far less on what to emphasise. Thankfully, that is changing, though
much of the knowledge gained from research has yet to trickle down
to regular practice.
What to do!
The American College of Sports Medicine (ACSM), widely considered
the leading authority on exercise research and recommendations,
suggests that programs for older people include four components:
aerobic fitness; strength; flexibility and balance. That last one in
particular is crucial for this age group; balance declines with age,
unless it is practiced regularly. In fact, the ACSM now stresses the
importance of what is called neuromotor training – balance, agility
and coordination – for people of all ages, noting that it is particularly
important for older people.
Anyone over the age of 65 has a one-in-three chance of falling
each year. Yet we have ample evidence that specific balance training,
performed frequently, decreases the likelihood of a fall. If you aren’t
including a balance component in your work with older adults, now
is the time to start!
We know the enormous benefits of strength training for this age
group, including its effect on bone density. Yet developing the right
strength program, particularly for older clients who present with
chronic conditions such as arthritis or osteoporosis, or who may
have been sedentary for decades, can be challenging. We need to
keep our clients safe, but if we simply sit them at fixed machines and
count their reps, we are not challenging them physically or mentally.
Of course, when we talk about older adults, we have to
acknowledge the enormous variations within this group, from the
82-year-old who plays tennis three times a week to the 60-year-
old who’s been sedentary for three decades. Yes, we are training
individuals, not age groups. That said, I would like to offer a few
suggestions that will apply to many older clients (most of whom
will not have been exercising regularly all their lives) based on the
available research and my own experience of training dozens of older
adults.
Ask and assess
As well as having new clients fill out a standard health questionnaire,
I ask them if they have had a fall in the past five years and whether
they have had a bone density test (if so, I ask to see the results).
I also run them through a 5-minute balance test (see box and
images on next page). Someone who has difficulty completing all
levels of the test is at increased risk of falling and needs to start
with basic balance exercises. Someone who is able to complete all
phases will still benefit from balance training, but can start at a more
advanced stage.
A basic postural assessment may show up another common
issue with this age group. By the time they reach their 60s and 70s,
many people, even strong, fit ones, have experienced shoulder
The 30-second article
• While older adults vary enormously in
their fitness, strength and agility, there
are a few areas of fitness that have
particular benefits for most of them
• Balance training has been shown to be
effective in preventing falls, which
affect one in three people over the age
of 65 every year
• Balance and stability can be
incorporated into a strength training
regime by featuring exercises that
include weight shifting, unilateral
movements and exercises done
standing on one leg.
problems such as shoulder impingement
or frozen shoulder. Many more will present
with forward head posture and rounded
shoulders. For them, it’s important to pay
close attention to posture; allow plenty of
stretching of shoulders, chest and upper
back; avoid, at least initially, overhead lifts;
and focus primarily on pulling exercises
such as rows and vertical pulls, rather than
pushing ones like the bench press, chest
press and shoulder press.
Exercises for this age group
These are some great ‘go-to’ exercises for
use in training sessions with older clients.
Sit to stand
One of the most practical exercises you can
do. There’s a lot of talk about functional training
in our industry – well, it doesn’t get more
functional than this. This exercise is a beauty,
because the ability to get out of a chair is crucial
to people’s ability to live independently. For
those with poor lower body strength, you can
build up a step to the necessary height. Have
the seat low enough so that the person needs
to make an effort to stand, but high enough
so that he or she can stand up from it without
using their arms. For those with poor balance,
have support available.
Cable horizontal pull
If we simply sit clients at fixed machines and
count their reps, we are not challenging them
physically or mentally.
62 | NETWORK SUMMER 2018
The target muscles are similar to those of a
seated row machine, but if your client can
stand and use a cable machine with the arm
set at around waist height, he or she will
be using many other muscles and getting
practice in balance and stability. This exercise
will work the muscles of the upper back, so
it’s great for posture and shoulder health. Pay