for the aging – we need to
interpret it
Nervous System
– Cortical atrophy (CNS) and neurotransmitter decrease
– Decline in cerebral blood flow
– Conduction velocity slows 10-15%
– PNS affected by conduction velocity delays
• Sensory System
– Sight, hearing and taste diminish
– Vision (farsightedness) and other diseases
– Hearing and auditory problems lead to loss of balance and
coordination
Musculoskeletal Problems with Aging
• Decrease in muscle mass and hence strength as we age
• Fiber shift and decrease in type II size
• Decreased BMR as a result of less muscle
• Loss of contractile force capability
• Collagen fiber changes causing reduced flexibility (especially in
spine and discs)
• Bone loss (20% men, 35% women) and is accelerated 2-3 times in
women after menopause – contributes to many problems
---------------------
AN ADL-RELATED METHOD FOR ASSESSING POWER OUTPUT IN SENIORS
DJ Sandler, SA Bamel, DC Stanziano, F Ma, BA Roos, JF Signorile
Stein Gerontological Institute, Miami Veterans Affairs Medical Center
GRECC, University of Miami, Florida International University
Between the ages of 65 and 89 explosive lower limb extensor power
declines 3.5% per year compared to an annual 1-2% in strength. In
elderly males, maximal anaerobic power has been reported to decline
8.3% per decade from age 20 to 70. These data are not surprising
given the selective loss of faster contracting motor units with
sarcopenia.
Power is one of the major performance variables associated with
independence, fall prevention and rehabilitation following injury.
A number of researchers have measured power in older individuals;
however, the techniques used were either too expensive to be utilized
for general screening purposes, relatively dangerous for this
population, or not task-specific.
Guidelines for Exercise and Aging
• Comprehensive medical exam assessing cardiovascular, respiratory,
etc.
• Exercise screening questionnaire and physician should indicate
contraindications
• Encourage family support for adherence
• Use RPE for all exercises
• Weight training following aerobic exercise for 8-15 reps; possibly
circuit training
• Monitor heart rate after 2-3min and periodically
• Warm-up and Cool-down (5-10min) including stretching and gradual
increase/decrease in intensity
• Monitor environment and dehydration status as well as post-exercise
re-hydration
• Patience and repetition of exercise instruction is required – work
closely with your client
• Speak carefully, demonstrate exercises
• Stretching is very important – increase flexibility
• Exercise should occur 2 hours after eating
• Deconditioning is much more rapid – focus on baseline strengthening
• Exercise adherence is vital – add variety to your program – include
education
• Age itself should not affect intensity – client must work hard to
see benefits
------------------
Tissue Adaptation Phase
1. Start with resistance that is manageable and does not cause
failure.
2. Train all major muscle groups which are biomechanically related to
ADL and fall prevention. Be sure to train agonist/antagonist pairs.
3. Begin at a low intensity and volume, increase volume first then
intensity, use the Tissue Adaptation Period to teach proper form
while increasing tissue strength.
4. Don't allow neuromuscular facilitation and quick strength gains to
dictate a change in training pattern.
The only data available concerning the Speed-Strength or Power Phase
as it relates to an older population comes from our data (Carmel et
al., 2000; Signorile et al., 1996, 2000). These data showed a
much more rapid rise in torque for the High Speed or Power group than
was seen in the Low Speed or Hypertrophy group, although the peaks
occurred at similar times (app. 12-16 training days or 4-5 weeks).
Power data has yet to be assessed, but given these time frames and
the relative intensity of high-speed work we suggest a 3-5 week cycle.
Linstrom et al. (1997) found in a study comparing 22 young
individuals (28±6 yrs) to 16 older individuals (76±3 yrs) that
relative to their strength older individuals have similar properties
with respect to muscle fatigue and endurance. Schwendner et al.
(1997) found that older individuals who had a propensity to fall had
similar MVCs to no-fallers but showed significantly shorter times to
fatigue, longer recovery times, and less shifts in their EMG median
power frequencies.
----------------------
Multi-planar free-weight movements may prove to be extremely
important in fall-prevention. Kerrigan et al., 2000 showed that an
increase in peak external hip flexion moment during stance was
among the parameters which dictated changes in gait, Greenspan et al.
(1994), Cummings and Nevitt (1989) and, (Cummings, 1987) all
confirmed that the highest incidence of hip fracture is during falls
to the back and side. Maki & McIlroy (1997) showed that lack of
lateral stability existed in those who had trouble regaining even
anterior/posterior balance.
Useful link:
newoldage.blogs.nytimes.com/
==============================
Jamie Carruthers
Wakefield, UK
presentation regarding the training of seniors:
*We are living longer
• Older population will require wider range and expansion of existing
health and rehab services
• Services need to help older persons maintain functional independence
• Greater need for well-educated practitioners, as well as educational
programs about aging
• Demand of personnel to help elderly people will greatly exceed
future supply
--------------
* 40% of people over 65 are functionally limited
• 42% have arthritis, 39% hypertension, 27% heart disease, 12%
arteriosclerosis, 8% diabetes
• 33% of Seniors are prone to falling
– 30% of those lose independence
• Many cannot perform Activities of Daily Living (ADLs) because they
lack physical strength and stamina
• Longer recoveries and hospital stays and more help is needed
--------------
Exercise and Aging
• Loss of muscle mass decreases exercise capacity bringing the
elderly closer to their physical activity threshold
• Physical activity delays disease and restores functional mobility
• We need to convince aging people that they need to exercise by
changing their beliefs
• Data shows the value of exercise for the aging – we need to
interpret it
Nervous System
– Cortical atrophy (CNS) and neurotransmitter decrease
– Decline in cerebral blood flow
– Conduction velocity slows 10-15%
– PNS affected by conduction velocity delays
• Sensory System
– Sight, hearing and taste diminish
– Vision (farsightedness) and other diseases
– Hearing and auditory problems lead to loss of balance and
coordination
Musculoskeletal Problems with Aging
• Decrease in muscle mass and hence strength as we age
• Fiber shift and decrease in type II size
• Decreased BMR as a result of less muscle
• Loss of contractile force capability
• Collagen fiber changes causing reduced flexibility (especially in
spine and discs)
• Bone loss (20% men, 35% women) and is accelerated 2-3 times in
women after menopause – contributes to many problems
---------------------
AN ADL-RELATED METHOD FOR ASSESSING POWER OUTPUT IN SENIORS
DJ Sandler, SA Bamel, DC Stanziano, F Ma, BA Roos, JF Signorile
Stein Gerontological Institute, Miami Veterans Affairs Medical Center
GRECC, University of Miami, Florida International University
Between the ages of 65 and 89 explosive lower limb extensor power
declines 3.5% per year compared to an annual 1-2% in strength. In
elderly males, maximal anaerobic power has been reported to decline
8.3% per decade from age 20 to 70. These data are not surprising
given the selective loss of faster contracting motor units with
sarcopenia.
Power is one of the major performance variables associated with
independence, fall prevention and rehabilitation following injury.
A number of researchers have measured power in older individuals;
however, the techniques used were either too expensive to be utilized
for general screening purposes, relatively dangerous for this
population, or not task-specific.
Guidelines for Exercise and Aging
• Comprehensive medical exam assessing cardiovascular, respiratory,
etc.
• Exercise screening questionnaire and physician should indicate
contraindications
• Encourage family support for adherence
• Use RPE for all exercises
• Weight training following aerobic exercise for 8-15 reps; possibly
circuit training
• Monitor heart rate after 2-3min and periodically
• Warm-up and Cool-down (5-10min) including stretching and gradual
increase/decrease in intensity
• Monitor environment and dehydration status as well as post-exercise
re-hydration
• Patience and repetition of exercise instruction is required – work
closely with your client
• Speak carefully, demonstrate exercises
• Stretching is very important – increase flexibility
• Exercise should occur 2 hours after eating
• Deconditioning is much more rapid – focus on baseline strengthening
• Exercise adherence is vital – add variety to your program – include
education
• Age itself should not affect intensity – client must work hard to
see benefits
------------------
Tissue Adaptation Phase
1. Start with resistance that is manageable and does not cause
failure.
2. Train all major muscle groups which are biomechanically related to
ADL and fall prevention. Be sure to train agonist/antagonist pairs.
3. Begin at a low intensity and volume, increase volume first then
intensity, use the Tissue Adaptation Period to teach proper form
while increasing tissue strength.
4. Don't allow neuromuscular facilitation and quick strength gains to
dictate a change in training pattern.
The only data available concerning the Speed-Strength or Power Phase
as it relates to an older population comes from our data (Carmel et
al., 2000; Signorile et al., 1996, 2000). These data showed a
much more rapid rise in torque for the High Speed or Power group than
was seen in the Low Speed or Hypertrophy group, although the peaks
occurred at similar times (app. 12-16 training days or 4-5 weeks).
Power data has yet to be assessed, but given these time frames and
the relative intensity of high-speed work we suggest a 3-5 week cycle.
Linstrom et al. (1997) found in a study comparing 22 young
individuals (28±6 yrs) to 16 older individuals (76±3 yrs) that
relative to their strength older individuals have similar properties
with respect to muscle fatigue and endurance. Schwendner et al.
(1997) found that older individuals who had a propensity to fall had
similar MVCs to no-fallers but showed significantly shorter times to
fatigue, longer recovery times, and less shifts in their EMG median
power frequencies.
----------------------
Multi-planar free-weight movements may prove to be extremely
important in fall-prevention. Kerrigan et al., 2000 showed that an
increase in peak external hip flexion moment during stance was
among the parameters which dictated changes in gait, Greenspan et al.
(1994), Cummings and Nevitt (1989) and, (Cummings, 1987) all
confirmed that the highest incidence of hip fracture is during falls
to the back and side. Maki & McIlroy (1997) showed that lack of
lateral stability existed in those who had trouble regaining even
anterior/posterior balance.
Useful link:
newoldage.blogs.nytimes.com/
==============================
Jamie Carruthers
Wakefield, UK