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Strength: Use It and Improve It

Do you notice that it’s harder to lift a bag of groceries, stand from a chair, maintain your balance, or go up and down stairs as you age? This could be due to sarcopenia, an age-related loss of muscle mass and physical performance. This loss can start at middle age and progress as we get older.


The following are factors that can contribute to this muscle loss:

  • Immobility

  • Deficiencies in diet

  • Inflammation

Note on Immobility: Immobility can occur for many reasons including after a hospitalization, after a surgery, or walking and moving less because of fear of falling. This weakness can lead to limited tolerance and desire to participate in daily activities.


The good news is that this muscle weakness can often be improved or prevented with strength training exercises and walking.


The CDC recommends two or more days a week of strength training for adults. There are many benefits to making strength training a lifelong habit including:

  • Improved performance in daily activities

  • Improved sleep

  • Improved management of blood sugar

With all of these benefits considered and numerous more, getting involved in a strengthening program alongside a health and wellness professional can get the ball rolling. Visit a physical therapist or a personal trainer to have a program tailored to you. These professionals can help to consider all of the important components of a productive, individualized strength program by making sure that the program matches your current abilities. Are the exercises difficult enough for you? How many reps/sets should you be doing? At what intensity should the exercises be performed?


The American Physical Therapy Association developed a synopsis, which is a summary of evidence and studies, in regards to strength training for older adults. The synopsis looked at several research studies on this topic to make a recommendation on strength training for older adults. They found that the subjects in the studies, “even seniors in nursing homes,” who participated in a more challenging program had the most benefits in strength gains.


If you are in physical therapy, working with a trainer, or working on strength on your own make sure that the you are challenging yourself with the exercises. If an exercise is easy for you, you should be making the exercise more difficult by adding repetitions, increasing resistance, or performing new exercises. Before progressing an exercise, make sure that you can perform the exercise at current level with good form and without pain. Do not progress an exercise if you cannot maintain proper form. It’s best to start with light weight, or simply bodyweight, so you can perfect your form. If you are thinking about starting a new exercise routine, it is recommended that you speak to and get clearance from your doctor first. Do not participate in strength training if you have painful or swollen joints.


Rate of Perceived Exertion (RPE) Scale


A good way to rate the difficulty of exercises is to use the Rate of Perceived Exertion (RPE) scale. Based on a study published in 2012 there is a correlation between intensity of an exercise and RPE. RPE is a valid way to measure your exercise intensity. Traditionally, the use of a 1 rep max has been used. However, the 1 rep max is problematic due to it being difficult to measure and the risk of injury to an older adult that can occur in determining 1 rep max.


The study determined that the following exercise intensities correspond with the associated RPE:

  • Very High Intensity = RPE 17-18 “very hard”

  • High Intensity = RPE 15-16 “hard”

  • Lower Intensity = RPE less than or equal to 11 “fairly light to light”

High intensity exercises are better for improving strength than low intensity exercise, and lower intensity exercise tends to be better than higher intensity exercise to improve balance. Based on this study, RPE should be around 15-16 to improve strength and less than 11 to improve balance. The real take home point here is that RPE can be used successfully and can help us to understand whether or not we are working hard enough!


 

1 - Woo J. Sarcopenia. Clin Geriatr Med. 2017; 33(3):305-314

3 - Choosing Wisely: https://www.choosingwisely.org/patient-resources/physical-therapy/; accessed March 12, 2020

4 - Row B, Knutzen K, Skogsberg N. Regulating explosive resistance training intensity using the rating of perceived exertion. J Strength Cond Res. 2012; 26 (3): 664‐671.








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