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Exercise & Physical Activity for the Older Adult
Terms in this set (74)
what are the fun, functional, & frail values for TUG?
what are the fun, functional, frail, and failure values for gait speed?
fun: >1.5 m/s
function: 1.5-.9 m/s
frail: .8-.5 m/s
failure: <.5 m/s
what are the fun, functional, frail, and failure values for 400m walk?
fun: <5 min
function: 5-7.5 min
frail: 7.5-13 min
failure: >13 min
what are the fun, functional, frail, and failure values for 6MWT?
what are the fun, functional, frail, and failure values for FSST?
what are the fun, functional, frail, and failure values for BBS?
what are the fun, functional, frail, and failure values for DGI?
what are the fun, functional, frail, and failure values for chair rise?
natural aging produces a strength decline of __% a decade
what is the most common initial manifestation of the frailty phenotype? lack of what increases this rate?
what is an independent predictor of risk of incident mobility disability?
self report of modification of method of doing a task in the absence of difficulty
what is a key issue in maintaining independence in old age?
a progressive and generalized skeletal muscle disorder that is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability, and mortality
accentuating and reinforcing those capabilties impacted only slightly by the aging process
generating new ways of sustaining function in those aspects which are greatly impacted
selective optimization with compensation
developmental process used to describe the relation between age-related changes within individuals and changes in behavioral and cognitive styles; as individuals advance through life they are increasingly faced by age-related deficits which places limits on their cognitive and behavioral resources
what are the elements of exercise prescription for older adults?
overload, specificity, progression, frequency, duration, and time
what types of fibers do we lose as we age?
how to minimize loss of 2b fibers as we age
try to recruit them more often (by lifting heavier)
when is it okay to overdose older patients?
if they are afraid (no patient buy-in) --> trying to build trust and therapeutic alliance; if they're irritable or in pain; if they're really weak and/or deconditioned (start lower to minimize DOMs); teaching technique (if they've never done a movement before)
minimum of __ weeks needed to achieve a true ________ response in muscle tissue (changes in muscle structure require what?)
6 weeks; strengthening; protein synthesis
improved motor performance occurs when due to what?
almost immediately; due to neural factors rather than strengthening response
neural adaptations occur (before/after) structural
how many reps does it take to achieve a learning response that is considered long term?
muscle tissue must be exposed to a stimulus of at least __% of a muscle's maximum force generating capacity to improve that muscles force
overload of __% or __RM is necessary to create significant strength gains that will also translate to ______ gains
60%; 15RM; functional
what is the preferred workload for strengthening?
80% of 1RM
what is advised for older adults in frail or deconditioned states who are beginning strengthening programs?
start with lower intensities to allow for gradual accommondation
older adults are ________ dependent and ________ sensitive; which means what?
intensity dependent; volume sensitive; have to work at certain insensities to see results but don't need as much volume
_____ rather than _____ may be a better predictor of function
power rather than force
loss of type ____ muscle fibers due to what?
type II; age and/or disuse
older adults with weakness often only have one gait speed
when performing an eccentric contraction, __________ the speed of the movement overloads the activity
when performing a concentric contraction, __________ the speed of movement overloads the activity
functional improvement in training occurs when?
when the exercise stimulus closely matches the desired result
specificity has led to the practice of ____________
the concept of strengthening a movement rather than a muscle
frequency of sessions varies and depends on what?
with the type of exercise being done
how often can balance and skill be practiced?
variable intensity prevents what?
overtraining and deterioration in performance
how often can strengthening at high intensity be done?
2-3 days a week for a specific muscle group
in older adults, ____ set of each exercise is effective for the first ____ months of training
1 set; 3 months
how long should older adults hold a stretch? why?
60 seconds; tissue is stiffer
what are the primary and secondary considerations in exercise prescription for older adults?
primary - whether or not exercise will challenge or overload patient's ability
secondary - specificity
motor learning requires an exercise program aimed at ___________ with focus on __________
adaptations or improvement; focus on frequency
types of exercise for older adults
balance; postural; strength; power; stretching; tai chi; aquatic; aerobic
why are older adults more dependent on exercise?
they have a diminished muscle protein synthetic response to protein intake; exercise helps maintain a balance between muscle synthesis and protein breakdown
what is the best way to determine intensity?
RPE; multiple rep max; handheld dynamometry; functional testing
what are some tests used to test strength?
heel raise test; supine hip extensor test; sit to stand; plank; single leg squat test; floor transfers; wall squat
where do we want older adults to fall on the OMNI resistance scale?
aging adults with what diagnoses should begin exercise at lesser intensities, from ______% of 1RM
MI (3-6 weeks; you don't want to increase pressure); acute MSK conditions; pts for whom resistance exercise could negatively affect post-surgical healing tissue; tissues that have been immobilized
30-60% of 1RM
95% 1RM = __ reps
90% 1RM = __ reps
80% 1RM = __ reps
70% 1RM = __ reps
60% 1RM = __ reps
exercising at 30-60% (reaching momentary muscle fatigue around __ reps), one should rate as _____ or _____
15 reps; fairly light or somewhat hard
momentary muscle fatigue is identified as follows:
if exercise speed increases and unable to complete reps when prompted to move slowly; exercise form deteriorates and pt is unable to complete reps when prompted to maintain good form; failure to exercise through full ROM and unable to do so when prompted
the average person performing a good quality exercise at 70-80% of 1RM will experience momentary muscle fatigue anywhere from ______ reps; should rate difficulty as _______
8-12 reps; somewhat hard or hard
older adults tolerate and respond robustly to supervised high-intensity resistance exercise
resistance training is a first-line intervention for management of frailty
an attempt to use the stretch reflex of the muscle spindle and elastic energy that is stored in a stretched muscle to enhance an immediate reciprocal contraction in that muscle; any functional task measured for speed
what is the precaution for plyometrics/power in older adults?
older adults may not have the soft tissue and muscle integrity required (decreased elasticity of connective tissue; decreased type II fibers and muscle mass; start low and go slow)
what are some tests that can be used to test plyometrics/power in older adults?
floor transfer; STST; fullerton; stair climb test
when is stretching indicated in older adults?
indicated to promote adaptation of shortened muscles to a more lengthened position
what muscles are frequently shortened in older adults?
suboccipital muscles; pectoralis minor; downward rotators and protractors of shoulder; lumbar spine extensors; hip flexors; ankle plantarflexors
what are some tests to use in older adults to test for flexibility of muscles?
thomas test; wall to occiput; hip extension ROM; DF ROM; back scratch; sit and reach
exercise technique that involves learning multiple poses that are linked together with slow movements that emphasize control and balance
what are the benefits to tai chi in older adults?
mediates effects of chronic conditions, decreases stress, lessens depression, improves mental health and cognitive function, improve balance and fitness, decreases falls
why would gait speed predict survival?
walking requires energy, movement control, and support and places demands on multiple organ systems; slowing gait may reflect both damaged systems and a high-energy cost of walking; gait speed integrates known and unrecognized disturbances in multiple organ systems (many of which affect survival); decreasing mobility may induce a cycle of reduced physical activity and deconditioning that has a direct effect on health and survival
community ambulation distance
600m (minimum needs to be at least 200m)
community ambulation gait speed
fall risk gait speed
physiological contraints (impairments) that impact gait
ROM; strength; balance; motor control; sensation; endurance; cognitive ability
psychological contraints (personal factors) that impact gait
anxiety/fear; depression; lack of self efficacy/confidence; lack of motivation
simply walking a patient will improve the patient's performance in walking above a critical threshold
false; will NOT improve the patient's performance, if there is no overload or challenge it will not improve above a critical threshold
planned, structured, repetitive and intentional movement intended to improve or maintain physical fitness
functional aerobic outcome measures include:
6MWT, 2MWT, 400m walk test, 2-minute step test, 60s STST, 3m step test
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