1. Strength and Flexibility Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California State University, Fullerton

2. 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.

3. Affected Postural Muscles Erector Spinae Quadratus Lumborum Iliopsoas Tensor Fascia Lata Piriformis Rectus Femoris Hamstrings Gastroc-soleus Pectoralis Major Upper Trapezius Levator Scapula Sternocleidomastoid Scalenes 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 TightnessProne to Weakness Bandy & Sanders, 2001

4. Practical Implications The following muscle groups should be targeted for improvement: Hip Abductors Hip Extensors Knee Extensors Ankle Plantarflexors Critical for smooth forward translation of COM during gait

5. 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

6. Strengthening Muscles of Upper Body Suitable Progression: SeatedStanding Balance Challenged

7. Strengthening Muscles of Lower Body Add dyna disk to increase challenge

8. 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)

9. 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.

10. Implications for Programming Flexibility exercises are a particularly important component of the program for older adults with: Arthritis Low back pain Parkinsons Disease Multiple Sclerosis History of physical inactivity

11. 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

12. Stretching Muscles of Cervical Region “Turtles”

13. Stretching Muscles of Upper Body

14. Stretching Muscles of Hip and Lower Body