Exercise for Older Adults - Strength and Agility
Exercises to Reduce Fall Risk
Several factors have been identified as contributing to a reduction in fall risk although few are effective independently. A comprehensive exercise program has demonstrated the ability to increase the confidence level of participants. Examples of specific exercises can be found at the National Center for Injury Prevention and Conrtrol . According to a 2002 article “Falls and Fear of Falling: Which Comes First?” published in the Journal of the American Geriatric Society, balance confidence is an indicator of fall risk.
A Comprehensive Conditioning and Exercise Program for Physical and Social BenefitsA 2005 study reported in Gerontology that there was a direct relationship between agility and self-reported quality of life measures. Reducing fall risk and simultaneously increasing perceived quality of life are desirable goals for older adults and various exercises contribute to overall well-being. A 2004 article “Exercise Training and Fall- Risk Prevention for Community-Dwelling Elders” published in the American Journal of Recreation Therapy indicated that while home based exercise programs can be effective the drop out rate is high, reinforcing the need for social support. Make sure that exercise is not done to late in the day as that may interfere with proper sleep hygiene.
Tai Chi and Agility Training
Although many forms of exercise may contribute to improved balance the one most commonly tested and recommended by the CDC is Tai Chi. Participants in formal Tai Chi programs were reported to have a 55% decease in their risk of falling. Tai Chi develops a sense of postural alignment and coordinated movements coupled with synchronized breathing.
Hour long Tai Chi programs are easily conducted in a community setting accessible to older adults such as senior centers. No special equipment is needed, only a knowledgeable instructor and space for the class to move is necessary. Although the optimal class size is about 15 people fewer numbers do not reduce the benefit. Tai Chi training should probably be done about 3 times per week and alternated with other forms of daily activity.
Resistance Training for Strengthening
Resistance training programs strengthen the lower extremities resulting in a more active lifestyle, functional confidence, and participation in more activities of daily living. A variety of equipment is available for strengthening but the exercise can be accomplished by a simple repeated slow movement from a sitting to a standing position using the legs as much as possible to facilitate the movement. A word of caution here is in order, going from a sitting to standing position rapidly can result in dizziness and falls so proceed cautiously and preferably with assistance.
For a more measured approach resistance-bands can be utilized and the amount of resistance increased as strength increases. This exercise is best initiated with a knowledgeable trainer or physical therapist but as one progress it can be done anywhere. This is again an opportunity for a community of seniors to make it a social event.
Actual weight training requires specialized equipment that focuses on specific muscle groups. Weight training can also be as simple as ankle weights or involve complex machinery. A general workout is best but only lower limb strength has been shown to effect fall reduction. At any age or physical condition the use of weight machines should be accompanied with an experienced trainer.
Conditioning with Stretching Exercises
Stretching exercises have shown no independent effect on fall reduction but should be included in any comprehensive exercise program. Stretching is incorporated in both agility programs (such as Tai Chi) and resistance training programs to prevent injury. In addition, stretching exercises promote maintenance of maximum range-of-motion to allow for easier movement with less effort.
References
Li, F., Harmer, P., Fisher, KJ., McAuley, E., Chaumeton, N., Eckstrom, E., Wilson, NL. Tai Chi and fall reductions in older adults: A randomized controlled trial. Journal of Gerontology. 2005 Feb;60A(2):187-94
Wolf SL., Barnhart, HX., Kutner, NG., McNeeley, D., Coogler, C., Xu, T. Reducing frailty and falls in older persons: An investigation of Tai Chi and computerized balance training. Journal of the American Geriatric Society, 44,497-498.
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