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