Our ability to perceive where we are and how we should respond to changing sensory conditions during our daily lives is heavily dependent on (a) the amount and quality of information we receive from our peripheral sensory receptors and (b) how the brain organizes and integrates that information once it has reached the central nervous system (CNS).
Each of the three sensory systems (visual, vestibular, and somatosensory) contribute to balance and mobility experiences significant changes as a function of the aging process.
· Decline in visual acuity, contrast sensitivity, and depth perception
· The threshold for detecting vibration and joint movement increases- may not detect changes in time to respond
· The number of sensory receptors (hair cells) within the inner ear’s vestibular apparatus drops
· A reduction in the gain of the vestibular-ocular reflex (VOR)
Although older adults generally are able to compensate for small age-related changes occurring in each of these systems, impairments associated with particular medical diagnosis (e.g. macular degeneration, peripheral neuropathy, Meniere’s disease) combined with severe deconditioning (loss of muscle strength, joint flexibility and range of motion, and reduced stamina) will negatively affect the postural control system which limit both the types of activities older adults can perform successfully and the environments in which they can function successfully. This causes the older adult to lose balance easily and falls begin occur.
In balance and mobility training we focus on optimizing functioning of the unimpaired sensory systems while compensating for the systems that are known to be permanently impaired.
Careful review of our clients' medical history, and balance and mobility assessments helps us determine which sensory system is permanently impaired or becoming progressively more impaired over time (e.g. macular degeneration, peripheral neuropathy). Your trainer or therapist will then select exercises that would force the use of other, non-impaired sensory systems, so that the older adult can compensate for the loss in one sensory system by maximizing the function of another sensory system.
Balance and mobility exercises will benefit the older adult when exercises are targeted to the impairment. Just signing up for a balance class may or may not provide the results that you are looking for.
Our senior clients enjoy a holistic approach in restoring balance with multisensory balance and mobility training two to three times per week in combination with (two to three times per week) muscle strengthening exercises and daily cardiovascular exercise (e.g. walking, cycling or recumbent cycle, recumbent/seated stepper-NuStep, or recumbent elliptical, swimming), a home and environmental fall safety check. We may also request your healthcare provider to perform a medication review and annual eye exam. This holistic intensive intervention can make dramatic improvements in functional fitness, overall health, and quality of life of our older adult client.
Information from FallProof balance and Mobility Training professional training manual
One of the main priorities of your cardiovascular system is to maintain an adequate blood pressure to ensure sufficient blood flow to your brain.
HYPERTENSION is a blood pressure of >140/90mmHg or being on blood pressure medication (140 is the systolic and 90 is the diastolic blood pressure). High blood pressure increases with age, after age 50 it steadily increases.
- 70% of Americans over the age of 75 have high blood pressure or are on blood pressure medication, with two thirds of those on medication not achieving appropriate blood pressure control, and
- 30% are unaware they have high blood pressure
High blood pressure is an independent risk factor for coronary artery disease, stroke and renal failure (kidney cannot filter waste from the blood). The higher your blood pressure the greater the chance of a heart attack, heart failure, stroke and kidney disease. Long-term high blood pressure thickens the heart muscle and becomes less efficient as a pump.
CHECK YOUR BLOOD PRESSURE on a regular basis and take a reading on both your left and right arm. Sit for about 5 minutes with both feet on the floor before you take your blood pressure. When you experience a difference of 15 mmHg between blood pressure on your left or right arm (either systolic or diastolic you need report this to your healthcare provider.
Your fitness professional often works in collaboration with clinicians and nutritionists to optimize blood pressure lowering potential through lifestyle modifications with pharmacotherapy. Remember that all medications have side effects, are costly and that your first defense for preventing and managing high blood pressure is lifestyle modification.
THE BENEFIT of a targeted and purposeful exercise program that you can prevent and manage your blood pressure, and that you will also see improvements in functional health and fitness. All these are essential for maintaining a high quality of life as you age and long-term independence. Your fitness professional follows the exercise guidelines from the American College of Sports Medicine and the American Heart Association to help you prevent, lower and maintain your blood pressure that includes cardiorespiratory training and resistance training.
Non-medication treatment for high blood pressure includes the following:
LIFESTYLE MODIFICATION TO MANAGE HYPERTYENSION
APPROXIMATE SYSTOLIC BLOOD PRESSURE REDUCTION RANGE
Maintain and manage a normal body weight BMI 18.5-24.9)
5-20 mmHg/22 pound or 10KG weight loss
Adopt DASH eating plan
Consuming a diet rich in fruits and vegetables, low fat dairy with reduced content of saturated fat
Dietary sodium reduction
Reduce salt/sodium intake to no more than 100 mmol per day
Engage in regular aerobic physical activity such as brisk walking at least 30 minutes per day. Most days of the week
Moderation of alcohol
No more than two drinks (24 oz beer, 10 oz wine, OR 3-oz 80 proof whiskey)
Source: ACE CMES manual
Active aging, being physically active, exercising regularly and staying engaged in life are important in the maintaining our function, health, fitness and perfomance. But, face it, when we get older, the body is changing and the exercise program we have been doing may not be appropriate when to maxizing function and fitness is the goal.
Many systems of the body gradually change, some faster than others. Changes in skeletal system (bone density and joint health), muscular system (muscle strength), and the sensory systems (vision, sense of touch and pressure, and sometimes even problems with vertigo).
Those gradual changes can suddenly catch up with us unexpectantly. Older adults who are least active and older adults most active are most prone to falls. Fall related injuries are the main reason older adults lose their independence.
You can find out if you are on track and have the fitness level necessary to stay highly functioning and stay independent. A comprehensive assessment can identify your weaknesses and strengths and scoreyou against seniors of same age and gender. You will find out lower body and upper body strength ,flexibility, balance and agility, aerobic endurance. Specific tests can also identfy if your balance is effected and if you are at high fall risk.
As a Pro-Active Aging Older Adult you will be able to discover what exercises will be most beneficial and which one's should be the focus of your exercise program in your quest to stay independent with exceptional quality of life. This may be the most important test that can do to help you add many healthy and functional years to your life.
Give us a call for more information and to schedule your Active Aging Wellness Assessment.
About 15 million people will have a stroke each year. There are many reasons why people have a stroke and many strokes happen because of modifiable risk factors.
Six million people will die of a stroke, and 5 million become permanently disabled.
If you knew you were at risk and had the chance, would you want to prevent a stroke from happening?
Each of the following attributes includes a percentage that indicates stroke risk.
Circle the risk factor that applies to you:
- Hypertension 47.9% (high blood pressure)
- Physical inactivity 35.8% ( sedentary lifestyle- too much sitting- insufficient physical activity)
- Lipids LDL Cholesterol 26.8% Poor diet 23.2% (too many calories or poor nutritional value)
- Obesity 18.6% (excess body fat)
- BMI of > 30 (and high waist circumference)
- Smoking 12.4%
- Cardiac causes 9.1%
- Alcoholic intake 5.8%
- Stress 5.8%
- Diabetes 3.9%
Hypertension or high blood pressure holds the top spot and should be the primary focus of a focused exercise program and lifestyle modification.
Your physician may prescribe medication to lower your risk factors, remember that many medications come with immediate and long-term side effects that can effect your quality of life.
Choose lifestyle modification as your first defense for high blood pressure. Many other medical conditions can be prevented, better managed and treated with targeted exercise. Ask your certified personal fitness professional how to get started. (Source IDEA Fitness Journal October 2016)
A lifetime of wear and tear, the effects of a sedentary lifestyle(too much sitting) and other poor lifestyle choices catches up when we reach midlife and accumulate in those later years with chronic health and medical problems, causing dis-function and pain, and eventually loss of independence or early death. Pretty bleak outlook, right?
However; THE GOOD NEWS is that it is never too late change improve your habits and begin regular exercise and reap the benefits. No matter what your age, most of us have the ability to restore and regain function, improve health and prevent or postpone development of additional chronic medical conditions. Beginning an exercise program when you are having medical problems can help offset the immediate and long term effects.
Exercise programs specifically designed to improve your medical condition can help you better manage and even treat the condition( i.e. arthritis, diabetes, osteoporosis and osteopenia, heart disease, stroke, joint replacements, back problems, etc). Even seniors well into their 90's can benefit from beginning regularly performed targeted exercises and can add years to their life and improve quality of life with improved strength, stamina, balance and mobility, and just feeling just feeling better.
Unfortunately, many seniors have given up and have accepted that life must end in pain and disfunction, disability and dependency. Most older adults beginning with a targeted exercise and physical activity plan can make dramatic improvements in functional health, such as the strength to get up from a chair, walk the stairs, getting in and out of a car, basic self care and performing recreational activities that require balance and mobility with less pain and confidence.
In general, the more medical conditions you have and more severity increases the more targeted your exercise program needs to be to receive desired results.
Staying healthy and free of injury is essential for older adults who desire to stay independent for as long as possible. It takes good strength, balance and mobility to protect our independence from falls and related injuries. One-third of people 65 and older falls annually, and 1 out of 5 falls causes a serious injury such as head trauma, hip or other bone fracture. More than two-thirds of deaths from falls were at home and 40% of older adults receiving chronic or long-term care are due to fall injuries.
When a client contacts us to begin an exercise program to help him/her restore and optimize strength, vigor, balance and mobility for optimal health and to perform with ease activities of daily living, we get excited! Helping people achieve health, function and fitness beyond their imagination is our specialty. How we get you started:
- Client request a Medical Release for Exercise Testing and Exercise Training from healthcare provider
- Client completes a Health Medical History Questionnaire so we learn more about the you
- When client has available, we also request a copy of the most recent blood test as well as bone density scan results
- We review client medical release, completed questionnaire, blood test and bone density information
- Client goes through Take-In Screening, this includes taking vital signs such as blood pressure, pulse, body weight, BMI and a Fall Risk Screen.
- The Fall-Risk Screen can tell us if the client is at risk for falling and at risk for losing independence
- The next assessment will be a Balance and Mobility Assessment which can identify the type of balance and mobility exercises to select to provide optimal benefits
- The last assessment will be the Senior Fitness Test, this functional fitness test shows the client’s strength and weakness and if he/she is at risk for losing independence
- We analyze all data and develop a Physical Activity Plan, an Exercise Program with a Personal Training Workout Program and Independent Exercise Recommendations.
- Personal training for optimal results is recommended to be performed at a minimum of two to three times per week.
- Re-assessments of the Fall Risk Screen, Balance and Mobility Assessment and Senior Fitness Test is performed at 3 to 6 month intervals to make sure the individual is on track in keeping their functional health, to track changes over time where we can readjust the exercise program, and when medical status changes.
When you have been diagnosed with pre-diabetes type 2 or have diabetes type 2, physical activity and targeted exercise can improve the condition and can reduce the risk for developing related medical condition. Targeted exercise and physical activity and often leads to needing reduced dosage of medication which avoids the side effects many medications bring along with them.
The ‘Magic Pill’ called exercise helps reduce body fat, better manage bodyweight, boost bone health (helps in prevention of osteoporosis and osteopenia), reduce blood sugar, lower Hemoglobin A1c, improves overall health, increases functional fitness level, improves mood, feeling better, among older adults a reduced risk for falls and related injuries, and maintain and sustain a higher quality of life.
Prevention and improvement of chronic medical conditions such as diabetes type 2 is possible with targeted exercise training combined with lifestyle physical activity which reduces daily blood sugar levels and lower hemoglobin A1c. Regular targeted exercise has also proven to have the same effects on blood sugar as several commonly prescribed diabetes drugs. Being able to reduce the dosage of medication and even eliminating the medication all together results in less or no side effects. Side effects, especially in older adults often lead to increased fall risk, injuries and disability, and death.
Prevention: Healthy life style habits can prevent the development of most chronic medical conditions common in the United States. Adopting regular exercise, healthy, sensible nutrition and stress relief can reverse Diagnosed Pre-Diabetes condition by preventing the development of full blown diabetes.
Management: In persons with type 2 diabetes, a reduction in daily blood sugar and a lower A1c can dramatically reduce development of the many diabetes related medical conditions (i.e. dementia, heart disease, peripheral neuropathy in hands, leg and feet, balance problems, falls, Charcot, amputations, and loss of vision) which not only affect quality of life due to long term disability and high healthcare costs, but also the length of one’s life.
Benefit: Physical activity and targeted exercise increases muscle strength and thus increases your blood sugar uptake, this lowers your daily blood sugar levels and over a period of several months’ results in a reduction in Hemoglobin A1c. That ‘Magic Pill’ is within your reach, it starts with a ‘single step and movement’.
What we can do for you: after we receive a Medical Release for exercise and you have completed your Health Medical Health History Questionnaire, we will ask if you have available your most recent blood test and bone density test, and schedule you for initial screening and assessments.
After a careful review and evaluations, we develop your Recommended Physical Activity Plan and design your Exercise Program. If needed we also seek the assistance of our Certified Diabetes Educator to help you better manage your blood sugar and make sure you thoroughly understand how to manipulate your food intake, physical activity and exercise regime to best manage your blood sugar and avoid spikes of hypoglycemia and hyperglycemia which can damage your nerve and brain cells.
Living successfully with diabetes and avoiding development of this disease in the first place is possible.
When preparing Exercise Prescriptions and Physical Activity Plans for new clients I often include daily walking as part of the weekly exercise program.
Many clients however tell me that they do not like to walk without a purpose.
What bigger purpose is there than walking to improve your personal health and well-being?
Below are some more ideas to walk with a purpose:
• Boost your energy level
• Expend energy to better manage your body weight
• Improve and strengthens functions of the heart
• Improves oxygen flow throughout the body
• Reduces the hazardous effects of sitting
• Transport yourself
• Enhances brain function and problem solving skills
• As you age, a brisk walk can help you avoid incontinence
• Extend your independence
As a variation Nordic Walking can bring you daily walk into 4-wheel drive walking mode with an even higher boost in energy expenditure and boost in muscle strength and endurance.
How long for health improvements? 30 minutes on most days of the week
How long for weightloss? up to 90 minutes on most days of the week is recommended to lose weight and better manage body weight.
How many steps? for the average person 10.000 steps are receommneded, for the older adult it is 6000 steps
Exercise professonals serve as extensions of a Healthcare" Team"- working with the clinical care team on the other side of the healthcare system-to-community bridge. Exercise is Medicine (EIM)is focused on encouraging primary care physicians and other health care providers to include physical activity when designing treatment plans for patients and referring their patients to EIM Credentialed Exercise and Exercise Professionals.
Physical acvtivity and exercise are integral in the prevention and treatments of diseases and should be regularly assessed and "treated" as part of all healthcare. Exercise is a powerful complement to traditional medical intervention, and in many instances, allows a physician to significantly reduce a patient's drug dosage or eliminate the need for medicine altogether.
Unfortunately the media and our society bombard us with drug advertisements on TV and many magazines with many causing more serious side effects than the condition for which it is to be taken.
We are all familiar with the Declaration of Independence, why become dependent on drugs that are unnecessary, harm your body and decrease your quality of life?
Sign your own Declaration of Independence and adopt lifestyle habits that include physical activity, exercise, healthful and sensible nutrition. It is called Lifestyle Medicine! Free yourself from unnecessary and damaging medications and drugs, and Live the American Dream "Let Freedom Ring"