Senior fitness programs and health outcomes

Senior Fitness

Describe the effect of exercise on blood sugar levels. How will this effect your exercise recommendations for both insulin dependent and non-dependent clients food intake?

Exercise certainly helps to monitor and assure healthy blood sugar levels. It can help to decrease current glucose levels in the blood as well as burning stored blood sugar, which is a leading factor in helping individuals lose weight. Moreover, exercise can increase muscle mass and cardiovascular endurance. The addition of muscle can further help in regulating blood sugar levels and glucose usage during exercise sessions.

When making recommendations for exercise schedules for clients with diabetes and other insulin related disorders, I would certainly begin with a solid examination of the individual's specific background. While I would certainly be interested to know about any potential problems even with non-diabetic clients, I would like to know about the severity and specificity of the diabetic individual's medical history. With this knowledge I would proceed to create a customized workout plan. Being that insulin is a key regulator of glucose and the body needs increased amounts of glucose during workouts, most diabetics struggle with heightened levels of strenuous exercise. Therefore, I would be diligent in monitoring the heart rate of such clients, while also garnering feedback from them very regularly during the workout. The most likely outcome would be that the workout routines for persons with diabetes or other insulin related disorders would be much less intense than those for non-dependent clients.

16) Define rheumatoid arthritis and osteoarthritis. What are the primary concerns for you as a trainer when training an arthritic client?

Rheumatoid arthritis is a relatively common disease causing inflammation of the joints, tissue around the joints and occasionally other organs throughout the body. This disorder is classified as an autoimmune disorder, whereby one's own immune system triggers its onset. This disease has been shown to be a major predictor of heart attacks (especially in women). In fact, it has been shown that the risk of heart attack for women with rheumatoid arthritis is twice that of a normal woman.

Osteoarthritis is a disorder that progressively erodes the joints to the point where bony spurs and cysts are created at the margins of joints. This disease causes the diminishment of cartilage in an individual's joints and can cause extreme limitations in joint movement.

Once again, the ultimate creation of a specific exercise program would depend on the individual. By assessing the severity of the illness, I would create a customized program to work around the specific limitation of the disorder. However, being that almost all forms of arthritis cause exercise to become highly painful, there are several generic considerations that must be made in all cases. As a result of the pain experience from exercise, many arthritic patients choose inactivity. Though as a trainer, I would concern myself with increasing their joint mobility and improving the functional capacities of the client's joints to hopefully reduce pain. In doing so, I would utilize non-weight-bearing exercises, because weight-bearing activities typically causes pain and discomfort in arthritic patients.

17) What are the muscles that make up the rotator cuff? List the mechanisms for rotator cuff injury and contraindicated movements.

The rotator cuff is comprised of four muscles. This group of muscles amalgamates at the shoulder to form a strong level of protection for this vital joint. The four muscles are referred to as the supraspinatus, infraspinatus, teres minor, and subscapularis.

When one or multiple muscles in the rotator cuff become torn (a common injury during the elderly period), there are several exercises and contraindicated movements that can exacerbate the injury. Many "press" and "pull" movements are often not recommended when a client has suffered a rotator cuff tear. These mechanisms include: military press, bench press, pull-ups, pull-downs, inclines and declines. Additionally, any exercise where heavy strain is placed on the shoulder is not recommended.

18) List the Spectrum of hearing impairments. Discuss tips and considerations for communicating with the hearing impaired individual?

Hearing impairments regularly affect the elderly. Most types of hearing loss occur progressively, whereby it becomes harder and harder to verbally communicate with the individual. While other forms of hearing impairment can strike quickly and hearing can be lost forever. The true spectrum of potential hearing disorders ranges from deafness to periodic hearing disturbances. Nevertheless there are numerous possibilities found within this arena. Such potential outcomes include the following: deafness (including Sensorineural deafness and Nerve deafness), hearing loss, Conductive hearing loss, Presbycusis, reduced hearing, and hearing disturbances.

In communicating with a hearing impaired individual, it is critical for me to maintain eye contact and assure that I have their attention. Especially in a training environment where there is a potential for injury, it is highly essential for me to develop an effective means of communicating with my clients prior to workouts. I would probably sit down and discuss some type of workable system for communicating before I begin training a client with a hearing impairment. I would probably focus on maintaining a close proximity to the individual, ensuring that I am always facing them when I am communicating, speaking slowly, clearly and concisely.

19) Name three individual sports activities what would be appropriate for a visually impaired client. Explain your reasoning for each activity you recommend.

One sporting activity I would certainly recommend for visually impaired clients is golf. While numerous programs exist for blind golfers around the globe, I believe that this would be an ideal sporting endeavor for visually impaired individuals. Being that visually impaired persons are often put off by the hustle and bustle of many contact and team sports, I think the tranquil features of golf would certainly be a welcomed experience. By not having to respond to the yelling and hitting and shouting and fast movements that accompany many other sports, visual impaired individuals could embrace golf while enjoying the outdoors and the company of trusted guiding individuals.

Another sporting activity I would recommend is swimming. This sport is unquestionably capable of providing a visually impaired person (any person for that matter) with a world-class workout. Additionally, little aid would be necessary once the individual is capable of gauging the parameters of the pool. Therefore, this type of activity could also provide these individuals with a sense of independence that they do not often experience in their day-to-day lives.

Yet another newly created sport is called Goalball. This is a team sport played and created exclusively for the visually impaired. The object of the game is to roll a ball, which contains bells past the opposing team. There are two teams of 3 players, which alternate rolling and defending. The offensive team rolls the ball in a manner that is either hard or soft, depending upon player style, in an attempt to get the ball past the opposing three players. The defensive team listens for the approach of the ball and attempts to prevent or block the ball from crossing the line. The ball is rolled back and forth with the offensive and defensive team alternating until time expires for the half (Therapeutic Recreation, 2011). This can increase a visually impaired individual's sense of camaraderie, while also engaging in cardiovascular exercise.

20) Summarize the phases of a strength and Endurance Program as outlined in the senior Fitness Text. How do the recommendations for older adults differ from those you would use with a healthy, young adult?

The text outlines three distinct phases of a typical and effective strength program. The first phase (known as "The Knowledge is Power" phase) primarily consists of educating the client before engaging in actual workouts. Using lighter weights and progressively increasing repetitions, much of the time should be taken teaching perfect form. The second phase (known as "Train Don't Strain Concepts") continues with the educational nature of phase one, whereby the trainer is now attempting to teach the client to differentiate between good and bad muscle pain as the intensity of workouts increases. This phase also focuses quite a bit on breathing patterns and synergistic approaches to exercise routines. Finally, the third phase (known as "Forever: Going Strong Keep it Up!") focuses on the intensification and individualization of workouts to meet the specific needs of the client. This phase also initiates a greater degree of variety in workouts to ensure continuous progress. While all of the above concepts are extremely useful for young adults as well, the primary difference in strength programs for elders and youngster in this case lies in the number of repetitions completed, the amount of weights used and the intensity.

The text also outlines some helpful tools regarding cardiovascular endurance for the elderly. One of the primary programs recommended for these individuals includes arm crank ergometry. This is typically used for individuals with lower body disabilities and has been shown to greatly improve physiological responses. Another endurance recommendation is lower body ergometry. This type of cycling activity is very helpful in developing cardiovascular endurance and building leg strength. Also, incorporating alternative forms of cardiovascular exercise like walking, swimming and low-impact aerobics, into one's regiment has also been shown to produce endurance improvements.

21) Discuss flexibility programming and how it relates to your older client. What are the physiological factors that a trainer must be aware of? Discuss the importance of maintaining flexibility as we age.

Flexibility is an extremely important aspect of healthy aging. Greater levels of flexibility directly correlate into greater ease in performing one's daily responsibilities around the house and in public. Ideally, stretches should be performed after a brief warm-up at the beginning of a workout and also after a brief cool down at the end of a workout. These periodic stretch periods will help to both prepare the muscles for the upcoming workout and help to healthily heal the muscles after the workout is complete. Each facet is extremely important in achieving the greatest possible results out of a workout. When taking the time to engage in exercise, it is absolutely vital to incorporate stretching in order to protect the muscles and keep the fully functional so that we can grow well, not old.

22) Define the term assessment as it is used in the fitness field. Include examples of the assessments you would use to help design a program for an older client. Explain why you would choose those assessments and of what value are the results.

An assessment is a tool that helps a trainer to initially gauge his or her client's physical fitness level prior to exercise. Assessments also provide a benchmark from which to evaluate the client's future progress. Each assessment should always include several elements of fitness like muscular strength and endurance, flexibility, and cardiovascular endurance.

In constructing a fitness program for an older client I would certainly use a number of assessments. One such assessment would be the 12-minute Cycling Test. This assessment is lower-impact (as compared to running) and is very effective at determining a client's current level of cardiovascular endurance. Another area I would certainly want to assess would be muscular strength. In doing so I would likely incorporate an upper and lower body test into my ultimate assessment. The upper body test might consist of a controlled bench press, while the lower body test might consist of a controlled seated leg press. I would also assess the client's flexibility by asking him or her to stretch and marking their achieved range of motion.

23) Use the Karvonen formula to calculate the target heart rate for a 70-year-old client who has a resting heart rate of 80 beats per minute. Discuss why it is important to be able to accurately predict training and max heart rates for your clients.

Using the Karvonen formula, this individual's target heart rate should be between 130 and 140, with a maximum of 150.

By being able to accurately predict and determine the ideal training and max heart rates for clients, a trainer can then determine the level at which that client is able to perform. With this information, trainers can then determine how hard they will push their clients, what exercises they can and cannot handle, and when they are in fact making improvements. Conversely, this vital data will also allow trainers to determine when it is time to pull back on exercise routines or permit longer rest periods.

24) Describe how and when you would use the Borg RPE scale. Describe the training situations where using RPE values would be more appropriate than a predicted max heart rate.

The Borg Rating of Perceived Exertion Scale allows clients to autonomously rate their level of physical exertion on a numerical scale. By doing so, it gives them the opportunity to assess how much effort they are exerting and how intense the exercise is to them. This information is also very useful to the trainer. In concert with a client's heart rate data, this information can provide a trainer with the knowledge of how to progress with an exercise schedule and what areas a client may be struggling with.

While conventional knowledge dictates that a client's heart rate is the most reliable indicator of physical exertion, there are some cases in which the Borg scale might be preferable. For instance, the Borg scale is often the preferred method to assess intensity in clients who are taking medications that affect the heart rate or pulse.

25) Use the tables provided in Chapter 10 of the senior fitness text to determine the strength rating for both upper and lower body for the following 2 clients?

Bob male, 180 lbs, 55 years of age, leg press 1 rm = 255 lbs bench press 1 rm = 150 lbs.

Bob's Upper Body Strength Rating would be .83 which is classified as "Good"

Bob's Lower Body Strength Rating would be 1.42 which is classified as "Fair"

Sally female 140 lbs 62 years of age, leg press 1 rm = 155 bench 1 rm = 65 lbs how would you explain the results to your clients?

Sally's Upper Body Strength Rating would be .46 which is classified as "Average"

Sally's Lower Body Strength Rating would be?1.11 which is classified as "Good"

26) Describe one internal motivator and one external motivator with respect to engaging in physical activity, what is the difference between the external and internal motivation?

Internal motivation is a desire born from within a person to do something in order to achieve a sense of personal satisfaction. Individuals with a heightened sense of internal motivation will work tirelessly to achieve their goals even in the absence of commendation or compliment. One common type of intrinsic motivator arises from knowledge. A client might have a certain disease (i.e. heart disease) that runs in his or her family. Knowing that exercise can prevent the onset of this kind of illness, many individuals do not need any constant external pushers to achieve their fitness goals.

On the other hand, external motivation refers to the extrinsic motivation a client may receive from his or her trainer. Accreditation, praise, money and other types of public recognition are all forms of external motivation. The positive boosts in self-image and self-esteem that are typically gained through these reinforcements make many individuals want to continue towards their goals. One common example of an external motivator is a loving wife who continuously praises and compliments her husband's efforts in his strict adherence to a workout program and its results.

27) What can you do as a trainer to effect motivation in your older clients? List 3 common deterrents to starting a program and describe what you would say or do to your client to get them over that hurdle.

One very common deterrent (especially with older clients) to beginning a workout program is the potential for pain that may be caused. Many elder clients who have unfortunately contracted some type of disorder will not want to be exposed to the painful ordeal that they believe exercise to be. However, as a trainer, it is my responsibility to educate such a client about the numerous and wide-ranging benefits of exercise and how routines can be customized to work around any existing conditions.

Another very common deterrent to starting an exercise program is bad habits and ignorance. Many elderly clients have been set in their ways for many years and will not be eager to completely revamp their lifestyles. Additionally, much of the equipment that will be utilized in a typically workout program will be foreign to them. Therefore, once again, it will be up to me as a trainer to educate these clients in the proper use of fitness equipment and the correct form for various exercises. This process will also likely involve a great deal of organization on my part so that I can ensure them of their progress.

Yet another very common hurdle to overcome in initiating a workout program for an older client is self-doubt. Being that many seniors choose to forgo fitness, clients of this demographic may feel embarrassed or unsure of their ability to enter this uncharted territory. Therefore, it certainly behooves any trainer to take some extra time to truly get to know the client and learn to appreciate their concerns. By taking this extra time, trainers will be able to teach their clients about the various benefits of their proposed programs and further develop a genuine sense of trust with these individuals.

Define the following three terms and what role they play in exercise programming among older adults:

Socialization -- this concept refers to a senior's desire to work with people their own age. Being in this type of communal environment will lessen any potential feelings of embarrassment, while also making the fitness endeavor more comfortable and relaxing. This type of interactive fitness atmosphere has also been shown to help combat feelings of depression and anxiety. Therefore, it is important for trainers to encourage their clients to get to know one another and bring their friends to the fitness center.