“sit tall, stand strong” chair-based exercise course for frailer, older adults & disabled...
TRANSCRIPT
“Sit Tall, Stand Strong”
Chair-Based Exercise Coursefor
Frailer, Older Adults & Disabled Adults
Welcome to Day 2
Any Questions?Any Questions?
Recap of class structure:Warm-up Circulation Boosting 1MobilityCirculation Boosting 2StretchesCirculation Boosting 3
EnduranceStrengthCool down
How ageing, inactivity, disease, functional impairment and
disability affect bones, joints, muscles, nerves, heart and
lungs….
BonesBones
Functions of the Functions of the SkeletonSkeleton
ShapeProtectionStorage of mineralsProduction of blood cellsMovement through joints
Knowledge
Base
Page 43
Possible changes to Bone Possible changes to Bone associated with ageing, disability associated with ageing, disability
and inactivity:and inactivity: Reduced bone mineral density
Increased risk of osteoporosis
Loss in height
Postural problems
What is Osteoporosis?What is Osteoporosis?
Skeletal disorder characterised
by low bone mass and
deterioration of bone
with increase in bone
fragility and susceptibility to fracture(Consensus Department Conference 1993)
Bone becomes thinner and more fragile
OsteoporosisOsteoporosis
OsteoporosisOsteoporosis
40 years 60 years 70 years
JOINTS
Structure of a synovial joint
Knowledge
Base
Page 48
Possible changes to joints Possible changes to joints associated with ageing, disability associated with ageing, disability and inactivity:and inactivity:
• Less synovial fluid• Synovial fluid more viscous• Cartilage wear and tear• Reduced joint stability• Reduced range of movement• Ligament less flexible• Joints more stiff
MUSCLESMUSCLES
Structure of Skeletal Structure of Skeletal MuscleMuscle
Possible changes to Muscles Possible changes to Muscles associated with ageing, disability associated with ageing, disability
and inactivity:and inactivity:
Reduction in muscle massReduction in number of muscle fibresIncreased connective tissueIncreased size of motor unitsReduced elasticity of tendons
The same size difference is seen between 30 yr old and 80 yr old
Active, strength-trained 70 yr old female
Sedentary
(Adapted from Sipilä & SuominenMuscle Nerve 1993;16:294)
Potential consequences
• Reduced:– Power– Strength– Endurance– Fine control– Heat production– Immune function
Nervous SystemNervous System
Knowledge
Base
Page 59
Nervous System Nervous System
Possible changes to Nerves Possible changes to Nerves associated with ageing, disability associated with ageing, disability
and inactivity:and inactivity:
• Reduces number of nerves
• Reduced speed of transmission
• Slower information processing
Potential consequences:Potential consequences:Slower movement speedImpaired short term memory Reduced reaction timeSlower pace of learningReduced balanceIncreased fallsSlower response to instructionsPoorer coordinationReduced sight and hearing
HEART AND HEART AND LUNGS AND LUNGS AND
BLOOD VESSELSBLOOD VESSELS
The LungsThe Lungs
Knowledge
Base
Page 56
Gaseous Exchange in the Gaseous Exchange in the AlveoliAlveoli
Diaphragm and Diaphragm and Intercostals MusclesIntercostals Muscles
Possible changes to the lungs Possible changes to the lungs associated with ageing, disability associated with ageing, disability
and inactivity:and inactivity:
Decreased elasticity of the lungs Weaker breathing muscles Less flexible rib cage Reduced gaseous exchange Increased breathlessness Reduced maximal inspiration and reduced expiration
Blood Vessels….
ArteriesArteries
Veins Veins
CapillariesCapillaries
Possible changes to the blood Possible changes to the blood vessels associated with ageing, vessels associated with ageing,
disability and inactivity:disability and inactivity:
• Increased furring and hardening of the arteries• Increased blood pressure and risk of hypertension • Reduced number of capillaries in muscles• Reduced oxygen delivery to muscles, reduced ability to sustain activity
ATHEROMA
The heart ….
Possible changes to the heart Possible changes to the heart associated with ageing, disability associated with ageing, disability
and inactivity:and inactivity:
• Decreased cardiac muscle • Decreased blood pumped out• Decreased maximal heart rate
Consequences…• Reduced ability to work at high intensity•Tasks require greater percentage of max heart rate• Reduced ability to sustain activity
Leading WorkshopLeading Workshop
Warm-up CB1MobilityCB2Stretches
Warm-Up Component Warm-Up Component CB11. Alternate heel raises, Arm Swings, Leg Marches, Tap & ClapMobility2. Shoulder Lifts and Circles3. Side Bends4. Ankle Activators5. Trunk TwistsCB2Stretches6. Back of Thigh Stretch7. Chest Stretch8. Calf Stretch9. Upward Side Stretch
The Functional Model
Practice Workshop…….
Safety First…
• This session will cover:– PARQ screening– Contraindications to exercise– Exercise cautions– Medication effects on safe exercise
participation
PARQ…
See pages 5 & 6 of your learner file
Absolute contraindications• Unstable and uncontrolled health conditions as follows:
– Uncontrolled pain or feeling unwell on arrival– Lasting, increased pain following previous session– Suspected acute injury– Recent injurious fall without medical assessment– Severe breathlessness or dizziness– Recently diagnosed cardiovascular events– Recent medication changes– Uncontrolled pulmonary problems– Inability to follow simple instructions placing themselves or
others at risk of injury– RA flare up or acute systemic illness/infection– Unexplained lethargy
Cautions• Known current injury/wound that is
identified and/or protected
• Observable pain of known origin
• Problems understanding instructions
• Unable to safely maintain balance while seated
• Infection control
• Latex allergy
Common effects of medication
• Reduced alertness• Postural hypotension• Reduced balance• Reduced proprioception• Difficulties with exercise intensity monitoring• Urinary urgency/frequency• Slowed reaction time• Poor coordination
Session PlansSession Plans
Why?
They will assist you in your exercise session
What should it contain?
Include relevant information to deliver a safe and effective exercise session!
Session PlansSession Plans
Name of exercise and planned rests Repetitions and/or Time How to perform the exercise safely and
effectively (teaching points/key safety considerations)
Purpose of the exercise Alternatives and adaptations
See page 23 of your learner file
SAMPLE SESSION PLANSAMPLE SESSION PLANPosture/Teaching Points/or Instructions?
Exercise Name & Planned Rest
Exercise purpose &
ADL’s
Reps and/or Time
Teaching Points
(Key safety considerations)
Adaptations and/or
Alternatives
Shoulder Lifts
Shoulder Rolls
• Sit tall, feet flat on floor• Knees hip width apart• Knees above ankles• Smooth continuous movements• Lower with control• Lift shoulders up • Avoid poking chin• Roll shoulders back• Avoid arching the back• Breathe normally• Keep tummy in
What makes a COMPETENT and What makes a COMPETENT and SUCCESSFUL Chair-Based SUCCESSFUL Chair-Based
Exercise Leader?Exercise Leader?
Prepare to lead a small group on day 3 Use the “how to be even better” info sheet
to help with the leading sequenceComplete all 3 worksheets ready to hand in on day 3 for marking