Contemporary Sports Issues – Page 65

Exercise Testing and Prescription for the Senior Population

Submitted by: Jon YeanSub Lim, CSCS, USSA Doctoral Student

Introduction

Today, the average of life expectancy has gone up in the United States (U.S.) and is expected to increase even more in the future. The U.S. Bureau of Census (1994) predicted there will be more than 40 million people over 65 years old in the year 2010. The growth in the senior population of the U.S. is a similar trend throughout the world. Consequently, the health, fitness and well-being of the senior population are of increasing concern in today’s society.

Aging is a normal biological process in human beings involving the gradual alteration of body structure, function, and tolerance to environmental stress. From approximately age 30, effectiveness of various physiological functions begins a subtle decline that becomes more obvious around age 55-60. However, physiological aging does not occur at the same rate throughout the population. At the present, it is difficult to distinguish reasons of decline in physiological functions. The reasons could be from advancing age, deconditioning from physical inactivity, disease, or any combination of them (ACSM, 1995).

There is a biological and a chronological age. Biological age focuses on senescent changes in biological and physiological processes, whereas chronological age focuses on elements of calendar time. An individual who is 70 years of age may have a biological age of 45, based on his/her health and fitness status. Biological age may be reduced by regularly participating in a well-designed physical fitness program. Nakurma, et al. (1989) found that active elderly men who followed a regular exercise program were able to significantly lower their biological age with improvement in functional capacity and maximal aerobic power. This may explain that normal aging processes account only for a portion of the loss of physiological function; physical inactivity accounts for greatest amount of the loss with age (Poehlman et al., 1991). This loss from physical inactivity is avoidable through adequate and regular exercise.

The benefits of physical activity for older individuals are well documented. It improves cardiorespiratory function, reduces risk factors for coronary artery disease, and most importantly enhances of the ability to perform daily activities (Blair, 1993; Huhn, 1993). There is no clear evidence that exercise will improve longevity, but there is little doubt that it improves the quality of life in old age. It maintains endurance, strength, and joint mobility while it reduces the incidence and severity of hypertension, osteoporosis, obesity, and diabetes mellitus. The purpose of this paper is to provide general guidelines of effective and safe exercise testing and prescription for the senior adult population. The physiological changes accompanying advancing age which influence exercise should be considered in the design of effective and safe exercise programs for the senior population.

Physiological Changes With Aging
The study of physiological changes with aging come from data collected from different cross-sectional and longitudinal studies (Table 1). It is crucial to have knowledge of the physiological changes of aging in order to have a safe and effective exercise program for older individuals. With advancing age, there are gradual decreases in basal metabolic rate (BMR), bone density, maximum oxygen consumption (VO2 max), muscle mass, muscle strength, and range of motion (ROM).

Table 1
Effects of Exercise Training and Aging

Variables

Aging

Exercise Training

Resting heart rate

Little or no change

Decreases

Maximal cardiac output

Decreases

Increases

Resting & exercise blood pressure

Increases

Decreases

Maximal oxygen uptake

Decreases

Increases

HDL

Decreases

Increases

Reaction time

Decreases

Increases

Muscular strength

Decreases

Increases

Muscle endurance

Decreases

Increases

Bone mass

Decreases

Increases

Flexibility

Decreases

Increases

Fat-free body mass

Decreases

Increases

Precent body fat

Increases

Decreases

Clucose tolerance

Decreases

Increases

Recover time

Increases

Decreases

(ACMS Guidelines for Exercising and Prescription, 1995)

The benefits associated with exercise are well documented showing the enhancement of the ability to perform daily activities in old age (Table 1). Most of the physiological changes of aging can be improved with regular exercise training.
Exercise Testing
The American College of Sports Medicine (ACSM) recommends that older individuals should obtain a medical clearance from their physician prior to maximal exercise testing and before their participation in vigorous exercise. In addition, health screening of the participant should be conducted in order to optimize safety during exercise testing and participation to develop an individualized, safe and effective exercise prescription.

After the completed health screening, the participant should have a pre-exercise evaluation which will provide a baseline measure of body composition, cardiovascular endurance, flexibility, and muscle strength. The protocols for testing older individuals need to be modified for any special needs they may have. The ACSM provided factors to be considered when selecting an exercise testing protocol for older individuals (Table 2).

Table 2 Factors to Be Considered When Selecting an Exercise Testing Protocal for Older Adults
Characteristic	•	Suggested Test Modification
Low VO2 max	•	Start at low intensity (2-3 METs)
More time to attain a steady state	•	Long warm-up (>3 min), small increments in work rate (0.5-1.0 MET per stage), longer stages
Increase fatigability	•	Reduce total test time (ideally 8-12)
Increase need to monitor ECG, blood pressure, and heart rate	•	Cycle ergometer preferred
Poor balance	•	Cycle ergometer preferred
Poor ambulatory ability	•	Increase treadmill grade rather than speed
Poor neuromuscular coordination	•	Increase amount of practice, may require more than one test
(ACSM Guidelines for Exercise Testing and Prescription, 1995, p.230)

These baseline measures are very useful in the development of exercise prescription and educating participants in physical fitness and their individual status.

Exercise Prescription
The American College of Sports Medicine (1991) recommends the goals for exercise in the senior population should be to maintain functional capacity for independent living, reduce risk factors for heart disease, retard the progression of chronic disease, promote psychological well-being, and provide opportunities for social interaction.

Although many of the general principles of exercise prescription are the same for individuals of all ages, special care must be given when setting up a fitness program for older individuals. Exercise programs for older individuals should be tailored to combine endurance, muscle strength, and flexibility to promote the quality of their life. The general exercise prescription guidelines for the senior population are developed from the ACSM guidelines (1995).

Mode

The mode of exercise for the older population should be activities with low-impact on their joints. The activities include walking, stationary cycling, water exercise, swimming, or machine-based stair climbing. The activity needs to be accessible, convenient, and enjoyable to the participant.

Duration

The duration of an exercise program should start with short periods and gradually progress in length. During the initial stage, it may be difficult for some old adults with physiologic limitations to perform exercise for 20 minutes. It will be possible for them to perform exercise in shorter sessions of five to 10 minutes repeated several times throughout the day. In addition to the duration of the exercise program itself, elderly people need additional warm-up and cool down time, perhaps as much as 10 minutes or more.

Intensity

The intensity of the exercise program must start out low since elderly people are more prone to exercise-related injuries. Because low intensity exercise is associated with a lower risk for injury, it should be encouraged in the elderly population. Exercise intensity should be sufficient to overload the cardiovascular, pulmonary, and musculoskeletal systems without overstraining them. The recommended intensity by the ACSM for older adults is 50 to 70% of heart rate reserve (1995). The intensity level of exercise should be regularly monitored by heart rate, or rating of perceived exertion (Borg, 1982).

Frequency

Generally, the frequency of exercise programs recommended is three to five days per week (ACSM, 1995). Emphasis on more frequent activity (five to seven days per week) may be made with seniors if they exercise very low intensity with short duration. This recommended increase in frequency has physiological relevance for the maintenance of endurance capacity as well as flexibility. In addition, the greater frequency may enhance compliance and lead to a greater probability of the subject assimilating physical activity in the daily routine.

Progression

Progression should be conservative and gradual for older individuals. The initial stage, usually four to six weeks, should include low intensity exercise to permit adaptation with minimal risk for injury. Elderly subjects may need a longer period of adjustment before exercising at higher intensity levels. It is better to increase exercise duration initially rather than intensity in order to avoid injury and ensure safety. Progression in an exercise program should be based on how well the individual is responding to the current regimen, the medical and health limitations of the individual, and individual goals. Exercise programs should be reviewed on a regular basis to ensure they are meeting the needs of the participant.

References

American College of Sports Medicine. (1991). Guidelines for Exercise Testing and Prescription (4th ed). Baltimore: Williams & Wilkins.

American College of Sports Medicine. (1995). Guidelines for Exercise Testing and Prescription (5th ed). Baltimore: Williams & Wilkins.

Blair, S. (1993). Physical activity, physical fitness, and health. Res Quart Exerc Sport 64: 365-376.

Borg, G. (1982). Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise, 14, 377-381.

Hyhn, R. (1993). Cardiac rehabilitation in the cost containment environment. Cardiopul Phs Ther J 4: 4-8.

Nakamura E., Moritani T., & Kanetake, A. (1989). Biological age versus physical fitness age, Eur J Appl Physiol 58: 778-785.

Poehlman, E., McAuliffe, T., Van Houten, D., & Danforth, E. (1991). Influence of age and endurance training on metabolic rate and hormones in healthy men, Am J Physiol 159: 66-72.

U.S. Bureau of Census. (1994). Statistical Abstract of United States

U.S. Sports Academy2013-11-27T19:05:43-06:00February 11th, 2008|Contemporary Sports Issues, Sports Exercise Science, Sports Studies and Sports Psychology|Comments Off

Alabama High School Soccer Undergoes Eligibility Rule Changes

Submitted by: Dr. Joe Manjone, Dean of Student Services, Continuing Education & Distance Learning, USSA

Changes in the penalties for Alabama High School soccer players receiving misconducts have had very little effect on the numbers and types of cards issued during the 1997 and 1998 Alabama high school soccer seasons (note: high soccer is a spring sport in Alabama). Although ineligibility penalties for yellow cards were eliminated, there was a slight increase in the number of yellow cards issued per game in 1997, but the number of yellow cards issued per game in 1998 was almost equivalent to 1996. At the same time, revised red card (includes red/yellow cards) penalties seemed to have very little effect on the number of. red cards (ejections) issued per game.

During the 1996 spring season and for several years prior, penalties for Alabama high school soccer players receiving misconducts were as follows: the first accumulation of three yellow cards – ineligible for the next game; the second accumulation of three yellow cards – ineligible for the next two games; the third accumulation of three yellow cards – ineligible for the remainder of the season; the first red card – ineligible for the next game; the second red card – ineligible for the next two games; and the third red card – ineligible for the remainder of the season.

For the 1997 and 1998 seasons, soccer eligibility rules regarding a misconduct were changed to conform to the rules in effect for other high school sports. All penalties for yellow cards were eliminated. The red card (or red/yellow) penalties are as follows: a player’s first red card – the principal at the player’s school receives a warning from the Alabama High School Athletic Association (AHSAA); a second red card – the player is ineligible for the next game; and a third red card – the player is ineligible for the remainder of the season.

Prior to 1997, misconduct card totals had to be kept by each team, and the coach was responsible for enforcing the penalty. With the new rules, the referee who gives the ejection must submit a report to the AHSAA, and the AHSAA is responsible for informing the school and seeing that the penalty is enforced.

In 1996, 649 game reports were sent by the head referee in each contest to this writer. In these 649 games, there were 545 yellow cards and 104 red cards given out. This resulted in an average of .84 yellow cards and .16 red cards per game.

In 1997, 513 game reports were submitted. In these 513 games, there were 486 yellow cards and 71 red cards awarded, resulting in an average of .95 yellow cards and .14 red cards for game.

In 1998, 747 game reports were submitted. In these 747 games, there were 612 yellow cards and 113 red cards. This resulted in an average of .82 yellow cards and .15 red cards for game.

As reported above, except for a slight increase in the number of yellow cards given in 1997, the change in the penalties given to players who receive red and yellow cards has had little effect on the average number of red and yellow cards given per game. Although there has been little change in the average number of cards given, there has been considerable criticism about the revised penalties from Alabama referees about the penalty changes.

In giving their opinion about the revised changes to the penalties for players receiving yellow and red cards, the following are some of the statements that were expressed:

1 “The penalty for yellow cards was too harsh under the old system, so I often refrained from giving out a yellow card.”

2 “Giving out a red card means that I will have to take the time to submit a report that will be sent to the school principal, who may then penalize the whole team. It makes me now reconsider if a red card is really necessary.”

3 “Recently, the overtime period for a tie game was changed from two ten-minute regular time and two five-minute sudden victory overtime periods to two ten-minute sudden victory overtime periods. This decrease in game time could have had an effect on the number of cards awarded per game.”

4 “If officials would have turned in game reports for all the games played, the results might have been different.”

5 “The changes were good, because schools do a good job in taking action against players who are ejected from games”

What are your feelings concerning player eligibility penalties for red and/ or yellow cards? Please let this writer know. E-mail: Joeman@USSA-SPORT.USSA.edu

Editor’s Comments: Dr. Joe Manjone is the Alabama State High School Association Soccer rules interpreter. He is also the region V soccer officials’ representative for the National Intercollegiate Soccer Officials’ Association. He is a National High School soccer clinician, and has been officiating high school soccer since 1959.

U.S. Sports Academy2013-11-27T19:07:18-06:00February 11th, 2008|Contemporary Sports Issues, Sports Coaching, Sports Facilities, Sports History, Sports Management|Comments Off

Portable Defibrillators Protect Fans, Players at High School Athletic Events

Submitted by: Linda Del Monte, R.N., Medtronic Physio-Control

In big cities, sports arenas are among the top five places where sudden cardiac arrest (SCA) occurs-but what about towns that don’t have major league stadiums? If little league or the varsity squad is the only game in town, that’s where the people will go, and that’s where SCA will happen.

SCA is one of the most common causes of death in the US, claiming about 325,000 lives each year. Until relatively recently, treatment for SCA-an electrical shock known as defibrillation-was usually administered either in a hospital or by emergency medical service (EMS) personnel. Innovative communities are looking for ways to improve access to defibrillation. They are equipping firefighters, police-and now high school coaches and athletic trainers-with automated external defibrillators (AEDs), allowing them to provide critical treatment before EMS arrives. The leading seller in the field is the LIFEPAK® 500 AED, manufactured by Medtronic Physio-Control of Redmond, Wash.

Unlike the models of defibrillators intended for use by paramedics, nurses and doctors, AEDs do not require extensive medical knowledge to understand or operate. The expertise needed to analyze the heart’s electrical function is programmed into the device, enabling trained professionals to respond to cardiac emergencies. For more information about Medtronic Physio-Control, visit the company’s website at http://www.physiocontrol.com.

U.S. Sports Academy2017-11-02T13:56:01-05:00February 11th, 2008|Contemporary Sports Issues, Sports Studies and Sports Psychology|Comments Off

Youth Risk Behavior Surveillance Systems Survey

Submitted by: Center for Disease Control

36.4% of high school students
smoked cigarettes during the past month, while 16.7% smoked cigarettes
on 20 or more days during the past month, and 9.3% used smokeless
tobacco.

Only 29.3% of high school students
ate five or more servings of fruits and vegetables during the
past day. 4.5% took laxatives or vomited to lose weight during
the past month. 4.9% had taken diet pills to lose weight during
the past month.

63.8% of high school students
did vigorous physical activity three or more days during the
past week. 20.4% did moderate physical activity five or more
days during the past week. 48.8% were enrolled in physical education
class. 27.4% attended physical education class daily.
–Center for Disease Control, based on a survey by the 1997 Youth
Risk Behavior Surveillance Systems survey.

U.S. Sports Academy2017-12-11T11:27:54-06:00February 11th, 2008|Contemporary Sports Issues, Sports Studies and Sports Psychology|Comments Off

The Sun May Set at Last Over the Union

Submitted by: Dr. Thomas P. Rosandich, President, USSA

This past week on campus at the United States Sports Academy we had Tan Sri Dato’ Elyas Omar, the former Lord Mayor of Kuala Lumpur, the magnificent capital city of Malaysia, to receive an honorary doctorate during our 26th Annual Graduation Celebration.

Dato’ Elyas served for more than a decade as the Lord Mayor of Kuala Lumpur and was perceived to be the second most powerful man in Malaysia next to the Prime Minister. He had a rather unlimited budget during the heyday of Malaysia, when they were showing a national growth of nearly 20% per year. He built the very beautiful city of Kuala Lumpur, a mix between Asian and Western architecture, into a bustling capital city with buildings that are the highest in Asia, and a fast transit system that takes the people from one end of the city to the other, over the bustling streets of bazaars. He maintained the beauty of the traditional British railway stations, except this one features Islamic architecture, which is not what one would see in Victoria station in London. The same is true with many of the buildings including City Hall, the Parliament and the Selangor Sports Club in the heart of the city.

Tan Sri Dato Elyas Omar is a great sport enthusiast who built a sport complex equal to no other in the world. It is capable of hosting a major international competition, including the Commonwealth Games that will commence 10 September 1998. He not only built the sport complex but, in collaboration with the United States Sports Academy, led Malaysia’s badminton team to the world title (The Thomas Cup) in 1995. More importantly, he led the bid for hosting the 1998 Commonwealth Games which is a reflection of the British Empire Games that was started in 1930. It was often written before the start of World War II that the sun would never set on the Union Jack (the name for the British flag) in the British Empire. This Empire virtually disintegrated with the invasion of Asia by the Japanese Imperial Armies in the early 40’s. However, the last of the great British Empire in the Far East came to a halt with the transfer of ownership of Hong Kong to the Peoples Republic of China in July 1997.

The Commonwealth Games is often called the Friendly Games because the early structure of the competition focused on individual performances rather than team competitions. How can anyone imagine there would be an international competition developed by the British without football (soccer) or even cricket, as that was and has been the structure of the Games until this year.

Malaysia is the first Asian country (Third World) that has hosted these competitions. Many people have been more than concerned. From the beginning there has been an ill wind (ghost wind called ungan in Malaysian) blowing hot and cold. It is made up of traditional British games with players all dressed in white suit and tie, who “out snooker” one another by bowling iron balls on a grass surface maintained to the quality of a golf green one would find at Augusta, Georgia. If you wish, you can take in a friendly game of squash and, of course, tennis, given the Wimbledon tradition, as well as a wide variety of traditional British sports that one would watch while enjoying afternoon tea and cucumber sandwiches on the veranda.

The general prediction from the Western world is that the Commonwealth Games in Malaysia are heading for dire straits even though it had an unlimited budget and the Director of Games (the former Chief of Staff of the Army), who is the brother-in-law of Prime Minister Dato’ Seri Dr. Mahathir bin Mohamad. Incidentally, he is as anti-American as anyone can be, particularly since Malaysia has gone through an economic nosedive, like all of Asia during the past year.

As always in Southeast Asia, whether it be the current financial crisis or anything else, there are always confrontations between the countries that make up the Association of Southeast Asian Nations (ASEAN). Alarm bells are going off on many fronts even though the Malaysians are doing everything in their power to muffle the problems, from facilities to the difficulties they are currently facing with Indonesian immigrant workers who are being abused in Malaysia. This could well boil over into the world’s hottest and stickiest capitals (where on a good day, one needs to change shirts at least three times a day).

There have been some concerns about the athletes who oftentimes end up on the low end of the totem pole in most international competitions, particularly as it relates to the heat and the very high and dangerous levels of smog in Malaysia – a result of the on-going forest fires that have affected the region for most of this past year.

The fires that continue to burn in Borneo were set by the Indonesian leadership to clear the forest for agriculture. The Australian and New Zealand doctors indicate that the athletes may have to wear masks during the competitions. However, the Malaysians are promising that the smog will not reappear. This is hard to imagine since the fires are burning underground in Borneo and there is no way to put them out. I cancelled my last trip a year ago to the SEA Games in Jakarta because of the smog, but I will be going to Malaysia in the coming weeks as a credentialed VIP to observe this competition.

The Games now includes two team sports, rugby but not football and, of course, at long last the friendly game of cricket. New Zealand, Australia, and the Fiji Islands are among the best rugby nations in the world in which they rule as king of all sports. Cricket, of course, is part of the normal fare throughout the Old Empire, just like tea and crumpets.

We all hope that the prevailing winds that blow in September will cool the temperature, but it is clear that the superstars of the athletic world are more than likely the ones to be cooled toward the Friendly Games where the cash prizes are not there, making these Games something of an anachronism. Actually, the Friendly Games, founded during the days of the British Empire, no longer fits the image and philosophy or even the world sport schedules as it did in the days of the magnificent rubber plantations of Malaysia. Today’s competitors do not want to run for fun, like the old school bash that they had once a year. Simply, they want cash.

Secondly, the Friendly Games does not provide the global platform that sponsors seek, particularly now that it is being held within weeks of the World Cup in Soccer when the television budget has drained the sponsors. In fact, this Games will be held three weeks after the European Championships and in the middle of the IAAF Grand Prix Final in Moscow and the Track and Field World Cup in South Africa. The kicker on this whole Games format is, while one understands top track athletes running for money, the British are not sending either a cricket or a rugby team to this competition due to a long and tiring season.

The saving grace for the XVI Commonwealth Games, which may lack the superstar glamor, is that the Malaysians will no question put on a superb spectacle. Despite the economic turmoil, this will be the largest Commonwealth Games ever held, with more than 6,000 athletes from 67 nations utilizing 26 venues in and around Kuala Lumpur.

The Commonwealth Games is really run like a small town theater production. There are those who would like to see the event reshaped and stripped of its last vestiges of Colonialism to enter the arena like the Olympic Games, with all the top level competitive sports rather than adopting new programs like cricket. Meanwhile, there have been subtle political changes. Rather than having the Queen of England open the Games (as she has for the last 16), they will be opened by the King of Malaysia. The Queen has been relegated to the closing ceremonies.

In 1998 the Games in Malaysia is only the second time it has been held outside of the Mother Country and its dominions, e.g., Canada and Australia. The next Games is scheduled to be back in the UK in Manchester in 2002. It is clear that the alarm bells are going off a second time as Manchester has indicated it will have to scale down the Games unless the British government comes forth with a subsidy of nearly 40 million pounds, which is not likely to happen.

With the global sport picture becoming so congested, it may be that the Commonwealth Games as the British Empire knows and loves it has had its day in the sun with the Union Jack being hauled down maybe for the last time. The sad question is, is there anyone who really cares? Meanwhile Malaysians are undaunted by all these questions. They have already put their bid in for the next Summer Olympic Games following the Olympic motto — higher, further and faster. Good luck.

U.S. Sports Academy2013-11-27T19:07:59-06:00February 11th, 2008|Contemporary Sports Issues, Sports Facilities, Sports History, Sports Management|Comments Off