I recently read a fantastic book: “BALANCE In Search of the Lost Sense” by Scott McCredie which reinforces my believe that our body is an amazing machine, a super computer that is capable for making adaptations to the challenges we place upon it even at advanced age(90+ years)!
This book shows that the type of physical activities performed on regular basis affect how well we can live and how efficiently our bodies can function even at advanced age. This books goes into detail about our vestibular system; THE NEXT BIG THING IN FITNESS, how its function affects anyone from a fetus in the womb to older adults with balance problems to pilots, athletes, that it relates to our cognitive function, fear of heights and fear of crowds and most of all that it can improve and that we can maintain its function with appropriate training. You have probably said once or twice in your life that you are “out of shape “, which really is not possible because you are in the shape you have adapted to as a result lifestyle habits and challenges placed upon it. Our function (physical function, cognitive function, optimize our use of vision, proprioception and vestibular) will improve when we challenge it and do it regular and consistently. Even while we are aging we can maintain function to the end.
When you have difficulty getting out of your chair, need a walker for mobility and have had several falls you maybe considering assisted living care, right? This is a decision that should not be made too fast before exploring other options. The other option is targeted exercise and exercise specifically in falls risk reduction.
At age 92 our client X was facing this dilemma, a comprehensive pre-exercise screening determined s/he was at high risk of falling by scoring 2% on the chair stand test and 20% on the 8-foot up and go test with a 38 out of a max 56 score on Berg Balance Scale.
We implemented the multidimensional and multisensory FallProof Balance and Mobility program-training regimen twice a week. Lower body strength improved by 58% bringing our client up to the 60th percentile which is the cut-point score best associated with having the fitness level needed to perform the types of activities required to remain physically independent until late life, with late life defined as age 90 and beyond. Additional improvements experienced: 8-foot up and go test from 20% to 45% and Berg Balance Scale improved from a 36 score to a whopping score of 51(max score is 56).
During the last 3 years client X had a stroke causing a temporary loss of vision, mobility and strength, however with continued multisensory and multi dimensional exercise training client X is in better shape now than before the stroke.
Now 3 years later and 95 years of age, client X is still going strong and is planning again his annual trip to the East Coast.
Falls are the main reason why oldder adults lose independence. Balance problems are often a subject that is ignored for too long to the point that injuries happen.
Question(1) Do you have balance problems, but no falls and do not use a cane or walker or other person to keep you up? If your answer is Yes, a community balance and mobility program may provide benefits.
Question (2) have you had 1 or 2 falls with or without injury? If your answer is yes, a targeted and individualized balance and mobility program and/ or physical therapy may provide best results.
However, speaking with your doctor is important. Also prepare for your Annual Medical Wellness Visit and request a fall risk assessment, this includes:
- Physical exam
- Medication review(CDC STEADY Recommendations)
- Eliminating medication that places you at high risk for falling. For example psychoactive drugs and over the counter drugs such as Tylenol PM(which contains Benadryl and Benadryl
- Reducing doses of medications (e.g. , anti hypertensives) to the lowest effective dose
- Avoiding prescribing medications where the side effect outweighs the benefit(e.g., skeletal muscle relaxants)
- As your doctor to check the following risk factors: Postural dizziness(dizzy standing from seated or lying position)
- Feet and footwear
- Use of mobility aids (cane, walker, another person)
- Visual acuity check
- Vitamin D ( is testing due)
- Calcium, do you need additional supplemention
The following are modifiable risk factors for falling that you can do something about:
- Lower body weakness
- Previous falls
- Muscle weakness
- Gait and balance problems
- Poor vision
- Postural hypotension
- Chronic conditions (e.g., arthritis, stroke, Parkinson's, incontinence, dementia, osteoporosis) Fear of falling
Remember that there are numerous risk factors for falling and these vary between each person. But falls remain the main reason older people lose independence and therefor should be the #1 reason to talk to your doctor about.
The most beneficial balance and mobility programs that provide the best benefits are those that include comprehensive assessments and are individualized, preferably One-on-one and are with a certified balance and mobility specialist (best program is FallProof) or Physical Therapist who specializes in balance and mobility disorders.
Active Aging and Nordic Walking are a Perfect Fit.
Put the spring back into your step or the power back into your walk.
Active Aging Nordic Walking is suitable for older adults that like the challenge of moderate to intense fitness walking, as well as older adults with medical conditions for which the Nordic Walking Poles can help compensate for (e.g. MS, osteoporosis, diabetes, arthritis, joint replacements and joint pain, beginning balance or mobility problems, and more…).
How Nordic Walking can help boost a healthy lifestyle:
· For the older adult with challenging medical conditions:
o When health and mobility challenges or pain in feet, knees, hip, back and hands keep you from [enjoying] your outdoor walking or hiking activities, Nordic Walking poles may give you relief the relief you are looking for.
o Nordic Walking poles can take off stress to feet, knees, hip, and back, and you don’t even have to hold on to the poles when your hands or finger are in pain. Nordic Walking provides physical exercise for the upper and lower body, and the brain, and can provide stability for those beginning to experience balance problems.
o When hand and finger pain is too intense to even hold a cane for stability and balance, the Nordic Walking Poles instead are comfortably strapped to the wrist and have a quick release button for when you need to take off a jacket or sweater or want to get out your water bottle while you are enjoying your outdoor activity.
· For the active aging older adult:
o When maintaining your fitness level, preventing chronic disease and enjoying the outdoors are important to you, Nordic Walking is a great activity to add to your exercise choices to improve and maintain fitness and a healthy lifestyle. This weight bearing activity works on aerobic endurance and muscle endurance for both upper and lower body muscles, promoting both weight maintenance or weight loss, bone density and boosts brain function. Cardiovascular exercise promotes a healthy blood pressure, improved cholesterol and can prevent the risk for developing disease such as diabetes and heart disease. The exercise can also reduce the risk for developing diabetes related medical conditions.
o For the highly fit and athletic:
o Nordic Walking can help you maintain and optimize your health and fitness and is a great choice when running is no longer an option or when you like to take a break from running. Nordic walking originated in Finland when cross-country ski athletes needed to stay in optimal shape and condition during the summer months. Nordic walking can provide a high intensity fitness training choice that works both the body and the brain when correct techniques are learned and used.
I recently travelled to California to obtain training through ANWA(American Nodric Walking Association). This day-long event was very productive and inspiring to me. Nodic Walking is not very popular in Oregon, Nordic Walking poles are not even sold at REI(only walking or hiking sticks, which will not work for Nordic Walking).
I am planning a nordic workshop sometime in the spring. When you are interested in participating please let m eknow. I will keep the group small-upto 6 participants- because I will have to supply poles for participants to work with.
Maintaining bone health is essential throughout cancer treatment for both men and women. A nasty side effect of Intermittent Hormone Therapy is bone loss. Aromatase Inhibitors (AI’s) block the production of estrogen and are associated with an increased risk of osteoporosis sand fractures. For many men following prostate cancer bone loss is not explained by the oncologists. A simple sneeze or couching fit can break or fracture a rib. Vertebrae can break for no reason, causing a curved spine. Nothing good comes from a bend skeletal frame that prevents organs to maximize their abilities such as when lungs are not able to expand fully which are more vulnerable to pneumonia. A broken hip can leave a patient bedridden for a long time.
Dr. Catherine Van Poznak states that diet and exercise (weight bearing activities and resistance training) are the foundation of maintaining and regaining strong bones as well as taking the appropriate amount of calcium and vitamin D supplements. The National Comprehensive Cancer network (NCCN) Task Force on Bone Health in Cancer recommends bone density DEXA screenings regardless of age or gender on a regular basis. Men are advised to have a DEXA scan before starting hormone therapy and again a year later, and to pay attention to bone health.
Osteoporosis in the spine or hip increases the risk of fractures which can also happen by performing inappropriate or high risk exercises or movements. Don’t let your favorite exercise be a bone crushing event. I recommend you consult a qualified health fitness specialist who can analyze your current exercise program or activities of daily living and design a safe bone building and preserving exercise program that still meets your fitness goal.