New York Physical Therapy Ebook Continuing Education

The musculoskeletal system goes through many changes with age. The structure and function of many elements of the system change, although late life exercise can make musculoskeletal system symptoms less severe, serious, and/or painful. All body Summary of body system changes with aging With aging, numerous changes take place throughout the body’s system, and a summary of the changes resulting from aging and inactivity can be found in Table 4. It is clear that activity and exercise slow or even mitigate many age-related changes,

tissues, including those of the musculoskeletal system, undergo DNA methylation alterations across the life span, which have been shown to reverse after resistance and endurance exercise participation for a period of time (Murach et al., 2022). resulting in a delayed onset of frailty and mobility limitations in older adults. The benefits of both aerobic and resistive exercise are numerous and will be explored in greater detail in the following sections.

Table 4: A Summary of Changes in the Major Body Systems with Aging and Inactivity Body System Changes Cardiovascular • Decreased number of cardiomyocytes.

• Decreased ability to alter heart rate. • Increased thickness of arterial walls. • Increased stiffness of arterial walls. • Increased systolic blood pressure. • Decreased diastolic blood pressure. • Decreased maximal cardiac output. • Decreased VO 2max. • Decreased ability of lungs to expand. • Increased kyphotic posture. • Decreased chest wall compliance. • Decreased strength of diaphragm. • Decreased efficiency of breathing. • Decreased sex hormones. • Decreased growth hormone. • Increased systemic inflammation. • Increased insulin resistance. • Decreased muscle strength and power. • Decreased muscle quality. • Increased intramuscular fat. • Decreased bone mass.

• Increased size of cardiomyocytes. • Increased thickness of left ventricle. • Increased connective tissue in extracellular space. • Increased fatty infiltration. • Separation of sinoatrial node from heart tissue. • Decreased number of pacemaker cells. • Decreased maximal heart rate. • Decreased elastic tissue in lungs. • Decreased elastic recoil of lungs. • Premature closing of small airways. • Decreased ability to empty air from lungs. • Increased stiffness of intercostal muscles. • Calcification of costal cartilages.

Respiratory

Endocrine

• Changes in body fat distribution. • Increased visceral fat. • Increased intramuscular fat. • Decreased subcutaneous fat. • Decreased muscle mass. • Increased tendon stiffness. • Decreased synovial fluid. • Decreased satellite cells. • Decreased alpha motor neurons. • Buildup of endocrine waste. • Weight gain. • Inflammation.

Musculoskeletal

Interstitial

• Autoimmune issues. • Edema. • Skin breakdown.

Note : From Papp et al. (2021).

EXERCISE AS AN INTERVENTION

mental health (symptoms of anxiety and depression), disease progression (CD4 count and viral load). ● Improvement in cardiovascular and respiratory functio n: Improved oxygen metabolism, decreased heart rate and blood pressure, increased exercise thresholds. ● Reduction in cardiovascular disease risk factors : Reduced HR and BP, reduced total body fat and intraabdominal fat, reduced insulin needs, reduced blood-platelet adhesiveness and aggregation, reduced inflammation. ● Decreased morbidity and mortality : Primary prevention, secondary prevention, higher activity and fitness levels associated with lower incidence of osteoporotic fractures, cancer of the bladder/breast/colon/endometrium/lung, and gallbladder disease, all same reductions to mortality as cancer. ● Other benefits : Decreased anxiety and depression, improved cognitive function, enhanced physical function, enhanced independent living, enhanced feeling of well- being, enhanced QOL, enhanced HRQOL, improved sleep, enhanced at work/sport activities/recreational activities, reduced risk of falls and injuries, prevention or mitigation of functional limitation, effective therapy for many chronic conditions.

Bedrest was once a common prescription for recovery from illness. Today it is widely acknowledged that bedrest is more harmful than helpful for most illnesses and chronic conditions. It is now understood that physical activity is crucial, even in frail older adults (Frontera, 2017). Bedrest leads to increased loss of muscle mass and a rapid decline in physical function, including a loss of muscle strength and power as well as mobility in older adults (Frontera, 2017; Reidy et al., 2017). There is a breadth of evidence showing associations between physical activity and health outcomes for adults and older adults (Liguori & American College of Sports Medicine, 2020; WHO, 2020): ● Cancer survivors : All-cause mortality, cancer-specific mortality, risk of cancer recurrence, physical function, health- related quality of life (HRQOL). ● Hypertension : Cardiovascular disease mortality, risk of comorbid conditions, physical function, HRQOL, disease progression (measured through blood pressure response to physical activity). ● Type 2 diabetes : Cardiovascular disease mortality, risk of comorbid conditions, physical function, HRQOL, and disease progression People living with HIV: Cardiovascular disease mortality, risk of comorbid conditions, physical function (physical fitness, exercise tolerance, strength), HRQOL,

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Book Code: PTNY1024

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