Maintaining Fundamental Movement Skills into the Later Years of Life

Transcription

1 Maintaining Fundamental Movement Skills into the Later Years of Life Naoimh McMahon BSc, MA Sport Studies and Physical Education and Health Action Zone Conference 20 th April 2013

2 Overview What are the fundamental movement skills that you need in the later years of life? Why do fundamental movement skills become compromised towards the later years of life? What is the best evidence to maintain fundamental movement skills? What are the challenges of implementing best practice guidelines?

3 Fundamental Movement Skills are those skills that provide us with the ability and opportunity to engage in quality physical activity, sport specific skills and activities of daily living

4 Determinants of Physical Health Design Genes Accidents External Agency Maintenance Internal Agency Ageing Ageing (Bortz, 2005)

5 Internal Agency Muscle strength and VO 2 max have been shown to be powerful, predictive biomarkers for subsequent disability and death. A physically fit person exhibits a decline in VO 2 max at the rate of 0.5% per year. An unfit person loses this basic competence at the rate of 2% per year 4 times as fast. With continued use, muscle strength and power deteriorates at a slow rate, but with disuse, such as a casted limb or sedentary lifestyle muscle strength can decay at 1% per day. (Bortz, 2005)

6 Sarcopenia Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death. (Cruz-Jentoft, 2010) (Sayer et al. 2008)

7 Exercise Interventions & Sarcopenia: The Evidence Through physical exercise and training, especially resistance training, it may be possible to prevent sarcopenia. (Evans and Campbell, 1999) Resistance training remains the most effective intervention for increasing muscle mass and strength in older people. Elderly people have reduced food intake and increased protein requirements. As a result, adequate nutrition is sometimes a barrier to obtaining full benefits from resistance training in this population. (Borst, 2004) Progressive resistance training is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities. (Liu and Latham, 2009) Using both resistance and endurance exercise in the elderly makes it possible to modify the age-associated decline in muscle function and decelerate the development of muscle weakness. (Seene and Kaasik, 2012)

8 The International Classification of Functioning, Disability & Health Health Condition (Disorder or Disease) Body Structures & Functions Activity Participation Environmental Factors Personal Factors (World Health Organisation, 2001)

9 Consolidated Framework for Implementing Research (CFIH) (Damshroder et al. 2009) Characteristics of the Intervention Outer Setting Inner Setting Characteristics of the Individual Process To see far is one thing, going there is another

10 Clinical Messages 1. Loss of skeletal muscle is predictive of reduced ability to execute fundamental movement skills in later life 2. Progressive resistance training has a protective effect against this loss of skeletal muscle or sarcopenia 3. Feasible interventions are required that facilitate individuals early in life to engage in progressive resistance training and maintain movement skills late into life

11 References Borst, S. E. (2004). Interventions for sarcopenia and muscle weakness in older people. Age and Ageing, 33(6), Bortz, W. M. (2005). Biological basis of determinants of health. American Journal of Public Health, 95(3), Cruz-Jentoft, A., & Michel, J.-P. (2013). Sarcopenia: A useful paradigm for physical frailty. European Geriatric Medicine. Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F.,... Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis. Age and Ageing, 39(4), Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science, 4, 1-50.

12 References Evans, W. J., & Campbell, W. W. (1993). Sarcopenia and age-related-changes in bodycomposition and functional capacity. Journal of Nutrition, 123(2), Liu, C. J., & Latham, N. K. (2009). Progressive resistance strength training for improving physical function in older adults. Cochrane Database of Systematic Reviews(3). Sayer, A. A., Robinson, S. M., Patel, H. P., Shavlakadze, T., Cooper, C., & Grounds, M. D. (2013). New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age and Ageing, 42(2), Seene, T., & Kaasik, P. (2012). Muscle weakness in the elderly: role of sarcopenia, dynapenia, and possibilities for rehabilitation. European Review of Aging and Physical Activity, 9(2), World Health Organisation. (2001). International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organisation.