Exercises to Help the Elderly to Stand & Transfer

Many of the activities we take for granted in our youth may become more challenging as we age. Even the simple act of transferring from a sitting to a standing position can be a daunting challenge that discourages physical activity in many elderly. Helping your patient or client strengthen the muscles involved in standing and transferring can greatly enhance their quality of life.

The primary issues that make it difficult for an older adult to move from sitting to standing include muscle weakness from inactivity, especially after a period of illness, limited joint range of motion from excessive sitting and poor postural habits and poor balance related to impaired vision, medications and joint pain or stiffness. Fear of falling may also make your older adult reluctant to stand without assistance. Exercises designed to strengthen the muscles involved in standing, and static and dynamic stretches for the hips, knees and ankles can all be effective in building skills and confidence.

The primary muscles involved in standing include the gluteus maximus, which functions as a hip extensor, the quadriceps, which function as knee extensors, and the various muscles that act to stabilize the ankles. Tightness of the hip flexor muscles due to long periods of sitting is common in older adults and can lead to an inability to fully extend the hips, pitching the torso forward when standing, which makes for unstable posture. Thus, stretches for the hip flexors should be included in your exercise program.

A well-designed exercise program can be effective in improving your older adult's ability to stand and transfer. A 2009 study published in the "International Journal of Exercise Science" found that strength and power training exercises were effective in reversing age-related decline in muscle strength, power, velocity and force control. Resistance machines, free weights, resistance bands and body weight exercises are all effective tools for improving functional strength for activities of daily living. Exercises performed in an in waist-deep pool afford the natural buoyancy and resistance of the water. Many older adults feel more confident in the water because if they lose their balance, they will not fall on a hard surface. Pool exercises should always be supervised.

To strengthen the gluteus maximus, begin with an elevated bench or chair so that your client's knees are at an angle midway between standing and sitting. Stand in front of your client and allow them to hold your hands for support as they rise to their feet and sit again. Perform three sets of 10 repetitions. Gradually lower the seat height each week until they can rise from a normal chair height. To strengthen the quadriceps, perform seated knee extensions with ankle weights or with a resistance band wrapped around the ankle. Do three sets of 10 on each leg. To strengthen the muscles that stabilize the ankles, perform a one-legged stance with the client holding your hands for support. Begin with five seconds and gradually increase to 30 seconds. Follow with standing toe raises, performing three sets of 10.