Chapter 23 Exercise Guidelines for the Postmenopausal Woman

1. Chapter 23Exercise Guidelines for the Postmenopausal Woman Shawn Anger, MS, NSCA-CPT Texas Tech, Physical Therapy Today Exercise Center Lubbock, Texas Chelsea Barker, MS, NASM-CPT Texas Tech, Physical Therapy Today Exercise Center Lubbock, Texas

2. Learning Objectives • The cardiopulmonary physiology for older women when engaging in activity. • The changes in bone mass density for postmenopausal women. • The conformational changes of muscles and strength capabilities as women age. • Guidelines for appropriate exercise for postmenopausal women.

3. Cardiovascular Changes • VO2 max decreases with age by 5-10% per decade • Max HR decreases • Heart rate recovery time increases • Resting blood pressure increases from a narrowing of the blood vessels • Changes occur due to a decrease in compliance in myocardial tissue

4. Pulmonary Changes • Alveoli lose elasticity with age. • Pulmonary blood volume decreases with age. • Intercostal muscles become more stiff and weak. • Rate of ventilation increases is also slowed giving another reason for an increased warm-up time.

5. Bone Mass Density Changes • Rate of reabsorption is greater than the rate of new bone formation. • This condition is often diagnosed as osteoporosis. • Bone mass loss can be substantial with rates of 20% loss at age 65 and 30% loss at age 80.

6. Prevention of Bone Density Loss • Adequate calcium intake. • Weight bearing activity causes stress on the bones that stimulate • Difficult to increase bone density. The goal should be to stabilize bone density loss. • Bone density loss occurs mostly in trabecular bone, which is found in the vertebrae, the neck of the femur, and the wrist leaving these areas prone to fracture.

7. Changes in Skeletal Muscles and Strength Capabilities • Women lose strength at a faster rate with age than men. • Loss in strength comes in part from a decrease in motor units. • Type II fibers decrease while type I fibers increase. • Overall loss in muscle mass, seen especially in the lower extremity.

8. Benefits of Exercise for Postmenopausal Women • Increase resting metabolic rate. • Improved balance to reduce the risk of falling and subsequent fractures. • Maintain healthy and strong muscles. • Maintain bone density.

9. Exercise Guidelines • Effective training intensity for resistance training is 50-80% 1RM. • Increase intensity by 5% for upper extremity exercise and 10% for lower extremity exercise. • Ensure that the facture prone areas are areas of focus in a training program.