It may be beautiful to do nothing and rest afterwards, as the saying goes, but older people who are generally fit and do not have health problems which limit their mobility should aim to be active every day and to notch up at least 150 minutes a week of moderate-intensity aerobic activity, such as cycling, fast walking or dancing, according to the Department of Health. They can’t just do nothing after that either, as their physical activity guidelines also recommend muscle-strengthening exercises that work all the major muscle groups, on two or more days. There are suggestions for alternatives but none of these involve sitting down with the crossword; rather, you could add in some vigorous activity, such as jogging. And I’m afraid housework and other daily activities don’t count, as these don’t require enough effort to raise your heart rate (they haven’t tried my vacuum cleaner).
The NHS Choices website, as well as detailing the guidelines, does give some useful exercise tips and highlights various schemes for engaging people in physical activity. We elves are well aware of the benefits of outdoor play so we will be interested to see whether ‘senior playgrounds’, custom-made outdoor gyms for older humans, catch on. Popular in many parts of the world, the UK’s first opened in Manchester in 2008, with one in London’s Hyde Park soon following. Free to use and equipped with easy to use equipment, designed to provide gentle exercise, the aim is to encourage older people to exercise in a pleasant environment and one which provides an alternative to the indoor gym. You can hear what some of the users think of it in this video from the NHS Choices website.
One potential benefit of physical activity in older people is improving balance and this is the subject of a Cochrane review, first published in 2007, which indicated that regular exercise helps older people improve their balance and reduce their risk of falling. This review has now been updated with 62 new studies added. From the 94 randomised controlled trials, involving 9,917 participants aged 60 and over, now included in the review, the authors identified eight types of exercise which had been tested to improve balance. These were:
- Gait (walking), balance, co-ordination and functional tasks
- Strengthening exercises
- 3D (including Tai Chi, qi gong, dance, yoga)
- General physical activity (walking)
- General physical activity (cycling)
- Computerised balance training using visual feedback
- Vibration platform used as intervention
Here’s what they found:
- Some exercise types compared with usual activity are moderately effective, at least immediately post intervention, in improving clinical balance outcomes in older people
- In general, the effective programmes ran three times a week for a duration of three months and involved exercises that challenged people’s balance while standing
- It was difficult to combine results from different studies because there was considerable variety in the types of participants and in the exercise programmes, as well as in the outcomes assessed and the use of many different methods to measure them
- Many included trials were not of high methodological quality which limits the strength of the evidence
- Most studies did not monitor or report adverse effects
The authors concluded:
“There is weak evidence that some types of exercise (gait, balance, co-ordination and functional tasks; strengthening exercise; 3D exercise and multiple exercise types) are moderately effective, immediately post intervention, in improving clinical balance outcomes in older people. Such interventions are probably safe. There is either no or insufficient evidence to draw any conclusions for general physical activity (walking or cycling) and exercise involving computerised balance programmes or vibration plates.”
Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database of Systematic Reviews 2011, Issue 11. Art. No.: CD004963. DOI: 10.1002/14651858.CD004963.pub3.
A Cochrane summary and podcast are available for this review