In today’s world of health conscious celebrities and fitness personalities, we may overlook a very large part of our world that lives with limited mobility. Individuals with limited mobility may include seniors, disabled adults, and those with chronic medical conditions. These people can be very close to us, including our siblings, our parents, grandparents, and relatives.

How can these very special individuals build and maintain their muscle mass, increase range of motion, and improve coordination?  How can they keep their independence, enjoy their hobbies, and be a positive influence for others?

The answer is exercise.  The National Institute on Aging (NIA) reports one of the best interventions for improving health at all ages, including older ages, is exercise.[i]

Without exercise, physical impairments will lead to greater functional limitations in everyday life. These limitations can include difficulty getting out of a chair, going up steps, lifting, and reaching.

Fortunately, much of the decline we see in these individuals is reversible. Exercise not only improves our overall health, it will positively affect our everyday life too.

Exercise creates stronger muscles, bones, tendons, and ligaments. It will improve mobility, coordination, range of motion, and create better posture. This increased activity will improve functional mobility and delay the onset of physical frailty.

Work on your major muscle groups

You will need to first strengthen your ankles, knees and hips. These muscles are used for walking, standing, and getting up from a chair. Building these muscles will increase your stability and balance with stepping.

Strengthening the abdominals will increase your core stability, posture, balance and general mobility.

Working on your chest, back, arms, and shoulders will assist with pushing and carrying things, walking when swinging arms, spinal posture, pulling motions, and will help reduce the impact of a fall.

How to begin to exercise

Before you begin to exercise, talk to your physician and let them know you would like to start a strengthening program. Then start with a simple workout of stretching and strengthening exercises. Begin with 2 or 3 workouts a week.

Gradually progress your program to 30 minutes of moderate exercise daily. Your exercise session can be spread out over the course of the day in 10 minute sessions. Make sure you perform strengthening exercises at least 2 days per week.

For your strength workout, start with a single set of 8-12 repetitions. You can use either free weights, body weight, or a resistance band. Work your large muscle groups before your small muscle groups. Make sure to rest 1 minute between sets.

 

3 Important Exercise Principles

Seniors and others with limited mobility resulting from a chronic health condition should follow these three simple exercise principles.

• First, the exercise should be functionally related to your daily life. If you have stairs at home, then work on your leg strength. If you have high cupboards, work on your shoulder range of motion.
• Second, your exercise should be challenging. This will allow you to make the type of gains in mobility and strength that will truly make a difference in your life. For example, uses ankle weights when performing leg exercises to increase the benefit of the exercise, and effectively improve your leg strength.
• Lastly, you should allow for fluctuation in your health. Some days you will be sick and unable to exercise. You may have an exacerbation of a health condition like arthritis or asthma. You may feel increased pain in your joints or have trouble breathing. Exercise to the best of your ability for that day. Listen to your body and don’t overexert.

 

Exercising with Health Conditions

Coronary heart disease: Avoid high intensity exercise which can cause a coronary event and know the warning signs for stopping exercise. Strength training is most important for this population because seniors with heart disease can grow increasingly sedentary. This results in decreased muscle mass and strength, loss of physical function, and the inability to perform daily activities.

Hypertension: Resting blood pressure increases with age. Monitor your blood pressure and make sure that exercise is not causing abnormal fluctuations, especially during the early stages of your program.

Safety

Make sure you warm up your muscles with a few minutes of limbering exercises for the neck, arms, and legs. Begin strengthening with a light weight at first. Then gradually add more repetitions to your exercise, then more weight, then more sets.

Only work in a pain free range of motion. Discontinue an exercise if it is painful, or reduce the repetitions. When lifting a weight, never hold your breath. Breathe out on the effort part of an exercise, and breathe in during the relaxing part of the exercise. Avoid hyperextending or locking joints. Allow 48 hours between exercise workouts.

 

Four essential exercises for those with limited mobility

1. Sit to Stand:
   Begin seated on edge of chair, bring toes under knees, lean over and stand up 10 times.

Figure 1 Sit to Stand

2. Triceps Press:
   Begin seated on chair with arm rests. Extend elbows and lift bottom off chair 10 times.

Figure 2 Triceps Press

3. Seated Row:
   Place elastic band on chair in front, raise elbows and pull straight back while pinching shoulder blades together 10 times.

Figure 3 Seated Row

4. Back Extension:
   Seated edge of chair with elastic band held firmly on chest. Lean back with elastic band on chest 10 times.

Figure 4 Back Extension

 

Yoga and Tai Chi

Mind body exercises like Yoga and Tai Chi Chuan can be very beneficial for those with limited mobility.  This type of exercise integrates the mind or the awareness of your body movement with the exercise, and is coordinated with your breathing. This form of exercise uses movement along with a meditative state. Many older adults find these types of exercise beneficial in managing their fitness and health concerns.

Aquatic Training

Many children and adults use aquatic training as their preferred means of exercise. The benefits of aquatic exercise include increased oxygen uptake, lowered blood lipid levels, increased muscle strength and endurance, and improved flexibility.  Exercisers are more able to move through a complete range of motion.

Seniors love the playful and social benefits along with the physical improvements with aquatic exercise. The hydrostatic pressure is like a support stocking. It aids venous return and increased range of motion. It also reduces edema or swelling particularly in the feet.

The buoyancy and viscosity of water decreases the weight bearing impact of exercise, and reduces the compressive forces on the joints.  It also decreases the fear of falling, especially in stroke patients and improves stability especially with limbs that are more flaccid.

Conclusion

Recent research and studies show that exercise can be safe and effective for women and men with physical disabilities, chronic health conditions, and age related changes, regardless of abilities.

Muscle strengthening improves your ability to perform activities of daily living, which in turn, improves your overall health and sense of well-being.

The benefits of exercise include increased strength, more endurance, greater muscle capacity, improved range of motion, greater energy, improved self-image, and more confidence.

A well rounded physical activity program including strength, endurance, flexibility, and balance is vital in preventing additional functional limitations. It is never too late to start an exercise program if you are a person with limited mobility.

 

[i] NIA (2009). Exercise for all older adults: NIA guide shows and tells

 

This article can be seen online at: Complete Wellbeing Magazine