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May 27, 2010

My Mom's Advanced Exercises

Yesterday, I talked about how I a did a brief balance assessment on my mother, who has been visiting for a few days. I gave her three very basic exercises to help with ankle strength, leg strength, and core stability.

Today, I want to share the "advanced" exercises that I assigned her. I call them advanced, only because they build on the previous exercises, or would be harder for her to perform than the basic three I described yesterday. Again, I only assigned three additional exercises because if I assign too many, none will get done.

First are bridges. To do bridges correctly requires mastery of the abdominal drawing in maneuver. So this exercise builds on that basic skill. Mastery of the bridge helps with basic transfers such as picking up the hips in order to shift the body in bed. It is designed to strengthen hamstrings. Strong hamstrings are necessary for standing from a sitting position and stair climbing. If you'll recall, my mother was a bit slow with the 5 times sit to stand, so this exercise should help with that. Also, since we live on a second floor walk-up apartment, I noticed she is a little slow on the stairs. I could discuss changes in the visual and vestibular systems that occur with aging, here, but lets just say that use of handrails becomes critical for safety as we age.

Side-lying leg raises target the gluteus medius muscle. I don't know why, but this muscle is weak on just about everybody we see in the clinic. Maybe it is because we in industrialized nations sit so much. A strong gluteus medius helps prevent tredelenburg gait or hip drop when we walk (think vampy runway walking). In lower level patients, because they are weaker and may not be able to work against gravity, this exercise can also be done standing. However, done standing, this exercise is sneaky because it works the hip opposite of the moving leg, forcing both gluteus medius and minimus to stabilize the body in the functional position we are targeting: standing! Heh, heh. Watch for and minimize side to side weight shifting.

Finally, I assigned my Mom crunches. She claims she's never been able to do a sit-up. Luckily, sit-ups are no longer considered a good exercise for strengthening the abdominal muscles. Once the shoulder blades clear the supporting surface, the deep hip flexor muscles called psoas engage and the abdominal muscles are no longer targeted. Not only that, for people with low back issues, it puts undue stress on the lumbar spine and can cause additional damage. So throw sit-ups out of your exercise repertoire unless you need to pick your torso up by your hip flexors.

I have to credit my mother with being a good student who was not afraid to ask questions. So she asked for aerobic recommendations and wondered if working out on an exercise bike would benefit her aerobically. The answer is yes and no. She will see improvements in aerobic capacity, especially if she plans to bicycle around her neighborhood (big hills there and she doesn't even own a bike, so not likely). What I think she was really asking is if bicycling would help her with walking endurance. It is a good question and you would think the answer would be yes. It's not about lung and heart function, it's about what is happening with the muscles and cycling and walking use muscles differently. According to the specificity principle of exercise, the way to gain walking endurance is to walk; for swimming, swim; for cycling, ride a bike.



Posted by linda at May 27, 2010 7:47 AM

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