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Tips about Planning Physical Activities Programme for Elderly

It is never too late to start a physical activity programme. Taking part in a variety of physical activities regularly can lead to many health benefits, such as improving musculoskeletal health, cardiorespiratory fitness and body adiposity; prevention of fall, osteoporosis and mobility decline, decreasing the risk of developing hypertension, type II diabetes and certain cancers such as breast and colon cancer; reducing cardiovascular disease mortality and all-cause mortality. Moreover, engagement in regular physical activities can also benefit psychological and mental health; such as reducing symptoms of anxiety and depression; improving quality of sleep and cognitive health; slowing down progression of cognitive decline and reducing risk of developing dementia.

An active lifestyle requires an increased engagement in physical activities during daily living. Examples of these activities include work or household chores, walking instead of taking transportation for short distance travel, recreation and leisure (including exercise). On the other hand, the time spent in sedentary activity should be limited, as high levels of sedentary behaviour imposes detrimental risk to health. Examples of sedentary activities include watching television and lying in bed.

In order to gain more health benefits from physical activity, elderly should choose a variety of activities suitable to their physical fitness, and ensure that the activities are performed in the correct way. Here are four principles:

Principle 1: Physical activity programme should be balanced

Physical activities could be classified into aerobic physical activities, muscle strengthening activities and multi-component balance training activities A balanced physical activity programme should therefore comprise a combination of these major types of physical activities which is conducive to striving for all-round health benefits.

Principle 2: Choose different types of physical activities

Elderly can choose different physical activities based on their own target, health condition and interest:

1. Aerobic Physical Activities:

  • Benefits: Improve cardiopulmonary function
  • Examples: Household chores include mopping, sweeping windows and walking a dog. Exercises include fitness walking, Tai Chi Chuan, swimming, riding fitness bike, and different ball games

2. Muscle Strengthening Activities:

  • Benefits: Strengthen muscles, prevent osteoporosis (especially with weight-bearing exercise), and improve balance. For elderly persons with joint pain, muscle strengthening activities can improve mobility
  • Examples: Household chores or work-related activities that require lifting heavy objects. There are three options of load for muscle strengthening activities: (1) using one’s own body weight as loads; such as sitting up and doing a mini-squat; (2) using weight training machines; such as leg press and chest press machines; and (3) using small exercise equipment; such as water bottles, dumbbells, cuff weight and elastic resistance bands

3. Multi-component Balance Training:

  • Benefits: Improve balance and prevent falls
  • Examples: Balance-focused physical activities which include social dance and Tai Chi Chuan, or gait and balance training under the guidance of a physiotherapist. Moreover, muscle strengthening and stretching exercise that help balance training should also be included; such as muscle strengthening exercise for thighs and stretching exercise for calves

Principle 3: Do adequate amount of physical activity

The World Health Organization recommends older adults to do the following types of physical activity at adequate intensity and frequency in order to maximise health gains.

1. Aerobic Physical Activities:

  • Older adults should do at least 150-300 minutes of aerobic activities of moderate-intensity; or at least 75-150 minutes of aerobic activities of vigorous-intensity; or an equivalent combination of moderate- and vigorous- intensity activity throughout the week

2. Muscle Strengthening Activities:

  • Older adults should do muscle strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week
  • Muscle strengthening activities should be started with lighter loads, and then progress gradually to moderate or greater intensity

3. Multi-component Balance Training:

  • Older adults should do multi-component balance training that emphasises functional balance and strength training at moderate or greater intensity, on 3 or more days a week

Principle 4: Do physical activity according to one’s capacity and take a progressive approach

  • For elderly persons who have chronic diseases or any queries of their health condition, please consult a healthcare professional prior to starting a physical activity programme or increasing the intensity of their physical activity programme. You can also refer to the article : “Exercise Safety”
  • Elderly should match the intensity and amount of physical activities in accordance with their level of mobility and health condition. They should start with a low intensity and shorter duration, and then progress to increase the frequency, intensity and duration gradually over time if their condition allows
  • Elderly should stop any physical activities immediately if they encounter discomfort or difficulties. They are advised to seek medical advice if the problem is severe or persisting.
  • The intensity of functional balance training should be adjusted to be suitably challenging to the elderly. Elderly should take safety precautions for fall prevention according to their ability to balance; such as holding on a handrail, sturdy furniture, or getting assistance from carers
  • If elderly are not able to meet the recommended duration and intensity of physical activities due to health limitation, they could still improve their health by doing lighter physical activities in accordance with their level of fitness