Cody Sipe by Cody Sipe
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More than 90 million adults in the U.S. (28% of the population) are over the age of 55 and, unlike many stereotypes would have you believe, they are a diverse population. When it comes to why they exercise, however, many do so for the same reasons. According to a recent study, two of the top three concerns for this population are losing their functional abilities and cognitive abilities. These are two important, front-of-mind issues that motivate older adults to begin an exercise program and start working with a trainer. Therefore, it is critical that your exercise programming focuses on improving these two areas.

Fortunately, many of the same exercise strategies and techniques that improve physical function are cognitively stimulating as well. Here are some effective training strategies for helping your clients improve both physical and cognitive functioning.

Evolve Your Strength Training

Many trainers believe that the way to improve function in older adults is by improving muscle mass and strength. While it is true that muscle strength is an important component of function, it is not the only factor. How strong does an older adult need to be? Strong enough. That may seem like a glib answer, but an older adult’s functional ability is dependent on numerous factors including speed, power, motor control, coordination, balance, mobility, agility and cardiorespiratory endurance. There seems to be a critical threshold effect for muscle strength when it comes to function, which means that a person needs enough strength to perform his or her functional activities, but further improvements won’t really improve function further. To maximize functional improvements, you need to get out of the traditional “three sets of 10 reps for all major muscle groups” method and start approaching function in a more comprehensive manner by addressing the other factors listed above.

One key way to evolve your strength-training approach is to focus more on muscle power (moving a load quickly). Power is more closely related to physical function than muscle strength for older adults, and power training (according to several systematic reviews) improves function to a greater degree. Several studies suggest that low-load, high-velocity training is the most beneficial for improving balance, while also making the client feel as if the workout is easier (according to perceived exertion ratings). With your clients, start using more explosive movements with lighter loads and focus on getting them to move quickly. Exercises to try include explosive chair stands, jumps, medicine-ball throws or the “8’ Up and Go” test.

A second approach is to focus more on complexity as a progression variable rather than load. This requires a person to move in novel ways, which is not only good for improving physical abilities, but has also been shown to stimulate the brain by creating new neural pathways. Lunges are a great example: Rather than increasing a client’s load while doing front lunges, have the client imagine standing in the middle of a clock face and lunge at all different times on the dial. Calling out the times in quick succession requires the client to react (stimulating cognition) and move quickly, thus generating power. Chair drills that require a client to navigate an arrangement of chairs quickly while having to sit down and stand back up in each one also utilizes power and increases complexity. There are additional ways to increase complexity in your strength training, including doing a back lunge while performing a one-arm cable row or performing a series of movements that flow together (sort of like learning a new dance move).

Balance

Balance becomes an increasingly important factor with advancing age, and can decline rapidly in some individuals, which puts them at risk of injurious falls (especially after the age of 70). Therefore, balance training must be considered as an essential piece of your clients’ routines, even if it is just as a preventive measure. However, balance is a complicated concept and is dependent on a variety of systems working together in a dynamic fashion, including the sensory (somatosensory/proprioceptive, visual, vestibular) systems and motor systems (center of gravity control, postural strategies, gait, etc.).

Again, older clients vary widely on the areas in which they struggle; therefore, what is effective for one person will be ineffective for another. Intensity is an important factor to consider because each client’s balance ability must be challenged if it is to improve. For example, if standing on one leg is relatively easy for a client, that is not an appropriate challenge for him or her. In addition, balance training is about more than having a client stand on an unstable surface; in fact, this approach should be included but kept to a minimum. When integrating balance training into a client’s program, consider manipulating these three primary progression variables before moving on to others:

  • Static to dynamic
  • Planned to reactive
  • Wide to narrow base of support

Last Word

The six functional domains include neuromuscular, musculoskeletal, balance, mobility, cardiorespiratory and cognition. While each of these domains is important for every older client to function well, they need to be applied individually to achieve optimal results.

References

Byrne C, Faure C, Keene DJ and Lamb SE.  Ageing, Muscle Power and Physical Function:  A systematic review and implications for pragmatic training interventions.  Sports Med (2016) 46:1311-1332.

Rice J and Keogh JWL.  Power Training: Can it improve functional performance in older adults? A systematic review.  International Journal of Sport Science (2009) Vol 2, Issue 2.

With over 80 million adults over the age of 55, it’s critical that you have the knowledge and skills to safely and effectively develop training programs for active agers. Find out more about ACE approved courses by the Functional Aging Institute.

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