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Given that my father only complains a little bit about his left knee, which routines should him practice to be fit and prepared for ordinary tasks? Pilates, gym and physical therapy?

More details about my father: he still works and walks a lot, but there is no special program or a sport he is practicing. He feels that he is slowly loosing a little bit of strength and not sleeping as easy as he used to.

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Please narrow down the scope of your question. At the moment it is far too broad to be reasonably answered. Have a look at the faq. Subjective questions ("what is the best?") are also not really a good fit for our Q&A format. –  Baarn Jan 19 '13 at 23:49
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Information about your father's current fitness levels other than his knee would also help too. What does he do currently if anything? What is he looking to gain out of exercise? –  Matt Chan Jan 19 '13 at 23:59
    
As the others have pointed out this is broad scope. However, the best thing for the elderly is weight-bearing, low impact exercise (like walking). It promotes bone growth and incorporates large muscle groups and balance. However, if this irritates his knee injury, it isn't a good option. Narrow it down a little and this question can be better answered. –  Grohlier Jan 20 '13 at 3:05
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up vote 4 down vote accepted

Pilates, gym and/or physical therapy can all be appropriate exercises for your father depending on his present condition, his goals of exercise, and availability of appropriate instruction, as can aquatic exercise, Yoga, walking, Tai Chi etc.

Exercise programs for seniors who are beginning to get into exercise are best when supervised by trainers or instructors who are trained in working with the geriatric population and their needs. Exercise programs for this population should address all of the concerns listed below and recognize that progression of difficulty may go at a slower pace. Pilates or gym workouts, if new to your father, should begin with an instructor so that he can learn the proper form and prevent injuries.

Elderly people who have not been working out consistently or who have had musculo-skeletal problems over their lifetime may have to deal with the following concerns when creating an exercise program:

  1. Joint Pain and degenerative changes
  2. Loss of mobility and range of motion
  3. Loss of muscle strength
  4. Problems with balance
  5. Postural changes
  6. Thinning bones
  7. Reduced Cardio-Respiratory capacity
  8. All of the above can lead to reduced function with daily activities like going up and down stairs, bending or squatting down, reaching overhead, carrying groceries, getting up and down off of the floor, getting up from low seats, functional walking speed and balance, endurance and tolerance to exercise etc.

This age group requires medical clearance before beginning an exercise program. The doctor will refer your father to physical therapy if appropriate. The doctor can give your father guidance as to what exercises are appropriate for your his health condition, such as a safe exercise target heart range.

  • Aquatic exercise is a good way for the elderly to get a good cardio and resistance workout with little to no impact on their joints. The bouyancy of water also helps them achieve exercises that they might have difficulty with on dry land. Because these are generally good exercises for seniors, aquatic exercise programs for the elderly are often readily available.
  • Cardio -

    • Walking can be a good exercise if it does not aggravate his knee. Nordic walking poles can help to improve balance, posture and to reduce joint pain. Walking groups often meet to walk at malls or other safe areas which adds a socialization aspect to the exercise.

    • Cycling, stationary cycling and elliptical training can be easier than other weight bearing exercises on painful knees due to reduced impact.

  • Resistance Training is an important aspect of workouts for seniors. Weight training, resistance bands, resistance cuffs and barbells for aquatic exercise, body weight exercises are all helpful to improve daily functional activities, posture, muscle and bone strength.

  • Flexibility and Range of Motion exercise can be done with a gentle stretching program at home on a regular basis. A stretching strap is a useful tool. Yoga with modified or restorative postures can achieve excellent results. Yoga will also help improve balance and strength.
  • Bone Strength - Osteoporosis or thinning of the bones is a factor to consider with senior exercises. High impact exercise can lead to fractures depending on the degree of osteoporosis. Progressive strength training can improve bone health and posture. Wearing a weight vest when walking can help to strengthen bones of the spine and legs. (link from our site's amazon store)

  • Physical Therapy - Ideally, a baseline evaluation and follow up assessments by a physical therapist can help identify problem areas and direct your father's program to correct aspects such as postural muscle imbalances, range of motion, strength, balance and functional activities. Additionally if your father's knee condtion warrants direct treatment, a geriatric or orthopedic physical therapist can address this as well.

The Arthritis Foundation has community exercise programs, including aquatics, walking and Tai Chi exerise classes which may be helpful since your father has some knee pain. You can check to see what they have in your area.

Good luck and congratulations to you for encouraging him and helping him get started. A little bit of exercise can make a big difference in keeping your father functional.

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