Identifying the Five Levels of Functionality:

The book Physical Dimensions of Aging (Spirduso, 1995) identifies these five levels of functionality:

  • Physically Dependent: These individuals cannot execute some or all of the Basic ADLs and are dependent on others to survive.
  • Physically Frail: These individuals can perform some or all of the Basic ADLs but can’t perform all of the activities necessary to live entirely independently. Often this is directly related to a disease or other condition that challenges them physically.
  • Physically Independent: These people live independently, usually without any debilitating disease or condition, but they have very low health reserves.  Most of these individuals are one illness or injury away from a loss of independence.
  • Physically Fit: These individuals exercise at least two times a week or work at a physically demanding job or hobby. They are at a lower risk for moving into the physically frail category because of improved health reserves.
  • Physically Elite: These individuals train on an almost daily basis to compete in races or competitions, work at physically challenging jobs or engage in very active recreational endeavors.

You could easily have participants from 3 of these categories in one Golden Beats class!

Exercise Prescriptions for the Elderly

The exercise goals for elderly adults should vary greatly from those of younger adults (West J. Med 1987, 147, 477-80). While younger adults exercise to reach their peak physical condition, older adults need to be adding physical fitness into their routines to maintain a quality of life.  Therefore, there should be different goals and guidelines for specific age groups. It is suggested that any physical activity should be personally tailored to an individual’s needs and abilities as well.  The U.S. Surgeon General, the American College of Sports Medicine (ACSM),the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) currently recommend 30 minutes of moderate physical activity, performed on most days of the week.  The World Health Organization (WHO) suggests that inactive individuals should start with small amounts of physical activity and gradually increase duration, frequency, and intensity overtime.

Exercise Guidelines for Older Adults:

  • Include 150 minutes of moderate – intensity aerobic physical activity during the week, at least 75 minutes of vigorous-intensity of aerobic physical activity during the week, or an equivalent combination of moderate- and vigorous – intensity activity.
  • Perform aerobic activity in bouts of 10 minutes.
  • To improve fitness levels and increase health benefits perform 300 minutes of moderate-intensity aerobic activity or 150 minutes of vigorous-intensity aerobic activity per week, or combine moderate-intensity and vigorous-intensity physical activity throughout the week.
  • For 3 days a week, perform physical activity to enhance balance and prevent falls.
  • Engage in strength training activities that involve all or a greater part of the major muscle groups at least 2 days a week.
  • Those elderly individuals who are at risk for falling should also consider including exercises that will help to recover their loss of balance. http://www.aafp.org/afp/2010/0101/p55.htm
  • When health issues don´t allow one to exercise at this level, encourage physical activities for their specific abilities and conditions.
  • (See the Drums Alive Balance, Coordination & Proprioception section in the Skills and Examples Chaper)

http://www.who.int/dietphysicalactivity/factsheet_olderadults/en/

All older adults will experience some normal age-related physical changes.  If steps aren’t taken to reduce or slow the process, some of these changes can be devastating.  Besides the normal changes that occur with aging there is an increase in chronic disease and disability.  Although these limitations may require that older adults modify their lifestyle, most are able to remain functional.  It wasn’t very long ago that people would say that they couldn’t participate in certain exercise regimens because of these conditions – now it seems we more often hear the opposite.  It’s because of these conditions that older adults are exercising!  Understand that for many of your participants simply walking from their car to your class can wear them out.  Many of your participants will be close to their maximum fitness level during the normal everyday activities of life.  As their instructor, you should learn their limitations and offer appropriate modifications for movements for those participants.

Before initiating an exercise program, most older adults with diagnosed chronic health conditions (e.g., diabetes, heart disease, osteoarthritis) should devise an appropriate activity plan in consultation with their physician that focuses on cardiac risk factors and physical limitations.

We want to encourage our participants to exercise appropriately so they attain the maximum benefit at the lowest amount of risk.