Stretch yourself: Exercise for the elderly is a growing and rewarding field

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The Independent Online

We are an ageing population. In the future, there will not only be more older people, but they will live longer and therefore be more likely to have disabilities. If we don't act quickly to help increase their levels of independence, society may be in trouble.

That's the message from today's sport and exercise scientists. Growing numbers among them are specialising in helping this age group to keep fit and healthy – the rewards of which they say are second to none. "Older people really appreciate it when you do something like enable them to regain their balance or strength," says John Buckley, who for the past 20 years has been running his own exercise and physiotherapy business, where the average age of members is 65, many of whom have chronic conditions. "It has a big impact on their quality of life, and can be the difference between them living independently as opposed to relying on others."

Buckley enjoys seeing older people benefit from the social component of exercise too. "For many people, the rewards are as much about socialising as the physical benefits. In fact, it's often that element that keeps people coming back," he says.

Buckley explains that unlike sports and exercise scientists who hanker to work with high performing athletes, practitioners like him tend to focus on more basic things such as co-ordination, flexibility, balance and strength. "It might not sound as glamorous as training elite athletes, but actually it's only the select few who work in that field," he says. "In any case, my area of work has an impact on far more people. It's about normal human beings being able to live life to the full."

Other sports and exercise scientists choose to work in research – usually providing an evidence base for practitioners such as Buckley. So far researchers have been able to prove things like the benefits of exercise to people with Alzheimer's and the exact intensity of exercise that benefits people with cardiovascular disease.

Mark Hamer, senior researcher at University College London, runs the English longitudinal study of ageing. "One aspect of the work I'm interested in is how exercise is important for mental health in the ageing population. Depression is quite a big problem among elderly people and our data seems to suggest that even a little bit of physical activity can have a huge impact on the risk of depression," he says.

Hamer has also studied precisely how physical activity helps to maintain muscle strength and physical function. "Muscle strength and physical function are both very strong predictors of death. So it's a very important area," he says.

Hamer says research in this field is "exploding" in recognition of the importance of the elderly keeping active. "There are quite a lot of elderly cohorts now, whereby sports and exercise scientists follow a bunch of people as they age through their elderly years. It's very exciting and challenging work."

James Beale, senior lecturer in sport and exercise psychology at the University of East London, combines his research role with work as a practitioner. The areas he has studied include how exercise impacts on dementia, sleep patterns and mood. In addition, he has looked at how to keep an elderly population exercising. "In the population at large, we have a two-thirds drop-out rate for exercise – and that figure is even greater among the elderly," says Beale. "After all, it can be difficult enough for an older person to do something they haven't done before and even harder to continue doing it."

With this in mind, Beale's research has worked out exactly what kind of exercise is likely to keep them interested and provide the maximum benefit. "What we found is that by keeping an elderly population on moderate intensity exercise, they are more likely to receive benefits than a higher intensity exercise programme." In other words, a brisk walk is easier to work into their daily lives – and more beneficial – than running in a gym, something they are less used to and more likely to become injured by doing.

It's not that gyms are completely surplus to requirement for the elderly. More and more focus on special activities for this age group and increasingly, these are run by sports and exercise scientists. Bupa, for example, has a joint venture with David Lloyd piloting a centre of excellence in Enfield.

All the staff at what's called the Core Exercise Clinic are either physiotherapists or exercise physiologists and they are additionally qualified in areas of expertise such as cardiac rehabilitation or pulmonary rehabilitation. Although the centre is open to all, the oldest member is 86 and each member has a comprehensive health assessment including testing for cholesterol, lung function, cardio respiratory fitness and glucose levels. The staff then develop a personalised exercise programme tailored to the member, which is closely monitored. Someone with lung issues, for instance, will have a pulmonary-specific programme, including Breathe Easy classes.

Clinic manager Kate Henley, a qualified exercise physiologist, says that while lots of sports and exercise science graduates lean towards personal training or fitness instruction, she was attracted to working in a team that could provide more specialist and lasting effects. Meanwhile, the appeal of working with the mature population, she says, was that you work with very particular conditions and you have a very specific goal.

"I also find it incredibly rewarding to see the motivation and confidence increase among older people, especially as that often happens very quickly," she says. "As soon as you get them on to the most basic of programmes, you can see an increase in their heart rate and their functional strength. I have people telling me they can reach for a jar in the cupboard for the first time in months."

It's not all about cycling machines and cross trainers. Some of the most effective exercises are chair based. "One of the biggest issues for elderly people is that once they are sat down, they can't get up without extra help," says Dan Gordon, principal lecturer in exercise physiology at Anglia Ruskin University. One of his projects is using biomechanics to make a chair that gives even the most infirm the ability to get up and, ultimately, have a freer lifestyle.

Gordon says working with the elderly still isn't that popular among sports and exercise science graduates, but he doesn't think that will be the case for long.

'You help them feel more confident'

Joanne McAllister is a healthy lifestyle facilitator at North East Essex Primary Care Trust, a job that involves community outreach work and running a cardiac rehab programme.

"My work with cardiac patients involves people who have had heart attacks or who are at risk of having one. We do circuit training with them, which involves the patients doing an hour of exercise with us once a week. We write home-based exercises for them to do for 30 minutes every other day. If a patient can't come in – because of transport issues or because they have problems with mobility – we visit them at home.

My background is a sport and exercise science degree, followed by an MSc in cardiac rehab, both of which I did at the University of Essex.

The reason my job requires that background is that you've got to have a knowledge and understanding behind things such as heart disease and diabetes, as well as which exercises and what intensity of exercise will benefit each patient. If you think about something such as osteoporosis, which many of our older patients have, that alone can limit movement, so you need to adapt the exercises and use the right equipment accordingly.

The rewards of the job are huge. These are people who come in perhaps unable reach to get the sugar out of the cupboard and suddenly they're not just able to do that, but can walk further and feel more confident generally. That massive improvement on their quality of life happens quite quickly."

Joanne McAllister is a Healthy Lifestyle Facilitator at North East Essex Primary Care Trust, a job that involves (among other things) running a cardiac rehab programme and doing community outreach work.

"My work with cardiac patients involves people who have had heart attacks or who are at risk of having one. We do exercise circuit training with them, which involves them doing an hour of exercise with us once a week. We write home-based exercises for them to do for 30 minutes every other day. If a patient can't come in – for instance, because of transport issues or because they're badly mobilised – we visit them at home.

My background involves a sport and exercise science degree, followed by an MSc in Cardiac Rehab, both of which I did at the University of Essex. The reason my job requires that background is that you've got to have a knowledge and understanding behind things like heart disease and diabetes, as well as what exercises and what intensity of exercise will benefit each patient. If you think about something like osteoporosis, which many of our older patients have, that alone can limit movement, so you need to adapt the exercises and use the right equipment accordingly.

The rewards of the job are huge. These are people who come in perhaps unable reach to get the sugar out of the cupboard and suddenly they're not just able to do that, but walk further and feel more confident generally. That massive improvement on their quality of life happens quite quickly."

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