Over 70? How to stay active during lockdown
“There is no situation, there is no age, there is no condition where exercise is not a good thing, so anything that can be done to allow people to get exercise is clearly a good thing.”
Professor Chris Whitty, England's Chief Medical Officer and the Department of Health and Social Care's Chief Scientific Adviser, daily COVID-19 briefing, April 15th 2020.
When confined to our homes we can inadvertently find ourselves doing less physical activity - an effect which is becoming pronounced due to current coronavirus COVID-19 related restrictions. We all know it’s even more important to move well and stay mentally engaged – so important that the phrase ‘exercise is medicine’ is quoted in the British Medical Journal as part of official advice for GPs assisting older patients during the current pandemic. For some, exercise helps mitigate the increased risk of underlying conditions, for others it helps maintains good health. Here are my favoured exercises and top tips to help over 70s during lockdown.
4 risk factors for developing coronavirus complications whose management can improve with moderate exercise:
· High blood pressure
· Cardiovascular disease
· Type 2 Diabetes
· Respiratory conditions e.g. Asthma, Bronchiectasis or reduced lung function from smoking
Current guidance states that each week all adults should do 150 minutes of moderate activity (breathing more heavily but still ok to talk) or 75 minutes of vigorous activity (breathing fast, difficulty talking), or a combination of both. Resistance work twice a week's also recommended. It’s tough for many at the best of times, but the good news is that the first 30 minutes of exercise makes the greatest difference to our health and wellbeing (see the graph below) (1). Gradually build up from where you are now, adding time and intensity in small increments. Even 10 minutes at a time is effective. (1).
Which exercises are best for older adults? Those which focus on
1) Working the heart – e.g. elevating the arm beyond 90 degrees, walking briskly. The increase in heart rate maintains heart, lungs and blood vessel health and helps manage weight. Less weight on sore joints reduces the pressure on them, which in turn can reduce pain and further joint damage.
2) Breathing – e.g. Deep breathing exercises
3) Large muscles and resistance – e.g. walking up the stairs, gardening. These activities use the resistance of body weight and the big muscle groups in arms and legs and may require lifting and carrying, which adds a ‘weight’ to work against.
4) Balance and coordination – e.g. Pilates or Tai Chi. These help you feel confident on your feet and less likely to fall, especially in the dark or on uneven ground.
Caution:
As always, consult a doctor before increasing your exercise level significantly and don’t exercise if you feel unwell. If an exercise causes pain, seek medical or physio advice.
4 favourite starter exercises
1) Deep breathing with lateral lifts
2) Windmill arms
3) Stair walking
4) Calf raises
All can be done repeatedly up to 15 repetitions in a set. Some repetitions are good ( you can start with as little as 4 to 6 repetitions) more is better.
1) Deep breathing with lateral lifts
How to do it: Take a deep breath in. Slowly lift arms to the side and elevate them above your head. Breathe out as you bring your arms slowly down.
Make it harder: Place small weights - e.g. 500 g tins - in your hands, do more reps, lift arms higher.
2) Windmill arms
How to do it: Stand tall, adopting an upright posture. lift one arm up, then as you bring it back down, bring the other arm up. Repeat this cycle.
Make it harder: Do more quickly, add small weights, lift arms higher.
3) Stair walking
How to do it: Walk up and down your dtairs using a handrail (as long as you feel safe to do so). Practise step ups - step up and down the bottom step or up and down on one leg, then the other.
Make it harder: Do step ups to the second step, using the stair rail. Take care - you can have someone behind you if you are concerned but feel strong enough to try it.
4) Calf raises
How to do it: Stand tall, hold onto a supportive surface e.g. table/kitchen bench. Rise up slowly on both feet, then lower down. Repeat.
Make it harder: do more repetitions, do more quickly, do while reducing how much support you need from your hands. If confident and strong you can do it one leg at a time.
If these are too easy for you, you can do mini squats, lunges and wall press ups - see 5 exercises you can do at home
4 easy actions to improve the body’s defences
1. Do a physical activity you enjoy
that way, you are more likely to stick with it.
2 . Get outside or near an open sunlit window
If you have a garden, go outside. Vitamin D from the sun helps maintain bone strength and regulate immune function, and maintaining healthy levels of vitamin D in turn helps reduce risk of respiratory infection. (2) According to national surveys in the UK, across the population approximately 1 in 5 people have low vitamin D levels. Age also impacts Vitamin D production - a 70-yr-old makes 4x less vitamin D 20-something - so getting it from the sun, supplementation and diet is important. Sun helps disease-fighting T cells move faster to getting to where they are needed.
3. Sleep well and stick to a sleep routine
According to research brilliantly presented in Matthew Walker’s book, Why We Sleep, sleep has a powerful effect on our immune system and mental health. Disruptions to normal rhythms, getting too little sleep (i.e. less than 7 hours of sleep a night) is associated with increased risk Alzheimer’s Disease, some cancers, depression and cardiovascular disease. It’s common sense – we feel tired when we get the flu as the body tries to heal itself, we’re more easily agitated if we haven’t slept. Simple and free!
4. Break up sedentary activity.
Prolonged sitting - above 6 to 8 hours per day and extensive TV watching - is associated with greater risk of all-cause and cardiovascular mortality (eg. heart attack or stroke) independently of moderate activity levels (3). Breaking up sedentary activity also helps manage weight and kickstart your metabolism. Standing with a laptop, tablet or book on a high surface or walking and standing while on the phone all helps.
Extra resources:
Sport England has launched a 10-minute audio exercise routine aimed at keeping older people healthy and active during the coronavirus lockdown. It's also available on BBC Sounds.
(1) UK Chief Medical Officers' Physical Activity Guidelines, September 2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf
(2) Martineau, A., et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
BMJ 2017;356:i6583. https://www.bmj.com/content/356/bmj.i6583.
(3) Patterson R., et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol. 2018;33(9):811-29.
(4) Walker, M. Why we sleep: unlocking the power of sleep and dreams. New York, NY : Scribner, Simon & Schuster, Inc., 2017.