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The Health And Wellness Coach’s Value Proposition

Every potential coaching client is looking to have the question ‘What’s in it for me?’ answered. Every coach needs to be able to succinctly answer that question by conveying what they will provide for their client.

Potential coaching clients are rarely familiar with what a coach, especially a health & wellness coach, can do for them. They are used to dealing with educators and consultants, medical and otherwise, not coaches. Usually clients expect to be directed, educated, and led in the best direction for them. All too often they hear a wellness coach tell them something like:

“I’m not going to tell you what to do. I’m not going to tell you what to eat or how to exercise. You’re the one in charge. You’re the one behind the steering wheel. You’ll be making your own wellness plan, and I’ll help you follow it.”

Why should this person become your client when it appears that they, themselves, are going to be doing all the work? Our client-centered approach to coaching does not mean we are not providing value, however we have to communicate the value of what we offer, and do it very clearly. What will the client gain from coaching?

This is true for the self-employed coach as well as the coach working for a wellness program, a disease management company, an insurance carrier, or any other organization that provides wellness and health coaching. It is about engagement. When coaches are confronted with the “incentivized” client, who is reluctantly complying with coaching in order to get their prize (or much-needed insurance discount), conveying the Health And Wellness Coach’s Value Proposition is more vital than ever.

Here is my way of presenting The Health And Wellness Coach’s Value Proposition. Please adapt to your own words and use it!

The Health And Wellness Coach’s Value Proposition*

“Thank you for your interest in improving your lifestyle and your life. You may be new to coaching, and especially wellness coaching, so let me share with you the value that it brings.

Wellness/health coaching is all about you living the best life possible for you. To do that most people find there needs to be some improvements in their way of living, their lifestyle. Making those improvements, those changes is challenging when you have to do it all by yourself. Perhaps you’ve already had some experience with that.

When I work with someone in coaching I’m here to serve you. You are the one in charge of your life and our work together. It’s your hands on the steering wheel. I’m not going to tell you what to do and give you a pre-maid wellness plan. But, together we can co-create a plan to help you succeed at making the lifestyle improvements that you want to make.

As your coach I will be working with you to get very clear about where you are at with your health and well being right now. We’ll help you take stock of that by exploring together, using some coaching tools that will help give you a more complete picture, and by going over the lifestyle improvement recommendations you’ve gotten from treatment professionals. Then we’ll work together to help you form a clear picture of the kind of life you want to live, your healthiest life possible for you. We’ll compare where you’re at and where you want to be and together form a solid plan to help you get there.

Once we have that plan we’ll work together as allies to help you be accountable to yourself and follow through on the steps you need to be taking on a regular basis to help you achieve the goals you have in your plan. I’ll be with you throughout the journey. I’ll be there to help you strategize over, under, around and through the barriers that come up. I’ll help you with challenges that make it tough for you to live the healthy life you want and together we’ll help you keep on track. Together we’ll help you find and develop the sources of support that will make your changes last. We’ll evaluate our progress and adjust the course along the way as we need to. My goal is to assist you in becoming self-sufficient in your wellness, to be able to live a healthy life in a completely sustainable way.

I bring the value of a professional that knows about succeeding at lifestyle improvement. I bring the value of an ally.”

*Created by Michael Arloski, Ph.D., PCC, CWP. Please adapt to your own words and use it! If used intact you must include authorship credit and contact information (Real Balance Global Wellness Services, Inc, https://www.realbalance.com). 


Originally published on Real Balance blog. Reprinted with permission.

Dr. Michael Arloski is the CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). Real Balance has trained thousands of wellness coaches worldwide. Dr. Arloski is a board member of The National Wellness Institute, and a founding member of the executive team of The National Consortium For Credentialing Health and Wellness Coaches. He is author of the leading book in the field of wellness coaching: Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.

senior-woman-virtual-exercise

Two Big Fitness Marketing Mistakes Post Pandemic

If you make either of these two big fitness marketing mistakes post-pandemic, it will cost you. You’re going to make them totally unintentionally. I mean of course, right? Why would anyone intentionally make a marketing mistake?

Beyond that, though you may think that yes, you’ve got these two bases covered and realize after reading this and listening to my podcast on the topic, no you don’t.

One way you know is you’re attracting the wrong kind of people.

Another way is you’re not getting any engagement on your social or your content marketing. 

If you confuse, you lose.

  • What are you sharing in your social media posts?
  • Do people understand what you do, why you do it?
  • Are you establishing yourself as a go-to authority in the area where you want people to find you for programs, products, and services?

Analyze:

  • The name of your social media profile
  • The posts you create (one by one because that’s how they see them)
  • The way you’ve positioned yourself

And then apply this to the following to avoid the two biggest fitness marketing mistakes

Big Fitness Marketing Mistake #1: No Specific Audience

The other day I reviewed a business website and social media platforms as part of a social media audit. It was hard to know who the ideal customer was and if I couldn’t tell as a fitness marketer looking for it, how could anyone?

Just because you’re focused on a certain age and gender (demographic), it doesn’t mean that everyone in that demographic wants the same thing.

First, there’s your niche. Are you about food, exercise, mindset, hormones, weight loss? What is your specific niche?

But that’s not even enough.

Here’s an example

Take women in menopause. Many are married, but an almost equal number are single. Are you talking about dating? About traveling alone? Or about family vacations? About drinking wines and trips to Napa? Some (I’m one) wouldn’t enjoy that at all because they rarely, and then barely, drink.

Some women have a conservative view of menopause, what’s happening and possible, while others are thinking about doing triathlons after retirement. Who are you talking to?

Women in perimenopause are more likely to have kids at home full-time jobs, and a unique set of problems, compared to women just post-menopause. There’s a subset of women in post-menopause who did have children later… so who are you talking to? Define it very specifically. And realize, they need to feel “like you.” If your images, videos and copy doesn’t resonate with who they are or want to be, you miss the opportunity to help women looking for you.

Find out the #2 biggest fitness marketing mistake and listen to Debra’s podcast on this topic… visit Debra’s blog, Fitness Marketing Mastery


Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She serves on the MedFit Education Foundation Advisory Board, is an international fitness presenter, and author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

corrective-exercise-stretching-fitness

Benefits of Being a Corrective Exercise Specialist

Research shows that 90% of people report painful and limiting musculoskeletal conditions affecting the success of their workouts. (4) In response to this need corrective exercise is booming with fitness professionals becoming educated about musculoskeletal assessments, movement analysis and corrective exercise to help both themselves and their clients feel and function better. Becoming a specialist in corrective exercise and integrating these strategies into your fitness business has many advantages. 

  • Attract More Clients: Latest research indicates the number one reason people seek the help of a fitness professional is to assist them with muscle/joint pain. (4) If you are qualified to address these problems, you will attract more clients.
  • Increased Revenue: Having a sought-after specialty qualification in corrective exercise has been shown to increase your income by as much as 50%. (1)
  • Utilize Fool-Proof Assessments: When a client comes to you with pain or complains of pain during their workout, you can take a strategic and active approach to assessing and correcting the underlying cause of their problem.
  • Use Proven Methods: The corrective exercise strategies contained in well-recognized corrective exercise certifications like The BioMechanics Method have been tried and tested on real clients and produce unbelievable results. 
  • Design Better Workouts: A better understanding of functional anatomy and movement can not only help you get clients out of pain, but it can also assist you in designing more effective exercises. This enables you to create high-performance programs for both weekend warriors and professional athletes.
  • Accelerate Client Results: Injuries and movement dysfunction limit the types and intensity of workouts clients can perform. Helping clients feel better so they can perform better, both in and out of the gym, lets them realize goals sooner.
  • Keep Clients Coming: When clients get injured, they drop out. Addressing your client’s muscle imbalances and movement dysfunction at the outset of their program decreases the likelihood they will experience pain or injuries and ensures they can continue working with you.
  • Increase Word of Mouth Referrals: The ability to help clients get out of pain and achieve their goals is marketing gold. They will confidently refer friends, family and colleagues to you for help. You will also be able to successfully network with health professionals who need a trusted, qualified corrective exercise specialist to whom they can refer patients.
  • Get Ahead at Work: Latest research indicates that advanced qualifications weigh heavily in an employer’s decision when looking to promote a staff member. (2)
  • Edge out the Competition: Statistics show that 89% of clients are looking for a fitness professional to help them alleviate their aches and pains. Yet only 56% of personal trainers offer corrective exercise services.4 The knowledge and skills you obtain by earning a corrective exercise qualification could provide you with a major competitive edge in the fitness arena.

Helping clients overcome aches and pains can be a profitable and rewarding experience. A sound understanding of biomechanics will allow you to develop and use your practical corrective exercise skills. It also provides an outlet for you to market your unique services and become one of the industry’s most sought-after professionals.


MedFit Network (MFN) members receive 20% off The BioMechanics Method Corrective Exercise Specialist certification. Members can get their discount coupon here.


Justin Price is one of the world’s foremost experts in musculoskeletal assessment and corrective exercise and creator of The BioMechanics Method Corrective Exercise Specialist certification (TBMM-CES).  The BioMechanics Method is the fitness industry’s highest-rated CES credential with trained professionals in over 70 countries. Justin is also the author of several books including The BioMechanics Method for Corrective Exercise academic textbook, a former IDEA Personal Trainer of the Year, and a subject matter expert for The American Council on Exercise, Human Kinetics, PTA Global, PTontheNET, TRX, BOSU, Arthritis Today, BBC, Discovery Health, Los Angeles Times, Men’s Health, MSNBC, New York Times, Newsweek, Time, Wall Street Journal, WebMD and Tennis Magazine.

 

References

  1. NASM. 2015. Annual NASM-CPT Survey. Chandler, AZ: National Academy of Sports Medicine.
  2. National Federation of Personal Trainers, 2012. www.nfpt.com
  3. Price, J. 2018. The Biomechanics Method for Corrective Exercise. Champaign, Illinois: Human Kinetics.
  4. Schroeder, Jan., and Donlin, Ayla. 2013. IDEA Fitness Programs and Equipment Trends Report. IDEA Health & Fitness Association.
female-trainer-senior-client-exercise-ball

Flip the Script: How Fitness Professionals Can Overcome Challenging Clients

If you are a fitness or medical fitness professional, there is a good chance you have heard one or more of the following statements at least once in your career. In fact, there is also a good chance you have heard these statements on a daily basis. 

1. I am a little tired and my muscles are a little sore from our last session, so I am going to cancel today and rest. 

2. I don’t want to do “that exercise” because I have never done it before.

3. My doctor told me that I should not be squatting, bending, reaching, twisting, etc… 

Many of you reading this article can relate to at least one of the above and may have even let out a slight sigh of frustration when it comes to overcoming challenging clients. Overwhelming amounts of research show that exercise can help to improve your health and fitness without hurting your joints.(1) With your current treatment program, exercise can: 

  • Strengthen the muscles around your joints 
  • Help you maintain bone strength 
  • Give you more energy to get through the day 
  • Make it easier to get a good night’s sleep 
  • Help you control your weight 
  • Enhance your quality of life 
  • Improve your balance 

However, many of our clients still believe that exercise will aggravate their joint pain and stiffness, but that is not the case. Lack of exercise actually can make your joints even more painful and stiff.(2) If the muscles and surrounding tissue are strong, it helps to maintain support for your bones. Choosing not to exercise weakens those supporting muscles, creating more stress on your joints. 

While fitness and medical fitness professionals understand the importance of exercise, the way we translate this to our clients is key. Oftentimes, clients receive misinformation along with mixed messages from doctors, family members, friends, and of course, social media. However, after decades of both academic and professional research working with special demographics, I have discovered a powerful technique to increase clients’ willingness to improve their health through exercise. The answer lies not only in showing the client how each exercise emulates real-life situations, but also how it affects their independence.

For example, telling a client, “Today we will be working on how to safely and effectively execute a squat,” is a lot different than saying, “Today we will be practicing our sit to stand movements so that you have the lower body strength and flexibility to rise from your favorite chair without assistance.” 

Most importantly, it is important to reiterate to your client that their lack of strength, mobility, and balance leads to a more sedentary lifestyle that will decrease their ability to function independently as time progresses. Additionally, muscle atrophy, joint immobility and poor flexibility are key indicators that functional movements, or movements that are required to perform everyday tasks, will soon be a thing of the past.

If a client is unwilling to perform various exercises, here are some conversation starters:

  1. Did you know that this is not just an exercise, but one of the foundational movements to support strength, balance and flexibility in your everyday life?
  2. Do you know the definition of functional fitness?
  3. Do you know that this isn’t just an exercise, but will help you walk up and down the stairs, get up from a seat, carry your groceries, and pick up a grandchild?
  4. Are you ready to give up your independence? 

Christine M. Conti, BA, M.Ed, is an international fitness educator and presenter. She currently serves as the Director of Membership for MedFit Network, sits on the MedFit Education Advisory Board and is a course author for MedFit Classroom. She is also CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation and co-host of Two Fit Crazies & A Microphone Podcast

Check out Christine’s online course with MedFit Classroom, Arthritis Fitness Specialist:

References

  1. CDC: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. (2021, April 5). Benefits of Physical Activity. Center for Disease Control and Prevention. Retrieved September 10, 2021, from https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
  2. Mayo Clinic. (2021). Exercising With Arthritis: Improve Your Joint Pain and Stiffness. Mayo Clinic. Retrieved September 9, 2021, from https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20047971
food-and-vegetable-coop-box

Breast Cancer: How To Reduce Your Risk | Fact Sheet from PCRM

A healthy diet and lifestyle can lower your risk of getting breast cancer.

These four simple tips can boost your health in other ways, too!

Choose Plant-Based Foods

Healthy foods from plants (vegetables, fruits, whole grains, and beans) can lower your breast cancer risk in several ways. They are often low in calories and high in fiber. This helps you feel full and lose weight if needed.

High-fiber, low-fat diets can also help reduce estrogen levels. Lower estrogen levels can lower your risk of breast cancer. A recent study showed that eating less fat and more fruits, vegetables, and grains could help protect breast cancer survivors, too. Packed with nutrition, plant-based diets can also reduce the risk of other diseases, like diabetes and heart disease. For the best nutrition, eat a variety of plant foods each day. Be sure to include a good source of vitamin B12, too, such as a supplement. Keep salt intake low, but when you do use salt, choose the iodized kind.

Fill up on veggies.
Not only are they healthy, but some have cancer-fighting nutrients. Try adding broccoli, collard greens, or cabbage to meals.

Eat more soy.
Tofu, soy milk, and edamame may help protect against breast cancer. Studies show that women who eat more soy have a lower risk of breast cancer. Soy foods may help protect women who’ve already had breast cancer, too.

Avoid processed meats.
Hot dogs, bacon, sausage, and lunch meats have been linked to a higher risk of breast cancer. Swap in healthy plant-based proteins like beans, tofu, or nuts instead.

Download the Physicians Committee for Responsible Medicine’s Fact Sheet, Breast Cancer: How To Reduce Your Risk, to read the remaining 3 tips! Feel free to download and share this free resource.


The Physicians Committee for Responsible Medicine is a 501(c)(3) nonprofit organization, headquartered in Washington, DC. Our efforts are dramatically changing the way doctors treat chronic diseases such as diabetes, heart disease, obesity, and cancer. By putting prevention over pills, doctors are empowering their patients to take control of their own health.

Fact sheet shared with permission from PCRM. Click here to view other PCRM Fact Sheets.

seniors-biking-in-gym-group

Exercise’s Impact on Cognition

It’s not news that the brain changes with age. Significant changes in regions of the brain occur in healthy adults as they age, based on MRI studies.(1) The caudate, cerebellum, hippocampus, and association cortices shrunk substantially. This shrinkage in the hippocampus and the cerebellum accelerates with age. The hippocampus, the site for new memory formation, is involved with learning and emotion with a rich supply of estrogen and progesterone receptors. The cerebellum coordinates voluntary movements including all conscious muscular activity, balance, coordination, and speech.

Incidence of Dementia

The United States is experiencing both a declining birth rate and an increased average life span. This combination will increase the percentage of people over the age of 65 to 19.6%, resulting in a total of 71 million people by the year 2030.(2) The number of people over the age of 80 is also expected to increase to 19.5 million by 2030.(2) These changes will greatly increase the number of people with dementia since 6% to 10% of North American individuals aged 65 or older have dementia; this increases to 30% in those aged 85 or over.(3)

Dementia, or senility, is a difficult-to-define cluster of symptoms that include memory loss, loss of vocabulary, and loss of motor function in the absence of a change in the level of consciousness. Dementia can be measured qualitatively by verbal memory tests such as the Blessed Orientation-Memory-Concentration test, comprising six questions as listed in the following table:

The scores from each of the table’s six items are multiplied to produce a weighted score. Score 1 for each incorrect response; weighted error scores greater than 10 are consistent with dementia.(4)

Exercise Affects the Brain

The incidence of Alzheimer’s dementia can be used as a measurement of brain health.(5) As part of his study “Exercise Is Associated With Reduced Risk for Incident Dementia Among Persons 65 Years of Age and Older,” Eric B. Larson, MD, MPH, et al asked 1,740 mentally healthy men and women over the age of 65 how many days per week over the past year they had exercised for at least 15 minutes. The incidence of Alzheimer’s disease (AD) was significantly higher for individuals who exercised fewer than three times per week (19.7 per 1,000 person-years) compared with those who exercised more than three times per week (13 per 1,000 person-years). These results were not influenced by the E4 alleles on the apolipoprotein gene, which indicates a genetic predisposition for AD.

Laura Podewils et al studied the relationship between physical activity and dementia in 3,375 men and women over the course of 5.4 years.(6) Physical activity in these individuals over the age of 65 was assessed via the Minnesota Leisure Time Questionnaire. The subjects were questioned regarding the frequency and duration of their physical activity over the previous two weeks. Like Larson et al, this study found that increased exercise decreased the incidence of Alzheimer’s dementia.

The Mini-Mental State Exam can be used as a measure of cognitive ability or impairment. The 30-point questionnaire commonly used by health care providers screens for dementia, evaluates cognitive impairment, and follows cognitive change over time, making it an effective way to document an individual’s response to treatment.(7) Kristine Yaffe, MD, et al used the Mini-Mental State Exam to show that cognitive performance increases as the number of blocks walked per week increases.(8) The study involved 5,925 women over the age of 65 over a six- to eight-year period.

The most objective measure of cardiovascular fitness is the measurement of the maximum rate of oxygen consumption as measured during incremental exercise—milliliters of oxygen per kilogram of body mass per minute. A subjective measure of exercise amount or duration is not as accurate as the above direct measure, which is called maximum oxygen consumption or VO2 max. Deborah Barnes, PhD, et al conducted a six-year study of 349 individuals over the age of 55 measuring both VO2 max and subjective measures of fitness. Barnes found only the lower levels of VO2 max correlated with cognitive decline.(9) The four studies mentioned show a positive cognitive benefit from exercise. A meta-analysis performed by Colcombe and Kramer from 1966 to 2001 examined 18 studies of fitness training and cognitive function in nondemented older adults. They concluded that fitness training had a positive influence on cognition.(10)

Prospective controlled human studies provide more robust data than both animal and uncontrolled studies. Stanley J. Colcombe et al were the first to show in a prospective controlled setting that increases in cardiovascular fitness in humans results in increased functioning of the prefrontal and parietal cortices. These data suggest that increased cardiovascular fitness can affect improvements in the plasticity of the aging human brain and may serve to reduce both biological and cognitive senescence in humans.(11) In addition, women tended to exhibit the greater benefit.(12) In a literature review, Kramer et al complemented these data through the use of MRI, which is very accurate in the brain. Through this technique, Kramer and colleagues concluded that older adults who participated in the aerobic training group demonstrated a significant increase in gray matter volume in regions of the frontal and superior temporal lobe when compared with controls. The results suggest that even relatively short exercise interventions can begin to restore some of the losses in brain volume associated with normal aging.(12)

Animal studies offer some insight into how aerobic exercise benefits brain function. Aerobic exercise increases brain function in both young and old animals. Aerobic exercise increases the levels of brain-derived neurogenic factor (BDNF) and insulinlike growth factor 1 (IGF-1). BDNF has been shown to regulate neurotransmitters, including dopaminergic and cholinergic systems and may be playing an important role in the exercise-induced effects on the brain.(13) BDNF may be involved in the postexercise changes seen on a brain MRI. In addition, IGF-1 may be mediating the effects of exercise on BDNF, neurogenesis, and cognitive performance. Animal studies provide information on the effects of exercise that is difficult to obtain in human intervention studies. The sum of these animal studies overlaps with results from human studies and suggests that exercise is an effective enhancer of neurocognitive functioning in both young and old animals.(12)

AD, the most common form of dementia, shares many age-related pathophysiological features of type 2 diabetes, including insulin resistance, disrupted glucose metabolism in nonneural tissues, peripheral oxidative and inflammatory stress, amyloid aggregation, neural atrophy, and cognitive decline. Brain insulin resistance appears to be an early and common feature of AD, a phenomenon accompanied by IGF-1 resistance, promoting cognitive decline independent of classic AD pathology.(14) Such a large set of shared features suggests shared etiologies.

Recommendation

High-intensity interval training (HIIT) is a type of endurance training involving short periods of maximal effort followed by periods of maintenance or recovery effort. What can differ is the timing and type of endurance exercise. A typical cycling HIIT pattern may be four to six maximal 30-second cycling sprints separated by 4.5-minute recovery periods of comfortable cycling. When HIIT is compared with longer steady endurance training, the HIIT patterns show increased mitochondrial density in muscle cells and greater muscle performance improvements.(15,16)

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This article was featured in Today’s Geriatric Medicine.

Today’s Geriatric Medicine is a bimonthly trade publication offering news and insights for professionals in elder care.

Get a Free Subscription to Today’s Geriatric Medicine

 


This article was featured in the Jan/Feb 2016 issue of Today’s Geriatric Medicine (Vol. 9 No. 1 P. 26). Written by Robert Drapkin, MD

Robert Drapkin, MD, a medical oncologist and competitive bodybuilder in Clearwater, Florida, specializes in helping elderly adults achieve a healthful lifestyle to combat illnesses or disease and to extend lifespan.

 

References

1. Raz N, Lindenberger U, Rodrigue KM, et al. Regional brain changes in aging healthy adults: general trends, individual differences and modifiers. Cereb Cortex. 2005;15(11):1676-1689.

2. Chapman DP, Williams SM, Strine TW, Anda RF, Moore MJ. Dementia and its implications for public health. Prev Chronic Dis. 2006;3(2):A34.

3. Hendrie HC. Epidemiology of dementia and Alzheimer’s disease. Am J Geriatr Psychiatry. 1998;6(2 Suppl 1):S3-S18.

4. The Blessed Orientation-Memory-Concentration Test. University of Missouri Geriatric Examination Tool Kit website. http://geriatrictoolkit.missouri.edu/cog/bomc.pdf.

5. Larson EB, Wang L, Bowen JD, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med. 2006;144(2):73-81.

6. Podewils LJ, Guallar E, Kuller LH, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol. 2005;161(7):639-651.

7. Pangman VC, Sloan J, Guse L. An examination of psychometric properties of the mini-mental state examination and the standardized mini-mental state examination: implications for clinical practice. Appl Nurs Res. 2000;13(4):209-213.

8. Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med. 2001;161(14):1703-1708.

9. Barnes DE, Yaffe K, Satariano WA, Tager IB. A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc. 2003;51(4):459-465.

10. Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14(2):125-130.

11. Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004;101(9):3316-3321.

12. Kramer AF, Erickson KI, Colcombe SJ. Exercise, cognition, and the aging brain. J Appl Physiol (1985). 2006;101(4):1237-1242.

13. Knüsel B, Winslow JW, Rosenthal A, et al. Promotion of central cholinergic and dopaminergic neuron differentiation by brain-derived neurotrophic factor but not neurotrophin 3. Proc Natl Acad Sci U S A. 1991;88(3):961-965.

14. Talbot K, Wang HY, Kazi H, et al. Demonstrated brain insulin resistance in Alzheimer’s disease patients is associated with IGF-1 resistance, IRS-1 dysregulation, and cognitive decline. J Clin Invest. 2012;122(4):1316-1338.

15. Gibala M. Molecular responses to high-intensity interval exercise. Appl Physiol Nutr Metab. 2009;34(3):428-432.

16. Billat VL. Interval training for performance: a scientific and empirical practice. Special recommendations for middle- and long-distance running. Part I: anaerobic interval training. Sports Med. 2001;31(1):13-31.

Physical therapist gesturing thumbs up besides senior woman on yoga ball

Medical Fitness – A Win for Professional and Patient

Medical Fitness is a growing trend in health care. Medical Fitness helps extend basic healthcare from the classic and formal model of a person being a patient, receiving treatment and being discharged entirely, to after-care professional services. Medical Fitness is the integration of ongoing fitness, wellness and preventive care under the supervision of health professionals such as physical therapists, exercise physiologists, personal trainers, nutritionists, acupuncturists, chiropractors, massage therapists, mental health practitioners, health and wellness coaches, yoga professionals and more.

Medical Fitness is appropriate for many types of conditions such as arthritis, diabetes, orthopedic conditions, pre and post-natal, heart disease, fibromyalgia, stroke, cancer, mental disorders,  and others. When properly implemented, Medical Fitness is a win-win for both patient and health professional.

Physical therapist gesturing thumbs up besides senior woman on yoga ball

Medical Fitness Advantages for the Patient

First, after discharge from the formal healthcare world, the patient can be referred to a variety of health professionals educated in the patient’s condition, providing both a continuum of care and a multi-discipline approach. For example, a person discharged from physical therapy after a total knee replacement might be referred to a certified personal trainer facility educated in post-rehabilitation of a total knee to continue to make further functional gains and improvements. If that person needed help with weight loss, perhaps a referral to a nutritionist would be included. If they also had issues with coping with their diminished function, a consult with a specialist in mental health might be provided as well.

Second, many times the medical facility in which care was provided will have a Medical Fitness component associated with it. Direct referral to this type of facility can provide the patient with security and confidence, being familiar with the facility and with the knowledge that the new health professional is familiar with their condition and diagnosis.

Medical Fitness Advantages for the Health Professional

First, by being part of a Medical Fitness community the health professional can refer a discharged patient for follow up care, secure in the knowledge that their patient will be cared for by an ancillary care professional who is trained and certified to provide a proper continuity of care plan along with the appropriate goals and treatments.

Second, by referring to a Medical Fitness multi-discipline team, the health professional receives security that if their patient has any other issues, those concerns will be addressed. For instance, with the example of the total knee replacement patient needing assistance with weight loss or nutrition consults, (treatments that don’t fall under the umbrella of physical therapy), the physical therapist is assured their patient will be helped to achieve a better transition back into their “non patient” status.

Third, when the health professional refers their patient into a Medical Fitness wellness and preventative care environment, the chance for overall improved outcomes is increased. Patients learn better self-confidence in caring for themselves, taking charge of their own health and lifestyle. If a patient’s condition begins to backslide, the wellness program professionals can help make sure the patient gets referred back to the health professional in a timely manner.

In conclusion, Medical Fitness benefits all involved. Quality of care is improved. Patients receive access to multi- discipline care and can learn to take charge of their life. Health professionals receive security of proper continuity of care and gain improved patient outcomes.


Douglas Feick, PT is a licensed physical therapist in Texas, with emphasis in orthopedics for over 15 years. He is President of BioEx Systems Inc, a software company providing software solutions for physical therapists, athletic trainers, chiropractors, dietitians and personal trainers. His hobbies include scuba diving, raising bees and he is an avid skydiver.

brain-digital-image

The Neuroscience of Mind-Body

In an era where neurological disorders and mental illness run rampant, effective and scalable non-pharmacological interventions are desperately needed. Luckily, science continues to demonstrate the efficacy of exercise-based interventions in improving cognitive, neurobiological, and mental health outcomes in a variety of populations. Multiple modalities of exercise, such as aerobic training and resistance training, continue to demonstrate improvements in several measures associated with brain health. While aerobic exercise has received a majority of the spotlight over the past couple of decades, other forms of exercise have also moved to the forefront of the exercise-neuroscience literature.

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Helping Older Adults Flex their Stress Resilience Muscles 

We can all agree that stress levels have skyrocketed to an all-time high following the “year of fear.” Older adults with chronic conditions have been the hardest hit since they are most vulnerable to Sars-CoV-2 and severe outcomes. Millions have been struggling with the fear of infection and mortality; inactivity and muscle weakness as well as social distancing and isolation. Helping older adults build stress resilience strategies into daily life is critical to bolster and protect physical, mental and social wellbeing.

Living under chronic stress leads to bad decisions. That’s because the part of the brain called the amygdala is activated when under threat. It is our survival brain with the “fight or flight” response being its signature. This means that blood is flowing to the “reactive” brain and away from the “thinking and planning” part of our brain, the pre-frontal cortex.   

This can contribute to poor eating, activity and lifestyle choices. Convenience and processed foods can easily take center stage along with sedentary behaviors and heavier use of drugs and alcohol. This can lead to malnutrition, decreased blood flow and the increased risk and severity of chronic conditions as well as impairing immune function. It is a recipe for dis-ease and higher health risks, particularly in pandemic times.

Chronic stress puts the body into a catabolic state of “breaking down” while also turning down the volume on the body’s anabolic pathways of “building up” (1). The body was designed to live in the parasympathetic state, also known as “rest, digest, heal and repair” mode.  Constantly living in the stress response leads to high levels of cortisol, oxidative stress and pro-inflammatory cytokines (immune messengers). This chemical marinade literally shrinks muscle and brain cells (2).  

Chronic Stress Stinks & Shrinks

What happens when muscle and brain cells atrophy? Sarcopenia and cognitive decline arrive on the scene. This in turn leads to the downward spiral of physical and mental pathology that can include disability, dependency, dementia, an increased risk of falls, fractures and hospitalizations.   

Resilience is a Process

The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress,” or “bouncing back” from difficult experiences (3). It is an adaptive process that can be developed. Being “hardy” or resilient is linked with positive outcomes, including improved functional mobility, health and longevity.  

Medical fitness specialists can help older adults build stress resilience by empowering them with education and encouragement. This can be a powerful intervention as it combines education with behavior modification. It includes asking questions while providing clear messaging that reduce fears and clarify health benefits followed by simple actionable steps. The pro-active older adult can choose to practice the strategies that resonate with them.  Being accountable to and encouraged by a trainer knowledgeable about geriatrics can support the process of building resilience to weather “stress storms.” 

Building Stress Resilience

Like health, resilience is multi-dimensional and includes physical, mental and social components. As fitness professionals, we understand that exercise activity is the most powerful intervention to relieve stress because movement positively impacts the health of every cell in the body and brain. After all, who doesn’t feel better after an appropriate workout or walk in the sunshine?!

5 Simple Strategies

Being mindful of breathing, eating and moving are great ways to build stress resilience.  Living in the present moment helps develop awareness, connection and calm. Avoid overwhelm by choosing to practice one small step at a time.

1. Breathe Deeply. Breath connects body and mind. Stress breathing is shallow breathing. By focusing on the depth and pace of breath, the parasympathetic nervous system is engaged. Encourage older adults to become aware of tension and overwhelm; to take “Breathing Breaks” while focusing on breathing in and out through the nose. It can be as simple as starting with 3 deep breaths and working up to 30.  

2. Eat Slowly. In order to digest food and absorb nutrients properly, eat seated in a relaxed, calm environment.  Encourage older adults to slow down and focus on chewing food 20-30 times. This supports the mechanical breakdown of food for better digestion. While eating, focus on the food’s aroma, flavor, texture, mouth feel and swallowing. 

3. Tea Time. Take a few minutes to savor a warm cup of herbal tea like lemon balm, lavender or chamomile.  Enjoy the aroma and feeling of warmth in hand and the body. This practice is a wonderful way to wind down at the end of the day or as needed.

4. Gratitude Attitude. Before rising and/or going to bed, think about, say out loud or write down 3 things you are grateful for. Practicing gratitude is linked with boosting happiness, optimism and a sense of greater well-being (3).

5. Move more. Inactivity and sedentary time slows down blood flow, metabolism and immune function. Encourage older adults to break up sedentary time with 5 minutes of movement every hour. Light intensity activity like house cleaning has been shown to reduce the risk of mobility disability by 40%! Simply moving more throughout the day is powerful medicine, especially when paired with a tailored exercise program. 

Today, building stress resilience is absolutely critical for older adult’s functional and cognitive health.  They will be so grateful for your guidance!


Cate Reade, MS, RD is a Registered Dietitian, Exercise Physiologist and Functional Medicine Practitioner candidate on a mission to improve functional mobility and health span utilizing the power of lifestyle medicine. She has been teaching, writing and prescribing healthy eating and exercise programs for over 25 years. Today, as CEO of Resistance Dynamics and inventor of the MoveMor™ Mobility Trainer, she develops exercise products and programs that target joint flexibility, strength and balance deficits to help older adults fall less and live more.


References 

  1. Kirwan R et al (2020). Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. Geroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528158/
  2. Mohammed A & Kunugi H (2021). Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era. Int J Endocrinol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152925/
  3. MacLeod, S et al (2016). The impact of resilience among older adults. https://www.sciencedirect.com/science/article/pii/S0197457216000689