Aerobic Training for OA

gait speed

longer we can keep walking the better and we need to walk fast

danger walking speed

<0.6 m/s

warning walking speed

0.6 - 1.0 m/s

community ambulator walking speed

> 1.0 m/s

2 traffic lanes (8m) critical speed

1.14 m/sec

4 traffic lanes (16m) critical speed

1.33 m/sec

OA gait speed is a powerful predictor of (5)

• mortality

• ADL/mobility disability

• hospitalization

• falls

• length of hospital stay

what is now being viewed as a vital sign

walking speed

what is gait influenced by? (6)

• MSK

• age

• environment

• injuries

• diseases

• mood

contributors to walking speed (8)

• individ health status

• motor control

• MSK performance and condition

• sensory & perceptual function

• endurance & habitual activity level

• cognitive status

• motivation & mental health

• characteristics of the env’t in which one walks

abnormal values (9)

• balance

• muscle strength

• ROM

• endurance

• cardiovascular fitness

• coordination

• cognition

• vision

• need / appearance of mobility aid

principles for OA aerobic training (7)

• specificity

• overload

• functional relevance

• challenge

• accommodation

• inter individual variability

• rest & recovery

specificity

consider the energy system and functional tasks you want to target

overload

progressively overload by FITT or challenge of an exercise

what tends to be more stressful for OA than manipulating volume

intensity (speed, load)

overload principles (4)

• inc 1 variable @ a time

• inc duration before intensity

• inc duration in 1 min increments

• inc intensity by using arms in more challenging ways

challenge

focuses on increasing demands placed on multiple body systems rather than just manipulating FITT

accommodation

client may feel fine one day but arthritis flares up next day, adapt program

CSEP PA guidelines for older adults (65+)

at least 150 mins of mod to vig intensity aerobic PA per week in bouts of 10 min or more

classic interval training

max/near max effort w short periods of complete rest

interval conditioning

higher intensity (1-6 min) w equal or longer active recovery

**recommended for OA’s

continuous training

>6 min uninterrupted at submax intensity

ultimate goal

program that combines both

• initial stages = interval conditioning

• 12-16 weeks progress by extending duration to include continuous training using CV eqpt

safety margins to consider (7)

• env’t concerns

• progress slowly and cautiously

• client pleasantly tired

• ensure adeq warm up and cool down

• stop exercise for angina

• avoid unsupported ex if balance issue worse than normal

• hydration