Upload
sue-scott
View
3.843
Download
0
Tags:
Embed Size (px)
DESCRIPTION
Designed for Personal Trainers, this workshop will help trainers asses the needs and design exercise programs for older adults to improve balance, stength, posture and flexiblity. The ideas are fun and fresh, specific to balance and mobiltiy skills and based on the book, ABLE Bodies Balance Training (Human Kinetics, 2008).
Citation preview
April 10, 2023
P r e s e n t e d b y
Sue Scott, MS
Renewable Fitness & ABLE BODIES®
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S ®
Balance Training Tool Box
for Older Adults
A Squeaky Wheels Approach to Balance and Mobility
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Better Living through Exercise
ABLE CAPABLEBALANCED
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Squeaky Wheels Approach to Balance
• Exercise Science Perspective
• Critical Thinking
• People Skills
Able, Capable Living
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Perspective: Exercise As Medicine
Imagine the possibilities!
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Exercise as Medicine
Movement is a medicine
for creating change
in a person's
physical, emotional, and mental states.
~Carol Welch
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Prescribing Exercise as Medicine
Specificity
Overload
Protocols Mode, IntensityFrequency, Duration
Outcomes
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Specificity
Finding the right targets
• Specific to tasks• Appropriate systems
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Overload
Stress that is more than normalIndividualSystem(s)Engaging, challenging, safe
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
ACSM Position Statement on Balance Training
Use progressively more difficult postures . . .
that gradually reduce the base of support
require dynamic movements that disturb the center of gravity
stress posturally important muscle groups
reduce sensory input
conform best to the accepted theories of balance control and adaptation
~ASCM Position Statement, 1998
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Balance Protocols for Fragile Elderly
SpecificityOverload
ProtocolModes
•Specific to goals •Engage relevant systems•Multiple modes•Layering
Intensity•Challenge system •Engage the Individual
Frequency & Duration•Still researching
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Understand the Overall Picture . . . Specific components for balance in the
elderly
Strength
PostureFlexibility
VisionVestibularSomatosensoryReflexes
ExperiencesSkillsLearning
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
What Tools Will You Need in Your Tool Box?
Posture & Flexibility
Strength & EndurancePurposeful strength
•Legs, core muscles and triceps
Balance and MobilityVisual, vestibular Somatosensory Automatic systemsGait training & ADL skills
Confidence & Trust Educate and engage their mind Good, clean fun
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Where to Start?
Tools Critical thinking skills
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Assessments
Identify & Explore ProblemsObserve
•Posture•Flexibility•Agility•Strength
Written evaluations•Existing•Balance Confidence
So Ma’am, What seems to be the
problem?
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Assessments
Flexibility & PostureModified Sit & Reach (Rikli, Jones) Back Scratch Test (Rikli, Jones) Grids
StrengthChair Stands
Endurance 2-minute Step Test (Rikli, Jones) 6-minute Walk (Rikli, Jones)
PowerMax Gait Speed (Rose)
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Balance Assessments
BALANCE Walkie Talkie (Rose) Walk with Head Turns (Horak)
Modified CTSIB (Horak, Rose)
Get up and Go (Rikli, Jones; Horak)
Rise to Toes (Horak)Toe Taps on Step (Horak) Functional Reaching (Rose)
Tandem Walk (Rose)Tandem Stand
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Balance Training Progressions and Layering . . .
Gradual increases in difficultyResistanceBalance requiredComplexity of the taskNumber of systems involved
Makes each exercise or activity more productive
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Flexibility
Improves range of motion in key joints
Better posture More efficient movement
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Flexibility
Ankles & Calves Hamstrings, Gluteals AB/ADDuctors
Chest & BackShoulder girdleTriceps
Axial skeletonHead turns, tilts, rolls, chin dips
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
FLEXIBILITY Tools
Conceptual Activities Enhance cognitive learningLearn with their bodies and their minds •Inside out Learning
Build confidence & trust
Physical ActivitiesTarget key jointsProvide somatic cues & sensations
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Conceptual Flexibility
Venus Di Milo Arms
Inside-Out Learning
A sense that their arms can reach much
further
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Flexibility Activity
Supple Spine
Relaxercise - Zemach-Bersin and Reese, 1990
Even gentle flexibility can improve function
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Whole Body Flexibility
Farmer’s StretchCarry the
Baby
Gentlemen’s Bow
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Posture & Core Stability
Inter-related, ComplimentaryProper alignmentBraces posture
Steadies against balance disturbancesJostling crowds, perturbationsHead turns, arm swings
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Conceptual Posture Tools
Parts of the Whole
Breathe Easy
Posture Affects Function
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Conceptual Core Strength Tool
Torso as a Cylinder
Take Home MessagePosture affects balanceRenewable
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Conceptual Tool for Core Stability
Mohammed & the Mountain
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Training Core Strength
Target MusclesScapula & Head RetractorsAbdominals & Obliques Back Extensor
Simple to ComplexParts to WholeResistanceTask ComplexityElements of Balance
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Sample Strength Progressions
Tall SitsAdd overload
•Reps, time•Resistance
Add motion •Buddha’s Prayer•Curl up & sit tall•Indian Chiefs, Chiefs w/a twist, w/ knee lift
Add elements of Balance •Narrowed base•Dyna Disc
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Posture & Core Strength Training
Rows Seated w/ a tall a sit Alternating arms or obliquely Seated on a Balance discCombined with small squats
Knee Lift, Abs inSeatedCurl up and sit tallStandingDyna disc or ball w/ holder
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Core Stability – Back Extensors
Up & UpsStretchingReaching w/one armAdd Venus Di Milo ArmsW/ balloon W/resistance YMCAsStanding
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Strength with a Purpose
Target MusclesPosture and Back ExtensorsWhole legTriceps
Movement patterns mimic ADLsFlag SalutesTeeter Totter Chair Stands
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Progressions & Layering for Strength Training
As tolerated To fatigue (within 6-15 reps)Parts of motion before whole motionSingle muscles groups to multiple muscle groupsSeated, Standing, MovingMusicSecondary tasks
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
More Examples: Heel & Raises
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Balance Training
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Balance Safety & ConfidenceTAKE TURNS!
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Systems of Balance
Visual Somatosensory Vestibular
Automatic
Integrated Many systems are used simultaneouslyLayers of systems, skills, experiences
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Vision - Visual Targets
Look ahead HorizonNext turnLook awayFlash Lights
Layer Posture & Core StabilityBalance Challenge
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Kinesthetic – Somatosensory
The Ball GameComing to our Senses
Belly Button Training
Sways and CirclesTai Chi
Reduced vision
Inside Out Learning
Cue for sensations
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Vestibular
Head & or Eye MotionSeatedDiscs, BallsStandingWalking
ExamplesSeated
•Head moves•Eyes move
Walking•Words on the Wall in the Hall
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Transitions – Control CoM
Already covered Sit to Stand Belly Button Training Sways Heel Toe Rocking
Traffic SchoolChange of PaceChange Directions Red light, Green LightObstacle Course
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Transitions – Controlling C of M
Walk the Line
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Transitions with Music
Side SteppingHeel ToeHeel touchesBack touchesBoth
MarchingToe TapsOn the groundTo a lineOn a stepOn a higher step Mind -
Body Connection
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Gait
Rock n WalkStride LengthObstacle Course
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Automatic
Dual TasksVerbalMotorCognitive
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
The Need for Better Balance Programming
In 2004
Best Practices StatementBest Practices Statement
Physical Activity Programs and Physical Activity Programs and Behavior Counseling in Behavior Counseling in Older Adult PopulationsOlder Adult Populations
MSSE 36:11; 2004MSSE 36:11; 2004
Found just 6 exercises to improve balance in frail
elderly
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Background: How Did I Get Here?
Sue Scott, MSMasters & Bachelors in Exercise Science
ASCM certified
Exercise Prescription, Kinesiology at PSU
Specialize in balance & mobility for older adults•Frail Elderly •Parkinson's Disease
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Develop appropriate physical activities to improve balance and balance confidence in frail populations Encourage the elderly to live active, capable, involved lives Make these ideas available to others
Mission
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Exercise Enables
Capable, Able, ActiveTo do whatever we enjoyMore self-reliant, independentConnected to families, communities & values
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Achievements
Achievements2000 Developed a balance training program•Designed for Frail Elderly
PostureFlexibilityStrength with a purposeBalance Challenges
2003 Grant from National Blueprint Active Aging Partnership •Tested ABLE BODIES® techniques•Significant improvements Balance, strength, flexibilty and daily activity
© 20
07 ID
EA H
ealth
& F
itnes
s As
socia
tion.
All R
ight
s Re
serv
ed.
w w w . i d e a f i t . c o m I N S P I R E T H E W O R L D T O F I T N E S S®
Blueprint Momentum
IAHSA Trondheim, Norway
ACSMAnnual Meeting, Nashville
APHAPhiladelphia
OHCAPortland, Oregon
Human KineticsDue out next year