CD - Australian Fitness Network

AQUA
OSTEO-FIT: BONE-CONSCIOUS AQUATIC EXERCISE
AQUATIC EXERCISE GOALS AND GUIDELINES FOR
PEOPLE WITH OSTEOPENIA OR OSTEOPOROSIS
• Regular exercise, most days of the week, for 30 to 45
minutes per session, targeting all fi tness components
possible (cardiovascular endurance, strength, endurance,
fl exibility). A well-rounded program will include activities
like walking, pool exercise, and the weight room.
• Exercises to build muscle mass – especially strength of the
core and lower extremities.
• Exercises to strengthen postural stabilisers, especially
spinal extensors.
• Activities and challenges to improve balance and fall
recovery.
• Avoid: loaded spinal fl exion (activities like rowing,
crunches, lifting heavy loads), high impact exercises, and
activities that might result in falling.
IDEAS FOR THE POOL
Naturally, you should consider the age, strength, and health of
your clients when trying more diffi cult exercises.
1. Be sure your pool deck is free of trip hazards, and insist that
clients wear appropriate footwear.
2. Be the posture police! People will strengthen postural
stabilisers by maintaining a long, strong spine and stable,
neutral pelvis throughout all movements.
3. Slow your music and movement to allow people time to
stabilise properly.
4. Anchor! Take impact out of your class. Although impact
helps build bone, it can be painful for joints, and may not
be appropriately controlled in the pool. Level II, III, and
grounded movement promote increased core activation
and training.
5. Avoid loaded spinal fl exion: tucks, spinal twisting or lateral
fl exion loaded with resistance such as a noodle or fl utter
board can be risky. Often, osteoporosis isn’t diagnosed
until a fracture occurs.
6. Train the core by maintaining perfect posture during wellcontrolled
movements of the arms and legs. This provides
functional, safe core conditioning.
7. Use a variety of pool depths, if possible. Shallow water
walking loads bones more; deep water vertical stabilisation
is excellent core and balance training.
8. Incorporate balance challenges: if necessary, start with
the support of a pool wall or trainer. Teach fall recovery
before escalating challenges. As mastery is achieved,
increase stability challenges by altering base of support
(narrow versus wide), standing surface (pool fl oor versus
an unstable object), proprioception (close the eyes, turn
the head away from direction of travel) and multi-task – do
activities to challenge balance during mental distraction.
Perform all examples with perfect posture:
a. Weight shifting foot to foot – progress to lifting the
trailing foot.
b. Single leg stance, ‘tight-rope’ (tandem stance) balance
or walk, with postural perturbations such as single arm
circles.
c. Single leg, feet together, or tandem stance – reach out
to the point of loss of balance, and initiate fall recovery.
62 NETWORK WINTER 2010 www.fitnessnetwork.com.au
d. Add attention challenges while maintaining posture
and balance – look away from where you are stepping;
transfer a small ball from hand to hand while walking or
holding a stance.
e. Stand on unstable surfaces, such as a noodle under
one or both feet, in contact with the fl oor, or balance
suspended vertically in deep water (wearing a fl otation
belt) while you do any of the following:
• Toss a small ball between partners.
• Move across the pool with small hops (shallow) or
arm propulsion (deep).
• Change directions of movement unpredictably
(laterally, diagonally).
• Keep the body straight and still while you move
only one arm vigorously.
• Partner tug-of-war using a towel or one or two
noodles.
As confi dence and strength improve, try the above
activities with eyes closed, while counting, singing or saying
the alphabet backwards, turning the head away from the
direction of attention.
Reprinted with permission from the Aquatic Exercise Association,
www.aeawave.com
References and Resources
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exercises on quantitative ultrasound variables in
postmenopausal women. Am J Phys Med Rehabil. 2005 Jan;
84(1):52-61.
Colado, J.C., Travis Triplett, N., Tella, V., Saucedo, P., Abellán,
J., Effects of aquatic resistance training on health and fi tness in
postmenopausal women, Eur J Appl Physiol (2009) 106:113–122
Cosca, D., , Aquatic exercise is a great activity at any age, U C
Davis Health System, www.ucdmc.ucdavis.edu
Melzer, I., et al, A water-based training program that include
perturbation exercises to improve stepping responses in older
adults: study protocol for a randomized controlled cross-over
trial, BMC Geriatrics 2008, 8:19
NIH Consensus Dev. Panel. “Osteoporosis Prevention,
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Essentials of Physical Medicine and Rehabilitation. Eds. Walter
R. Frontera, et al. 2nd ed. Philadelphia: Saunders, Elsevier,
2008.
Wallace, B. A., and R. G. Cumming. Systematic Review of
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Philadelphia: Mosby Elsevier, 2009.
Woollacott, M., Shumway-Cook, A., Attention and the control of
posture and gait: a review of an emerging area of research, Gait
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