Aer­o­bic, mus­cle-strength­en­ing ac­tiv­i­ties es­sen­tial to keep fit in old age

The Weekend Australian - Travel - - Health - EX­ER­CISE CHRIS TZAR

‘ GIVEN the breadth and strength of the ev­i­dence, phys­i­cal ac­tiv­ity should be one of the high­est pri­or­i­ties for pre­vent­ing and treat­ing dis­ease and dis­able­ment in older adults.’’

Last month, the Amer­i­can Heart As­so­ci­a­tion (AHA) and the Amer­i­can Col­lege of Sports Medicine (ACSM) re­leased one of the most sig­nif­i­cant joint state­ments in pub­lic health in re­cent years.

Based on the re­search ev­i­dence to date, the state­ment is a rec­om­men­da­tion on phys­i­cal ac­tiv­ity for older adults ( Cir­cu­la­tion 2007;116:000-000).

Rep­re­sent­ing the most rapidly grow­ing age group, the rec­om­men­da­tions tar­get men and women aged 65 years and over, as well as adults aged 50 to 64 years with chronic health con­di­tions or phys­i­cal lim­i­ta­tions.

The doc­u­ment high­lights con­cerns that cur­rent ac­tiv­ity lev­els in this age group are well be­low the level re­quired to pro­mote or main­tain healthy liv­ing.

‘‘ Reg­u­lar phys­i­cal ac­tiv­ity, in­clud­ing aer­o­bic ac­tiv­ity and mus­cle-strength­en­ing ac­tiv­ity, is es­sen­tial for healthy age­ing. This pre­ven­tive rec­om­men­da­tion spec­i­fies how older adults, by en­gag­ing in each rec­om­mended type of phys­i­cal ac­tiv­ity, can re­duce the risk of chronic dis­ease, pre­ma­ture mor­tal­ity, func­tional lim­i­ta­tions, and dis­abil­ity.’’

While the rec­om­men­da­tions draw on re­search that demon­strates how ex­er­cise works as a ther­apy to com­bat both age-re­lated and lifestyle-re­lated con­di­tions, it must be noted that th­ese rec­om­men­da­tions out­line the min­i­mum ac­tiv­ity re­quired for health ben­e­fit.

The doc­u­ment em­pha­sises that many adults should ex­ceed the min­i­mum rec­om­mended amount of ac­tiv­ity. Aer­o­bic ac­tiv­ity: To pro­mote and main­tain health, older adults need to per­form mod­er­ate-in­ten­sity aer­o­bic phys­i­cal ac­tiv­ity for a min­i­mum of 30 min­utes, five days each week or vig­or­ous in­ten­sity aer­o­bic ac­tiv­ity for a min­i­mum of 20 min­utes on three days each week. Com­bi­na­tions of mod­er­ate and vig­or­ous in­ten­sity ac­tiv­i­ties can be per­formed to meet this rec­om­men­da­tion.

On a 10 point scale — where sit­ting is 0 and an all-out or max­i­mal ef­fort is 10 — mod­er­atein­ten­sity ac­tiv­ity is a 5 or 6 and re­sults in a no­tice­able in­crease in heart rate and breath­ing.

On the same scale, vig­or­ous-in­ten­sity ac­tiv­ity is a 7 or 8 and pro­duces dra­matic in­creases in heart rate and breath­ing.

It should also be noted that th­ese rec­om­men­da­tions are in ad­di­tion to rou­tine ac­tiv­i­ties of daily liv­ing, such as house­hold tasks, walk­ing or shop­ping. Mus­cle-strength­en­ing ac­tiv­ity: Older adults should per­form strength train­ing ac­tiv­i­ties for a min­i­mum of two days each week.

The rec­om­men­da­tions in­clude eight to 10 ex­er­cises util­is­ing ma­jor mus­cle groups per­formed on two or more non-con­sec­u­tive days per week.

A weight should be used that al­lows 10 to 15 rep­e­ti­tions per ex­er­cise. The level of ef­fort for strength train­ing should be mod­er­ate to high. On a 10 point scale — where no move­ment is 0 and max­i­mal ef­fort is 10 — mod­er­ate ef­fort is a 5 or 6, and high in­ten­sity is a 7 or 8.

Flex­i­bil­ity (or joint range of mo­tion) ac­tiv­ity:

At least 10 min­utes of flex­i­bil­ity ac­tiv­i­ties are rec­om­mended at least two days each week and prefer­ably per­formed on all days that aer­o­bic or strength train­ing is per­formed.

A gen­eral stretch­ing rou­tine should ad­dress ma­jor mus­cles, with 10 to 30 sec­onds for a static (still) stretch and each stretch re­peated 3 to 4 times. Bal­ance ex­er­cises: Older adults liv­ing in the com­mu­nity and at risk of falls (mo­bil­ity is­sues or a his­tory of falls) are ad­vised to per­form bal­ance ex­er­cises three times per week.

Th­ese bal­ance spe­cific ex­er­cises com­ple- ment the mus­cle strength­en­ing ex­er­cise rec­om­men­da­tions to re­duce the risk of falls and fall-re­lated in­juries. Ac­tiv­ity plan: Older adults with a chronic health con­di­tion should have an ac­tiv­ity plan de­vel­oped to en­sure that the pro­gram works op­ti­mally as a treat­ment or ther­apy. Cer­tain risks in­clud­ing falls, in­jury and other ad­verse events need to be ad­dressed with spe­cific tai­lored ex­er­cise pre­scrip­tion from a health­care provider.

So with the warm weather ap­proach­ing, there is no bet­ter time to start rou­tine phys­i­cal ac­tiv­ity, and en­joy its ben­e­fits for a bet­ter qual­ity of life.

Be­fore com­menc­ing ex­er­cise or mod­er­ate in­ten­sity ac­tiv­ity, con­sult your GP for a med­i­cal as­sess­ment and see your lo­cal ex­er­cise phys­i­ol­o­gist for an ac­tiv­ity plan that in­cludes spe­cific ex­er­cise pre­scrip­tion and ad­vice. Chris Tzar is an ex­er­cise phys­i­ol­o­gist and di­rec­tor of the Lifestyle Clinic, Fac­ulty of Medicine, Univer­sity of NSW www.lifestyle­clinic.net.au

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