At least 75% of people aged> 65 years are not exercising at the recommended intensity, although the health benefits of exercise are well known: longer survival time Improved quality of life (eg endurance, strength, mood, sleep, flexibility, insulin sensitivity. possible cognitive function, bone mineral density [with weight-bearing exercises]) In addition, many older people do not realize how hard they are to train and how much power they are capable. Training is one of the safest ways to improve health. Due to the decline in exercise capacity due to aging and age-related diseases older people can do even more of exercise benefit than younger ones. Training is always useful, even if it is started at a later age. Understanding, moderate strength training helps the elderly to carry out their daily activities. Many elderly patients need advice on a safe and adequate regular exercise program. The greatest health benefits occur with aerobic training, especially when patients begin to train sedentary. The force decreases with age, and reduced power may impair body function. For example, almost half of the women> 65 years and more than half of the women can lift> 75 years no weight of 4.5 kg. Strength training can increase muscle mass by 25 to 100% or more, and thus greatly enhance the function. The same level of muscle work requires less cardiovascular stress, and an increase in muscle strength in the legs improves walking speed and climbing stairs. In addition, z have. As older people with more muscle mass better nitrogen balance, a better condition and better prognosis in critical illness. Contraindications Absolute contraindications (1) are: Acute myocardial infarction (MI), unstable within 2 days Permanente angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis symptomatic severe aortic stenosis Congestive heart failure Acute pulmonary embolism, pulmonary infarction or deep vein thrombosis Acute myocarditis, pericarditis Acute aortic dissection Physical Impairment which excludes a safe and sufficient movement relative contraindications (1) are: Known arterial stenosis of the left main coronary artery Moderate to severe aortic stenosis with uncertain relationship with symptoms tachyarrhythmias with uncontrolled ventricular rate Acquired advanced or complete atrioventricular block hypertrophic obstructive cardiomyopathy with severe style standing gradient More recently, stroke or transient ischemic attack Mental impairment with limited ability to safely collaborate resting hypertension with systolic or diastolic blood pressure> 200/110 mmHg Uncorrected medical conditions, such as significant anemia important electrolyte disorders and hyperthyroidism, most patients with relative contraindications can play sports, although usually with less strong intensity and as other patients under structured conditions (cardiovascular rehabilitation). eineigen in forms Sometimes shorter workouts can be kombininert with breaks in a higher exercise intensity that these people should engegenkommen more than continuous light workout. The exercise program can (relate, for. Example, arthritic diseases, particularly those weight-bearing joints such as knees, ankles and hips) for patients with other conditions to be adjusted. Patients should be clearly stated that they have to finish their training and seek medical attention if they develop chest pain, dizziness or palpitations. Screening procedures before beginning any exercise program should allow the elderly to medical examination, particularly heart disease and physical limitations. A routine ECG is not necessary unless history and physical examination to show something else. Stress tests are usually also unnecessary in elderly people who start their training slowly and want to gradually increase the intensity. In people with mainly sedentary who want to start with intensive training, stress tests should be made if they have one of the following problems (1): Well-known coronary heart disease symptoms of coronary heart disease ? 2 cardiac risk factors (eg, hypercholesterolemia, hypertension. , obesity, lack of exercise, smoking, family history of early coronary heart disease) lung disease, known or suspected diabetes is known or suspected General note Fletcher GF, Ades PA, Kligfield P, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 128 (8): 873-934, 2013. Training Program A comprehensive training program should include aerobic activity weight training flexibility and balance training variation (regular change of exercise to avoid an adaptation to the same stimulus, but also minor injuries by repetitive to avoid actions) Often, a single program can be designed to reach all the training goals. Strength training improves muscle mass, strength endurance and strength. When strength training different types of exercises included in the program, improve the many exercises the flexibility and improved muscle strength improves joint stability and balance. In addition, the kardivaskuläre function improved when the breaks between training sessions are very short. The duration of aerobic training for the elderly is similar to younger adults, but the execution should be less intense. Normally the person should during exercise to be able to get comfortable to entertain, and the intensity should be at ? 6.10 of maximum effort. Older people who have no contraindications, can adapt their heart rate (HR max) to one that is age appropriate. Some older people with poor physical condition must first improve their functional skills (eg., By weight training) before they can begin aerobic training. Strength training works on the same principles and techniques as in younger adults. First, lighter weights should be used (eg. As with bands or weights as light as 1 kg are) before the weights are then slowly increased. A more aggressive training (the use of initially higher resistance) should be done under the supervision of a qualified fitness professional. To improve the mobility of the major muscle groups should be stretched once a day, preferably after exercise when muscles are most compatible. The balance training often demands the center of balance through exercises in unstable conditions, such as when standing on one leg or with a balance board or rocker board. This training can help people with impaired proprioception, but it is also prescribed often elderly, so as to prevent falls. However, it is often ineffective because of balance movements are very different. If you can keep an equilibrium device the balance, it is not said that it works equally well in a different situation. For most older people who want to prevent falls, general agility and strength training is more effective. Such programs increase the strength around the joints and provide better postural control in standing and walking. If someone has because of problems with balance difficulties with standing and walking, challenging exercises are (z. B. Standing on a rocker board) simply connected to a high risk of injury and therefore contraindicated.