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Group Exercise Program for LTC Settings

An OT student shares her exercise regiment with LTC residents.

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Evidence indicates that elderly people should exercise, with goals, to prevent disease and promote quality of life. Physical exercise promotes and maintains a good quality of life. Exercise also can improve socialization and cognition skills as well as reduce risks of depression. It is important for the elderly to perform exercise regardless of their limitations or existing health conditions.

 As individuals get older they can experience confusion, loss of balance and coordination, and mobility deficits (Radomski & Latham, 2008). Lower- and upper-extremity exercises build strength and endurance. A study by Fujisawa et al. (2007) found that exercises such as tai chi and balance training prevented falls in elderly participants.

Exercise also helps prevent exacerbation of heart disease, diabetes mellitus, stroke and degenerative joint disease. Other benefits of exercise include improved circulation, enhanced relaxation, social stimulation and reduction of anxiety. Long term, exercise also can facilitate cognitive improvement, better fine- and gross-motor skills, improved flexibility and improved behavior.

Individuals must be motivated (Best-Martini & Potenhagen-DiGenova, 2003), whether intrinsically or extrinsically, to maintain exercise programs because the benefits of exercise may not be apparent to them in the beginning. Our job as health care providers is to help these individuals see how and why exercise is relevant to their own lives and health (Best-Martini & Potenhagen-DiGenova, 2003).

An Exercise Program
Last September I had the opportunity to create and implement group exercise programs in our LTC houses. My goals for the program are to simply keep our residents moving. The strengthening exercises include both upper and lower extremity

Since my programs have started, the residents have responded very positively and look forward to attending. During each program, residents visit and encourage each other. Most importantly, they laugh and enjoy themselves.

Wellness Program Exercise Description
Population: long-term care residents, adult day care registrants

Location: LTC houses, wellness gym, rehab solarium

Duration/Frequency: 30-45 minutes. Residents in each house participate in exercise group once a week. Adult day care registrants participate twice a week.

Equipment: Thera-Bands™, large exercise ball, parachute, one-pound weights


Program Structure (30 minutes)
:
Warm up
Breathe deeply.

Main Workout (20 reps of each)
March in place up and down. (hips)
Kick each foot forward and backward. (hips)
Kick each leg to the side. (hips
Rotate ankles. (ankles
Touch toes. (spine
Open and close arms with 1-lb. weights/Thera-Band. (shoulders)
Push arms above head with 1-lb. weights/Thera-Band. (shoulders)
Touch shoulders (curls) with 1-lb. weights/Thera-Band. (biceps)
Shrug shoulders. (shoulders)
Flip wrists with 1-lb. weights/Thera-Band. (wrists)
Look up/look down. ("yes") (neck)
Play piano. (wiggle fingers)
Touch each finger to thumb. (fingers)
Open and close hands. (fingers)

Warm down
Breathe deeply.

You might also incorporate into the program additional exercises in standing and ambulation, only with appropriate residents or registrants, and group kickball while sitting.

Marianne Pastorella, CTRS, is an occupational therapy graduate student at Utica College, Utica, NY.


References  

Bastone, A. & Filho, W.J. (2004).  Effects of an exercise program on function performance of institutionalized elderly.  Journal of Rehabilitation Research and Development.  41(5), 659-668. 

Best-Martini, E. & Botenhagen-DiGenova, K. (2003). Exercise for Frail Elders. Chicago, IL:  Human Kinetics.

Fujisawa, M., Ishine, M., Okumiya, K., Nishinaga, M., Doi, Y., Ozawa, T., Matsubayashi, K. (2007).  Effects of long-term exercise class on prevention of falls in community-dwelling elderly: Kahoku longitudinal aging study. Japan Geriatrics Society. (7), 357-362

Radomski, M. & Latham, C.A. (2008). Occupational Therapy for Physical Dysfunction (6th ed.). Baltimore, MD:  Wolters Kluwer/Lippincott Williams & Wilkins.

Stuck, B.D. & Ross, K.M. (2006).  Prescribing exercise for the frail and home bound. Journal of Geriatrics. 61(5), 22-27. 


 

I just wanted to mention that as a therapist you must have an order, complete an evaluation, and have a plan of care in place. I think setting up an exercise program is a great idea, but I would suggest letting another staff member lead the group. If a you as a therapist lead it you could be endangering your license. Without an evaluation you might not be aware of contraindications for various patients possibly causing harm.

Christine Smith,  OTRJanuary 26, 2011
Edgerton, OH




     

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