EFFECTIVE EXERCISE FOR SENIORS
Ming Leung, Physiotherapist
Regional Coordinator, Seniors Falls and Injury
Prevention
Fraser Health Authority
Debbie Cheong
Provincial Coordinator,
BC Women’s Hospital & Health Centre
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Do not duplicate these slides without the
permission of the presenters.
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Current Practice
Give us feedback on your exercise class
 What are the principles in conducting your
exercise class?
 Warm up?
 Strength?
 Stretches?
 Agility?
 What are your exercises targeting? – just exercising
 What are precautions?
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Current Practice
What we have seen:
 Sequence – Head to toe
 General range without focus on movement
required in activities of daily living
 Mixture of warm up, range and strength
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Objectives for physical activity programs
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Safe, effective, simple
Fall prevention
Improve posture and strength
Progressive
Maintain mobility and independence
Improve quality of life
Adherence
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GOALS
 Improve participant’s functional ability,
quality of life, and reduce the risk of falls
 Increase independence, confidence and
dignity
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FRASER HEALTH INITIATIVE
 Appropriate program to meet the objectives
and goals
 Program that can change the practice of
delivering exercises
 Program that is sustainable
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What is OSTEOFIT?
 Evidence-based
 Exercise intervention program designed for
people with osteoporosis who are at high
risk for falls and fractures
 Developed by BC Women’s Osteoporosis
Program
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OSTEOFIT Works!
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10
8
6
4
+5%
2
0
-2
-4 Dynamic
balance
+13%
+5%
Control
Intervention
Static
balance
Knee
extension
Carter et al. (2002). Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with
osteoporosis: randomized controlled trial. CMAJ; 167 (9).
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OSTEOFIT
 Safe, gentle, effective
 Not a regular aerobic program
 Unique
 Low impact
 Warm up, agility, resistance, stretching
 FUN!
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PRIORITIES IN OSTEOFIT
 Posture
 Strength
 Balance, coordination and agility
 Activities of daily function
 Fall prevention
 Improve confidence
 Mental stimulation
 Progressive
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TYPICAL POSTURE OF OLDER PERSON
Forward head
• Lower trapezius
• Neck flexors
Rounded upper
back
• Middle and lower trapezius
• External shoulder rotators
Limited shoulder
range
• Deltoid
• External shoulder rotators
Poor elbow and
finger extension
• Triceps
• Forearm and Finger extensors
Flat low back
Limited Hip range
Poor knee
extensors
Limited ankle
range
• Spine muscles
• Abductors
• Extensors (butt muscles)
• Quadriceps
• Feet muscles
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EXERCISES TO IMPROVE POSTURE
Forward head
Rounded upper back
Limited shoulder range
Poor elbow and finger
extension
Flat low back
Limited Hip range
Poor knee extensors
Limited ankle range
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•
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•
•
Sit tall, chest lifted
Create more double chins (gently!)
Sit tall and Big Breath in
Open arms with thumbs up
Raise arms singly to front, side
External shoulder rotators
• Full straightening of the arm and fingers
• Sit tall
• Just imagine creating a gap at lumbar spine
• Challenging to do seated!
• Side sitting knee drop may be safe for some.
• Sit tall and extend knee fully
• Ankle ROM; seated or standing if safe to do.
• Toe actions really help also.
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EXERCISES TO IMPROVE FUNCTION
Lift and Carry
Reach and Retrieve
Step Up and Over
Sit to Stand
Walking
Personal care
• Medial deltoids, strengthen shoulders
• Mobility of the shoulder
• Triceps, straighten arm.
• Hip flexor strength, core strength
• Quadriceps, glutes, hamstrings, ankles
• Quads, glutes, hamstrings, core
• Hip mobility, lower body strength, balance
• Ankle flexibility, agility, movement of toes
• Joint ROM
• Maintain flexibility.
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EXERCISES FOR FALL PREVENTION
Lower body strength
Core
Balance
Joint mobility
Agility
Speed and Reaction
• All muscles of lower body especially the hip
abductors, quads, glutes, gastrocs
• All muscles of the trunk
• Weight shifting
• Quadriceps, glutes, hamstrings, ankles
• Quads, glutes, hamstrings, core
• Joint mobility, directional changes
• Upper and Lower body strength,
coordination
• Quickness of movement in the upper arm,
flexibility
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GENERAL GUIDELINES
 Start with small range of movement 4 to 6
repetition
 Take joints through all planes of movement
 Alternate upper and lower muscle groups
 All strength exercises will be alternated
 Initial exercises are un-resisted, low
repetition, target primarily range and
posture
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APPLICATION OF RESISTANCE
 Is exercise equipment (handheld weights
and resistance bands) being applied
effectively and safely?
 Do you understand the principles of strength
training and loading of muscles?
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MODIFICATIONS & PROGRESSIONS
 Are modifications being made for those with
chronic conditions?
 Is warm up effective and includes all joints in
full range of motion in all planes of
movement?
 Do the exercises result in improved strength,
function and ability?
 Is there monitoring of progressions?
 Has there been a decrease in falls?
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SUMMARY
 Improve knowledge and skill of the Activity
Coordinator in application of safe and
effective physical activity.
 Objectives include increasing strength,
improve functional ability, thereby
maintaining independence of the residents.
 Reduction in falls and injury
 Mentally stimulate
 Improve quality of life
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