Physical training for the older adult has become an area of great interest over the past five years. Current research has assured personal trainers that healthy older adults can participate in standard training programs. It is also encouraging that regular physical activity has been shown to produce physiological improvements regardless of age. (Pollack 1971).
Because you are working one on one, you can further the wellness of older adults by translating the benefits of general exercise into a program specific to "real-life function." The more information you can acquire from individuals regarding their specific needs, the better you can customize their exercise programs.
Of course, any older client will require medical clearance. Take careful notice of any training restrictions the physician may indicate, and telephone the physician if you have any questions.
One of the more striking characteristics of the aging process is impaired motor performance (Wiswell et al.1990), which is demonstrated in the slowing of movements, the loss of fine coordination and a decrease in maximum strength. Training for real-life function as I'm using the term means helping clients regain or improve their ability to stand up, sit down and maintain general independence. These activities require coordination, synchronization and a certain amount of strength.
Functional tasks can range from the simplest self-care to executive-level occupational responsibilities (Reuben & Solomon 1989). To help clarify the description of these tasks, three categories of function have been defined:
Basic Activities of Daily Living (BADL) include bathing, eating, dressing, using the toilet, transferring from one place to another, and walking.
Intermediate or Instrumental Activities of Daily Living (IADL) include such tasks as cooking, shopping and light housework.
Advanced Activities of Daily Living (AADL) are recreational, occupational or community service functions.
The older client most often seen by the personal trainer will generally range between the IADL and AADL categories.
Evaluating Functional Ability
Analysis of functional ability does not require a lot of statistical normative data. Older adult clients are the least concerned about how they compare to the norm. Instead, they are very concerned with their own progress, which you can record and report.
When designing an exercise program for older adults, you can address functional tasks in the interview phase. You can usually determine clients' levels of independence by simply asking them about their ability to get out of bed, dress, prepare meals, shop and perform other daily activities.
A lot of information can also be acquired through observation of functional mobility. Does the person need assistance getting up from the floor or from a bench? Make your observations part of your notes.
Even if you are unsure of the individual's basic functional capabilities, using the typical screening tests considered it standard in our industry, such as the step test or bike ergometer, may actually be putting the cart before the horse. An older adult may not score well on a simple step test due to nonspecific joint pain, an inflamed tendinous attachment or muscle cramping-all of which are common in a deconditioned older adult.
Failing to complete the test makes the client feel worse. He or she may even leave the test facility in pain, which may increase the next day. After going to all this trouble, the trainer still doesn't have any more information, and may end up with one less client.