老年人运动篇

jacky

Exercise in the Elderly
Aka: Exercise in the Elderly, Active Older Adult, Activity in the Elderly

• Efficacy
  
  • Sedentary relative risk of Cardiovascular disease: 1.9
  • Exercise reduces age related morbidity and mortality
    
    • See Exercise for benefit summary
    • Impacts functional independence
    • Fitness Activity reduces mortality 19%
    • Productive Activity reduces mortality 35%
      
      • Employment
      • Volunteer work
      • Gardening
      • Shopping
      • Housework
        
    • Social Activity reduces mortality 20%
      
      • Movies
      • Sporting or recreational activity
      • Recreational travel
      • Group participation
        
    • References
      
      • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Glass  [AU] AND 1999 [DP] AND  BMJ  [TA]]Glass (1999) BMJ 319:478-83[/url]
        
  • Benefits realized even if Exercise started at late age
    
    • Life expectancy increases even at age 75 years
      
      • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Paffenbarger  [AU] AND 1986 [DP] AND  N Engl J Med  [TA]]Paffenbarger (1986) N Engl J Med 314:605-13[/url]
        
    • VO2 max decline reversed up to 30% at 6 months
      
      • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=1998 [DP] AND  Med Sci Sports Exerc  [TA] AND 30 [VI] AND 992 [PG]](1998) Med Sci Sports Exerc 30:992-1008[/url]
        
• Physiology
  
  • Muscle strength declines with aging
    
    • Muscle strength declines 15% per decade after age 50
    • Muscle strength declines 30% per decade after age 70
      
  • Framingham Disability study
    
    • Unable to lift 10 pounds: 45% of women over age 65
    • Unable to lift 10 pounds: 65% of women over age 75
      
• Contraindications to Exercise
  
  • Absolute
    
    • Recent Electrocardiogram changes
    • Recent Myocardial Infarction
    • Unstable Angina
    • Third degree Heart Block
    • Acute Congestive Heart Failure
    • Uncontrolled Hypertension
      
  • Relative
    
    • Cardiomyopathy
    • Valvular heart disease
    • Complex ventricular ectopy
      
  • References
    
    • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=1998 [DP] AND  Med Sci Sports Exerc  [TA] AND 30 [VI] AND 992 [PG]](1998) Med Sci Sports Exerc 30:992-1008[/url]
      
• Indications for Stress Testing before Exercise
  
  • Exercise at >60% of VO2 Max
    
    • Men over age 45 years
    • Women over age 55 years
      
  • Known Coronary Artery Disease
  • History of cardiac, pulmonary, or metabolic symptoms
  • Cardiac Risk Factors (two or more)
  • Diabetes Mellitus
    
• Recommended Exercise program
  
  • Stretch major muscle groups daily after Exercise
  • Perform balance training twice weekly
    
    • One legged stands
    • Circle turns
    • Heel stands
    • Consider covering eyes while performing activities
      
  • Cardiovascular fitness
    
    • Moderate Aerobic Activity (2 to 5 METS)
    • Activity totals 30 minutes or more on most days
      
  • Strength Training
    
    • Set of 10-15 repetitions each of 8 to 10 Exercises
    • Perform Exercises 2-3 times per week
    • Work all muscle groups, slowly and through full ROM
      
  • Flexibility training
    
    • Perform 2-3 times weekly
    • Only mild discomfort should be felt
    • Repeat 3-4 times per stretch with 30-60 second rest
    • Perform both static and dynamic stretches
      
      • Static stretch (hold position 10-30 sec then relax)
      • Dynamic stretch (fluid motion such as Tai Chi)
        
• References
  
  • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=1998 [DP] AND  Med Sci Sports Exerc  [TA] AND 30 [VI] AND 992 [PG]](1998) Med Sci Sports Exerc 30:992-1008[/url]
  • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Nied  [AU] AND 2002 [DP] AND  Am Fam Physician  [TA]]Nied (2002) Am Fam Physician 65:419-28[/url]
    

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