Strength Training For Older Adults
Written by Craig B

Strength Training For Older Adults

From time to time we feature an interview that is worth quoting in full. Such an interview is one with Dr. Roger Fielding on Strength Training for Older Adults. Below is the text from the interview at the News In Health website. You can find the original at: https://newsinhealth.nih.gov/2020/03/dr-roger-fielding-strength-training-older-adults

Disclaimer: You should speak with a medical professional before undergoing any exercise regime. Use proper safety precautions and have assistance available when you exercise.

NIHNiH: Are the benefits of strength training different for different age groups?

Fielding: The benefits of strength training across the lifespan are relatively similar. But as people get older, there’s a progressive decline in the amount of muscle mass and muscle strength.

So as we age, I think it’s even more important to consider incorporating some strength training into our physical activity routine, to either slow down the progression of that decline or to some extent prevent it from occurring.

NIHNiH: How does strength training help older adults live independently?

Fielding: There’s a very close relationship between the loss of muscle strength with aging and the development of mobility limitations and poor physical functioning. As people lose muscle mass and muscle strength, they begin to develop problems with their ability to walk, their ability to get up from a chair, to climb a flight of stairs. And those changes can reach a point where people lose their ability to be living independently.

Interventions that can prevent that loss in muscle mass and strength as people age may be able to delay or prevent people from losing their independence.… The most robust type of exercise training to prevent the loss of muscle strength and the loss of muscle mass is strength training.

NIHNiH: What would you say to an older adult who feels unsure about how to start strength training?

Fielding: The first thing to remember is that some exercise or a little bit of exercise or physical activity is better than no exercise and no physical activity. So anything you can do is going to have benefits that are real and sustainable.

More and more, there are programs at local gymnasiums, local health clubs, and accessible gyms like the YMCA and other organizations that are very targeted for older people. So if people are intimidated, I would suggest they look to see if there are programs like that in their community that might be more friendly and more accessible and welcoming to their age and their demographic.

There are also some strength training activities that can be done with things like ankle weights, or using your body weight and a chair. So there are some strength training activities that don’t really require specialized equipment or going to a gymnasium, that people can do to start off with.

They may ultimately progress to getting strong enough that they might want to go to a gym or a community program where there’s a bit more challenge. But there are certainly things that you can do in your home that are very scalable and accessible that don’t involve going to the gym.

NIHNiH: What are some tips for staying motivated with a new strength-training program?

Fielding: Ask yourself: Why do you want to do this? Like, you want to go on a four-mile hike or be able to play in the yard with your grandchildren or start playing a sport again. Goal setting can be really useful in trying to keep people motivated to stay with a program of physical activity.

It’s also important to find something that you really like to do and can make part of your daily routine, activities, or behaviors. If you’re somebody who absolutely loathes going to the gym, signing up for a gym membership is not going to be the right strategy for you. But getting some hand weights and some ankle weights that you can use at home, in a place where you’re very comfortable, may be something that’s going to get you motivated to start.

Some people really like to exercise with a friend or partner, or with a group of people. In that case, finding someone that you want to embark on a strength training program with can also be a really good way to keep you adherent and keep you motivated. The important thing is finding something that works for you.

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Getting Your Home Ready For Knee Or Hip Surgery
Written by Craig B

Getting Your Home Ready For Knee Or Hip Surgery

The Government website Medlineplus offers the following advice on preparing your home for knee or hip surgery. You can see the original article, here.

Before you go to the hospital for surgery, set up your home to make your recovery and life easier when you come back. Do this well in advance of your surgery.

Ask your health care provider or physical therapist about getting your home ready.

Make It Easy for Yourself

Make sure everything you need is easy to get to and on the floor where you will spend most of your time. Limit your stair use to once a day.

  • Have a bed that is low enough so that your feet touch the floor when you sit on the edge of the bed.
  • Set up your bed on the first floor if you can. You may not need a hospital bed, but your mattress should be firm.
  • Have a bathroom or a portable commode on the same floor where you will spend most of your day.
  • Stock up on canned or frozen food, toilet paper, shampoo, and other personal items.
  • Make or buy single meals that can be frozen and reheated.
  • Make sure you can reach everything you need without getting on your tiptoes or bending down low.
  • Put food and other supplies in a cupboard that is between your waist and shoulder level.
  • Place glasses, your teapot, and other items you use a lot on the kitchen counter.
  • Make sure you can get to your phone. A portable phone can be helpful.
  • Place a chair with a firm back in the kitchen, bedroom, bathroom, and other rooms you will use. This way, you can sit when you do your daily tasks.
  • If you will be using a walker, attach a sturdy bag or a small basket. Put in it the things you need to have close by such as your phone, a notepad, a pen, and other necessary items. You can also use a fanny pack.

You may need help bathing, using the toilet, cooking, running errands, shopping, going to provider visits, and exercising. If you do not have someone to help you at home for the first 1 or 2 weeks after surgery, ask your provider about having a trained caregiver come to your home. This person can also check the safety of your home and help you with your daily activities.

Other items that may help:

  • A shower sponge with a long handle
  • A shoehorn with a long handle
  • A cane, crutches, or a walker
  • A reacher to help you pick up things from the floor, put on your pants, and take off your socks
  • A sock aid to help you put on your socks
  • Handle bars in the bathroom to allow you to steady yourself

Bathroom Setup

Raising the toilet seat height will keep you from flexing your knee too much. You can do this by adding a seat cover or elevated toilet seat or a toilet safety frame. You can also use a commode chair instead of a toilet.

You may need to have safety bars in your bathroom. Grab bars should be secured vertically or horizontally to the wall, not diagonally.

  • DO NOT use towel racks as grab bars. They cannot support your weight.
  • You will need two grab bars. One helps you get in and out of the tub. The other helps you stand from a sitting position.

You can make several changes to protect yourself when you take a bath or shower:

  • Put non-slip suction mats or rubber silicone decals in the tub to prevent falls.
  • Use a non-skid bath mat outside the tub for firm footing.
  • Keep the floor outside the tub or shower dry.
  • Place soap and shampoo where you do not need to stand up, reach, or twist.

Sit on a bath or shower chair when taking a shower:

  • Make sure it has rubber tips on the bottom.
  • Buy a seat without arms if it is placed in a bathtub.

Avoiding Falls

Keep tripping hazards out of your home.

  • Remove loose wires or cords from areas you walk through to get from one room to another.
  • Remove loose throw rugs.
  • Fix any uneven flooring in doorways. Use good lighting.
  • Have night lights placed in hallways and rooms that can be dark.

Pets that are small or move around may cause you to trip. For the first few weeks you are home, consider having your pet stay elsewhere (with a friend, in a kennel, or in the yard).

DO NOT carry anything when you are walking around. You may need your hands to help you balance. Use a small backpack or fanny pack to carry things such as your phone.

Practice using a cane, walker, crutches, or a wheelchair. It is especially important to practice the correct ways to:

  • Sit down to use the toilet and stand up after using the toilet
  • Get in and out of the shower
  • Use the shower chair
  • Go up and down stairs

Alternative Names

Hip or knee surgery – getting your home ready; Osteoarthritis – knee

References

Niska JA, Petrigliano FA, McAllister DR. Anterior cruciate ligament injuries (including revision). In: Miller MD, Thompson SR, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 98.

Rizzo TD. Total hip replacement. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 61.

Weinlein JC. Fractures and dislocations of the hip. In: Azar FM, Beaty JH, Canale ST, eds. Campbell’s Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 55.

Review Date 11/5/2018

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Using A Cane
Written by Craig B

Using A Cane

Learn how to properly use a cane to stand up and walk, sit down onto a chair and go up and down stairs. Read on to learn more.

To Stand Up And Walk 

  1. Quad cane: Push up from the armrest of the chair or from the bed to a standing position. Grasp the cane and make sure you are steady.
  2. Standard cane: Hold the handle of the cane in one hand as you push up from the armrest. Once standing, pause to be sure you are steady.
  3. Move the cane forward a short distance. Make sure you keep the cane a few inches out to the side.
  4. Step forward with your injured or weaker leg first, putting weight onto the cane. Then take a step with your stronger leg.
  5. Look up to see where you are going, not always down at the floor.

To Sit Down Onto A Chair 

Back up until you feel the chair against your legs. Instructions based on type of cane are:

  • Quad cane: Place both hands on the chair arm. Ease down into the chair.
  • Standard cane: Hold the cane in one hand and the armrest with other hand. Ease down into the chair.

To Go Up The Stairs

Push down on the cane. Step up with your stronger or uninjured leg. Then step up to the same step with your weaker or injured leg. Bring the cane up.

To Go Down The Stairs

Place your cane down one step. Step down with your weaker or injured leg. Then step down with your uninjured leg.

If you have a railing, hold onto it with your other hand. If you use a large quad cane, you may need to turn it sideways so it fits on the step.

To Prevent Falls

  • Be sure your cane is in good condition. Your cane should have grooved rubber tips covering the bottom of each leg(s) of the cane.
  • Avoid throw rugs and waxed floors.
  • Be careful when walking on wet or slippery surfaces.
  • Wear low-heeled, tie shoes for better support.

Follow your physician’s orders regarding any limits on your activities.

Source: https://my.clevelandclinic.org/health/articles/15541-how-to-use-a-cane

Having a home safety assessment performed to identify fall risk and provide safety recommendations followed up by installation, can greatly reduce your risk of falls in your home environment. You are unique and your needs are too!

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4 Wheel Walkers
Written by Craig B

Choosing And Using Walking Frames

Walking frames can give people a greater level of support and balance. Read on to learn how one can work for you!

Comfort

You need your walking frame to be simple and comfortable to use. You will need it suited to your weight as well as your height. Give a few different models a go and see which one suits you needs.

Transportation And Storage

If your walking frame needs to be stored or transported it will need to be foldable. at the very least you will require a secure place away from the outside elements so it can maintain its durability.

Getting Fit

When being fitted ensure the crease in your hand is at the same level as the hand grip on the walker. You will need your elbows to bend between fifteen to thirty degrees so you can be both comfortable and safe.

Usage

Its is best to be facing forward when using your frame. use your leg that has been impaired first and bring the frame forward, then your less inflicted leg. Do not position the frame too far forward and when sitting down, use the arms of the chair or someone else for support.

What Are Rollators?

These are walking frames that have wheels and offer increased stability and balance and also a great compromise between a walker and a cane. They can also include baskets for shipping and seats when you need a rest!

Having a home safety assessment performed to identify fall risk and provide safety recommendations followed up by installation, can greatly reduce your risk of falls in your home environment. You are unique and your needs are too!

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