I’ve researched, studied and tested more exercises than I care to remember to try and figure out which ones are the best for improving physical function.
It is difficult to make an absolute list because the best exercise for an older adult is determined by their current needs and abilities.
However, after two decades of training older adults there are several that have risen to the top of my list because they offer a multitude of benefits for clients, can be easily modified or varied, and can be used with a wide range of functional levels. Here are a few that you’ve just got to try.
Standing 1-Arm Cable Row
This is a great functional way to challenge the posterior chain with a small transverse plane demand. Put clients in a split stance with legs slightly bent in order to resist the forward pull of the cable. Posture is key so cue them to stay upright and “solid” during the rowing movement. Do not allow them to twist about the waist. You have the option of doing this with same foot forward as the hand holding the cable (ipsilateral) or opposite foot forward (contralateral). Switch back and forth from session to session for variation. Vary the height of the cable to alter the line of pull and create a new demand.
What Time Is It?
Awesome exercise that includes multi-planar lunges while challenging cognitive processing. Have clients stand in an open space and imagine they are in the middle of a clock face that is on the ground. 12:00 is in front of them, 3:00 to the right, 6:00 behind and 9:00 to the left with all of the other numbers in their normal positions. Call out a time, such as 12:00. The client should lunge to that time and then return as quickly as possible. For the numbers on the right side of the clock they should lunge with their right foot and vice versa for the left side. You can increase the cognitive aspects of this exercise by calling out the times quickly so they have to react quicker or by calling out 4 or 5 times in a row that they must remember. This exercise is very scalable. For frailer clients or those with balance problems I have them step instead of lunge. For advanced clients I have them perform upper-body tasks simultaneously with the lunge.
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Getting out of a seat is a common, everyday task. In order to add a power aspect to this movement I have clients perform chair stands explosively. They begin in a standing position and lower themselves slowly to the chair. Once they transfer their weight to the chair they must “explode” and stand up as quickly as possible. The movement should be similar to jumping but without plantar flexion so that they clients don’t actually come off the ground (for the few that could). Foot position affects performance and varying foot position can be beneficial. The basic position is feet in front, shoulder-width apart. You can also do wider than shoulder-width with toes pointing slightly out or shoulder-width but with a staggered stance (one foot slightly ahead of the other). When using the staggered stance you can have them take 3-4 steps after standing like if they were taking off from the chair to race someone.
Through the Gait
Practicing different gait patterns has huge benefits for older adults. Their gait tends to become stiff and inflexible so that they cannot negotiate environmental demands as easily such as steps, slopes, slippery surfaces, uneven ground, etc. Some of my favorite gait patterns to use are Monster Walks, Sleeping Dog, Carioche, Braiding, Red Light Green Light (yes like the children’s game), Heel Walks and Toe Walks. Cueing vision is very important. Clients have a strong tendency to look at their feet the whole time. Cue them to keep their head up and focus on something across the room. Safety is also a major issue. Be sure to use an open area and stay close to them so you can catch them if they stumble.
You can use a low-inertia cable column, a Keiser (pneumatic) cable column or a resistance tube for this movement that focuses on anterior core stability. Do not use an old school cable column that doesn’t allow you to perform fast movements without the weight jerking around. Have clients grab the cable with it anchored at about chest height. The client gets in a staggered stance and turns away from the cable so that they can perform a 1-arm chest press. Keeping an upright posture have the client “punch” in front of them by extending their arm and twisting their body slightly. They should not lean forward but rather maintain their upright posture throughout. A great variation of this is to have them stand beside the cable. So let’s say the cable is anchored to their right. They will step to their left and turn their hips and body to the left simultaneously while punching. Since they have turned their body they end up in a lunge position punching straight ahead. So it is as if they are trying to punch someone beside them. In fact, I typically stand beside them and put my chin out as a target and tell them to try to knock me out (one person almost did when I stood a little too close!)