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EFFECTIVE EXERCISE FOR SENIORS

Ming Leung, PhysiotherapistRegional Coordinator, Seniors Falls and

Injury PreventionFraser Health Authority

Debbie CheongProvincial Coordinator,

BC Women’s Hospital & Health CentreDo not duplicate these slides without the permission of the presenters.

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Current PracticeGive us feedback on your exercise class

What are the principles in conducting your exercise class? Warm up? Strength? Stretches? Agility? What are your exercises targeting? – just

exercising

What are precautions?

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Current PracticeWhat we have seen: Sequence – Head to toe General range without focus on

movement required in activities of daily living

Mixture of warm up, range and strength

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Objectives for physical activity programs

Safe, effective, simple Fall prevention Improve posture and strength Progressive Maintain mobility and

independence Improve quality of life Adherence

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GOALSImprove participant’s functional

ability, quality of life, and reduce the risk of falls

Increase independence, confidence and dignity

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FRASER HEALTH INITIATIVE Appropriate program to meet the

objectives and goals

Program that can change the practice of delivering exercises

Program that is sustainable

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What is OSTEOFIT?Evidence-based

Exercise intervention program designed for people with osteoporosis who are at high risk for falls and fractures

Developed by BC Women’s Osteoporosis Program

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Carter et al. (2002). Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ; 167 (9).

OSTEOFIT Works!

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ControlInterventionPe

rcen

t Cha

nge

+5%

+5%

+13%

Dynamic Static Knee balance balance extension

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OSTEOFITSafe, gentle, effectiveNot a regular aerobic programUniqueLow impactWarm up, agility, resistance,

stretchingFUN!

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PRIORITIES IN OSTEOFITPostureStrengthBalance, coordination and agilityActivities of daily function Fall prevention Improve confidenceMental stimulationProgressive

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TYPICAL POSTURE OF OLDER PERSON

•Lower trapezius•Neck flexors

Forward head

•Middle and lower trapezius•External shoulder rotatorsRounded upper

back

•Deltoid•External shoulder rotatorsLimited shoulder

range

•Triceps•Forearm and Finger

extensorsPoor elbow and finger extension

•Spine musclesFlat low back

•Abductors•Extensors (butt muscles)Limited Hip

range

•QuadricepsPoor knee extensors

•Feet musclesLimited ankle range

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EXERCISES TO IMPROVE POSTURE

•Sit tall, chest lifted•Create more double chins (gently!)

Forward head

•Sit tall and Big Breath in•Open arms with thumbs up

Rounded upper back

•Raise arms singly to front, side•External shoulder rotators

Limited shoulder range•Full straightening of the arm and fingersPoor elbow and finger

extension

•Sit tall• Just imagine creating a gap at lumbar

spine

Flat low back

•Challenging to do seated!•Side sitting knee drop may be safe for

some.

Limited Hip range

•Sit tall and extend knee fullyPoor knee extensors

•Ankle ROM; seated or standing if safe to do.•Toe actions really help also.

Limited ankle range

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EXERCISES TO IMPROVE FUNCTION

•Medial deltoids, strengthen shouldersLift and Carry

•Mobility of the shoulder•Triceps, straighten arm.

Reach and Retrieve

•Hip flexor strength, core strength•Quadriceps, glutes, hamstrings, ankles

Step Up and Over

•Quads, glutes, hamstrings, coreSit to Stand

•Hip mobility, lower body strength, balance

•Ankle flexibility, agility, movement of toes

Walking

•Joint ROM•Maintain flexibility.

Personal care

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EXERCISES FOR FALL PREVENTION

•All muscles of lower body especially the hip abductors, quads, glutes, gastrocs

Lower body strength

•All muscles of the trunkCore•Weight shifting•Quadriceps, glutes, hamstrings, ankles

Balance

•Quads, glutes, hamstrings, coreJoint mobility

•Joint mobility, directional changes•Upper and Lower body strength,

coordination

Agility

•Quickness of movement in the upper arm, flexibility

Speed and Reaction

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GENERAL GUIDELINESStart with small range of movement 4 to

6 repetitionTake joints through all planes of

movementAlternate upper and lower muscle groupsAll strength exercises will be alternatedInitial exercises are un-resisted, low

repetition, target primarily range and posture

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APPLICATION OF RESISTANCE

Is exercise equipment (handheld weights and resistance bands) being applied effectively and safely?

Do you understand the principles of strength training and loading of muscles?

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MODIFICATIONS & PROGRESSIONS

Are modifications being made for those with chronic conditions?

Is warm up effective and includes all joints in full range of motion in all planes of movement?

Do the exercises result in improved strength, function and ability?

Is there monitoring of progressions? Has there been a decrease in falls?

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SUMMARY Improve knowledge and skill of the

Activity Coordinator in application of safe and effective physical activity.

Objectives include increasing strength, improve functional ability, thereby maintaining independence of the residents.

Reduction in falls and injury Mentally stimulate Improve quality of life