The natural aging process causes physical and biological changes that impact our fitness levels. As we get older, we may experience a decline in any of the four dimensions of fitness: endurance, flexibility, balance, and strength. While this is normal, it doesn’t mean that we cannot become more physically fit regardless of our age. Personal trainers who work mainly with older clients can improve their wellbeing by assessing clients’ performance in each domain and creating a tailored workout plan.
Here’s what you need to know about the four dimensions of fitness as well as what physical therapists who work with senior clients can do to help them achieve and maintain peak fitness.
1. Endurance
Endurance one measure of the body’s capacity for physical activity. In the context of fitness, there are two common measures of endurance. Cardiorespiratory endurance is a person’s ability to maintain activities that elevate heart rate and challenge lung capacity. When our cardiorespiratory endurance is high, we can perform high-impact activities such as running or spinning without losing our breath.
Muscular endurance refers to how many repetitions of a strength exercise you can perform before experiencing fatigue. Physical exertion generates lactate, a substance that the muscles create when burning energy. Excess lactate contributes to muscle fatigue, burning, and labored breathing. People with high levels of fitness produce or clear lactate efficiently, which allows them to sustain physical exertion for longer periods of time.
2. Coordination/Balance
Balance reflects one’s muscle and bone strength. Strong muscles, joints, and tendons can support the body’s weight effectively. People of advanced age may develop balance issues due to muscle tone loss and reduced bone density. Poor balance is associated with a higher risk of falls and impaired mobility. Building musculoskeletal strength and improving joint stability are two ways to improve balance and coordination.
3. Strength
From age 30 to 60, our muscle strength declines by up to 8 percent every 10 years. This muscle loss can be exacerbated by a sedentary lifestyle caused by reduced mobility or illness. Exercise counters muscle weakness by encouraging hypertrophy. This occurs when stress and resistance create small abrasions within the fibrous muscle tissue. When the damaged tissue repairs itself, the muscle grows back thicker and stronger. Strength training using resistance bands or weights can trigger muscle-building hypertrophy and improve muscle tone. Personal trainers can design routines that help seniors build muscle growth without risking injury.
4. Flexibility
Age-related changes also impact our muscle extension and joint range of motion. Muscle fibers become stiffer and shorter over time, which reduces flexibility. The body also produces less lubrication in the joints. This makes movement more rigid. Tendons and ligaments also retract, making it more difficult to move and control our joints. When people move beyond their range of motion, they experience pain. This can cause us to limit our activity level, which further reduces flexibility.
Stretching helps the body regain flexibility by extending stiff muscle fibers, ligaments, and tendons. While stretching the body to its limit is uncomfortable at first, it should not be painful. Eventually, the nerves will become less reactive. Clients can improve their flexibility through static and dynamic stretches. During a static stretch, the muscle remains in position for up to one minute at a time. Dynamic stretches involve movement.
Assessing the Fitness of Senior Clients
Trainers can assess each dimension of a client’s fitness level by administering physical tests. Some commonly-used fitness tests include the Groningen Test—designed specifically for individuals with dementia or stroke complications—and the Fullerton Functional Test. Each of these tests actually consists of a group of tests assessing each of the four categories of fitness.
Most fitness tests measure endurance with a walking or stepping exercise. Clients walk or march in place for between two and six minutes. The trainer evaluates endurance by recording the number of steps completed or the distance walked.
Trainers assess lower and upper body strength using separate metrics. The chair stand test measures lower body strength. The client begins the exercise by sitting in a chair with their back straight. They then rotate between standing and sitting for 30 seconds. Individuals who complete fewer than average reps may need to focus on lower body strength. Upper body strength is measured with the arm curl test. The client has 30 seconds to complete as many curls as possible holding a four, five, or eight-pound weight.
Reach tests measure upper and lower body flexibility. People who can clasp their hands together behind their backs have good upper-body flexibility. The results of a modified sit and reach test depend on how successful the client is at touching the toes on their outstretched leg.
Balance can be assessed in several ways. For example, clients may stand on one foot or use a balance board. The 8-foot up-and-go test is a common exercise used to determine fall risk. The client begins the evaluation seated in a chair. Once the timer starts, the client must stand up, walk around a cone placed 8 feet away, and return to their seat. The trial is done two times. A shorter completion time indicates better balance and agility.