In preparation my blog posts, I always do research, specific scientific studies, on the subject and then link to the studies I use. When I searched for studies on strength training intensity and seniors, the information was overwhelming. There have been so many studies on strength training and aging. Basically…..its good. What I found supported that a progressive strength training program helped increase muscle mass, and maintain quality of life as we age. I also found that most seniors are not getting the recommend amount of strength training. (2 days a week according to the ACSM)
One of my biggest pet peeves when I was practicing physical therapy was when I would get a patient that told me the only thing they did in rehab was sit in a chair doing upper body exercises, and march and kick their legs along with a walk to and from the therapy room. I really hope with all my heart my fellow therapy professionals were doing more than that, and my patients memories were cloudy.
In 2014 the APTA and ABIM launched their Choose Wisely campaign, of which they advocate “Don’t prescribe under-dosed strength training programs for older adults. Instead, match the frequency, intensity and duration of exercise to the individual’s abilities and goals.” And since have been advocating strength training for seniors to their abilities and not below. Working in the field of Home Health I can say that this recommendation has been slow to trickle down.
Seeing this in the physical therapy field brings me to the fitness field. Now granted I have seen some videos of some fantastic strength training programs for active seniors. I’ve seen seniors in cross fit, body building and gyms. This….is fantastic. But…I believe the fitness industry will be tasked with serving a population of frail and deconditioned seniors not just active seniors. As insurance benefits decline, and medical cost increase, people are going to look to fitness professionals to guide them with an exercise program after their insurance reimbursed physical therapy has ended. The active baby boomer market is already a growing demographic for fitness professionals. Baby boomers are more likely to advocate for their health and to spend money to maintain it. But guess what? These people have parents and they are more likely to advocate for them as well. Many of my clients are over 80 and their training programs have been facilitated by their children.
So what does this mean for the fitness professional? I think most fitness professional are comfortable with exercise prescription for active agers but what about your not so active agers? This is my advice to you:
- Get a medical release, even if they pass the PAR-Q. Also contact their physical therapist if they have recently been discharged. They have already done a thorough assessment and can give you insight into the clients needs and any contraindications before you even start. (this can also lead to a great relationship where the therapist may send you future clients)
- Do a thorough fitness assessment. Be sure to use testing appropriate for your client. Don’t do a 1RM on a 85 yo with rheumatoid arthritis. You could use 30 sec chair rise test or the 30 sec arm curl test. And be sure to look at balance as well. Look into a senior fitness specialist certification to expand your knowledge.
- Progress your strength training program. For your frail individuals this may take longer. Progress the clients weights and repetitions just like any other clients. I think this is especially important for group fitness instructors working at senior centers. Its easy to fall into a rut. Its easy for your clients to fall into a rut or to be fearful of increasing the resistance band or hand weights. It falls on the instructor to educate, encourage, and guide the participants to increase their resistance when what they are doing has become too easy. (remember back to a progressive strength training program is beneficial)
- GET OUT OF THE CHAIR!!!! For Gods sake get your client out of the chair! (as they are able of course) Upper body exercises can be done in standing to promote balance and improved endurance. I don’t know about you but most of my clients are excellent sitters, its in standing they have the issues. Of course this varies by client. I have some clients with spinal stenosis that we have to alternate standing and sitting exercises to prevent onset of back pain but I still get them ON THEIR FEET!
Strength training should be a vital component of everyone’s fitness program but it can be argued that its even more important as we grow older. Strength training prevents the natural loss of muscle mass that happens with age starting in our 30s. Improved muscle mass can translate to better balance, and better overall function. Historically we have treated seniors carefully, using only light weights and resistance and doing the same simple exercises over and over again. But a growing body of research supports that progressive strength training programs tailored to the individuals capability (don’t give the entire class 2 pound weights, some may need heavier) is our best path to improve function as we age.
And for God’s sake, GET THEM OUT OF THE CHAIR!
Katrina Wolf is and ACSM certified personal trainer and ACE certified senior fitness specialist. She brings her 20+ years as a physical therapy assistant working with seniors and frail elderly to the fitness profession. Her passion is to improve seniors quality of life through exercise and education. She also strives to educate other fitness professionals regarding seniors and exercise. Her special interest include Stoke survivors and those living with Parkinson’s Disease and other neurological disorders.
Click here to get more information about working with Katrina