As humans we are living longer and longer as modern medicine improves. The life expectancy for humans as 81 years of age by year 2030. With the increasing age of our population we will continue to see an increase in older individuals getting injured from falling in their homes or in the community. According to the CDC 1 in 3 people over the age of 65 each year fall. With our life expectancy increasing and the increasing percentage of our population that is over 65 years of age increasing, its important we develop strategies to help them live not only a long life, but a quality life into their older age.
Aging is not an excuse for falling into a sedentary lifestyle. Movement is medicine. Physical activity and exercise are both crucial when trying to prevent future falls and secondary health complications which are related to lack of physical activity. Much like an athlete trains in the gym in order to perform better in their sport, an older adult needs to train in the gym so they perform better in their life. The training needs to be specific to what they need to do in their life. In other words, the training needs to be "functional". Some of the major risk factors for falls are muscle weakness, gait deficiencies, balance deficits, needing an assistive device, impaired ADL's, cognitive impairments, medications, and cardiovascular deficits. The good news is physical activity and exercises is a great way to combat all of those risk factors.
The older adult may present with other co-morbidities which must be taking into consideration when developing their program, however they need to be challenged. The individual needs to perform movements which are directly applicable to their daily life and dosed appropriately so they make improvements. The SAID principle does not stop applying to older adults just because they have reached a certain age. In order to see the change we seek, we must challenge them in the aspects of life we wish to see them improve in.
Below is a list of movements which should be included within every over adults fitness program.
1) Sit to Stand (Squat) from a low box
One of the major functional deficits older adults present with is losing the ability to stand up from their chair without the use of hands. Getting up and sitting down independently is one of the activities in which keep us functioning as an independent human beings. The sit to stand from a low surface or whats called a "Box Squat" in the strength and conditioning world is an excellent way to ensure we maintain the ability to get up and down without assistance. This can be performed with and without load depending on the individual. You can load it with bands, kettle bells, dumbbells, or barbells. You can modify the difficulty by raising or lowering the surface in which the individual needs to stand up from.
2) Walking backwards
Another functional deficit which older individuals tend to present with is the inability to walk backwards. Many older individuals become extremely fearful of this activity and many suffer falls because of their inability to perform backwards walking. In a fitness program this can be included in many different ways; running backwards, backwards pulls backwards agility ladders, or just walking backwards over different surfaces. Maintaining the ability to walk backwards will enable individuals to decrease their fall risk as they age and maintain a more independent lifestyle.
3) Lateral and Forward Step ups
Walking up steps becomes a very difficult thing to do for many older individuals. Their difficulties are not limited to just steps though, any activity which forces them to step up onto or down from something becomes challenging. The forward and lateral step ups are both great ways to challenge this movement in a controlled manner. By modifying the step height and the load that they must use to perform the movement, you can ensure the individual is gaining the appropriate training effect to best improve their function in life.
4) Floor to Stand
The inability to control yourself down to the floor then stand back up has been shown in research to be a predictor of all-cause mortality. For an human to maintain their independence into old age, they need to be able to stand up from the floor without assistance. If an individual cannot stand up from the ground following a fall, then they ultimately are going to be a risk of dying if they fall when no one is around to help them get up. That may sound a little harsh to some, but its the reality of the situation. The easiest way to ensure someone does not lose the ability to sit down on the ground and stand up from the ground is to force them to do it often. Programming movements which force individuals to stand up and sit down on the floor without assistance will ultimately help them maintain the mobility and strength to do so.
5) Single leg balance and proprioceptive exercises
Last but not least, an individual needs to be performing some form of single leg balance in their exercises program. Every step an individual takes, any object they step over, getting into and out of the tub, getting into and out of their car, all will demand some degree of single leg balance and control. Losing the ability to stand on one leg often leads to falls and other medical problems down the line. In a fitness program, these should be included in order to help maintain the single leg control needed for independent living down the line.
Some of you may be reading this and saying "I can do all those things now, I'm not old, and I don't need to work on them." That may be true, but you can do these things until one day you can't. To ensure that you do not lose the ability to do these basic human functions, include them in some form or fashion in your fitness programs (or at least in your daily life). The better you get at these movements, the easier it will be to maintain them as you progress in age. The better you can do these movements as you age, the better chance you'll live a higher quality of life in your older age.
Dr. Michael Tancini, DPT
Ground to Overhead Physical Therapy
Phone: (619) 354-6591
Address: 10999 Sorrento Valley Rd, San Diego, CA 92121
San Diego, California, Physical Therapy, Crossfit, Sports Therapy, Recovery, Rehabilitation , Movement Specialist, Knee pain, Back Pain, Hip pain, Shoulder pain, Specialist