Strength Balance and Function in the Elderly

Transcription

1 Strength Balance and Function in the Elderly Chris Ingersoll, PhD D. Casey Kerrigan, MD Phil Rowland, BS Jason Rutkowski, MS Arthur Weltman, PhD Institute on Aging, General Clinical Research Center, Kinesiology, Physical Medicine and Rehabilitation University of Virginia ACAC

2 Introduction Maintaining independent living and high quality of life are important for the elderly Compelling evidence exists regarding the benefits of physical activity programs for the elderly However, information regarding optimized programs integrating strength, balance and function for the elderly is lacking

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4 Every day you get older. It s the law Sundance Kid to Butch Cassidy

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6 Sarcopenia Age related loss of skeletal muscle mass

7 Sarcopenia Reduced protein reserves Decreased strength and functional capacity Frailty, Falls Reduced aerobic capacity Reduced energy requirements

8 Sarcopenia Reduced levels of physical activity Loss of motor units (aging CNS) Reduced rate of muscle protein synthesis changing endocrine function (testosterone, estrogen, growth hormone) Increased dietary protein needs

9 Sarcopenia Basal Metabolic Rate Activity Strength Frailty V O 2max Bone Density Body Fat Energy Needs Osteoporosis

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11 VO 2max of sedentary 75 year old woman compared to O 2 cost of activities VO2max Run (6.5 mph) Cleaning Climb Stairs Walk (2.5 mph) Oxygen consumption (L/min)

12 Age-related changes in thigh cross-sectional area 21 year old woman 63 year old woman

13 Impaired Strength Inability to lift 4.5 kg Men Women Jette, Am. J. Public Health, 71, 1981 %

14 Death Rates According to Individual Performance Tests Age and Sex Adjusted Test Category Walk Chair Stands Standing Balance % Distribution

15 Aerobic Exercise and Aging: : Does aging effect the adaptation to aerobic exercise training?

16 VO 2max (ml kg -1 min -1 ) Pre-Training Post-Training 0 OLD YOUNG Old (60-70) Young (20-30)

17 Older men and women experience a greater relative increase in aerobic capacity as a result of 12 weeks of aerobic exercise training YOUNG (age 20-30) OLD (age 60-70) 0 10 % Change in VO2 max 20 Meredith, CN, et al. Peripheral effects of endurance training in young and old subjects. J Appl Physiol 66(6): , 1989.

18 Resistance Exercise

19 50 40 * * PRE-TRAINING MID-TRAINING POST-TRAINING 1 RM * * 10 0 EXTENSORS FLEXORS Extensors Flexors Frontera, WR, et al Strength conditioning in older men: Skeletal muscle function and mass. J Appl Physiol 64: , 1988.

20 P r e P o s t Activity 2000 (kcal/week) 1000 Control Exercise 0 Pre Training Post Training

21 In very old nursing home residents, 10 weeks of progressive resistance exercise training Increased walking speed Increased stair climbing ability Increased spontaneous activity Decrease in depressive symptoms

22 The Effects of an Aggressive Balance Program on Strength, Balance and Function Balance Group Control Group Age BMI

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29 Strength (NM) 180 Trunk 120 Knee Control Balance Flex Ext 0 Flex Ext

30 Balance Path Length (cm) Control Balance

31 Function Time (seconds) Control Balance m Walk Distance (feet) 6-min walk 12 Time (seconds) Sit to Stand 5 times

32 Helen Zechmeister, Age 81, Weight Lifter

33 Woody Brown Age 83 Surfer

34 John Turner: Age 67 Weight Lifter

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