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Strength Training for Geriatric Participants

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As the aging person reaches the age of 60, muscle strength will begin to diminish rapidly. A 3-4 day per week strength training program will benefit the geriatric adult. Not only in day to day activities, such as standing from a seated position, walking, and grabbing of objects, but because of the chemical reactions in the brain that improve memory and navigation, the geriatric will obtain those benefits also. Gym owners need to be mindful of the extra precautions of working with the geriatric person.

The results of a survey showed that most left due to injury, but many left due to the feeling of not being supported in their efforts. Scheduling and class locations were other factors that cause many of the geriatric to cease exercising even though the benefits are well proven. Even after injuries many of the participants would still attend in the future. Should geriatrics include strength training during their older years?

Sarcopenia is defined as the loss of muscle tissue as the part of the aging process. Muscle strength declines from the age of 30, until we reach the age of 50, gradually. After we reach 60 years of age, muscle strength continues to decline at a rate, of some observations, up to 15%. After we reach 80 years of age, it may decline as high as 30%. Because of this decline in muscles strength, natural balance and gait diminish accordingly, causing more falls and other injuries. As the elder person continues to fall, because of decreased strength, recurrent injuries will happen. It is well documented that strength and power training is good for adult’s health and fitness. However, power declined quicker than strength in the adult.

As the elder grew older and weaker, quality of life was affected. A simple daily task as lifting one’s self from a chair, reaching and gripping objects, and the lifting of objects become increasingly difficult. However, because of strength training these attributes to aging can be reverted and the individual can regain strength. Strength gains were improved as much as 22% and other large power gains were seen 150% of 70% of body mass. These results were obtained by high resistance training followed by 8-15 repetitions, for 1-3 sets. This becomes the recommendation by the American College of Sports Medicine.

Training had to be modified for the geriatric trainee. Plyometrics or Olympic style lifting couldn’t be used for the inexperienced trainee. Use of machine-based and free weights allowed the trainee to exercise in a safe and controlled manner. Overall improvements were seen throughout many other studies such as, stair-climbing speed, gait speed, balance, chair stand, floor to raise stand, lift and reach, and whole-body physical function. However, other studies have been performed that focused more on power training than strength training. The design of these workouts was based on 16 normal day to day activities, focusing on the lower body, upper body, balance, coordination, as well as endurance. The group that performed power training had better results. More testing is required to see any real value of power training over strength training. Most research has recommended that elderly people should work out 3-4 times per week for optimal results. With side effects being rare, even underachievers can have success by starting out with less frequent workouts and working toward the goal of 3-4 times per week.

Many benefits in strength training of individuals (>60 years) include increasing muscles mass, the firing rate of the muscle, and the use of additional muscle units. There have been many studies that have shown that strength training can prevent the impairments that come with aging. Other benefits from strength training were noticed by elderly dealing with fibromyalgia, showing decreased symptoms and increased strength from weight training.

In another study by Ciolic et al. men (aged 25, 65, and 72) completed a 13-week training program. The results in all three age brackets were the same, with each group seeing similar strength gains with workouts using heavier weights throughout the 13-week training program. Elderly trainees experienced the same effectiveness in strength training as men 40 years their minor. Strength training offers other benefits to the geriatric patient. Exercise has been found to improve specific brain regions, particularly the precuneus and entorhinal cortices, which are responsible for memory and navigation. During the onsite of Alzheimer’s disease, most people do not realize any issues, however, toxic changes are taking place in the brain. Starch like protein deposits in the brain, and once healthy neurons fail to fire, and other neurons begin to die. In the earliest stages of Alzheimer’s disease, the deposits have been found, and by increasing activity in this region of the brain, may help to prevent dementia.

By participating in physical activity that includes strength training, neuronal plasticity may be preserved. The growth and development of nervous tissue will be created by the release of the hormonal factors produced by this physical activity. The proper exchange of oxygen and glucose, called the neuron factor, will continue to operate properly.

In a study by Hiroyuki (2017), 24 elderly women (75-83) were randomly selected and entered a control group or intervention group. Only those that were assigned to the intervention group attended a 3-month, bi-weekly, 90-minute session that focuses on strength training, physical therapy, and aerobic exercise. Participation was at 100%. Each session involved 10 minutes of warm-up and stretching followed by 20 minutes of strength training. The remaining 60 minutes, the participants worked on strength training, stair climbing, standing posture, and aerobic exercise using a stationary bike. Because of increased glucose metabolism, memory and navigation were increased (left posterior entorhinal cortex), and speech was improved (left superior temporal gyrus). Not only were positive results seen in the participant’s memory, navigation, and speech, the gait strength increased in the intervention group was observed over the controlled group. Overall, both groups had increased glucose metabolism in different areas of the brain. Results from this test suggested future disability in older adults can be realized because of the activities associated with strength training, based on the results of the chemical reactions that happen in the temporal lobe.

Though the benefits of strength training for geriatrics have proven beneficial for geriatrics, many of them discontinue the programs for several different reasons. In a study by Burton et al (2017) found that injury, illness, holidaying, and nonsupport from the local trainer were the main reasons for discontinuing the program. Other issues, such as health issues, pain, tiredness or fatigue, or even lack of available exercise facilities were also leading issues for geriatric participants not to participate in strength training. Because of the results from this test, it is hoped that gym owners and/or trainers can provide proper instruction for the geriatric participant, keeping them involved in programs that will be entirely beneficial to their overall health.

Research assistants, along with two elderly participants created a survey to mailed to individuals to determine why the ceased participating in strength training. Both representatives had prior experience in education at a professional level. Their responsibility was to review the survey questions, methods of training, and language to make sure that it was geared toward the elderly people whom would receive the survey. The survey would be mailed to participants (<60) who had participated in local gyms that had programs structured toward the elderly. Gym owners were contacted to obtain mailing addresses for individuals that met two requirements: they had recently participated in a strength training program and had quit within the last 15 months. Gym members prepared the surveys as instructed by the research assistants and mailed them to the members of their local gym that matched the criteria. 293 individuals were mailed the survey and a self-addressed, postage paid, return envelope was provided for them to return the survey. The questionnaire was based on local demographics of the participant (age, sex, location, self-reported mental and physical health, and prescribed drugs they were currently taking), the reason they had joined the local gym (including how often they worked out), the cost of their membership, motivation level of workouts, and the support the received at the local gym helping them to follow proper workout routines.

A tool was used to grade the level of the participants, from 0 to 400, based on a scale used to measure the physical activity of elderly patients, called the Physical Activity Scale for the Elderly (PASE). 56 out of the 293 surveys were received that were mailed. The mean age of the respondents was 71.5, 44 were women, 12 were male. 44 reported they had good physical health, 22 claimed very good physical health, and 17 responded they had excellent physical health. PASE scores showed that this group was more physically active than others of a similar age. 32 of the respondents attended the program for >4 months. 5 of the respondents left within the first month. 19 of the respondents left within months 2 – 3. 15 of the correspondents responded that were given more than adequate support, 26 responded with adequate support, and 1 responded they were given inadequate support. 18 participants stated that the reason why the left the program was due to injury. 36 participants responded that they left the program because of class times and availability in the preferred classes. 39 of the participants stated that they would return to strength training because they 10 of them enjoyed it, 7 of them like the fitness aspect of it, 5 liked the benefits of exercise, and 3 would return if they found a new instructor.

The benefits of strength training outweigh the disadvantages. Each participant that continued in strength training was able to see beneficial that resulted in many different categories; from physical strength that was gained for daily day to day activities, to the benefit of the chemical aspects that happen within the brain to improve memory and navigation. Gym owners and instructors must also improve the overall experience for geriatric participants by paying attention towards their unique needs of instruction, modification of workouts that will reduce injuries, and to adjust class times that allow the geriatric participant to attend more classes. Follow up is also essential with the geriatric participant in the event of extended leave, as it is shown that most still wanted to return even after an injury.

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