At Home Exercise Manual
- 1. 2014 DC Amanda In Completion of KINS 7800L DIVAS at Home
- 2. INTRODUCTION Staying fit and active is enjoyable when you have the right tools. It can also make you feel better physically, emotionally, and mentally. Just because you graduated from the DIVAS program does not mean you can’t stay active! Derived from the program is this modified version you can perform at home. Just like the original program, this modified version will work your muscles, get your blood pumping, but will focus more on balance and flexibility. Having good balance controls your body’s position in space, whether you are still or moving around. It helps with tasks such as walking without staggering, climbing stairs without tripping, bending over without falling, and so on. According to the Centers for Disease Control and Prevention (CDC), about one million adults aged 65 or older fall each year; that is roughly one out of every three. Maintaining a good sense of balance can help prevent falls and subsequent injuries. Also important, aerobic and resistance training improve the quality of life and increase the functional capacity in daily living activities. Aerobic exercise helps maintain and improve various aspects of lung and heart function and enhances endurance. This means that you can walk longer or go up a pair of stairs with more ease and less breathlessness. Strength or resistance training also improves functional capacity by mitigating the loss of muscle mass and age-related strength loss. The combination of these modes of exercise will improve the quality of life, reduce risk factors associated with disease, and ultimately extend independent living. The CDC and the American College of Sports Medicine (ACSM) have websites that have ample information on exercise, exercises guidelines, and physical activity trends. Along with balance, aerobic, and resistance exercise, one needs to work on flexibility, as it is essential for joint health. As you age, the muscles in your body become shorter and more rigid, leading to pain and a decrease in the range of motion of shoulders, the spine, and hips. Stretching and flexibility work is a good way to relieve tension and keep you moving without hassle!
- 3. FUNCTIONAL EXERCISES For resistance training, each major muscle group should be exercised 2 to 3 days a week. For older adults, it is beneficial to do 10 to 15 repetitions to improve strength. Chair Stands Why are they important? This exercise strengthens the leg muscles and make standing from a chair easier. You will need: - A chair - A timer Instructions 1. Start from a seated position with your feet shoulder to hip width apart 2. Cross your arms over your chest and push off the ground with your legs until you are standing 3. Lower yourself back down to the original position and repeat Frequency Duration Intensity Sets Repetitions 3 days/week - 30 seconds - Progress to 40 seconds Moderate - 2 sets - Progress to 3 sets As many as possible Cues Here, speed is not as important as properly executing the movement. When you stand, fully straighten your legs. When you lower yourself back down, you want to make sure that the seat touches your rear. Don’t forget to breathe. As the exercise becomes easier, you’ll want to increase the duration or the sets.
- 4. Wall Push-Ups Why are they important? They strengthen your chest muscles as well as your arms, which makes pushing and carrying things easier. You will need: - A counter top - A timer Instructions 1. Start in a pushup position on the counter with your arms slightly wider than shoulder width 2. Lower your body down until your chest hovers over the counter 3. Using your arms, push yourself up back to the original position and repeat Frequency Duration Intensity Sets Repetitions 3 days/week - 30 seconds - Progress to 40 seconds Moderate - 2 sets - Progress to 3 sets As many as possible Cues You want to make sure that your body is straight throughout the whole exercise. You only want to bend at the elbows, not the hips. If the exercise is too difficult, try stepping closer to the counter. As the exercise gets easier, step back a little bit more. Keep your head in a neutral, relaxed position. Once you find that the exercise is not challenging anymore, try push-ups on your knees. Remember to inhale when you are going down and exhale when you are coming back up.
- 5. Transfer Task Why are they important? “I’ve fallen and I can’t get back up!” is not a phrase you’ll use if you do this exercise. It facilitates the ability to get back up from the ground, which is a critical skill to have during aging. You will need: - A mat or carpet - An open space you can move in - A timer Instructions 1. Facing your mat or your carpet, bend down towards the ground with your arms in front of you 2. Using your knees, roll on over to a seated position 3. Once seated, stand back up using your arms and legs until you are in the starting position and repeat 4. Do as many repetitions you can in 30 seconds Frequency Duration Intensity Sets Repetitions 3 days/week 30 seconds Vigorous 2 sets As many as possible Cues The purpose of the mat or carpet is to make sure you don’t hit your knees on hard surfaces. You also want to make sure that your entire bottom touches the mat before starting to stand. If this task is too difficult, you could use a chair for assistance.
- 6. Wall Sits Why are they important? They strengthen and increase endurance in your thighs, which is important at any age. You will need: - A wall Instructions 1. Cross your arms on your chest 2. With you back flat against the wall, lower yourself until your thighs are parallel to the ground 3. Hold this position for as long as you can and repeat Frequency Duration Intensity Sets 2 days/week Hold as long as you can Vigorous 2 sets Cues Your knees and hips should be at 90 degrees. Make sure your knees are not going beyond your toes. Remember to breathe.
- 7. Planks Why are they important? Core strength is important for many activities of daily living. A strong core can help with your back, your posture, and increase your functionality. You will need: - A mat or carpet - A timer Instructions 1. Lay on a mat face down 2. Prop yourself up on your elbows and hold the plank for 15 seconds 3. Slowly lower yourself back down unto the mat, rest, and repeat Frequency Duration Intensity Sets 3 days/week - 15 seconds - Progress to 30 seconds Vigorous - 2 sets - Progress to 3 sets Cues Make sure you keep your back level with your legs. Don’t let your shoulder blades sag between your shoulders, keep your upper back up. Resist the urge to raise your bottom higher than your shoulders. For a modified plank, you can do them on your hands like you would a push up.
- 8. Pelvic Tilt Why are they important? They improve posture and tighten muscles in the buttocks and abdomen. You will need: - A mat or carpet Instructions 1. Lay flat your back 2. Have your knees bent, feet flat on the ground, and arms at your side with palms down 3. Slowly raise your hips until your lower and mid back are off the floor 4. Hold for a couple of seconds and slowly lower your hips, rest, and repeat Frequency Duration Intensity Sets Repetitions 3 days/week - 15 seconds - Progress to 30 seconds Vigorous 3 sets 10 reps Cues Breathe throughout the exercise. Make sure your upper back and shoulders remain on the floor. When your hips are raised, your buttocks should be flexed, it should also be where you feel the exercise.
- 9. Bicep Curls You will need: - Weights or cans of soup Instructions 1. Hold weights with your arms at your sides 2. Keeping your upper arm fixed, raise the weight, flexing your bicep, all the way up 3. Slowly lower the weight back down and repeat Frequency Intensity Sets Repetitions 2 days/week Light to Moderate 2 sets 10 reps Cues Avoid swinging the weights up. Keep your core tight while bringing the weights up and avoid leaning back. Make sure that you slowly the weight in a controlled and slow manner.
- 10. Shoulder Press You will need: - Weights or cans of soup Instructions 1. Hold the weights with palms facing forward at shoulder height 2. Press the weights up until your arms are extended above your head 3. Lower the weights slowly to the starting position and repeat Frequency Intensity Sets Repetitions 2 days/week Light to Moderate 2 sets 10 reps Cues Make sure your wrists are stiff and straight. You can perform these exercises in the standing or seated position.
- 11. BALANCE EXERCISES Balance exercises should be performed for at least 20 to 30 minutes or more, 2 to 3 days per week. Exercises involving agility and coordination are recommended to improve and maintain physical function and reduce falls. Walking toe to heel Instructions 1. Start at one end of a room 2. Place your right foot in front of your left foot so that your right heel touches the toes of your left foot 3. Now make a step with your left foot and touch your left heel to the right foot’s toes 4. Repeat this process until you have walked the length of a room. Frequency Intensity Sets Repetitions 3 days/week - Light - Progress to a faster pace 2 sets 2 lengths of the room Cues Keep your back straight, with your chest out a little. For added difficulty, place your hand in front of your face and look only at your hand when you walk. To progress, walk a little faster while still maintaining proper movement.
- 12. Walking on heels and toes Instructions for walking on heels 1. Start at the end of a room 2. Balance on your heels and start walking forward Instructions for walking on toes 1. Stand at the end of a room 2. Stand on the balls of your feet and walk forward Frequency Intensity Sets Repetitions 2 days/week Light 2 set 1-2 lengths of the room Cues Walking on heels and toes are good exercises for finding weaknesses in the ankle. Remember to walk with a normal gait. Use your arms for balance. Walking on toes can also strengthen your calves.
- 13. Balancing on One Leg Instructions 1. Stand with one leg behind you 2. Slowly lift up the leg behind you while lowering you upper body forward 3. Try and hold this position for a couple of seconds and repeat on the other leg Frequency Duration Intensity Sets 3 days/week - Hold for 30 seconds - Progress to 40 seconds Moderate 2 sets Cues This exercise is a challenge. It involved coordination, core strength, leg strength, and some flexibility. To make the exercise easier, use a wall or chair for support. Do not fully rely on the support as that defeats the purpose of the exercise. To increase the difficulty, raise the back leg a little higher while keeping your torso in the same position or, in case of hip immobility, hold something in front of you.
- 14. FLEXIBILITY STRETCHES Flexibility work should be performed at least 2 to 3 days a week. Stretches held for 30 to 60 seconds confer greater benefits and should produce mild discomfort, but not pain. NECK AND SHOULDERS Neck Roll Instructions 1. Slowly bend your head forward as if you were looking down at your shirt 2. Roll your head to one side, stretching your neck 3. Smoothly keep rolling your head back until you are looking up at the ceiling 4. Keep rolling to the other side until you are back to the starting position Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps Cues You want to execute this stretch slowly and smoothly. Keep your back straight by pushing out your chest a little. Keep your shoulder relaxed.
- 15. Shoulder Roll Instructions 1. From a neutral position, shrug your shoulders all the way up and roll them back, squeezing your shoulder blades together 2. Bring your shoulders down and relax 3. Reverse the direction of the rolling and repeat as needed. Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps Cues You want to extend your shoulders as far up, down, back, and forward as possible. Try to draw circles with them. Keep your neck relaxed and your back straight.
- 16. BACK Wall Reach Instructions 1. Stand in front of a wall with your heels, rear, and shoulder blades touching the wall 2. Put your arms up on either side of you and reach up as high as you can reach without pain in your shoulders 3. Hold this stretch and relax 4. Repeat as needed Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of mild discomfort 2-4 reps Cues Remember to keep your shoulder blades on the wall as you reach up. If you cannot fully extend your arms up, that’s fine. However, you should still feel a slight discomfort in your back.
- 17. Low Back Stretch Instructions 1. Start face down on the ground 2. Place your hands palm down by your chest 3. Push up with your arms until your torso is erect while keeping your hips down Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of mild discomfort 2-4 reps Cues Make sure to keep your hips as close to the ground as possible. For increased difficulty, start by placing with your hands by your waist rather than your chest, then proceed with the stretch. You should feel the stretch in your lower back area. If it is too difficult, place your hands a little forward.
- 18. LOWER BODY Quad Stretch Instructions 1. Bend your knee and grab your ankle from behind 2. Gently pull your ankle towards your body until you feel a stretch in your front tight muscle 3. Hold the stretch and repeat on the other leg. Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps Cues Keep your back straight as that will help with a deeper stretch. You can use support if you cannot maintain your balance. This stretches the front of your thigh.
- 19. Hip Stretch Instructions 1. Cross your right leg over the area just above your left knee 2. Slowly lower yourself as though you were going to sit in a chair behind you 3. Hold the stretch and repeat on the other leg. Modified Instructions: 1. Lay on the ground and bend your left leg 2. Cross your right leg over your left leg 3. Cross your finger behind your left thigh and pull towards your chest 4. Hold the stretch and repeat on the other side Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps on each side Cues You can use support if you cannot maintain balance. You should feel the stretch on the hip area of the bend leg. If you are standing, make sure that the extended leg’s knee is not going over your toes, as this could cause some knee pain.
- 20. Laying Hip Stretch Instructions 1. Lay on the ground with one leg bent in the air 2. Pull the bent leg with your arms to your chest 3. Hold and repeat on the other side Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps Cues You can either pull your leg straight to your chest or you can pull the leg slightly to the side. The hip area as well as the back of the leg should feel the stretch.
- 21. Crossover Hip Stretch Instructions 1. Lay down on the ground facing the ceiling 2. Bend your right leg and extend your right arm to the side 3. Slowly cross your right leg over your body to the left side 4. Hold and repeat on the other side Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps Cues Try and keep your shoulder blades on the ground. The extended arm is to remind you to keep your torso facing the ceiling. Ideally, only your leg should move from side to side. You can fully extend your leg or keep it slightly bent. This stretch should be felt on the sides of the torso and in your hip area.
- 22. Leg on Chair (Hamstring Stretch) Instructions 1. Place a leg on a counter or a chair 2. While keeping both legs straight, slowly reach forward to the elevated leg and hold 3. Gently lower your leg back down to the ground and repeat with the other Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of mild discomfort 2-4 reps Cues Keep the standing leg and the leg on the counter straight. If you cannot reach your foot or ankle, that is okay. Just reach as far forward as you can. You should feel a mild to moderate stretch at the back of the leg on the counter. For a modified stretch, step forward with one leg and reach down for it, bending the back leg a little. Use this modified version if you have hip immobility.
- 23. Calf Stretch on Wall Instructions 1. Place the ball of your foot on the wall 2. Lean into the wall by bending your knee slightly until you feel a stretch in your calf 3. Hold the stretch and repeat on the other leg Frequency Duration Intensity Repetitions 2-3 days/week 30-60 seconds To the point of feeling tightness 2-4 reps
- 24. AEROBIC EXERCISES This one is simple. All you have to do is go for a walk or ride a bike! Take your best friend, husband, or dog and take a stroll around the park or the neighborhood (if it is safe to do so). Take this stroll for 30 to 60 minutes a day. You may also break up your sessions into smaller 10 minutes bouts. Just make sure that you get, in total, at least 150 minutes a week of moderate activity (30 minutes each session) or at least 75 minutes of vigorous activity (15 minutes each session). Do this at least 5 day a week, but preferably every day. To determine the intensity at which you are working, you can use a 10-point scale that starts at 1 (very easy, no effort) and goes to 10 (very hard, maximal effort). A rating of 5-6 on this scale would be considered “moderate” and a rating of 7 or more would be considered “vigorous”. By now, you must be wondering what moderate activities and vigorous activities are. Here are some examples: Moderate activities Vigorous activities - Walking at a normal leisurely pace - Sweeping floors or vacuuming - Cleaning the garage - Mowing the lawn - Ballroom dancing - Golf - Tennis doubles - Fishing from a riverbank - Walking at a very, very brisk pace - Hiking up a steep grade - Jogging - Running - Carrying heavy loads - Digging holes - Swimming leisurely - Tennis singles