Chair-based resistance exercises in care and nursing homes
As residents in care spend on average 75% of their waking time in sedentary activities, you would think that the last thing they need to do involves more sitting. But chair-based exercise is a perfect solution for those who lack the strength or stability to participate standing up.
Care homes can do a great deal to encourage and support exercise and activity for its residents including chair-based exercise classes which can be adapted to suit individuals.
Staff can play a vital role in encouraging residents to participate by reassuring them that the session will be fun and not too vigorous. The benefits are wide ranging with the emphasis on helping residents to be mobile and manage activities of daily living such as getting dressed, walking unaided to the toilet and generally maintaining as much independence as possible.
A good exercise programme for older adults should focus on:
- Simple functional movements to improve mobility
- Stretching exercises to improve range of movement
- Rhythmic aerobic movements to music at a low to moderate intensity
- Resistance exercises to improve strength
- Balance exercises for those who can participate safely
Resistance exercises – which involve working against a load – are often neglected in the care home yet they are absolutely vital to address the problem of sarcopenia (loss of muscle mass and strength).
There is a growing body of research evidence which finds that targeted resistance based exercises can significantly reduce frailty in older adults. Sarcopenia is estimated to cost the NHS £11.9 billon1; these costs are represented by increased hospitalisation, nursing home admissions, and home care expenditure. In addition, there is encouraging findings on the impact of exercise on those with cognitive impairment as well2.
So how can we take this research and turn it into practice?
Resistance bands and balls offer a realistic solution and can be done in a group setting or individually for those who need more guidance. The simple sit-to-stand is one of the best exercises to improve leg strength and can be done every day. A seated leg raise can help strengthen quadriceps to aid walking, or squeezing a resistance ball between the legs can improve strength to aid balance.
By focusing on what the individual can do, rather than what they can’t, means everyone can participate at some level; the most frail people often have the most to gain from being active and this group should not be excluded from taking part in physical activity. It’s always wise to get advice from a medical professional before participating.
Move it or Lose it ensure all exercises are related to everyday purposes – such as putting on socks, getting out of bed or up off the toilet – so participants can relate to this and work towards achieving personal goals. It is possible to turn back the clock on sarcopenia and once strength is improved it allows for so many other opportunities to join in other activities, or simply be able to get out and about again.
It’s really important to ensure that instructors know how to teach these exercises safely and effectively. Here are some videos of four simple chair-based resistance exercises as seen in Nursing and Residential Care Magazine recently.
1Beaudart et al (2014) Sarcopenia: burden and challenge for public health. Arch Public Health, 72:45
2Forbes, D et al (2015) Exercise programs for people with dementia. Cochran Review.