Strength and FlexibilityStrength and Flexibility

Debbie Rose, Ph.D.Debbie Rose, Ph.D.

Co-Director, Center for Successful AgingCo-Director, Center for Successful Aging

California State University, FullertonCalifornia State University, Fullerton

Age-Related Changes

Muscle:• Reduction in skeletal muscle mass – Sarcopenia• Increase in fat and connective tissue within

older muscle• Reduction in diameter and size of muscle fibers.

Greatest reduction in type II fibers (fast-twitch)• Reduction in number of functioning motor units

in aging muscles. Greatest change in lumbar vs cervical and thoracic motor units.

• Collective result of changes in muscle is reduced muscle strength.

Affected Postural Muscles

Erector SpinaeQuadratus LumborumIliopsoasTensor Fascia LataPiriformisRectus FemorisHamstringsGastroc-soleusPectoralis MajorUpper TrapeziusLevator ScapulaSternocleidomastoidScalenes

Rectus Abdominus

Serratus Anterior

Gluteus Maximis, medius,

minimus

Lower Trapezius

Vastus Medialis and lateralis

Short cervical flexors

Extensors of Upper Limb

Tibialis Anterior

Prone to Tightness Prone to Weakness

Bandy & Sanders, 2001

Practical Implications

The following muscle groups should be targeted for improvement:• Hip Abductors• Hip Extensors• Knee Extensors• Ankle Plantarflexors

Critical for smooth forwardtranslation of COM during gait

Implications for Gait

Weak Hip Abductors

Weak Hip Extensors

Weak Knee Extensors

Weak Plantarflexors

Weak Dorsiflexors

Excessive movement in frontal plane and slowing of gait

Reduced stride length and gait velocity

Decreased step length and gait velocity

Reduces/eliminates heel rise during terminal stance –affects gait speed

Reduced toe clearance leading to possible trips, falls during gait

Strengthening Muscles of Upper Body

Suitable Progression:Suitable Progression:SeatedSeated

StandingStandingBalance ChallengedBalance Challenged

Strengthening Muscles of Lower Body

Add dyna disk to increase challenge

Age-Related Changes

Joint ROM and Flexibility:• Declines gradually from approx. 30 years with

greater declines after age 40 years• Increased viscosity of synovium• Calcification of articular cartilage• Stiffening of soft tissue (joint capsule and

ligaments)• More frequently used joints exhibit less decline

(e.g., anterior trunk flexion range vs back extensor; upper vs lower extremities)

Age-Related Changes

Joint ROM and Flexibility:• Ankle ROM declines with age, more so

in women vs men.• Between 55 and 85 years, women lose as

much as 50% in ankle ROM, but men lose only 35% (Vandervoort et al., 92)

• Not all older adults lose flexibility at the same rate. Physical activity levels play an important role.

Implications for Programming

Flexibility exercises are a particularly important component of the program for older adults with:ArthritisLow back painParkinsons DiseaseMultiple SclerosisHistory of physical inactivity

Upper Body Muscle Tightness or Weakness: Implications for Function

• Tight cervical region

• Weak back extensors

• Weak Abdominals

• Weak upper extremities

Driving;obstacle avoidance during gait

Poor upright posture; pain

Core stabilization for reaching; improved postural set

Lifting, carrying, bathing, cleaning, etc

Stretching Muscles of Cervical Region

“Turtles”

Stretching Muscles of Upper Body

Stretching Muscles of Hip andLower Body