Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
Eric Chessen 1

When To Pass “Go”: Criteria for Baseline Mastery and Coaching The Neuroadaptive Population

“So every few weeks you change things up, right?”

A common question asked by parents when I begin working with a new athlete in my program. 

“I change the exercises once we see independent mastery. Variety is just variety without pre-requisite skills being developed. So yes, I’ll add some new exercises…when it makes sense.”

If there’s one thing I can’t do it might be avoiding long-winded sentences. 

For the autism and other neuroadaptive populations, developing strength and enhancing motor skills does not come easily. Pre-existing deficits in motor control and stability can present a challenge for engaging in a variety of physical activities. Many individuals with ASD often find physical activity aversive due to myriad factors. Among these are;

  • New/novel tasks and environments
  • Instructions that may be unclear
  • Elevated anxiety and uncertainty 

The pathology behind movement limitations is a combination, mostly a feedback loop, of muscular and neurological impediments. Differentiation in neuronal firing for those with autism causes a delay in neuromuscular performance, often resulting in movement that can be described as “clunky,” “inhibited,” and compensatory patterns are often observed.

Given the importance of fitness, particularly the development of strength and stability for neuroadaptive populations, it is critical to implement programming that addresses strength deficits and contraindicated movement patterns. An effective approach progresses or regresses exercises based on current level of ability.

Criteria for Baseline Mastery (CfBM) is a protocol borrowed from the practice of Applied Behavior Analysis (ABA). CfBM provides us a clear description of when a skill is mastered and what the requirements are for that goal. Mastery, in this definition, means that the skill can be performed to a particular level independently. 

In our Autism Fitness™ programs, we use CfBM to set goals, track progress, and provide appropriate progressions and regressions for each athlete with every exercise. With squats, we very often reduce range of motion (ROM) by having the athlete squat to a box or similar stable platform. Depending on trunk stability, an upper body support may also be required. Having the athlete hold onto a band (held lengthwise by the coach), provides additional support. What we’re after is the athlete’s best performance of the squat with a complete reduction of compensatory movement.

Establishing a standard for performance enables us to set both general and specific goals for each athlete. For squats, as with most of our strength-focused exercises, we use 3 sets of 10 reps as our goal. Within those sets and repetitions, we are looking for stability and control throughout the entire range of motion (hips below parallel). While 3 x 10 may initially read like a standard-issue hypertrophy protocol (not necessarily bad, either), there is further reason to embrace this scheme. Three sets provides enough stimulus for the athlete and enough observational opportunity for the coach for integrity or technical breakdown of the movement. If and when the athlete is able to maintain technical control of the squat for 3 sets of 10 reps, it will be abundantly clear that they have mastered the skill, at least to the current level of challenge. 

We use 10 repetitions because it takes us far enough away from maximal loading to be safe (especially for detrained athletes) and an excellent range for improving general strength and muscular development. If an athlete can perform 10 consecutive squats below parallel maintaining rooted foot position and spinal integrity, we have valid claim to progressing the exercise.

For those with neurodevelopmental challenges, it may take months to improve on a particular exercise. Strength and stability aside, proprioception (the real-world “mind/body” relationship) often presents as a particular obstacle. Our athlete may confuse squatting with bouncing or sitting, intentionally or unintentionally rushing through the exercise. 

We have to be careful in assessing the underlying reason for the bounce and/or sit squat. When we consider through the lens of the PAC Profile™, we ask whether this is a physical, adaptive, and/or cognitive concern. For each possibility, we can apply particular questions.

Physical: Is the squat progressed beyond the current capability of the athlete and are they compensating as a result?

Adaptive: Is the athlete sufficiently motivated to complete the exercise at their current level of ability?

Cognitive: Does the athlete understand the expectation for performance of the squat? Are we certain it is clear for them? 

Our goal for each athlete, strictly from the physical perspective, is safe and effective performance of each exercise or movement pattern before adding variety. Building a foundation of strength, stability, and motor planning can have restorative and preventative benefits and enhance quality of life at any age.


Eric Chessen, M.S. is the Founder of Autism Fitness. An Exercise Physiologist with an extensive background in Applied Behavior Analysis (ABA), Eric has coached successful fitness and adapted PE programs for the neurodiverse population over 18 years. Eric is the creator of the Autism Fitness™ Certification and PAC Profile™ Method. He is also Director of Neuroadaptive Programming for Inclusive Fitness. He resides in Charlotte, NC. Go to AutismFitness.com for more information. 

strength-training-2

Healthy Aging and You: The Power of Strength Training

I recently thought about why we exercise and what we choose to do first – and it isn’t generally strength training. Why is that? I believe it’s because we feel we CAN’T do something about becoming stronger unless we join a gym – and then we always seem to gravitate to cardio exclusively as if that is all we can do. We want to lose weight, feel better about ourselves, burn stored fat or just increase our energy level, but what if there was a better way?

fitness tracker

3 Pros vs. 3 Cons of Wearable Fitness Trackers – Are Any Right for You?

Fitness trackers are some of the hottest tech gadgets on the market. They can measure your daily steps count, monitor your heart rate, log how many calories you’ve eaten, and even analyze your sleep quality. Some models can read your blood oxygen levels and use GPS technology to keep track of your running, walking, or biking route. Many people swear by making this type of “wearable” technology a part of their daily routines.

But is there any merit to all this hype?

Are fitness trackers a passing trend or a worthy addition to your health and exercise routine?

Why wear a fitness tracker?

We all know that it’s important to exercise regularly, especially as we age. Studies have shown that physical activity can extend longevity, prevent cardiovascular disease and stroke, and combat the onset of dementia. Having a regular exercise routine is an important part of keeping your body feeling young and in shape. The trouble is that many people struggle with keeping up a consistent workout routine. This is where fitness trackers come in.

Fitness trackers are wearable health devices designed to monitor your activity level. They come in all shapes and sizes, from simple models that are little more than glorified pedometers to advanced smartwatches that can track your body’s vital signs in micro detail.

Tracking your fitness activity also can be an important step to taking charge of your health because it makes people more conscious of their health. Having a log of your activity level and vital signs can also be a valuable tool to share with your doctor or personal trainer. Seeing hard data makes it easier to create a sustainable routine you can stick to.

The Pros of Using a Fitness Tracker

Helps build routine

For many people, blindly exercising without any way to track their progress can be frustrating. It can be hard to find the motivation to get moving when you have no way of knowing if your efforts are working. Wearing a fitness tracker allows you to see your progress in real-time and make adjustments. If you track 5,000 steps a day, you can make it a goal to gradually increase to the recommended 10,000 steps per day. It can be motivating to see your numbers improve, which makes it easier to stick to your routine.

Motivates you to move more

Most of us spend far more time than we’d like to on the couch. Sitting too much can be deadly. It’s a good rule of thumb to get up and move for 15 minutes for every hour that you spend sitting down. Many fitness trackers come with built-in reminders for this exact reason, helping you remember to get up and move throughout the day.

Keeps track of your dietary choices

Many fitness trackers offer ways to input your daily food and water intake via the connected apps. Keeping track helps make sure that you’re getting adequate nutrition. Studies have shown that tracking your food intake can lead to weight loss, even without following a specific diet plan. The information can also help a dietitian or a personal trainer get an idea of your daily meal plan. They can use this data to help you formulate a healthy diet, and logging your choices regularly can help you stick to it.

The Cons of Using a Fitness Tracker

Can be overwhelming

Some people may find the amount of data to be overwhelming. Many devices offer far more options than the average person needs, and the high cost of some premium models means they may not be an ideal investment. Those who are less technically savvy may also find the device’s smartphone app frustrating to use, or simply not worth the trouble.

Ask yourself what’s most important to you to keep track of — such as your heart rate, number of steps and estimated number of calories burned — then look for models that only track those features. You’ll save money and save your brain from information overload.

May lead to obsessive behavior

The detailed stats that a fitness tracker provides can be a tremendous motivation for some people. But for others, this may open a gateway to obsessive behavior. Many people can’t help but fixate on obtaining perfect stats, and may push themselves too hard to achieve them. The number on the screen is only a best estimation of your daily activity, not a measure of your self-worth! It’s also worth noting that fitness trackers are not medically accurate with their stats, and there can be vast discrepancies between different models.

Not as useful in the long-run

While a fitness tracker can be a valuable tool to motivate you in the early stages of your fitness journey, they’re not as useful for keeping the weight off in the long-run. Surveys have shown that around ⅓ of people who buy fitness trackers stop wearing their devices after six months. Other studies have found that they’re not as helpful for losing weight as most people would believe. A randomized trial by the Journal of American Medicine found that people who didn’t wear a fitness tracker actually lost around 8 pounds more on average compared to their device-wearing counterparts.

Does that mean that wearing a fitness tracking device will inhibit your progress? Not necessarily. Those in the study who wore the trackers still saw improvements to their body composition and physical fitness thanks to their new diet and exercise routines. That’s because the trick to living a healthy lifestyle is finding a routine that works and sticking to it. If the fitness tracker helps you do this, excellent! If not, another method of motivation might be better for you.

The Best Alternatives to Fitness Trackers

It’s worth noting that shelling out hundreds of dollars for a fitness tracker isn’t the only way to monitor your health. If you want to get an idea of what your heart rate is like while exercising, try this simple experiment: go for a brisk 30-minute walk around your neighborhood. When you get to the halfway point, try singing one of your favorite songs. If you can sing it perfectly without any hesitation, up the pace.

You can also set “stand up and move” reminders on your watch or smartphone. For tracking your food intake, there are a number of apps available to let you log your daily meals. Some people enjoy keeping a physical food journal rather than going with a purely digital route. You can always experiment until you find the right method.

The Bottom Line

When used correctly, a fitness tracker can be a helpful tool that offers detailed feedback on your body’s activity level and other aspects of your health. If you need an extra boost to get moving or want to keep a close eye on your progress, they can be a worthwhile investment. However, if you have a tendency to obsess over small details or don’t need the extensive data that a fitness tracker provides, another option might be better to track your progress. Ultimately, how you choose to track your activity is your choice. Whatever option you choose, the important thing is that you keep moving and stay active at a healthy level.

Originally printed on aviv-clinics.com. Reprinted with permission.

Aviv Clinics delivers a highly effective, science-based treatment protocol to enhance brain performance and improve the cognitive and physical symptoms of conditions such as traumatic brain injuries, fibromyalgia, Lyme, and dementia.

Our intensive treatment protocol uses Hyperbaric Oxygen Therapy and cognitive and physical training as well as nutrition management for better brain health. The medical program closely tracks clients’ progress before, during, and after the treatment protocol, using customized tablets and other technology. Based on over a decade of research and development, the Aviv Medical Program is holistic and customized to your needs.


Aaron Tribby, M.Ed is Head of Physiology for Aviv Clinics where he is responsible for managing a team of physiologists, physical therapists, dietitians, and stress technicians at Aviv Clinics – the first hyperbaric medical treatment center of its kind in North America dedicated to improving brain performance. He also oversees the cardiopulmonary exercise tests and CPET in the clinic, responsible for analyzing each test. Leading to Aviv Clinics, his clinical experience is focused on health and wellness, strength and conditioning and nutrition within both the non-profits and private sectors including Mercy Hospital and MusclePharm, respectively.

 

References

  • Aviv Clinics – Brain Performance. Aviv Clinics USA. (2021, July 1). https://aviv-clinics.com/hyperbaric-medical-program/.
  • Gartner Survey Shows Wearable Devices Need to Be More Useful. Gartner. (2016, December 7). https://www.gartner.com/en/newsroom/press-releases/2016-12-07-gartner-survey-shows-wearable-devices-need-to-be-more-useful.
  • Jakicic, J. M., Davis, K. K., Rogers, R. J., King, W. C., Marcus, M. D., Helsel, D., Rickman, A. D., Wahed, A. S., & Belle, S. H. (2016). Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss. JAMA, 316(11), 1161. https://doi.org/10.1001/jama.2016.12858
  • Langhammer, B., Bergland, A., & Rydwik, E. (2018, December 5). The Importance of Physical Activity Exercise among Older People. BioMed research international. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304477/.
  • Patel, A. V., Maliniak, M. L., Rees-Punia, E., Matthews, C. E., & Gapstur, S. M. (2018). Prolonged Leisure Time Spent Sitting in Relation to Cause-Specific Mortality in a Large US Cohort. American Journal of Epidemiology, 187(10), 2151–2158. https://doi.org/10.1093/aje/kwy125
  • ScienceDaily. (2019, February 28). Tracking food leads to losing pounds. ScienceDaily. https://www.sciencedaily.com/releases/2019/02/190228154839.htm.
Senior couple on country bike ride

Creating Fit and Functional Older Adults

Beginning in the seventh grade, I became fascinated with age—specifically how our bodies’ functional capacities decrease with the passage of time. When I once shared this perception with my 98-year-old grandmother, she said, “Just wait until you’re 80.” I’m still far from 80, so I can only imagine how difficult it will be then to stand up from a chair or run around the neighborhood.

The biggest factor in the decline in physical capacity with age is level of physical activity. When your clients remain active throughout adulthood, they can retard the aging process and continue to live a life worth living. I know 70-year-olds who are fitter than 30-year-olds.

Physiology of the Older Adult

After age 30, most physiological functions decline at a rate of approximately 0.75 to 1 percent per year. Perhaps the biggest functionally-related physiological change with age is a decrease in muscle mass, called sarcopenia, which is due to a loss of motor units (a motor neuron and all the muscle fibres it connects to) and atrophy of fast-twitch muscle fibres. With the loss of motor units comes denervation of muscle fibres (a lost connection between the motor neuron and the fibres within the motor unit). This denervation causes the muscle fibres to deteriorate, resulting in a decrease in muscle mass, which significantly decreases the older adult’s muscle strength and power, making certain activities of daily living difficult.

Men and women generally attain their highest strength levels between ages 20 and 40, after which the strength of most muscle groups declines, slowly at first and then more rapidly after age 50. Muscle strength decreases approximately eight percent per decade after age 45, with greater strength losses occurring in women compared to men. In both men and women, lower body strength declines more rapidly than upper body strength.

With the loss of muscle mass also comes a loss in mitochondria, which decreases muscular and aerobic endurance. Mitochondria are unique in that they have their own specific DNA, so when older adults lose mitochondria, they also lose mitochondrial DNA. If your clients want healthy functioning muscles as they age, they need lots of healthy mitochondria.

Cardiovascular fitness also declines with age, in part due to a decrease in maximum heart rate and stroke volume (the volume of blood the heart pumps per beat). With a lower maximum heart rate and stroke volume comes a lower maximum cardiac output (the volume of blood the heart pumps per minute), a decreased ability to deliver oxygen to the muscles, and thus a lower VO2max (the maximum volume of oxygen the muscles can consume). VO2max decreases by 8 to 10 percent every 10 years after the age of 30 in healthy, sedentary adults. When maximum cardiovascular functioning declines, so does the workload that can be tolerated at a given percentage of the (lower) maximum. Decreases in VO2max with aging can be variable, particularly if your clients remain active. But if not attended to, a youthful run becomes an aged walk.

Training the Older Adult

Although many physiological factors decline with age, up to 50 percent of this decline is due to deconditioning rather than aging. With proper training, your clients can lessen the physiological effects of aging and remain fit and functional.

Arguably, cardiovascular exercise will always be more important than strength training throughout your client’s life because heart disease is the most common cause of death for both men and women. No one has ever died of a weak biceps muscle. But people die of weak hearts every day. One cannot live very well or very long without a strong heart. Since the risk of heart disease increases as people age, older adults need cardiovascular exercise just as much or even more than do younger adults. Like younger adults, older adults should do at least 30 minutes of cardiovascular exercise on most, if not all, days of the week. The more physically fit one remains, the slower the rate of cardiovascular decline. Maintaining exercise intensity, rather than a higher volume of training, is the key to minimizing the loss of aerobic fitness as your clients age.

Strength training also becomes more important as people age. Given that aging is accompanied by a decrease in muscular endurance, strength, and power, resistance training should take on greater weight (pun intended) when training an older client. I’d even go as far to say that every person over the age of fifty should strength train because that’s about the age at which people start to lose a significant amount of muscle mass. And that loss in muscle mass with age affects your client’s ability to function. If you’ve ever seen a senior citizen try to stand up from sitting in a chair or witnessed how catastrophic a fall can be to a senior, you know how much benefit strength training can have. The positive effects of strength training on bone density, muscular strength and endurance, balance and coordination (which reduces the risk of falling and fractures), functional mobility, physical aesthetics, and self-esteem cannot be denied.

Train older clients with heavier weights and fewer reps per set to target improvements in muscular strength, or with lighter weights lifted quickly to target the fast-twitch muscle fibres and improvements in muscular power. Greater strength gains occur at intensities of 80 to 90 percent of the one-rep max (the maximum weight that can be lifted just once). Although we tend to think of power training as something done to improve athletic performance, it has big implications for older adults, whose muscles lack strength and power. Research has shown power training to be very effective for strength and power development in seniors. Since it takes longer to recover from workouts as people age, give your clients more time between intense resistance and cardio workouts.

If you train older adults with higher intensity, less volume, and more recovery between workouts, not only will they be fitter and stronger, they may even be able to keep up with my 98-year-old grandmother.

From CanFitPro magazine. Sept./Oct. 2017.  Reprinted with permission from Jason R. Karp, PhD


Jason Karp, PhD, is the 2011 IDEA Personal Trainer of the Year, 2014 recipient of the President’s Council on Fitness, Sports & Nutrition Community Leadership award, and creator of the REVO₂LUTION RUNNING™ certification. He has more than 400 published articles in international running, coaching, and fitness magazines, is the author of eight books, including Run Your Fat Off and The Inner Runner, and speaks at fitness conferences and coaching clinics around the world. Get training programs and autographed copies of his books at run-fit.com.

boomers-biking

Mountain Grit: Meet Jim

For all you medical fitness professionals out there, meet Jim, 75. Jim exemplifies the mindset towards aging that we all can emulate.

From urban to suburban, rural to remote, the glass is half-full – so lets fill-it-up’. SPIRIT truly can change the way and the pace at which we age.

[Excerpted from The Training Corner column in the Lone Peak Lookout]   

Q: Hi Pat!  I am sick and tired of my family members and friends telling me to slow down.   

I am 75 and in pretty darn good health. I was blessed with some good genes. Both of my very active parents lived well into their 90s. I’ve never gotten fat, and I quit smoking and heavy drinking back in my 20s. I drive my wife crazy because I am one of those ants-in-pants guys who just can’t sit still until the day is done. OK, I have some aches and pains, wear a hearing aid and need glasses just for reading. No big deal!   

Right now, I am in the throes of remodeling my daughter’s kitchen. I thrive on projects. They are a challenge, so I am always looking for something to fix. I am also the go-to guy when my neighbors need a helping hand. My true passion is calf-roping, so I mentor and teach the younger dudes. Yeah, I can still do it, but I lost my favorite horse last year, so I coach instead. My wife and I love the outdoors, and enjoy hiking, fly fishing, skate skiing and snow shoeing 1-2X/week.

We do all of our own outdoor maintenance, too. If for some reason, my day is void of physical work or play, I walk for 30 minutes, just to keep the pump pumping.  

I did construction all my life, and my back and shoulders act up on occasion. But over the years, I have collected a bag of maintenance tricks from various physical therapists. I have a morning routine of breath-work with tai-chi like moves, and some core preservation exercises. I use that foam roller with the bumps, too, my best friend for about 10 years, now. This regimen seems to work.  

Pat, am I just plain oblivious to this aging thing? Isn’t the body in motion the best brain and overall health potion? I am confident in my skills and abilities, so why would I slow down?  Any suggestions on telling the naysayers to put a sock in it?

Jim, 75

Pat’s Answer:  Hi Jim!  No, you are not oblivious. Yes, a body in motion is the best path to aging younger. Continue to get up and get after it every day. You have purpose, passion, meaning and relevance in your life. There is no need to slow down. You are thriving at 75, and are inspiring others. Keep up the pace, unless something rocks your competence and confidence. We CAN continue to learn, grow and discover throughout our lifespan, if we avoid ruts, complacency and stagnation.

Here is some ammunition for you:

  • Traditional retirement is dead. We reWIRE!  60+ is the time to wind up, not wind down. Act III is ripe with opportunity, adventures, vocations, projects, dreams and sharing the wisdom. You chart your journey.
  • The way and the pace at which we age is malleable. It is deeply rooted in Hardiness and GRIT, not talent. When we invest in our 5 Pillars of Hardiness (Purpose, Movement, Diet, Rest-Recovery-Regen, and Stress Ops), through DAILY habits, patterns and practices, we fortify our resilience, durability and robustness for the long haul. Aging is NOT a disease. It is an accumulation of how we react and respond to the ‘ups and downs’ of life, how we adapt to and bolster our reserve capacity.
  • Aging is living life to the fullest, a journey. 35 is seasoned, that is we have reached our peak biological development. This does not mean that we cannot continue to learn, grow and discover, nor set personal bests in physical endeavors. Check out the Senior and Master Games.   
  • We are individuals. We age at different rates. We are unique in personality, upbringing, physical work-play experiences, life lessons, and ‘what makes us tick’. “If I choose to climb a ladder and clear snow off the roof, quit barking at me. I know my limits, after doing it for 40 consecutive years. And by the way, I take no MEDS, so my balance is pretty darn good.”  
  • “We don’t live life to be safe and healthy; we live safely and healthfully to live life to the fullest!”

From Albert Einstein, and so relevant today, “A ship is always safe at shore, but that’s now what it was built for.” Reasonable risk is the springboard into learning, growth and discovery. Push out of the comfort zone, or slide backwards. A fool-proof safe, static and secure mentality can lead to stagnation, apathy, and even depression. 

In summary, Jim, keep moving, working and playing ‘til you can’t. Vintage vehicles need DAILY maintenance to run well, so continue your morning regimen. If you notice that you are losing strength, you may need to tweak your training for strength and power gains. Mentor and lead by example. No need to preach to the naysayers. Just ask them, “What makes YOU tick? Ok, I’m not YOU.” 

In the soon to be released, Cardiac Rehab Fitness Specialist course, be prepared to rethink your approach to coaching people up to living life to their fullest. In my Pillars and 7S Buckets approach to reclaiming, restoring and rebuilding Hardiness for the long haul, you will be inspired to change the way and the pace at which you age. Jim has the Spirit, and Hippocrates had it right…

“Know the person who has the disease; not just the disease who has the person.”  —Hippocrates


Patricia ‘Pat’ VanGalen, M.S. brings a unique blend of education, practical experience, common sense application, science and research to her lecturing, teaching, training and coaching. She launched her professional career 40+ years ago in physical education and coaching, then spent the next 10 years in corporate-industrial fitness, health promotion, cardiac rehab and injury risk reduction programming design, implementation and management. Visit her website, activeandagile.com.

Senior-Fall-Prevention

After a fall, would you make it back up? Moves for Functional Fitness

The primary reason we move to a long-term care facility is not an illness but dependence on others due to physical weakness. Deconditioned seniors have the greatest potential to improve functional strength. With practice, you can develop muscles to recover from a fall. Fear only increases our risk.

A Recovery

Imagine you fell. Take deep breaths. Do toes and fingers move? Where is the phone? If it’s not close, you roll, drag, crab walk or crawl. Once near a chair or low table:

  1. Roll onto your belly. Rest.
  2. Raise onto forearms and knees. Rest.
  3. Aim your buttocks toward the chair. Rest.
  4. Press up to hands and feet. Rest.
  5. Go backwards to the chair. 
  6. Back your hips onto the chair. Rest.

The 10 Moves

Hopefully, you never fall, but practiced weekly, these exercises can improve strength and stamina for moving in bed, sitting up and life. Do these on your bed. Have a friend nearby. Start with one exercise 1-3 days a week for 1-3 weeks. Then add on. To gain more, try them under the weight of your covers. Listed in progression: 

  1. Practice rolling. Lie sideways across the bed; feet hanging off. Exhale away from the bed. The exhale stabilizes your low back and releases pressure on the heart. Face up, roll to each side. Rest. Repeat 10 times. Roll from face down to your sides. Rest. Repeat. Roll from the foot of the bed to head of the bed. Rest. Repeat 10 times. Avoid rolling from edge to edge on the bed. 
  2. Lie on your side; place your upper hand on the bed. Exhale- push on your lower elbow and top hand to lift shoulders and head up. Rest. Repeat 10 times. Switch sides.
  3. With no pillow, lie on your back to lift your hips. Exhale before and during the lift. Rest. Repeat, but stay up for a count of 5. Do not hold your breath! For low back issues, try it with one leg straight. Rest. Alternate. Repeat.
  4. Lie on your side with a head pillow. Keep head, shoulders and knees down; lift your hips with an exhale. Rest. Repeat. Stay up for a count of 3. Switch sides. Try it up, on one elbow. Rise out of the shoulder. Press into your upper hand too.
  5. Practice scooting: Lie face up. Exhale- lift your hips, shift them to one side, lower hips. Then lift to return to center. Repeat, alternating sides. Try scooting twice to each side, adding your upper body to travel. Stay on the bed!
  6. Crawl onto the bed on all fours. Engage your abdominals for support. Practice staying on forearms and knees. Rest. Repeat, adding a few seconds. Practice on hands if your wrists allow. Rest. Repeat.
  7. Crawl onto your bed from the foot of the bed. Crawl to the headboard. Crawl backward. To practice crawling sideways, enter the bed from the side. No slippery bedspreads!
  8. Drag your hips or crab walk on forearms or hands. Use deep breathing to move. Rest often. Use your glutes. Stay aware of your location on the bed.
  9. Standing with back of legs touching a chair, walk hands down the legs and back up to standing. Sit to rest. Repeat. Stop if dizzy. From a fall, standing is not a goal, but prepares us for the next move.
  10. When you feel ready to walk on all fours on the floor, stay near a couch or low table. Look behind to go backward. Sit to rest. Repeat. 

Please Note

Do whatever you can. Many of us feel dizzy or have joint limitations that affect performance. The biggest mistake is to quit, because of temporary discomfort or lack of confidence. With consistent practice, discomfort typically lessens.

Another way to recover from a fall involves kneeling to a lunge position next to a chair. This works for able-bodied seniors. Find what is best for you. Every week, practice your weakest steps until you gain confidence.


As an ACE-certified Medical Exercise Specialist with decades of experience training fragile to fit seniors, Emma Spanda Johnson designs adaptive exercise programs, for clients of all abilities. She is a nationally certified personal trainer with an Orthopedic Specialty. Emma offers virtual training sessions, visit her MedFit Network profile for details.

 

References and Resources

Smiling elderly woman training in a group

It’s time to play!

I had just returned home from an amazing educational conference in Arizona. Some of the most educated and credentialed humans in the fitness world had come together to share and learn the most up-to-date and evidenced-based systems in the fitness world. My thoughts felt like a bag of ping pong balls had been dropped, bouncing in many directions at once.

I was getting out of my car on the way to get groceries. All the lessons, lectures, and workouts swirling in my mind. I was looking for a common thread. What was the connection to all that I have learned?  Then, I hear this clippity clack clippity clack! I look over my shoulder in the parking lot of a Publix. There was this young girl holding her mother’s hand. She had her princess outfit on, crooked crown, fake jewels and plastic shoes. The shoes skipping on the pavement was the clippity clack sound that made me look. I giggled at the difference between mom’s face, stress, deep thought and worry, and the young girl’s free and happy smile. Then I see them in the store. The young princess was leaping from colored tile to colored tile. I could see the imaginary moat she might be trying to cross while being chased by the creatures below.

I flashback to a seminar and one of the drills I just experienced with Master Instructor, Andy Hainey. Bounding in multiple planes of motion to challenge the athlete’s ability to accelerate and decelerate force efficiently. This beautiful happy princess was naturally doing some of the most advanced programming I flew thousands of miles to study.

BOOM! It hit me. PLAY…. she was PLAYING! The sessions and lessons that shone brightest and stayed with me from the workshops, were those that felt like play. They were technical and evidence-based, and they were fun! No one used jargon or spoke of the sagittal plane or the eccentric phase.  They made it fun.

Benefits of Incorporating “Play” into Your Programming for All Ages

The are many studies of the benefits of play and physical relation between activity in youth populations. The evidence shows a positive relation between physically active youth, and seven areas of cognitive performance (perceptual skills, intelligence quotient, achievement, verbal tests, mathematics tests, developmental level/ academic readiness, and other). Sibley et al., 2003

Playing increases enjoyment and adherence at all ages. It creates a positive reaffirming cycle of success. The more you enjoy something, the more time spent doing it. The more time spent doing an activity, the more skilled you become. The greater the skill level you achieve or the higher the achievement, the more you will enjoy doing the activity. 

We forget what it was like to play as we age with all the responsibilities and stresses we have We are told to put childish things aside. As a “fitness professional” we are blessed to keep playing in many senses of the word. I have spent many hours of my life educating myself and gaining certifications. While I believe that time has been well spent, my clients continually tell me their favorite aspect of our time together is the fun factor.  

Many feel as though they haven’t repeated a workout ever. This is not the case. I do follow the NASM OPT model. It is a progressive system that can be applied to every aspect of fitness training. Our body has a miraculous ability to adapt to specific demands placed on it. That is my primary guide to programming for my clients. Once we establish their baseline abilities through comprehensive assessments, and what goals they want. Then we create the program based on the S.A.I.D. principle (Specific Adaptation to Imposed Demands). The assessments many times feel intimidating and clinical and set that as the tone for you and your client.  If we as trainers and coaches make the assessments fun and non-intimidating games (I use the term drills in place of games for my adults many times) or play, we can start creating a positive nurturing environment for our clients.  Don’t just show them where they are deficient. Let them show and celebrate what they are capable of.

Bottom line is, have fun and play! You will enjoy every session. Your clients will look forward to each session. They will give their all and get better results.  Keeping clients training is one of the most challenging parts of what we do.  Embrace your inner child, and theirs. Get them to hop from stone to stone in monster infested waters or bring out the agility ladder. Either way just play!


Coach Pete Guzman is a NASM Master Trainer with CES, PES, YES, CNC, SGPT MMACS and 4th degree Black Belt. Look for his upcoming seminar in June to find out more about youth programming and adding fun to your clients’ journeys.

woman-and-baby-exercise-fitness

Can Exercise help treat women with postpartum depression?

According to several studies, exercise has been proven as an effective method of treating and preventing depression. Some studies suggest that physical activity may be as powerful as anti-depressants for treating mild to moderate depression over time. The same is true for women experiencing mild to moderate postpartum depression. It’s important to note that there are different levels of postpartum depression and screening is available through hospitals and doctors’ offices if PPD is suspected. Both the Edinburgh Postnatal depression scale questionnaire and a PAR-Q medical history questionnaire will help give insight to healthcare practitioner and patient on treatment methods.

outdoor-fitness-class

Moving Together Outside

Every afternoon around 4:00 pm, just outside my study window, I can hear the sounds of outdoor physical activity classes held in a nearby park. Instructors calling, students responding, joyful sounds of activity and movementthe opposite of what I am doing as I start my seventh Zoom meeting of the day.  

Along with the majority of Americans, I am sitting more and moving less during the pandemic. In fact, physical activity levels are down around 32% in a nation where only 23% of us met recommended guidelines for both aerobic and strength training activities before the pandemic. Shockingly, but somehow not surprisingly, 61% of Americans report experiencing undesired weight gain29 pounds on averageduring the pandemic.

The fitness professionals leading those classes outside my window provide an outstanding case study in the value of adaptability and sheer determination to get people moving. 

During the early stages of the pandemic, their studios were closed. Later on, capacity limits were too constraining, and their studios were too small and poorly ventilated to hold their classes indoors. Therefore, they needed to come up with an innovative solution to keep their businesses open. They worked with our city government to secure permitsat an affordable priceto move their classes to an outdoor public park that was accessible to all community residents.

This is not the only example of fitness professionals successfully securing permits or shared use agreements from their local governments. There are success stories from San Diego, Long Beach, Washington, DC, Austin and Boston. However, these stories are too few and far between.  

Our attention over the past year has been almost single-mindedly focused on an infectious disease, yet beneath the COVID-19 pandemic that raged lay the dual epidemics of physical inactivity and obesity that helped fuel it. People with obesity have more than double the risk for hospitalization from COVID-19 and a nearly 50% higher risk of death. The odds of death are 2.5 times greater for people who are consistently physically inactive, compared with people who consistently meet recommended guidelines, and physical inactivity was found to be the strongest modifiable risk factor for severe COVID-19.

Qualified, credentialed fitness professionals have an important role to play in getting people moving. We have worked hard to gain the expertise to provide safe, structured physical activity programming for different types of populations. We are true believers in the mental and health benefits of physical activity and are trained in helping others change their behavior to experience these benefits.  

The American Council on Exercise has launched a grassroots campaignMoving Together Outsideto support qualified fitness professionals in their efforts to get people moving by expanding access to community spaces. I see it as a win-win-win. For fitness professionals, seeking ways to work with students and clients outdoors during and after the pandemic. For municipalities, seeking safe and affordable physical activity options to offer to residents. For community residents, seeking opportunities for social connection and movement.  

I am proud to be the national spokesperson for the Moving Together Outdoors Campaign. I invite my fellow fitness professionals to become a campaign supporter at advocacy@acefitness.org. Lets help good ideas spread, so the daily physical activity classes that I hear from the park next to my home are sounds heard daily from parks across the nation.   


Dr. Amy Bantham, DrPH, MS, MPP, is the CEO/Founder of Move to Live More, a research and consulting firm addressing physical inactivity, chronic disease and social determinants of health through cross-sector collaboration and innovation. A certified health and wellness coach, personal trainer, and group exercise instructor, Amy holds a Doctor of Public Health from the Harvard School of Public Health. She can be reached at movetolivemore.com or @MovetoLiveMore

 

References

  • American Psychological Association. Stress in America: One Year Later, a New Wave of Pandemic Health Concerns. 
  • Meyer, J., McDowell, C., Lansing, J., Brower, C., Smith, L., Tully, M. & Herring, M. (2020). Changes in physical activity and sedentary behaviour due to the COVID-19 outbreak and associations with mental health in 3,052 US adults. 
  • Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., … & Shekar, M. (2020). Individuals with obesity and COVID19: A global perspective on the epidemiology and biological relationships. Obesity Reviews.
  • Sallis, R., Young, D. R., Tartof, S. Y., Sallis, J. F., Sall, J., Li, Q., … & Cohen, D. A. (2021). Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British journal of sports medicine.
  • U.S. Department of Health and Human Services. (2018a). 2018 Physical activity guidelines advisory committee scientific report.