Change is coming and at a fast pace. The demand for better quality care at lower cost requires new thinking. Improved practices in person-centered care is a necessity as we continue to provide the highest quality of care and services to all the lives we touch. With the post acute care continuum and the transition of care culture shift, we are working towards shorter length of stays in skilled nursing facilities.

One way of working towards improved outcomes in shorter lengths of stays is to provide meaningful, functional and purposeful activities to address strength training in the older adult. The goal is to maximize efficiency and safety in functional movement in order to transition care safely by utilizing the whole body in exercise to maximize functional outcomes in shorter periods of time.

The Principles of Strength Training:

• Overload: providing a load that is new to the body to get a positive training effect
• Specficity: work muscles in a specific was to get desired outcomes
• Progression: continually providing overload* to get a continued benefit without plateau
• *Note: “Overload” does not always mean add weights; it can be achieved by changing part of the activity by changing supportive surfaces, speed of movement, height changes, etc.

By analyzing the desired functional performance outcomes you can identify the typical demands, the range of skill involved in the activity, and the meaning/importance ascribed by the older adult to that activity. Once the body functions/structures and required actions and performance skills needed are identified then a therapist can modify that activity and progressively challenge performance and improve strength and safety while participating in activities of daily living.