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The Roles of a Medical Fitness Specialist: Scope of practice, prevention and interprofessional collaboration

/9 March 2022/ All MFN blog/

Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.

Scope of Practice

Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.

An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.

Prevention

In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.

Interprofessional Collaboration

Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.

Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.

An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:

  • Knowledge of basic chronic disease pathophysiology
  • The use and side effects of common medications taken by someone suffering from a chronic disease
  • The knowledge to perform and analyze basic assessments related to movement and anthropometry
  • The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers
  • FITT protocols, exercise progressions, and regressions
  • The implications of exercise and activity for individuals with chronic disease
  • Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease
  • Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise
  • The ability to recognize a medical emergency
  • Current CPR and adult AED are required

Personal Trainers & Fitness Professionals: Prevent & Manage Chronic Disease and Collaborate with Clinicians

Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.

For a limited time, save 40% on this course by entering coupon code MFNBLOG40 at checkout.

This article was featured in MedFit Professional Magazine. 

Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program. 

trainer-resistance-band-senior-woman-client

So, your doctor told you to start exercising! Now what?

/2 March 2022/ All MFN blog/

Have you ever been given this very simple, yet incredibly complicated advice from your doctor? 

“You could really benefit from starting an exercise program.” 

If so, you are lucky to have a doctor who understands the power of exercise! In fact, exercise has been proven to help prevent diseases, reduce pain, decrease dependency on medications and improve overall quality of life. (1) The benefits are seemingly endless. However, are you someone who hasn’t the slightest clue as to what to do next? Where should you go? Who should you ask for help? Fear not, because you are not alone! Take a deep breath and follow these simple steps to begin a safe, effective and lasting exercise program today. 

Identify the Why! 

If a medical professional suggests you begin an exercise program, what is their reasoning behind it? While “obesity is linked to more than 60 chronic diseases”, your doctor may not be suggesting that you need to lose weight, but instead, suggesting that you need to address a specific weakness. (2) Do you have a medical condition where weight loss or improved cardiovascular health could add more quality years to your life or reduce your dependency on medications? Asking your doctor to fully explain these questions will help you understand how specific exercises can improve your physical and mental wellbeing. 

For example, if you have a heightened risk for falls, improving strength and balance is of utmost importance. However, if you are overly dependent on high blood pressure medications, your goal may be to improve cardiovascular health through aerobic activities. If you suffer from chronic pain or various forms of arthritis, the objective of your exercise routine will be more focused on enhancing mobility and flexibility, improving muscle imbalances and strength, as well as assisting with pain management through mindfulness techniques. Knowing your “why” is the first step towards clarifying your “how”. 

Invest in Yourself 

The most important things in life are NOT things. -Anthony D’Angelo 

It is rumored that Tom Brady, better known as the G.O.A.T. and the winningest quarterback in the NFL, spends over a million dollars a year on his health. Odell Beckham Jr., another famous NFL star, says that “I take care of my body each and every day. I put, probably, over $300,000 in my body in the offseason… It’s a lot to upkeep. I don’t ever want to decline.” (3) In all honesty, do you blame these athletes for spending so much money on their health when their health is their livelihood? 

When a medical professional suggests that you begin an exercise program, it is because they believe it will help your overall mental and physical well-being. While you may not be a professional athlete, you may be someone who wishes to remain active and independent for the remainder of your life. Therefore, it is paramount to invest in a certified fitness professional or medical fitness trainer to help create a program that meets your individual needs. 

Think about it like this, when your car needs to be fixed, do you try to fix it yourself or do you seek a certified specialist who will make an educated assessment, create a game plan and implement the necessary changes? I think it is safe to say that you will spend money on your car, but may scoff at the thought of hiring a trainer. What is more important? Things can be replaced, but people are irreplaceable. There are certified fitness professionals in your area you can find via a simple internet search or by posing a question on social media to your local chamber of commerce. With that being said, don’t be afraid to shop around and interview various trainers to make sure they are a good fit for you! 

Find a Match 

Find a job that you enjoy doing, and you will never have to work a day in your life. -Mark Twain 

Mark Twain was onto something when he spoke about the importance of enjoying what you do! This same principle applies when you set out on an exercise journey. If swimming scares you or you have nightmares about running, then pick exercises that you enjoy. Do you love to dance? Try taking some dance classes! Do you enjoy riding your bike? Let that be a part of your new exercise routine. If you dread your exercise sessions, loathe your trainer or hate every minute of your workout, then it is not going to last. If it feels like work, it’s not going to work! Exercise should be an enjoyable, yet challenging, part of your day! 

In addition, be sure that you take the time to assess how you are feeling and clearly communicate this to your trainer. If you are feeling run down, overly sore, or under-the-weather, your body is trying to tell you something. All of these signs are extremely important when it comes to enjoying the endless benefits of making exercise a part of your life. Now, let’s take action and begin to take control of your health. 

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. 

References

1 Roy-Britt. “How Diet and Exercise Can Prevent Disease. January 8th, 2020. www.elemental.medium.com How Diet and Exercise Can Prevent Disease | Elemental (medium.com)

2 Holland, Kimberly. “Obesity Facts in America.” Healthline. January 18th, 2022. www.healthline.com 

3 Zeegers, Madilyn. Tom Brady Inspired Odell Beckham Jr. to Invest in his Body. April 6th, 2020. Tom Brady Inspired Odell Beckham Jr. to Invest in His Body (sportscasting.com)

running-determination

The Moment of Truth

/16 February 2022/ All MFN blog/

According to the Advanced English Dictionary, © HarperCollins Publishers, “if you refer to a time or event as the moment of truth, you mean that it is an important time when you must make a decision quickly, and whatever you decide will have important consequences in the future. Both men knew the moment of truth had arrived. (As a sentence example)”

We all come to crossroads in life when we are faced with a decision that will change our life’s direction one way or the other. You have to make that decision quickly, without procrastination, and decide where you are headed. Sometimes, if you get old enough like me, these times come more than once. They are said to be our “moment of truth”.

In September of 2017, I started a closed Facebook Group called MS Fitness Challenge GYM for those of us with MS who are doing their best to beat MS through fitness. It is a platform for MSers to be educated on exercise, nutrition and mindset in the battle against this disease. It’s also a place where we can interact, share our goals, talk about our trials and victories and be able to connect with like-minded MSers who want to encourage and uplift each other in a positive atmosphere of health. We currently have, at the time of this writing, over 7,000 members.

Every day, I read a post about how hard it is to exercise and follow a strict nutrition plan from the members enrolled. The member’s post about the limitations, pain and issues of their symptoms that make it difficult to follow through with exercise. And, they talk about the mental blocks to sticking with an exercise or diet program.

I know. It’s not easy having MS or any challenge in life and dealing with our ups and downs let alone trying to push ourselves to get to a gym or work-out at home and follow a diet that is ONLY full of great foods and supplements for MS. I get it!

But what I’d like you to look at is the consequence of NOT getting into a regular fitness routine, NOT watching what you put into your body, and NOT setting your mindset to the positive dial. MS will not go away; it’s incurable (right now). And the disease symptoms will not improve unless you take a proactive stance against it. Exercise, nutrition and the thoughts in your mind has been proven, through programs such as my MS Fitness Challenge and many others, to help MSers in one way or another in this battle. You can read over and over again, in a multitude of platforms, the testimonials from MSers who have switched to an MS-based diet and implemented an exercise routine seeing great improvement in their quality of life. We are not talking cure here. We are talking a better day-to-day existence despite MS. And, really, this translates to any obstacle you have in your mental or physical health. The choice is yours. Do you want to choose the road that takes the work necessary to a more fulfilled lifetime, or let whatever your challenge is tell you how to live? This is the moment of truth.

The first step is getting your thoughts, motivation and determination in order. Your body will not go where your mind doesn’t take it. So fitness starts in the most influential muscle in your body… your brain. Getting revved up and ready to take on your barrier through fitness is a choice that has to be made. It is not something that most have waiting to come out. It is a desire found deep in your thoughts and feelings. You have to dig down and pull it out because there is a serious amount of action that needs to be put into play with the reaction of… “I want to beat MS” or “I’m tired of being obese” or whatever your challenge is.  And once you make this choice in your moment of truth, you do not want to look back.

When your choice to overcome your challenge is made, now it’s time to settle in on the exercise and nutrition programs that will kick start this new truth in your life. I understand the confusion of where to begin; what are the best programs for you; who helps you? This is where research and support comes in and why I founded my MS Fitness Challenge charity. We are the MS cause dedicated to educating, training and inspiring people with MS to live a lifestyle of fitness through knowledge.

So, who’s ready to stand at that fork in your road, look at it hard and tell it you are going down the road to fitness?  I’ve been traveling that road my whole life, without MS and with MS and there is no better path to follow. Your moment of truth has arrived…

Fitness Professionals and Personal Trainers: Improve the Lives of Those with MS

Become a Multiple Sclerosis Fitness Specialist! This MedFit Classroom online course, co-authored by David Lyons and CarolAnn, will prepare you to work with clients with MS to help develop strength, flexibility, balance, breathing, and improve their quality of life.

Multiple Sclerosis Fitness Specialist

David Lyons, BS, CPT, is the founder of the MS Bodybuilding Challenge and co-founder of the MS Fitness Challenge with wife Kendra. He has dedicated his life to helping people with MS understand and be educated on the importance of fitness in their lives. He is an author and sought after motivational speaker, dedicated to helping others by sharing the lessons gained from his life experience.  His most recent book, Everyday Health & Fitness with Multiple Sclerosis was a #1 New Release on Amazon at its release. He is the 2013 recipient of the Health Advocate of the Year Award; in 2015, he received the first ever Health Advocate Lifetime Achievement Award, and the Lifetime Fitness Inspiration Award in Feb 2016. In 2017, David received the Special Recognition Award from the National Fitness Hall of Fame.

Senior woman with help of physiotherapist

Trainers Can Make a Difference: A Personal Trainer’s Effect on Knee Surgery Preparation

/14 February 2022/ All MFN blog/

One of my highest honors as a Personal Trainer has been to work alongside my clients in preparation for knee surgery and post-surgery rehabilitation. Working alongside a Physical Therapist (with the client’s permission to share information) to bring the client to a complete recovery has been a privilege and an excellent learning opportunity.  

Pre and post-surgery are two very different stages, but both require the client and trainer’s knowledge, trust, and commitment. Today I will focus on the preparation for knee surgery from the perspective of a Personal Trainer. 

First and foremost, the Personal Trainer must act within their scope of practice.  Most nationally accredited Personal Trainer certifying agencies have clearly outlined the scope of practice that a trainer must work within. 

Here are a few DO’s and DON’Ts from The American Council on Exercise (ACE) that apply to the subject of pre-knee surgery clientele. 

Personal Trainers DO receive guidelines from Physicians or Physical Therapists. They DO design exercise programs, refer clients to appropriate allied health professionals or medical practitioners if needed. Trainers DO design exercise programs after a client has been released from rehab, and as trainers, we work with clients, not patients.  

Personal Trainers DON’T diagnose, prescribe, treat injuries or disease, rehabilitate or work with patients. 

There was a time when I would stop working with a client as they were awaiting knee surgery for fear of causing more damage. Still, after going through my own knee surgery, I realized there is much I could have done to prepare appropriately and that trainers can do for clients as they prepare for surgery to help put them in the best possible position for a full recovery. 

One significant preparation step for any knee surgery, often overlooked, is upper body strength. The client will likely be on crutches or possibly a wheelchair post-surgery.  When your legs are not fully functioning, you rely heavily on your upper body to move from place to place, from sitting to standing and getting to your Physical Therapy sessions.  I found success doing body weight work for the upper body in preparation is very helpful and can prevent shoulder injury as the client needs to move their body from bed to crutches or crutches to toilet and the like. Lifting out of a chair and putting a large amount of body weight on the arms is exhausting and, again, can strain or injure those joints and muscles, which can put the healing process from the surgery leg on a slower rehab pace. 

Body weight exercises for the client pre-surgery can be as simple as lifting and scooting themselves laterally across a bench, or maybe learning to use rail support to lift themselves out of a seated position, sitting with legs extended on a mat on the floor, lifting their hips to clear the ground to shift around.  Engaging and strengthening the shoulders, biceps, triceps, and even strengthening the wrists and handgrip has excellent benefits.  Encouraging core work from all six sides (Rectus abdominus – front, erector spinae – back, Obliques internal and external – right and left, diaphragm – top, and pelvic floor – bottom) to support the upper body moving the body weight is very beneficial.  We also shouldn’t forget mobility and stability in the upper body to assist in recovery. 

The second important step to surgery preparation is strengthening the muscles that support the knee in all directions. This will allow the client to be in the best possible condition to rehabilitate well. It may be necessary to be creative in finding ways to do this without putting weight on the knee joint.  Place a high priority on mobility and strengthening in the upper leg; quadriceps, hamstrings, hips, glutes: the lower leg;  gastrocnemius, soleus, tibialis, and lower leg extensor muscles. 

Personal Trainers can make a difference. Stay within your scope of practice, educate yourself on knee health, and take advantage of every opportunity to collaborate with a physical therapist or medical practitioner to learn, grow, and serve your clients with the highest quality. 

With knowledge, trust, and commitment, trainers can make a marked difference in the clients’ recovery. 

Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30 plus years of experience to a long, fulfilling career in the fitness industry. In the past 13 years at the University of Texas at Austin, Shannon has led continuing education workshops in multiple group fitness formats and topics specific to personal training; she also has written the curriculum and manuals for numerous workshops accredited by the American Council on Exercise (ACE). Shannon is currently a monthly contributor to Campus Rec Magazine for Fitness and Wellness. 

physical-therapist-and-client

7 Reasons Why Exercise is Important for Chronic Pain

/9 February 2022/ All MFN blog/

When it comes to managing chronic pain due to past injuries, most of us are familiar with common modalities like oral medication, topical analgesic gels, acupuncture, massage, pain therapy machines, meditation/mindfulness, or even surgery. However, did you know that exercising regularly is also an effective tool to manage chronic pain? 

Treating pain mainly falls into 2 categories:

  • Passive Treatment: Designed to address the pain (symptoms) 
  • Active Treatment: Designed to address the cause 

Passive treatment includes treatments that are performed on you such as ultrasound, infrared rays, needling, and manual therapy such as massage or chiropractic manipulation. The therapist is in control during this type of treatment and it mainly focuses on acute pain relief. It does not address or correct the cause of the pain. Brief pain-free periods may ensue, but passive treatment rarely increases the likelihood of complete recovery. For most, one of the main reasons is because people rely too much on passive treatment alone. Passive treatment is usually recommended during the early stage of rehab or for acute pain to help regain minimal functionality, to promote early stages of healing, and to break the vicious pain-cycle. 

Active treatment requires you to be physically involved in the process while working towards a cure to pain. Some active treatments include stretching, a corrective exercise program, and resistance training. However, it is extremely important that you are given the correct active treatment program that is relevant to your injury or condition as well as your goals. Correct exercises are able to address the root of the problem and may even prevent injuries. Active treatment is salient in the mid to late stages of rehab when one is nearly back to full functional capacity. The key is to strike a balance between passive and active therapies to best suit the type of chronic pain. 

In order to treat chronic pain, it is important to understand that pain is a complex and individualized experience. Moreover, physical exercise may seem counterintuitive when you’re already suffering from pain, but whether your pain is intermittent or constant, adopting exercise as part of your active treatment can play an important role in managing pain for the long run. 

Here are the 7 reasons why exercise is essential to manage chronic pain:

1. Exercise alters pain tolerance

Athletes tend to report higher resilience towards pain compared to people who are sedentary. Studies have shown that active individuals are also likely to perceive pain differently. People who perform aerobic exercise or resistance training regularly, may develop the ability to adapt and desensitize the sensation of pain, thereby altering their pain tolerance in the process. 

2. Exercise increases the tissue’s tolerance threshold

Recurring injuries can happen when an excessive load surpasses the tissue tolerance level. Excessive load can come in many forms such as lifting up a pail of water, gardening, or from over-training. Gradually performing optimal exercises coupled with rest can stimulate and improve tissue tolerance margin. An increased threshold can help prevent an injury from reoccurring. 

Source: McGill, Stuart; (2017). Ultimate Back Fitness and Performance. Backfit Pro Inc.

3. Exercise improves blood circulation

Frequent exercise is associated with enhancement of the cardiovascular system. Aside from reducing risk of heart disease, increased blood flow raises the oxygen levels and helps deliver key nutrients within the body that are essential for cellular healing and reparation of injured tissues.

4. Exercise releases feel-good hormones

People living with chronic pain may experience severe disturbances in their psychological state. One can become anxious, depressed or stressed due to physical limitations. Therapeutic exercise can help elevate mood by releasing feel-good hormones such as endorphins and dopamine while at the same time reducing stress due to the release of hormones such as cortisol. 

5. Exercise may help address the root cause of the pain

Common injuries such as chronic lower back pain can be caused by many factors like continuous poor movement, muscle imbalances or past traumatic injuries. Exercise can help tackle the root of the problem by identifying compensating movements or muscle weakness through a series of assessments and resolve them with an exercise program. 

6. Exercise strengthens the body’s structure

“Use it or lose it” is a popular phrase used by physical therapists and exercise professionals when it comes to exercise. The connective tissues that move our body and support the joints are muscles. When the muscle stop being challenged, they lose function and strength. Over time, this weakens muscles and exposes the musculoskeletal structure to potential harm. 

7. Exercise improves confidence

In addition to strengthening muscles and improving overall health, exercise can also enhance motor skills by stimulating the connection between the central nervous system and the muscles. Neuromuscular training helps improve balance, stability, proprioception and joint control. This can translate to pain-free movement and a decreased risk for falls. Practicing quality movements via routined exercise can boost functional capacity to perform various activities of daily living without fear of injuries. 

Regular exercise that encompasses both aerobics and strength training is strongly recommended because it is both healthy and effective to decrease chronic pain. However, be sure to seek the advice of a certified medical fitness professional to help you design an appropriate pain management strategy that is appropriate for your condition.

Ke Wynn Lee is an author and an international award-winning corrective exercise specialist who currently owns and operates a private Medical Fitness Center in Penang. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.

 

References

  • Ageberg, Eva1; Roos, Ewa M.2 Neuromuscular Exercise as Treatment of Degenerative Knee Disease, Exercise and Sport Sciences Reviews: January 2015 – Volume 43 – Issue 1 – p 14-22 doi: 10.1249/JES.0000000000000030 
  • Järvinen TA, Järvinen TL, Kääriäinen M, Aärimaa V, Vaittinen S, Kalimo H, Järvinen M. Muscle injuries: optimising recovery. Best Pract Res Clin Rheumatol. 2007 Apr;21(2):317-31. doi: 10.1016/j.berh.2006.12.004. PMID: 17512485. 
  • Jones MD, Booth J, Taylor JL, Barry BK. Aerobic training increases pain tolerance in healthy individuals. Med Sci Sports Exerc. 2014 Aug;46(8):1640-7. Doi: 10.1249/MSS.0000000000000273. PMID: 24504426. 
  • F. Koltyn, R W Arbogast. Perception of pain after resistance exercise. (Br J Sports Med 1998;32:20–24)
  • McGill, Stuart; (2017). Ultimate Back Fitness and Performance. Backfit Pro Inc. 
  • Staying Healthy: Exercise to Relax. Harvard. December 2021. 
  • https://www.health.harvard.edu/staying-healthy/exercising-to-relax 
fall-prevention1

Fall Prevention: Tip for Preventing Falls

/7 February 2022/ All MFN blog/

Falling is an issue for almost every chronic condition discussed in this text, from peripheral neuropathy to CVA’s, as well as sarcopenia that leads to fragility. Things like poor hearing, dizziness, joint stiffness or even wearing glasses can also disrupt a person’s balance. Some medications such as blood pressure, sleep medications and antidepressants may influence balance. A bad fall can make a chronic condition even more disabling. The consequences of a fall include serious injury, limited activity and significant medical costs. Many older people never fully recover from a fall. 

Guarding Against Falls 

If they are going to fall, most people (particularly stroke victims) will fall toward their weak side. They can also fall forward or backward. They fall primarily because their muscles are weak and their legs crumple under them or because their balance is poor. The American Geriatrics Society suggests fall screening be done at each annual doctor’s visit. Tell your client to mention to the doctor if they are having a balance problem or have fallen within past 12 months. 

Safety Tip 

If the person’s left side is weaker, stand at the person’s left side and just a little behind. Put your right hand on their belt or transfer / gait training belt and your left hand on the front of their shoulder. In this position you can push back on their shoulder and push forward on their hips to straighten them up, or you can pull them against yourself. In case you cannot hold the person up, you are in a good position to ease them gently to the floor if they should start to fall. Remember to use good body mechanics. If a person is falling, you can do more harm to your back and to them by straining to hold them up than if you ease them to the floor. You should never hold a person only by the arm or let them hold onto you, because if they suddenly start to fall, you will both fall over. 

Tip: Transfer belts are available at most drug stores. 

Preventing Falls

Keeping the walkways well lite is a good precaution. Nightlights on. To make house safer consider the following top 10 safety checklist items:

  1. Don’t let person rush to phone or door.
  2. Discourage them from wearing long bathrobes or slippers that can be a tripping hazardous.
  3. Teach person to get up slowly from sitting or lying, to avoid postural hypotension, (Low Blood Pressure).
  4. Teach them to transfer safely from place to place.
  5. Make sure person knows how to use cane or walker properly
  6. Remove all tripping hazards, extension cords, books, throw rugs. If the people have pets make sure toys are out of way and cats should wear a bell.
  7. Keep things within reach, to avoid step stool use.
  8. Have grab bars installed where needed.
  9. Use non-slip mats where needed.
  10. Teach them to be alert to outside hazards, wet sidewalks etc. 

Reprinted with permission from Karl Knopf

Karl Knopf, Ed.D, served as the Director of The Fitness Therapy Program at Foothill College for almost 40 years. He has worked in almost every aspect of the industry from personal trainer and therapist to consultant to major Universities such as Stanford, Univ. of North Carolina, and the Univ. of California well as the State of California and numerous professional organizations. Dr. Knopf was the President and Founder of Fitness Educators Of Older Adults for 15 years. Currently, he is the director of ISSA’s Fitness Therapy and Senior Fitness Programs and writer. Dr. Knopf has authored numerous articles, and written more than 17 books including topics on Water Exercise, Weights for 50 Plus to Fitness Therapy.

References

  • Focus on Healthy Aging publication, 2016
  • ISSA Fitness Therapy Course, 2019
  • WebMD – focus on falls, March, 2019
  • IDEA Journal, Effective Posture, February 2015
  • American College of Sports Medicine, “physical activity falls and physical function, ,July, 2019
  • Weights for 50 plus, Knopf Ulysses Press, 2006
  • Resistance Band Workbook, Knopf, Ulysses Press, 2013
  • Stability workouts on a Balance Board, Knopf, Ulysses Press, 2017 Core Strength for 50 plus, Knopf, Ulysses Press, 2012