This document discusses physical activity for disabled and elderly people. It defines physical activity and exercise, and explains the health benefits of physical activity, including reduced risk of heart disease, diabetes, obesity, and hip fractures. It recommends that physical activity programs for the elderly and disabled include aerobic exercise, strength training, and flexibility training, along with guidelines for frequency, duration and intensity. Barriers to physical activity for these groups are addressed, as well as ways to motivate participation through social support, alternative activities, and tracking progress. Environmental and medical factors to consider with exercise programs are also outlined.

1. Physical Activity for
Disabled and Elder
People
Assoc. Prof. Deran Oskay
Gazi University
Faculty of Health Sciences
Department of Physiotherapy and Rehabilitation

2. Physical Activity
• The term “physical activity”
describes many forms of movement,
including activities that involve the
large skeletal muscles.
• Activities that involve the small
skeletal muscles (e.g. playing board
games, drawing, writing) are
important, but they do not provide
the health benefits of activities that
involve the large skeletal muscles
and require substantial energy
expenditure.

3. Physical activity is defined as movement that involves contraction of your muscles.
Any of the activities we do throughout the day that involve movement — housework,
gardening, walking, climbing stairs — are examples of physical activity.
Exercise is a specific form of physical activity — planned, purposeful physical activity
performed with the intention of acquiring fitness or other health benefits
What is Physical Activity
What is Exercise

4. The major difference, however, is that structured exercise usually
involves a greater increase in physical fitness than general physical
activity because it is performed at a higher intensity level.
Nonetheless, both types of movement are needed during the day
to confer optimum health benefits.

5. Physical activity is defined by its duration,
intensity, and frequency
• Duration is the amount
of time spent
participating in a
physical activity session
• Intensity is the rate of
energy expenditure
• Frequency is the
number of physical
activity sessions during
a specific time period
(e.g. one week).

6. Physical activity is disappearing
from everyday life
• Labour-saving devices
• Transport patterns
• Concerns over safety in
public spaces
• Sport as entertainment
• The impact of
information technology
Leading to an increase in
sedentary and physically
less demanding lifestyles

8. Aim of physical activity in elderly
• Entering old age
Making Activity Choices
To promote and extend healthy active life and
compress morbidity
• Transitional phase
Increasing the Circle of Life
To maintain independence and reduce long-term
dependency
• Frail older people
Moving in the Later Years
To maintain independence and improve quality of life

9. Exercise Programs In The Elderly and
Disabled
• 12.6 million people
have coronary heart
disease
• 1.1 million people
suffer from a heart
attack in a given year
• 50 million people
have high blood
pressure
American Heart Association. 2002 heart and stroke statistical update. Dallas, TX:
American Heart Association, 2001.

10. • 17 million people have
diabetes
• 90% to 95% of cases are
type 2 diabetes,
associated with obesity
and physical inactivity
• approximately 16 million
people have “pre
diabetes”
Centers for Disease Control and Prevention. National diabetes fact sheet: general
information and national estimates on diabetes in the United States, 2000. Atlanta, GA:
U.S. Department of Health and Human Services, CDC, 2002.
Exercise Programs In The Elderly and
Disabled

11. • 107,000 people are newly diagnosed
with colon cancer each year
American Cancer Society. Cancer facts & figures 2002. Atlanta, GA: American
Cancer Society. Inc. 2002
Vainio H, Bianchini F. Eds. Weight control and physical activity. IARC Handbooks of
Cancer Prevention. IARC Press Vol 6, 2002
Exercise Programs In The Elderly and
Disabled

12. Exercise Programs In The Elderly and
Disabled
• 300,000 people suffer
from hip fractures each
year
Popovic JR. 1999 National Hospital Discharge Survey: Annual summary with detailed
diagnosis and procedure data. National Center for Health Statistics. Vital Health
Statistics 13(151).2001

13. Exercise Programs In The Elderly and
Disabled
• 50 million adults
(age 20-74) are
obese
• 61% of the adult
population are
either obese or
overweight

14. • Research has shown that all
individuals benefit from regular
physical activity
• Mobility and functioning in older
adults, including the frail, can be
improved through physical
activity
• Regular physical activity reduces
morbidity and mortality from
chronic diseases
Exercise Programs In The Elderly and
Disabled

15. Exercise Programs In The Elderly and
Disabled
Physiological Changes
• Cardiovascular
• Respiratory
• Nervous System
• Musculoskeletal
• Renal
• Metabolic Systems

16. Exercise Programs In The Elderly and
Disabled
Physiological Benefits
• Increased Cardiovascular and
Cardiorespiratory Function
• Increased Muscle Mass, Strength, & Efficiency
• Increased Flexibility,Coordination, and
Balance
• Decrease Cholesterol Levels
• Improve Weight Control and Nutrition
• Aides Digestion & Reduces Constipation

17. Exercise Programs In The Elderly and
Disabled
Psychological Benefits
• Decreased Anxiety and Tension
• Increased Self-Esteem
• Increased Energy Level
• Better Sleeping Patterns
• Improved Socialization
• Improved Quality of Life

18. Get Moving!
• Components of an exercise
program
– Aerobic Activity
– Strength Training
– Flexibility Training
Use an exercise log to help you plan
and keep track of your exercise
program
WHO 2002

19. Aerobic Activity
Definition
Continuous movement that uses big muscle groups and
is performed at an intensity that causes your heart,
lungs, and vascular system to work harder than at rest
Cardio respiratory Fitness is built through aerobic
exercise
Aerobic exercise conditions and strengthens our heart,
respiratory system, muscles, and immune system
CDC physical activity report 1999

20. Types of Aerobic Exercise
Outdoor Activities
– Walking
– Jogging/running
– Bicycling
– Swimming
– Basketball
– Soccer
– Jumping Rope
Indoor Activities
– Treadmill machine
– Stair climbing machine
– Stationary bike
– Elliptical trainer
– Rowing machine
– Aerobics, boxing...

21. Strength Training
Definition
Muscle work against resistance that improves strength
and endurance
– Strength allows us to move, and endurance allows us
to perform work over time
Muscles = 40% of our lean body mass
Use it or lose it: unused muscle disappears (atrophy)

22. Types of Strength Training
Free Weights
– use of dumbbells and/or bars with weights on the ends
– involves balance and coordination; useful for enhancing
function in daily activities and recreational sports
– Bonuses: convenient, cheap, and provides a wide variety
of exercises that work several muscle groups together
Your body, your weight
– The most convenient form of resistance exercise
– Pushups, pull-ups,. Lunges, squats….

23. Flexibility Training
Flexibility = The ability to move a joint through its
range of motion
– We lose flexibility with disuse and aging
Benefits
– Decreased chance of muscular injury, soreness, and
pain
– Helps prevent and reduce lower back pain
– Improves joint health (tight muscles stress our
joints)
Activities stretching, yoga, pilates, tai chi

24. How Much and How Hard?
Frequency: 3-5 days per week
– Aerobic exercise: a minimum if 3 days a week are
necessary to reach most exercise goals and minimize
health benefits
– Strength training: a minimum of 2 days per week
– Flexibility training: a minimum of 3-5 days per week
• Duration
– Aerobic: 20-60 minutes of continuous aerobic activity
– Strength: 1-3 sets of 8-12 repetitions
– Stretching: Stretch all muscle groups and hold
positions for 10-30 seconds

25. What helps older people and
disabled to
become active?
Barriers and motivation

26. Barriers to activity
Intrinsic barriers
• Those that relate to
the beliefs, motives
and experiences of
the individual, e.g.
previous
experiences at
school, concerns
about over-exertion,
or perceptions of
physical activity.
Extrinsic barriers
 Those that relate to
the broader physical
activity environment,
e.g. skills and
attitudes of others,
the types of
opportunities
available, access
and safety.

27. Previous experiences
• Opportunities in school
• Activity not associated with fitness and health
• Armed forces
• Limited experiences of sport
• All aspects of life were more physically
demanding

28. Extrinsic barriers
• Skills and attitudes of others, e.g. exercise
instructors, GPs, leisure/recreation managers
• Appropriate programming
• Accessible opportunities (transport)
• Safe activity environments (parks, well-lit
streets)
• Positive images of older people

29. How to motivate older people?
• Give knowledge about the benefits of the
exercises.
• Explain how to perform the exercises.
• be made safe exercise environment
• Giving the informative booklet
• Alternative activities
• activities to be admissible by the elderly

30. How to motivate disabled people?
• Develop a reward system that reinforces small
accomplishements in the exercise program
• Offer a buddy system that will allow the person to to
exercise without missing a session or spmeone they
enjoy being arround
• Keep records of performance. İt is critical to know how
much and how often the person is exercisisng
• ın the sportive activities keepwall charts to record
progres
• Many disabled will enjoy to see their names on this
board
• Find alternative activities

31. Exercise Programs In The Elderly and
Disabled
Environmental Concerns
• Room Temperature
• Water Intake
• Meal Time
• Clothing

32. Exercise Programs In The Elderly and
Disabled
Medications and Exercise
• Polypharmacy/Self Medication
• Renal Excretion of Chemicals is Reduced
IMPORTANT
• Know Medications and Side Effects

33. Exercise Programs In The Elderly and
Disabled
Risks and Contraindications To Exercise
• Abnormal Heart Action
• Pain/Pressure in the Chest
• Dizziness/Lightheadedness
• Poor Coordination
• Flare Up of an Arthritic Condition
• Nausea/Vomiting
• Extreme Breathlessness
• Muscular Pain
• Unusual Fatigue
• Mental Confusion

34. Thanks for your kind
interest….