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Below you will see sample text of what is included in the course.

Exercise and Older Adults 

Limitations on physical activity increase with age due to disabilities such as arthritis, hypertension, hearing impairment, heart disease, cataracts, orthopedic problems, diabetes, and lack of socialization. Many older people could be more independent if they were more fit. 

Programs should focus on the aforementioned problems and also on prevention. Attention should include individuality based on genetics and their education, health care, economic status, etc. Regular exercise is better than a sedentary lifestyle. 

The decrease in VO2 max affects performance in any activity. Not being able to engage in physical activity affects anyone’s quality of life and independence.  The VO2 max can be increased 10 to 30% with endurance training. Exercise also helps lessen loss of bone density. 

Most of muscular strength decreases after the age of 50, with more rapid decrease after 70 years of age due to a loss of muscle mass. An intense resistance training program increases muscle mass  and strength and can increase VO2 max. Studies state that strength training should occur before aerobic exercising. Strength is needed to have the ability for safety movements. 

Flexibility with older people is important. Being able to move a joint with normal ROM helps with daily activities. How the joint moves is influenced by the muscle and connective tissues with the joints. 

With programs for the elderly, safety and injury prevention are major concerns for the Fitness Instructor. Proper training is required. At no time should a FI overlook the need for a physical exam and recommendation from the client’s doctor. 

Older individuals should engage in some kind of physical activity on a daily basis. Each person is different. One 70 year old person can be stronger and have more VO2 max than another 70 year old.

 The Journal of Applied Physiology classifies the levels of aging abilities: 

        Level I:     Healthy; in good condition; no major problems; has exercised for last 5 years.

        Level II:    Ambulatory/nonactive; no major problems; has not been in a structured exercise

                        program

        Level III:   Ambulatory/disease failure: has severe coronary disease, arthritis, diabetes, or

                        pulmonary disease

        Level IV:   Frail elderly: requires some assistance with ADLs; can walk/stand for a short distance

                        with a device, but sits most of the time

        Level V:    Wheelchair dependent:  cannot stand or walk 

Personnel needed with these levels are the physician, physical therapist, and other licensed medical staff. The FI should follow the program presented by these medical professionals. 

Programs should be based on moderate-intensity activities per an individual basis. Exercise should not aggravate joint problems. Balance and safety is of utmost importance. Some older people will only be able to do 5 – 10 minutes of exercise while others will be able to participate in 30 minute sessions. Movements should be slow and pain free. Intensity and duration should remain at the low end. 

Socialization is very important for the older generation. With improved activity and fitness, the person can remain active or return to society.

PREVENTING INJURY 

Aerobic exercise injuries can be reduced by controlling the tempo of the exercise. 

Assessing clients for problems, for abilities, and for strength can help decrease injuries from the wrong exercises. 

Beginners should not have an intense workout as would a person who regularly exercises. 

Injuries such as cuts should be covered with a bandage. 

Rest, ice, and elevation are temporary steps for immediate care of most muscle/joint injuries until the injured person can visit a physician. 

Some orthopedic injuries are caused from overuse or irritation of a musculoskeletal problem. 

Refer injuries to a physician. 

Check the area for safety. 

Don’t modify equipment by trying to make it function in a different way than was designed by the manufacturer. 

With free weights:  Use collars on the bars. Make sure a client has a secure hold on a weight before letting it go. Ask if he has hold of the weight before releasing it.  When maneuvering with bars and weights, be aware of other people and machines near your immediate area. Do not unload one side of a bar because the bar end with the remaining weights will flip. 

Have dumbbells, barbells, and other objects in a safe area of the floor. Warn clients of the hazards and be careful yourself. 

Spot the client and communicate your actions in advance. Do not get distracted while spotting. 

A client’s weight should be distributed to prevent falls and injuries. For example, a lunge requires the center of gravity in the low back and abdominals for balance.

BEGINNERS WEIGHT TRAINING PROGRAM

 

EXERCISE & CATEGORY			SESSIONS1-5	SESSIONS 6-10	SESSIONS  11 +
		Incline bench press, Chest.	1 set 10 -12 reps	2 sets 8 -10 reps	2 -3 sets 10 -12 reps
Keep your back firmly into the bench, smoothly pushing the weight up, keeping it incline with your chest. Avoid hitting your chest when you bring the weight down.
		Upright row Shoulder's	1 set 8 - 10 reps	1 set 12 - 15 reps	2 sets 10 -12 reps
Hold the bar in the center, and lift taking elbows up and out to your sides, no higher than your shoulders. Take care not to hit your chin when lifting the weight.
		Leg extension Quads	2 sets 8-10 reps	2 sets 8 - 10 reps	2 sets 10 -12 reps
Make sure the machine is comfortable, adjusting any levels to enable you to lift the weight smoothly and under control. Avoid any jerking rapid movements.
		Hands to knees, Abs.	1 set 12 -20 reps slow	2 set 12 - 15 reps	2 sets 15 + reps
Aim to work slowly, sliding your hands along your thighs no higher than your knees. If your neck hurts, support it with 1 arm, while taking the other up your leg.
		Bicep curls normal	1 set 8-12 reps	2 sets 8 -10 reps	2 sets 10 -12 reps
Concentrate on keeping the elbows tucked into your sides, keeping your back straight and shoulders back, lift and lower the weight slowly in a controlled motion.
		Tricep kick backs	1 set 10-12 reps each arm	2 set 8 - 10 reps	2 sets 10 -12 reps
Work the arm in a smooth controlled action. Aim to take the weight behind you, by straightening the arm. Begin with a lightweight to obtain correct technique.
		Hip rolls Abdominals	1 set 6 turns each way slow	1 sets 8 turns each way slow	1 set 10 turns each way slow
Aim to keep your knees and ankles together, and simply roll from one side to the other in a slow controlled motion.
		Lying Hamstrings	1 set 8-10 reps lightweight	1 set 10 -12 reps	2 sets 8 - 10 reps
Control the movement on this exercise, starting with a lightweight to prevent any injury. Position the footpads to be placed at ankle height.
		Lateral pull down Back	1 set 10 - 12 reps light	2 sets 8 - 10 reps	2 set 10 -12 reps
Always perform this exercise as a beginner by taking the bar down in front of you. Take the bar down no further than shoulder height in a controlled motion.
		Seated Calf Raises	1 set 8-12 reps slow	2 sets 10 -12 reps	2 sets 12 + reps
Hold some weights on your knees, while slowly lifting  your heals off the floor. Aim to keep your heals raised for a few seconds before lowering under control.

SEATED WEIGHT TWIST
This is a good exercise for the oblique muscles.

Sit on the end of the bench with your feet firmly on the floor. Slowly twist at the waist from one side to the other, keeping your back straight and head up.

Variations are standing or holding a dumbbell close to the chest.

Avoid twisting too far round, aim for small movements.

Vitamins --

Vitamins regulate chemical reactions within the body. Since your body doesn’t make most of the vitamins, you have to get them through your diet. Unlike the other nutrients, vitamins are not energy sources. 

Vitamins are classified in two groups:  fat-soluble and water-soluble. The water-soluble vitamins (B complex vitamins and vitamin C) will dissolve in water. Your bloodstream carries these vitamins, letting your body use what it needs, then you excrete the unneeded amount through urine. Water-soluble vitamins are not stored, so you have to regularly consume these from your food choices.   

Vitamins A, D, E, and K are the fat-soluble vitamins (dissolve in fat). They attach to body chemicals made with lipids, or fat, and are carried into your bloodstream and throughout your body. These vitamins can be stored in body fat by your body, so too much of vitamins A and D can build up to toxic levels. 

The Different Vitamins – 

Vitamin A promotes normal vision, helps one see normally in the dark, promotes the growth and health of cells and tissues, protects you from infections, works as an antioxidant, and may reduce your risk for certain cancers.  Sources for vitamin A are: liver, fish oil, eggs, milk fortified with A, carrots (raw), pumpkin, yams, tuna, cantaloupe, mangos, turnip, beet greens, butternut squash, spinach, fish, and eggs. Lack of this vitamin can produce night blindness; dry, scaly skin; problems with reproduction; increased risk of cataracts; macular degeneration; and hearing, taste, smell, nerve damage. Too much of the vitamin can produce vomiting and nausea, headaches, insomnia, dry skin, joint pain, and constipation. 

Vitamin B1 (thiamine) helps produce energy from carbs in all the cells of the body.  Sources for thiamine are rice bran, pork, ham, fresh peas, beans, breads, wheat germ, oranges, enriched pastas, tortillas, and liver. Lack of this vitamin can produce fatigue, weak muscles, nerve damage, edema, and an enlarged heart. Chronic alcoholics usually have a thiamine deficiency. Too much will be excreted by the body. 

Vitamin B2 (riboflavin) helps produce energy in all the body cells, and helps change tryptophan ( an amino acid) in food into niacin. Sources are poultry, fish, fortified grains and cereals, broccoli, turnip greens, asparagus, spinach, yogurt, milk, eggs, liver, and cheese.  Lack of riboflavin (only from severely malnourished people) includes eye disorders, dry and flaky skin, sore red tongue, cracks in the corners of the mouth, red eyes, skin lesions, dizziness, hair loss, inability to sleep, sensitivity to light and poor digestion. Too much of this vitamin has been reported to have no side effects. 

Vitamin B3 (niacin) helps enzymes function normally in your body, helps produce energy in all the cells, and helps your body use sugars and fatty acids. Sources are chicken breast, tuna, veal, beef liver, fortified breads and cereals, brewer’s yeast, broccoli, carrots, cheese, corn flour, dandelion greens, dates, eggs, fish, milk, peanuts, pork, potatoes, tomatoes, peanut butter, and legumes. Lack of niacin can cause diarrhea, mental disorientation, canker sores, fatigue, halitosis, indigestion, headaches, loss of appetite, and dermatitis.  Too much can cause nausea, vomiting, abdominal cramps, diarrhea, and flushing. Severe toxicity can lead to liver damage, irregular heart beat, gouty arthritis, and rash to large portions of the body. 

Vitamin B5 (pantothenic acid) helps body cells produce energy and helps metabolize proteins, fats, and carbs from food.  Sources are meat, poultry, fish, whole-grain cereals, legumes, milk, fruits, mushrooms, fresh vegetables, whole rye and whole wheat flour. Lack of B 5 is extremely rare. Symptoms are the same as the above B vitamins. Too much of B 5 is not considered to be toxic. 

Vitamin B6 (pyridoxine) helps your body make nonessential amino acids, helps turn tryptophan into niacin and serotonin(a messenger in your brain), and helps produce other body chemicals including insulin, hemoglobin, and antibodies that fight infection. Sources are chicken, fish, pork, liver, whole grains, nuts, legumes, avocados, bananas, brown rice, soybeans, and carrots.  Lack of this vitamin can cause mental convulsions among infants, depression, nausea, greasy flaky skin, sore tongue, cracks on mouth, anemia, and seizures. Too much (2,000-6,000 mg/day or 100 milligrams/day) can cause nerve damage.

Vitamin B12 (cyano-cobalamin) works closely with folate to make red blood cells, serves as a vital part of many body chemicals, and helps your body use fatty acids. Sources are mainly from animal products – meat, fish, eggs, poultry, tuna, clams, ham, cooked oysters, salmon, and blue cheese. Lack of this vitamin can produce unsteady gait, chronic fatigue, constipation, depression, digestive disorders, liver enlargement, hallucinations, tongue inflammation, irritability, and palpitations.  Reports do not show toxicity for too much. 

Vitamin C (ascorbic acid) helps produce collage, a connective tissue that holds muscles, bones, and other tissues together; helps keep capillary walls and blood vessels firm to protect you from bruising; helps your body absorb iron and folate; helps keep your gums healthy; helps heal cuts and wounds; protects your from infection by stimulating antibodies; and works as an antioxidant to inhibit damage to body cells. Sources are broccoli, cantaloupe, kiwifruit, oranges, pineapple, peppers, pink grapefruit, strawberries, asparagus, avocados, collards, dandelion greens, kale, lemons, mangos, onions, radishes, watercress, papaya, tomato juice, baked potato with skin, raw cabbage, and spinach. Lack of C  gives poor wound healing, bleeding gums, easily bruised, nosebleeds, joint pain, lack of energy, susceptibility to infection, and in severe cases can cause scurvy (disease causing loose teeth). Too much can cause abdominal bloating and diarrhea. 

Vitamin D helps prevent bone deformities in infants; helps prevent delayed tooth development, weak muscles, and softened skull in children; and helps prevent osteoporosis in adults.  Sources are salmon, sun exposure, sardines, mushrooms, eggs, fortified milk, fortified cereals, herring, liver, tuna, cod liver oil, and margarine. Too much D can cause headaches, vomiting, constipation, diarrhea, fatigue, loss of appetite, excessive thirst and urination, protein in urine, and liver and kidney damage. 

Vitamin E’s main role is as an antioxidant. Other claims have not been proven. Sources are vegetable and nut oils, spinach, whole grains, wheat germ, margarine, hazelnuts, almonds, peanut butter, and sunflower seeds. It is generally non-toxic if you take too much. 

Vitamin K’s sources are green leafy vegetables and cauliflower. Lack of K is rare except in newborns where bleeding tendencies are possible. Elevated levels of K can interfere with the effects of anticoagulants and a type of jaundice may occur in premature infants.