CLIENTS WITH UNIQUE NEEDS KNR 313 BETTY HENSON. TRAINING SENIORS In 2016, the baby boomers will...

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TRAINING SENIORSIn 2016, the baby boomers will start to turn 70.

This group and their parents have 47 times the wealth of the young and will account for 70% of the disposable income in the U.S. by 2017. Thus older clients have the desire and the funds to pay for wellness services.

By 2050, 1 in 5 Americans will (21%) will be 85 or older.

To train this population safely, there needs to be an awareness of the physical, practical, and psychosocial concerns.


SENIORS

Roughly 1/5 of men and 1/3 of women over the age of 70 are unable to perform at least one common functional task such as walking, climbing stairs, or stooping.

On the flip side, this means that 70-80% of that population do not have functional impairments. (Sipe & Ritchie)


SENIORSBe prepared for common issues and their implications when working with

Seniors.

Chronic Disease

Arthritis

Hypertension

Heart Disease

Cancer

Diabetes

Stroke

Osteoarthritis (degeneration of joint cartilage) is the most common, affecting roughly half of men and over 60% of women.

Second is hypertension which affects approximately 4 in every 10 men and half of all women in this age bracket

Deconditioned Seniors are especially at risk for shoulder, spine, neck and knee problems.

(Sipes & Ritchie)


MUSCLE LOSS

Between the ages of 50 and 70, muscular strength declines, on average, by 30%, even with sharper losses after age 80.

Resistance training helps to improve the quality of life and prevent additional disease or disability problems, along with improved functional abilities, reduced incidence of back pain, enhanced insulin sensitivity, decreased body fat, and increased muscle mass.


CARDIOVASCULAR DISEASE

ACSM – Moderate resistance training 2-3 days/week with 8-10 exercises while performing 10-15 repetitions is safe and effective for most CV patients.

Low to moderate intensity – 40%-50% of IRM or that which can be completed for 15 reps

In a large scale study, a 23% reduction in CVD was reported for men who participated in resistance training exercises for a minimum of 30 minutes per week.


HYPERTENSION

Affects about 1 in every 3 adults. Defined at 140+/90+mmHg

Known as the “silent killer”

Resistance training of 6-30 weeks have been found sufficient for lowering blood pressure in patients diagnosed with hypertension

Clients with “controlled” hypertension can exercise with limited restrictions

Lifestyle modifications for clients with hypertension:

proper exercise

weight loss

dietary changes

adequate sleep

reduction in sodium

Medications are given to lower bp


HYPERLIPIDEMIA


CLIENTS WITH DIABETES


DIABETES


OLDER ADULTS

Men and Women aged 50 and over may begin sensible conditioning programs.

Medical Conditions and health issues must be considered.

An effective, well-rounded program should train the major muscle groups of the body (chest, shoulders, abdomen back, hips, legs and arms)

Individual goals and current level of activity will determine the focus of RET.


TYPES OF RESISTANCE TRAINING

Body Weight

Weight machines

Free Weights

Bands and tubing

Water

Novice exercisers begin with 4-6 exercises with minimal resistance and increase as form and confidence build.

ACSM suggests that 8-10 exercises be included that are multi-joint or compound exercise and target more than one muscle or joint.


ACSM GUIDELINESProgress to a moderate (5-6) or vigorous (7-8) intensity for 8-12

repetitions for two to four sets

Intermediate steps may include performing one set of 10-15 repetitions at a comfortable weight, then performing one set of the same repetitions at the target intensity and then adding more sets.

REST – 3 minutes between sets or perform a circuit of different exercises alternating upper and lower body to provide rest

FREQUENCY – work the major muscle groups 2-3 times/week, with a day of rest in between sessions

PROGRESSION – When a given set of an exercise can be completed at an RPE lower than the recommended 5 to 8, then the resistance should be increased or when 15 repetitions can be completed increase by 5%

ORDER – If Seniors perform both aerobic and resistive training, complete the aerobic activity first. If only doing resistive, complete a 5-10 minute aerobic warm-up.


ACSM GUIDELINES

Intensity: Moderate intensity (i.e., 60%-70% one repetition maximum [1-RM]). Light intensity (i.e., 40%-50% 1-RM) for older adults beginning a resistance training program. When 1-RM is not measured, intensity can be prescribed between moderate (5-6) and vigorous (7-8) intensity on a scale of 0-10.

Type: Progressive weight-training program or weight-bearing calisthenics (8-10 exercises involving the major muscle groups; 1 set of 10-15 repetitions each), stair climbing, and other strengthening activities that use the major muscle groups.


ACSM GUIDELINES

Even though you are probably not training them for a body building competition, a small amount of weight increased at regular intervals will increase muscle mass and affect metabolism, bone density, decrease insulin resistance and even aid in better sleep patterns. Make sure to include sufficient core exercises to improve balance and stability, which will reduce the risk of falls. Add exercises that mimic daily activities in order to build functional fitness-strength that seniors can use on a daily basis.


BALANCE TRAININGThe ability to maintain control of the body movements whether in an

attempt to remain stationary or to move in a controlled fashion.

FREQUENCY – 2 to 3 days/week or as often as needed

INTENSITY – No specific recommendations. Progressing from loss of balance to stability

TYPE –A. Include progressively difficult postures that gradually reduce the base of support.(Two-legged with wide base to feet together) B. Use dynamic movements that perturb the center of gravity. (Walk, stop, back step) C. Stress postural muscle groups (e.g. heel stands, toe stands) D. Reduce sensory input (loosen grip, one hand touching)


BALANCE PROGRAM


FLEXIBILITY FOR SENIORS

Flexibility is a key component in an exercise program, especially for older inactive adults, and a necessity at the end of each workout. Tight muscles will reduce the body's range of motion, can affect balance, reduces fluidity to the joints, and reduces the ability to perform daily tasks. Slow easy stretches are important due to lack of elasticity in the muscles. Stretches can and should be performed daily unless the client complains of too much discomfort the next day. Progressing to deeper stretches will begin to reduce discomfort until the muscles are accustomed to the stretching.


FLEXIBILITY FOR SENIORS

ACSM Recommends:Frequency: At least 2 days/week

Intensity: Stretch to the point of feeling tightness or slight discomfort. RPE of 5-6 on a scale of 0-10

Time: Hold stretch for 30-60 seconds.

Type: Any physical activities that maintain or increase flexibility using slow movements that terminate in sustained stretches for each major muscle group using static stretches rather than rapid ballistic movements.


SENIOR FITNESS TESTS

Assess the key physiological parameters (i.e., strength, endurance, agility, and balance) needed to perform common everyday physical activities that often become difficult for older individuals

Two specific tests included in the SFT, the 30-s chair stand and the single arm curl, can be used to assess muscular strength and endurance in most older adults safely and effectively.


30 SECOND ARM CURL TESTSENIOR FITNESS TEST MANUALHUMAN KINETICS

Protocol Women: 5 lbs Men: 8 lbs. Sit in chair with elbow extended, using “hammer grip” Test is conducted with dominant hand Tester can hold upper arm, so only lower arm moves Client curls the dumbbell upward, turning the palm up

(flexion with supination) Arm must be fully bent and then fully straightened


SCORES – ARM CURL

AGE MALE FEMALE

60-69 15-22 12-19

70-79 13-21 11-17

80-89 10-17 8-15


30 SECOND CHAIR STANDSENIOR FITNESS TEST MANUALHUMAN KINETICS

Protocol Sit on chair, arms crossed at the wrist and held at the chest Count the number of times the client stands up in 30 seconds Rest is allowed, but the clock keeps running


SCORES: 30 SEC. CHAIR STAND

AGE FEMALE MALE

60-64 12-17 14-19

65-69 11-16 12-18

70-74 10-15 12-17

75-79 10-15 12-17

80-84 9-14 10-15

85-89 8-13 8-14

90-94 4-11 7-12


PREGNANT CLIENTSHealthy pregnant women without complications who exercise

regularly can continue participating in adjusted sessions of physical activity.

Careful guidance and motivation are necessary for sedentary women who choose to start an exercise program during pregnancy.

Benefits of Exercise

Improved cardiorespiratory and muscular fitness

Faster return to pre-pregnancy weight, strength, and flexibility

Reduced postpartum belly

Improved mood and self-concept

Reduced feelings of stress, anxiety, and depression

May reduce the risk of developing preeclampsia (pregnancy-induced hypertension) and gestational diabetes (a form of diabetes first diagnosed during pregnancy.)


CONTRAINDICATIONS FOR EXERCISE

~Pre-eclampsia

~Ruptured membranes

~Premature labor during the pregnancy

~Persistent bleeding after 12 weeks

~A cervix that dilates ahead of schedule

~Significant heart disease or restrictive lung disease

~Multiple birth pregnancy that creates a risk of premature labor

~A placenta that blocks the cervix after 26 weeks.

~Poorly controlled Type I diabetes, seizures, hypertension

~Extreme obesity

(See pg. 480 for additional conditions)


EXERCISE GUIDELINES FOR HEALTHY PREGNANT WOMEN*Perform at least 15 minutes of moderate intensity PA per day

and increase to 30 minutes on at least 3, if not all, days/week

*Resistance train the major muscle groups with multiple repetitions (12-15) and avoid isometric contractions

*Avoid exercise in the supine position after the first trimester.

*Exercise should not continue past the point of fatigue and should never reach exhaustive levels.

*Maintain adequate hydration, appropriate clothing and optimal environmental conditions during exercise.

*Sports that would present the potential for mild abdominal trauma or loss of balance should be avoided (basketball, soccer, horseback riding, skating, plyometric training.


RESISTANCE TRAINING FOR YOUTH

Benefits of Strength Training for Youths: Increases in muscle strength and power Increases in local muscle endurance Increases in bone mineral density Improvements in blood lipid profile Improvements in body composition Increases in motor skill performance (jumping, throwing and

sprinting) Improvements in athletic ability Increases in resistance to sport-related injuries Improvements in body image and self-confidence A more positive attitude toward lifetime physical activity


YOUTHRISKS AND CONCERNS

Risk of injury – about same for youth and adult.

Area of concern is the growth plates of the long bones – radius in the arms and the femur in the legs.

Growth plate – section of cartilage where the growth of the long bones is initiated. This area is weak link in the developing skeleton because growth cartilage is not as strong as

bone. This should not be a problem if programs are properly designed and supervised by QUALIFIED

adults. The risk of a growth plate fracture is minimal if boys and girls are taught how to strength train properly and the use of appropriate training loads.

Plate fractures have not been reported in any youth resistance training study published to date. Repetitive and overuse injuries to the soft tissue of the muscles, tendons and ligaments are of

greatest concern.

Programs need to be carefully designed and appropriately progressed with safety guidelines.

Many spend time developing the “mirror muscles” (Chest and biceps) and forget the abdominals, lower back. Lower back injuries were a common site for injuries when injuries were reported.


YOUTH GUIDELINES FOR TRAINING*Qualified adults should provide supervision and instruction.

*The training environment should be safe and free of hazards

*Resistance training should be preceded by a 5-10 minute dynamic warm-up

*One to three sets of 6 to 15 repetitions should be performed on a variety of exercises.

*Include exercises for the upper body, lower body and midsection.

*Increase resistance gradually (5-10%)

*Resistance train two or three, nonconsecutive days per week.

*Children should cool down with less intense calisthenics and static stretching.

*Vary the resistance training program over time to optimize gains and prevent boredom.


YOUTH TRAININGMODE OF TRAINING Can use body weight, rubber tubing, medicine balls, free weights, child-

sized weight equipment, stability balls.Most kids are too small for adult machines, but some teens can use them

with additional pads.Increments of weight stacks may be too much weight CHOICE AND ORDER OF EXERCISESBoth single and multi-joint exercises can be used. Single-joint may be

more appropriate for beginnersPerform large muscle groups first, then smaller groups and multi-joint

before single jointPerform more challenging exercises first before muscles fatigue.


YOUTH TRAININGTRAINING SETS AND REST

~Children should perform 1-3 sets on a variety of exercises. They do not need to perform the same number of sets on all exercises.

~Begin with a single set, then add sets.

~Youth should rest about 1 minute between sets and exercises

~Those who are more advanced may need 2-3 minutes of rest

RATE OF PROGRESSION

Start with a basic workout for the first 4 weeks, using relatively light weights and learn proper technique. TECHNIQUE BEFORE MORE WEIGHT

Allows child’s muscles, tendons and ligaments time to adapt to the demands of exercise.

On average, a 5-10% increase in training load is an appropriate increment for increasing the intensity of most exercises.

Example: A teenager performing 2 sets of 15 reps with 20 lbs. on the dumbbell bench press can probably progress to 22 lbs and reduce the reps to 10 to allow for gains. Form and technique first!


OVERWEIGHT AND OBESITY


CONTRACT


OVERWEIGHT/OBESE


MODERATE AMOUNTS OF PA


RECOMMENDATIONS


CLASSIFICATIONS


ATHLETES


ATHLETES


ATHLETES


ATHLETES


ATHLETES

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CLIENTS WITH UNIQUE NEEDS KNR 313 BETTY HENSON. TRAINING SENIORS In 2016, the baby boomers will...

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