July 26, 2022

Gentle exercises for old and frail people

Strength and balance exercises may assist elderly persons with heart problems to avoid falls and maintain their independence.

Gentle exercises for old and frail people
Photo by Ivan Samkov: https://www.pexels.com/photo/couple-holding-each-other-s-hands-8127501/

Exercise can improve both the length and quality of your life, especially if you start young and stick with it. However, as people age, heart disease and other health issues can derail workout programmes. The ensuing loss of muscle and endurance frequently contributes to frailty, which affects around a quarter of persons over the age of 85 but can develop at earlier ages as well (see "What is frailty?").

Frailty is typically overlooked since it develops gradually. Darlene Harrier, a physical therapist at the Harvard-affiliated Beth Israel Deaconess Medical Center, says that it's usually a family member who notices that the person looks a little less steady or walks more slowly than usual.

What is frailty?

Clinicians define "frail" as persons 65 and older who have age-related physical decline that makes them vulnerable to injuries and other health problems. Although we commonly associate frail people with a thin body, persons who are overweight or obese can also be frail. Overweight, frail people may be even weaker than their slimmer counterparts because fat has replaced muscle and they have more weight to move around.

You are deemed frail if you match three of the following requirements, according to one widely accepted definition:

You have shed 10 or more pounds without trying in the last year.

You have difficulty standing on your own or have a weak grasp.

You walk slowly; 15 feet takes you more than six or seven seconds.

You are frequently weary and are unable to function three or more days each week.

You're not very active; domestic duties and things you used to enjoy seem too difficult.

Possible choices

But don't think there's nothing you can do if you or your spouse, partner, or parent are weak. People who have had a heart attack or heart surgery may be able to take part in cardiac rehabilitation. But this exercise and lifestyle programme is supervised and has sessions that last an hour several times a week for several months. So, it might not be a good idea for weak people.

Instead, think about working with a physical therapist. They can help people get back their strength and mobility by giving them safe, personalised exercise plans. Harrier says that primary care doctors and geriatricians are usually glad to send their patients to physical therapists. She adds that they want to keep them as independent as possible and reduce the chance that they will fall. During a session, a physical therapist can check a person's heart rate, breathing rate, blood pressure, and oxygen saturation at rest and then again after a short period of exercise.

Heart disease and frailty

People with heart problems need guidance and monitoring from experts even more than others. Coronary artery disease can make it hard to exercise and cause chest pain or shortness of breath even at low levels of effort in people who are already weak. Other heart problems, like a narrowed heart valve or a heart rhythm disorder, can make people more likely to feel dizzy or pass out, which makes them more likely to fall. And falls are especially dangerous for people who take anti-clotting drugs, which are given for many heart problems because they make the risk of bleeding higher.

Gentle exercise examples

Stamina can be built by walking, even at a slow pace and with a cane or walker if needed. Harrier says that you can do simple strength exercises while sitting in a chair or even while lying in bed so that you don't have to get up off the floor afterwards. She recommends clamshells and bridges as ways to strengthen your legs. For clamshells, you lie on your side with your knees bent and move only your top knee up and down while keeping your feet together. For a bridge, lay on your back with your knees bent. Then lift and hold your buttocks off the ground. To work your core muscles, you can also do mini-crunches on your back. Just reach your fingertips up to your bent knees. Sitting in a chair, make fists and punch straight ahead and over your head to build arm strength.

If you find it hard to keep your balance, try this exercise. Stand in a corner with your back against a wall and the back of a chair in front of you to give yourself support on all sides. Practice standing with your feet close together, then one in front of the other, and if you can, on one foot at a time.



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