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INTRODUCTION

INTRODUCTION. an opportunity to get to know each other. Dave. Simon Hanna Clinical Exercise Specialist Cambridgeshire Community Services (NHS) Falls Prevention simon.hanna@nhs.net. Aims of the day.

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INTRODUCTION

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  1. INTRODUCTION an opportunity to get to know each other

  2. Dave Simon Hanna Clinical Exercise Specialist Cambridgeshire Community Services (NHS) Falls Prevention simon.hanna@nhs.net

  3. Aims of the day • To gain knowledge about the ageing process & exercise programming related to age related physiological changes • To understand how the ageing process affects exercise programming and recognise how to be able to safely and effectively lead a session for or including older people • To understand what exercises need to be incorporated in a session for or including older people • Identify the main conditions and disabilities affecting older people and adapt accordingly • To understand the key elements to effective communication with older, individuals to encourage, motivate and give feedback to improve performance

  4. CURRENT PERSPECTIVES Physical activity and ageing

  5. Ageing

  6. Ageing • Everybody does it • Everybody does it differently

  7. Terminology/Jargon BADL’s Basic activities of daily living such as eating, bathing and dressing IADL’s Instrumental activities of daily living that are requires for independent living such as housework, shopping and stair climbing

  8. Percentage of older adults (over 70 years of age) classified at various points along a continuum of physical activity Independent Fully functional people now (may have reduced IADL’s) but low activity levels may cause physical declines leading to frailty/dependence Fit/Elite Highly active people who should remain mobile into later life barring injuries/illness Dependant/Frail People who need help with basic BADL’s or with IADL’s Chair Based Exercise Supported Standing Exercise Appropriate opportunities for physical activity 25% 70% 5% Adapted from: Spirdusa,w.w (1995) Physical Dimensions of Ageing. Champaign IL: Human Kinetics

  9. A different “spin” on fitness? • Strength to lift household objects or get up from the floor • Flexibility to wash hair, tie shoes • Balance and agility to climb stairs • Co-ordination and dexterity to open a door with a key or get dressed • Stamina to walk to the shops

  10. Key Factors for a Fulfilling Old Age • Social & emotional • Functional role • Independence • Regular physical activity

  11. Sedentary vs active lifestyles >3 hrs per week targeted exercise Myocardial infarct - 3 x less likely Osteoporosis - 2 x less likely Fall-related injuries - 2 x less likely Hip fracture - 2 x less likely Reproduced with kind permission from Later Life Training

  12. WHO, 1996 “regular physical activity helps to • “preserve independent living” and • “postpone the age associated declines in balance and co-ordination that are major risk factors for falls”

  13. Exercise for Older People Physical Activity helps to: Independence Posture Balance/reactions Co-ordination Strength Sleep Circulation Immune system Likelihood of falls Likelihood of fractures Incontinence Constipation Blood pressure Depression Social isolation

  14. Keeping up with the Grandchildren

  15. Meeting Friends

  16. Mental Stimulation

  17. Rejuvenation (16 – 20 years)

  18. Exercise for Older People • Bone loading activity • Target postural muscles • Target functional muscles • Practice functional movements • Provide opportunities for socialisation • Improve body composition

  19. Absence of Disease Physical activity prevents: • Osteoporosis • Non-insulin dependant diabetes • Hypertension • Ischaemic heart disease • Stroke • Colonic cancer • High cholesterol

  20. Psychological Function Physical activity improves: • Depression • Anxiety • Alertness • Sleep • YOUNG AND DINAN 2000

  21. ‘Physical activity in LATER LIFE’ 1999 Age related changes are only partly the result of disease and largely the result of inactivity Dr Dawn Skelton ‘Physical Activity in Later Life’ (DoH)

  22. Components of Physical Fitness

  23. What is Physical Fitness? Physical fitness is the ability to meet the demands of everyday life with vigour and alertness – without undue fatigue and with enough energy in reserve to enjoy leisure time pursuits’ Merton, Sutton and Wandsworth

  24. Muscular Strength (+ Speed/power) Aerobic Fitness (Stamina) Physical Fitness Muscular Endurance Flexibility (Suppleness) Motor Fitness

  25. Aerobic Fitness • Take in, transport and use oxygen • Use of large muscle groups e.g. legs • Walking, cycling, dancing and swimming • Increased leg strength may lead to standing and light aerobic activity

  26. Muscular Strength • The maximum amount of force a muscle can exert • Progress by increasing the load to a maximum of 8 repetitions • Activities of Daily Living (ADL’S) all require a degree of strength • Key area: Quadriceps (the INDEPENDENCE muscle)

  27. Muscular Endurance • Ability of a muscle to keep going • Circulation Boosting promotes muscular endurance • Muscular strength takes priority for chair-based exercise

  28. Flexibility • The range of movement at a joint • Stretch key muscle areas to promote greater ROM • Key areas: Calf/Hamstring/Pectorals • Reduces risk of injury • Perform daily tasks more easily • Improves posture

  29. Motor Fitness • Includes speed, reaction time, balance and co-ordination • Motor fitness lost through sedentary living rather then be the ageing process • If you do not use it, you lose it!

  30. How much is enough? ?

  31. How much is enough?

  32. “Man does not cease to play because he grows old. Man grows old because he ceases to play” George Bernard Shaw If I’d known I was going to live this long, I’d have taken better care of myself Dubey Blake Reproduced with kind permission from Later Life Training

  33. Class Structure ?

  34. PRACTICAL CLASSThe warm-up

  35. The Warm-Up Component Aims: • To prevent injury • To promote circulation, generate heat and warm the muscles • To mobilise the joints in order to improve jointfunction & ROM in the performance of everyday activities • To stretch out the muscles • To stimulate the nervous system to enable more skilful performance • To enhance enjoyment and motivation by providing a relaxed, fun atmosphere at the beginning of the class

  36. WHAT MAKES A COMPETENT SUCCESSFUL CHAIR-BASED EXERCISE LEADER?

  37. Strength TrainingHow much is enough? ?

  38. ACSM Guidelines for health related gains in strength • 2-3 x per week • 20 – 60 Minutes • Moderate Intensity • (80%/1rm) 8-12 reps • 1 set training initially

  39. Strength Guidelines • Build up to between 5-8 reps • Aiming for 8-12 reps • Slow Controlled repetitions • Hold (up to 5 seconds at peak contraction) • Progress cautiously but ambitiously

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