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Episode 2 - Physical Activity


During this episode Dr Des chats with Senior Physiotherapist Jennifer Watts who has over six years’ experience in the public and private sector. She currently works within the rehabilitation setting and is passionate about how to empower older Australians to stay physically active as they age.


See below show notes on a summary of topics covered, including an attachment for the 6 minute walk test.


Mobility as we get older:

  • Mobility gradually declines as a natural part of aging.

  • After the age of 30, you start to lose muscle mass and strength (a term called Sarcopenia). After the age of 60, this rate of decline is higher.

  • After the age of 45-50, bone density starts to reduce more quickly, particularly in women after menopause. This can lead to more brittle bones which break more easily during a fall.

  • Joints become more stiff with age due to the cartilage between bones becoming thinner and the amount of synovial fluid decreases.

Deteriorating mobility warning signs:

  • Recurrent falls, being less able to get up from a chair, furniture crawling.


Many factors contribute to falls:

  • Uneven surfaces, decreased eyesight, medication issues, decreasing postural stability and reaction time, weak leg muscles, neurological causes e.g. foot drop or Parkinson’s disease.

  • If it becomes a regular occurrence it is best to get assessed by a doctor or Physiotherapist.


Australian Government Department of Health: National exercise guidelines for >65’s


“For people aged 65 years and over, we recommend at least 30 minutes of moderate intensity physical activity on most, preferably all, days. If you find 30 minutes difficult right now, start with just 10 minutes once or twice a day. After 2 weeks, increase to 15 minutes twice a day. Over the course of the week, try to incorporate different types of activities. Try to reduce the time you spend sitting down.”

What exercise is best?

Best to incorporate a combination of all types of exercise: strength, flexibility, balance and cardiovascular exercise.

  1. Moderate intensity physical activity such as brisk walking, swimming, cycling, gardening!

  2. Strength training: climbing stairs, lifting weights, carrying groceries, squats or sit-to-stands.

  3. Flexibility: stretching (mourning routine), yoga, tai chi, bowls.

  4. Balance training: one on one Physiotherapy, group balance classes, dancing, tai chi.


Incorporate incidental exercise into every day. e.g. walk the dog, x5 sit-to-stands each time you get up from a chair, calf raises at the kitchen sink, parking the car a bit further away etc.

  • “Pre-hab” or rehabilitation prior to surgery – often get the best results post-operatively (physically and being mentally prepared).

  • Strengthening muscles around arthritic joints helps to reduce pain by providing a ‘gapping’ between the ‘bone on bone’ joint. Exercise warms up arthritic joints and reduces pain.


Is walking enough?

  • Walking is the best medicine but not the only medicine.

  • Current strong evidence shows, strength training can actually help rebuild muscle mass and increase bone density, even as we age! You can somewhat reverse Sarcopenia.

  • In order to have balance, you need muscle strength as a foundation.


Further information/resources:

Timed Up and Go Test
.pdf
Download PDF • 2.62MB

Private Home Physiotherapists (Northern Beaches):


Seniors gyms – “Active Seniors – Health Centre” in Dee Why, Gordon & Bondi.



Local exercise classes in Sydney Northern Beaches:


‘Active & Healthy’ Government website, where you can search exercise programs in your local area: https://www.activeandhealthy.nsw.gov.au/


E.g. ‘Healthy Lifestyle’ – activity classes for older adults across Northern Sydney. Runs on a term basis. E.g. Tai chi, yoga, pilates, aqua aerobics, stretch and tone, tone and balance, virtual exercise.


E.g. ‘Steady and Strong’ held in Mona Vale Hospital. A 6-week exercise program designed and run by physiotherapists to reduce risk of falls for >65’s. Participants need to enrol in My Aged Care and will be assessed by a physiotherapist prior to commencing.


E.g. ‘Stepping On’ is a group-based program designed for people who are living at home and have experienced a fall or are concerned about falling. It covers a range of issues, including falls and risk, strength and balance exercises, home hazards, safe footwear, vision and falls, safety in public places and community mobility. People need to walk independently or with a walking stick.



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