Staying Fit, Active and Functioning Well








Staying Fit, Active and Functioning Well

Focus: ”Don’t lose any more function than can be helped”

The Aged Population is on the Increase!

The fastest
growing population is the older adult with the majority of
them are living well and independently in their own homes.
This population is getting
increasingly “top heavy”. At the last Australian census 6 million people were
aged between 50 and 89 years.
Demographic trends over
the next three decades project that the global numbers of adults aged 65 years
and older will
double to around two billion by 2050
. These demographic trends will
have an impact on the health care system

 

Regular physical activity is a priority health
issue for all Australians. “
Whilst we are young we challenge our bodies, but over time the mind and
body can start become more challenged”.
A fulfilling quality life is important for everyone.
Anybody, no matter their
condition, culture, age or ability needs exercise to remain active throughout
life.
The
benefits of exercise are universal and span across all decades.

Everyone wants to be as
active, for as long as possible to remain independent and in control of their
life.
Age should not be a
barrier to participation in an appropriate activity program. There is a good
percentage of older people who are still very capable of participating in some
form of exercise and remain active and able a s result. How this is carried out
is dependent on health, ability and fitness status.
For an active life everyone needs sufficient energy, adequate strength, balance and
functional mobility to maintain good body control and prevent any unnecessary losses
occurring.
 Physical activity programs
combining aerobic, strength and flexibility components (including a balance
element) have promising results and can protect against physical and cognitive
decline associated with ageing. 

Functionality involves many tasks
done together to achieve purposeful results throughout the day. These
activities involve a combination of muscular strength (power), endurance,
flexibility, balance and co-ordination as well as good cognitive skills.  Optimal capacity is required to perform daily
tasks and achieve purposeful and effective results.
With advancing age and
low activity levels,
muscle
strength and elasticity diminish. There is also an associated loss of reserve
capacity (reduced energy supply). 
Flexibility and
strength declines gradually from 30 years onwards with greater declines after
age 40 years and beyond.
 The long-term implication in reduction of strength is decreased
functional ability and increased risk of falls (+ fractures).
 Joints stiffen and the body becomes tighter
which can restrict daily activity, making movement more difficult.
All these factors contribute to a reduction
in physical abilities, fitness and health, loss of function and reduced
activity levels.

“Through effective, comprehensive functional fitness
programs, older adults may be able to avoid, postpone, reduce or even reverse
declines in physical performance”

Functional Fitness for Older Adults – 
Patricia Brill.  Human Kinetics3

Ask yourself these questions……….. How Well Are You Doing
Now?

·        
Do
you have enough energy for all activities throughout the day?

·        
Do
you feel you are coping well?

·        
  What
are you not able to do as well as before?

·        
  Do you have any chronic conditions that limit
movement?

·        
What
exercise are you currently doing?

·        
Do
you have any mobility problems?

·        
Do
you have any chronic conditions that limit movement?

·        
How strong
do you feel you are?

·        
How flexible are you?

·        
Any
changes with age or condition?

·        
Do
you have good balance?

·        
Have you sustained a fall (s) over the past year

·        
Are you walking well or slower than before?

 

If any of your answers to the
above questions are a problem, take action to improve
your overall functional abilities by doing effective and safe exercises. Seek
help from appropriate health / fitness professionals concerning
the exercises you need to
stay active

 “The weakest and oldest among us can become
some kind of athlete…….but only the strongest can
survive as spectator. Only the hardiest can survive the perils of inertia,
inactivity and immobility”
                                                                             (Bland and Cooper 1985

NB. If you would
like some more practical ideas concerning fundamental movement to assist
maintain your functional abilities you can purchase some resources from
Movement Matters. Please see www. movementmatters.info website for more
information

Sources / references

1 World Health
Organization. (2002). Active ageing: A policy framework

 (WHO/NMH/NPH/02.8), Geneva: WHO
Noncommunicable Diseases and Mental Health Cluster. Retrieved May 2015, from
http://whqlibdoc.who.int/hq/2002/

 

2. The Gerontologist, 2016, Vol. 56, No. S2

Updating the Evidence for Physical Activity: Summative Reviews of the
Epidemiological Evidence, Prevalence, and
Interventions to Promote
“Active Aging”

This review highlights the importance, and complexity, of promoting
PA among older adults.

Adrian Bauman,
MD, MPH, PhD,1,* Dafna
Merom, PhD,2 Fiona C. Bull, PhD,3
David M. Buchner, MD, MPH,4 and Maria A. Fiatarone
Singh, MD5

1School of Public Health, Sydney
University, New South Wales, Australia. 2School of Science and
Health, Western Sydney University, New South Wales, Australia. 3Centre
for Built Environment and Health, The University of Western Australia, Perth,
Australia. 4Department of Kinesiology and Community Health, University
of Illinois at Urbana-Champaign. 5Exercise, Health and Performance,
Faculty of Health Sciences, Sydney University, New South Wales, Australia.

©
The Author 2016. Published by Oxford University Press on behalf of The
Gerontological Society of America. All rights reserved. For permissions, please
e-mail:
journals.permissions@oup.com.

 

3. Functional
Fitness for Older Adults –  Patricia
Brill.  Human Kinetics

Keep Moving – Stay Mobile

Focus : Arthritis and Exercise

Fitness and health decline with age
and may eventually fall below the level required to be able to undertake
everyday activities easily and safely. One reason for this could be as a result of
arthritis causing joints stiffening and muscles to
weaken. The body becomes less easy to move and joints become stiffer restricting
effective daily activity. Inactivity is associated with

·        
400% increased risk of disability
which restricts the ability to perform  of daily activities

·        
300% increase in risk of balance
disorders and increased risk of fall related injuries;

·        
200% increase in risk of gait
abnormalities

There
are many reasons why it becomes harder to move. S
ome of the following are the causes
and limitations that may reduce and change activity

·        
Ageing

·        
Injury

·        
Changes in
fundamental function
occur due to reduced
little / limited activity (being sedentary)

·        
Changes in overall fitness
and body control such as endurance, strength and flexibility.
 

·        
Changes in the physiology of
the body occur in the musculo-skeletal, neuromuscular
and neurological systems

·        
Multiple chronic conditions
such as osteoarthritis, osteoporosis, sarcopenia (muscle weakening) diabetes,
heart disease etc. can alter the bodies ability to
move effectively and efficiently.

·        
Changes in mental states, for
example depression and dementia, can reduce an individuals’ motivation and
ability to stay active

·        
Changes in balance
and walking patterns increases
the fear of
falling
which in turn also reduces the motivation to move more than necessary

These factors all correlate and
contribute to a reduction in physical abilities, fitness and health, loss of
function and reduced activity levels.

It is vital that the body is kept as
flexible as possible. 

Ask yourself these questions.

·        
Are you flexible enough to carry out all activities
throughout the day easily?

·        
Do you feel you are doing activities well as you always have?

·        
What are you not able to do as well? 

If any of your answers to the
above questions are a problem, take action to improve
your overall mobility by undertaking appropriate exercises. Seek help from
appropriate health / fitness professionals concerning
the exercises you need do to stay mobile

Arthritis

Arthritis is one major
condition that can restrict movement. It is important however to keep the
joints moving and working as best as possible to keep them from stiffening up
and limiting movement further. Some important facts and considerations need to be
taken into account prior to participation in an
exercise program.

Facts

There are over 120 conditions that fit under the umbrella of
arthritis but the major ones being Osteoarthritis
and Rheumatoid Arthritis. It
is a condition
which affects joints and the surrounding tissue and is often associated with
joint pain, stiffness, swelling, fatigue, reduced mobility and reduced muscle
strength.
It is not wear and tear, degenerative changes occur within the structure and
composition of the cartilage resulting in structural weakness and damage
.  This degeneration limits movement,
causing pain and swelling within and around the joint structure.
 Cartilage is designed for load bearing;
absorbing impact; sustaining shear forces. The major potential problems
associated with arthritis are functional limitations and lifestyle restrictions.

Exercise is one important way of keeping joints as healthy as possible and
preventing the muscles surrounding the joints from weakening  

Osteoarthritis – generally affecting a few joints. Hallmark signs
and symptoms:
Joint pain; Stiffness; Muscle weakness;
Instability; (inflammation)

Rheumatoid Arthritis – affects the entire body
systems.   Hallmark signs and symptoms:
More swelling although intermittent

Arthritis and
Exercise

Exercise is
an important part of the management of arthritis and its associated
complications. It is not
contraindicated for either condition

and will assist
maintain functional activities necessary for daily living.

Overall
Aims with Exercise

·        
Mobilise joints – move the
joints as far as possible.

·        
Relieve pain (not exacerbate it)

·        
 
Stabilise joints by
strengthening surrounding muscles.

·        
Work on improved functional activities.

·        
Protect joints to prevent deformity (good form and alignment
needed).

·        
Work to improve posture and gait patterns. Improve general
fitness.

·        
Maintain a healthy weight

NB. If you
would like some more practical ideas concerning fundamental movement to assist
maintain your functional abilities you can purchase some resources from
Movement Matters. Please see www. movementmatters.info website for more
information

 

Stretching -Not Straining …the basics

The body becomes
resistant to stretching but
it is an important component of an exercise
program (as is strengthening)

Keeping flexible is an important component of an exercise
program especially for people who are inactive
and have arthritis. Muscle elasticity
diminishes with age with increased muscle stiffness that results in joint restriction
and the body becomes tighter.  Increased
stiffness can occur in all joints of the body and surrounding soft tissue e.g.
tendons, ligaments, joint capsule, fascia. Restricted movement is directly linked to reduction in functional
abilities
and there is a marked increased susceptibility to falls and associated
injuries.

·        
Always
consider and apply correct starting position and body alignment for all
movements

·        
Avoid
bouncing or jerky movements (especially with arthritic joints changes)
 

·        
Only
stretch as far as is comfortable (there is no such thing as no pain no gain)

·        
Try
to hold the stretch for at least between 15- 20 seconds at a time to allow the
tissues to stretch as far as they are able

Exercise Tips

·        
Be aware of any AGGRAVATING exercises or movements and
change your exercise regime accordingly.

·        
Keep movements as
smooth as possible.

·        
Avoid weight
bearing exercises for long periods of time.

·        
Care needs to be
taken to prevent getting overtired.

·        
Any inflammatory
response may require rest and
limited excess movements

·        
Little
and often is often a good way to start exercising and then build up the level
and degree of activity

When to be
Cautious

ü  Consider that inflammatory
responses may require APPROPRIATE rest. 
Be aware of possible AGGRAVATING exercises or movements

ü  After joint replacement surgery follow the guidelines and
instructions carefully

When Not
to exercise!

ü  If there is a flare up of the condition, (hot and swollen joints)
with very limited movement and extreme pain is present.

ü  Remember the 2 hour pain rule ……..Reduce
the program if the pain in the joints persists longer than two hours
immediately following an exercise session and does not settle for a couple of
days.

NB.
Exercise in warm water as an alternate type of exercise (it can make movements
easier to manage and provide some pain relief).