ACSM Health & Fitness Summit - Idea

IDEA Personal Trainer Institute
March 2, 2013
Practical Exercises for Sedentary Seniors (Session #346)
Mary Yoke, M.A., M.M.
(mmyoke@indiana.edu)
This workshop provides practical information geared to help you make a difference in the lives of
deconditioned Seniors. As our population ages, fitness professionals continue to need practical
knowledge of specific exercises and techniques, especially for very deconditioned older
participants and those with arthritis and/or osteoporosis. In this session, you’ll learn and practice
a multitude of chair and balance exercises appropriate for frail and sedentary elderly clients.
At the end of this session, participants will be able to:
create a variety of Level One exercises for seniors
identify characteristics of aging that affect exercise programming
understand issues important for people exercising with arthritis and/or
osteoporosis
I. Characteristics of Aging That Affect Exercise Programming
Decreased maximal heart rate
Decreased VO2 max
Increased blood pressure
Increased use of medications
Slower reaction time
Progressive loss of bone mass (osteoporosis)
Increased % body fat (creeping obesity)
Loss of muscle strength due to sarcopenia
Declining flexibility
Increased tendency toward dehydration
Increased susceptibility to soreness and injury
II. Benefits of Exercise for Seniors
Increased strength with mild to moderate hypertrophy (Fiatarone et al, 1994)
Increased bone density
Improvements in joint range of motion
Improved balance
Increased lean body mass and decreased % body fat
Improved glucose tolerance
Improved cholesterol status
Decreased stress
Decreased risk of dementia (Abbott et al, 2004)
Enhanced sense of well-being
Improved ability to carry out activities of daily living
III. ACSM Guidelines for Older Adults (2010)
A. Cardiorespiratory Fitness
Walking is an excellent choice for many seniors; water exercise and stationary cycling
are good for those who must limit weight-bearing exercise.
Any modality that does not impose excessive orthopedic stress.

The activity should be accessible, convenient, and enjoyable.
Intensity levels should start low (possibly as low as 40% of HRR).
Avoid using age-predicted heart rates (e.g. 220 – age) due to HR variability in older
adults and increased risk of CHD. Instead, use rate of perceived exertion (RPE).
Shorter bouts of exercise (e.g., 10 minutes) may be preferable.
B. Resistance Training
Carefully supervise the first several sessions.
Begin with minimal resistance.
Perform one set of 8-10 exercises that involves all major muscle groups.
Perform 10-15 repetitions at an RPE rating of 12-13 (somewhat hard).
Perform all exercises within a pain-free range of motion.
Machines are preferable to free weights for most older adults.
C. Flexibility Training
Provide a well-rounded program of stretching and maintain range of motion of all joints.
Consider devoting an entire session to flexibility for beginner older adult exercisers.
D. Balance Training
2-3 days per week
Use progressively difficult postures that gradually reduce the base of support
Use dynamic movements that perturb the enter of gravity
Train postural muscle groups (e.g. lower leg muscles)
Reduce sensory input
IV. Osteoarthritis (Degenerative Joint Disease)
Approximately 27 million adults have osteoarthritis, with the knee and the joints
of the hand being the most common sites. It is caused by a wearing away of the
articular cartilage, leading to bone-on-bone abrasion—resulting in joint pain and
stiffness. Typically, there are cycles of more and less pain. Exercise and physical
activity have been shown to be very effective in managing osteoarthritis pain.
Strategies for exercising with osteoarthritis include:
Start with short bouts of low-intensity, low or non-impact exercise.
Avoid higher levels of exercise on day when arthritis pain is severe.
Stretch daily, if possible, always staying within a pain-free range of motion. If possible,
gently move every joint every day.
Perform strengthening exercises twice a week for unaffected joints.
Strengthen affected joints on days when relatively pain-free.
Isometric exercise may be preferable.
Water exercise can be very beneficial.
Be gentle with any joint that is hot or swollen.
Stop any exercise that causes pain.
V. Osteoporosis
Osteoporosis is a condition of abnormally reduced bone density, leading to
fragile, porous bones and the increased risk of bone fractures.
Exercise recommendations include:
Avoid all spinal flexion, especially cervical spinal flexion; perform as many exercises as
possible in an upright position.
Spinal extension may be beneficial in reducing the risk of vertebral fractures (Sinaki et al,
1996).
If the client is pain-free, it is appropriate to recommend aerobic weight-bearing activity
4x/week, resistance training 2-3x/week, and flexibility training 5-7x/week.
Perform resistance training with the load directed over the long axis of the bone.
Include balance training and functional exercises related to activities of daily living.

Avoid high-impact activities and any activities with an increased risk of falling, such as
crossover stepping, step aerobics, skating, and trampolines.
VI. Motivational Techniques for the Elderly
Be aware of hearing difficulties: face participants, speak clearly with appropriate volume,
control background noise.
Avoid patronizing language.
Regularly bring in new facts about the benefits of exercise and physical activity.
Play music they enjoy. Ask for their favorites.
Create an atmosphere of fun.
Include introductions
Encourage participants to come early and stay late for social interaction with each other.
Show a genuine and sincere interest in each participant.
VII. Exercise Recommendations for Sedentary Seniors
Avoid doing too much, too soon.
Focus on safety.
Do exercises standing whenever possible.
Use varying movement patterns and functional exercises.
Level 1 2 3 4 5 6 7,etc.
Very safe
High risk, controversial
Appropriate for almost everyone
Appropriate only for the very fit
Stable and supported
Unstable, high balance and core stability challenge
Single joint, muscle isolation
Multi-joint, multi-muscle, multi-planar
VIII. Chair Exercise
Challenge yourself to come up with a variety of Level One exercises. Level One
exercises are very safe, require little skill, and are appropriate for almost everyone.
They are generally performed with the body in a very stable position. Consider
exercises from the weightroom, Pilates, yoga, etc. Equipment might include dumbbells,
barbell, elastic tubing or bands, small balls, medicine balls, Osteoballs, Pilates circle,
etc.
Warm-up
Cardiorespiratory Training
Muscle Conditioning Exercises
Balance Exercises
Flexibility Exercises
Special category: Feel-good Exercises!
IX. Feel-Good Exercise Examples (Chair)
Sun breaths
Shoulder (scapular) rolls performed backwards
Posterior/anterior pelvic tilts, lateral pelvic tilts, pelvic circling
Windshield wipers, progress into spinal twist, add shoulder circumduction
Baby cobra (hands or elbows on seat back of chair in front)
Ankle circles, figure 8’s, dorsiflexion/plantarflexion
X. Hand and Wrist Exercises
Play pretend piano
Wrist circles, wrist figure 8’s

Make fists, open wide
Extend and flex fingers (flexing only the last two joints of each finger); attempt to touch
fingertips to palm of hand
OK signs with each finger, stretching other fingers into extension with opposite hand
Finger lifts with palm down on thigh or table
Thumb touches to base of each finger
Thumb circles and figure 8’s
References and Resources:
Abbott, R.D., White, L.R., Ross, G.W., Masaki, K.H., Curb, J.D., & Petrovich, H. (2004). Walking
and dementia in physically capable elderly men. Journal of the American Medical Association, 292,
1447-1453.
Aerobics and Fitness Association of America (2009). Longevity Training for Seniors Workshop
Outline. Sherman Oaks, CA: AFAA.
American College of Sports Medicine (2010). ACSM’s guidelines for exercise testing and
prescription (8 th ed.). Baltimore: Lippincott Williams & Wilkins.
American Council on Exercise (2005). Exercise for Older Adults, 2 nd ed. Champaign, IL: Human
Kinetics Publishers.
American Senior Fitness Association. www.seniorfitness.net
Annesi, J.J. & Zimmerman, W. (2001). Group training for increased adherence to regular physical
activity. In J. Clark (Ed), Contemporary readings in senior personal training (pp. 59-61). New
Smyrna Beach, FL: American Senior Fitness Association.
BioMed Central Limited (2010). Walking linked to eased osteoarthritis. Medical News Today.
Retrieved from http://www.medicalnewstoday.com/releases/179233.php.
Best-Martini, E., Botenhagen-DiGenova, K.A. (2003). Exercise for Frail Elders. Champaign, IL:
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Center for Disease Control, (2012), www.cdc.gov/aging, retrieved, 8/16/2012.
Chodzko-Zajko et al (2009). Exercise and physical activity for older adults. Medicine & Science in
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Fiatarone, M.A., O’Neill, E.F., Ryan, N.D., Clements, K.M., Solares, G.R., Nelson, M.E., et al.
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International Council on Active Aging. www.icaa.cc
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Human Kinetics.
Metcalfe, L., Lohman, T., Going, S., Houtkooper, L., et al. (2001). Prevention of Osteoporosis: the
Bone, Estrogen, Strength Training (BEST) Study. ACSM’s Health & Fitness Journal, 5:3, 6-14.
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Rose, D.J. (2003). Fall Proof! A Comprehensive Balance and Mobility Training Program.
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