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Brief physical activity guidance for older adults in isolation

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Resources on brief physical activity guidance for older adults in isolation for patients and clinicians

Giving Older Adults Brief Physical Activity Advice.
Given current clinical pressures, clinicians dealing with older adults will likely have limited time, and this adapted 3As model may provide a possible structure to clinician’s advice.

Ask: Permission to discuss physical activity as something that could make a difference to health and wellbeing

Advise/Explain/Explore: Ask how they physical activity levels have changed and what they could do to increase it? 

Agree: A plan considering what they will do, how they will do it. Try to ensure that it includes some cardiovascular, muscle and bone strengthening activities including resistance exercises, balance and co-ordination elements to the plan.

Cardiovascular: Ideally the individual should be slightly out of breath when performing the activity. Aim to build to 150 minutes a week of moderate activity preferably spread over the week. If the intensity is right, Patients should be able to hold a conversation but will be unable to sing

Resistance Exercise: Resistance training aims to increase muscle mass and promote neuronal adaptation. Any exercise or movement usually with some weight or load which causes the muscles to fatigue. Ideally the patient should aim for at least 2-3 sessions a week for muscle and bone health.(14)The focus should be on compound movements: movements that work multiple joints and therefore muscles. This could include squats, sit to stands from a chair, farmer’s walks (walk carrying heavy items), wall push-ups, heavy gardening amongst many other options.

Ideally the patient would pick 3-5 exercises or movements to challenge their major muscles and likely aim to fatigue at a number of repetitions between 8 and 12.(15) The stimulus and fatigue to the muscles is more important than the rep range and beginners may want to consider 10-15 rep range.(15) The weight should be a challenge for the number of repetitions performed.  Ideally with time, the number of sets performed of each exercise, and the load, would be increased.


Resources for Patients
The NHS Live well has a range free advice and programmes from more strenuous to chair based exercises:
https://www.nhs.uk/live-well/exercise/

Tips, advice and guidance on how to keep or get active in and around your home:
https://www.sportengland.org/stayinworkout


Resources for Clinicians
Moving medicine provides physical activity brief intervention advice aimed to be used by the clinician based around 11 chronic conditions and primary prevention using a behaviour change framework:
https://movingmedicine.ac.uk


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