GREATER FLEXIBILITY MORE CHOICE DEBBIE MELLOR HEAD OF NHS EMPLOYMENT Department of Health.
Strength and Flexibility Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California...
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Transcript of Strength and Flexibility Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California...
Strength and FlexibilityStrength and Flexibility
Debbie Rose, Ph.D.Debbie Rose, Ph.D.
Co-Director, Center for Successful AgingCo-Director, Center for Successful Aging
California State University, FullertonCalifornia State University, Fullerton
Age-Related Changes
Muscle:• Reduction in skeletal muscle mass – Sarcopenia• Increase in fat and connective tissue within
older muscle• Reduction in diameter and size of muscle fibers.
Greatest reduction in type II fibers (fast-twitch)• Reduction in number of functioning motor units
in aging muscles. Greatest change in lumbar vs cervical and thoracic motor units.
• Collective result of changes in muscle is reduced muscle strength.
Affected Postural Muscles
Erector SpinaeQuadratus LumborumIliopsoasTensor Fascia LataPiriformisRectus FemorisHamstringsGastroc-soleusPectoralis MajorUpper TrapeziusLevator ScapulaSternocleidomastoidScalenes
Rectus Abdominus
Serratus Anterior
Gluteus Maximis, medius,
minimus
Lower Trapezius
Vastus Medialis and lateralis
Short cervical flexors
Extensors of Upper Limb
Tibialis Anterior
Prone to Tightness Prone to Weakness
Bandy & Sanders, 2001
Practical Implications
The following muscle groups should be targeted for improvement:• Hip Abductors• Hip Extensors• Knee Extensors• Ankle Plantarflexors
Critical for smooth forwardtranslation of COM during gait
Implications for Gait
Weak Hip Abductors
Weak Hip Extensors
Weak Knee Extensors
Weak Plantarflexors
Weak Dorsiflexors
Excessive movement in frontal plane and slowing of gait
Reduced stride length and gait velocity
Decreased step length and gait velocity
Reduces/eliminates heel rise during terminal stance –affects gait speed
Reduced toe clearance leading to possible trips, falls during gait
Strengthening Muscles of Upper Body
Suitable Progression:Suitable Progression:SeatedSeated
StandingStandingBalance ChallengedBalance Challenged
Strengthening Muscles of Lower Body
Add dyna disk to increase challenge
Age-Related Changes
Joint ROM and Flexibility:• Declines gradually from approx. 30 years with
greater declines after age 40 years• Increased viscosity of synovium• Calcification of articular cartilage• Stiffening of soft tissue (joint capsule and
ligaments)• More frequently used joints exhibit less decline
(e.g., anterior trunk flexion range vs back extensor; upper vs lower extremities)
Age-Related Changes
Joint ROM and Flexibility:• Ankle ROM declines with age, more so
in women vs men.• Between 55 and 85 years, women lose as
much as 50% in ankle ROM, but men lose only 35% (Vandervoort et al., 92)
• Not all older adults lose flexibility at the same rate. Physical activity levels play an important role.
Implications for Programming
Flexibility exercises are a particularly important component of the program for older adults with:ArthritisLow back painParkinsons DiseaseMultiple SclerosisHistory of physical inactivity
Upper Body Muscle Tightness or Weakness: Implications for Function
• Tight cervical region
• Weak back extensors
• Weak Abdominals
• Weak upper extremities
Driving;obstacle avoidance during gait
Poor upright posture; pain
Core stabilization for reaching; improved postural set
Lifting, carrying, bathing, cleaning, etc
Stretching Muscles of Cervical Region
“Turtles”
Stretching Muscles of Upper Body
Stretching Muscles of Hip andLower Body