RESEARCHDr Tim Henwood, Universityof Queensland/Blue CareResearch and PracticeDevelopment CentreUsing resistance training toreduce later life disabilityThe <strong>Australia</strong>n Instituteof Health and Welfarewarns that over thenext two decades thedirect cost of Residential<strong>Age</strong>d Care (RAC)service expenditure in<strong>Australia</strong> will increasesubstantially comparedwith other primaryhealth services.<strong>Age</strong>ing of the population and anincreased prevalence of complexhealth conditions, coupledwith the increasing need forintensive RAC services, will bethe underlying cause. In <strong>Australia</strong>presently, there are some 165 000RAC bed placements available.However, the demand is projectedto more than treble by 2050. Asa population, 45% of adults >85years require assistance withactivities of daily living, whilein RAC this figure approaches100%. A primary cause ininstitutionalisation, disability,morbidity, mortality, decreasinggait speed and increasing fallsrisk is the age-associated lossin muscle mass and function,termed sarcopenia.However, evidence is strong thatsarcopenic can be effectivelyprevented and rehabilitatedthrough targeted exercise.The benefits of exercise for olderadults are irrefutable. Studiesshow that community-dwellingadults maintaining an activelifestyle have increased physicaland cognitive health whencompared to their sedentarycounterparts. And for the42<strong>LASA</strong>-Q <strong>Focus</strong> | Autumn edition 2013
RESEARCHpreviously sedentary it is nevertoo late, with research showingexercise and physical activity willincrease health and wellbeing,and reduce symptoms of diseaseand the associated medicationneeds independent of age, levelof fitness, disability or disease.But it is resistance trainingand weight-bearing exercisethat is the greatest stimulus toprolonged physical independence.Specifically, with regularresistance training older adultsexperience increases in musclemass, muscle strength, bonemineral density, muscle powerand muscle endurance, will haveimproved balance and flexibility,and a reduce falls risk. Mostimportantly, these gains transferto improved capacity in activitiesof daily living and a reducedlevel of disability. Demonstratingit is never too late to becomeinvolved, a landmark study invery old (~90yrs) institutionalisedadults show significant increasesin muscle strength (174%),walking speed (48%) and midthighmuscle area (9%) with only8 weeks of resistance training.While older <strong>Australia</strong>n arebecoming more involved in someform of exercise, insufficientnumbers are incorporatingresistance and weight bearingexercise into their routines.Primary barriers to participationare access to equipment andknowledge about getting a safeand effective workout.Moreover, for the averageolder individual attending amainstream gymnasium is anincredibly daunting conceptand is often unaffordable. Toaddress this, targeted facilitiesare emerging with risk assessedappropriate equipment andprograms designed and deliveredby allied health professional.One form of equipment that isproving popular is HUR Healthand Fitness Equipment.Designed with the older adult orthose in needed of rehabilitationin mind, HUR offers a range ofmachines to target upper- andlower-body muscles. Near zerostarting resistance and ‘stepless’adjustment together with easyaccess and lower joint pressuremake the equipment ideal forexercising older adults wheresafety is a priority.One care provider that hasincorporated HUR equipment intotheir wellbeing programs is BlueCare.Recently, the South Brisbane,Ashgrove and Toowoombafacilities each installed threepieces of HUR equipment intotheir day therapy centres. Sincetheir instalment the machineshave been used for individualtreatments and multiple groupexercise classes. Used inconjunction with therabands,dumbbell and wall exercises,programs form progressiveresistance circuit class forcommunitydwelling old and veryold adults, at risk of developingor in the early stage of chronicconditions, Parkinson’s clientsand/or anyone who wishes toimprove general strength andfunction. Together with the alliedhealth therapists, clients haveembraced the equipment andnoted improvements in theirself efficacy, balance confidenceand decreased their overall fallsrisk. Personal testimonials revealclients are “feeling stronger”,“have more energy” and “feellike they are in a gym” whileusing the equipment in a safeand enjoyable environment. Inturn, class numbers have grownand reflect the willingness ofolder individuals to access safeeffective programs with tangiblebenefits.Extending the opportunity forthe old and very old <strong>Australia</strong>nto get involved in regularappropriate resistance traininghas the potential to reduce thedirect impact of sarcopeniaon health care expenditure.This concept is aligned withthe <strong>Australia</strong>n Governmentpriority areas of promoting andmaintaining good health byadhering to the “Wellness and reenablementapproach”.Specifically, resistance trainingcommenced later life has theability to reduce the negativeimpact of dependency andfacilitate the retention andregaining of daily living skills.Moreover, the protection of laterlife wellbeing and independencethrough targeted exercise willsignificantly increase the qualityof life of <strong>Australia</strong>’s oldergeneration.Dr Tim Henwood, University ofQueensland/Blue Care Research andPractice Development Centre; RichelleStreet and Frank Nguyen Cuu, BlueCare Allied Health; Ari Kallinen, HUR<strong>Australia</strong> www.huraustralia.com.au<strong>LASA</strong>-Q <strong>Focus</strong> | Autumn edition 2013 43