?Considerations when working with older/senior clients?

[Chris Correia]

I know I can search around to find stuff, but I'm looking for hot leads to sites, speople, resources, on exercise/movement considerations for seniors.

I'm considering starting a daytime martial arts class for seniors, at least post-55, but even post 60 or 65.

I'm wondering what concessions to make, what types of movements or activities are red flags in general, as well as what and how to adapt for common physical considerations/limitations.

There are technique adaptations which will be necessary, but I am also thinking about general exercise adaptations/considerations.

Your input and direction is appreciated!

EDIT/addition:

My current class format is along the general lines of some general warmup, conditioning and flexibility work (generally 15-20 minutes) followed by technique practice, curriculum, drill, etc for 45 minutes or so.

[drs]

http://www.aafp.org/afp/20020201/419.html

Chris,

I'm not in your business, but please see the link above and I'll start out the responses with a few thoughts.

Muscle mass has been found to be an indirect correlation to nursing home placement. You lose muscle mass and you can't transfer from bed to chair to bathroom and can't rehabilitate after your hip fracture. Therefore, every senior needs to understand the importance of strength training.

Tinneti has worked most of her professional career on fall prevention in the elderly. My impression is that balance exercises are key.

In "Cortlandt Forum" April 2006, page 46, Marian Limacher MD (professor of medicine in the division of cardiovascular medicine at the University of Florida, Gainesville) responded as follows:

Q: Should exercise recommendations change as patients age?

Dr. Limacher: My colleagues and I have helped healthy sedentary older folks--some well into their 80s--by starting them slowly and having them progress steadily, trying to maintain the same heart rate rather than having it rise. If these people exercise much more intensely in an attempt to reach their target heart-rate levels, injuries go up. Being aware of this risk is important, and exercise programs can be changed to accommodate it. Walking is better than running, and switching to a bicycle or to swimming will reduce the rates of injury, including muscle strains, sprains, and stress fractures. People who fail to maintain their training fall back; they lose it if they don't use it. Older, master's-level athletes who do upper-body weight training lose less muscle mass than track athletes who only run.



Best of Luck

[LisaS]

I think you have to be willing to work with the group that you get - if you get all Mahler's, you can drive one way, if you get a class of my BIL (healthy, out of shape) - another way, a class of women as my mom was when she retired - very different again.

[UConnJulie]

I have spent a good part of my career working with older adults ... I agree with LisaS that some will be dynamos and some will have you thinking creatively to get them moving. I have found that posture is a big issue for many older adults, especially if they have been largely inactive ... so incorporating things like stick ups, thoracic extensions etc into the warm up might be helpful. Drs gave you a good resource with Mary Tinetti ... she works at Yale and has come to my work to collaborate on a special project (The Connecticut Collaboration for Fall Prevention). Her big thing is a lot of balance exercises which are nothing special or tricky ... just a lot of single leg exercise progressions. The key is that you keep the client safe and start with what they are ABLE to do ... build confidence, then slowly progress to more difficult. For example, if the client cannot do a single leg balance, then you have them do it holding on with one hand (if able), then progress to 3 fingers, then 2, then 1, then none.

Things you will want to know in advance is if they have any orthopedic restrictions from joint replacement surgery (if they have restrictions, they should know them and be able to tell you). Also any medical restrictions ... cardiac, etc would be important to know.

I think that the key is finding the level at which they can perform, and progress slowly from there, allowing them success, while still providing a challenge. But that is really true of working with any age, right?

[karky]

Originally Posted by LisaS

I think you have to be willing to work with the group that you get - if you get all Mahler's, you can drive one way, if you get a class of my BIL (healthy, out of shape) - another way, a class of women as my mom was when she retired - very different again.

A Martial arts class full of Mahlers...

[Chris Correia]

Originally Posted by UConnJulie

I think that the key is finding the level at which they can perform, and progress slowly from there, allowing them success, while still providing a challenge. But that is really true of working with any age, right?

Yep!

Thanks for the input and insights. All helpful as I piece this together.

BTW, this story was the original impetus to move this along further.

And this story (different version)

And one other

There used to be a video. I might have saved it, but I'll have to search. Really neat.

EDIT:

Here's a clip from the video feature story, just to whet the appetite. The full story has disappeared, unfortunately.