05 May Healthy Aging – because age is just a number if you Exercise Right
Exercise and Bone Density
Regular physical activity and exercise plays a vital role in maintaining and optimizing bone density throughout life and as we age. The specific goals of exercising for bone health continuously change throughout life; from building maximum bone strength in childhood and adolescence to reducing bone loss and optimising quality of life in old age. For the elderly, the focus is on prevention of sarcopenia (muscle wasting) and addressing risk factors for frailty and falls, particularly difficulties in balance, walking ability and mobility.
Bone strength effectively can be addressed through different types of exercise. Bones ultimately become stronger when a certain amount of load is placed on them. Exercises recommended for good bone health include:
- Weight-bearing aerobic exercise (exercise done while on your feet) – for example, brisk walking, jogging and stair climbing.
- Progressive resistance training (lifting weights that become more challenging over time).
- Moderate to high impact weight -bearing exercise – for example, jumping, skipping, dancing, tennis
Resistance training requires muscles to contract when lifting weights, placing stress on the muscle and related bones. The bones strengthen as they adapt to this extra strain. It is best to target specific muscle groups around areas that are most vulnerable to osteoporotic fractures (hip and spine). It is also wise to strengthen leg muscles to improve balance.
Importantly, the amount of exercise, weight used and degree of difficulty with each exercise must increase or vary over time based on one’s individual needs and health status in order to obtain optimal benefits and avoid adverse effects from exercise. Thus, it is extremely important to consult and exercise with the right health professional, like an accredited exercise physiologist, who understands your individual health care needs.
Balance Exercises and Falls Prevention – Staying on your Feet
Falls increase with age, with substantial patient harm resulting in high healthcare utilisation. A fall is defined by the World Health Organization as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Despite the fact that the natural ageing process often places older adults at an increased risk of falling evidence is strong that with appropriate and targeted exercise, individuals can improve their balance and reduce their falls risk. Interestingly, 50% of all falls occur around the home and approximately one third of people over 65 fall each year. It is also estimated that around 6% of falls result in a fracture so preventing falls has become an important part of managing bone health and functional ability.
Common causes and noted risk factors of falls include, but are not limited to; poor muscle strength, low blood pressure, inner ear complications, functional impairment, cognitive impairment, medication side effects, poor nutrition, poor vision and hazards in the environment. Despite these risk factors, exercise programs of a high volume that incorporate some resistance and/or weight bearing components and prescribe static and dynamic balance and agility exercise can reduce falls risk by greater than 20%, with an increasing impact for those at increased age. It is recommended that exercises that challenge balance in the following three ways for falls prevention and are performed for at least 2 hours a week on an ongoing basis
- Reducing the base of support
- Moving the centre of gravity (by controlling the body’s position while standing)
- Reducing the need for upper-limb support (by using standing exercises that do not need the arms for support)
Exercise recommendations for good balance include:
- Heel to toe stance
- Heel to toe walking
- Sideways walking
- Backwards walking
- Seated Knee Extensions
- Standing Leg Curls
- Toe Raises
- Step Ups
- Standing on one leg (with hand support as needed)
- Repeated chair stands (getting up and down from a chair)
- Tai chi
Note: Brisk walking is not recommended for high risk individuals
Prolonged longevity, independence, increased wellbeing, increased muscle strength and power and physical performance are just some of the notable benefits obtained when completing exercises targeted at falls prevention. However despite these benefits, special care needs to be taken with balance training and exercises need to be performed in ways that minimize the risk of falling (ie no environmental hazards and using had support as required). For optimal benefits, it is recommended that falls prevention exercise programs are designed or delivered by a trained professional, such as an Accredited Exercise Physiologist. This will ensure the exercises are challenging yet safe and cater to one’s individual health care needs and goals.