Physical Therapy for Healthy Aging
The month of September is Healthy Aging Month, a month to promote ways individuals can stay healthy as they age. One of the best ways to support healthy aging is regular exercise under the guidance of a physical therapist. Physical therapists are experts in movement and exercise prescription, creating customized exercise programs to maintain and improve older adults’ balance, strength, and coordination and prevent falls.
What is Healthy Aging?
Healthy aging, as defined by the World Health Organization, is the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability means that older adults have the capability to maintain physical independence and mobility to perform and meet daily needs and activities with sufficient strength, balance, and coordination.
As we age, we naturally experience decreases in muscle mass and bone mineral density, loss of elasticity in connective tissue, and a decline in balance and coordination skills, which can negatively impact older adults’ independence and function.
However, regular exercise can minimize these declines and improve muscle strength, bone density, and overall fitness and balance. Research has shown that regular physical activity is the number one contributor to longevity, adding extra years to a person’s life even if they only began exercising in their older years.
Physical Therapy-Led Therapeutic Exercise for Older Adults
Regular exercise is an essential component of healthy aging, helping seniors maintain independence and improve their physical and mental health. Exercise not only improves muscle strength, builds bone density, enhances balance and energy, and slows age-related cognitive decline, but also boosts mood, improves sleep, and enhances brain function. Regular exercise can also help older adults reduce the risk of falls, manage chronic pain, and lower the risk of chronic diseases like diabetes, heart disease, and dementia.
Physical therapists are experts in movement and exercise prescription, creating customized exercise programs to maintain and improve older adults’ balance, strength, and coordination and prevent falls. A physical therapist designs a comprehensive exercise program, including aerobic exercise, resistance training, balance and gait training, and flexibility exercises.
Aerobic conditioning, such as exercising on a stationary bike or walking on a treadmill, helps build aerobic capacity and endurance, maintain heart and lung health, and improve circulation. Aerobic exercise requires the use of large muscle groups, which increases blood flow and places a demand on the heart and lungs. Through aerobic exercise, when this demand is repeated on the muscles, heart, and lungs, the body adapts by increasing its capacity to tolerate the added load, increasing endurance. A study of adults ages 40 and older found that taking 8,000 steps or more each day (compared to only taking 4,000 steps per day) was associated with a 51% lower risk of death from all causes.
Flexibility training can involve lower body stretches, specifically of the low back, hamstrings, and hip flexors to promote good mobility and joint alignment and prevent tight muscles and stiff joints. Balance exercises help older adults maintain stability when standing, walking, or changing direction, which can include walking on flat and uneven surfaces, navigating obstacles such as walking over small hurdles, or balancing on a balance board. Balance training is often combined with gait training exercises, which can include marching over small hurdles or backward walking.
Resistance training is a critical aspect of an older adult’s exercise program for healthy aging. Researchers found that in adults older than 55, muscle mass was a better predictor of longevity than weight or BMI. Resistance training builds muscle through repetitive movements that isolate the muscle groups to strengthen them, using weights, resistance bands, or body weight. The therapist usually targets large muscle groups in the arms, back, and legs (gluteal and quadricep muscles) as well as the core muscles. Resistance training also strengthens bones, which reduces the risk of a bone fracture from a fall, and helps to make joints feel less stiff and keeps soft tissues more toned.
Aquatic therapy in a warm water therapy pool may be used by physical therapists as well to build aerobic capacity and strength in a safe environment. Aquatic therapy decreases the amount of stress on joints, so individuals can work on balance, muscle strength, and mobility more easily. Water offers greater resistance than does the air, requiring more effort when lifting weights without the pressure placed on joints when weightlifting on land. This helps patients build strength with less pain. Aquatic therapy may be done first in older adults who have significant mobility and strength deficits. Once these individuals build strength and function in the water, they can progress to aerobic exercise and strength training on land.
In the video below, Mangiarelli Rehabilitation physical therapist Bobby demonstrates three essential gait training exercises for healthy aging:
