Exercise Testing and Rx in Older Adults Flashcards
Aging AND Muscle Strength
After age 50:
Muscle mass declines 1-2% per year
Muscular strength can decline by1.5% per year
After age 60:
Muscular strength can decrease by up to 3% per year
Age-related muscle loss:
25% in adults aged 65 and older
Increases to 30-50% in adults 80 and older
Functional Changes
Strength
Grip Strength
Upper-Body Strength
Lower-Body Strength
Mobility & Function Repeated Chair Stands Timed Get-Up-and-Go 4-meter walk 6-minute walk Stair Climb
_____ _____ is the primary factor underlying age and gender related strength differences
Influences walking ability
Muscle mass (not muscle function) is the primary factor underlying age and gender related strength differences
Influences walking ability
Related to falls
Decreases metabolic rate
May result in increased fat deposition and reduced bone density and insulin sensitivity
Maintaining or increasing muscle mass will facilitate functional independence and reduce chronic disease
Cachexia
wasted look, produced due to diseased state
Sarcopenia
muscle loss due to normal aging
Muscle Quality
Described as the ratio of muscle strength to muscle mass
Specific Torque
Lower extremity-isokinetic torque of knee extensors in Nm to leg lean mass in kg
Elbow flexor-extensor peak torque in Nm to arm lean mass in kg
Specific Force
Upper extremity-grip strength in kg to arm lean mass in kg
Muscular strength is lost at a greater rate than lean mass with aging
Skeletal Muscle Index
Ratio of appendicular lean mass relative to height in meters squared
Normalizes muscle to frame size
Gender differences persist because men tend to have more muscle mass than women regardless of height
FITT
F – Frequency
I – Intensity
T – Time (duration)
T – Type (mode)
Frequency
≥ 5 days / week of moderate intensity; ≥ 3 days / week of vigorous intensity activity; or some combination of moderate and vigorous activity 3-5 days / week
Exercise sessions of longer duration or higher intensity necessitate more recovery time and should be performed less frequently
The opposite is true for shorter duration or lower intense exercise
Intensity
Ideally described as a percentage of Heart Rate Reserve (HRR) or VO2 max
Typically between 50% - 85% of HRR
Prescription should be based on the fitness level of the client!!
Age-predicted maximal HR (APMHR)
APMHR = 220-age
Error range of + 10-15 bts/min
Karvonen Formula
Uses APMHR to determine heart rate reserve (HRR)
HRR = APMHR – RHR (e.g. amount HR can increase from resting to max)
Target HR = (HRR x % intensity) + RHR
Rate of Perceived exertion (RPE)
6-20 scale
13-15 (moderate intensity)
16-18 (vigorous intensity)
0-10 scale
5-6 (moderate intensity)
7-8 (vigorous intensity)
The Talk Test
METHODS: Healthy volunteers (N = 16) performed incremental exercise, on both treadmill and cycle ergometer. Trials were performed with respiratory gas exchange and while performing the Talk Test.
CONCLUSIONS: The Talk Test approximates ventilatory threshold on both treadmill and cycle. At the point where speech first became difficult, exercise intensity was almost exactly equivalent to ventilatory threshold. When speech was not comfortable, exercise intensity was consistently above ventilatory threshold. These results suggest that the Talk Test may be a highly consistent method of exercise prescription.
Foster, C. Med Sci Sports Exerc. 2004 Sep;36(9):1632-6.
Duration
30-60 minutes per day (150-300 minutes/week) of moderate intensity activity in ≥ 10 minute bouts
20-30 minutes per day (75-100 minutes/week) of vigorous intensity activity
Duration should be inversely related to intensity
Mode
“Any modality that does not impose excessive orthopedic stress”
Dependent on: Equipment availability Personal preference Client’s ability to perform the exercise Client’s goals (specificity, specificity, specificity…)
Progression
Increases in frequency, intensity, or duration should generally be limited to 10% per week
Dependent on training status and population
