Please complete the following “Physical Readiness Questionnaire” prior to entering this section.
If you answer yes to any of the following statements, please consult your health professional before starting an exercise routine.
- I have a heart condition and my health care professional recommends only medically supervised physical activity.
- During or soon after exercise, I have pains or pressure in my neck, left shoulder, or arm.
- I have had chest pain within the last month.
- I tend to lose consciousness or fall over due to dizziness.
- I feel extremely breathless after mild exertion.
- My health care provider recommends I take medicine for high blood pressure or a heart condition.
- I have bone or joint problems that limits my ability to do moderate physical activity.
- I have a medical condition or other physical reason not mentioned here that might need special attention in an exercise program.
(This physical activity readiness questionnaire was taken from the American Heart Association’s (AHA) Start Program).
Please be aware that prior to undertaking any new or increased level of exercise, you should seek to ensure you are not going to harm yourself in doing so. Where you are unsure or uncertain on how to perform a particular level or type of physically strenuous activity, you should consult a doctor to assess your physical suitability to the task.
There are a lot of products claiming to be miracle drugs, offering a quick fix to improve your health. In reality, the closest thing to a miracle drug is consistent exercise! The World Health Organisation (2008) has recognised the important role exercise plays in maintaining good health (15). Exercise is even being prescribed to prevent and treat chronic diseases and certain types of cancer. The Australian government has jumped on the bandwagon and established the ‘Australian Physical Activity Guidelines’, suggesting ways to increase your levels of physical activity (6). To complement this, we’ve designed some basic half-hour and hour-long resistance training programs, which can be performed at home and/or in a clinic. These should be done in addition to your aerobic exercise (i.e. walking, jogging, running, swimming or cycling) to receive optimal benefits.
Some of the benefits of consistent exercise include: (7-10)
- Improved fitness = Reduced fatigue/increased energy (to help you keep up with your children or grandchildren etc.)
- Improved self esteem, social interactions and ability to perform daily activities = Reduced risk of depression
- Lower body fat = Reduced obesity risk
- Increased muscle mass = Reduced risk of developing sarcopenia (age related muscle loss or becoming obese
- Maintained or improved bone density = Reduced risk of developing osteoporosis
- Improved balance = Less risk of falls
- Reduced risk of developing a chronic health condition = i.e. heart disease, stroke, hypertension, type II diabetes and cancers such as colon, prostate and breast.
Physical Activity Recommendations for Australian Adults (6)
There are four steps for better health for Australian adults:
Together, steps 1-3 reflect the minimum amount of physical activity you need to improve your health. They are not intended for high level fitness, sports training or weight loss. For best results, combine an active lifestyle with healthy eating. Step 4 is for those who are willing and able to achieve greater health and fitness benefits.
Step 1: Think of movement as an opportunity, not an inconvenience
Any form of movement is an opportunity for improving health. Don’t see it as an inconvenience or a waste of time, it’s an investment in yourself.
Step 2: Be active every day in as many ways as you can
For example, use the bicycle instead of the car, or complete tasks without using labour saving devices.
Step 3: Do at least 30 minutes of moderate physical activity on most, if not all, days.
You can accumulate 30 minutes (or more) throughout the day by doing several shorter (10-15 minute) sessions of physical activity.
Step 4: If you can, do some regular, vigorous activity for extra health and fitness
Please note that step 4 does not replace Steps 1-3. It simply adds an extra level for those who want greater health and fitness benefits.
Physical Activity Recommendations for Older Australians (6)
It’s never too late to become more active, and enjoy the benefits of exercise. “Too old” or “too frail” are not good reasons to avoid movement. Most physical activities can be adjusted to suit those who have health or movement problems, including those living in residential care facilities.
There are five physical activity recommendations for older Australians:
1). Older people should do some form of physical activity, no matter what their age, weight, health problems or abilities.
2). Older people should be active every day in as many ways as possible, doing a range of physical activities that incorporate fitness, strength, balance and flexibility.
3). Older people should accumulate at least 30 minutes of moderate intensity physical activity on most, preferably all, days.
4). Older people who have stopped physical activity, or who are starting a new physical activity, should start at a level that is easily manageable. From there, you can gradually build up to the recommended amount, type and frequency of activity.
5). Older people who continue to enjoy vigorous physical activity should carry on doing so, provided recommended safety procedures and guidelines are adhered to.
Exercise Tips
- Avoid doing too much too soon. Exercise programs need to be progressive.
- Wear suitable footwear if doing a lot of walking, jogging or running.
- Have a good warm-up prior to the session.
- Always cool down after physical activity to prevent the ‘pooling of blood’. Remember to stretch to release tension built up in muscles from the repetitive movements.
- Keep well hydrated while performing exercise and monitor your urine colour when you have finished exercising. Drink water until your urine is clear.
- Avoid drinking alcohol after exercise as this will dehydrate you even more and reduce your body’s ability to repair your muscle fibres.
- Listen to your body! Forget the saying ‘no pain, no gain’. If you feel pain, or experience dizziness, tightening of the chest or anything that just doesn’t feel right, stop what you are doing immediately and seek help.
Get ‘FITT’ Model
Frequency
Ideally you would do some cardiovascular exercise at least five times per week at a moderate intensity. If your exercise is more strenuous, the frequency could be lowered to 3-4 times per week. You can perform resistance training to complement your cardiovascular training. If it is a “whole body routine” it should be performed two to three times per week. If it is a split program (focusing on either upper or lower body) you should perform the routines two to three times each (4-6 sessions) per week. Flexibility training should be incorporated into the cool down of every exercise session (whether cardiovascular or resistance training), to alleviate the tension which will have built up in the muscles. You can also add balance training to your exercise routine (2-3 times a week, if you feel up to it!).
Intensity
If your level of exercise is too easy, you are unlikely to gain physical benefits. However if you work a little harder (moderate-intensity) you are likely to see and feel the difference. The difficulty of the exercise you do depends on your health status and risk factors. You should always talk to your doctor about any strenuous activity before attempting it, even if it’s just a one off event. Unless you are competing as a professional, you should to stick to moderate-intensity, which is considered safer and can still be very beneficial.
To help gauge what intensity levels you are working at you can use:
- Talk Test
- Rating of Perceived Exertion (RPE) Scale
- Heart Rate (HR)
- Monitoring Resistance Training Intensity
Talk Test
This is a simple test designed to monitor physical exertion during exercise. You should be able to talk during exercise. If you can’t, you may be pushing yourself too hard and increasing your risk of exposing underlying health conditions (7).
Rating of Perceived Exertion (RPE) Scale
The RPE scale is designed to help you assess how hard you feel your body is working during exercise. It is based on the physical sensations a person experiences during physical activity, including increased heart rate, increased breathing rate, increased sweating, and muscle fatigue. Although this is a subjective measure, its been shown to provide a fairly good estimate of the heart rate during physical activity. The RPE scale can be particularly useful for those whose heart rate does not respond typically to exercise (eg. Cardiac patients on ß-Blockers). The scale ranges from 6-20, with 1-5 regarded as far too easy. When exercising, you should be aim to stay in the green region. A rating of 12-16 is classified as moderate intensity. By exercising at this level you’re doing wonders for your health, without placing your body under too much stress, which can cause more harm than good (1). If you feel the level is between 17-20, slow down immediately (or stop if necessary). As your fitness increases, you will be able to work harder and you will find you are able to do more. If you are consistent, improved fitness and good health will come with time. It’s a long term goal, so there is no rush!
Heart Rate (HR)
Heart rate is widely used to monitor exercise intensity (14). The simplest way to assess your maximum heart rate (HRmax) is to use this formula:
HRmax= 220 – age (in years)
To find out what your heart rate should be at a certain intensity (%HRmax), multiply this result by a percentage (in decimal point form).
Example: I am 60 years old and want to work at intensities between 60-90% what should my target heart rate (THR) be?
HRmax= 220 – 60 = 160 beats/min
THR60%= 160 x 0.60 = 96 beats/min
THR90%= 160 x 0.90 = 144 beats/min
This means if you were to work at intensities between 60-90% you should try to keep your heart rate between 96-144 beats/min.
To gain all the health benefits of exercise, without putting yourself at risk, you should perform exercise between 60-90% of HRmax. Starting at lower intensities and gradually building to higher intensities as fitness levels improve.
Feel free to use more than one kind of test (such as the talk test and RPE scale mentioned above) as everyone is an individual, and can be an exception to the rule.
Measuring Heart Rate (radial) (13)
This assessment helps us to measure the amount of times the heart beats per minute
1. Find the bony process on the inside of the wrist.
2. Keep two fingers in line with the bony process and lay them flat across the first quarter of the wrist (palm up).
3. Apply pressure until you feel the pulse.
4. Ignore the first pulse and count the rest for 15 seconds.
5. Multiply this number it by four to determine your heart rate per minute.
Alternatively, you can purchase electronic heart rate monitors which are much more convenient and relatively inexpensive. They are available from most sport shops.
Monitoring Resistance Training Intensity
For resistance training, change the amount of repetitions and/or resistance used to alter the intensity of the effort. You can also use the RPE scale mentioned above to gauge the intensity you are working at. Again, you should be working at the ‘safe’ moderate range (12-16). The physical benefits that you may gain from working at higher intensities are not worth the extra stress you place your body under.
Time
For cardiovascular/aerobic training it is recommended you accumulate a total of at least 30 minutes of physical activity per day. You can spread your exercise over the course of the day, for example three 10 minute bouts.
For resistance training, progressively increase the amount of sets and exercises you perform. As you increase the volume of work being performed, the duration will also have to increase. The programs we have supplied are either split (half body) programs taking approximately 30 minutes or whole body programs taking approximately 1 hour. As you become more familiar with the exercises and routines, the time taken to complete the program will be less.
Type
The best thing you can do is finding a form of exercise you enjoy. That way you are more likely to adopt it as a lifelong habit. Most people who don’t do this stop their exercise regime within six months(2).
It doesn’t have to be regimented physical activity! It can include:
- Mopping or sweeping floors
- Playing with the kids down at the park
- Extending the walk to and from your car when going to the shops or work
You should also try to increase the amount of “incidental” exercise in your day. For example, take the stairs instead of the lift. You could also do a few floor exercises or sit on an exercise bike while watching television. Who said men can’t do two things at once!
Cardiovascular/Aerobic Training
Fitness refers to your ability to perform exercise using powerful movements (and large muscle groups) for a prolonged period of time (14). Examples of cardiovascular/aerobic training include:
- Sport and recreational activities
Resistance Training
Improving or maintaining your muscular strength and endurance allows you to do your daily activities with less stress on your body. Muscle function, as well as bone density and connective tissue integrity, is improved by resistance training (14). We have created some sample resistance training programs, illustrating how to perform exercises for major muscle groups in the body. You can find them below in exercise programs.
Flexibility Training
Maintaining your optimum range of motion (ROM) in all joints is important to keep your musculoskeletal system working at its best (14). Many elderly people lose their independence because of a reduction in muscular strength and flexibility. A flexibility program, in combination with resistance and cardiovascular exercises, can help to improve or maintain the amount of daily activity you can do. During exercise, the repetitive contraction of the muscles builds up tension which should be released when you finish. You can relieve the tension by stretching at the end of your cool-down. We have provided you with some examples of flexibility training, covering the major muscle groups in the body, in cool-downs.
Balance Training
Balance refers to the ability to maintain equilibrium while moving or while in a stationary position (12). Loss of balance can lead to a fall, and a potentially bad outcome. Older people often have lower bone density, making them more likely to break bones if they do fall. The ‘neck’ of the thigh bone, or femur, is a particular trouble spot. Unfortunately, about half of all elderly people who have a fracture are unable to walk again. The ability to maintain equilibrium is influenced by several factors:
- Proprioception (‘touch and feel’ sense)
- Flexibility
- Environmental Hazards
Exercise can help improve balance. Please note that medications, environmental hazards and vision must also be addressed to reduce the risk of falls (10).
When you are performing balance exercises, please perform them close to a rail or wall. This way, if you do lose balance, you can easily stop yourself from falling. It is also a good idea to have someone supervise your balance activities just in case you become unsteady. Some examples of balance exercises are:
- Normal Stance with eyes closed (Very Easy Difficulty)
Advance by having feet side by side with eyes closed (Easy Difficulty)
- Standing on one leg (Moderate Difficulty)
Advance by closing eyes (Hard Difficulty)
- Have the heel of front leg touching toes of back leg, whilst in standing position (Moderate Difficulty)
Advance by closing eyes (Hard Difficulty) or
By rotating head from left to right with open eyes (Hard Difficulty)
Advance by closing eyes whilst rotating head from left to right (Very Hard Difficulty)
- Heel-toe walking (Moderate Difficulty)
Advance by performing it backwards (Hard Difficulty)
- Standing on balance boards (Hard Difficulty)
Advance by moving upper body limbs – transferring your weight (Very Hard Difficulty)
Exercise Programs
- Warm-Up
- Home Based Exercise Programs
- Clinic Based Programs
- Cool-Down
The exercise programs provided by MEHN have been developed by AAESS (Australian Association For Exercise and Sports Science) accredited exercise physiologists who have provided it as template for individual fitness progression. MEHN will not be in any way responsible or accountable for any negative impacts or unforseen issues arising from the use or misuse of these exercise video examples.
Please refer above for further information on gauging exercise intensity and identifying the appropriate exercise plan for you. By continuing to the video links below you effectively acknowledge that you have read and are aware of the implications of undertaking a self managed exercise program, as stated in the Website Terms and Conditions.
Having said all that, above all we hope you gain much benefit from safely utilising these exercise programs.
Warm-Up
If you plan to perform physical activity you should commence with a warm-up. The purpose of a warm-up is to slightly elevate the muscle temperature and increase blood flow, which can improve performance and reduce the risk of injury (10). Warm-ups are usually made up of 5-10 minutes of low intensity exercise, gradually building up to moderate intensity, so you start to sweat (12). This may include activities like walking, jogging, cycling and light swimming. You may also rehearse the specific movement you are going to be performing at lighter intensities (i.e. bench press with just barbell and perform 10 repetitions) (10). Light stretching can also be included in warm-up routines.
Home Based Exercise Program
For those who don’t have an exercise physiologist in your area, or can’t afford to see one, this section is for you. You should still consult your doctor, to make sure exercise won’t do you any harm. The body weight home based programs have been designed to require minimal equipment, with some requiring none at all. The weight resistance home based programs require simple equipment such as dumbbells and ankle weights. The body weight home based resistance training program has five levels of progression, so you should be able to find an intensity level to suit your capabilities. If performing the weight resistance home based program, you just alter the weight, repetitions and sets to suit your capabilities. Any of the exercises can be substituted for easier or harder versions. The programs below are just examples, not strict guidelines.
Body Weight Home Based Program (Colours indicate Intensity Level)
Weight Resistance Home Based Program
Clinic Based Program
For those who have access to a clinic, you should have a program designed specifically for you. A whole body program should include 8-10 exercises covering the major muscle groups required for active daily living. If performing a half body split program, it should include 4-6 exercises for each program (either upper body or lower body). You should perform each type of exercise (a “set”) 2 to 4 times. The amount of times you perform the movement (repetitions) per set should range from 6 to 15.
Below are sample programs:
Cool-Down
Cool-downs should be performed after physical activity for approximately 5-10 minutes (12). A cool-down gradually relaxes the body, bringing it closer to its pre-exercise state. Cool downs have many benefits, including:
- Removal of waste products (such as lactic acid) from muscles more rapidly, leading to a faster recovery from fatigue. Lactic acid, when ‘flushed’ into the blood, becomes an important energy source.
- The mild activity causes the muscles to act as ‘pumps’, directing extra blood back to the heart and vital organs. This process prevents the ‘pooling of blood’ in the limbs.
- Reduced muscular stiffness and decreased chances of fainting or experiencing dizziness.
- Following intense cardiovascular/aerobic exercise there are increased “catecholamines” in the blood. In higher risk people, elevated catecholamine levels can trigger cardiac irregularities. Most of the time this happens after exercise, not during. These irregularities are considered rare but it is best to be safe and perform a careful cool down. This can help control the amount of catecholamines in your blood, especially if you are in a high risk category (12).
Static stretches should be performed at the end of a cool-down. Try to include a stretch for every major muscle group you used during physical activity. You may like to include some of the following into your stretching routine.
Exercise Complimenting Medical Treatment, Surgery & Rehabilitation Programs
More recently, physical activity and physical fitness has been used to help cancer patients. This is quite a new area of research, but exercise is consistently showing to have a positive impact on affected people (5,9). For example, if cancer treatments have side effects such as muscle loss, decrease in bone density and fatigue, certain forms and volumes of exercise (prescribed by an exercise physiologist) can go a long way towards counteracting these side effects (9).
Exercise is also used as a therapy to assist those recovering from injuries/operations. This is because it has been shown to reduce recovery time (3). The benefits of good fitness and well developed muscles have also been seen to help prior to surgery (i.e hip or knee replacement). It’s been found that those who improve their general fitness, and work on the muscles (pre-hab) in the surgery area have faster recovery rates, compared to those who do not perform ‘pre-hab’ (3).
References
(1) Borg, G. (1998). Borg’s Perceived Exertion and Pain Scales. Champaign, IL : Human Kinetics.
(2) Brott, A. (n.d.) Blueprint for men’s health: A guide to a healthy lifestyle (2nd ed.). Washington, DC: Men’s Health Network.
(3) Brukner, P. & Khan, K. (2006). Clinical Sports medicine (3rd Ed.). McGraw Hill.
(4) Crichton, N. (2001). Information Point: Visual Analogue Scale (VAS). Journal of Clinical Nursing, 10, 706
(5) Courneya, K. S. (2003). Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc, 35(11), 1846–1852.
(6) Dpt. of Health & Ageing. (1999). National Physical Activity Guidelines for Adults. Australian Government: Canberra.
(7) Foster, C. (2008). The Talk Test as a Marker of Training Intensity. Journal of Cardiopulmonary Rehabilitation & Prevention, 28 (1), 24-32
(8) Fox, K.R. (1999). The influence of physical activity on mental well-being. Public Health Nutrition, 2, 411-418.
(9) Hayes, S. C., Spence, R. R., Galvao, D. A. & Newton, R. U. (2009). Australian Association for Exercise and Sport Science position stand: Optimising cancer outcomes through exercise. Journal of Science and Medicine in Sport, 12, 428-434.
(10) Howley, E.T. & Franks, B.D. (2007). Fitness Professionals Handbook (5th ed.). Human Kinetics: Champaign, IL.
(11) Hu, F.B., Stampfer, M.J., Solomon, C., Liu, S., Colditz, G.A., Speizer, F.E., Willett, W.C., Lee,
(12) Nieman, D.C. (2007). Exercise Testing and Prescription: A health-related approach (6th ed.). McGraw-Hill: NY.
(13) Maud, P.J. & Foster, C. (2006). Physiological Assessment of Human Fitness (2nd ed.). Human Kinetics: Champaign, IL.
(14) Whaley, M. (2006). ACSM’s Guidelines for Exercise Testing and Prescription (7th ed.). American College of Sports Medicine. Lippincott, Williams and Wilkins: Baltmore, MD.
(15) WHO. (2008). Recommended amount of physical activity: Factsheet. Retrieved 17th June, 2009, from www.who.int/dietphysicalactivity/factsheet_recommendations/en/print.html
(16) Winstanley, M., Woodward, S., & Walker, N. (1995). Tobacco in Australia: facts and issues. Victorian Smoking and Health Program: Melbourne.
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