Chapter 23Exercise Guidelines for the

Postmenopausal Woman

Shawn Anger, MS, NSCA-CPTShawn Anger, MS, NSCA-CPT

Texas Tech, Physical Therapy Today Exercise Center Texas Tech, Physical Therapy Today Exercise Center Lubbock, Texas Lubbock, Texas

Chelsea Barker, MS, NASM-CPTChelsea Barker, MS, NASM-CPT

Texas Tech, Physical Therapy Today Exercise Center Texas Tech, Physical Therapy Today Exercise Center Lubbock, TexasLubbock, Texas

Learning Objectives

• The cardiopulmonary physiology for older women The cardiopulmonary physiology for older women when engaging in activity.when engaging in activity.

• The changes in bone mass density for The changes in bone mass density for postmenopausal women.postmenopausal women.

• The conformational changes of muscles and The conformational changes of muscles and strength capabilities as women age.strength capabilities as women age.

• Guidelines for appropriate exercise for Guidelines for appropriate exercise for postmenopausal women.postmenopausal women.

Cardiovascular Changes

• VO2 max decreases with age by 5-10% per decadeVO2 max decreases with age by 5-10% per decade• Max HR decreasesMax HR decreases• Heart rate recovery time increasesHeart rate recovery time increases• Resting blood pressure increases from a narrowing Resting blood pressure increases from a narrowing

of the blood vesselsof the blood vessels• Changes occur due to a decrease in compliance in Changes occur due to a decrease in compliance in

myocardial tissuemyocardial tissue

Pulmonary Changes

• Alveoli lose elasticity with age.Alveoli lose elasticity with age.• Pulmonary blood volume decreases with Pulmonary blood volume decreases with

age.age.• Intercostal muscles become more stiff and Intercostal muscles become more stiff and

weak.weak.• Rate of ventilation increases is also slowed Rate of ventilation increases is also slowed

giving another reason for an increased giving another reason for an increased warm-up time.warm-up time.

Bone Mass Density Changes

• Rate of reabsorption is greater than the rate Rate of reabsorption is greater than the rate of new bone formation.of new bone formation.

• This condition is often diagnosed as This condition is often diagnosed as osteoporosis.osteoporosis.

• Bone mass loss can be substantial with rates Bone mass loss can be substantial with rates of 20% loss at age 65 and 30% loss at age of 20% loss at age 65 and 30% loss at age 80.80.

Prevention of Bone Density Loss

• Adequate calcium intake.Adequate calcium intake.• Weight bearing activity causes stress on the bones Weight bearing activity causes stress on the bones

that stimulate that stimulate • Difficult to increase bone density. The goal Difficult to increase bone density. The goal

should be to stabilize bone density loss.should be to stabilize bone density loss.• Bone density loss occurs mostly in trabecular Bone density loss occurs mostly in trabecular

bone, which is found in the vertebrae, the neck of bone, which is found in the vertebrae, the neck of the femur, and the wrist leaving these areas prone the femur, and the wrist leaving these areas prone to fracture.to fracture.

Changes in Skeletal Muscles and Strength Capabilities• Women lose strength at a faster rate with Women lose strength at a faster rate with

age than men.age than men.• Loss in strength comes in part from a Loss in strength comes in part from a

decrease in motor units.decrease in motor units.• Type II fibers decrease while type I fibers Type II fibers decrease while type I fibers

increase.increase.• Overall loss in muscle mass, seen especially Overall loss in muscle mass, seen especially

in the lower extremity.in the lower extremity.

Benefits of Exercise for Postmenopausal Women• Increase resting metabolic rate.Increase resting metabolic rate.• Improved balance to reduce the risk of Improved balance to reduce the risk of

falling and subsequent fractures.falling and subsequent fractures.• Maintain healthy and strong muscles.Maintain healthy and strong muscles.• Maintain bone density.Maintain bone density.

Exercise Guidelines

• Effective training intensity for resistance Effective training intensity for resistance training is 50-80% 1RM.training is 50-80% 1RM.

• Increase intensity by 5% for upper Increase intensity by 5% for upper extremity exercise and 10% for lower extremity exercise and 10% for lower extremity exercise.extremity exercise.

• Ensure that the facture prone areas are areas Ensure that the facture prone areas are areas of focus in a training program.of focus in a training program.