I searched this last week’s medical journals to find an article to write about. Unfortunately there was nothing I felt would be of interest to most of my patients. My fall back is usually JAMA, but the latest issue dealt with combat casualties, care for mass casualty events, treatment of post dramatic stress disorder and suicide… I pass. So I thought that this week I would write about the recommendations that were published in the Clinical Updates in Women’s Healthcare by the American College of Obstetricians and Gynecologists from April. There was a section dealing with physical activity for “older” adults and I, of course, wondered what their definition of older was… and as usual it encompassed anyone at or over the age of 65. Upon reviewing their recommendations, I realized that these are probably relevant to women and men of any age; so here they are:
- 30 to 60 minutes of moderate intensity exercise, performed on five days each week or more. This can include walking, jogging, running and bicycling.
- 20 to 60 minutes a day of vigorous intensity exercise performed on three days a week or more. Higher endurance activities will include swimming, cross-country skiing and aerobic dancing. Team sports such as basketball, soccer and volleyball and racket-sports such as tennis and racquetball included. They obviously can be very vigorous but since they also include intermittent periods of exercise and rest their effectiveness for continuous aerobic activity makes the calculation of duration more difficult.
- Resistance exercise that involves each major muscle group should be performed on 2to 3 nonconsecutive days per week using a variety of exercise equipment or body weight resistance. This can be done with weight training machines, free weights, elastic resistance ( bands) or body weight resistance activities (push-ups, pull ups, sit ups, stair climbing and Pilates). Most individuals should aim for 10 to 15 repetitions of approximately 8 to 10 exercises to improve strength and power. The recommendations also includes correct breathing techniques… There should be exhalation during the effort phase and inhalation during the lengthening days.( All those exercise coaches were right!)
- A series of flexibility exercises for each of the major muscle – tendon units, performed two days a week or more for at least 10 minutes is recommended to improve joint range of motion. This should include static stretches, performed by slowly stretching a muscle or tendon group and holding for a period of 10 to 30 seconds. Slow stretching allows greater stress relaxation and generates lower forces on the tendon. Holding the stretch at the point of tightness or mild discomfort for 10 to 30 seconds enhances joint range of motion. There is still a debate regarding the best time to stretch. Current evidence suggests that it is most effective when the muscle temperature is elevated after light to moderate exercise.
- As we get older, coordinated actions become increasingly important in preventing falls and injuries. Walking on uneven or difficult terrain (try sand) is said to improve balance. The Chinese wellness practices such as can tai chi and qi gong which emphasize posture, breathing and meditation will increase our balance. Regular yoga practice can be quite amazing; it has been shown to be associated with improved gait, balance, flexibility, lower body strength and weight loss. To add to its increasing popularity, it also has been found to be effective in reducing blood pressure, glucose levels and cholesterol levels. Then we come to Pilates which is my favorite… It’s an exercise system focused on improving flexibility, strength and body awareness. It enables us to build core muscle strength and achieve better spinal alignment. One of the more fabulous benefits of Pilates is that it helps us become more aware of maintaining correct posture (I remembered to sit up straight as I wrote this) and activating core muscles in our every day activities.
So there you have it; it’s a fairly inclusive list and perhaps seems to be overly time intensive for many adults. But the impact of exercise (and it can be low-impact) on our health and longevity can be greater than many of the “preventive” medications that physicians prescribe. So I hope you’ll sit up, pay attention and get going.