Corporate Fitness and Active Aging

As we age there are many different changes that start to happen to our brain such as shrinkage, vasculature and cognition. With age, the brain shrinks and changes occur at all levels, from chemicals to morphology. Stroke, lesions, and dementia are all more common as people get older, as is memory impairment. Fortunately there are quite a few things we can do to help prevent or slow the process of some of those changes from happening. Regular exercise, a good diet, and low to moderate alcohol consumption, all of which minimize cardiovascular risk, appear to help the aging brain, as does increasing cognitive exertion in the form of schooling, games or meaningful activities. Physical and mental health may be the best defense against the effects of aging on the brain.

When you start to engage in personally meaningful activities whether it be volunteering, exercise, games or hobbies they are known to make you feel healthier and happier. As we age it can be easy to give into that mindset and feeling that we may not be able to do all the same things we used to and leave you feeling discouraged and hopeless. It’s important to remember that really this the perfect time to find new activities and hobbies to try. Learning new skills can improve your thinking ability and memory. Some research on engagement in activities such as music, theater, dance and creative writing has shown promise for improving quality of life and well-being, from better memory and self-esteem to reduced stress and increase social interaction.

Another way to get involved in new activities is to reach out to a friend or neighbor for ideas and for company. Social interactions and social activities are great ways to keep your brain active and engaged with the community around you. Participating in personally meaningful and useful activities with others will leave you happier, and feeling more purposeful. These activities appear to assist and maintain your well-being and may even improve cognitive performance.

Take the time to reach out and spend time with family and friends or donate your time to a local charity or maybe to join a group dedicated to a pastime you enjoy. Join a walking group for senior citizens. Check out what local community organizations have to offer and give them a try. There are more and more groups that meet online, providing a means to interact with others who share your interests or obtain support from the comfort of your own home. Trivia quizzes, sudoku, arts and crafts, word puzzles, learning a new language, starting book club, trying a new workout class are all great ways to keep your mind engaged and busy. Go out of your comfort zone and try something new and take a friend with you.

Other ideas to keep you on your toes:

1. Use your non-dominant hand for everyday tasks ( brushing teeth or eating).
2. Test your memory by creating a list, it could be grocery list or 10 movies you want to watch and then memorize them. See how may you can recall by the end of the day.
3. Jigsaw puzzles are a great brain workout using strategy and problem solving skills.
4. Exercise is a great way to combine physical and mental workouts. They don’t have to get you sweaty you can go walking, take a tai chi or yoga class.
5. Reading is a fantastic brain exercise that stimulates your brain and can slow cognitive decline. Pick up a book from your local library, a magazine at the salon or even read the posters on the walls around you.
   
   

High intensity interval training (HIIT) sounds like something that is best for the 20-40 year old or athletes, however research begs to differ. Studies show that high intensity interval training is good for all ages, even if there are chronic health issues and you’re not a lifelong exerciser. In fact, HIIT workouts may be able to provide more benefits than other less-intense modes of exercises, such as steady state cardio.

Steady state cardio vs Interval training vs HIIT

When most people go to the gym, they get on their favorite piece of cardio equipment set the speed and move at the same rate throughout their workout. This type of cardio is known as steady state cardio. Sometimes, people will use the different functions on the machines such as hills, weight loss or interval training. All of these have a different levels of high and low intensity. This is known as interval training. HIIT workouts are similar to interval training with the primary difference being the intensity of interval. With a HIIT workout the intensity is between 80-95% of your maximum heart rate. (220-your age= your maximum heart rate)

Benefits of HIIT Workouts

Increases Muscle Size and Strength

Did you know it is common to lose eight pounds of muscle as we age? Maintaining or improving muscle mass is not only important for everyday physical tasks like picking things up, reaching for something, getting up out of chair, but healthy muscles are essential for organ function, skin health, immunity and your metabolism.

Stronger Heart and Better Lung Capacity

Numerous studies have found that HIIT workouts are more beneficial than steady state cardio at improving cardiorespiratory. A study published in Cell Metabolism found that cycling between short periods of intense exercise and periods of recover, improved both cardiovascular and respiratory health in older adults. The over-65 group specifically experienced an impressive 69 percent increase in their ability to take in oxygen.

In addition, research shows that HIIT and interval workouts put less stress on the heart when compared to steady state aerobic exercise.

Lower blood sugar and insulin resistance: We know exercising is beneficial for losing weight, however according to a report by the Aarhus Hospital in Denmark, a short 10 minute HIIT routine three times a week, is one of the most effective forms of exercising for reducing type-2 diabetes risk and lowering blood glucose levels to healthy levels.

Improves Memory: Memory loss is something that can affect us all, however as we age our memory recall seems to fade. HIIT exercises are very beneficial for improving memory. Specifically, it improves the high-interference memory—the kind that helps you tell two similar things or memories apart.

Ready, Set, Go: Before starting any new exercise regimen, make sure to get clearance from your doctor. The best way to integrate HIIT workouts into your current exercise plan is to start with longer rest periods, such as 1 minute high intensity followed by a 3 minute recover. As your recovery improves, work on shortening the recovery time. Remember to have an effective HIIT workout, giving yourself time to recover is key.

Some ways to add HIITS to your current workout routine

Walking: Start by walking at a comfortable pace. Then for one minute walk as fast as you can and pump your arms and/or raise your knees. If you’re on a treadmill, increase the elevation. Then walk at a pace that will allow your breathing and heart rate to come down.

Swimming: Swim a few laps at your normal speed, then swim one lap at an all-out sprint. Go back and swim at your normal or a little slower speed.

Bike/Nu Step: Start by peddling with little or no resistance. To raise the intensity you can either increase your speed, increasing resistance or both. After your sprint, go back to the speed/resistance you started with.

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These are both great questions and very important to the older adult population. I hear all the time that people don’t like to drink water because they will need to go the restroom more. This can be an inconvenient especially during the night but in the long term we need to make sure we stay hydrated. Proper hydration is essential in keeping multiple systems of the body functioning properly. Most people need to drink at least three liters of water per day. You can get this water from many different sources including vegetables. If you can get one liter from what you eat during the day with a fruit and vegetable rich diet, then you will only need to drink two liters.

You need to make sure that your fluid needs are also based on activity levels. If you are more sedentary you will not need to consume as much water as if you are out doing intense activity or spending time in the heat. Fluid intake also will need to be increased during times of illness and dehydration. Medication can also increase the need for water intake. As always make sure you are having some of these discussions with your physician. The signs of dehydration can be headaches, fatigue, low blood pressure, dizziness, and nausea. Dehydration occurs when you are losing more water than you take in. When you do feel thirsty make sure to drink water as soon as possible. Delaying water intake will result in dehydration faster. Fad diets can also increase the need of water. When you feel thirsty you want to drink water as soon as possible.

It can be very beneficial to start your day with at least one glass of water. You can have this before breakfast or with your breakfast. This will help to get you on the right track for the rest of the day. I try and have another glass around 10am and then one before lunch. If you are trying to lose weight, drinking water will help you to not overeat as you will feel full sooner. In addition if you are exercising or working outdoors, make sure you have water close by and regularly drink to replace the fluids you are losing through activity.

They make all sorts of flavoring for water to help avoid the same bland taste or you can add sliced fruit for added flavor. I also try to drink a glass of water about half an hour before I go to bed, this allows enough time for me to use the restroom before I go to sleep not disturbing me during the night. This will also help to keep you from dehydration during the night and make sure your body is functioning at its highest level. Interested in better tracking your water intake? You can also purchase a water bottle that will have a measurement to show how much you should drink per hour or allow you to track overall ounces through the day as you drink and refill.

‘’I am so stiff”. This is a statement heard quite often. More than likely, that stiffness or any type of unknown muscle pain may be result due to the lack of muscular flexibility. Flexibility is crucial in preventing muscle shortening while maintaining muscle length. Some additional benefits of flexibility are improved posture, physical performance, and strength. Stretching does not have to be done before or after an intense work out but should be incorporated within our everyday routine. If our muscles are warm, stretching can be done. I’d suggest immediately after a warm shower. Be sure to be grab a chair also. Yes, you can obtain the same results without being in a standing position.

Here are 6 basic seated stretches that can be done daily to improve flexibility:

1. Sit and Reach: This stretch is designed to target your hamstrings which are on the back of your thigh. Tight hamstrings are one of the most common areas of stiffness seen in seniors due to the shortening of the muscle group. To begin slide to the edge of your seat. Starting with one leg out straight and the other at a 90-degree angle, take your hand on the same side of the leg that is out and reach for your foot. You want to make sure that your leg is completely straightened. Your knee should be locked. You may not be able to touch your foot in the beginning, but with practice and consistency that will eventually be your result.
2. Torso Twist: This stretch targets your mid-section/torso. Sitting with great posture at the edge of your seat, take your left hand and place it on the outside of your right knee. If you have an arm rest place your right hand on the arm rest. If an arm rest is not available, place your right hand behind you. You’ll then want to twist at your torso as if you were looking over your shoulder. Repeat these instructions upon twisting to the left.
3. Seated Cat Cow: Cat Cow is a stretch that targets your midsection and your back. Sitting up nice and tall, place your hands on your knees. You will alternate slowly between rounding your back and arching your back. Repeat at least five times.
4. Upper Back Stretch: This stretch focuses on your upper back and shoulders. Wrap both hands around yourself as if you were giving yourself a big hug. You’ll then want to take your hands a pull your shoulders forward and hold.
5. Triceps Stretch: Our triceps are often neglected when exercising, as well as stretching. Start by placing your hand behind your shoulder. You will then take your other hand and place it on the back of your arm, pushing your arm back as far as that muscle allows.
6. Head Tilts: This stretch will target the sides of your neck. By leaning your head to either the right or left, you will begin to feel a stretch down the side of your neck. Try your best to keep your shoulders relaxed. Lifting your shoulders will defeat the purpose of this stretch.

Now that you have this take-home list of stretches, how will you incorporate stretching into your everyday routine?

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Improving balance can be tricky. Where do we start? What even is balance training? Standing on one leg? Walking more? It seems like everyone has their own idea of balance. What we do know, is that it becomes more important for active older adults to build and maintain balance with each passing year.

All of these can certainly help our balance! But a method that has seen success is building strength, endurance, and balance from the ground up. It makes sense after all. Our feet are the only part of our bodies in direct contact with the ground as we walk. It stands to reason that strengthening the foot, ankle, and muscles of the lower legs would be helpful.

We have been incorporating lower leg and foot/ankle exercises for the past year but two of the most practical ones (in my experience) have been the short foot drill (invented by Dr. Vladimir Janda) and the tibialis raise (popularized by Ben Patrick the “knees over toes guy”).

The short foot drill can be complicated to learn and teach but I have found it to be highly beneficial for seniors. It might take a few extra minutes to explain the nuances of the drill but once they have their “lightbulb moment” this drill can be beneficial for essentially any standing movement one encounters. The idea is to spread the toes wide to widen the base of the foot. Try and find the “foot tripod”. This means the 1^st metatarsal (by the big toe), the 5^th metatarsal (by the pinky toe) and the heel. Then gently (think 20% effort) press the tips of the toes into the ground until the 1^st metatarsal head lifts up.

This movement can be further complicated, but I find that this is a good starting point for most people. This movement trains the intrinsic foot muscles which are responsible for building and maintaining the arch of the foot. For those who have flat feet or collapsed arches, this can be an essential movement.

While some residents are still in the process of learning the short foot drill, the ones who have “got it” speak about the benefits. They have noted that it applies to standing exercises as well as balance and stability while walking and standing throughout the days. Some have said it has lessened their knee pain. My personal favorite bit of feedback was from one of our most consistent class attendees who said the short foot drill felt like it was “waking up” her feet and legs. I think it is a very important drill to put time into learning and teaching.

The tibialis raise is (fortunately) a good deal easier to teach and explain. While the typical version is performed standing, I almost always use a modified seated version with our senior fitness classes.

The basic concept behind tibialis raises is to strengthen the often neglected and underdeveloped anterior tibialis muscle. This muscle is responsible for “dorsiflexing” the foot which is a technical term for saying “this muscle lifts the foot up”. When practicing this exercise, I instruct our residents to put their fingers on the tibialis anterior muscle so they can feel it contract as they lift the front of their feet upwards. This has been the most useful method for allowing them to feel the muscle contract. Activating and strengthening this muscle seems to have a positive effect on knee and ankle healthy. The tibialis anterior can be thought of as one of the “braking” muscles of the lower body. When one is walking or changing direction, some of the forces from the ground should be absorbed by the tibialis anterior. When this muscle is weak or inactive that can lead to extra forces irritating the knees or ankles. Having strong and healthy tibialis anterior muscles can protect the legs and increase balance.

As for results, well it depends. There isn’t an exact way to track how effective these exercises are. As mentioned, I have heard great feedback from my residents. When it comes to balance, I think incorporating these two exercises to strengthen and activate the feet and lower legs as part of a comprehensive exercise plan can be highly beneficial to almost anyone.

If you’ve ever worked with older adults you likely know about this love/hate relationship everyone has with any program labeled “Fall Prevention”. Residents are certainly interested in learning about how to prevent falls. They have a healthy fear of falling. But often times, they don’t want to move outside of their comfort zone to practice the things that will actually improve balance and fall prevention.

So what better way to face a fear than head on, right?

That’s what NIFS fitness managers did during Fall Prevention Week. With an average of 50 program participants at each site, there was certainly interest in the topic! Here are some tips for the basics of planning a robust Fall Prevention Week:

Get other departments involved

The week may have been okay without any other staff support, but I think you have a better investment from the community and from the residents when other departments get involved. The first department that comes to mind for this topic is Physical Therapy. Many PT departments were happy to work with NIFS staff in bringing presentations, device checks, and even home safety checks to residents. I think it goes without saying that partnering with Food & Beverage is always fun because who doesn’t like to have snacks? Fortunately, many of our communities also have a dietitian on-site and are able to take it one step further with an event centered on balancing nutrition along with balancing the body. The possibilities are really endless.

Have a mix of interactive and educational events

One of the most popular events across the board was the Fall Prevention Presentation with the Getting Up From a Fall Workshop. During this presentation, NIFS staff members discussed ways to avoid falls in the first place, but they also took the time to demonstrate how to safely fall and (where appropriate) how to get back up off the floor. Participants then had the option to work one-on-one with staff and learn how to safely get themselves onto the floor and back up into a chair without falling. Residents appreciated the chance to learn and then to try things themselves.

Follow up with participants

A key element to Fall Prevention Week is tracking who participated so we know who to reach out to afterwards. There’s always a “next step” available so it’s nice to be able to personalize that according to the needs of the specific participant. For some people, it’s a balance evaluation, for others it might be a 1-on-1 exercise prescription, and for others it’s simply going to be a class recommendation. No matter what the recommendation is, just following up with each individual makes the week more personal and gives them more buy-in to continue working on their own fall prevention skills.

As Fitness Centers and gyms have opened back up after closing from the Pandemic, it’s a good time to restart our exercise routines and habits. There are many components to meet the healthy recommendation for exercise in older adults such as cardio, strength or endurance training, balance, and flexibility. To break it down, I decided to use the same model as the food pyramid and create an exercise version of that pyramid. Over the years the food pyramid has been used to simplify what quantities to eat of what food groups. Larger quantities shown in the bottom of the pyramid and the least quantities at the top. In this model the same concept applies. All components of exercise are necessary for a healthy exercise lifestyle but the exercise components on the bottom should be done more than the quantities at the top.

Cardio can be done almost every day. It is the base foundation of a healthy exercise lifestyle. It should be done about 5 days a week for at least 30 minutes (or 150 minutes/week). It helps strengthen one of the most important organs of the body: the heart. Luckily, it can be done simply through walking, biking or using cardio machines in your local Fitness Center.

Either strength training or endurance should be done at least twice a week on nonconsecutive days and includes exercises for each large muscle group of upper and lower body. Not as often as cardio but still a firm foundation to the body and upkeeping muscle strength to perform ADLs (Activities of Daily Living) like cooking, cleaning, getting around the house or other buildings and activities that make life more enjoyable like hobbies or recreational activities.

Balance and Flexibility are recommended about 2-3 times a week for maybe 10-15 minutes. This becomes important the older we get as every day injuries become more apparent due to falling and low flexibility. It is also important for seniors because as the risk of falling increases and the chances of getting severe injuries from falls increases.

The top category is Rest Days. Everyone’s rest time looks different but is important to everyone’s body. Rest can include proper sleep, rest from exercise or rest from an injury. With rest from sleep, it helps us function better during the day, being more aware of our surroundings to help reduce falls and giving us energy to exercise. Rest from exercise helps prevent an injury from over training. There is a reason strength training isn’t recommended every day. To repair the muscles from training they need to rest to recover and build back up. Rest from injury is another important element to a healthy active life. By not allowing injuries to properly recover decreases the benefits from future exercise as you aren’t able to do it 100% and it may cause more injury due to overcompensation.

There’s no one category of exercise that can help fulfill the benefits of all the different categories combined throughout the week. When residents come to ask what specific exercise, they can do to better their life, is like asking what food they can eat to decrease weight quickly. It must all be combined to reap the benefits of a healthy lifestyle. There are a lot of elements to a healthy lifestyle but broken down into a week, picking just one or two a day will help fulfill a weeks’ worth of exercise recommendation. Just like we need to eat and supply our bodies with energy every day we need to utilize the energy created in the most optimal way to better our life for the next day, week or month.

When we think of aging, some think about wrinkles, aches, and pains and the negative associations of the aging process. Yet there is so much more to aging! No, we cannot stop the aging process, but we can choose to live a healthy lifestyle. This is the time to do things you have never done and find enjoyment.   Here are just a few things to consider when aging gracefully and living your best life!

Be nice to your skin

To keep your skin looking and feeling at its best:

• Stay hydrate. On average we should drink 7-8 cups of water a day to keep our skin looking good and our body functioning appropriately. When we become dehydrated our skin can become dry and folded.
• Wear sunscreen and even a hat to keep the sun off your face
• Wear sunglasses when outdoors to protect your eyes from sun damage
• Use gentle skin care products
• Make sure and have a yearly skin cancer screening

Exercise

Regular exercise helps control your cholesterol, blood pressure, body weight, and reduces the risk of hardening of the arteries, stroke, and heart attack. A good fitness program conditions muscles, tendons, ligaments, and bones to stimulate bone growth and helps prevent osteoporosis while keeping your body limber and lowering your chances of injury. Exercise is also good for managing low back pain, arthritis, and diabetes. Incorporating regular exercise into your life can help you feel better, sleep better and give you the endurance to enjoy your best life.

• It is recommended to participate in cardiovascular exercise 3-5x/week for 30-60 minutes. Walking, dancing, and cycling are examples of cardiovascular exercise.
• It is also recommended to do strengthening exercises 2-3/week. These exercises can be done with weights or bands.

Proper Diet

• Eat food high in fiber to help with healthy digestion and to avoid constipation. High fiber foods will also make your belly full!   Men 51+ need 30 grams of fiber and women 51+ need 21 grams of fiber daily. When increasing your fiber intake start slow and work up to the proper daily intake.
• Fill your plate with 50% fruits and veggies, 25% grains and 25% lean protein. Try to use fresh fruits and veggies that aren’t saturated in sugars and sauces. When choosing grains look for items that are whole grain such as bread, cereals, rice or pasta. And when choosing proteins go for the those that are lean in fat such as peanut butter, nuts/seed, bean, fish, or chicken.
• Limit foods high in cholesterol, sugar and saturated or trans fats.
• Refer to myplate.org for more dietary guidelines for older adults

Mental Health and Mindfulness

Being happy and healthy goes a long way when it comes to mental health. Many factors can affect our mental health and some we don’t even realize. Being mindful of our stresses can improve our focus and our memory.

• To keep your mental health in check surround yourself with good people. People who motivate you to be better and give off positive energy. Spend time with family, friends and loved ones.
• Accept your age. Aging is unavoidable so learn to embrace it and live that best life
• Get sleep. Aim for seven to eight hours of sleep a night. Shut off the electronics and let your brain relax and let your body rest. Getting enough sleep can help reduce stress, depression and even lower your risk of obesity.
• Accept and live in the moment. Focus on the present and don’t stress over things you can’t fix. Engage in activities such as yoga or tai chi.

Though aging is inevitable we can influence how our journey goes.   It is never too late to start making healthy choices for a healthier happy future. Now is the time to age with grace and start living your best life!!

As we age, we are constantly looking for ways to continue living our lives to the absolute fullest. One key element to reducing the effects of aging and to warding off possible health threats is to sustain a healthy and active lifestyle!

Living an active and balanced lifestyle that incorporates a mixture of aerobic, muscular strength and endurance, and balance and flexibility exercises will help to ward off a wide range of diseases. For example, regular exercise helps the body control blood pressure, body fat, heart disease, anatomical and structural impairments, cholesterol, and can even help reduce cognitive decline.

More times than not have I heard clients tell me that the aches and pains, or other health issues they have is just part of aging. While this may be true to some extent, you can still improve your over well-being in your older adult years even if you have never exercised in the past. Of course, the earlier you get started with an exercise routine the better but even just by including a moderate amount of exercise has shown substantial health benefits particularly for adults 50 years and older. Now that you recognize that exercise can help turn around your health at any age, the next step is figuring out what types of activities you enjoy and will be able to stick with long term.

Beginning an exercise program later in life will require you to find more meaning behind why you are moving. As previously mentioned, you should choose activities in which you enjoy doing so that sticking to a regular program is easier. To avoid normal biological changes caused by aging, pursue kinder, gentler workouts that consist of slower and longer warm-ups and cool-downs, and exercise routines that focus on lowering the risk of injury while still promoting posture, strength, endurance, flexibility, agility, and balance.

The most effective type of cardio training for an older adult is low impact physical activities. For example, swimming, walking, cycling etc. Many fitness professionals recommend a minimum of 20 minutes of cardiovascular training most days of the week. Personally, I have found it easier to get clients to commit to a cardio training program when they work their way up to 20 minutes. In other words, starting off small with bouts of cardio in 5–10-minute increments every day and then gradually increase the time. Just getting up and taking a walk around your apartment or through the halls can be a good way to burn some calories and get you moving!

Between the ages of 50-70 years old we lose 30% of our muscle strength. Sedentary adults beyond the age of 50 can expect to lose upwards of about 0.4 pounds of muscle per year. To slow this process down it is important to include strength training exercises into your routine at least twice per week. This way you will allow for adequate rest times for all muscle groups. It is important to have a strong upper body as well as a strong lower body. Increased leg strength has been shown to reduce the risk of falls with seniors greatly. Personally, I find it easier for my clients to stay committed to their strength training routine when they focus on the full body rather than splitting up their upper and lower body day.

One fear many older adults have is their increased risk of falling. On average falls are reported by 1/3 of all individuals over the age of 65. You can easily prevent your risk of falling by including regular balance training into your exercise program. Including a regular stretching routine into your overall exercise program can help to prevent injuries and can even help to increase blood flow to tired muscles, aiding in the recovery process.

The truth of the matter is that exercise is and will always be one of the main elements in living well across the lifespan. There are many ways to get started on an exercise routine. Everything from personalized exercise prescriptions, group fitness classes, and even personal training may be an appropriate starting point. There is something for every active ager out there, so get up and get moving!

In this blog, we covered some of the basics of how exercise is vital to those living with Parkinson’s Disease (PD) in slowing the progression of the disease and managing symptoms. Now let’s chat about creating a Parkinson’s specific group fitness class for your members with PD. For me, group fitness is one of my favorite ways to exercise – something about the fun and engaging group atmosphere, accountability, motivation, and support from peers makes solo-exercise feel especially unappealing some days. Participating in group exercise can have huge benefits for your PD population too, but not just any group class is appropriate. Parkinson’s specific exercise classes can address common symptoms of PD including impaired balance and coordination, stiffness, freezing, poor posture, and limited flexibility/mobility which can in turn help to improve quality of life and help perform ADL’s more easily. Through a carefully developed exercise routine, individuals with PD may be able to slow the progression of the disease and improve their mobility and independence.

First, ensure that you (if you are the instructor), or your fitness staff have had adequate training and educational background on PD and are specialized in the training of individuals with PD to ensure classes are both safe and effective. You’ll want to encourage your members to check with their physician prior to starting a program and we recommend obtaining medical clearance as well.

While considering the unique training needs of members with PD, classes should be adapted to accommodate a variety of ability levels and include a variety of exercises which require both focus and effort. Each member should also be working at a moderate to vigorous intensity for the most effective workout. Utilize the RPE scale to ensure they are feeling somewhere between a 4-6 (moderate) or 7-8 (vigorous) out of 10. The components you want to include are aerobic, strength, balance, multitasking and flexibility for a complete workout. We recommend timing classes to be 50+ minutes in length so you have adequate time to warm up and training time inclusive of all components.

Structuring your classes: Start off with a warmup which includes raising the heart rate, warming up the body, stretching and flexibility exercises and of course some deep breathing. We want our PD members to really focus on deep breaths so they can relax and get a good stretch which in turn will combat muscle rigidity and assist in ADL’s.

Next, shift your focus to include aerobic training and strengthening exercises. Again, for aerobic exercise we want our participants to be working hard! This might be a time to consider adding in some dual tasks for cognition and coordination too! Dual tasks can be combined with any of the other training modalities so make sure to pepper those in often throughout your class. Try things like walking while counting backwards, catching a ball, standing on a foam pad while answering questions, or a variety of compound exercises. For this, just think “multitask” and have participants do two (or more!) things at once. For strengthening exercises, aim to hit the major muscle groups, but at the very least, you want to strongly address the muscles of the core, quads, glutes, back and triceps as they all lose strength and lead to poor postural changes.

Balance training is another essential training component in class as members with PD are two times more likely to fall when compared to those without PD due to slower reaction time, freezing, decline in mobility and balance, and lower body muscle weakness. You’ll definitely want to practice balance exercises and safe movement techniques in every exercise session!

Some other movements to add into your classes include boxing movements, yoga or tai chi practices, big movements, utilizing the voice loudly by counting or singing, and brain teasers or cognitive challenges. As always, end with adequate time to allow the body to cool down, stretch and some more deep breathing.

A few additional considerations as you develop your PD class include choreography and music! Studies have shown dancing and choreographed movements can help with balance, gait, confidence, movement initiation and QOL. Similarly, using music can reduce stress, improve breathing and voice quality, and make it FUN for you participants!