Exercise and Activity Long ACC


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Exercise and Activity Long ACC

  1. 1. Exercise & Good Health: No Matter the Age
  2. 2. Most anyone can benefit from additional physical activity! And it is never too late!
  3. 3. In today’s society, effective fitness is desperately needed to improve the physical health of the frail elderly.
  4. 4. Benefits ■ According to a study performed by The National Institute on Aging, for the elderly age 75 and older: ► 40% cannot walk two blocks ► 32% cannot climb ten steps ► 22% cannot lift ten pounds ► 7% cannot walk across a small room ► 50% of those who fracture hips never walk independently again, with many dying from complications
  5. 5. Benefits ■ Staying physically active and exercising regularly can help prevent and delay many diseases and disabilities. ■ Even moderate exercise and physical activity can improve the health of people who are frail or who have age-related diseases.
  6. 6. Benefits ■ According to the study of adults aged 72 to 80, elderly ―couch potatoes‖ were much more likely to die within about six years than those whose lives included regular activity no more strenuous than: ► washing dishes ► vacuuming ► gardening ► climbing stairs
  7. 7. Benefits ■ NIA indicates that an inactive lifestyle can cause older people to LOSE ground in four areas important for staying healthy and independent: ► strength ► balance ► flexibility ► endurance
  8. 8. Benefits of Exercise in Older Adults Cardiovascular Osteoporosis Osteoarthritis •Improves physiologic •Decreases bone density loss •Improves function parameters in postmenopausal women •Decreases pain •Improves blood pressure •Decreases hip and vertebral •Decreases risk of coronary fractures Cancer artery disease •Decreases risk of falling •Potential decrease in risk of •Improves congestive heart colon, breast, prostate, rectum failure symptoms and decreases Neuropsychologic health •Improves quality of life and hospitalization rate •Improves quality of sleep decreases fatigue •Improves lipid profile •Improves cognitive function •Decreases rates of Other Diabetes mellitus, type 2 depression, improves Beck •Decreases all-cause mortality •Decreases incidence depression scores. •Decreases all-cause morbidity •Improves glycemic control •Improves short-term memory •Decreases risk of obesity •Decreases hemoglobin levels •Improves symptoms in peripheral •Improves insulin sensitivity vascular occlusive disease These benefits were presented in the article ―Promoting and Prescribing Exercise for the Elderly,‖ by Robert J. Nied, M.D., Michigan State University, East Lansing, Michigan and Barry Franklin, Ph.D., William Beaumont Hospital, Royal Oak, Michigan of the American Academy of Family Physicians (AAFP).
  9. 9. Benefits A recent Harvard Alumni study found: ■ Modest increases in life expectancy were possible even in those people who did not begin regular exercise until age 75. ■ Compared with people who were active only in younger years and then stopped exercising, mortality rates were lower in those people who did not begin regular exercise until later in life, but who were exercising.
  10. 10. DESPITE THIS PERSUASIVE DATA, up to 75 percent of older Americans are insufficiently active to achieve these health benefits!
  11. 11. Habit is the single best predictor of inactivity across all age groups.
  12. 12. ―Many characteristics we associate with older age—like the inability to walk long distances, climb stairs, or carry groceries— are largely due to a lack of physical activity,‖ explains Dr. John Montgomery, a family physician, medical epidemiologist and Vice President of Senior Care Solutions with Blue Cross and Blue Shield of Florida (Caregiver.com).
  13. 13. There are some common misconceptions about exercise and the elderly that keep people away from fitness:
  14. 14. Misconceptions ■ Frail older adults are unable to exercise. ■ It is unwise and unsafe for the frail elderly to begin an exercise program. ■ Frail elderly gain few benefits from exercise. ■ It is too difficult to set up exercise programs for the frail elderly.
  15. 15. Increasing Activity Physicians can have the greatest overall impact by helping their sedentary patients become active. ■The American Academy of Family Physicians (AAFP) believes motivating patients to begin exercise is best achieved by focusing on: ► individual patient goals ► concerns ► barriers to exercise
  16. 16. Increasing Activity ■ To increase long-term compliance, exercises should be: ► straightforward and fun ► geared toward a person’s individual health needs, beliefs and goals ■ The most successful compliance with long-term exercise is likely achieved by: ► identifying and overcoming barriers to activity ► setting specific goals ► recruiting spouse/family support ► providing positive reinforcement
  17. 17. Common Barriers to Exercise in Older Adults Barrier Approach Self-efficacy Begin slowly with exercises that are easily accomplished; advance gradually; provide frequent encouragement. Attitude Promote positive personal benefits of exercise; identify enjoyable activities. Discomfort Vary intensity and range of exercise; employ cross-training; start slowly; avoid overdoing. Disability Specialized exercises; consider personal trainer or physical therapist. Poor balance/ataxia Assistive devices can increase safety as well as increase exercise intensity. Fear of injury Balance and strength training initially; use of appropriate clothing, equipment, and supervision; start slowly. Habit Incorporate into daily routine; repeat encouragement; promote active lifestyle.* Subjective norms Identify and recruit influential others; education of patient and influential family/friends. Fixed income Walking and other simple exercises; use of household items; promote active lifestyle*. Environmental factors Walk in the mall; use senior centers; promote active lifestyle*. Cognitive decline Incorporate into daily routine; keep exercises simple. Illness/fatigue Use a range of exercises/intensities that patients can match to their varying energy levels. * Examples of an active lifestyle include using a golf pull cart while golfing, using a push mower, participating in activities such as stand and cast fishing or gardening, and taking the stairs.
  18. 18. Guidelines ■ The American College of Sports Medicine (ACSM) presents guidelines for adults over age 65 (or adults 50-64 with chronic conditions, such as arthritis). ■ Older adults or adults with chronic conditions should develop an activity plan with a health professional to manage risks and take therapeutic needs into account.
  19. 19. Recommendations ■ Basic recommendations from ACSM and American Heart Association: Do moderately intense OR Do vigorously intense aerobic exercise aerobic exercise 30 minutes 20 minutes a day, 3 days a week a day, 5 days a week AND Do 8–10 strength-training exercises, 10–15 repetitions of each exercise, 2–3 times per week AND If you are at risk of falling, perform balance exercises AND Have a physical activity plan
  20. 20. Recommendations ■ Flexibility is also important: ► Each day aerobic or strength-training activities are performed, take an extra 10 minutes to stretch the major muscle and tendon groups, with ► 10–30 seconds for each stretch ► Repeat each stretch 3–4 times ► Flexibility training will promote the ease of performing everyday activities
  21. 21. When to Stop Exercising ■ A person should consult his or her physician if exercise results in: ► chest pain ► dizziness ► cold sweats ► extreme breathlessness ► very rapid heart rate that lasts longer than 5–10 minutes after stopping activity If a movement causes pain, stop!
  22. 22. Beneficial Exercises ■ To stay healthy and independent, focus on improving the magic four areas of fitness: ► strength ► balance ► stretching/flexibility ► endurance
  23. 23. Strength is central to daily function, especially in the very elderly.
  24. 24. Strength Exercises ■ build muscle ■ increase metabolism ■ keep weight and blood sugar in check
  25. 25. Muscle strength declines by 15 percent per decade after age 50 and 30 percent per decade after age 70; however, resistance training can result in 25 to 100 percent, or more, strength GAINS in older adults.
  26. 26. Walking ■ Most of the variance in walking speed in the elderly is related to leg strength. Increased strength has been shown to improve: ► walking endurance ► stair-climbing power
  27. 27. Strength training also improves nitrogen balance and can, when combined with adequate nutrition, prevent muscle wasting in institutionalized elderly persons.
  28. 28. Muscle soreness lasting a few days and slight fatigue are normal after muscle-building exercises. Exhaustion, sore joints, and painful muscle pulls are not normal.
  29. 29. Balance Exercises ■ Balance exercises help the elderly stay independent by: ► building leg muscles ► helping prevent falls
  30. 30. While we know hip fractures are one of the leading causes of death among senior citizens, Tai Chi, a form of Chinese martial arts, may help improve balance and avoid the falls that can break hips and other bones.
  31. 31. Endurance exercises— walking, jogging, swimming, raking—increase heart rate and breathing for an extended period of time.
  32. 32. Build up endurance gradually, starting with as little as five minutes of endurance activities at a time.
  33. 33. Endurance Exercises ■ Examples of moderate endurance activities for the average older adult are listed below. Older adults who have been inactive for a long time will need to work up to these activities gradually: ► walking briskly on a level surface ► swimming ► gardening, mowing, raking ► cycling on a stationary bicycle ► bicycling on a standard bike
  34. 34. Endurance Exercises ■ The following are examples of activities that are vigorous. People who have been inactive for a long time or who have certain health risks should not start out with these activities. ► climbing stairs or hills ► shoveling snow ► brisk bicycling up hills ► digging holes
  35. 35. More Endurance Exercise Tips: ■ Stretch after your activities, when your muscles are warm. ■ Drink water. ■ Dress appropriately for the heat and cold. ■ Use safety equipment such as helmets for biking to prevent injuries.
  36. 36. Remember—endurance activities should not make you breathe so hard that you can’t talk and should not cause dizziness or chest pain.
  37. 37. Just doing household chores and other mundane activities of daily living is enough to help older adults live longer.
  38. 38. Caregiver.com’s “Mobility and Exercise: No Excuses” article puts it simply: “Exercise is one of the best gifts of encouragement a caregiver could share with his or her loved one, and it’s something that everyone will enjoy and benefit from, no matter what the level of mobility.”
  39. 39. Exercise is also a top strategy to ward off or cope with caregiver burnout.
  40. 40. Most older persons can benefit from additional physical activity! And it is never too late!
  41. 41. For More Information… ■ Contact American Companion Care for more exercise and good health resources. ► American Companion Care 15461 South Acuff Street, Olathe, KS 66062 (913) 390-6300 Sheril@AmericanCompanionCare.com www.AmericanCompanionCare.com
  42. 42. Resources ■ American Academy of Family Physicians (AAFP) ► www.aafp.org/afp/20020201/419.html ■ American College of Sports Medicine ► www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=/ CM/HTMLDisplay.cfm&CONTENTID=7764 ■ Caregiver.com ► www.caregiver.com/channels/mobility/articles/mobility_and_exercise.htm ► www.caregiver.com/articles/general/exercise%20_for_seniors.htm ■ CNN ► www.cnn.com/HEALTH/for.your.health/2001/10/elderly.exercise/index.html ■ Fox News ► www.foxnews.com/wires/2006Jul11/0,4670,FitnessElderly,00.html ■ National Institute on Aging ► nihseniorhealth.gov/exercise/benefitsofexercise/04.html ► nihseniorhealth.gov/exercise/benefitsofexercise/06.html ► nihseniorhealth.gov/exercise/exercisestotry/01.html ■ University of Iowa Hospitals and Clinics ► www.uihealthcare.com/topics/medicaldepartments/ familymedicine/elderlyexercise/index.html