The last 6 months have effected people differently. For example, some people have found it to be a good opportunity to increase their time exercising. They were not running around and had time to focus on their health. This is probably particularly true for those who stayed connected to services on line or, who have a good understanding of the impact of not exercising and have the confidence to keep going.

On the other hand we have people who, for a variety of reasons, don’t engage with the internet and they also may not be as aware of the impact of increasing sedentary behaviour. There are also those who may be afraid to go outside their front door. This increases sedentary behaviour - gone is the walk around the supermarket, the stairs at the shopping centre or even the walking form car parks to destinations. For this second group of people, lack of physical activity and exercise has a variety of negative effects.

The bones are not being loaded as they should and bone density responds positively to bones being loaded. Muscles are not being used a whole lot and so they can get quite laid back - becoming weaker because they think they are not needed. Weaker muscles can increase the risk of falls, fear of falls and decreased ability to do day to day tasks. This can lead to further sedentary behaviour and the cycle keeps going.

Decreasing physical activity and decreased conditioning have other unwanted effects, general diminishing of health and even progression to frailty. This poorer health state can impact on recovery if a bone is broken or if surgery is needed to fix a broken arm or hip. Unfortunately because of the duration of the COVID 19 crisis, decreasing physical activity and decreased volume of exercise has really set in. The prolonged time has been enough to cause significant impact on bones, muscles and may other systems in the body.

The good news is that older people respond to exercise the same way as 20 year olds! Deconditioning and even fragility can be reversible. People can get back to their weight bearing exercise, to bone and muscle building and can improve balance and coordination. If you are out of action for the last couple of months it is recommended that you return to activity slowly and gradually but progressively. This is the best way to minimise the risk of injury and ensure that you are improving. If you are not sure where to start, then just do something you are safe and secure doing - anything is better than nothing!

When a situation arises whereby access to our usual motivations to exercise and remain physically active are removed, then we need to bear in mind that we may decondition. We may be used to walking to and from work, going for a walk at lunch time, walking around a workplace floor and up and down stairs. We may be used to attending a gym or exercise classes, going to the golf or tennis club and even walking around shops.

It is important that we don’t walk blindly into a situation where we allow deconditioning to happen. At any age it can have a short and long term effect on our over all health and wellbeing. In older people it can also have a effect on our ability to function safely and independently.

During this corona virus crisis there is a lot that we can not control, but there is a lot that we can control as well.

Social distancing and social isolation are the circumstances we find ourselves in at the moment. Some will also find themselves in a state of illness and recovery. This crisis will all pass but, in the meantime, we all need to prevent our current circumstances from effecting us any more than is necessary. With that in mind, the evidence-based tools we need to stay as well as we can are:

150 minutes a week of moderate intensity aerobic exercise. This means, being active to the point that you could converse with another person but you would be a bit more aware of your breathing in doing so. If you are new to exercise or recovering from illness, then a relaxed pace, gentle walk is perfect. If you can get out for walk or run in a quiet area, do. If your balance is not great and you are fearful of falling, walking or marching on the spot for even one minute at a time, regularly will do just fine. Everything counts and it all adds up.
Strength training exercises on 2 days of the week. This means different things for different people. Basic body weight exercises may be enough here - going from sit to stand, squats, push ups against the wall/ stairs or floor, climbing steps, rising up and down on your toes, kneeling and getting up again. If you do these things in your day to day life then doing a few extra, regularly will help keep muscles working.
Balance It is important that, whatever you are doing in terms of exercise or day to day activity, that you don’t put yourself at risk for a fall. You can use your hands and a stable surface to support you during activities. It is a good idea to be aware of how much support your upper limbs are giving your balance. Balance seems to respond best to doing a little bit often. Exercises can be as simple as standing one leg with hands on a kitchen counter. You will be looking to have a little wobbling going on at your ankle but at the same time being in control and safe. And the really good news is - no matter what age you are, your body will respond to exercise!