I have a 74 year old male client who is awaiting a knee replacement (the other knee has already been replaced). He has had numerous surgeries (quadruple bypass, brain stem, removal of fluid from his knee, etc.) and is a real trooper. He cannot stand for very long so I have been doing most of my workouts with him in a chair. He would like to build more leg strength so he can stop using his walker and use a cane but it is very difficult to work his lower body with strength building exercises. Any suggestions on what I should be doing to (1) build his leg strength up and (2) keep him from getting frustrated until he gets his knee surgery?
Without knowing how long ago the other knee was replaced, his pain level, or what meds he’s taking for pain, or when surgery is going to happen here’s my answer other than the great ideas like water for ROM and walking, nu step or sci-fit, TM or bike(as tolerable) ~that haven’t been suggested already:
1. Why not work him lying on a bed or table (or floor if he can get there)? I think most people consider this “post op” or “rehab” but a lot can be gained. The following exercises can be done perhaps without pain? Lying straight leg lifts, bridges, ball rolls/heel slides, abductor, adductor ball squeezes, hip extension, prone leg curl with band resistance, pilates ring work, clamshell, and lots of core work too! Often when folks are in chairs they aren’t aware of their core especially if they’re worried about leg pain. This will go far helping his rehab. Good leg can help then progress to single leg if tolerable and ankle weights.
2. IMO: If someone feels pain standing, squatting might produce more lower body imbalance. I’d stick to partial squats with him holding on to something (standing) and work upper body in chair.
Difficult exercises first.
3. Calf raises too.
4. Bike with upper body (schwinn) so he can help himself too.
I like all the answers above, I too have worked with an elder client that was mostly limited to a chair. I alternated legs and arms as to not tire his legs to quickly in a 30 minute session. I did not have access to a pool. I had him do sitting/standing squats as others suggested, I feel it is probably the number one exercise to keep geriatrics strong and mobile. I put a step on top of the bench to limit the range in the beggining. I put a squishy ball between his knees for the adductors, and used my hands or a band for the abductors. But one exercise I loved that I did not see above was chair walks. I used my office chair with rollers, and had him alternate leg pulls to pull the chair across the room for hamstrings, in the beginning I “pushed” a little from the back of the chair to assist, and before long, he needed no assistance! I also had him to leg extensions, holding isometrically to help quad strength. I would have him walk in between to build up stamina in his legs! And I assisted and stretched quads, hams, calves and hips, which are very tight at this stage! I hope this helps a little, nothing is more satisfying then working with seniors and increasing their longevity and mobility!
Hi Leandra. As several others have indicated, your first step should be to follow any restrictions or limitations posed for your client by his physician and other healthcare providers. I’ve worked with a similarly-situated elderly male client and used cycling as a great way to not only improve his ROM, but also his leg strength. Each client is different, and so how you approach your particularly client should be based on several specifics, including his motivation and interest in a particular activity that you choose for him.
I hope that this helps.