Geriatric Strength Training. Chad Hensel, PT, DPT MHS, CSCS

Size: px

Start display at page:

Download "Geriatric Strength Training. Chad Hensel, PT, DPT MHS, CSCS"

Michael Johns
5 years ago
Views:

1 Geriatric Strength Training Chad Hensel, PT, DPT MHS, CSCS

2 Who are the geriatric? A minority group that we will all become members of Most commonly grouped as those age 65 and over Growth rate exceeds that of the general population; by 2040, 1 in 5 Current life expectancy is 83 years in US

3 Over 85 category is the fastest growing demographic according to the U.S. Census Bureau Chronological age may not necessarily correspond to psychological or physiological age Medicare B caps, exemptions

4 Run! The Baby Boomers are coming! Identifies the generation born between 1946 and the early 1960s Single largest generation in US history Will be eligible for traditional Medicare in 2011

5 Aging Theories There is no single accepted theory as to the cause of aging Hayflick theory Free radical theory Endocrine theory Combination?

6 Effects of Aging: Senses HOH Visual changes Loss of sense of smell Loss of taste

7 Exercise and Diabetes Special Considerations

8 Type I and Type II Type I Insulin dependent Onset: <30 Does not respond to diet alone Often not obese at Dx Type II Non-insulin dependent Onset: >30; rapidly rising in younger pop. Diet can affect disease early on Commonly obese at Dx

9 Benefits significant to DM Increased insulin sensitivity Improved glucose metabolism Increased thermic effect of food

10 Patient Recommendations Exercise with a partner support Keep a daily log Plan ahead for sessions Wear a diabetic ID bracelet Wear good shoes Practice good hygiene Monitor caloric intake/expenditures

11 Exercise and Arthritis Special Considerations

12 Type There are several varieties of arthritis More commonly seen in Therapy Osteoarthritis and Rheumatoid Arthritis While the two diseases are quite different, exercise goals are similar

13 Goals for the Arthritis Patient Preserve or restore range of motion around affected joints Increase muscle strength and endurance to enhance joint stability Increase aerobic conditioning

14 Muscle Strengthening Goal Utilize both isometric and isotonic resistance Isometric to be used during times of acute exacerbations ACSM recommends building up to 2-32 times a week of resistance training High rep, high resistance, and/or high impact are not advised

15 Aerobic Exercise Goal Should not be performed during acute flares Low impact i.e. i.e. swimming, water aerobics, walking, cycling, rowing Start with 10 to 15 minutes every other day Gradually increase to 30 to 45 minutes at moderate intensity

16 Complications Common complications to be aware of: OA: spinal stenosis, spondylosis RA: cervical spine subluxation, foot pain and instability, loss of hand grip strength

17 Considerations in Ther Ex Planning What type of arthritis does the patient have? What sx are experienced and what limitations does the patient have? What meds are used and what are their side effects? What specific joints are most painful? Ask yourself: can this patient participate in a regular exercise regiment?

18 Research Exercise has not been shown to increase the disease process Several ongoing studies are examining whether exercise, and specifically resistance training, can reverse the damage from the disease

19 Questions?

20 Physiology of Strength Training

21 Factors which affect gaining of strength and muscle mass 1. Genetics 1. Size of muscle fibers 2. Type of muscle fibers 3. Ability to train without muscle soreness 4. Anatomic lever arrangement of muscle to bone 1. Longer the lever, greater force potential

22 See attached Muscle Fibers

23 DOMS: Delayed Onset Muscle Soreness Confirmed: Eccentric greater than concentric Theories: Spasm hypothesis Tear theory microtears in individual muscle fibers Excess metabolite theory resistance leading to excess staying in muscle edema edema muscle muscle irritation nerve nerve ending irritation Connective tissue damage

24 Environmental Factors Nutritional status Adequate nutritional intake (total calories) Adequate protein intake Adequate fluid intake Nervous System Activation Increased CNS activation Improved synchronization of motor units Lowering of neural inhibitory reflexes

25 Physical Factors which influence strength levels Adaptations in the contractile mechanisms Muscle hypertrophy Muscle hyperplasia Thickens and strengthens connective tissue Increase in bone mineral content Improves structural integrity of tendons and ligaments

26 Performance Capacity Performance capacity is the end result of the blending of many physiologic, biochemical, neurologic, and biomechanical support systems and is NOT determined by any single factor.

27 Physiological Adaptations Cardiac hypertrophy Improved HDL levels Reduction of stress levels Improved physical appearance Enhanced energy levels Improved elation in personality

28 STRENGTH TRAINING: Concepts and Advanced Techniques

29 The Basics There are six components of the strength training program: 1. Training Time 2. Training Frequency 3. Training Volume 4. Training Intensity 5. Type of Exercise 6. Quality of Exercise speed, breaks, etc

30 Training Time Length of individual sessions Length of training time in a week Rest intervals are removed Ideal varies from minutes depending on intensity

31 Training Frequency # of training sessions per given week Athletes: 3-15/week3 Recreational Athletes: 2-6/week2 Elite: > 15 /week

32 Quality of Exercise Proper form Concentric phase, 2 count Eccentric phase 4 count

33 Sets: How many? Research shows that one set is sufficient to improve strength For motor learning and neurogenic effects, greater number of sets may be useful sets per muscle group/one time per week

34 Reps 3-66 : mass building; highest strength gains 6-12: some mass building, some endurance gains, neurogenic improvements Greater than 12 reps will work on endurance training and will not serve to enhance strength levels significantly

35 Rest Breaks Shorter= enhanced cardio effects; less than 1 minute Moderate= improved strength gains 1-1 8minutes After 8 minutes, a warm up set must be performed to prepare the muscle for activation again 48 hour minimum breaks between sessions

36 **Overload Supersetting Forced Reps Giant Sets Rest Pause Mid Range Pause

37 Overload New and progressively higher training demands enable the athlete to develop both physical and mental functions to increase performance capacity

38 Supersetting Combining two different exercises for the same muscle group into one continuous set. Most effective if the first exercise is linear followed by an angular exercise. Example: bench press, followed by butterfly machine

39 Forced Repetitions To have a training partner assist you lift the weight for a few extra repetitions once you have reached muscular fatigue.

40 Giant Sets Supersetting three different exercises into a single giant set. Example: Crunches supersetted with crossover crunches supersetted with reverse crunches.

41 Rest-Pause Training Designed to maximize load without heavy weights Benefits of hypertrophy as well as endurance training 3-55 mini-sets in each set, with pauses in between each mini- that hold EX: reps/rest 10/15, 8/15, 6-8/156 8/15 pause is held in an isometric contraction Rest at least two minutes after each long set

42 M id Range Pause Going with the principle of the rest-pause training Client pauses in different points through the range to maximize muscle tension in an isometric manner Benefits: Increased muscle metabolism and increased stimulus for muscle growth Costs: Increased muscle fatigue

43 Chair Dips

44 Chair Dips

45 Shoulder Raise

46 Shoulder Raise

47 Side Raise

48 Side Raise

49 Seated Row/ Overhead Tricep Press

50 Alt DB Curls

51 DB Trunk Rotation

52 BOSU Balance Balance Throw

53 BOSU-- High Throw

54 Swiss Ball Circles

55 Swiss Ball Marching

56 Pullovers

57 Bolster Marching

58 Incline Bench T

59 Shrugs

60 Abduction with ER

61 Forearm Curls

62 Hamstring Curls/ Hip Abd

63 Side Bends

64 Seated March/ Heel Raises

Performance Enhancement. Strength Training

Performance Enhancement. Strength Training Performance Enhancement Strength Training Muscle Fiber type & Performance Slow twitch More efficient using oxygen to generate fuel for continuous extended muscle contractions Contract slowly, but continue