FUNctional Fitness Therapeutic Recreation Ontario 2017 TRO Strong - - PowerPoint PPT Presentation

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Having a Ball FUNctional Fitness

Therapeutic Recreation Ontario 2017 TRO Strong & Free Conference

MISSION:

Canadian Centre for Activity and Aging To develop, encourage and promote an active, healthy lifestyle for Canadian adults that will enhance the dignity of the aging process

National Research Centre

Living Laboratory in London Ontario at Western University Research – Restorative Care, Functional Fitness, Senior Fitness, Falls Prevention Courses, Conferences, Consultations, Program Evaluations Model Exercise Programs

The Reality: Physiology of Aging

Functional decline is manageable. Need to work for the benefits -no pill to provide fitness benefits….. Physiological Functional Decline 1% loss in Strength, Balance, Flexibility, Cardiorespiratory and metabolism per after the age of ____. __-35 10% 36-45 10% 46-55 10% 56-65 10% 66-75 10% 76-85 10% ….

The Reality: Physiology of Aging

Functional decline is manageable. Need to work for the benefits -no pill to provide fitness benefits….. Physiological Functional Decline 1% loss in Strength, Balance, Flexibility, Cardiorespiratory and metabolism per YEAR after the age of _24-27_. 25-35 10% 36-45 10% 46-55 10% 56-65 10% 66-75 10% 76-85 10% ….

Functional Mobility

The ability to interact with one’s environment effectively

Functional Mobility

• Cardiorespiratory Endurance
• Anaerobic Capacity
• Muscular Strength
• Muscular Endurance
• Balance
• Flexibility
• Coordination
• Body Composition

Functional Mobility Well Apparently Healthy

• Cardiorespiratory Endurance
• Anaerobic Capacity
• Muscular Strength
• Muscular Endurance
• Balance
• Flexibility
• Coordination
• Body Composition

Functional Mobility Frailty

• Cardiorespiratory Endurance
• Anaerobic Capacity
• Muscular Strength
• Muscular Endurance
• Balance
• Flexibility
• Coordination
• Body Composition

Functional Fitness

The fitness to be able to complete household, social and daily living needs “Functional Threshold”

RISK MANAGEMENT

Safe & Effective

Training

• Certifications
• Current

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Observation

• Teaching formats
• Monitoring techniques
• Sight & Sound

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Instructor to Participant Ratios

1:20 General SFIC standard 1:25 Advanced group high mobility 1:11 Special Condition 1:8 FFOA 1:5 Specialized training PRES 1:4 Restorative Care 1:1 High Falls risk HSEP/ TEP

General Safety

• No Holding Breath
• Footwear
• Alignment

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ABC

Alignment Breathing Control

Evidence Based Exercise Options

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Contraindications NO

• No hyperextension
• f the neck
• No hyperextension
• f any joint
• No head below heart

(toe touches)

• No jumping/ high impact

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Contraindications NO

• No bouncing

while stretching

• No straight legged situp/

full sit up

• No double leg lift
• No deep knee bends

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Contraindications Continued

• No hurdler’s stretch (hyperflexion knee)
• No rapid torso twists
• No lateral flexion beyond 20 degrees
• No forward flexion of the spine

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Special Considerations

Arthritis Osteoporosis Diabetes Cardiovascular Disease Stroke Cognitive Impairments Frailty

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First Aid & CPR

• Current CPR
• First Aid Kit
• Access to phone
• Access to water

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Environment

• Flooring
• Railings
• Equipment
• Cleanliness
• Temperature

Contraindicated Exercises

NO Head Rotation

No Rapid Torso Twist

No Hanging No Head below heart

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No Hyperextension of the neck No Lateral Flexion Beyond 20degrees

No Rapid Torso Twists

No Full/ Straight Legged Sit Ups, Double Leg Lifts

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Arthritis

Osteoarthritis (OA) – process of ageing and weight-bearing pressure causes cartilage to be torn or frayed. Joint becomes inflamed as two opposing surfaces rub against each other. Rheumatoid Arthritis (RA) – body’s autoimmune system attacks joints; inflammation leads to red, hot, swollen, painful joints Fibromyalgia – widespread pain in muscles, ligaments, and tendons for three months or longer

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Arthritis and Exercise

Considerations:

• Encourage good posture
• Balance between rest and exercise
• Special attention to footwear
• Gentle ROM exercises in the morning
• Rhythmical movements
• Shorter periods of exercise
• “If it hurts too much, don’t do it!”

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Osteoporosis

• Low bone mass and deterioration of bone tissue

leading to increased fragility and risk of fracture

• Not normal aging
• Increased rate of fractures

Physical Activity - reduces injurious falls and fractures, maintains and preserves bone density, reduces chronic pain, and enhances functional mobility and independence!

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Osteoporosis and Exercise

Regular exercise program

• Cardiorespiratory weight bearing exercises
• Resistance training
• Balance training
• Stretching
• Training programs should be progressive
• Postural education
• Avoid repeated and loaded

spinal flexion, forward and to the side!

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Osteoporosis and Exercise

DO NOT DO Bend forward from the waist Use your knees or “hinge” from your hips Lift heavy items above shoulders or reach up above head to get something from shelf Check weight of object first. Bend your knees and keep back straight while lifting. Avoid activities that overload spine while bent (eg. putting roast in oven, shoveling driveway, putting wet laundry in dryer) Ask for help, strengthening muscles, modify task, plan ahead Use the Osteoporosis Canada exercise guidelines Be aware of your risks for falling (eg. loose rugs, dark rooms, poor balance and eyesight)

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Diabetes

Chronic disease caused by an insulin insufficiency, or an insensitivity to its action resulting in abnormally high levels of blood glucose

• Type 1 – the body produces little or no insulin; onset is

most common in children and young adults

• Type 2 – pancreas does not secrete enough insulin and

the body’s insulin sensitivity is reduced; onset most common in middle aged adults and older

• Prediabetes- elevated blood glucose levels not high

enough to be diagnosed with Type 2 diabetes

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Diabetes and Exercise

Exercise reduces heart disease risk, improves control of blood glucose and blood pressure, and decreases body fat!

• Regular exercise increases insulin sensitivity – at least 3x

per week with no more than two consecutive days without exercise

• Aerobic Exercises – walking, swimming, or cycling for

150 minutes minimum/week

• Resistance Training – weights and machines 3x per

week using all muscle groups (progressing to 3 sets of 8- 10 repetitions)

• Flexibility exercises

Considerations:

• Notify physician on intent to exercise
• Make sure participants are wearing

appropriate footwear

• Be prepared for cardiovascular

complications of diabetes while exercising (eg. shortness of breath and atypical pain, which may be relieved with rest)

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Hypoglycemia

Hypoglycemia – abnormally low levels of blood glucose

Here’s what to look for:

• Dizziness/Light-headed
• Shaky
• Sweaty
• Hunger
• Blurred Vision
• Mood change/irritability
• Tired/no energy
• Not thinking clearly
• Heart pounding
• Headache
• Nervous, excited,

anxious

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Cardiovascular Disease

Cardiovascular disease is the #1 cause of death in Canada for both men and women! Includes: Atherosclerosis Coronary Artery Disease (CAD) Angina Pectoris Myocardial Infraction (Heart Attack) Congestive Heart Failure Stroke

Warning Signs Of a Heart Attack:

• Mild pain, heaviness or pressure in

the chest

• Shortness of breath
• Upset stomach or nausea
• Sweating and cold, clammy skin
• Severe, crushing chest pain
• Pain spreading down shoulders

and arms

• Pain in neck, jaw, back, or threat
• Fear

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CVD and Exercise

Regular exercise can:

• Train the heart muscle and cardiovascular system to work efficiently
• Lower blood pressure
• Improve cholesterol
• Help decrease body fat
• Reduce stress

Special Considerations:

• Notify physical on intent to exercise
• Gradual warm-up and cool-down recommended
• Walking is an excellent choice
• Avoid exercising above target heart rate
• Medications that alter heart rate: rating of perceived exertion

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CVD and Exercise

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Stroke

• Sudden injury to the brain when blood flow in an artery stops

Ischemic Stroke – caused by a blockage in an artery; approximately 80% of all strokes. Hemorrhagic Stroke – caused by a rupture of an artery; approximately 20% of all strokes. Transient Ischemic Attack (TIA) – caused by a temporary blockage in an artery.

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Here’s what to look for:

SUDDEN onset of one or more (even if temporary):

• Weakness/numbness
• Vision troubles
• Trouble speaking or understanding
• Severe or unusual headache
• Loss of balance/dizziness

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Stroke and Exercise

Every person experiences stroke uniquely!

• Aerobic exercise
• Strengthening
• Stretching
• Balance & Coordination

Dementia

• Brain disorder characterized by impaired

cognitive functioning that can affect learning and memory, mood and behaviour, as well as the ability to conduct daily activities and high level functions

• Alzheimer's Disease – most common form of

dementia; it is a progressive, neurodegenerative disease that attacks the brain and impairs memory, thinking, emotions and behaviour

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Dementia

People with dementia experience:

• Difficulty with memory and

intellectual abilities

• Confusion
• Language problems
• Poor or decreased judgment
• Disorientation in place and time
• Changes in behavior and

personality

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Dementia and Exercise

Proper nutrition, health maintenance, and social activity are critical for enabling the highest quality of life!

• People who are the most physically active have a 30-40% lower risk of

developing dementia!

• Aerobic activity
• Simple strength training

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Dementia and Exercise

Special Considerations:

Choose activities that are:

• Familiar
• Simple
• Repetitive
• Structured
• Flexible
• Success-oriented
• Fun
• Repeat instructions
• Recognize that repetitive

questioning is common

• Recruit a spouse, offspring, or
• ther workout partner
• Using signs, written

instructions, and labels may help with communication

• Demonstrating activities
• Maintain eye contact, show

interest and be patient!

• Environment should be quiet,

calm, familiar, and enjoyable

Frailty

• Accumulation of disease & disability with reduced

physiological capacity  loss of functional mobility decreased independence

• Caused by accumulative effects of sedentary lifestyle

and chronic conditions

• An overall decline in functional mobility

Frailty and Exercise

Three elements of functional mobility when designing programs for frail older adults:

1) Bed/Mat mobility: those who are bed bound 2) Transfers: those who are chair bound 3) Wheelchair mobility: those restricted to a wheelchair

Frailty and Exercise

Class components:

• Warm-Up (deep breathing and

loose, large rhythmic motions)

• Walking (high mobility vs. low

mobility)

• Lower Body Conditioning

(standing, sitting, abdominals and buttocks)

• Upper Body Conditioning

(standing/sitting)

• Balance training
• Cool-Down

For Urinary Incontinence:

• Encourage pelvic floor exercises
• r Kegel exercises

(hold each for 4-10 seconds)

• Perform 10 of these contractions

three times daily

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Community Programs Certification Standard

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Community Programs

Length: 60-75 minutes Content: Warm-up, Cardio, Cardio Cool Down, Muscular Training, Balance & Flexibility

Retirement Living

Length: 20-60 minutes Content: Warm-up, Cardio, Strength, Balance, Flexibility

Home Care

Length: 5 minutes- 45 minutes Content: Strength, Balance, Flexibility; Progressing: Endurance and Cardio

Restorative Care Long Term Care ACTIVE GUIDELINES

ACTIVE GUIDELINES

A- Assessment C- Care Plan/ Document T- Team Commitment I- Implementation V- Verified Approach E- Evaluation

Long Term Care

Length: 20-45 minutes Minimum: 15 minutes daily Content: Strength, Balance & Flexibility

Restorative Care

Length: 20-45 minutes Minimum: 15 minutes daily Content: Strength, Balance & Flexibility, Activities of Daily Living Retraining

EXERCISE PROGRAMING

1.

One size fits all approach doesn’t work for this population

2.

Exercise Prescription Principles – specificity, progressive

• verload, FITT, reversibility

3.

Small group programs with clients with like needs and abilities

4.

One on One programming – Pre-habilitation, Post Rehabilitation, Recreation, Restorative

5.

Components of Fitness - Strength, Balance, Flexibility, Cardiorespiratory Endurance

MAXIMIZE POTENTIAL

Restorative Care Functional Fitness Recreation Programs

• Improves core stabilization
• Improves balance, posture, strength, cardio, body

awareness and coordination

• Can progressively increase or decrease the intensity
• f each exercise by making slight adjustments in

body position

• Helps to reduce stress on joints

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BALL EXERCISES

Benefits of Using Balls Disclaimer

• Can enhance the “fun” of exercise
• Can make Rec Programs MORE Functional
• Website – www.uwo.ca/actage for sample Ball

Picture Package TRAINING AVAILABLE – 2-3 HOURS - $75 MIN 11 PARTICIPANTS Balls - $3.50 – order from our website

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Some Sample Ball Exercises Ball workshop ….

Questions

For More Information:

Leslie McAdam lbrown59@uwo.ca 1-866-661-1603 X2 http://www.uwo.ca/actage FACEBOOK – Canadian Centre for Activity and Aging Twitter @westernuCCAA

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For more info contact: : Leslie McAdam lbrown59@uwo.ca