Exercise training and prescription for the elderly.

Most exercise programs designed for healthy persons older than 65 emphasize fitness development, but the maintenance of functional capacity and quality of life are equally important. The basic guidelines for frequency, intensity, and duration of training and the mode of activity recommended by the American College of Sports Medicine for healthy adults are also appropriate for the elderly. The difference in the exercise prescription for the elderly participant is the manner in which it is applied. Given that the elderly person is more fragile and has more physical-medical limitations than the middle-aged participant, the intensity of the program is usually lower while the training frequency and duration are increased. The mode of training should avoid high-impact activities, and the progression of training should be more gradual. The prescribed training heart rate for the elderly at 40% to 80% of maximal heart rate reserve is slightly lower than the 50% to 85% recommended for young and middle-aged participants, but its relationship to relative metabolic work (50% to 85% of maximal oxygen uptake) and rating of perceived exertion are similar to those found for younger participants. Because of the importance of maintaining muscle mass and bone in middle and old age, a well-rounded program including strength/resistance exercise of the major muscle groups is recommended. Hence the exercise prescription for the elderly should emphasize low to moderate intensity and low-impact activities, avoid heavy static-dynamic lifting, and allow a gradual progression in training.