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Physical activity is defined as 'any bodily movement produced by skeletal muscle that requires energy expenditure' [208]. This includes housework, gardening, sports, exercise, leisure and recreational activities.
Exercise is a 'subset of physical activity and it is the planned, structured, repetitive movement done with the purpose of improving or maintaining physical fitness' [208].
How much physical activity do older people need?
The American College of Sports Medicine and the American Heart Association [197] recommend people aged 65 years and over undertake 30 minutes of physical activity on most days of the week, which can be accumulated in three lots of ten minutes. In addition, older people should undertake muscle strengthening exercise, using a resistance weight, once a week. On at least two non-consecutive days of the week, ten minutes of daily flexibility and balance exercise will help to reduce falls [38].
Why is physical activity important for falls prevention?
Physical activity is the most promising falls prevention strategy as a single intervention [22, 39] and as a part of a multifactorial approach [198]. Overall, physical activity can reduce falls by 18% [71].
Australian social trends indicate that participation in physical activity decline as a person ages [199]. The 2006 Queensland Health Omnibus survey supports this finding with 59% of Queenslanders aged between 50 and 59 years and 58% of Queenslanders aged 60 to 74 years reported as being sedentary or insufficiently active to achieve a health benefit [200]. This has remained the trend from 1997 to 2006 [37].
Falls prevention research indicates the keys to preventing falls among the general population is being active on most days of the week, and performing moderate to high challenge balance exercises at a minimum of twice a week. Community falls prevention programs incorporating balance exercises should allow 25 weeks to see a benefit [71].
Adequate nutrition is fundamental to physical activity [41], so any attempt to promote physical activity needs to consider the nutritional status of participants and be coupled with appropriate nutritional interventions.
What types of physical activity prevent falls?
Research shows that specific exercises such as Tai Chi, balance, gait training and strength building group classes or individualised in-home programs reduce falls risk by 12% and the number of falls by 19% [25, 31, 201]. These exercises can also increase the time before a person has their first fall [22]. Strength training is the only reliable intervention that increases muscle mass, strength and power [202]. To achieve the benefits, these programs should develop a physical activity program specifically for the individual [22, 38] and increase the intensity, challenge and duration of physical activity over time [22, 38].
Older people’s attitudes towards physical activity
A 2006 Australian study of older people’s attitudes towards the National Physical Activity Guidelines provides interesting insights into older people's thoughts on being physically active. The key issues raised included:
| "So a young person is going to tell me that I have got to do this exercise or that exercise. I am going to ignore them. I want someone my own age bracket who knows what the heck he is talking about and knows what I am feeling when I am doing exercises." [205]. |
Don't use the "e" word
It is preferable to use the term "physical activity" instead of "exercise" when promoting physical activity among older people. Studies show older people view exercise as formal exercise classes and routines rather than general activity, and something that only exceptional older people do [150 ].
Research also advises not to show older people doing demanding exercises when developing materials to encourage older people to participate in physical activity. This was not viewed positively or seen to be representative of the general older population [150].
Barriers to participating in physical activity
There are many factors that deter people from being active. Research with older people has identified these factors as being:
Active Ageing research conducted in North Queensland found similar barriers to physical activity. For more information on this research, visit: Active Ageing research summary, North Queensland.
Another common barrier was the belief by an older person's family and carer/s that older people will hurt themselves if they are too active. The challenge for those working with older people is to reduce these barriers and highlight the benefits of physical activity, using what motivates people to encourage them to join in.
Motivating older people to participate in physical activity
Research indicates that it is never too late to start physical activity and gain health benefits [205]. Identifying the reasons why people undertake physical activity is important and can be used to promote and encourage people to be active.
Studies show that older people participate in physical activity because they:
Research [205] recommends three important points to highlight when promoting physical activity among older people:
WHO global strategy on diet, physical activity and health
The World Health Organisation (WHO) has developed a global strategy on diet, physical activity and health. This website also offers information on population-based approaches to increasing levels of physical activity. WHO guide for population-based approaches to increasing physical levels of physical activity
Guidelines for promoting physical activity with older people
The United Kingdom Health Education Authority has developed useful guidelines for promoting physical activity with older people, including how to develop a physical activity plan for older people.
Australian National Physical Activity Guidelines for adults
The Australian National Physical Activity Guidelines for adults provide four key minimum steps people can undertake for a healthy life.
A physical activity guide for older Australians
The Department of Veteran Affairs and Sports Medicine Australia has developed a booklet demonstrating how easy it can be to stay fit and healthy as you age. Choose Health, Be Active
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