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Published byDuane Bridges Modified over 9 years ago
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Exercise and the Elderly
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Physiological Changes With Aging Aging or decrease in activity? Quality years
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Changes in maximal oxygen consumption Muscle mass – sarcopenia –Muscular Strength and Endurance Fat deposition and body composition Bone mineral density –Osteopenia –Osteoporosis Diagnosed using T-Score cmoparing to normal young adults
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World Health Organization Criteria for Classifying BMD Classification T-Score Normal BMD-1.0 or greater Osteopenia-1.01 to -2.49 Osteoporosis-2.5 or less Severe Osteoporosis-2.5 or less + fragility fracture
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Osteoporosis Bone turnover –PTH and vitamin D3 hormone Peak BMD –Trochanter and femoral neck in mid to late teens –Spine in mid 20s Determinants of peak BMD –70-80% genetics –20-30% lifestyle
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Bone loss –Age related 0.5 – 1%/year –Menopause 1-2%/year for a 5-10 year period –Loss of BMD will continue to pre-adolescent levels
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Fragility fracture –Women - Forearm ↑ at age 45-50 leveling off at 65 Men – no ↑ –Women - Vertebral ↑ age 55-60 rising linearly with age Men – ↑ 60-70 yrs –Women – Hip ↑ at age 65 and rises exponentially thereafter Men – ↑ 70-75 yrs
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Distal forearm fractures –Excellent marker for future risk –Wedge fracture at L2 →
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Exercise Testing Functional tests Potential effects of osteoarthritis Impact of muscular endurance
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Training the Elderly Still adapt normally to exercise –↑ fitness levels associated with reduced mortality and ↑ life expectancy Differences between training frail versus healthy elderly –Functional capacity and balance –Simple functional tests
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Training the Elderly Flexibility training Resistance Training –Important to ADLs and RMR –Careful evaluation of HTN elderly –Arthritics train through pain-free ROM –Reps 2-3s concentric, 4-6s eccentric, 8-12 reps to failure, 2d/wk, progress every 2-3 wks Breathing
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Reducing risks Calcium intake –Vitamin D ExercisePosture
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