Exercise scientists help us learn to enjoy movement at any age
To a three-year-old child it may mean crying ‘no’ and running down the hall. In a few more years, the child may feel the joy of independence the first time he can ride his bike all the way to a friend’s house or the day she takes the subway alone.
Seventy years later, independence is no less important to the adult who wants to remain in her own home, plant his own tomatoes, carry a bag of groceries, or simply get in and out of a favorite chair.
But independence can become more of a challenge as bodies and minds change with age. What does it take for an aging adult to maintain independence?
The answer depends on who’s asked. Financial planners, landscapers and interior designers can all give valuable advice. If the senior adult asked exercise scientists Ro DiBrezzo and Inza Fort what is key to maintaining independence, they would start with a one-word answer: “Mobility.”
“To be independent, you have to be somewhat mobile,” DiBrezzo said. “Mobility becomes a huge issue for people in their 70s and older.”
Fear of falling is one barrier to continued mobility for older adults, and DiBrezzo and Fort are quick to point out that it is an understandable fear.
“So many people over 70 do fall. The numbers are gruesome,” DiBrezzo said. “Last year alone in the United States we spent $14 billion on osteoporotic fractures.”
Using research to develop effective fitness programs, Fort, DiBrezzo and their graduate students aim at helping aging adults surmount the barriers between them and an independent life.
Fort is a professor of kinesiology, and DiBrezzo is University Professor of kinesiology and director of the Human Performance Lab in the College of Education and Health Professions. They are also part of the Office for Studies on Aging, a cross-disciplinary program at the university.
With kinesiology graduate students, they have worked with aging adults in community centers or in university health and fitness programs, such as Fitness for Fun. They show people how to prevent falls through strengthening muscles, increasing flexibility and improving balance. Strengthening muscles also strengthens bones as the muscles pull and stress the bone, promoting bone growth and reducing the risk of fractures.
“Many falls happen because the muscles have become weak, and people lose control over their balance because of poor muscle control,” Fort said. “If we can strengthen the muscles, then we’re improving balance.”
The importance of muscle fitness in the older population has been underestimated, according to the researchers, although they are encouraged to see that more physicians are prescribing four to six weeks of physical therapy as part of the recovery process for seniors who have been ill or hospitalized. In their work with older populations, DiBrezzo and Fort have found that older adults often lack the muscle strength and endurance to succeed in any exercise program. Consequently, the university programs deemphasize cardiovascular fitness for frail adults.
Instead, the programs emphasize functional strength and balance. Aging exercisers don’t care about bench-pressing 75 pounds. They care about picking up their laundry and kitty litter or doing light housework and yard work, all the activities that will keep them in their home.
Working with the Office for Studies on Aging, DiBrezzo, Fort and their graduate students offered an exercise program three days a week at a local senior center. After only ten weeks in PUSH, the Project Urging Senior Health, participants showed significant improvements in balance, strength, upper-body flexibility, and levels of HDL, the “good” cholesterol. In subsequent studies conducted with Barbara Shadden, a professor of communication disorders and co-director of the Offices for Studies on Aging, the researchers also found improvement in cognitive function after an exercise program.
Everyone is aging
By now, it’s generally accepted that exercise, particularly cardiovascular exercise, has a host of positive effects on health and daily living, from cutting the risk of cardiovascular disease to increasing metabolism and boosting energy levels.
On one hand, older adults face certain age-related challenges. Oxygen uptake capacity decreases with age, even for those who train regularly. Older people don’t recover as fast from illness or injury.
On the other hand, everyone is aging. Fort pointed out that that the mid to late 20s are the prime years physiologically. Flexibility, in fact, peaks at around 12 or 13 years of age. The trick in the fourth, fifth and sixth decades of life is to adjust, to find enjoyable activities, DiBrezzo said, that can be done “without pain or undue fatigue.”
Yet, less than one third of adults of all ages engage in regular physical activity. Why aren’t more people doing the things that will build strength today and for their next decade of life, like taking a brisk walk, playing softball or jumping in the pool?
One factor that affects who exercises is access to facilities, such as a pool, a park with tennis courts or a ball diamond, or simply a safe area in which to walk.
“We just assume that everybody has the same opportunity to exercise, and they don’t,” DiBrezzo said. “The research tells us that the number one reason kids participate in physical activity is opportunity. Having access to facilities is a big issue at any age.”
When facilities are available, setting realistic goals for exercise is also important.
“Over half of the people who start an exercise program drop out within the first two months because they usually start out too intensely,” Fort said.
With that in mind, Fitness for Fun trainers work with participants to develop realistic goals and to understand that aging bodies may need more warm-up and stretching, and muscles may take longer to recover after exercising.
“A client in her 50s will say ‘I want to weigh 138 pounds, because that’s what I weighed in college,'” DiBrezzo said. “And we have to tell her to let that go. It’s not going to happen.”
What can happen, though, with realistic goals and access to a variety of activities, is a discovery of the pleasure of movement, whether the body doing the moving is 18 or 80. In fact, DiBrezzo and Fort have found that attitudes about physical activity tend to be more a function of gender than of age.
Playing and Working
In an essay published in the Journal of Physical Education, Recreation and Dance, DiBrezzo, Fort and graduate fellow A. Page Glave examined the challenges women face in doing what is necessary to get regular physical activity.
Men, they write, play when they exercise and enjoy the competition of recreational sports. Women often approach exercise as work. It becomes just “one more thing they have to check off on their ‘to do’ list.”
From a practical standpoint, Fort said, “It seems harder for women than men to schedule exercise as part of the day. Women are balancing so many things that they have to make more of a commitment to schedule exercise.”
In their essay, the researchers identified self-worth as a major hurdle for women considering exercise; that is, women seem to have trouble “believing that the time spent exercising is valuable rather than a distraction from other more important responsibilities.” And they ask, “How do we get women to stick with it?”
For one, DiBrezzo and Fort suggest addressing self-worth issues in the beginning of an exercise program. Research has shown that women stick with an exercise program better when they value their own quality of life and engage in “positive self-talk.”
Women also respond to the social aspect of working with a partner. Working with a trainer can increase a woman’s confidence, particularly working with weights, as the researchers saw in exercise programs at the University of Arkansas:
“It is amazing to see women who cowered at the thought of going into the weight room at the beginning of a 10-week exercise program morph into women who ask to ‘work in’ with college-age men toward the end of the program.”
Instead of emphasizing the work in workout, the researchers suggest that physical educators value “the sheer joy of moving and exploring the boundaries of how far we can bend and stretch, how fast we can move, and how gracefully we can negotiate space.” They advocate that women be encouraged to play and to spend more time doing things they love to do that get them moving.
Such an attitude supports regular physical activity at any age.
Exercise vs. Age
What we like to say is that exercise is the great mediator for all things,” DiBrezzo said. “It will slow, it will delay, and at some level, it will actually reverse certain effects of aging.”
One benefit of particular interest to older adults is the effect of exercise on cognition.
“When you talk to anybody over the age of 70, they’ll tell you they want to stay mobile and want to stay sharp,” DiBrezzo said. “And exercise can help do both.”
Some research suggests that exercise will increase cognitive functioning, particularly in the pre-cortex, the area of the brain where executive functioning takes place. Included in executive functioning is working memory.
“We’re seeing people live longer and seeing more Alzheimer’s,” Fort said. “I think exercise has real potential for making a contribution to living independently longer.”
A new area of interest for DiBrezzo and Fort is using higher velocity training with older people, as appropriate to fitness levels. The concern is that trainers using traditional methods may be under-exercising people.
In high velocity training, DiBrezzo explained, the focus is on the speed at which the muscle is contracting. In most traditional exercise programs, trainers instruct people to go slowly, breathing in and out while stretching and contracting.
“Now we’re focusing on the adaptations that happen as the muscle contracts quickly,” DiBrezzo said. “In athletics, we call it explosive movement, and athletes train for explosive movement if they want to increase their vertical jump, for example. We think there may be some real benefits to older populations in training explosively. And of course, ‘explosively’ would be relative to their speed.”
For example, older adults could be doing resistive exercises, perhaps with therapeutic resistance bands, and trainers could instruct them to lift for a count of three, and then release down in a quick, explosive movement that promotes muscle growth.
The senior center adults who participated in PUSH can testify that simple movements – lifting a hand weight, gently twisting a waist – when they are repeated day after day can lead to the strength, balance and flexibility that makes further movement a pleasure. According to DiBrezzo, it is also a key to identity: “I tell people all the time that it is virtually impossible to define who you are without having some element of movement in it. How we negotiate space is in part who we are and how we express ourselves.”
Whether the prancing run of a toddler or a grandparent’s stroll around the park, movement is the key to independence at any age.
Please visit http://coehp.uark.edu/colleague/9082.php to see an article on the Human Performance Laboratory, run by professor Ro DiBrezzo.
Photos show members of the Adult Wellness Center in Rogers, Ark., enjoying a variety of activities.
photos by Russell Cothren, Eric Pipkin and Amanda Ryan