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  1. The term elderly doesn’t have a precise clinical definition, though it is often used in medical articles. Elderly has been used for older than 65 to older than 75, and some of us in the ST community are indeed getting older over time. Possibly coming into the definition of elderly at the age of 73, I do have an interest in exercises for older people. I also teach an ST class where the ages generally go from mid 60s to late 70s (though the oldest one has done yoga all her life and has enviable fitness and flexibility). Because it is a class of mixed fitness and abilities (some of whom are carrying injuries and after-effects of e.g. cancer) what we do is necessarily limited, though there is plenty of encouragement for those wanting to do more advanced versions. As well as flexibility, the focus is on core strength, balance and body awareness. One of the features of old age is muscle degeneration and loss of strength, known as sarcopenia. The extent to which this can be prevented or is reversible once it has occurred has been a matter for debate. The current consensus seems to be: 1. The best protection is to have a lot of muscle mass to start with, so you can lose more before becoming doddery. If you are not naturally endowed with a lot, the best thing is to build it up while young, when putting on muscle mass is relatively easy, and then exercise to keep it. 2. The next best thing is to start strength training at any age, even though it will not be as effective as when young. Positive effects have been reported even in the old-old (late 90s) (though that may be from a very low baseline). The strength training has to be for hypertrophy (80% 1 RM, or 5 reps to failure). It’s not appropriate to do this in my group class, and I’m starting a program on my own. Hating weights (I’m the skinny flexible type) I don’t want to go to the gym, and don’t have a spotter to learn styles like Olympic weightlifting, and want to use body-weight resistance exercises where possible. Given that the intention is that the weights will be beyond the maximum that I can handle, it needs to be very safe. At the moment I am doing: 1. Single-leg squats (I can make it more difficult by going lower). 2. Pull-ups – if I ever get good at these (like I was when young) I can try to move to a single arm version. 3. Push-ups (see no 2 comment). 4. I’ve tried shrugging up when in an elbow stand against the wall, but can do that too easily. I don’t want to do it with bending-to-straight arms (in a handstand) in case I collapse on my head. 5. Pull-ups holding a low barre with body almost horizontal (feet on floor), pulling the chest up to the barre (see no 2 comment). I don’t know if anyone has any further suggestions, and I would appreciate hearing if anyone does - remember that the muscles need to be maximally loaded and it needs to be very safe. I’d like to be able to exercise all major muscle groups just using body weight alone. Doing free exercises this way means that accessory muscles will be exercised as well, though I guess most wont be loaded heavily enough to combat sarcopenia. Should there be a special ST flavour for the elderly? The problem here is that there is such a range once people are in their 60s-70s-80s. The fittest will be able to do the same program as a younger person, while others may be limited to exercises like sitting in a chair and rotating their wrists 5x one way and 5x the other. Comments appreciated. Thanks, Jim.
  2. In my evening of websurfing on a wet night, with wife away, and car being serviced so not able to get to ballet, I found a really interesting paper (Ratzlaff CR, Br J Sports Med. 2012 Aug;46(10):699-701), on energy expenditure for males and females as a function of age. It takes into account all forms of activity, and not just sport and work. Interesting results: 1. Most energy is spent in occupation and in the home, not in sport. 2. Over much of their adult lives, women have greater total energy expenditure than men (mainly due to work in the home). 3. There is a precipitous drop in expenditure the 50s and older, and the very small expenditure from late 60s onwards. 4. Sport and exercise do not promote osteoarthritis - injuries do. Since activity is known to promote health and longevity, the massive decline of activity in old age is something that we should be concerned about. If I manage, I'll add the salient graph from the paper here. Keep active! click to enlarge (A) Lifetime energy expenditure for occupation and sport by gender. (B ) Lifetime energy expenditure for household and sport by gender (in metabolic equivalent (MET)-hours per week). Adapted from Ratzlaff CR, Doerfl ing P, Steininger G, Koehoorn M, Cibere J, Liang M, et al. Lifetime trajectory of physical activity according to energy expenditure and joint force. Arthritis Care Res (Hoboken) 2010;62:1452–9.
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