Strength and Balance Exercise Manual Getting the most out of Stepping On Welcome to the Stepping On program! Over the next seven weeks you will learn some ways to move safely with more confidence, and reduce falls hazards in everyday life. This handout will give you some tips on how to get the most out of the Stepping On program. Attendance: Every week, we will cover new information and build on the material covered in previous weeks. Many sessions are led by local health professionals who are experts in their field. You will get the most out of the program if you attend each session. If you are unable to attend any session please let your facilitator know as soon as possible. Groupwork: We encourage you to share your thoughts and ideas throughout the Stepping On Program. Your experience and ideas may help others in the group. Please observe the usual social etiquette – listening to others and taking turns to speak. If you are having difficulty hearing, please sit close to the facilitator. 1 Strength and Balance Exercise Manual The Exercises: Throughout the Stepping On program we will introduce you to seven simple strength and balance exercises. These exercises are an important part of the program and will help you to build strength, balance and confidence. These exercises should be done on a regular daily basis to get the maximum benefit. Your facilitator will demonstrate how to conduct the exercises safely but if you have any pre‐existing medical conditions or injuries, please let the facilitator know. REMEMBER:  Use the log sheets at the back of this Strength and Balance Exercise Manual to keep a record of how many pain free repetitions you can do. Give your muscles time to build up in strength before you exceed this number.  Always start with the basic level exercises and only progress to the upgrades or use weights when you can do the basic version without pain.  Exercise at your own pace and at a level that suits you individually. It is more than likely that 2 Strength and Balance Exercise Manual everyone in the class will be exercising at a different level.  Raise any problems with your facilitator as soon as possible. They may be able to offer helpful advice. Safety precautions:  If you have an existing knee condition, please speak to the facilitator before commencing the front knee strengthening exercise. This exercise can make some conditions worse, especially if you are using weights. Your Stepping On facilitator will be able to suggest safe alternatives to this exercise.  Always exercise holding onto something stable such as a kitchen bench or solid table.  Make sure you are medically able to do the exercises. Contact your doctor if you experience any of the following while exercising: o Dizziness o Chest pain o Shortness of breath Now that we have considered some tips for safety and enjoyment, it is Stepping On time! 3 Strength and Balance Exercise Manual Strength and Balance Exercises These exercises have been selected to help you reduce the chance of falls. When you do these exercises you can improve your:  Balance  Muscle strength You will only need to do the STRENGTH exercises three times each week and the BALANCE exercises daily. You can divide the exercises up — ‘snack on them’. They do not all have to be done at the same time. Between each set of exercises take three deep breaths. You may feel a bit stiff at first. This is quite normal. It is because you are using muscles that are not used to working in this way. It is important that you keep exercising. The stiffness will leave as your body becomes more used to the exercises. If you have any questions please ask next week at the program or call your facilitator at any time. 4 Strength and Balance Exercise Manual Getting stronger by using weights Strengthening your muscles is essential for keeping healthy bones and muscles that are needed for walking and for being independent in your daily activities. Aim to do these exercises three times a week with a rest day in between. Exercises which may include weights: 1. Front knee strengthening exercise 2. Side hip strengthening exercise Weight lifting technique: Lift the weight slowly through the entire range of movement. Never hold your breath while lifting.  inhale before lifting  exhale while lifting  inhale again while lowering the weight Start with no weight, then add a low weight (0.5–1kg; 1–2 lbs) and keep slowly increasing over a period of days. 5 Strength and Balance Exercise Manual Front Knee Strengthening Exercise  You could do this exercise while you are watching TV  Strap the weight onto your ankle  Sit on a chair with your back well supported  Straighten the right leg  Hold for five seconds  Lower the leg To progress this exercise you could: 1. Increase hold time to _______seconds 2. Increase number of repetitions 3. Complete exercise with a weight strapped to your ankle 6 Strength and Balance Exercise Manual Side Hip Strengthening Exercise Strap the weight onto your right ankle  Stand tall with your left side toward the bench  Hold on with your left hand  Keep the right leg straight and the foot straight forward  Lift the right leg out to the side, hold for ______seconds and return  Repeat _______times  Turn around and repeat as above for the left leg To progress this exercise you could: 1. Increase hold time to _______seconds 2. Increase number of repetitions 3. Complete exercise with a weight strapped to your ankle 7 Strength and Balance Exercise Manual Heel Raises Stand up tall facing the bench  Hold on  The feet are shoulder‐width apart  Come up onto your toes  Hold for ______ seconds  Lower the heels to the ground  Repeat this exercise _________ times To progress this exercise you could: 1. Increase hold time to _______seconds 2. Increase number of repetitions 3. Complete exercise without holding onto support 8 Strength and Balance Exercise Manual Notes 9 Strength and Balance Exercise Manual Balance Exercises: Balance is important for everyday activities. You can improve your balance and maintain your gains. The following balance exercises could be done every day, or whenever you think about them: 1. Sideways walking 2. Heel‐and‐toe standing 3. Sit‐to‐stand 4. Heel‐and‐toe (tandem walking) 10 Strength and Balance Exercise Manual Sideways Walking Stand tall and place your hands on your hips  Take 10 steps to the right  Take 10 steps to the left  Repeat Start by doing this with a wall or bench in front of you if you feel at all unsteady 11 Strength and Balance Exercise Manual Heel‐and‐Toe Standing Stand tall beside the bench  Hold on to the bench and look ahead  Place one foot directly in front of the other foot so the feet form a straight line  Bend both knees slightly  Hold this position for 10 seconds  Repeat with the other foot in front To progress this exercise: 1. Shift your weight back and forward 2. Stand beside the bench without holding on 12 Strength and Balance Exercise Manual Sit‐to‐Stand You could do this exercise while you watch TV  Sit on a chair which is not too low  Place your feet behind your knees  Lean forwards over your knees  Push off with both hands and stand up slowly  Repeat this exercise ___________ times To progress this exercise: 1.
Cross your arms and stand up without pushing on the armrests 2.
Stand up and sit down very slowly 3.
Try standing from a lower or softer chair 13 Strength and Balance Exercise Manual Heel‐and‐Toe (Tandem) Walking Start off by holding on to a bench  Move forwards slowly by placing one foot in front of the other (tandem walking)  Tandem walk forwards 5 to 10 steps  Pause then do another 5 to 10 steps forwards To progress this exercise: 1.
Tandem walk backwards 2.
Upgrade to fingertip support or no hand support 3.
Increase repetitions 14 Strength and Balance Exercise Manual Summary  Walking is good for you and we recommend that you walk regularly. But walking alone will not increase or maintain your muscle strength or balance.  You need to have good muscle strength and balance to help prevent falls.  When you are ready, you can make the exercises harder either by: 1. increasing the number of times you do each exercise; 2. increasing the hold period; or 3. increasing the amount of weight.  Keep doing the strength exercises at least three times a week and the balance exercises as often as you can.  You can do these exercises in one go or ‘snack’ on them at different times of the day. Do what works for you. 15 Strength and Balance Exercise Manual Notes: 16 Strength and Balance Exercise Manual Notes: 17 Exercise Record Week 1 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 18 Exercise Record Sit‐to‐stand Date Repeats Week 1 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 19 Exercise Record Week 2 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 20 Exercise Record Sit‐to‐stand Date Repeats Week 2 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 21 Exercise Record Week 3 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 22 Exercise Record Sit‐to‐stand Date Repeats Week 3 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 23 Exercise Record Week 4 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 24 Exercise Record Sit‐to‐stand Date Repeats Week 4 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 25 Exercise Record Week 5 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 26 Exercise Record Sit‐to‐stand Date Repeats Week 5 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 27 Exercise Record Week 6 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 28 Exercise Record Sit‐to‐stand Date Repeats Week 6 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 29 Exercise Record Week 7 Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 30 Exercise Record Sit‐to‐stand Date Repeats Week 7 Strength Exercises: use ankle weights every other day NOTE: if use of ankle weights increase your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 31 Exercise Record PHOTOCOPY TEMPLATE Balance Exercises: do these daily Be sure to stop exercising and consult your health professional if you start feeling unwell or uncomfortable or if you are not sure how to perform any exercise Sideways walking Date Repeats Date Repeats Heel‐and‐toe standing Calf raises Date Repeats Date Repeats Heel‐and‐toe (tandem walking) 32 Exercise Record PHOTOCOPY TEMPLATE Sit‐to‐stand Date Repeats Strength Exercises: use ankle weights every other day NOTE: if the use of ankle weights increases your hip or knee joint pain, stop using the weights Date Repeats Weight kilograms
No weights No weights No weights Front knee strengthening Date Repeats Weight kilograms No weights No weights No weights Side hip strengthening 33 Exercise Record Notes: 34