EXERCISE IS THE SINGLE MOST EFFICACIOUS INTERVENTION FOR OLDER ADULTS USED BY PHYSICAL THERAPISTS.
Only 12% of Older Adults engage in strength training. Hopefully after reading this article you will agree that most older adults should be engaging in some form of strength training.
Normal age related changes will happen in all of us as we move into the later decades of life but it is believed that the human body can maintain functions that allow not only independence but also leisure activities well into the 8th and 9th decade. Many older adults begin functional decline and reliance on others for independence during their early 70’s or even 60’s. We can break these groups into 2: ‘sucessful’ and ‘nonsucessful’ aging.
We have all seen robustly active 80 and 90 year olds whether it be on TV competitng in marathons, swimming miles in the ocean, or still plowing the fields of the family farm. Unfortunely we see many 80 and 90 year olds that can not perform activities of daily living independently. Sedentary lifestyle is the main precursor to ‘nonsuccessful’ aging and physical exercise is one of the driving forces behind ‘successful’ aging. Exercise with an emphasis on strength training allows older adults to maintain independence and participation in leisure activities. We often think of squatting and bench pressing when the word ‘strength training’ is mentioned but there are many ways an older adult can safely gain strength without adding risk for injury. The average adult begins loosing strength around 30 years old. We begin to loose 10% of our strength per decade and this loss accelerates to 15-30% per decade after the age of 60. The good news is that evidence has demonstrated that even very old adults can gain strength the same way younger people can. Loss of leg strength is among the highest indicators of institutionalization. Weakness in the legs leads to a higher fall risk, difficulty walking, and sarcopenia. These are all good reasons to start strength training.
Lets examine how an older adult should train.
Older adults need a longer warm up and cool down period when training as their bodies loose the ability to adapt quickly to changes in body temperature and heart rate. Warm up and cool downs of 5-10 min are needed vs. 3-5 minutes. The musculoskeletal system does loose some extensibility with age and due to this decrease in elasticity of collagenous tissues a stretch that one would hold for 15-30 seconds should now be held for 60 seconds.
HEART RATE(HR) MONITORING
Older Adults will reach their maximum HR much sooner. HR max is determined by subtracting your age from 220. An 85 year old female would have a max HR of 135 bpm. Sitting and standing multiple times may be enough of a challenge to reach at or near an older adults max HR. Monitoring of ones HR should be done. I would advise to do take your HR at your wrist vs. your neck because you do not want to cut off blood supply to the head. A health aging heart is able to reach 70-80% of the man HR. There are many HR monitors available as well as HR and oxygen saturation devices that give quick reading of your heart rate.
To gain strength, whether young or old, a person needs to be working between 60-80% of their 1 rep maximum(RM). I do not suggest older adults try to max out for one repetition. A better way to determine your 1RM is to identify what your 8RM is because this would be 80% of your 1RM. Your 15RM would correlate with 60% of your 1RM. Strength training needs to take place between 8 to 15 repetitions with >15 reps not being adequate stimulus for strength gains.
1 to 2 sets has been shown to be effective to gain strength if exercising between int 60-80% 1RM. Some authors suggest that 1 set is sufficient as most of the strength gains occur during the first set. If you are already active we suggest 10RM and if you are untrained we suggest 15RM progressing over 2-3 weeks to 10RM. Strength training should be performed 2-3 times per week.
What exercises should I do? Research shows that older adults benefit more from functional movement training. Practicing squatting or arising from sitting to standing can be more beneficial because it carries over into function vs. sitting and kicking out your leg with a weight on it. Stepping up stairs starting with a 6 inch stair progressing to an 8 inch stair is another way to train strength but also work on balance and coordination which are other areas older adults become deficient in. Marching in place with ankle weight or curling and reaching your arm overhead with weight are 2 other good ways to gain strength while practicing functional movements.