General Conditioning for an Active Life. B. Jon Ellingworth P.T.

Transcription

1 General Conditioning for an Active Life B. Jon Ellingworth P.T.

2 While thinning bones (osteoporosis) renders the skeleton prone to fractures, it s the gradual erosion of lean muscle (sarcopenia) and ensuing frailty, which leads to falls.

3 Providing the strength to stand, walk and pick things up, our skeletal muscles provide us with the physical freedom we enjoy Yet its erosion and the speed at which it occurs has a direct impact on how fast we age, as we move towards a sedentary lifestyle, frailty and the disability zone, a condition now referred to as sarcopenia.

4 Sarcopenia Progressive generalized loss of skeletal muscle mass, strength, and function which occurs as a consequence of aging

5 Contributing factors Loss of muscle mass and fibers Increased inflammation Altered hormonal levels Poor nutritional status Altered renin angiotensin system

6 To date pharmacological intervention have been shown to be of limited efficacy in counteracting the effects of sarcopenia

7 Resistance training remains the most effective intervention for sarcopenia

8 Maintaining muscle function is vital to maintain functional independence. Muscle mass and force reach their peak between 20 to 40 years of age and there after show a steady decline with age

9 Sarcopenia Is a syndrome characterized by progressive generalized loss of skeletal muscle mass and strength. It is usually accompanied by physical inactivity, decreased mobility, slow gait, and poor physical endurance which are common features of frailty syndrome.

10 Loss of muscle mass is a strong predictor of mortality later in life It has been estimated that up to 15 percent of people older than 65 years and as many as 50 percent older than 80 years have sarcopenia. Sarcopenia health costs in 2000 estimated at 18.5 billion dollars.

11 Sarcopenia causes Multiple factors Reduction in muscle mass related to reduced muscle strength. Related to a loss of muscle fibers as well as muscle fiber atrophy with a preferentrial atrophy of type II fast twitch fibers Hormonal changes GH and IGF 1 decrease in older age

12 Chronic inflammation Renin angiotensin

13 Sarcopenia No standardized diagnostic criteria Muscle mass assessment DXA: dual energy X ray absorptiomietry Low muscle mass >2 SD below the mean and low gait speed

14 Interventions Exercise and physical activity Nutrition Hormonal Angiotensin converting enzyme inhibitors Creatine

15 Exercise Aerobic exercise Resistance type exercise

16 Aerobic exercise Larger muscle of the body move in a rhythmic manner for a prolonged period of time. Linked to improvements in cardiovascular fitness and endurance capacity. Can increase the cross sectional area of muscle fibers

17 Resistance training Muscles working hard against an applied force or weight Has a larger effect on augmenting muscle mass and strength and attenuates the development of sarcopenia Frontera, et al demonstrated increased muscle CSA by 11 % as well as improvement in muscle strength by 100% after 12 weeks of high intensity strength training

18 Progressive resistance training Corchrane review of 121 controlled randomized trials of PRT revealed that doing PRT 2 to 3 times per week improved physical function, gait speed, TUG, climbing stairs and had significant effect on muscle strength improvement. Best results with higher intensity strength training

19 Nutrition Consumption of adequate amounts of dietary protein RDA of protein is 0.8g/kg/day with almost 40 percent of people over the age of 70 not meeting the RDA

20 Resistance training 2 to 3 times per week 8 to 12 repetitions at a weight that by 8 reps is difficult to continue. 1 to 3 sets per exercise 6 to 8 exercises of your major muscle groups

21 CDC recommendations 2 hours and 30 minutes of moderate intensity aerobic activity every week Muscle strengthening activities on 2 or more days a week that work all major muscle groups Moderate intensity aerobic exercise: If 0 is sitting and 10 working hard 5 or 6 would be moderate level activity, 7 or 8 would be vigorous intensity activity

22 Questions?

23 Thank you!

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