ANN ARBOR, MI -For many older adults, even a walk to the car tires them easily. A research program, sponsored by the VA Ann Arbor Healthcare System, and the University of Michigan Health System, is measuring the effects of a moderate intensity aerobic exercise program among older adults. Through aerobic circuit-training, these older men and women will help researchers determine if this type of exercise program can help older men and women more easily perform basic tasks of daily living.

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“Many older adults don't have enough endurance and they get fatigued easily. So our goal is to improve their endurance and reduce their fatigue in doing everyday tasks,” says Neil Alexander, M.D., director of the Mobility Research Center at the U-M Geriatrics Center.

“We feel that you don't need to exercise to your absolute maximum. You can still benefit and improve your physical activity and function without exhausting yourself,” says Alexander, associate director for research at the VA Ann Arbor Geriatric Research, Education, and Clinical Center.

Alexander notes many older adults have problems with their joints or get too short of breath or fatigued to participate in standard high intensity aerobic activity. For them, a less intense program might still be beneficial.

“The purpose of this study is to see whether an exercise program as a circuit can improve daily functional performance and physical activity. The program utilizes stations, putting together types of activities that you might have to string together in a consecutive manner, to simulate the stresses and demands daily activity might require. We also have some additional measures of oxygen uptake, which is done in the laboratory to see if the participant's ability to utilize oxygen has improved as a result of this program,” Alexander says.

Each station simulates a typical daily demand task, such as having to pick up something, walk in place or step up. The idea is for participants to maintain a certain heart rate level while performing these tasks.

Another goal of the program is to translate some of these exercises into actual daily physical tasks at home. Alexander says, “We work with the participants to start doing more stairs, walking further distances, walking down to the mailbox maybe more then once a day.”

Seniors participating in the study already feel it has improved their lifestyle. “I had a problem with balance and the doctor said exercise might help. Since I started this program I think I breathe better and I know that I have more strength and I can do things longer with less stress,” says 88-year-old Kay Doherty.

Importance of exercise for the elderly

Exercise improves circulation, strengthens muscles and allows an individual to lose weight and relieve stress, say experts at the U-M Health System. For older adults, exercise programs help increase mobility and endurance, enabling them to maintain independence by performing their daily activities with relative ease.

Research by the National Institute on Aging has shown it is never too late to benefit from exercise; it can improve cardiovascular functioning at any age. Aerobic exercise has the ability to offset normal aging of the heart by making it a better pump, even for an individual aged 60 or 70.

U-M Health System experts note other physical benefits of regular exercise, including decreasing blood pressure, total cholesterol, and blood sugar. At the same time, exercise also increases metabolic rate, which means an individual will burn more calories before exercising. In addition to physical benefits, exercise provides emotional benefits by improving one's sense of well-being, improving sleep and relieving depression.

An effective exercise program

According to the National Institute on Aging, four “building blocks” comprise an exercise program that will help older adults achieve significant health benefits. These components are:

• Endurance
• Strength
• Balance
• Flexibility

Endurance exercises increase breathing and heart rate, which in turn benefit the lungs, heart, and circulatory system. Endurance can increase stamina and delay or prevent many age-associated diseases such as diabetes, colon cancer, heart disease and stroke. Endurance activities include:

• Stair climbing
• Swimming
• Brisk walking or hiking
• Cycling
• Dancing
• Volleyball, basketball or tennis

Strength exercises build muscle mass and give an individual more strength to complete tasks on their own. One of the most positive aspects of strength training is a small increase in muscle can translate into a much greater increase in ability, especially in a frail person. Strength exercise also increases metabolism to keep blood sugar and weight in check, and may help to prevent osteoporosis. Strength exercises include:

• Weight machines to work the upper and lower body
• Martial Arts
• Pilates
• Rowing, cycling and hiking

An important point to remember about strength training is to vary one's activities to work muscles in both the lower body and upper body. In this way the body receives maximum health benefits by completing a balanced workout.

Improved balance is perhaps the single-greatest exercise benefit to an older adult. Improving one's balance helps to prevent falls -- which can lead to serious injury such as broken hips or other disabilities and can result in loss of independence. Balance exercises include:

• Yoga or Tai Chi
• Weight machines and other exercises that strengthen the back and leg muscles.
• Posture exercises, such as walking heel to toe in a straight line.

Flexibility , the last of the four building blocks, help to keep the body flexible and retain range of motion by stretching muscles and tissues that hold the body's structures in place. Stretching exercises can be used to help recover from, as well as prevent injury. Stretching exercises are typically done both before a and after a workout, allowing the muscles time to warm up and prepare for more strenuous activity. Flexibility also plays a part in preventing falls. Flexibility, or stretching exercises include:

• Yoga or Pilates
• Ballet
• Martial Arts
• Calisthenics

When and how much

• When beginning a program, build up endurance gradually.
• The exercise should feel somewhat difficult for you -- it should increase breathing and heart rate.
• Once you reach your exercise goal, you can divide your sessions into smaller segments, as long as they add up to 30 minutes daily.
• For strength exercises, begin with the minimum amount of weight for the first week, and increase it gradually. If you are able to easily do fifteen repetitions with a certain weight, it is time to increase the amount used.
• Balance goes hand in hand with strength exercises. Just by doing your regularly scheduled strength exercises you also improve your balance.
• Stretching should occur 3 to 5 times during each exercise session.

Remember that before starting any kind of exercise program, check with your doctor about recommendations or limitations such as a heart condition, bone or joint problems, or prescription drugs that might affect your ability to work out.

Resources:

U-M Health Topics A-Z: Exercise Essentials

U-M Health Topics A-Z: Exercise to Stay Healthy

AARP: Get Ready, Get Set, Get Moving!

National Institute on Aging: Exercise Can Boost Cardiac Fitness in Conditioned and Out-of-Shape Older People

Written by Megan Brady

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