My Transitions Scorecard Breathing

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My Transitions Scorecard

BalanceName___________________ Week of ________________

Day Number of Balance Exercises Completed

Thoughts

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My Transitions Scorecard

MobilityName___________________ Week of ________________

Day Steps/Distance ThoughtsSunday

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My Transitions Scorecard

Stair Negotiation- SteppingName___________________ Week of ________________

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Certificate of Achievement

This is to acknowledge that

Ester Summers

has completed the Transitions program on

July 14, 2018

and is

Recognized for Outstanding Effort

_____________________________

Transitions Therapy Leader

Breathing and Exercise Programsfor Senior Adults

How Breathing Exercises Can Help YouExercise -- especially exercise that works your lungs and heart -- has many benefits for seniors with and without documented breathing problems.:

Improve how well your body uses oxygen. Decrease your symptoms and improve your breathing Strengthen your heart, lower your blood pressure, and improve your circulation Improve your energy, making it possible to stay more active Improve your sleep and make you feel more relaxed Help you maintain a healthy weight Enhance your mental and emotional outlook Reduce your social isolation, if you exercise with others Strengthen your bones

Exercises for Improving BreathingStretching Exercises lengthen your muscles, increasing your flexibility.

Aerobic exercises use large muscle groups to move at a steady, rhythmic pace. This type of exercise works your heart and lungs, improving their endurance. This helps your body use oxygen more efficiently and, with time, can improve your breathing. Walking and using a stationary bike are two good aerobic exercises.

Strengthening Exercises involve tightening muscles until they begin to tire. When you do this for the upper body, it can help increase the strength of your breathing muscles.

Breathing exercises help you strengthen breathing muscles, get more oxygen, and breathe with less effort. Here are two examples of breathing exercises you can begin practicing. Work up to 5 to 10 minutes, three to four times a day.

Pursed-lip breathing:

1. Relax your neck and shoulder muscles.2. Breathe in for 2 seconds through your nose, keeping your mouth closed.3. Breathe out for 4 seconds through pursed lips. If this is too long for you, simply breathe out

twice as long as you breathe in.

Use pursed-lip breathing while exercising. If you experience shortness of breath, first try slowing your rate of breathing and focus on breathing out through pursed lips.

Diaphragmatic breathing:

1. Lie on your back with knees bent. You can put a pillow under your knees for support.2. Place one hand on your belly below your rib cage. Place the other hand on your chest.3. Inhale deeply through your nose for a count of three. Your belly and lower ribs should rise,

but your chest should remain still.4. Tighten your stomach muscles and exhale for a count of six through slightly puckered lips.

Exercise Guidelines Set realistic goals. Gradually increase the number of minutes and days you exercise. A good goal is to exercise

20 to 40 minutes, 2 to 4 times a week. Start out slow. Warm up for a few minutes. Choose activities you enjoy, and vary them to help you stay motivated. Find an exercise partner. Keep a record of your exercise to help you stay on track. As you end your exercise, cool down by moving more slowly.

Exercise Precautions

It's good to take precautions when exercising but remember that shortness of breath doesn't always mean you should stop altogether. Ask your doctor about when you should stop exercising and rest.

Here are other exercise precautions:

Always consult a doctor or other health care provider before starting a exercise program. If you have a change in any medications, talk to your doctor before continuing your exercise routine.

Balance exercise with rest. If you feel tired, start at a lower level. If you feel very tired, rest, and try again the next day.

Wait at least an hour and a half after eating before beginning to exercise. When you drink fluids while exercising, remember any fluid restrictions you have. Avoid hot or cold showers after exercising. If you've been away from exercise for several days, start up slowly, and gradually return to

your regular routine.

Exercises to avoid if you have COPD (chronic obstructive pulmonary disease):

Heavy lifting or pushing Chores such as shoveling, mowing, or raking Pushups, sit-ups, or isometric exercises, which involve pushing against immovable objects Outdoor exercises when the weather is very cold, hot, or humid Walking up steep hills

Ask your doctor whether exercises like weightlifting, jogging, and swimming are OK for you to do.

Breathing Exercises: When to StopIf you experience any of these signs or symptoms, stop your breathing exercise program right away. Sit down, and keep your feet raised while resting. Nausea

Dizziness Weakness Rapid or irregular heartbeat Severe shortness of breath Pain Pressure or pain in your chest, arm, neck, jaw, or shoulder

12 Best Balance Exercises for Senior AdultsOverall Summary Only

1. Single limb stance

A great place to begin is with the simplest standing balance exercise. Hold on to a chair and balance on one leg.

This is a great place to begin to feel your center of gravity over your ankles. This is your goal, maintaining your center over your ankles.

Try a few seconds balancing on each foot. Work up to a minute if you can. Then begin to hold on with one hand, then one finger and finally try to let go completely.

2. Eye tracking

Move on to the other exercises with static standing exercises as you gain confidence including this exercise which targets your vision and vestibular system.

This exercise can sometimes make you dizzy. If this happens, stop the exercise. Try it again with smaller head movements next time.

Gradually you will learn to do it correctly.

3. Clock reach

Make sure to hold on to a chair when attempting this exercise to prevent falls in the elderly. Don't reach back too far if you have pain in your shoulder.

(Use your one pound wrist weight here to increase your workout.)

4. Staggered stance

Also hold on to a chair when trying this exercise for elderly balance problems. Let go of the chair for a few seconds at a time if you feel comfortable.

5. Single limb with arm

Look up from your feet when balancing and pick a spot at eye level in front of you to improve falls in elderly. Lift your chest and bring your shoulders back.

Breathe in through your nose and out through your mouth

6. Balancing wand

This is a fun exercise and easy to do. Use a cane, broom or even an umbrella. Don't have too much fun with these balance exercises for elderly!

7. Knee marching

Try this one next to a counter so you can hold on when performing knee marching. This is also a great cardio exercise and for leg muscle weakness.

8. Body circles

This exercise for improving balance can be a little tricky. Keep a chair nearby if you are uncomfortable without one. Make sure your knees and hips are kept straight when you circle.

9. Heel to toe

The moving exercises are the most difficult. Only try this balance exercise when you have become good at the preceding exercises.

(If you have masking or painters tape, place an 8 to 12 foot piece in a straight line on the carpet or floor. This will allow you to maintain a straighter line when performing the walking exercises.)

10. Grapevine

Seniors who dance will be more familiar with these balance exercises. Try it in your kitchen holding on to the counter.

Walk several steps in one direction, turn around and walk back. Continue for several minutes. Gradually hold on less and less until you can take a few steps without holding on.

It may take a while, but keep practicing...you'll get it sooner or later!

11. Stepping

This series of stepping exercises are very challenging. You may have a stable family member demonstrate these for you first.

12. Dynamic walking

Try these only when you feel confident and have a helper in the home. Give them a try when you are stronger and more sure of yourself. These exercises are

great to do with someone else.

Holding hands with a stable family member will make these exercises easier and safer. (This is where you may use your pad of paper or a small book when walking.)

Step Aerobic Routines for Seniors

Step aerobics classes are sometimes so choreographed, beginners are too intimidated to join. Ironically, these beginners--the unfit and overweight--are the very people who most need to attend group fitness classes. Help beginners learn to step with very simple combinations. These moves can be used for all levels of stepper. Teach participants to use techniques like raising the step height, simple traveling moves and propulsion movements to increase intensity recommends the Idea Health and Fitness Association. Skip the complex mambo cha-chas and helicopter twirls and make the workout accessible to everyone.

Step 1.Warm up the class by introducing simple step moves. Start with basic step on

the right for 16 counts and then on the left for 16 counts. Reduce it down to 8-counts, 4-

counts, 2-counts until you are finally alternating basic for 16 counts. Do the same simple

reductive moves for the v-step. Move on to corner moves, introducing knee lifts, hamstring

curls, hip extensions and front kicks.

Step 2 Perform eight counts of alternating v-steps. Add on eight counts of

alternating turn steps. Take the participants over the top for eight counts and do corner

knees for eight counts.

Step 3. Do eight counts of alternating corner hamstring curls. Do four counts

of alternating basics followed by a repeater knee to each corner. Do eight counts of

jumping jacks on the floor and four, 2-count repeater knees with a march on the floor.

Step 4. Walk up and down on the bench with a right leg lead for eight counts.

Wlk up and down with a left lead for eight counts. Step tap to the corners for eight

counts and then alternate front kicks for eight counts.

Step 5. Cool down with a slightly slower tempo and review any moves with

which the participants struggled. Stretch the major muscle groups.

Seated Aerobic and Strength Training Exercises for Those with Limited Mobility

Even those with severe restrictions in their mobility should consider incorporating cardiovascular exercises, strength training, and flexibility exercises

Seated exercises are not a substitute for standing, provided you can stand, in which case you might want to consider low-impact exercises such as Tai Chi, yoga, walking, and water workouts instead.

Sitting for extended periods of time is an independent risk factor for poor health. Even if you are very fit, sitting all day can increase your risk for disease.

Stand up and walk as much as possible to avoid the health hazards associated with chronic sitting.

However, many are simply too old, frail, or disabled to even consider a high intensity program. Some cannot even stand. So what are the wheelchair bound supposed to do? Don't resign yourself to doing nothing! This is for you. It’s never too late to start exercising.

One Caveat — Don't Limit Yourself to Seated Exercises Unless You Have No Other Choice

It's important to begin with exercises suited to your current level of fitness and physical ability. Regardless of your starting point, you CAN improve. At the end of this program, you'll find one inspiring example of a disabled veteran who went from being unable to walk unaided, to regaining full mobility and even being able to run.

Recent studies show that standing greater than six hours a day reduces your risk of obesity by 30 percent and if you stand more than 12 hours a day it is reduced by 60 percent.

So let's be clear that these exercises are not a substitute for standing, provided you can stand. Unless you're wheelchair bound, consider low-impact exercises to start, such as Tai Chi, yoga, walking (which can incrementally be turned into a higher intensity exercise), and water workouts, for example.

What Types of Exercises Are Recommended If You Have Limited Mobility?

For starters, what types of exercises can a person with limited mobility actually do? Even those with severe restrictions in their mobility should consider incorporating the following types of exercises.

Cardiovascular exercises. This includes any movement that raises heart rate and increases endurance. If you cannot stand, water exercises can be an option.

But even if you're confined to a wheelchair, there are ways to get a cardiovascular workout.

Strength training exercises. This involves strengthening your muscles and bones using weights or other resistance-type exercises. Strength training is important for improving balance and stability.

If you have limited lower body mobility, you can still perform exercises to strengthen your upper body, including your core, back, arms, and shoulders. Provided you're not paralyzed, you can also strengthen your lower extremities with seated exercises.

Flexibility exercises are important for range of motion, and can help reduce pain and stiffness. These may include stretching exercises, either seated or on the floor, and chair yoga. Tai Chi can also be modified and adapted to be done while seated.

If your mobility is limited due to extreme fatigue or a painful condition such as rheumatoid arthritis, please know that both aerobic and strength training exercises can be very helpful for such conditions.2

Basic Tips and Tools to Get You Started

Here are some basic tips and tools you'll need to perform the seated exercises featured in this article:

A stable armless chair to sit in. Make sure it doesn't have wheels or slide easily, unless the exercise actually calls for a chair with wheels

A resistance band, two Frisbee rings or small (child sized) hula hoops, and hand weights of suitable weight based on your current strength

Optional items you may want if and when you're ready to increase the difficulty of the exercise: an exercise ball, wrist, and/or ankle weights

Remember to maintain good posture throughout each exercise, and engage your core by imagining your sternum moving back towards your spine

If you are frail and/or have poor balance, be sure to perform any and all exercises with supervision and/or assistance

Three 'Seated Dance' Workouts for Those with Limited Mobility

If you're wheelchair bound, be it due to age, obesity, injury, or illness, the key is to get as much of your body moving as possible.

1. Roller chair workout: For this exercise, you need an open, non-carpeted area, and a chair with wheels or casters. If you're in a wheelchair, it will do the job. Adding some music will make it more enjoyable. Here, all you need to do is to propel yourself around the area using your arms, legs, or both. Start at one minute, and build up.

2. Seated dancing: Select your favorite music. Sit on your bed, on a chair, or on an exercise ball (if your balance is sufficient). Here, the focus is on moving to the music in whatever way you can. Bounce up and down, wave your arms in the air, gyrate your hips, and tap your feet. To make it slightly more challenging, you can add wrist and/or ankle weights.

3. Hula hands and hips: For this, you need two Frisbee rings, small hula hoops, or Pilates rings. Place one ring around each wrist, and rotate your arms to make them spin in circles. To up the challenge, do this while sitting on an exercise ball, and rotate your hips in a figure eight pattern. Music, while optional, can make it more enjoyable.

Other Cardiovascular Chair Exercises

The three seated "dancing" exercises are examples of cardiovascular exercises that will raise your heart rate and build stamina. The video above demonstrates an entire aerobics routine, working both the upper and lower body while seated. Here are two additional suggestions not covered in that video:

Seated high intensity resistance training: Resistance training actually offers cardiovascular benefits, so the following exercise is an excellent way to reap the benefits of high-intensity exercise even if you cannot stand up. Start by wrapping a lightweight resistance band under the seat of your chair. Holding each end, do a quick series of chest presses — flexing your arms at the elbow, pulling the band toward your shoulders.

You can start with 10 repetitions, and work your way up to about 30.

Next, do a forward press by placing the band around the back of your chair. Make sure the band is under your armpits. Again, holding the ends in your hands, sit tall, and remember to engage your abs. Start with your elbows at 90 degrees, with palms facing down. Push your arms straight out in front of you while squeezing your chest muscles. Avoid locking your elbows. Bring your arms back to starting position.

To increase the resistance, simply wrap the band around your hands to shorten it, or grasp it further back.

Air-punching, with or without hand weights, is another simple cardio exercise that can be done either seated or standing. This exercise is also a good warm-up. Jab forward, alternating arms.

You want some speed here, so snap your arm forward as fast as you can, without fully extending your elbow joint, and then pull it back in as fast as you can. Do anywhere from 10 to 30 reps. Then, jab toward the ceiling, or as high as you can get if your upward range of motion is limited, for another 10 to 30 reps.

Three Seated Strength Training Exercises

There are as many seated strength training exercises for those with limited mobility as there are for able-bodied people. In most cases, the exercise needs only slight modification.

A YouTube search will also yield a number of videos demonstrating exercises for seniors and the disabled, or those unable to stand up. Here are but a few examples.

For the bicep curl, make sure you're using a weight that is appropriate for your current level of strength. If you're just starting out, a five pound dumbbell in each hand may be appropriate.

You want the weight to be heavy enough that by the time you complete 10 to 12 reps, you feel like you can't keep going.

1. Sit with good posture in a chair (remember to engage your core by imagining your sternum moving back towards your spine, to stabilize your posture); one dumbbell in each hand, palms facing forward, shoulders relaxed, and elbows close to your body

2. Focusing on your bicep muscle, bend your arm at the elbows and lift the weights about ¾ of the way toward your shoulders. Avoid rotating your shoulders forward, and keep your elbows fixed at your side

3. Breathe out as you lift the weight, and breathe in as you lower them

4. Do 10 to 12 repetitions

While the bicep curl above strengthens the muscle on the front of your arm, tricep exercises focus on the backside of your upper arm — an area that tends to get flabby with age and lack of use. If either of these exercises hurt your elbows, then don't do them. As the triceps tend to be weaker than the biceps, you may want to use a lighter weight to start; maybe as light as two pounds instead of five.

1. Sit with good posture in a chair, holding a dumbbell in your right hand

2. Raise the dumbbell above your head, and stabilize your right arm by placing your left hand on your right elbow

3. Slowly bend your right elbow, lowering the dumbbell down behind your head

4. From that starting position, raise the weight toward the ceiling, and then gently lower it back down behind your head

5. Repeat 10 times, then switch arms

By strengthening your shoulders, you will improve your ability to perform most other arm movements. It can also help relieve shoulder pain. To perform an overhead dumbbell press:

Sit with good posture; one dumbbell in each hand, with your elbows bent so the dumbbells are up by your shoulders, and palms facing forward

From this starting position, press the dumbbells toward the ceiling and then lower back down to shoulder height. Breathe out as you raise the weights, and in as you lower them

Repeat 10 to 12 times

It's Never Too Late to Start Exercising

Barring coma or full-body paralysis, virtually everyone can do something in terms of physical movement. So no matter where you're starting off, do start, and keep at it. One goal, depending on your situation, could be to regain your ability to stand for periods of time, and

later, to walk increasing distances, as chronic sitting is associated with worsened health outcomes all around; from an increased risk of diabetes to a shortened lifespan.

But even if you're confined for a wheelchair for the rest of your life, there are lots of ways to get physically active. If you don't believe me, take a look at the following video, featuring wheelchair bound athletes practicing CrossFit Redefined, a version of CrossFit specifically aimed at those in wheelchairs.

As you can see, some of these paralyzed individuals are fitter than most able-bodied people! The take-home message is that as long as you do what you can, and keep pushing your limits little by little, you'll be amazed at how much you can improve.

Walking Tips for Older Adults

Tools and Tips

Walking is the most popular form of exercise among older adults and it's a great choice.

What can walking do for you?

strengthen muscles help prevent weight gain lower risks of heart disease, stroke, diabetes, and osteoporosis improve balance lower the likelihood of falling

If it’s been a long time since you exercised, you may want to start out slowly. You can start with just 5 minutes and build up to the recommended 30 minutes a day. Your goal should be to get up to taking 100 steps a minute. Remember, the most important thing is to just get started.

Take these steps to get walking:

Join a walking program or walk with a buddyChances are you’ll stick with a walking program if you have someone to walk with. Some shopping malls or town parks may have these programs.

Wear the right shoes Comfortable sneakers work well for most people. If you have foot problems, you may want to look into orthopedic shoes or talk to your healthcare provider about how you can continue your walking program.  

Don’t let a cane or walker stop you It’s OK to use your cane or walker if you already have one. These can improve your balance and help take the load off painful joints.

Aim for the right pace Try to walk as fast as you can, but still be able to chat with a friend while walking. Aim for working as hard as you do when you climb up the stairs.

Talk to your healthcare provider if you have any problemsTell your healthcare provider if you have any pain or problems walking. Otherwise, don't let a health problem keep you from getting started. You may feel a little stiff and achy as you start walking, but many people feel better once they start moving!

3 Tips for Safe Walking1. Be Aware of your Surroundings

Plan to walk during the daytime or in well-lit areas in the evenings. Keep an eye out for uneven surfaces, possible obstacles, and other tripping hazards.

2. Keep HydratedBring a bottle of water (or other liquid) with you and be sure to drink plenty of fluids on your walk.

3. Dress Properly for the WeatherIf walking outside, wear layers of clothing so that you can take off layers if you're hot, or put more on if too cold.

Balance Exercises

Balance exercises can help you maintain your balance — and confidence — at any age. If you're an older adult, balance exercises are especially important because they can help you prevent falls and maintain your independence.Nearly any activity that keeps you on your feet and moving, such as walking, can help you maintain good balance. But specific exercises designed to enhance your balance are beneficial to include in your daily routine and can help to improve your stability. For example, balance on one foot while you're standing for a period of time at home or when you're out and about. Or, stand up from a seated position without using your hands. Tai chi is a form of movement training that has been found to improve balance and stability and reduce the incidence of falls.

If you have severe balance problems or an orthopedic condition, get your doctor's OK before doing balance exercises.

Weight Shifts

When you're ready to try balance exercises, start with weight shifts:

Stand with your feet hip-width apart and your weight equally distributed on both legs (A).

Shift your weight to your right side, then lift your left foot off the floor (B).

Hold the position as long as you can maintain good form, up to 30 seconds.

Return to the starting position and repeat on the other side. As your balance improves, increase the number of repetitions.

Single-Leg Balance

Standing on one leg is another common balance exercise:

Stand with your feet hip-width apart and your weight equally distributed on both legs. Place your hands on your hips. Lift your left leg off the floor and bend it back at the knee (A).

Hold the position as long as you can maintain good form, up to 30 seconds.

Return to the starting position and repeat on the other side. As your balance improves, increase the number of repetitions.

For variety, reach out with your foot as far as possible without touching the floor (B).

For added challenge, balance on one leg while standing on a pillow or other unstable surface.

Bicep Curls with a Dumbbell

You can do many balance exercises with weights. Try biceps curls with a dumbbell:

Stand with your feet hip-width apart and your weight equally distributed on both legs. Hold the dumbbell in your left hand with your palm facing upward (A). Lift your right leg off the floor and bend it back at the knee (B).

Hold the position as long as you can maintain good form, up to 30 seconds.

Return to the starting position and repeat on the other side. As your balance improves, increase the number of repetitions.

For added challenge, balance on the leg opposite the weight (C) or while standing on a pillow or other unstable surface (D).