Does the saying “Use it or lose it” apply? Would you be willing to take a magic potion that would keep you strong and trim, while improving your memory and mood? What if this same potion warded off cancers and disease? Many studies have indicated that exercise can have all these benefits, whether you take it up early or later in life.
Physical therapists (PTs) and occupational therapists (OTs) are in a unique position to assist the older adult in using exercise to maximize physical health and functional mobility. The first step is a comprehensive evaluation. A PT and/or OT conduct this evaluation in the office or in your home. They will ask questions about your medical history, specifically about any conditions that may limit your exercise capacity initially. It is important to tell the therapist of any painful conditions or bad experiences you have had with exercise in the past. They will perform a series of tests that will help them determine what problems may exist and how to address them. Both outpatient and home-health PTs and OTs understand the importance of finding out what types of activities you enjoy doing. After all, if it is not something you enjoy, you are more likely to continue it once your therapy is completed! Your PT and/or OT will develop a plan of care with goals for therapy with you. A schedule (usually 2 to 3
imes per week) will be arranged and you will be involved in every step along the way.
Musculoskeletal or neurological problems are ones that traditionally bring a client to see a PT or OT. A decline in muscle performance directly affects the performance of activities of daily living, walking, and balance as well as contributing to a risk for falls. Degenerative changes in the joints occur as early as the second decade and accelerate after 40 years of age. The joints most affected are the weight bearing joints: hips, knees, ankles, and spine. The result is pain and crepitation that interfere with joint mobility. In the spine, intervertebral discs begin to shrink and vertebral bodies begin to collapse leading to an actual loss of height. Another component of strength, often overlooked by the untrained eye is control of muscular force. This ability, termed by some as “steadiness”, declines significantly in older persons. The inability to accurately complete tasks such as household chores, signing checks, buttoning one’s clothes, or putting a key in a car ignition can rob an older person of some of the most meaningful activities associated with a good life.
It is a common misperception that older people with chronic illness are either too weak or cannot benefit from exercise training. An unfortunate consequence is that too many older people remain sedentary and inactive, thus exacerbating their disease states. A decline in some physiological functions are a normal part of the aging process, but it certainly does not rule out the benefits that exercise can provide to young and old alike. A low intensity aerobic program will provide benefits even for a well older person living independently in the community who has never taken part in regular exercise. Older adults show similar or greater gains in strength than younger persons after participating in an adequate training program. It does not take exercising to exhaustion to gain this advantage: both high intensity and moderate intensity exercise programs are beneficial.
When most people don’t think about the difference between successful and unsuccessful aging, they think about the difference between health and sickness. There is no doubt the body’s systems deteriorate as we age. But many of the problems associated with aging can be prevented. It is only recently that the public’s attitudes toward older persons has begun to include a view of ‘wellness’ and to embrace its implications. Helping an older person understand the benefits of exercise is a challenge that PTs and OTs are well equipped to answer
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