Corporate Fitness and Active Aging

Working with a senior population, the most commonly asked question I probably get is “How can I strengthen my legs/back/core.. etc?” As exercise professionals, we already know how as far as the exercise prescription goes, but with seniors, modality often becomes a challenge. Our clients typically have a whole range of physical issues to deal with including joint pain, balance issues, and overall weakness so the traditional sit-to-stand exercises aren’t always applicable. That’s where the TRX suspension training system comes into play.

The TRX was originally developed for Navy SEALS and other elite level soldiers and athletes, but over the years, it has worked its way into home gyms, rehab clinics, and even senior living communities. The TRX is portable, adjustable for all heights, allows you to control ROM, challenges core strength with almost every single exercise, and has hundreds of possible exercises your clients can enjoy.

When it comes to building strength in seniors, ACSM guidelines and other research will tell us that more repetitions are effective when it comes to older adult populations. But there is also evidence eccentric movements are also beneficial due to its reduced oxygen requirement lowering the metabolic demand, and the fact that muscles can move more weight in the lengthening phase versus the shortening phase (concentric).The TRX allows the use of both approaches to strength building, without any additional equipment, such as free weights.

For example, If I am working with a client who can only perform a few sit to stands by pushing off of their thighs or arm rests of a chair, simply prescribing more sit-to-stands may not be the best route, especially if the clients gets frustrated. Instead, I could place the client in a chair in front of a TRX, and use it for an assisted sit-to-stand! Simply have the client start standing up, and begin the descent down into the chair, making sure the hips are hinged back, the knees are bending and in alignment (as best as they can be) and have them sit as gently as possible. Then, perform the same exercise in reverse to stand up. Since the client already struggle to stand up without pushing, they can use the TRX to help pull themselves up, while pushing through the legs. Once the client has a feel for the exercise and can perform it safely, you could then start modifying the repetitions, intensity, and better yet, progress from sit-to-stand to a TRX assisted squat!

And that was just one example. If you have a client that’s looking to improve posture, a bit of upper body strength and core, the TRX row is a very easy to teach and effective. With the TRX adjusted to the proper height, have the client stand with the straps in both hands, with soft knees, shoulders down, and core engaged. Make sure you are standing behind them for safety purposes. Have client begin to lean back, allowing the elbows to leave their sides and begin to straighten out. Then, once the full ROM has been achieved, have the client drive their elbows back while squeezing the scapula together, returning to the starting position.

With limitless exercise possibilities, portability, and affordability, the TRX is perhaps the ultimate strength builder for seniors. The TRX company themselves have put out hundreds of videos on how to teach the exercises, ques, and progressions, so there are plenty of resources out there on how to use it. They even have their own certification courses! I would recommend any and all senior living communities to invest in the TRX and the education of their fitness professionals.

We all know that exercise is great for your health, but too often we think of improving our health as being able to move better, losing weight, having more energy, decreasing stress, or even improving our heart health, which are all great benefits don’t get me wrong! However, did you know that exercise can improve our memory and cognitive function as well? If not, you aren’t alone. The benefits that exercise can give our brain often tend to be overlooked.

Studies have shown that active individuals who are middle aged or older perform better on memory tests than those who are inactive. The best part is that being physically active does not have to mean doing an intense workout 7 days a week. Many studies have compared physically active people to those who are sedentary. These physically active people could simply be getting up and walking around for a few minutes every hour or going for a 20-minute walk at a leisurely pace most days of the week. Of course, being in the health and fitness field, we like to encourage individuals to try more formal types of exercise as well, but the benefits of simply getting up and moving should not be forgotten, especially when it comes to brain health.

A recent study that was published in November 2021 in the Journal of Neuroscience* found that active individuals in their 80s scored better on cognitive and memory tests than those individuals in the same age group who were more sedentary. The researchers also found that after some of the individuals had died, they were able to look at their brains and see that the inactive individuals showed greater signs of memory loss due to Alzheimer’s disease. Once again, I think it’s important to note that of the active individuals, there were few who formally exercised. Those who were in the active group simply moved more and spent less time being still.

So, what does that mean for us? It means, keep moving! If you find yourself sitting for long periods of time throughout the day, try the following tips:

• Set an alarm to go off every hour or put up a sticky note near your favorite chair that reminds you to move.
• Walk the halls in your community or, when the weather is nice, walk around the grounds for 15-20 minutes.
• See your NIFS fitness staff for some stretches that you can do at home while you’re watching TV
• If you want to really keep your memory and cognitive function sharp, try combining movement with spelling words or assigning a movement with a color. For example, you are assigned blue to stepping forward, red to stepping sideways, and yellow to stepping backwards. Have a friend say one of the colors and step to the direction associated with the color. The challenge is remembering which direction is assigned to each color. You can challenge the brain, while having fun!
  
  

Working on one’s strength, agility, form, balance and flexibility are all so very important. Building/working on one’s strength helps prevent or lessen an injury. Using weights helps to strengthen the muscles. That being said, working the same muscles every day is not beneficial. Muscles need time to recover. Doing repetitive movements breaks the muscles down and causes wear and tear which leads to injury.

An example would be a marathon runner. Many runners only run, which puts a lot of strain on the body. Some runners cross-train (cross-training is doing another from of exercise that helps your muscles work in another way. (elliptical, bike, swim)).

Cross-training helps the muscles to work differently. Some runners have this thought that if they lift weights it will slow them down. When it’s actually the opposite. Weight training helps strengthen the muscles that the pressure is putting on those joints and body parts while running.

Switching up a land based class to an aqua class

Bike > Nustep

Nustep > Elliptical

All of these things will force one to use their muscles differently.

Another thing one can do while on a piece of cardio equipment is change the resistance and or speed on the machine. Increasing the resistance for 30 seconds to 2 minutes will get the muscles to work harder. Then go back to where you started from. The same with speeding up on the bike or Nustep for 30 second intervals and then going back to the starting pace.

While using weights, the amount of weights that one uses should be changed up for 6-8 weeks or maybe earlier depending on the individual. The muscles need to be challenged, by using the exact same weight all the time doesn’t do that for a person. When the same weights are being used over and over the body is going through the motions. Even if you can’t do as many reps, build up to the amount of reps you are doing with the new weights. Do one set with heavier weights, go back to the original, then go back to the new weight.

It is important to keep track of how long you have done the same workout for. It would be great if one can remember to change it up every 6-8 weeks. This will keep shocking and challenging the body to be the best it can.

Compare this to eating the same food all of the time, one gets bored and loses the flavor. The same goes for exercise, the body gets bored and doesn’t get the results that are wanted by doing the same thing all of the time.

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.