Most of us accept stress as a necessary evil that is a part of the American lifestyle. But living under stress day in and day out can lead to heart disease. According to the American Psychological Association, prolonged stress can contribute to high blood pressure and circulatory problems, and if stress makes you angry and irritable, you are more likely to have heart disease or even a heart attack.
How do you assess your clients’ balance? How can you adapt your training plan to deal with natural fluctuations in their balance?
Physical balance is complex and can change daily. Many clients will refer to how long they can stand on one leg when asked about balance issues, but how useful is this as a measure of their postural control or their risk of falling?
Many people who’ve had any kind of formal balance assessment have only done so after having a fall. New statistics show that falls are the leading cause of trauma room visits, across all age groups, and in the case of those over 65, 1 in 4 falls each year. Indeed, the number of deaths by falling is increasing, and yet there are many proven interventions to improve balance and avoid falls.
Many older adults are reluctant to discuss falls or balance issues with their doctors, some wrongly believing that falling is an inevitable part of aging and marks the beginning of the end for them.
Fitness trainers have a significant opportunity to help educate their clients in both the measurement and management of balance and balance issues.
Good balance is the result of the somatosensory, proprioceptive and neuromuscular systems working together. Each system is complex and can be affected by factors such as stress, quality of sleep, medications and exercise habits so understanding where your client is on any given day is helpful for optimizing their health goals.
Regular balance measurement can also be a powerful motivational tool, especially for older adults who want to remain independent and age on their own terms.
Dr. Katharine Forth is an expert in motor control, and conducted post-doctoral research at NASA, where she became the co-founder of Zibrio technology. The Zibrio SmartScale is a bathroom scale that uses artificial intelligence to measure balance and fall risk in a simple 60-second test. The product won an innovation award from the Consumer Technology Association in 2020, and was named by AARP as the winning technology to help ‘older adults stay in the game’ at their pitch competition at CES 2020, judged by Joe Montana. More information can be found at www.zibrio.com
The spine is a complex structure, comprised of nerves, connective tissue, bones, discs, muscles and other essential integrative components. Whether it getting out of a chair or car, lifting or carrying items, some 29 muscles around the pelvic girdle and lumbar spine, provide stability. In this article, we will review the anatomy of the spine, common injuries to the lumbar spine, functional assessments and training strategies to work with clients with previous injuries.
Get your older adult clients ready for the rigors of tourism and active vacations with these training tips and pre-travel exercises.
Do your over-55 clients or class members want to travel for pleasure but need more strength, stamina and mobility? Do they worry they’ll miss seeing the world because they lack physical ability?
Alzheimer’s Disease (AD) is a neurodegenerative disease that strikes fear and terror into those who are getting on in years and family members who are in line to care for them. According to the Alzheimer’s Disease Foundation, in 2015 it is estimated that 5.3 million Americans have the disease. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented (1) although some experts now estimate that it may be the third highest (2).
15 Million People Suffer Stroke Each Year. There is a huge “real” need for stroke survivors to have continued physical therapy after their insurance has covered their (usually very limited) physical therapy sessions.
It’s an important time for fitness professionals to step up and gain stronger knowledge in physical rehabilitation with stroke survivors. This need is worldwide!
I know this because I have helped survivors worldwide and heard their stories of struggle. I’ve personally heard their human desire to get their bodies back to movements for everyday life. This includes things like walking, arm and hand function, balance, cognitive skills, stability, driving and much more!! Hundreds of thousands of survivors are desperately seeking proper care and guidance.
I have been asked by stroke survivors and caregivers worldwide for help. After I published my first book in 2017, The Stroke of an Artist, The Journey of a Stroke Survivor and a Fitness Trainer, I began being contacted from all over the world for help. I wanted so badly to help them all.
I also received calls and messages from personal trainers who had a survivor client. I was surprised at how some reacted. For example, one trainer, after spending an hour sharing knowledge and telling him to seek out more education beyond the one-day certification he had, responded with “So basically…” — he tried to sum up in one sentence how to train a survivor. And he had it all covered. I thought, wow, that survivor’s recovery is determined by this trainer’s ego and lack of listening skills. Most trainers I spoke with wanted a quick answer to full-body stroke recovery. They did not want to take the time needed to extend their knowledge.
I decided to begin a Stroke Recovery support group via private Facebook group page. There are almost 3000 members. It breaks my heart, but it keeps me constantly motivated to do what I can to help them and try my best to educate fitness professionals.
It is wonderful to have such a gathering from all over the world in this stroke recovery support group. It is serial and fascinating. Everyone is so kind and supportive in the group to one another. They encourage and try to help each other so much.
Look at all the different countries our members have gathered together from: Israel, Europe, Switzerland, Australia, Canada, UK, Africa, Great Britain, Vietnam, New Zealand, Scotland, Philippines, Fiji, Ireland, Indonesia, Micronesia, Mumbai, Maharashtra, Turkey, and many States in the United States.
I know how real the urgent need is for fitness professionals to gain knowledge to help survivors get their lives back.
I decided to help get the survivors and caregivers educated since finding the professionals to help them sucked.
I then wrote my book, Stroke Recovery, What Now? When Physical Therapy Ends But Your Recovery Continues
Around this time Lisa Dougherty with the MedFit Education Foundation contacted me to be on the Education Advisory Board and write a Stroke Recovery and Exercise CEC course. I was very excited to have a platform to reach professionals to educate them to bring needed care to stroke survivors.
Fitness professionals and physical therapists must continue their education way beyond the basics of getting their original certification, license and credentials.
Hundreds of survivors have shared with me their struggles to find great care. The stories blow my mind and frustrated me tremendously.
Here is one recent story.
A 54-year-old female survivor, who lives 3 hours away from me, was so excited and filled with hope again after we met in my support group and reading my books and watching my videos. She began to get hand movement back and decided to go find a physical therapist again. She searched, asked questions and found someone who appeared and sounded like they had the knowledge and expertise to help her. She was excited, she sent me a private message and told me what the therapist said. It sounded good. This therapist spoke the neuro words.
This survivor shared in the support group how excited she was and tagged me, thanking me for helping her feel hope again. Everyone was proud of her and encouraging her. I was thrilled.
A few days ago, she sent me a message that after her 5th session with this therapist, the therapist told her that she’d never worked with a stroke survivor before and can’t help her. She said she had gained more knowledge and recovery from me than 5 sessions with this therapist.
This upsets me so much. She deserves great care and real help. All stroke survivors do. Now she has wasted 5 insurance paid PT session and 5 co-pays. That is not okay!
I have hundreds of stories like this and some are worse.
So, to all fitness professionals and therapists…
Please don’t fake your knowledge and experience to gain a client. Don’t just talk the talk. Put the time and effort into continuing your education. Have integrity, a heart of passion and honesty in your work.
This can mean someone may walk or not walk again.
This can mean someone can hold a fork in their hand again or not.
This may mean someone can go back to work or never again.
And so much more!
In the case of the Survivor who was an artist in my first book, it meant he would paint again or not. He did paint again.
Survivors are encouraged and try to believe, never give up and don’t quit. But they need to have educated professionals they can trust to join their personal stroke recovery team.
And the fabulous 54-year-old stroke Survivor refers to me as “God’s Stroke Angel”. That makes my heart feel warm and fuzzy. ❤
Fitness Specialist and Educator Tracy Markley is the Founder of Tracy’s Personal Training, Pilates & Yoga in Florence, OR. Tracy has over 2 decades experience in the fitness industry; she holds numerous specialty certifications, including many for those with medical conditions & chronic disease. She’s also studied the Brain and the neurological system, and has had great success working with seniors and special populations in stroke recovery, neurological challenges and fall prevention. Tracy also serves on the MedFit Education Foundation Advisory Board
She’s authored 3 books: “The Stroke of An Artist, The Journey of A Fitness Trainer and A Stroke Survivor” and “Tipping Toward Balance, A Fitness Trainer’s Guide to Stability and Walking” and “Stroke Recovery, What Now? When Physical Therapy Ends, But Your Recovery Continues”. Her books bring hope, knowledge and exercises to those in need, as well as sharing her knowledge and experience with other fitness professionals.
Cardiovascular fitness has become universally acknowledged as a major determinant of health outcomes. Yet relatively few fitness facilities help their members quantify fitness in the way that is recognized by the research and medical communities as being scientifically valid. As the fitness and medical communities become more connected and increasingly partner with one another, a common language about cardiovascular fitness should be used.
Did you know as a health-fitness professional you can have a positive effect on a client’s health, longevity, and brain function by simply helping them prevent and manage hypertension? The good news is that it is easy- just get them to exercise regularly. The influence of exercise on blood pressure is significant, and for most clients promoting healthy blood pressure is as easy as learning how to assess BP, prescribe regular exercise, and re-assess BP. Almost every client with elevated BP will see results with regular exercise… so why not be the BP hero?
To be a BP hero, it is important to be educated in the anatomy of BP, how BP works, how to assess BP, BP disease exercise warning signs, and what has a positive effect on maintaining a good BP or lowering an elevated BP. This article gives you a snapshot insight into the fascinating world of blood pressure and exercise.
The body delivers vital oxygen and nutrients and removes waste and metabolic by-products through the combined effort of the cardiovascular and respiratory systems, referred to in combination as the cardiorespiratory (CR) system. The lungs in the pulmonary system are of particular interest as the closed loop vascular system passes through the lungs to pick up oxygen and dispose of carbon dioxide. The success of this closed-loop system relies heavily on a delicate balance to provide effective distribution of blood to virtually all organs and cells in the body.
The proper function of the cardiorespiratory system, and the ability of blood to continuously loop though the system, depends on maintaining the proper pressure in the vessels and organs of the cardiorespiratory system. The pressure is primarily controlled by the vascular system. The pressure maintained in the CR system is measured and monitored by blood pressure.
Blood Pressure is defined as the pressure/force exerted on the arterial walls with each heart beat. (Cleveland Clinic 2019) Blood pressure can be measured directly by a catheter in the artery, or indirectly with a blood pressure cuff and sphygmomanometer. Two pressures in the arteries are measured to determine blood pressure:
Blood pressure is the amount of force (hydrostatic pressure) that pushes the blood through the vascular system. Pressure drops gradually as the large arterial vessels branch resulting in lower venous pressures (compared to artery pressure) as the blood progresses through the closed loop system. Blood pressure and associated measures are commonly expressed in millimeters of mercury or “mmHg.”
BP is expressed by ventricular systole over ventricular diastole, for example 120/80. Blood pressure does not remain constant and varies throughout the day or over time in the aging process depending on many factors including exercise, stress, body position, medication, cardiovascular condition, respiratory health, proper hydration, and age.
Blood Pressure depends primarily on body size.
So, children and young adolescents have much lower blood pressures than adults. (Kenney 2019)
Current Guidelines for BP Classification and ManagementAmerican Heart Association 2019 (www.heart.org) |
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Systolic BP |
Diastolic BP |
Classification |
*Recommendations |
| <120 and | <80 | Normal | Healthy lifestyle choices and yearly checks. |
| 120-129 and | <80 | Elevated Blood Pressure | Healthy lifestyle changes and reassessed in 3-6 months |
| 130-139 or | 80-89 | High Blood Pressure Stage I | 10 year heart disease and stroke risk assessment. If less than 10% risk, lifestyle changes and reassessed in 3-6 months. If higher after reassessment, lifestyle changes and medication with monthly follow-ups until BP is controlled. |
| ≥140 or | ≥90 | High Blood Pressure Stage II | Lifestyle changes and 2 different classes of medicine, with monthly follow-ups until BP is controlled. |
| *Individual recommendations need to come from health care provider.
Source: American Heart Association’s Journal Hypertension published November 13, 2017. |
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Hypertension is defined as:
“Having a resting systolic blood pressure (SBP) >140 mmHg and/or a resting diastolic blood pressure (DBP) >90 mmHg, confirmed by a minimum of two measures taken on at least two separate days, or taking antihypertensive medication for the purpose of blood pressure control.” (ACSM 2018)
This chronic medical condition is called the “silent killer” because there are typically no symptoms. Learning how to assess BP for your client can put you forefront in the fight to detect and fight this deadly chronic disease. Elevated blood pressure can increase the risk for coronary artery disease, stroke, heart attack, kidney disease, peripheral artery disease, and heart failure. There are both genetic and lifestyle factors that can affect the development of hypertension.
A client with hypertension should engage in regular exercise after their blood pressure is effectively controlled. Exercise to control and manage high blood pressure should only be initiated after the client has seen their health care professional and is under medical supervision and treatment. Systolic blood pressure can increase significantly during exercise, so the client coming to you with high blood pressure should not exercise without medical clearance.
Hypertension causes the heart to work harder than normal at rest and with activity because it must pump blood from the left ventricle against a greater resistance in the arteries. (Kenney 2019)
The American Heart Association updated guidelines recommend treatment options including lifestyle changes and blood pressure lowering medications. The lifestyle modifications for those with hypertension can lower systolic approximately 4 to 11 mmHg with the largest impact from diet and exercise. (Whelton et al., 2017)
It is well documented in research that even light-moderate exercise can help control and lower blood pressure if you have hypertension. The World Health Organization (WHO) recommends a minimum threshold of 150 minutes per week of moderate intensity physical activity for health and quality of life. This threshold of physical activity plays an important role in cardiorespiratory health, longevity, brain health, muscle/bone health, balance and fall prevention, and function to name a few. Maintaining physical activity/exercise is recommended for prevention and control of virtually all chronic diseases.
In most people, hypertension responds very well to using physical activity/exercise as an adjunct therapy. Starting regular exercise typically helps you control hypertension with lower medication doses. As a health-fitness professional, it is very rewarding to see a client reduce or eliminate blood pressure medication through a regular exercise program.
To learn more, register for the upcoming webinar on the topic, Be a Blood Pressure Hero. Or take a continuing education course about blood pressure and exercise. Knowledge is power and will help you to become a BP hero!
Compiled by June M. Chewning BS, MA. The information from this article is from “Blood Pressure, Hypertension, and Exercise.” A continuing education course offered by FLS.
June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.
References
One of the greatest concerns for the aging population is cognitive decline which leads to loss of independence as well as an extreme burden on the caretakers. Individuals worldwide are fearful of being diagnosed with any of the various cognitive issues: Dementia, Parkinson’s, Alzheimer’s, and other forms of cognitive debilities. In 2015 there was an estimated 47 million people living with dementia and this number is expected to triple by 2050. In 2014, the Alzheimer’s Association reported that they believe there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.
Positive association between aerobic exercise or CV fitness and executive functions is highly consistent but cannot determine causality. Aerobic exercise (AE) has shown moderate to medium sized effects on executive function and memory. Resistance Training (RT) has improved executive function and memory. Combined AE and RT has the biggest (potentially synergistic) effect. It has been proposed that the physical and cognitive exercise might interact to induce larger functional benefits. Larger benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. “Claims promoting brain games are frequently exaggerated and at times misleading. … To date, there is little evidence that playing brain games improves underlying broad cognitive abilities, or that it enables one to better navigate a complex realm of everyday life (Consensus statement, 2014).
Neuroplasticity is the brain’s ability to reorganize and rebuild itself by forming new neural connections. The more neural pathways you have, the more resilient your brain is. Neurogenesis is the process of creating new neurons (brain cells).
Contrary to popular belief, neurogenesis continuously occurs in the adult brain under the right conditions such as with exercise. Substantial benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. It was also noted that the physical and cognitive exercise together might interact to induce larger functional benefits. “We assume, that physical exercise increases the potential for neurogenesis and synaptogenesis while cognitive exercise guides it to induce positive plastic change” (Bamidis, 2014). To maximize cognitive improvement, combine physical exercise with cognitive challenges in a rich sensorimotor environment that includes social interaction and a heaping dose of fun.
Brain health is becoming extremely important as individuals live longer. Today there is much more information available on how to train the aging brain.
Some great resources are:
Dianne McCaughey Ph.D. is an award winning fitness specialist with more than 35 years experience in personal training, group exercise, coaching, and post-rehabilitation. She is a master trainer for multiple companies and practices and teaches optimal wellness emphasizing the mind, body and spirit. She works with special populations and focuses on posture, gait, balance and corrective exercise programs for better function and health.
Cody Sipe, PhD, has an extensive background in the fitness industry with 20 years of experience as a personal trainer, fitness instructor, program director, exercise physiologist and club owner. He is currently an Associate Professor and Director of Clinical Research in the physical therapy program at Harding University. He is the co-founder and vice president of the Functional Aging Institute (FAI).