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Want to Improve Your Fitness? Let’s Do the SAFE!

Dr. Bartlett, Stephen Post, Hakob Khachatryan, Taylor Johnson, Armin Sheikh, Janet Lee

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Learning Objectives

To DESCRIBE the key elements within the Senior Athlete Fitness Exam.

To UNDERSTAND the significance of cardiovascular health, strength, balance, flexibility, and gait speed for older adults.

To DEMONSTRATE how older adults can improve cardiovascular health, strength, flexibility, balance and gait speed.

To EDUCATE on how older adults can improve cardiovascular health, strength, flexibility, balance and gait speed.

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SENIOR ATHLETE FITNESS EXAM

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SAFE

Gait

Balance

Flexibility

C/V

Strength

Check In

Welcome
Consent

Education

Handouts
Verbal

April 12th; In-Person SAFE (Senior Center) “Check Website or call office for details

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Cardiovascular Health

Blood Pressure

Goal: <140/90 mmHg

Heart Rate

Goal: 60-100 bpm

%O2 Saturation

Goal: > 95%

https://www.pulseoximeter.org/fl400.html

https://www.cnet.com/health/how-to-take-your-blood-pressure-at-home/

EDUCATION TIP: Purchase Automated BP Cuff- Improves Self-Efficacy (confidence) via Self-Management

Janet: Make sure you introduce yourself first

Describe what we will be doing when they come to this section:

Cardiovascular station

We will take your vitals -

BP: Aim for < 140/90. >140/90 this may indicate HTN which can increase risk of having other CV diseases.

Heart Rate: Normal heart rates at rest range from 60-100. However, values can sometimes be lower in athletes who train intensely and may drop into the 50s or even high 40s at rest for some.

%O2 Saturation: provides an estimated percentage of oxygen in your blood and should be above 90 to exercise but typically stays above 95 in healthy adults. (clip on R hand, ring finger)

Just for a tip, if you want to monitor your vitals on a regular basis for self-management, we recommend that you purchase automated BP cuff, and it will give you information about BP as well as HR.

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Cardiovascular Health

Waist Circumference

Narrowest aspect of the waist (or at belly button level)

Hip Circumference

Widest aspect of the hips

Waist-to-Hip Ratio

Goal: Female <0.82 / Male <0.90

https://silverbobbin.com/waist-vs-hip/

SIGNIFICANCE: Measure how much mass you carry at the midsection of the body

Carrying more weight around the waist increases risk for cardiovascular diseases, diabetes, etc.

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Cardiovascular Health

Significance of cardiovascular fitness?

When exercising, muscles require oxygen to function
give clues about how well your body can provide oxygen to working muscles when exercising

Regular Cardiovascular Exercise:

Improves Your Overall Health
Keeps You Competitive in Your Sports!

https://www.facebook.com/SeniorGames1/photos/?ref=page_internal

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Time to Move!

2-minute step test

(but we will only perform 1 minute today!)

https://geriatrictoolkit.missouri.edu/cv/2min-step-rikli-jones.doc

Before we move on to the next part of the SAFE assessment, we are going to do a mini version of a cardiovascular exercise to bring your heart rate up. So this is called 2 minutes step test.

So this is similar to march in place, but you are going to march as many times as possible in the 1 minute period. If you have difficulty with balancing, then you can march in place while holding on to something stable, or stand against a wall. You can also march in sitting if you want to.

OMNI; aim for moderate exertion

Go ahead and find the midpoint on your thigh. That is the height you want to raise your knee up to. Like I said, march as many times as you can with both legs, but only count the number of times the right knee goes up, and that will be your score. and at the end we will compare your score to the average values.

Ask Dr. Bartlett to unshare the screen for DEMO!! Then ask him to share the screen again.

hand off to Hakob

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How Challenging Is This Exercise?

https://www.apta.org/patient-care/evidence-based-practice-resources/test-measures/omni-exertion-scale

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Strength

5 TSTS (Five time sit-to-stand): Test of lower body strength

and indication for fall risk and decline of mobility.

Goals: Male: <= 7 seconds

Female: <= 8 seconds

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5 Times Sit To Stand

F ≤8 secs�M ≤7 secs

https://www.youtube.com/watch?v=4N4PhZlyYGM&ab_channel=PaulPotterPT

Age Bracket	Time (Sec)
60-69 y.o	11.4
70-79 y.o	12.6
80-89 y.o	14.8

Normative Values

chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/http://www.thompsonhealth.com/Portals/0/_RehabilitationServices/PT%20Mgmt%20of%20Knee/5XSST_handout.pdf

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Grip Strength

TIPS:

stress ball
wring towel
dough

Significance:

Predictor of mortality, functional

limitations and disability

Associated with quality of life, poorer bone density and falls

add video here

https://www.youtube.com/watch?v=cguUks_Eby0&ab_channel=PhysicalTherapyEducationSolutions

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Time to Move!

Squats

Compound exercise
Functional

google.com/imgres?imgurl=https%3A%2F%2Fi.insider.com%2F5f3d3b6f42f43f001ddfdbfd%3Fwidth%3D750%26format%3Djpeg%26auto%3Dwebp&tbnid=_3v67c-yyzYAEM&vet=12ahUKEwiXxdGo7fD9AhWHq44IHf83D98QxiAoBHoECAAQGw..i&imgrefurl=https%3A%2F%2Fwww.insider.com%2Fguides%2Fhealth%2Ffitness%2Fbenefits-of-squats&docid=r-gy4E6AS4aZDM&w=750&h=687&itg=1&q=squat%20muscles%20worked&ved=2ahUKEwiXxdGo7fD9AhWHq44IHf83D98QxiAoBHoECAAQGw

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30 second squat

Age	20-29	30-39	40-49	50-59	60+
Excellent	> 34	> 32	> 29	> 26	> 23
Good	33-34	30-32	27-29	24-26	21-23
Above average	30-32	27-29	24-26	21-23	18-20
Average	27-29	24-26	21-23	18-20	15-17
Below average	24-26	21-23	18-20	15-17	12-14
Poor	21-23	18-20	15-17	12-14	9-11
Very poor	< 21	< 18	< 15	< 12	< 9

Males

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Age	20-29	30-39	40-49	50-59	60+
Excellent	> 29	> 26	> 23	> 20	> 17
Good	27-29	24-26	21-23	18-20	15-17
Above average	24-26	21-23	18-20	15-17	12-14
Average	21-23	18-20	15-17	12-14	9-11
Below average	18-20	15-17	12-14	9-11	6-8
Poor	15-17	12-14	9-11	6-8	3-5
Very poor	< 15	< 12	< 9	< 6	< 3

Female

30 second squat

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FLEXIBILITY

Importance of Adequate Flexibility:

Decreased Risk of:

Injury during sport
Muscle strains
Fractures
Fall risk
Chronic Pain

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Flexibility Testing

Flexibility Portion Comprised of:

Pillow test

Shoulder Range of Motion Measurement

170 degrees

Ankle Range of Motion Measurement

7 degrees

Thomas Test

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Time to Stretch!

Flexibility Activity

Hips Square
Feet Forward
“Sink” Into Stretch
Arm Overhead to Increase Stretch

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30 Second holds

2 Reps

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Balance

Goal: to test and see if your balance is above cut score for fall risk

Significance:

Fall risk
Life expectancy
Mobility

Decrease Fall Risk:

Stay active
Improve lower extremity strength
Balance training

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Time to Work on Balance!

Sample Exercise:

Star Excursion
Can perform on flat, matt, BOSU Ball
Safety: Have a chair/counter or someone close by in case you lost balance
If too easy change surface

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Gait Speed

Significance of Walking Fast?

Walking in the community
Crossing the street
Participate in outdoor activities

Significance of Walking Slow?

Increased risk for falling
Increased risk of diseases
Increased risk of poor health outcomes

What is gait? Why does gait speed matter?

Gait is the manner in which a person walks and the speed a person walks can help assess a person’s functional mobility

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Gait Speed

0.2m/s = 0.4mph

0.4m/s = 0.9mph

0.6m/s = 1.3mph

0.8m/s = 1.8mph

1.0m/s = 2.2mph

1.2m/s = 2.7mph

1.4m/s = 3.1mph

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Gait Speed

Gait Speed Test Set-up:

How to perform:

First you will walk the full distance of the designated walking track
Then you will turn around and walk the entire distance as fast as you can (no running)
Results will be calculated by how fast you walked the 10 meter distance

Goals:

Men: 1.8 m/s
Women: 2.1 m/s

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Education Tip!

How do I know if I’m walking fast enough?

Go out into the community and see how you compare

What can I do to improve?

Start a walking routine, start small and progress over time based on your level of fitness
Do the mailbox method

Find a mailbox (or any other object) and walk as fast and as safely as you can to mailbox/object then slow down. Repeat every few minutes

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Time for Coffee and Questions

April 12th; In-Person SAFE (Senior Center) “Check Website or call office for details