UNIT 16OLDER ADULTS AND

PREGNANCY

Benefits of Exercise and Appropriate forms of

exercise

Introduction

A brief summary of the condition and the factors that you will need to consider

Any associated risks with that group The benefits of exercise for that group Recommendations for that group

Older Adults

Up to the age of 35 the structures of our body such as muscle and bone keep building up.

After this age we start to lose muscle and bone and the tendons and ligaments start to become weaker

The loss of bone is called Osteopenia and the loss of muscle is called Sacropenia

In particular we will start to lose our Type 2 muscle fibres

This also result in the creeping of fat gain over time

The main effects of ageing are?

Loss of muscle mass Loss of bone density Gain in body fat Loss of muscular strength Loss of muscular endurance Decline in cardiovascular fitness Lower ability to maintain balance Changes in posture

Can these be reversed

All of these effects of ageing can be reversed through a programme of resistance training with some cardiovascular work. Resistance training is very important.

“both aerobic and resistance training are beneficial for older adults but only resistance training can increase muscle strength and muscle mass” (Beachle and Earle 2000)

Safety considerations for training and older adults

Always use a PAR Q to identify underlying problems

If there are medical conditions then you will need to contact their GP to sign them off for exercise

Older adults take longer to warm up Allow at least 48-72 hr for recovery between

sessions All exercises should be pain free

The benefits of exercise are

Increase in muscle strength Less risk of falling due to improved balance Improved body composition Improved CV function Improved bone mineral density Reduced systems of medical diseases Greater ability to perform everyday exercise

such as carrying the shopping or going up the stairs

Exercise Recommendations

Cardiovascular fitness Frequency 3-5 per wk Intensity: RHR +20 bpm up to 40-70 of MHRTime: 20-30 mins Type: walking, swimming, cycling The equipment that should be chosen to avoid

excess stress on bones and joints Group training may make the session more

sociable and may improve retention over time. When increasing the training load increase duration before intensity

Exercise Recommendations: Resistance

Frequency 2-3 x pwk Intensity: 10-15 reps until loss of good

techniqueTime: 8-10 exercises at least one set of each

for 20-30 mins in totalType: machine and free weight depending

upon individual ability and mobility

Flexibility training

F: 2-3 x pwk I: Take to the pain of discomfort T: 10-15 sec per stretch Type: all major muscles and those which are

shorter than their functional length Keep stretching pain free, slowly stretch the

muscle into position and avoid any bouncy or jerky movement.

UNIT 16

Pregnancy and Exercise

Pre-natal women

Pregnancy is a time of rapid physiological change for the female , as a trainer it is vital to understand the changes that are happening to the body

More and more women are becoming wise to the benefits of exercise whilst training however the medical profession has always had a cautious approach due to the instability of the situation and the changes occurring

Trainer beware!!

As a trainer it is vital to understand the following

The physiological changes occurring The risks The benefits of exercise How to prescribe exercise Pregnancy is divided into 3 stages called

trimesters 1- 0-3 months 2-4-6 months 3- 7-9 months

Developing baby

During the 1st trimester we refer to the developing baby as a embryo and during the 2nd and 3rd as a fetus

It only becomes a baby when it is born The embryo/fetus is attached to the wall of the

uterus via the placenta which is a large structure full of blood vessels providing oxygen and nutrients and a means to waste exchange

It also provides a protective barrier against diseases within a fluid filled sac, which helps the temperature and acts as a shock absorber

Trainers concerns

Clearly a trainer will have concerns training a pregnant women which mainly comes from a lack of understanding or knowledge

What concerns may the trainer have Risk of miscarriagePhysical damage to the embryo/fetus Morning sickness Joint problems, back pains Changes in posture Overheating the mother or the embryo/fetusLoss of oxygen to the fetus

Limiting these risks

Choose regular moderate intensity Stationary cycling, swimming, walking, and static

stretching are recommendedAvoid jerky movements Don't exercise lying on your back after the 4th month Use longer periods of warming up and cooling down Stop exercise when they feel fatigued Increase energy intake – why?Keep well hydrated Avoid hot and humid conditions (ACOG 1994)

Training Considerations

During the 1st trimester the hormone progesterone will cause blood vessels to dilate (expand) and this will have the following effect

Lower BPINCREASED HR Feelings of sickness, fatigue and dizziness During the 2nd trimester the blood volume

start to increase although it is mainly plasma, the red blood cell count will start to rise towards the end of the 2nd trimester which has the following effects

contnd

BP returns back to normal Heart rate returns back to normal The mother does not feel as sick and less fatigued

#

The mother will experience a change of centre of gravity as the bump develops at the front

After the 4th month the hormone “Relaxin” is released making the joints more mobile. Its role is to allow greater movement in the pelvis when the mother has to give birth

3rd trimester

The mother becomes larger in size and weight and will have even more trouble balancing.

The mother needs to be realistic that the aim of the pre-natal exercises is to make the pregnancy and the delivery of the baby easier , it is not the time to be worrying about increasing fitness

They can expect a range of benefits through exercise such

Benefits of exercise during pregnancy

Improve circulation Less fluid accumulation in the lower limbs Fewer leg crampsReduced risk of sickness Improved self image Less chance of constipation Easier less complicated labour

Exercise recommendation

When deciding what exercises it will depend on

Stage of pregnancy Size of the mother Current level of fitness Potential of injury for the activity that she has

chosen Can she lie on her back Will the type of exercise place any additional

stress on her pelvic muscles

Cardiovascular and Resistance recommendations CVF- 3-5 pwk I- 40-70 of MHR T- 20-30 min sessions T- low impact rhythmical activity ?(swimming

cycling walking Resistance F- 2-3 pwk I- 15-20 repsT- 8-10 exercises 1-2 sets T- Exercise to cover all major muscle groups

Flexibility training

F- 2-3 pwk I- to the point where they feel discomfort T- hold for 8-10 sec T- maintenance stretches on all major muscle

groups

General recommendations are to keep well hydrated. Ensure an extra 250-300 kcal to cover the energy cost of exercise. All sessions should include pelvic floor exercises

Post Natal women

After the birth of the baby the mother may be keen to return to exercise as she feels that her body has changed

We have to take into consideration that the mother will have a baby to look after and that she has just been through a major physiological trauma and there is damage to many structures

http://www.youtube.com/watch?v=tyHnsI9uOsc

http://www.youtube.com/watch?v=7CyxISMCx1w&feature=relmfu

How to Exercise During Pregnancy.mp3

Post Natal Women

The benefits of exercise are Promote weight loss Improve self image Return tone to abdominal muscles Return strength to stretched musclesImprove flexibility to shortened muscles Improve posture

Post Natal Concerns

Joint instability and injury- the hormone relaxin will still be present in the body for up to 3-12 months so the joints may be unstable and prone to injury

Injury due to weak abdominal muscles- the core muscle may be stretched or even torn

Damage to the Pelvic Muscles- as the baby head passes through the pelvis it will stretch and tear the surrounding tissue- this can make it sore for the mother to sit or change position of the pelvic bones

Exercise Recommendations

Choose low impact exercise Use only maintenance stretching Start off with very gentle stomach exercises Ensure good posture Work to loss of form on resistance exercise

(what does this mean?)Include pelvic floor exercises