Maintaining Fundamental Movement Skills into the Later Years of Life

Naoimh McMahon BSc, MA

Sport Studies and Physical Education and Health Action Zone Conference20th April 2013

Overview

• What are the fundamental movement skills that you need in the

later years of life?

• Why do fundamental movement skills become compromised

towards the later years of life?

• What is the best evidence to maintain fundamental movement

skills?

• What are the challenges of implementing best practice guidelines?

Fundamental Movement Skills“…are those skills that provide us with the ability and opportunity to engage in

quality physical activity, sport specific skills and activities of daily living”

Determinants of Physical Health

• Design

• Accidents

• Maintenance

• Ageing

• Genes

• External Agency

• Internal Agency

• Ageing

(Bortz, 2005)

Internal Agency

• Muscle strength and VO2 max have been shown to be powerful,

predictive biomarkers for subsequent disability and death.

• A physically fit person exhibits a decline in VO2 max at the rate of 0.5%

per year. An unfit person loses this basic competence at the rate of 2%

per year—4 times as fast.

• With continued use, muscle strength and power deteriorates at a slow

rate, but with disuse, such as a casted limb or sedentary lifestyle

muscle strength can decay at 1% per day.(Bortz, 2005)

Sarcopenia“Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as

physical disability, poor quality of life and death.” (Cruz-Jentoft, 2010)

(Sayer et al. 2008)

Exercise Interventions & Sarcopenia: The Evidence

• Through physical exercise and training, especially resistance training, it may be possible to prevent sarcopenia.

(Evans and Campbell, 1999)• Resistance training remains the most effective intervention for increasing muscle

mass and strength in older people. Elderly people have reduced food intake and increased protein requirements. As a result, adequate nutrition is sometimes a barrier to obtaining full benefits from resistance training in this population.

(Borst, 2004)• Progressive resistance training is an effective intervention for improving physical

functioning in older people, including improving strength and the performance of some simple and complex activities.

(Liu and Latham, 2009)• Using both resistance and endurance exercise in the elderly makes it possible to

modify the age-associated decline in muscle function and decelerate the development of muscle weakness.

(Seene and Kaasik, 2012)

Health Condition(Disorder or Disease)

Body Structures & Functions

Activity Participation

Environmental Factors

Personal Factors

(World Health Organisation, 2001)

The International Classification of Functioning, Disability & Health

Consolidated Framework for Implementing Research (CFIH)

Characteristics of the Intervention Outer Setting Inner Setting

Characteristics of the Individual Process

(Damshroder et al. 2009)

“To see far is one thing, going there is another”

Clinical Messages

1. Loss of skeletal muscle is predictive of reduced ability to

execute fundamental movement skills in later life

2. Progressive resistance training has a protective effect

against this loss of skeletal muscle or sarcopenia

3. Feasible interventions are required that facilitate

individuals early in life to engage in progressive resistance

training and maintain movement skills late into life

References• Borst, S. E. (2004). Interventions for sarcopenia and muscle weakness in older people.

Age and Ageing, 33(6), 548-555.

• Bortz, W. M. (2005). Biological basis of determinants of health. American Journal of Public Health, 95(3), 389-392.

• Cruz-Jentoft, A., & Michel, J.-P. (2013). Sarcopenia: A useful paradigm for physical frailty. European Geriatric Medicine.

• Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., . . . Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis. Age and Ageing, 39(4), 412-423.

• Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science, 4, 1-50.

References

• Evans, W. J., & Campbell, W. W. (1993). Sarcopenia and age-related-changes in body-

composition and functional capacity. Journal of Nutrition, 123(2), 465-468.

• Liu, C. J., & Latham, N. K. (2009). Progressive resistance strength training for improving

physical function in older adults. Cochrane Database of Systematic Reviews(3).

• Sayer, A. A., Robinson, S. M., Patel, H. P., Shavlakadze, T., Cooper, C., & Grounds, M. D.

(2013). New horizons in the pathogenesis, diagnosis and management of sarcopenia.

Age and Ageing, 42(2), 145-150.

• Seene, T., & Kaasik, P. (2012). Muscle weakness in the elderly: role of sarcopenia,

dynapenia, and possibilities for rehabilitation. European Review of Aging and Physical

Activity, 9(2), 109-117.

• World Health Organisation. (2001). International Classification of Functioning, Disability

and Health (ICF). Geneva: World Health Organisation.