Corporate Fitness and Active Aging

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.

Talk to almost any senior about exercise and physical health and it likely won’t be long before they talk about a fear of falling. Falls become a major risk with every year one ages. For exactly this reason it is vital to prioritize balance and stability when training the senior population. Without the ability and confidence to walk comfortably, get on and off the floor, and move safely into and out of a seated position, seniors sacrifice a certain quality of life. On the contrary, improving balance and stability can dramatically increase the quality of life in senior populations. It’s easier to participate in more activities and socialize more if one is not nervous of stumbling or falling on the way there.

I have found appropriate strength training to make a huge difference improving balance. Several regular attendees of our group fitness classes have remarked that they feel more stable while walking, that they feel more confident getting out of chairs or off of the floor, and that they feel their hips and leg muscles working more to stabilize their body while standing or walking. This improves confidence and allows them to walk further, perform more advanced exercise, and remain more active in their daily lives. Strength can be a life saver! Check out these four tips for seniors to maintain and improve balance:

1. Use your hips!

The entire lumbopelvic complex (core and hips) is helpful for full body balance. The more one improves their core and hip strength, the more these muscles can contribute to full body stability. In our group classes we perform sit to stands (standing up out of a chair), one leg balances (supported against a wall if necessary), seated leg extensions, seated or standing hip abductions, seated or standing marching, and many more exercises that strength train the hip complex to improve balance.

2. Walk more (as long as it feels good)

If you can walk comfortably and without pain, it won’t hurt to add a little extra walking to your daily routine. Every time we walk, we are training our balance as every muscle of our lower body has to constantly be stabilizing as we shift our weight from one foot to the other. Walking is one of the best and simplest exercises to perform and requires no equipment.

3. Stand when possible

Many exercises can be performed seated or standing. As long as you feel comfortable to perform exercises standing, you will be working your balance. Even exercise such as overhead presses or bicep curls will help improve balance as the hips and core need to be active while standing.

4. If you don’t use it you’ll lose it

One of the worse things we all witnessed during the strict COVID lockdown was the loss of physical ability. Daily physical movement that people took for granted was suddenly severely limited. Without a regular daily schedule it becomes very easy to pass the days with little to no physical activity. Many found that their strength, balance, mobility, and endurance had decreased over the course of the lockdown. The best way to avoid this is to find ways to practice balance throughout the day. We have already mentioned walking more, but practicing getting in and out of seated positions, practicing getting on and off the floor, and practicing exercise that help you improve balance will all be critical for maintain these abilities for as long as possible.

Let us know if you have any enjoyable or interesting ways to maintain and train balance! Is your community in need of balance programming? Check Balance Redefined below.

As you might know, just the fear of falling can have significant and lasting impact on older adults or family members’ quality of life. In fact, the fear itself is a risk factor for falls. The good news is that falls can be prevented through balance-specific training and education, which is why NIFS has adopted a comprehensive balance-training method that goes far beyond simply offering balance-training group fitness classes.

It's Time for the Annual Balance Challenge

As part of our commitment to improving balance and reducing the risk of falls, we launched the annual Balance Challenge in 2013 and have been expanding on it ever since. Residents across the country will join us this month as we March into Better Balance with the 8th Annual Balance Challenge. This hallmark program has truly become a fan favorite, and NIFS staff at senior living communities across the country will be focusing on educating their members on fall prevention while providing special balance-training classes, programs, and events.

Participants will be encouraged to complete a Fullerton Advanced Balance Assessment as well as a pre and post self-evaluation survey relating to their perceived levels of balance and confidence. During the month of March, participants will have the opportunity to choose from a menu of programming that includes a balance fair, a fall-prevention presentation, a workshop on how to get up from a fall if one were to occur, small group discussions addressing the fears surrounding falls, a home safety check, and multiple modalities of balance training through group fitness classes, circuit courses, balance games, and more.

One strong advantage of hosting the Balance Challenge is that it shines a spotlight on the fall-prevention program offerings readily available all year long in the fitness center. NIFS staff members regularly collaborate with rehab and the healthcare team at the communities we serve to support resident transitions into and out of therapy. Residents appreciate the opportunity to continue building on the gains they made in rehab with the help of NIFS degreed and certified staff in the fitness center. This strong collaboration with rehab and robust service menu of programs is a great service model for supporting resident well-being year round, and the Balance Challenge serves as a reminder of everything that is available.

Results of Last Year’s Balance Challenge

Last year’s Balance Challenge resulted in many valuable accomplishments:

• Perceived balance: Across the communities, participants’ perception of their balance taken from their pre and post self-evaluations demonstrated a 12% increase in confidence.
• Fear of falls: Across the communities, participants’ fear of falling decreased by 18% as reported from their pre and post self-evaluations following the Balance Challenge.
• Total visits: There was an average increase of 11% in total resident participation to the fitness centers in March 2019 compared to March 2018.
• Group fitness visits: Group fitness classes saw an average increase of 17% participation in March 2019 compared to March 2018.
• Appointment volume: Resident engagement increased by 32% in the number of appointments conducted in March 2019 compared to March 2018.

The data tells a story, and clearly the residents increase their participation in fitness program offerings when there is an emphasis on comprehensive fall-prevention programming. They truly turn out to learn, train, and experience these offerings.

NIFS partners with premier senior living providers across the US to bring their residents best-in-class fitness and wellness programming. The NIFS Balance Challenge is a great example of how our qualified fitness professionals have the skills and resources to support resident well-being while increasing education about fall prevention and increasing overall participation in the fitness program. Click here to learn more about resident successes from participating in NIFS fall-prevention programming. Looking to get started with some balance training exercises? Click here for inspiration!

Check out NIFS Premier Fall Prevention Program: Balance Redefined, our comprehensive approach to fall prevention programming.

Training yourself to do something that feels unnatural is never easy, but it’s also never too late to learn an important skill. Balance is a focal point with our Active Aging population and something our residents are concerned with on a daily basis. Whether it be through designing exercise prescriptions to improve an individual’s balance, leading an educational presentation on aspects of balance, or leading a balance group fitness class, there are countless ways that we as professionals can attempt to help improve someone’s balance.

We recognize the importance of balance because the longer someone can maintain this skill, the longer they are able to remain independent. However, with all of this time, energy, and work dedicated to balance, I notice the same issue coming up consistently: residents are constantly looking down at their feet while they move.

The Lesson: Eyes Up!

When I moved to Virginia six years ago, I was finally in a place to fulfill a lifetime goal of mine: to own a motorcycle. I had no experience riding, I didn’t grow up around bikes, but I just was always fascinated by them and determined to learn to ride one. I am a cautious person, so before I did anything else, I participated in a Motorcycle Safety Foundation® Basic Rider course at a nearby community college. I learned many things during that course, but one lesson that has always stuck with me is instead of focusing on the road directly in front of your wheel, you should be looking down the road and keeping your eyes up. When you keep your eyes up and your focus ahead of you, you give yourself a valuable tool: time.

This is a lesson I work hard to get my residents to understand. When we walk, looking down at our feet gives us a sense of security that we know exactly where our foot is going to be and what our foot is going to land on, but it comes at a price. When our gaze is down at our feet, we can’t see what’s coming. We give ourselves very little time to identify a trip hazard in our path or to plan a route to avoid uneven or unstable surfaces. Much like riding a motorcycle, when you keep your eyes lifted, you give yourself more time to determine your best route because your brain has more time to process what you are seeing and plan accordingly.

Prepare for Balance Challenges

When we know that there are consequences to our actions, we often are very careful with those actions because we know what might result if we are careless. This awareness and concern has had the unfortunate effect of teaching us that we should fear falling and avoid it at all costs, so we look down at our feet. But just like riding a motorcycle, keeping your eyes up and looking well out in front of you may help you avoid obstacles, prepare for any balance challenges, and be safe through fall prevention.

Interested in learning more about NIFS effective balance programming?  NIFS premier fall prevention programming can help set your community apart from the rest. 

Stay active as you age by putting on your dancing shoes! Fred Astaire said “Dancing is a sweat job!” But you don’t have to break a sweat to obtain the benefits of dancing; they have been proven to be unsurpassable. Dancing can be a fun for your residents, it can add a social element to your community, and it's a really good way to keep exercise exciting!

Fitness Benefits of Dancing

Here is a list of some healthy reasons to dance your way to fitness:

• Improved cardiovascular, muscular strength, and flexibility.
• Promotes healthy blood pressure, cholesterol levels, triglyceride levels, and blood sugar.
• Coordination improves as you work through the different movements.
• Lung capacity can increase.
• Bone strength can increase; bone loss can be stopped or slowed down.
• Assists with weight control—half an hour of continuous line dancing can burn an average of 300 calories.
• The social aspects of line dancing are obvious. Your sense of well-being and the camaraderie you have with the other dancers is wonderful for your health.

In addition to the above, did you know that dancing is an excellent brain exercise? It integrates several brain functions at once, increasing connectivity. As people age, maintaining memory and continuing to challenge intelligence is a real priority. What better way than to dance? Dancing requires memorizing steps, and that provides mental challenges that are crucial for brain health. Consider the fact that to execute a dance you need to remember the specific steps that flow in a sequence, and the brain has to inform the body how to move in a timely manner.

Not only does the physical aspect of dancing increase blood flow to the brain, but the social aspect of the activity leads to less stress, depression, and loneliness, which can also cause memory issues.

What Dancing Can Do for Your Balance

Dancing is also all about balance. Dancing consists of changing up the steps, arm patterns, formations, speed, and rhythm. All of these factors play a significant role in maintaining balance. Just envision doing the grapevine movement, where you must maintain balance as one leg crosses behind the other all while in motion.

Read our blog [Balance Programs: Are you meeting your residents needs?]

Not to mention that when you are dancing you are also dual-tasking. Dual-tasking has shown to improve gait and balance because everyday life involves doing one or more things simultaneously (walking and talking, or moving forward and looking to the side as examples). Therefore, when you’re moving your feet one way and arms or head the other in a dance routine, you are dual-tasking. Also don’t forget the fact that you’re having to think which steps come next.

Try the Grapevine Movement

Want to get started? Here’s the simple grapevine movement. Safety always comes first. Designate a place where you can reach to hold on if necessary, and modify your movements if crossing one foot behind the other is too challenging.

A grapevine is a series of steps in one direction, stepping to the side. Count 1, 2, 3, 4 to the beat of the music and do the following:

• Step to the right with the right foot.
• Cross the left foot behind the right foot. (You can modify by just slightly stepping back and not crossing entirely.)
• Step right with the right foot, uncrossing your feet.
• Close your feet together.
• Repeat stepping to the left with your left foot as well.

See how NIFS Premier Balance Redefined Programming enhances resident wellbeing. Download our Media Kit below.

Falls are a big concern for senior living communities. Given the well-known statistics from the Centers for Disease Control and Prevention, it's easy to see why. The National Council On Aging provides compelling numbers as well. This is why we work so hard with our clients to establish robust, evidence-based, year-round programming that focuses on improving resident's balance and strength, as well as their self-confidence.  

One of the key elements for successful balance programming is drawing in as many residents as possible; we've found that the best way to accomplish this is through varied programming. It's not enough to simply put a balance class on the calendar. Communities have to take it one step further and offer other ways to interact.

NIFS Balance Redefined^TM programming offers everything from fitness testing to classes that teach participants how to safely get up from a fall. We've spent years evolving these services as we responded to resident suggestions and evaluated our program data.  Below are stories from residents whose lives have been positively impacted by the work our staff do.

Ms. Weigle

Despite losing her husband just a few days after they moved into the community, Ms. Weigle made a conscious choice to take that difficult first step out of their apartment to meet new neighbors, and within a few weeks someone invited her to try the Balance Class offered by the NIFS fitness center manager. She has been a faithful participant (and ambassador!) ever since and has expanded her lifestyle to include additional activities such as swimming, walking groups, gardening, and studying Spanish. 

Ms. Weigle takes her regular exercise so seriously that she’s told her family not to call in the morning on Mondays, Wednesdays and Fridays because she will be in the pool. When asked, she’s proud to share that through repeat balance testing with the NIFS manager, she is seeing her scores improve.  At 87 years old, she thinks becoming steadier on her feet has helped her in other areas of her health. In fact, in a recent doctor’s visit, she was praised by her doctor for exceptional blood pressure, and she was pleased to share that ankle pain which had long bothered her was no longer a problem. 

[Read more:  Ms. Weigle's full story]

Mrs. Chapin

When Mrs. Chapin moved to her community about ten years ago, she wasn’t new to exercise. With a COPD diagnosis almost 20 years ago, she started swimming laps, and even though she hated to exercise, she kept at it because she knew it was crucial to helping her stay well with a chronic disease. But when she and her husband moved into their community, she took a break from regular exercise to engage in so many of the other opportunities provided. 

She watched her husband’s health gradually decline, so she nudged him to join her for a Balance class, and they were regulars up until his passing last year. Through that loss, Mrs. Chapin felt the support of the members in her class, and was able to keep attending regularly. The social support in NIFS balance programming has been a significant and  positive as she draws her social network from that group. Mrs. Chapin’s annual senior fitness evaluation confirms she’s on the right track with maintaining her balance, but more important than the numbers is how Mrs. Chapin feels. She told us that at 88 years old, she feels steadier than ever and she’s thrilled to still be sewing quilts and clothes, as well as painting, and serving on several resident committees all of which wouldn’t be possible if she wasn’t in good shape. 

Mr. Sadler

Mr. Sadler never used to exercise.  But when he moved to his community in 2009, his decision to start taking group fitness classes and using the pool proved valuable to overcome health challenges that were just around the corner. After a knee replacement surgery didn’t go as expected, he had to have the surgery reversed and replaced the joint with surgical concrete.  Not only did that “fix” leave him unable to walk, he lost significant healthy muscle tissue as well. Following his release from physical therapy, Mr. Sadler was only mobile by scooter or wheelchair and he stopped attending an annual family beach vacation.

He knew his only hope to return to more independence, and maybe to enjoying that annual family vacation again was to get back to a regular exercise routine. After working closely with the NIFS team at his community, he was able to regain significant strength and balance through careful water training. Eventually, he got back to land-based exercise as well and at 87 years old, he has resumed driving and walks confidently with a walker. In 2015, he joined his family again at the beach for their annual vacation. 

[Read more: Mr. Sadler's full story]

Mrs. Boelter

Mrs. Boelter was physical active as a regular water aerobics participant before she moved into her community in 2013.  She was also an avid walker and all of that has continued with the help of the NIFS staff at her community. As her Parkinson’s disease progresses, she feels the importance of maintaining her activity level even more and shared that through regular personal training with the NIFS manager, she has more energy throughout the day. But most noticeably, she is more able to get moving in the morning compared to her previous routine.

Mrs. Boelter noted that although she’s had a number of falls over the past 20 years since she was diagnosed with Parkinson’s disease, she’s had no major falls since she started working with the NIFS staff on her balance. She tells everyone at the community about the benefits of the classes and personal training; she’s a living testament to being able to maintain her independence with regular balance training offered at her community.

Mrs. Moore

Mrs. Moore has been active in the fitness center and with the NIFS staff at her community since she moved in 2004. More recently however, she participated in the NIFS Balance Challenge at the suggestion of the NIFS manager. Through a series of evaluations, education, and fun games, residents engaged in the Balance Challenge understand how to improve their balance as well as how to avoid and manage falls. 

New information on managing falls proved to be very timely for Mrs. Moore when she sustained a fall outside of the clubhouse. After she got her bearings, she was able to use skills she had learned from the NIFS manager during the Challenge to get up on her own without injury. She shared she’s been able to use what she learned through the program to stay active with gardening and to keep up with her grandkids too. She has also become an ambassador for all services connected with balance training at her community. 

[Read more: Mrs. Moore's full story]

It's really common for communities to have missed opportunities when it comes to providing comprehensive fall prevention programming. We can help you spot and fill those gaps to provide exactly what your residents need to feel steadier and confident on their feet. Click below for more information about a free consulting session with NIFS to jump start balance training at your community.