Exercise is beneficial for everyone, but it is especially valuable for older adults. The American Academy of Family Physicians lists numerous reasons that geriatric patients should exercise, which include improved blood pressure, heart rate, cholesterol levels and bone health as well as a decrease in the risk of chronic diseases and obesity. Aside from the physiological benefits, it also improves functional mobility and promotes independence. There are very few absolute contraindications, or reasons, to prevent an older adult from participating in regular physical activity.
There are two types of contraindications to exercise, absolute and relative. Absolute contraindications are those that are fairly non-negotiable. They are usually classified as absolute because the risk of injury or even death, far outweigh the benefits of exercise. Usually the absolute are acute and once resolved, your physician will recommend moving forward with regular physical activity. Relative contraindications are those that are more flexible. Usually, some accommodations can be made to allow a person to exercise, however they serve as a warning to look out for complications. This can be done by exercising in a supervised setting with various parameters being monitored.
Exercise testing provides a unique way of assessing your physical capacity. It is beneficial in predicting disease and disease severity, evaluates medical interventions and functional capacity. The American College of Sports Medicine recommends exercise testing for older adults before they begin engaging in a moderate to vigorous activity routine. However, for some older adults, exercise testing is not recommended. ACSM lists recent changes in electrocardiograms, myocardial infarctions within the past 48 hours, or any other acute cardiac event as absolute contraindications to exercise. Unstable angina, uncontrolled-abnormal heart rhythms, severe aortic stenosis, symptomatic heart failure and suspected or known dissecting aneurysm are also classified as absolute contraindications. Others include pulmonary infarction, severe shortness of breath, inflammation or infection in the heart or any other systemic infection.
Aside from exercise testing, there are contraindications to program participation. These include all of the contraindications listed for testing as well as a few others. Severe orthopedic conditions, acute thyroiditis, elevated or low potassium levels, uncontrolled diabetes, blood pressure greater than 200 systolic or 110 diastolic, an orthostatic hypotension, recent blood clot, acute illness, fever or dehydration. There are also a few recommendations specifically for strength training. If you have congestive heart failure, severe valvular disease, uncontrolled hypertension and uncontrolled, irregular heart rhythms, ACSM recommends avoiding strength training until the issue is resolved or your physician assigns his consent to your participation.
Because cancer affects so many older adults, it is only fair to note that there are numerous guidelines for patients with cancer. If you are receiving chemotherapy, you should not exercise on days that you receive it or within 24 hours of receiving it. If you are having pain at the origin site of the cancer it is also advised that you not exercise. Vomiting, nausea and diarrhea are also considered contraindications in addition to poor nutritional intake. These are only a few of the potential contraindications to exercise for cancer patients, therefore it is advised that you talk to your doctor and fitness professional before participating in any exercise program once diagnosed with cancer.
- AAFP: Promoting and Prescribing Exercise in the Elderly
- “ACSM’s Guidelines for Exercise Testing and Prescription,” 8th edition. Lippincott, Williams & Wilkins, 2010.