practical living
Exercise advice challenged
based. You know, ‘the exercises to avoid’, and that’s certainly not
the message we want about physical activity. We know many adults
aren’t hitting the Australian government’s physical activity guidelines
– and it’s not just older adults; it’s people younger than 50.
So, first and foremost, we like to see positivity about physical
activity, because we know how many different parts of your health
it can impact – not just, say, mood and lifespan.
For older adults, we’re considering things like osteoporosis, pain
management and osteoarthritis. It’s well documented that physical
activity is one of the best interventions we have for osteoarthritis and
its management. And as we’re considering an older population, we’re
thinking about osteoporosis and falls management, as they can have
such a big impact.
So the APA’s press release says we don’t believe the Reader’s
Digest article is in the best interests of the public. The APA’s position
is that we should focus on the evidence base, and the evidence is
that exercise is safe for older adults and in their best interests for the
rest of their life.
What sort of exercise should be prescribed to older people?
APA refutes Reader’s Digest article on exercise
for people older than 50.
Scott Lynch interviewed by Megan Tran
T
he Australian Physiotherapy Association (APA) is urging
seniors to tailor exercise to their ability rather than age.
Counter to advice in a recent Reader’s Digest article, the
APA advises that exercise programs should be based on individual
ability and needs, rather than age, and is urging the publication to
retract the article ‘14 Exercises to Never Do After Age 50’ (the title of
the article online has since been changed).
APA’s managing director of community therapy, Scott Lynch,
says the focus should be on positivity and the benefits that physical
activity brings, like managing osteoporosis and pain.
“With the older population, you need to be thinking of fall
management and what’s safe for older people,” Lynch says.
So, what sort of exercise should be prescribed to seniors?
Lynch suggests resistance-based activities that are moderately
challenging. Aged Care Insite spoke with him to find out more.
ACI: What did the Reader’s Digest article recommend?
SL: The article basically went against what most of the evidence-
based literature at the moment says about exercises for older adults.
This article was largely about exercises that are ‘not safe’ for those
over 50, including push-ups, squats with weights, pull-ups, dead lifts
and plyometric leg exercises. They even commented on leg presses
as having the potential for lumbar spine disc injury. And they made a
lot of recommendations in terms of things that could be done.
The APA and a couple of the members – Megan Lowry and
Christian Barton – picked up on the article in terms of it not suiting
the evidence base. They thought we should make a press release.
Not only is APA there to represent its members, it’s there to advocate
for the public. So they put out a press release saying the article’s not
in line with the evidence base.
What’s the APA’s reaction to this publication?
This isn’t the first time we’ve seen something like this. We often
see the media putting out fear-based headlines about these sorts
of things. The headline in the Reader’s Digest was definitely fear-
20 agedcareinsite.com.au
That is the right question to ask. It’s always going to depend on the
clinical need. But if we take a broad scope first and think about the
Australian government’s physical activity guidelines just for better
health outcomes in general, we know that older adults should be
doing some sort of resistance exercise that is challenging for them at
least twice a week.
There are many different guidelines on the cardiovascular side
of it, but something simple for readers and people talking to the
public to remember is: Can you do some sort of moderately
challenging cardiovascular activity for 30 minutes a day?
Something that gets you breathing, a little bit of a sweat. There are
many things you can be doing.
The Reader’s Digest article was mainly commenting on resistance
exercises. So if we think about the resistance exercises that they’re
saying aren’t safe – things like heavier movements, squats with
weights, and dead lifts – there’s plenty of research to say that it’s safe
for older adults and in their best interests.
There’s a nice piece of research called the LIFTMOR trial. It took
101 females aged 65, plus or minus five years, with low bone mass,
and they did eight months of twice-weekly 30-minute sessions.
So, an hour of exercise a week, and that was heavy lifting – five sets
of five, 85 per cent or more of their one rep maximum. They did
movements like dead lifts, overhead press and back squats, and they
even did some drop landings, or what people in the sports world
would call depth jumps. They would jump up into a chin-up and at
the top of their chin-up they would drop down and land as heavily
as comfortable.
What that research showed was that those sorts of heavy lifting
were safe. They only had, I think, a couple of missed sessions due to
basic aches and pains, but no fractures, and this was a population
that had osteoporosis. So the outcomes of that study showed that
those doing the heavy lifting actually increased their lumbar spine
and femoral neck bone mineral density. And those doing what you
would consider more conventional old-school resistance exercises,
10–15 repetitions, 60 per cent of your one rep maximum, they
actually lost bone mineral density.
So, you need to look at the Australian physical activity guidelines,
and when you’re trying to target more clinical needs regarding
osteoporosis, falls management and the like, you need to look at
the evidence base. The takeaway message is that the older adult is
no different to the younger adult in terms of the body being robust,