Abstract des Autors

As our population ages, the number of older persons exercising continues to increase. When dealing with these individuals, it is important to consider the physical changes they have undergone during this maturing process. There are several things to look at when prescribing a flexibility program for an older person. One major consideration is his or her medical history. Be alert to preexisting conditions that prohibit certain positions. Some individuals may be unable to lie prone because of cardiac, pulmonary, or arthritic conditions. Consider modifying the stretch to a sidelying or supine position and make other body position changes as needed. Also be aware of a person's orthopedic medical history. Degenerative changes in spinal alignment may be significant enough to affect the available range of motion at other joints in the body. An example of this would be a reduction in the ROM available at the shoulders in a person with increased thoracic kyphosis and altered scapula positioning. Attempting to force a flexibility increase in someone with these alterations could be inviting injury to the soft tissue structures of the shoulder joint. Other physical considerations involve dealing with clients who have undergone total joint replacement surgery, especially the hip. Incorrectly combined motions of the hip can jeopardize the stability of the joint and risk reinjury. Speak with the client's physician or physical therapist about the surgical approach used. This will determine the combined motions that should be avoided. Also, when doing an older person's flexibility screen, try to achieve a sense of what is restricting his or her range of motion, for example, soft tissue limitations or bone-on-bone degenerative changes. While increasing soft tissue mobility around an arthritic joint can help reduce stress on the joint, some alterations in body positioning are required to accommodate for the degenerative changes without causing pain. In addition, consider the condition of the person's entire body when positioning him or her for a stretching program. Take care not to aggravate one condition while trying to treat another. Given the ongoing changes in health care and the ever increasing emphasis on physical fitness, the number of older persons exercising at fitness centers will continue to rise. When developing and initiating a flexibility program for older clients, keep these factors in mind: 1. Thoroughly review the medical history. Include both a general medical and an orthopaedic questionnaire. 2. Speak to the client's health care provider if there is uncertainty as to the correct exercises to prescribe based on the person's medical history or physical condition. He/she should be able to tell you what has worked well for the person in the past and make you aware of what to avoid. 3. Do a thorough flexibility screening to determine areas of soft tissue restriction and bony opposition. Be sure to promote positional changes during stretching exercises to accommodate for possible arthritic changes. 4. Make sure the person warms up thoroughly before beginning any stretching exercises. This will allow for an increase in tissue temperature and in the tissues' ability to accept stress with less risk of injury. 5. Use long, slow static stretches to achieve plastic changes in muscular and connective tissues. Be sure to stretch only to a point of stretch, not pain. Verf.-Referat