May 4, 2015

Dave Essex

Special Populations Presentation; Seniors

America is aging. The “Baby Boomer” generation has become today’s “Retired Senior citizens”. By the middle of this century 21% of all Americans will be age 65 or older. There are several issues dealing with the aging process. The leading causes of functional and physiological degeneration today are found mostly with the senior population.

Typical physiological forms of degeneration associated with aging are osteoporosis, arthritis, low back issues and obesity. Other issues surface with the body’s circulatory system. Arteriosclerosis, atherosclerosis and peripheral vascular disease which typically refers to a loss of elasticity of the blood vessels. The building up of plaque inside the vessels that restricts blood flow and the ability of the plaque to break off inside the vessel and move along until it completely blocks off circulation (usually the brain or lung which can cause stroke or pulmonary embolism).

Other changes associated with aging include reductions in the following:

Maximal Attainable Heart Rate Cardiac Output Muscle Mass Balance Coordination (neuromuscular efficiency) Connective tissue elasticity Bone mineral density

All these things are something the Personal Trainer needs to be aware of and have a good understanding of how to work with clients that are elderly and have some of these issues. These degenerative processes associated with aging can lead to a decrease in the functional capacity of older adults, including potentially significant reductions in muscular strength and endurance, cardiorespiratory fitness, balance, and flexibility.

The good news is that many of the deficits responsible for decreased functional capacity in older adults, including loss of muscle strength, balance and flexibility can be slowed and even reversed through participating in routine physical activity and exercise. Before beginning any exercise training, older adults must complete a Physical Activity Readiness Questionnaire (PAR-Q). Movement assessments to be performed would be the overhead squat (sitting and standing

from a seated position), or a single leg stance. Flexibility assessments should be performed to help provide information about the client’s quality of movement as well as the ability to perform Activities of Daily Living (ADL).

Self-myofascial release and static stretching are appropriate if the client has shown sufficient ability to perform the necessary movements. Using the OPT model, stages I and II levels of cardiorespiratory training would be appropriate (certain prescribed medications and other chronic health conditions must be carefully monitored and progressed slowly), with an emphasis on stabilization training (core, balance, and progression to standing resistance exercises).

Each area of training based on assessments should start at a safe level of intensity and progressions should be made slowly with constant supervison to ensure that proper technique and kinetic chain control are being followed to reduce the risk of injury. The PAR-Q form will help in identifying specific medical issues the client may have. Some of those issues will dictate what exercises are safe or contraindicated for their program. Some seniors may not have any maladies that keep them from participating in a full workout.

I would recommend starting the elderly client on a stationary bike for cardio training.

3-5 days per week at low to moderate intensity (40-60% of VO2 peak)

Try for 30 – 60 minutes (if client is just starting an exercise program we would shorten time and monitor Hear Rate) as long as client feels confortable.

Since the elderly typically have reduced range of motion and/or balance issues I would start flexibility exercises using self-myofascial release and static stretching.

If there are any questions regarding the clients ability to train, they should be referred to the clients personal physician.