Exercise Prescription and Rehabilitation Considerations for Older Adults: Summary 74
Complications/Consequences of Physical Inactivity Risk factor for the development of chronic conditions in older adults: • Heart disease, HTN, Congestive heart disease • Cancer: breast, colon, prostate, pancreatic • Depression, Cognitive disease • Type 2 diabetes • Obesity
• Osteoporosis, Osteoarthritis • Peripheral vascular disease • Physical frailty • Sleep apnea • Stroke • Balance problems and falls Mobility Disability
Physical Stress Theory Physical stress theory explains how tissues, organs, and body systems respond to mechanical and physiological stressors and how both overload and inadequate load impact tissues, organs and body systems. • Overload = more than usual stress • If too much stress is applied, then there is risk of injury to the tissues • If too little stress is applied, then the tissue loses its ability to absorb and dissipate stressors and atrophy can occur
Impairments and functional deficits that combine to interfere with individual’s normal ability to walk and move around in the community. This often occurs because of a temporary sedentary situation (such as a hospitalization). This has also been identified as the inability to climb a flight of stairs or to walk ¼ mile. Physical activity can provide protection against this. AGE RELATED STRENGTH LOSS WITHOUT PHYSICAL ACTIVITY = MOBILITY DISABILTY Muscle strength declines with age. This is a large contributing factor to mobility disability. Strength decreases on average 10% per decade starting after 30 years of age and increases to 15% per decade after age 60. Without physical activity in older adulthood OR if individuals did not build up a reserve in younger years through a lifestyle of physical activity, then this loss in strength can lead to mobility disability. The loss of power through older adulthood (often up to 20-30% per decade) also plays a role in mobility disability. This is all further impacted by the decline in other systems of the body that occurs with aging: cardiac, respiratory, hepatic, renal, cognitive and sensory. Aging • Fun = ability to do what one wants or desires • Function = must make choices about activities based on some decreased physical capacity: ○ These individuals are at risk for mobility disability • Frail = require help with ADLs • Failure = completely dependent or bedbound Aging does not mean that an individual will automatically decline into frailty. Many older adults can stay at the fun level. Physical activity is key to this. Physical activity can help to increase physical reserves so that individuals can maintain or return to a higher level of function.
TOO MUCH STRESS Appropriate overload
>100% OF MAXIMUM 60-100% of maximum 40-60% of maximum
INJURY OF TISSUE DEATH
Strengthening
Usual stress
No change in tissue
Too little stress <40% of maximum
Atrophy
No stress
0% of maximum
Loss of ability to adapt (death)
Too little stress can have a negative impact on all systems of the body. If the cardiopulmonary system is not receiving stressors, then deconditioning can occur and the risk for some diseases will increase. If the musculoskeletal system is not receiving stressors, then osteoporosis can occur. If too little resistance, too short of walking distances, too slow of a walking pace are used then no changes can occur.
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