Resident activities
training equipment in a care home, which was being used as part of the University of Stirling’s research, many residents stated it was not for them. This was understandable, as they have not been in a gym in years - if ever. Interestingly, after a cup of tea and a presentation to the group about why it was so important to maintain muscle, there was a complete change in thought. Almost everyone wanted to take part, even those not deemed frail enough to be part of the study. Suddenly, we saw a sense of competition and enthusiasm to become stronger. This obviously continued long after the study, as the care home also purchased the equipment that they use today. It might be challenging, but useful, to consider a comment made by the US geriatrician John Rude.
“In my opinion, most of the people I see in nursing homes are there because they are weak, not because they are sick.” Now, that is not to say that we can stop
people from needing to move into nursing homes altogether. It is never too late to strength-train, however, so we may be able to keep some in care homes or retirement communities a little longer if the main issue is weakness.
Inequalities in resistance training and training solutions
To be able to get up from a chair or bed requires muscle, to remain stable while going up or down the stairs also requires muscle. It also needs effective proprioception, in order to maintain balance. Walking also requires a degree of muscle, and balance, and even more so if we want to carry the shopping. This is important so that it is not
confused with other exercise suggestions or interventions. Movement and use of light training with resistance bands are a good start and far better than inactivity. However, to build
muscle you need to stress that muscle to a level that goes beyond gentle exercise. The National Centre for Sports & Exercise
Medicine in Loughborough interpreted the UK chief medical officer’s Physical Activity Guidelines for older adults and produced a great summary of strength training. This included: n Activities that improve strength are those that use the muscles against a resistance or extra weight and where they are performed slowly and repetitively e.g. 8-12 times.
n For a frailer, older adult, body weight or light resistance will initially have a strengthening effect. However, as strength improves, heavier weights and slow repetitions will allow the training effect to continue.
n Muscle strengthening activities involving all major muscle groups - including the shoulder girdle, arms, trunk, legs and muscles that surround the ankles - will provide substantial benefits for frailer, older people.
While we believe all resistance training in any form is a great start, it is hard to target all major muscle groups effectively, track improvement and increase resistance from something as simple as a resistance band. We therefore believe the UK should be doing more to engage our elderly to strength train efficiently using machine-based exercise. I well understand the issues that many later living sites have with implementing a strength and resistance training programme within their communities. For many, traditional gym equipment is too aggressive for their residents and if you can only add 5kg at a time, individuals may struggle to lift more and see the improvements that are important for the
February 2022
www.thecarehomeenvironment.com
individual’s mentality. The good news is HUR strength training
equipment - used in the University of Stirling study - provide a solution, as you can increase the weight 100g at a time. Furthermore, through the use of pneumatics it is safe for the elderly, as there are no ‘clunky’ weight stacks and it mirrors the natural transmission of the muscle.
Look north The Scandinavian and Nordic countries are far advanced in their thinking when it comes to maintaining muscle strength and it seems to be part of their DNA. I have visited a number of care homes in Finland and every place had a gym. During one visit, I asked a 90 year-old gentleman why he came to the gym every day. He just looked at me and said: “Why wouldn’t I? I want to walk to the shop every day to get a paper and if I just sat there, I would waste away.” This is a sentiment many share in the UK but have not had the push or facilities to be proactive with. Many sites tell us they do not have the
space. However, we have fitted gyms into the tiniest of spaces and our HUR Pulley can do a full body workout from one machine in a very small space. There is no reason not to provide effective solutions to resistance training.
Why has strength training taken a back seat? So, why in the UK are we so different to those in other countries? Well, it all comes down to priorities and education. Muscle does seem to be misunderstood. Perhaps this in part is due to the fact that the public messages we have received for many years - particularly for weight loss - have been focused on aerobic exercise of the heart and lungs, leaving strength training in the elite sport sphere.
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