DIFFERENT TYPES OF EXERCISES AMONG ELDERLY Outlines Introduction

DIFFERENT TYPES OF EXERCISES AMONG ELDERLY Outlines: Introduction Common terminology Benefits of Exercise for Elderly Contraindications of exercises among elderly Types of exercises among elderly Safety recommendations for elderly during exercise Common examples of each basic types

Introduction The frail elderly people present a clinical syndrome which comprises of unintentional body weight loss, muscle weakness, slow walking, self-reported exhaustion and low level of physical activity among the elderly people who are over the age of 65. It is of importance to note that some aging changes can be controlled feasible in many of the body organs through exercise.

Common terminology Physical Activity (PA): is defined as any bodily movement produced by skeletal muscles that result in energy expenditure. PA encompasses exercise, sports, and physical activities performed as part of daily living, occupation, leisure, or active transportation. Exercise: is a subcategory of PA that is planned, structured, and repetitive and that has as a final or intermediate objective for improvement or maintenance of physical fitness. Physical function: is the capacity of an individual to perform the physical activities of daily living. Physical function reflects motor function and control, physical fitness, and habitual PA

Benefits of Exercise to the Elderly Improvements in mental health, emotional, psychological, and social wellbeing and cognitive function PA is a protective factor for non-communicable diseases such as cardiovascular disease, stroke, diabetes, and some types of cancer. Delay in the onset of dementia and improved quality of life and wellbeing. Attain a high level of cardiorespiratory fitness and have benefits for the brain centers. PA and exercise play an important role to counteract sarcopenia and falls as well as improving physical performance and activities of daily living. Improve the elderly balance, flexibility, coordination, endurance, mental health, cognitive function and muscle tone. This greatly enhances functional independence. Significant reduction of body fat which lowers the probability of obesity. Regular exercise also decreases blood pressure; improves lipid profile hence reduced risk of hypertension. .

Contraindications A) Absolute contraindications include: �Acute myocardial infarction (MI), within 2 days. �Ongoing unstable angina. �Uncontrolled cardiac arrhythmia. �Active endocarditis. �Symptomatic severe aortic stenosis. Decompensated heart failure. �Acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis. �Acute myocarditis or pericarditis. �Acute aortic dissection.

B) Relative contraindications include: �Known obstructive left main coronary artery stenosis. �Moderate to severe aortic stenosis with uncertain relation to symptoms. �Acquired advanced or complete heart block. . �Recent stroke or transient ischemic attack. �Mental impairment with limited ability to safely cooperate. �Resting hypertension with systolic or diastolic blood pressures > 200/110 mm. Hg. �Uncorrected medical conditions, such as significant anemia, important electrolyte imbalance, and hyperthyroidism.

Types of exercises among elderly Exercise is generally divided into four major groups: - Exercise programs generally consist of four major components: strength, endurance, balance, and Flexibility 1 -Aerobic endurance activities/ exercise Aerobic endurance (or cardiovascular) activities require continuous and rhythmic movement of the body’s major muscles for a sustained period. Aerobic endurance activities (such as walking) are needed for a healthy heart and lungs, for weight control, to cross the road safely, and for the energy to play with grandchildren

2 -Resistance & strength activities /exercise Resistance activities (such as climbing stairs) involve creating resistance to help increase muscle strength and mass, as well as power and endurance. Strong muscles and bones are needed to lift and carry.

3 -Flexibility activities /exercise Flexibility activities (such as stretching) improve the range of movement possible at a joint by gently stretching the muscles, tendons and ligaments. Flexibility is specific to each joint and depends on a number of key variables such as the tightness of tendons and ligaments. Flexibility is required on a daily basis to tie shoelaces, wash hair and hang up washing.

4 -Balance activities improve a person’s ability to activities prevent falls caused by self-motion, the environment /exercise or other objects. Balance is required to climb stairs or get on and off a bus.

Safety recommendations -The older adult should speak to his/her doctor or health care provider before initiating concerns. -If the older adult experiences chest pain/pressure, trouble breathing or shortness of breath, light-headedness or dizziness, or nausea during exercise a doctor should be contacted. -Activities inducing sharp pain should be avoided. -If the older adult feels really tired or has severe discomfort (some soreness is normal), he/she should slow down and take it easier. -Exercise that causes increased joint pain should be avoided. -Proper breathing is imperative during exercise. -The older adult should never hold his/her breathe while exercising or straining, particularly for those who have high blood pressure. -An exercise plan that considers the older adult’s current physical ability and current activity level should be created. -Start slowly, especially if the older adult has not been physically active for a long time. Progressively build up the older adult’s physical activity.

-Safety equipment should be used (correct shoes when walking). -Unless otherwise directed by a doctor, make sure the older adult drinks plenty of fluids (water or other sport drinks). Even if he/she is not thirsty his/her body may need the extra fluids. -Exercise should be avoided during the hottest times of the day. When outside sunscreen should be worn. -Five to ten minutes of walking with light arm pumping may be a good starting point. Stretching muscles before they are warmed up may result in injury.

Common examples of each basic types with pictures A. Aerobic exercise A. Exercise timing/ schedule for older adults: it is recommended to do at least 30 minutes of activity on most days of the week

B. Strength Training Schedule / timing of exercise for older adults: The strength - training program should be performed 2 -3 times a week. The program should take 20 to 30 minutes depending on how long the older adult rests between sets or exercises The older adult’s warm-up should consist of light walking, cycling or marching in place to get the muscles warm and the body temperature up. Each 8 to 15 repetitions are called a set. The older adult should perform 1 -2 sets of each exercise listed on the following. Upper Body Strength Training Exercises I. Seated Lateral Raise II. Biceps Curl Lower Body Strength Training Exercises I. Leg Extension II. Heel Raises

Seated Lateral Raise

Biceps Curls For front of upper arms

Exercises for the Lower Body i. Leg extension for upper front of the leg

Heel Raises for calves, bottom back of leg

C. Flexibility Training Stretching improves range of motion for activities of daily living, such as combing hair, getting dressed, or picking up objects from the floor. Stretching may also prevent pain or injury. Schedule/ timing of stretching for elderly people: Encourage the older adult to stretch at least 2 -3 days/week, ideally 5 -7 days / week, preferably after an aerobic or strengthening workout. Each 8 to 15 repetitions are called a set. The older adult should perform 1 -2 sets of each exercise listed on the following

Stretching Exercises types: Lower Body Stretches I. Hip Rotator Stretch II. Calf Stretch Upper Body Stretches I. Shoulder Stretch II. Neck Stretch

Upper Body stretching exercises: - i. Shoulder Stretch

Neck stretch

Lower Body Stretching Exercises i. Hip Rotator Stretch

Calf stretch

D. Balance Training Balance Exercises to Try i. Single Leg Stand ii. Tandem Walking (Heel-to- Toe) Each 8 to 15 repetitions are called a set. The older adult should perform 1 -2 sets of each exercise listed on the following. Schedule/ timing of training for older adults: The older adult can begin with five balance-specific exercises, performed two times per week with each exercise lasting for 10 to 15 seconds. Balance Exercises to Try i. Single Leg Stand ii. Tandem Walking (Heel-to- Toe)

Single Leg Stand

Single Leg Stand

ii. Tandem Walking (Heel-to- Toe)