Muscle mass can begin to decline from the age of 40.  This is known as sarcopenia and can quickly lead to the loss of function and a consequent loss of independence.  Strong muscles can go a long way to helping to prevent falls and all the damage that can occur.  Strong muscles also encourage mobility and improved stamina.

All is not, however, lost.  This process can be reversed, it is possible to build muscle into our 90s (and maybe beyond), loss of muscle strength is not inevitable.  With a well-planned exercise programme muscles can be rebuilt.

The first imperative when working with older, frail people (generally aged 80 and over) is to encourage simple movements such as standing up form the chair with minimal help.  Deconditioned older people lose not just their mobility, they also lose their confidence.  Encouraging basic movement after a full assessment starts the process.    If walking is too strenuous at this stage then much can be gained from seated leg and arm movements.  These can be enhanced with the use of resistance bands and with encouragement, there will be an increase in muscle strength. We find that people often then progress to standing and taking a few steps.  As they gain confidence they are able to walk further and with less help.  The apparently simple task of getting up from a chair is an important exercise in itself and when repeated a few times on several days often become easier.

Introducing equipment adds an element of fun and challenge, so sharp turns round cones, using steps and the use of free weights add to the demands on muscles and on cognitive function.  The need to increase the weight of standard equipment is testimony to the success of the programme.  Fewer falls, increased energy and greater social interaction are observed.  Encouragement to perform squats and side lunges is a great help in maintaining strong legs and preventing joint stiffness.  For the more agile older people it is possible to carry out a range of floor exercises to help strengthen the core.

Ensuring that the major muscle groups are all exercised is important as is efficient warm up and cool down sessions.  A well-planned group exercise session pitched at the right level for the attendees leads to improved mobility and self-confidence.  Regular and repetitive sessions can help with cognition and over time the familiarity of the sessions helps those that attend to become more able to join in affectively.

Sarcopenia is not inevitable and can be reversed with a well-planned and appropriate exercise programme.