When I was in graduate school I discovered in my readings, the differences between open-loop systems and closed-loop systems approach. I fell in love with the Open-loop systems descriptions in business and how it contrasted with the closed loop. In this blog, I will explain what these systems are and how you likely operate in both but you need to invite the open loop systems into your practice and perhaps your own training. I will then explain how my program- MedFit Osteoporosis Fitness Specialist(MOFS)- uses a systems approach and how you can utilize it.
Determined, consistent and tenacious are just a few words I like to use to describe my Parkinson’s Disease “fighters”. I call them “fighters” because instead of lying down and giving up, they have chosen to take charge of their future. They commit to FIGHT BACK against Parkinson’s Disease, and that is a “fight” I want to join!
It is critical that you observe how the “fighter” moves, processes information and responds to challenges. We utilize that information and create fitness programs to address the motor symptoms those living with Parkinson’s Disease (PD) struggle with each and every day.
And the best place to start is with “Foundational Movements” that will broaden a fighter’s Activities of Daily Living (ADL). People living with PD require a unique fitness program to address the impact that PD has on their ADLs.
I encourage Fitness Professionals to start with the most basic form of each Foundational Movement before progressing to a more challenging version. Neurologically, progressive and regressive movements make an impact on people living with PD. I have learned that repetition and exercise phases are a necessary part of any fitness program, similar to the human development process.
Consider how humans learn how to move from birth to 3 years of age. First, we learn a skill such as rolling over and we repeat it until we succeed. Then, we move on to unsupported sitting, followed by crawling until one day we are up and running!
And just in case you are wondering, the best place to start with foundational movements is in the warm-up. The repetition of the drills enables the fighters to improve their form, prepare for the work phase and create new neural patterns that will improve their functionality.
Let’s briefly discuss the movement patterns and how each movement can improve ADLs.
This movement pattern is used daily and assists in maintaining the ability to use synergistic muscular tension, stability and mobility through the torso, hips, knees and ankles. However, every fighter is different which means they will need to start at different levels.
|Seated knee extension||Toileting|
|Squat/stand and lift heels||Cleaning|
Falling or the fear of falling is a significant issue for people living with Parkinson’s Disease. The ability to stand on one leg, shift weight back and forth, maintain an asymmetrical split stance, bend down or get up off the floor is crucial for fall prevention. Lunging, in its various stages, provides Fitness Professionals a way to identify weak links.
NOTE: Some overlap will occur with the lunge and hinge movement.
|Tap one foot behind||Vacuuming|
|Reverse Lunge||Stepping in/out of shower|
|Step one foot forward||Tying shoelaces|
|Forward lunge||Walking up/down stairs|
We ALL need to strengthen our posterior chain but it seems to be the one area many Fitness Professionals shy away from including in their program. When you consider how many times a day someone bends over, they must have the strength and basic knowledge of how to hinge so they don’t fall or hurt themselves.
This is even more important for people living with Parkinson’s Disease. If they fall, it could take months for them to recover and by that time, the disease has progressed. Make it a goal to include a hinge movement in every routine.
|Basic Deadlift with arms crossed||Getting in/out of car|
|Supported Deadlift with one foot behind||Toileting/Showering|
|Traditional Deadlift with weights||Dressing|
|Single Leg Deadlift
|House and Pet Management|
The push-up is one the most popular exercises of all time! Mastering the “push” is a different challenge. The “push” (not always push-ups) requires core stability, upper back and shoulder strength. Once mastered, people living with PD will notice an increase in power and strength.
Word of caution: Parkinson’s Disease typically affects a person’s posture. Please remember that anything overhead will alter the center of gravity which means some fighters need to perform a “push” exercise that keeps the arms closer to the body.
|Wall Push-up||Rising from the floor|
|Push-up on Smith Machine Bar||House cleaning|
|Push-up on knees||Showering|
|Push-up on hands/toes||Pushing large door open|
With so many postural issues due to weak muscles, developing a stronger “pull” will help people living with PD strengthen their back muscles which will decrease falls, improve posture and relieve back pain.
|Shoulder retraction only||Opening refrigerator|
|Shoulder retraction and hold||Vacuuming/sweeping|
|“Row” arms (no weights)||Showering|
|“Row” with tubes||Pulling up pants|
|“Row” with one arm||Picking a child or pet up|
People living with PD want the ability to carry a grocery bag, walk and pull out keys all at the same time. But if they do not know how to use their body correctly, multitasking can be scary. Carry exercises focus on leverage and load. The good thing is we can always make adjustments depending on other variables. For example, bad shoulders mitigate against the overhead version of the carry while weak hands prevent one from carrying heavy loads. Carry exercises don’t necessarily help prevent falling other than the benefits they provide by strengthening the core. However, Fitness Professionals need to remember that carry exercises will serve your fighters in the early pre-kyphosis stage as a posture exercise. Carry exercises also provide a challenging asymmetrical exercise if performed unilaterally.
TIP: The carry movement is a great way to challenge the core without doing crunches!
However, before beginning a gait/carry movement with your fighters, make sure they have been thoroughly assessed.
|Bird dog walk||Carrying laundry basket|
|Farmer’s walk with two weights||Child care|
|Farmer’s walk with one weight||Pet Care|
|Farmer’s walk with one weight overhead||House Management|
The core maintains the stability and strength of the torso and acts as a conduit for energy. The movement patterns listed above encourage core strength which means rotational exercises are not so much a movement pattern as a powerful supplement to the above foundational movements.
Rotational exercises for people living with PD help improve gait and posture, reduce falls, improve coordination and mobility, increase overall strength and, most importantly, enable them to independently perform ADLs.
Rotation Reminders for Fitness Professionals:
- Torso stabilizes the spine and allows movement by coordinating with the pelvic muscles.
- Flex, extend, bend and rotate
- Anti-Rotational Exercises best for beginners. People living with Parkinson’s DIsease often deal with Processing Information issues. Begin with basic exercises in order for fighters to learn proper form and technique.
- Muscles – Rectus Abdominis, obliques, rhomboids, deltoids, glutes, abductors, quads and adductors
Caution! Be sure to include the hips and the lower portion of the spine when rotating.
|Isometric tube hold||Enter/exit tub or shower|
|Isometric tube hold and step laterally||Enter/exit vehicle|
|Circles with tube||Emptying dishwasher|
|Circles with tube/squat||Laundry related activities|
|Torso rotation with tube||All ADL categories|
In closing, when Fitness Professionals learn the art of organizing movement patterns and creating a program that uses these foundational movements, their fighters living with Parkinson’s Disease experience physical gains such as standing without support, joint mobility, active core stabilization, integrated joint action, cognitive improvement and most importantly the ability to handle a challenging moment with confidence.
Having acquired these foundational skills with the help of you, their Fitness Professional, build trust and credibility for supporting a fighter’s long-term commitment to HOPE. As noted at the beginning of this article, our fighters are determined, consistent and tenacious. They have chosen to take charge of their future and FIGHT BACK against Parkinson’s Disease — a “fight” I hope you, as a Fitness Professional, join!
Become a Parkinson’s Fitness Specialist
You can acquire the tools and resources necessary to integrate foundational movements with ADLs within the Parkinson’s community. Sign up for Colleen’s 12.5-hour online course on MedFit Classroom, Parkinson’s Disease Fitness Specialist.
Colleen Bridges has worked for nearly 17 years as an NSCA Certified personal trainer, group exercise instructor and fitness consultant and as an independent contractor for Nashville’s first personal training center, STEPS Fitness. Her passion for understanding the body in sickness and in health, and how it moves, as fed her interest in and enhanced her talent for working with senior adults, especially those living with a neurological disorder such as Parkinson’s Disease.
Alcohol Use Disorder (AUD) may not be the first condition that comes to mind when discussing chronic conditions where exercise can provide substantial benefit. Yet, there is considerable evidence to support the idea that exercise therapy can prove quite beneficial in recovery from AUD Approximately 17.6 million Americans are diagnosed with alcohol addition or dependence each year. Likewise, AUD, like eating disorders, is a chronic condition that must always be managed as relapse occurs in 60-90% of patients (Brown et al.,2009).
I became interested in cardio exercise routines and memory several years ago when my older students began to tell me that their memories seemed to improve after they took my class. I was teaching mostly cardio exercise routines in those days. I started with simple steps and built up to a pretty complex routine. There has to be a connection I thought, between the physical movement, making your brain learn this routine, and improved memory.
A stroke is an obvious turning point in most survivors’ lives. In a best-case scenario, it can be as minor as a mild concussion. At worst, it is a disabling brain injury that leaves the person incapable of caring for themselves—or even breathing on their own. In any case, stroke clients can provide a significant challenge to a trainer wanting to help them, once medical care and primary rehabilitation has plateaued. This is especially true considering the variety of experiences a survivor can have, following a stroke.
Looking for the most powerful cancer-fighting vegetables on the planet? Then feast your eyes (and of course, your body) on the plant foods that have demonstrated the most dramatic protection against cancer: the cruciferous family of vegetables.
“An ounce of prevention is worth a pound of cure.”
This sentiment from Benjamin Franklin is as true today as ever. Especially when it comes to fitness and health. The past 50 years has seen a nearly triple increase in obesity rates for adults and youths. According to the website USAFACTS.ORG. this costs the American people $147 Billion annually. They also state that “roughly have of all medical cost associated with obesity are financed by Medicaid and Medicare”.
We know how important it is to manage and control our body weight to remain at the recommended weight for our health. But did you know that if you’re a sedentary adult who weighed the same today compared to 10 years ago, could actually mean that you’ve gained fat mass? Physically inactive people can lose as much as 3% to 5% of their muscle mass each decade after the age 30. Even if you are active, you’ll still have some muscle loss. As a result, if your weight has remained the same for the past 10 years especially when you’re not physically active, you’ve probably lost muscle mass and gained fat mass instead. This progressive loss of muscle mass is called sarcopenia.
You and your business are probably spending too much time competing in the “red ocean”.
You need to get out of the red ocean and head to safer waters.
I know what you are thinking… What is a red ocean vs. a blue ocean?
This concept comes from the book, Blue Ocean Strategy, and it is important to understand for career growth.
“Red oceans represent all the industries in existence today. This is the known market space.”
This is the market for generally healthy, “fit” clients.
“As the market space gets crowded, prospects for profits and growth are reduced. Products become commodities, and cutthroat competition turns the red ocean bloody.”
Sound familiar in your journey to find clients?
“Blue oceans, in contrast, are defined by untapped market space, demand creation, and the opportunity for highly profitable growth.”
“In blue oceans, competition is irrelevant because the rules of the game are waiting to be set.”
So what does this mean for you?
The red ocean in health and fitness is going after the 15% of the population who is generally healthy and looking for fitness solutions to get fit or lose some weight.
This 15% of the population is looking for great glutes and great abs and benefit from any basic fitness program…
…AND EVERY SINGLE FITNESS BUSINESS IS MARKETING TO THEM.
Hence, it’s the red ocean.
So, What’s the Blue Ocean?
The blue ocean, on the other hand, consists of the millions of people with existing conditions like arthritis, Parkinson’s, or Multiple Sclerosis, for whom the great glutes and abs programs aren’t appropriate
This group is not currently being bombarded with marketing messages about fitness.
These people are in need of fitness services delivered by a specialized professional (which you can become) who understands their condition AND knows how to make programs specific to their needs.
It’s time to start swimming in the blue ocean and get away the “cutthroat competition that turns the red ocean bloody.”
Learn more about the “blue ocean” by watching this free presentation from MedFit Classroom, The New Blue Ocean: Capitalizing on the Opportune Space Between Fitness and Medicine. Industry veteran Phil Kaplan discusses this important topic and how you’ll benefit from targeting this untapped market.