Welcome back yet again to a series of articles here at ThreeSpires Physiotherapy that I am writing about the effects of exercise and the benefits it has as you age and why you should continue exercising no matter how old you are. I know it has been a very long time since I last wrote a blog but as I explained in the last blog this has been due to the birth of our son Harry and all that entails. Anyway I have finally managed to scrape together enough time to try and finish off this series about exercise and aging. The last post looked at how much exercise you should do and how often and found that the guidelines and research recommend doing 2.5 hrs of moderate intensity exercise per week – totaling approximately 1000Kcals (Garber et al 2011) which can be broken down into 5 x 1/2hr sessions for ease if you wish. It is also possible to gain the same benefits by doing 3 sessions of vigorous exercise that total 75 minutes per week.

So the next question to answer is what type of exercise should I do and at what intensity. Unfortunately despite the research being reasonably clear about the overall amount of exercise you need to do, the research on what type of exercise and how intense an older person should do is much less clear and open to interpretation. Therefore the following suggestions are simply my own interpretation of what the latest research suggests and it is perfectly possible that someone else may interpret the research slighly differently.

 Okay, let's now consider what type of exercises there are out there to choose from, well there are two main types of exercise to choose from. Firstly there is aerobic exercise: this is basically exercise designed to increase the heart rate such as cycling or running and will usually (but not always) take quite a bit of time. Next there is resistance training: which involves performing movements or lifting things at usually a fairly high intensity, an example of this is lifting weights.

 So let's look in a bit more detail at aerobic exercise: I think it is fair to say that all the research out there would agree that any exercise regime for an elderly person should include some form of aerobic exercise. The debate lies around the intensity that the aerobic exercise should be done at, traditionally most exercise regimes for elderly people have focused upon low intensity aerobic exercise as it was thought that this was the safest way for elderly people to exercise. Now for some people with serious heart problems this is still the case and it must be emphasised that if you have any concerns or underlying conditions you should always seek the advice of a medical professional before embarking upon a new exercise regime. With that caveat there is a lot of relatively recent research that suggests that high intensity aerobic exercise is very beneficial for people of all ages (Di Pietro et al 2006, Wisloff et al 2007) and can improve fitness faster than conventional low intensity aerobic exercise.

 Next, we need to look at resistance training and what kind of intensity you should be doing there. For a long time it has been the accepted wisdom that resistance training for older people was either unwise or should be only done at a fairly low intensity , however multiple studies over the years have shown that high intensity resistance training is both beneficial and also safe (Dunstan et al 2002; Hunter et al 2000;Pu et al 2001). Obviously the usual caveats described above apply - if you are thinking about embarking upon a new exercise program it is always wise to seek the advice of a medical professional first. So with that in mind what does high intensity resistance training involve? Well the studies above put their relatively elderly participants through a series of lifting and strengthening exercises at anywhere between 80 to 90% of their 1 repetition maximum (1RM). To those who exercise already that phrase is self explanatory but for those new to exercise it means that they lifted a weight or performed an exercise that was 80 - 90 % of the maximum that they could do once. This is clearly a high intensity indeed for anyone of any age. Interestingly though the participants in the studies gained muscle mass and strength almost as well as younger people would, so it just goes to show that no matter your age, exercise is beneficial.

 Finally, if you have read this series of blogs and are now thinking: "well great I now have a lot of theoretical knowledge but what can I do now?", I would advise that you need to think about getting in touch with an exercise professional who can help structure a personalised training and exercise program for you. This way the exercise professional can look at your medical background age, perosnal goals and current fitness levels and help you come up with an exercise program that meets your needs.

 Here at ThreeSpiresPhysiotherapy we have a wealth of experience in designing structured training programs for older clients of all abilities, ranging from clients who have an extensive fitness background and just want a slight tweak or change to their current regimes to those who have experienced a long stay in hospital and are on the long road to recovery. For all these clients we look at their past medical history, prior injuries, current fitness state and  conduct an extensive physical and biomechanical assessment. The results of which are then combined with their personal goals to create a safe, effective and personalised training program which can be monitored and changed easily with sessions at regular intervals to re-assess fitness levels. 

If you would like to further information, to book a session or simply to have a chat then then give us a call on 07884 281623, email us at  enquiries@threespiresphysiotherapy.co.uk  or use the contact form.  

References:

Di Pietro L., Dziura J., Yeckel C., Neufer P. (2006) Exercise and improved insulin sensitivity in older women: evidence of the enduring benefits of higher intensity training. Journal of Applied Physiology 100 (1):142 – 149

Dunstan D., Daly R., Owen N., Jolley D., De Courten M., Shaw J., Zimmett P. (2002) High-Intensity Resistance Training Improves Glycemic Control in Older Patients With Type 2 Diabetes Diabetes Care 25 (10): 1729 – 1736

Garber C., Blissmer B., Deschenes M., Franklin B., Lamonte M., Lee I., Nieman D., Swain D., American College of Sports Medicine (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise 43 (7):1334 – 1359

Hunter G., Wetzstein C., Fields D., Brown A., Bamman M. (2000) Resistance training increases total energy expenditure and free-living physical activity in older adults Journal of Applied Physiology 89: 977 – 984

Pu C., Johnson M., Forman D., Hausdorff J., Roubenoff R., Foldvari M., Fielding R., Singh M. (2001) Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure Journal of Applied Physiology 90: 2341 – 2350

Wisloff U., Stoylen A., Loennechen J., Bruvold M., Rognmo O., Haram M., Tjonna A., Helgerud J., Slordahl S., Lee S., Videm V., Bye A., Smith G., Najjar S., Ellingsen O., Skjaerpe T. (2007) Training in Heart Failure Patients : A Randomized Study Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients Journal of The American Heart Association 115: 3086 – 3094