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Lori M Self Evaluation

A Self-Evaluation To Do at Home

Take notice before your muscles begin to evaporate, and you need someone else to take charge.

Here are some questions, allowing you to make a self-evaluation, which can help you decide if you need assistance.

  1. Can you walk 50 feet in 12 seconds? This benchmark is a good indicator of the ability to walk for exercise. If you can’t, it’s time to think about ways to get moving.
  2. Can you walk 400 meters (a little less than a quarter mile) in just over five minutes? For endurance, the threshold is walking 400 meters or about one lap around a high-school track.
  3. Can you stand up from a chair five times in 11 seconds or less? This is a way to assess lower body strength needed for numerous tasks climbing stairs, walking, getting out of a chair or car, picking something up off the floor, getting off the toilet, or stepping out of a tub.
  4. Can you walk 10,000 steps a day? If you can achieve this benchmark, good for you. Studies have shown that it can help protect people from osteoarthritis and from developing mobility problems.
  5. Can you stand still with one foot directly in front of the other for 10 seconds without tipping over? If you didn’t sway or step out, great. Practice more complicated moves by continuing to take ten steps in a straight line without losing your balance. (Click here to take my Balance Quiz.)

Exercise is for everyone. But the truth is, some people, especially seniors, lack the range of motion, strength and flexibility to exercise. That’s especially true for those just starting out.

Assessment tools used by personal trainers are designed to meet the basic criteria that helps to measure physical fitness parameters and functions needed to accomplish activities of daily living.

Reprinted with permission from Lori Michiel. 

Lori Michiel, NASM, has been assisting seniors in their homes since 2006 with customized exercise programs including those designed to address Parkinson’s, metabolic disorders, arthritis and diabetes. These adaptive programs are specifically designed to improve balance, circulation, flexibility, mobility and promote independence. Lori Michiel Fitness has over 40 certified trainers who are matched with clients in Los Angeles, Ventura and Orange Counties. Connect with Lori at www.LoriMichielFitness.com.


Is age truly a number or is it something different entirely?  

Is age truly a number or is it something different entirely?  

Having just turned 50 and totally feeling like I am in my 20s while looking, according to longevity face age technology, like I am in my 30s, I personally had to get to the bottom of this question. 

Over the past year, I have interviewed over 100 different longevity experts, written the best-selling book, the Codes of Longevity, and continue to pore through the research to realize that again and again one key answer keeps popping up. 

What it really means to be an “age” isn’t about good genes, a specific diet, cutting edge therapies, lotions, peptides or supplements, although these all do slow down the aging process.  

Age is experienced, understood, and expressed as a result of our perception. 

A key finding in the largest study to date done by Michigan State University on aging assessed over 1/2 a million people to discover that “our perception of age changes as we age”.     

What you believe and how you perceive yourself, your health and your potential matters! It’s literally the feedback from your brain to your body that plays a key role in either speeding up or slowing down the aging process. 

This is shown again and again in the literature from neuroscience and epigenetics to psychoneuroimmunology that the brain informs, impacts and influences the expression of the cells and your very DNA.  

Have you ever stopped to consider what you perceive about age? 

I remember as a kid seeing the elders in my Italian family at get-togethers as strong, jovial, playful, passionate, and vibrant people. I noticed their beautiful skin, how active they were and decided then and there I was going to age amazingly. 

On the flip side, when I was 35, my mother died of cancer at the young age of 54 and that shifted my belief about what aging might mean for me. 

What do you believe? How do you feel about age, a number, pick a number and consider if there is a person or experience that you can recall that influenced your perception or created a belief inside of you?

You may, like many, think of “youth” as an expression of mental and physical ability fueled by energy, focus, performance, and the capacity to take on whatever comes your way. What do you consider to be “middle-aged” perhaps you think of the body slowing down, weight increasing, energy decreasing, and a mild loss of desire setting in, because “that’s just what happens when we get older”. While “old age” can bring up thoughts of the inevitable breakdown of the body and mind that may one day confine us to a wheelchair or nursing home.  

While yes, there are plenty of examples of this occurring, it doesn’t have to.  

In a study published in the Frontiers in Aging Neuroscience, it was found that people who felt younger than their age scored higher on memory tests, rated themselves as healthy, had more grey matter in the brain and were less likely to have symptoms of depression.

You can begin to shift your perception, reconnect to the youthful you, and actually support your brain and body to reverse age by feeling younger. 

Here are a few ways to practice living life optimized at any age and any stage:  

Check your perception.

What you perceive, you believe. What you believe drives your feelings, emotions, habits, and daily actions. If you really want to express enhanced youthful vitality, begin by checking your perception of age. 

  • Ask yourself, what does age mean to me? Consider how or when you decided that and if it is actually what you want to be true for you today. 
  • Check-in daily and notice what age you perceive yourself to be today. If you want to be “younger” what if anything would you need to believe or feel today to make that possible? 

Set an ageless vision. 

Super centenarians hold a similar growth mindset in common. They don’t get fixed or rigid on what was or what is, they are open and look forward to what is coming while appreciating what is here in the now.  They feel like they will live forever but aren’t afraid to die today. They are beyond time and age.  

  • Check-in daily and ask yourself, what am I ready to more fully experience today? 
  • What am I  grateful for today? 
  • What can I look forward to in the days, weeks, and years ahead?  

As you look ahead while appreciating the moment you align with the feelings that energize, excite and engage you to more fully experience and enjoy your life at every age and every stage.

Learn, play and connect.

If your perception of age changes as you change, then how can you support lifelong vitality?  It’s rooted in novelty and growth.  The brain craves new experiences. Seek out opportunities to learn something new, like a game or hobby that you can play and enjoy with others for enhanced connection.  

Live your purpose.  

Purpose ignites all of the following steps. It’s the meaning from within that fuels your desire to learn, grow, connect, engage, laugh, play, and a part of your”why” you want to live a long youthful life.  

  • To connect, simply notice the moments, the people, the places, and things that feel life-giving and soul-filling.  Make more time, enjoy and experience those encounters more frequently for that youthful energy that gives you the capacity to enjoy your amazing life every day regardless of your age. 

Over the past year, I have upgraded my perception, I have challenged my beliefs and I know now with certainty that I can and easily will express boundless vitality, gratitude, and joy each day, every day, regardless of age to 120 and beyond. What are you ready to perceive and believe as possible for you as you feel your way young? 

Dr. Melissa Petersen is the host of the Longevity Summit, Founder of the Human Longevity Institute and Author of the Codes of Longevity. As a sought-out keynote speaker and expert in thriving, she is redefining what is possible in living a thriving life by design at every age and every stage, to learn more, visit: ww.DocMelissa.com


5 Pilates Exercises to Improve Respiratory Function

Pilates is a total body exercise method that is highly effective for strengthening and lengthening the entire body. While Pilates is mostly known to improve core strength (the “Powerhouse”), posture, and range of motion, this exercise method can be used to improve respiratory function in those suffering from respiratory diseases. Respiratory diseases include asthma, COPD, chronic bronchitis, emphysema, lung cancer, cystic fibrosis, pneumonia, and now COVID-19.  These diseases affect the way one breathes and lowers oxygen saturation that the body needs to function properly. One of the main principles in Pilates is breathing, thus the need to take a closer look at the effects of Pilates on respiratory function.

Benefits of Pilates Related to Respiratory Disease

  • Improves postural cavity to breathe properly.
  • Expands breathing capacity with diaphragmatic breathing.
  • Increases pulmonary ventilation which is needed for better respiratory function.
  • Improves lung volume.
  • Develops intercostal muscles (respiratory muscles) to better “squeeze” out impure air.
  • Improves exhaling all impure air out of the body while inhaling pure air.
  • Improves thoracoabdominal mobility.
  • Improves circulation to deliver oxygenated blood more efficiently.
  • Increased SpO2 (blood oxygen saturation).
    • >95% indicates healthy respiratory function.
    • <95% indicates taxed respiratory function.

The Pilates Breathing Method

Joseph Pilates, the creator of Contrology, stated in his book Return to Life Through Contrology: “Lazy breathing converts the lungs, literally and figuratively speaking, into a cemetery for the deposition of diseased, dying and dead germs as well as supplying an ideal haven for the multiplication of other harmful germs.”1

  • Lateral Breathing: The main goal for Pilates breathing is to breathe deeply expanding the ribcage without raising the abdominal muscles training them to jet out. Therefore, deep lateral breathing through the ribcage is the hub of the breathing technique. Proper breathing is inhaling through the nose and exhaling forcefully through the mouth. When one inhales, the ribcage expands out to the sides using the intercostal muscles, and then when exhaling the ribcage knits together like one is being sinched in a corset. According to Joseph Pilates, one should exhale forcefully getting all impure air out of the lungs like wringing out every drop of water out of a wet cloth.
  • Set Breathing Pattern: When performing the Pilates exercises, one should inhale to prep for the movement and exhale as one performs the movement.
  • Rhythmic Breathing Pattern: In some exercises, one breathes in rhythm to the exercise. This breathing consciously activates respiratory muscles to enable the lungs to expand and transport oxygen.

5 Effective Pilates Exercises to Improve Respiratory Function

The Hundred (Rhythmic Breathing)

  • Begin a tabletop position with the shoulder blades and head lifted off the mat looking forward.
  • Pump the arms up and down 100 times vigorously so the abdominals respond to and control the movement.
  • Inhale through the nose 5 times to the rhythm of the arms pumping, then exhale 5 times to the rhythm of the arms pumping.
  • Keep the lower back imprinted to the mat at all times.

Single Leg Stretch (Rhythmic Breathing)

  • In a supine position, lift the shoulder blades and head off the mat looking forward.
  • Bend the right knee towards the chest as the left leg extends straight out hovering over the mat.
  • Inhale through the nose as you switch the legs 2 times, then exhale as you switch the legs 2 times.
  • Inhale, inhale, exhale, exhale as you switch, switch, switch, switch.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 8 sets.

Dying Bug (Set Breathing Pattern)

  • In a supine position, position the legs in table-top and arms extend straight up towards the ceiling.
  • Press the right hand firmly on the right thigh and press the right thigh to the right hand in opposition.
  • Inhale through the nose as you extend the left arm back overhead and the left leg extends straight out hovering over the mat.
  • Exhale through the mouth and draw the arm in and the leg back to tabletop. Repeat on same side and switch.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 8 reps on each side.

Toe Taps (Set Breathing Pattern)

  • In a supine position, lift the legs into tabletop keeping the upper body and head down on the mat.
  • Anker the arms next to the body pulling the shoulders back and down on the mat.
  • Inhale through the nose as you lower both feet and legs together towards the mat. Keep the knees at 90º and the feet away from the glutes.
  • Exhale as you pull the legs back up to tabletop.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 10 reps.

Thread the Needle (Set Breathing Pattern)

  • Start in a side kneeling position with the hips lifted off the mat and one forearm down on the mat with the other arm straight up to the ceiling.
  • Inhale through the nose as you lean the body back an inch to expand the ribcage.
  • Exhale through the mouth as you rotate forward and thread the arm under the armpit towards the back. Crunch the obliques and transverse abs.
  • Inhale through the nose as you un-rotate and return to the start position with the arm lifted towards the ceiling.
  • Perform 8 reps on each side.

Pilates, respiratory function and research

The literature is scarce and sometimes conflicting about the benefits of Pilates breathing related to the respiratory system. However, there are some existing studies that look at the increase in lung volumes, respiratory motion, SpO2, and the reduction in respiratory rate using Pilates breathing exercises. More research needs to be conducted. Refer to suggested reading at bottom of article.

CarolAnn, M.S. Exercise Science and Health Promotion, is a 30+ year veteran in the fitness industry educating other health/fitness professionals to increase their expertise and brand influence.  She is on the MedFit Education Advisory Board and the head health/fitness educator for FiTOUR.  She is currently the Head Instructor at Club Pilates in Athens, GA.

Suggested Reading

  1. Cancelliero-Gaiad, K. M., Ike, D., Pantoni, C. B., Borghi-Silva, A., & Costa, D. (2014). Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Brazilian journal of physical therapy, 18(4), 291– https://doi.org/10.1590/bjpt-rbf.2014.0042
  2. de Jesus, L.T., Baltieri, L., de Oliveira, L.G., Angeli, L.R., Antonio, S.P., Pazzianotto-Fort, E.M. (2015) Effects of the Pilates method on lung function, thoracoabdominal mobility and respiratory muscle strength: non-randomized placebo-controlled clinical trial. Pesqui. vol.22 no.3. http://www.scielo.br/scielo.php?pid=S1809-29502015000300213&script=sci_arttext&tlng=en
  3. Hagag, A.A., Salem, E.Y. (2019) Pilates Exercises Improve Postural Stability, Ventilatory Functions and Functional Capacity in Patients with Chronic Obstructive Pulmonary Disease. IOSR Journal of Nursing and Health Science (IOSR-JNHS), vol. 8, Issue 4 Ser. VI., PP 86-91 http://iosrjournals.org/iosr-jnhs/papers/vol8-issue4/Series-6/M0804068691.pdf
  4. Baglan Yentur S, Saraç DC, Sarİ F, et al. (2020). Fri0613-hpr the effects of pilates training on respiratory muscle strenght in patients with ankylosing spondylitis. Annals of the Rheumatic Diseases;79:912. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2129


  1. Pilates, J., William, J. M., Gallagher, S., Kryzanowska, R. (2000). The Complete Writings of Joseph H. Pilates: Return to Life Through Contrology and Your Health. BainBridge Books, Philadelphia, PA. (Originally written 1945)

Sensory Input Drives Motor Output – “You gotta feel it to move it!”

In our previous article, we showed you this picture to help understand neuroplasticity and how neurons that wire together, fire together. In this blog we’ll use the same picture to understand how sensory input to the brain affects motor output.

The sensory area (purple) is on the front “slice” of the parietal lobe. The neurons here will be activated by sensory input such as touch, vibration, threat, pressure, temperature and joint position. Lying just in front of the sensory area is the motor area (blue), which is the back “slice” of the frontal lobe. The neurons here are activated through volitional movement.

In both the sensory and motor areas of the brain, you can see in the illustration that specific areas are dedicated to specific body parts. And those areas are represented in the same areas for sensory and motor (e.g., where the hand is located in the sensory area is in the same place in motor area along the “slice”).

Why sensory input matters for stroke survivors

The bottom line is that for you to move an area well, your brain must be able feel, or “sense”, the area well. This is why issues like peripheral neuropathy in the feet so greatly affect the ability to balance and walk. Having good sensory input from an area of the body is a prerequisite for good motor control when we try to move an area.

One of the most prominent dysfunctions after stroke is a reduced ability to move one side of the body. This can occur at many different levels, from total paralysis to reduced coordination of fine motor skills. Common examples include limb spasticity, usually in flexion (e.g., a clenched fist held close into the chest), or what is termed “drop foot”, an inability to dorsiflex (lift) the foot, which severely interferes with a safe, functional gait pattern. This happens because the stroke damaged areas in the motor cortex associated with the affected body part.

The good news is that by increased sensory input to the affected area, we can begin to improve motor output. You have likely seen this already if you have ever used things like percussion guns or kinesiology tape. The many new “toys” we see in the fitness industry these days are simply sensory input devices, providing the sensory area with more and novel input, which then allows the motor area to “fire” better and provide better movement (i.e., improved range of motion, more strength, etc.).

A 2017 study found that “kinesio tape application to the tibialis anterior has significant effects on motor recovery of the lower extremity, spasticity, ambulation capacity, HRQoL (health-related quality of life) and gait compared to the control group and baseline.” (1)

The concept of sensory input affecting motor output and how to harness it is not only for stroke recovery, but also for general fitness, performance, and pain clients!

Begin learning a neuro-centric approach to medical fitness and how to work with stroke survivors with our Stroke Recovery Fitness Specialist online course, available through the MedFit Classroom.

Pat Marques is a Z-Health Master Trainer and NSCA-CPT specializing in training the nervous system to improve performance and get out of pain.  After retiring from the Active Duty Army, Pat pursued his education and certifications in exercise science, initially working with wounded, ill, and injured soldiers. During this time that Pat discovered the power of using a neurological approach to training to get out of pain and improve fitness and performance. He currently provides exercise therapy, movement reeducation, and strength and conditioning for all levels of clients at NeuroAthlete, from chronic pain sufferers to Olympic-level and professional athletes.


  1. Belma Fusun Koseoglu, Asuman Dogan, Hilmi Umut Tatli, Didem Sezgin Ozcan,Cemile Sevgi Polat (2017). Can kinesio tape be used as an ankle training method in the rehabilitation of the stroke patients? Complimentary Strategies in Clinical Practice, Vol. 27.
avo on toast

Try These 5 Snacks to Lower Your Cholesterol

High cholesterol levels can dramatically increase your risk of heart disease. In particular, low density lipoprotein (LDL) cholesterol is the bad kind of cholesterol, and its the kind you most certainly do not want floating around in your bloodstream.

The good news is that, by sticking to the right diet, you can reduce LDL cholesterol levels in your blood and keep them at healthy quantities. You should make sure to eat only foods with lots of healthy fat and fiber, such as fruits, vegetables, seeds, nuts, whole grains, legumes (for plant protein), and lean meats like fish and chicken. Just increasing your fiber intake can reduce your cholesterol levels by 10% or more.

If you already have high cholesterol levels, its important that you dont aggravate the problem by taking even more saturated fats in your diet. Try to reduce quantities of dairy and meat in your diet, keeping them at no more than 5% of your daily caloric intake. For someone who consumes 2,000 calories a day, thats no more than 11 grams.

You should also be careful about which snacks you consume. Many snacks are highly processed, which means theyll contain high amounts of fat. Try to stick to healthy snack options that are packed with healthy fat and fiber.

In this article, well help you do just that by recommending 5 super snack foods that will keep your cholesterol levels as low as they need to be. They are all homemade, so its stuff you can get when doing your regular grocery shopping. Theyre also quite easy to prepare and flexible enough that you can use them as inspiration for your own recipes. Each of the snacks below is packed with healthy unsaturated fats, plenty of fiber, and consists of whole grains, vegetables, or fruits. They also have very little LDL cholesterol.

Avocado on Toast

Avocado is a popular fruit well known for its high amounts of healthy unsaturated fats. It has also been shown to drastically lower the amount of unhealthy LDL cholesterol in the body. Taking just half an avocado will provide up to 5 grams of fiber, more than enough to meet your daily requirements. If you take it with some whole-grain toast you can get even more fiber from the mix.

Making avocado toast is very easy. Simply toast a slice or two of whole-grain bread, peel and slice an avocado up thinly and top the bread with it. If youd like to add some flavor, sprinkle some herbs and maybe a bit of lemon juice.

Tuna Wraps

Tuna is a very nutritious food, with plenty of omega-3 fatty acids. Omega-3 is a healthy unsaturated fat that drastically lowers bad cholesterol levels in the blood. It also tastes really good if youre into fish!

To make some tuna wraps, start by making a tuna salad. Get a can of tuna and  mix it with your favorite vegetables, such as celery, onion, or something else. Dont forget to pour some olive oil into the mix too.

For the wrap, you can also get nori, a type of seaweed that comes in thin, edible sheets. Wrap the tuna in the nori and eat to your hearts content! Alternatively, if seaweed isnt your thing, you can get lettuce leaves to make tuna sandwiches.

Curried Salmon Salad Celery Boats

While were still on the topic of fish, salmon is yet another fantastic option. It is a delicious food and also a rich source of omega-3 fatty acids. Also, just like tuna, it can be used to make nutritious and delicious snacks.

To make salmon salad, get a can of salmon and oil-based mayonnaise. Mix the two together, and throw in some chopped grapes, curry powder, honey, and cashews. Next, take some of your delicious salad and place it on a few celery sticks to make a simple snack for your taste buds and health.


Lets take a quick moment to revisit the glorious avocado with this simple yet delicious and nutritious snack. Guacamole is simply a fancy name for avocado salad. You can make it by getting a ripe avocado and mixing half of it with a diced tomato, a chopped onion, some minced garlic, and some lime juice to give that extra zing. To give the guacamole even more character, you can mix it with slices of your favorite vegetables, such as asparagus, bell peppers, and carrots.


If you want a snack that gives you plenty of energy, oatmeal bites are yet another great option. Not only are they very low in bad cholesterol, but they are also a rich source of protein. You can make your own high-protein snack using rolled oats, ground flax seeds, chia seeds, nut butter, dried fruit, honey, and some dark chocolate.

Mix the ingredients into a thick paste that you can easily mold, and then scoop some portions and roll them into balls. Throw them in the fridge for long term storage, taking them out whenever youre going out and need some energy!

Jessica Chapman is a college paper writer and editor at BrillAssignment. She also writes best assignment writing service UK reviews. She is into sports and politics and enjoys traveling.


Active Aging Fitness

The future will see an increased proportion of elderly people throughout all modern societies. It is estimated by the WHO (World Health Organization) that in the year 2050 there will be equally as many elderly people in the world as there are children (1).  Not only will there be more elderly people but the perception of being old will also continue to change. Previously, age was seen as a natural weakness process and reduction in lifestyle options.


Medical Insurance and Medical Fitness or Exercise Therapy Coaching

Can you accept insurance for medical fitness/exercise therapy? Can your clients use their FSA & HSA (medical savings account) for your services? The answer to both questions is yes, however, it’s not an easy yes. The only way for your clients to do these two things is if you are billing for qualified medical expenses.

What are qualified medical expenses? Qualified medical expenses are expenses that mitigate, treat, or prevent disease per IRS.gov Publication 502. The IRS narrows the expenses that are deductible even more by limiting the qualified expenses to supplies (example: KT Tape) or an action being billed that will alleviate or prevent disability or illness. The catch for medical fitness/exercise therapy is that general health and well-being are not qualified medical expenses.

So, how can your client use their insurance or medical savings accounts for your services? The client needs their doctor to provide them with a prescription that identifies your services as medically necessary. The doctor saying you really need to lose weight is not a prescription.

What expenses or activities are covered per the IRS Publication 502? One example is a weight loss program for a client with a medical need for weight-loss. The weight-loss program becomes medically necessary when the doctor has diagnosed the client with obesity, heart disease, or some other disease and has determined that your weight-loss program or something similar will help the client improve or alleviate the disease or condition. What isn’t covered as a qualified medical expense are the dues for your club, the weight-loss program for a client without the prescription from the doctor, or the sessions to maintain good health after you fixed the problem your client had a prescription. The key is that a doctor or medical professional has diagnosed a disease and given the client a prescription for your services.

Accepting FSA & HSA is as simple as contacting your credit card processor and making sure you are set up correctly in their system. Most of the time this is as easy as answering a few questions about what you do. Making the decision to accept medical insurance at your facility is a much more extensive process, one that will require you to have a NPI (National Provider Identifier) number and a lot of extra time for the processing, filing, and record-keeping that goes along with dealing with medical insurance companies.

In short, if your client has a medical necessity for your services and their doctor has given them a prescription, then your client can use their FSA or HSA for their sessions. They also may be able to submit their receipts back to their insurance company for reimbursement. If your client doesn’t have a medical savings account or an insurance company that will reimburse them for their expenses, they can collect the receipts for the services, that qualify as medically necessary, and submit them with their taxes to their tax preparer. There are minimum limits that clients must reach before they can start using their medical expenses as itemized deductions. Their tax professional can help them with this.

To learn more about exactly what is and isn’t considered a qualified medical expense refer to the IRS Publication 502: irs.gov/pub/irs-pdf/p502.pdf

Heather Nusbaum is a Certified Management Accountant, Exercise Physiologist, Licensed Massage Therapist, MELT Instructor, and Master Trainer with NASM & ISSA. In 2013, Heather created Paws for Fitness a program to incorporate canines in the workout process. Over the years, this program has become a therapeutic modality within the training protocols of her business Nutree Fitness.

How did Heather go from Accounting and Business to Exercise Physiology? At a young age Heather was diagnosed with ‘Dysfunctional Knees’, this was a label that was attached to describe being in pain 24/7. This pain continued for the next 15+ years. After gaining weight due to age and inactivity, she realized that something had to give in her early 30’s. On her own she picked up and modified a box program and within 1 year had completely removed all the knee pain she’d suffered for the last 15+ years. Over the next few years it became apparent that she could help other people do what she had accomplished by accident, improving their quality of life and moving toward a pain free existence.