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?
I would recommend doing some basic chair squats, just as he would if he were getting up and down out of his chair. He could use the walker to assist if he has and at some point be able to use his own body weight without any assistance. As he gets stronger you can easily add resistance with a light dumbbell, if he were ever to need to challenge the exercise. Glute Bridge is another exercise that can be beneficial, as long as he can get up and down from the ground. This will help strengthen the core muscles and help build power within the hips, a very basic exercise with lots of benefits.
Chair exercises can be a great way to build leg strength! Resistance tubing is a versatile way to work many parts of the body- have him wrap it around his thighs or (seated or standing) step on the tube & move feet (or thighs) out & in to work inner & outer thighs. Resistance can be increased by crossing the band in front of the shins or shortening the tube length by gripping it further from the handles. If you have dumbells available, have him rest them about mid-thigh on one or both legs. He can practice raising one foot & then try leg extensions for hip flexors & quads.
A ball against a chair leg can be a great hamstring workout waiting to happen- just have him put his heel on the ball & try to “pop” it. This can be done with fast “pulses” or for a longer hold (great way to measure a starting point & progress). Also don’t be afraid to think outside the box- try “chair walks” by “walking” the glutes forward & backward (from the back of the seat to the front & vice versa) & use the chair to assist with balance during standing exercises. Keep encouraging him & if he’s still frustrated try to help him channel it into his exercises. Remind him that he’s making progress & not to worry about what can’t be helped- to just work around it.
Sounds like you’re on the right track. Karin has a good point that to get better at walking, he’ll have to walk! I like the idea of water workouts as well since there’s very little impact & lots of potential resistance but didn’t know if you have pool access? Make sure he’s medically cleared for everything you do with him. Feel free to contact me if you want more ideas!
I am on the assumption that you have all the medical clearance you need.
You have to think specificity. If he wants to get better at walking, you have to start doing more exercises standing. Find a safe environment where there is no risk of falling. Standing up from a chair ever which way is probably an exercise for him. See how many times he can do it. This will also give you something quantifiable. Have him do mini squats. Sit down to rest in between as necessary but then stand again.
He is in a challenging situation, and there is currently only so much you can do. After the surgery, he will be initially under the care of a physical therapist, and you should hook in there as quickly as possible so that you can assist him seamlessly after he has been cleared for exercise.
I wish you and him good luck.