Research demonstrates that staying active at any age has many benefits. The push to stay active is particular important as one ages and this is reflected in a number of government initiatives to promote exercise and well being in the elderly population.2

Regular physical activity is associated with decreased mortality and age-related morbidity1,2, 3. Studies suggest that older people should exercise at least 30 minutes per day, incorporating a variety of activities that include strength, balance and flexibility into their routine1.

Regular exercise provides a myriad of health benefits such as weight loss, improvements in blood pressure, lipid profile, insulin sensitivity, as well as improvements for bone and joint health. Exercise has been evidenced as a valid treatment option for diseases such as obesity, elevated blood pressure, Diabetes and Osteoporosis and Arthritis4. Despite this, up to 75 percent of older Australians are insufficiently active to achieve these health benefits. Few contraindications to exercise exist, and almost all older persons can benefit from additional physical activity. The exercise prescription consists of three components: aerobic exercise, strength training, and balance and flexibility.

Unfortunately exercise is not always given the emphasis in Aged Care facilities that it deserves. Due to time pressures and high staff to resident ratio, it can be challenging to incorporate regular exercises into activities of daily routine.

Some residents believe that exercise is no longer appropriate at their age and others, who are keen to maintain their current level of function, are unsure how to include regular exercise into their routine.

Vivir Physiotherapists play a key role in motivating residents and advising them regarding their physical limitations and/or comorbidities. Motivating residents to begin exercise is best achieved by focusing on individual goals, concerns, and barriers to exercise. Strategies include the “stages of change” model3, individualized behavioral therapy, and an active lifestyle. To increase long-term compliance, the exercise prescription should be straightforward, fun, and geared toward the individual’s health needs, beliefs, and goals2.

Residents tend to sit for many hours at a time during the day; at meal times, during lifestyle activities and even for afternoon naps. Prolonged spinal loading results in musculoskeletal deconditioning and can lead to the formation of pressure areas4; which has significant health and cost implications to resident and facility, respectively. Vivir clinicians work closely with teams within Residential Aged Care Facilities, to incorporate activity into residents’ daily routine (whether it is to stretch joints whilst dressing activities or encourage resident to reach up to comb hair). We also promote exercise classes and tailor each program to the needs of the individual.

One of Vivir’s success stories in endorsing an active lifestyle for the elderly is the implementation of an exercise class at Lynbrook Park in Victoria. What began as a simple addition to the lifestyle program aimed to maintain functional ability and activity levels, turned into an extremely popular choice on the activity calendar for the residents of Lynbrook Park.

In fact, it was so successful that soon a second class was added to ensure residents exercised in a safe space with optimal supervision. Extra equipment such as overhead pulleys, a resistance chair, seated bicycle, therabands and parallel bars (for gait retraining and balance work) were purchased.

Our skilled clinicians modified exercises to suit different levels of fitness and functional limitations; providing a mix of one on one contact mixed with the energy of a group activity.

Residents and staff are full of praise for the program, stating that the class is a steady fixture in their weekly schedule and highlighting the enjoyment gained from completing a challenging program suited to the individuals needs. In fact, this programme was so successful that it was adopted at other sites within the organisation.

Positive effects of the exercises program can be observed in several different areas: exercise programs that focus on balance and muscle strengthening have been shown to reduce the risk of falls in older adults6, also reducing the risk of fractures as serious complications. Residents are also able to maintain and even improve their functional status, which overall leads to an improved quality of life in the Aged Care setting7.

The set up of the exercise program includes:

  • A functional exercise circuit routine which has been shown to improve physical functioning, decrease pain and improve vitality1
  • Incorporation of strength training using equipment like shoulder pullies, therabands and weights with benefits including improvement of physical functioning, mood, decrease of anxiety perceived confidence for physical capability3
  • Exercises at a moderate intensity level which are most suited for older adults and the intensity of each exercise should be adjusted to the individuals capabilities and limitations4

This model of exercise is successful because:

  • Our skilled clinicians are able to tailor exercises to suit the individual needs and goals based on a through assessment and clinical reasoning.
  • Residents are involved in the goal setting process
  • Residents can move at their own pace and ability, as exercises are modified to suit different levels of fitness and functional limitations
  • Providing a mix of one on one contact mixed with the energy of a group activity.
  • Socialisation for residents/improving residents quality of life1
References:
  1. Journal of Strength & Conditioning Research The benefits of a functional exercise circuit for older
    adults Retrieved from http://journals.lww.com/nscajscr/Abstract/2005/08000/The_Benefits_of_A_Functional_Exercise_Circ
    uit_for.27.aspx
  2. Department of Health (2008) Choose Health: Be Active A Physical Activity Guide for Older Australians 2008
  3. Health Promotion Unit (2007) Stages of behaviour change: Queensland Stay On Your Feet Community Good Practice Toolkit. Division of Chief Health Officer, Queensland Health available at https://www.health.qld.gov.au/stayonyourfeet/documents/33331.pdf
  4. Applied Human Science – Journal of Physiological Anthropology -Physical Fitness and Psychological Benefits of Strength Training in Community Dwelling Older Adults retrieved from https://www.jstage.jst.go.jp/article/ahs/16/6/16_6_257/_article
  5. Europe PMC – Benefits of exercise for older adults. A review of existing evidence and current recommendations for the general population retrieved from
    http://europepmc.org/abstract/med/1576579 http://www.australia.gov.au/information-and-services/health/health-promotion
  6. Osteoporosis in Orthopedics – Exercise and fall prevention Retrieved from http://link.springer.com/chapter/10.1007/978-4-431-55778-4_11
  7. The Journal of Gerontology – Effects of Exercise on Body Composition and Functional Capacity of the Elderly Retrieved from http://biomedgerontology.oxfordjournals.org/content/50A/Special_Issue/147.short
  8. The Journal of Gerontology – Physical Activity and Quality of Life in older adults Retrieved  from https://biomedgerontology.oxfordjournals.org/content/56/suppl_2/23.full

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