Balance Training Toolbox for Older Adults

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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 …

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).

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Transcript

  • 1. Balance Training Tool Box for Older Adults A Squeaky Wheels Approach to Balance and Mobility
  • 2. Better Living through Exercise ABLE CAPABLE BALANCED
  • 3. Squeaky Wheels Approach to Balance
    • Exercise Science Perspective
    • Critical Thinking
    • People Skills
    Able, Capable Living
  • 4. Perspective: Exercise As Medicine
    • Imagine the possibilities!
  • 5. Exercise as Medicine Movement is a medicine for creating change in a person's physical, emotional, and mental states.  ~Carol Welch
  • 6. Prescribing Exercise as Medicine
    • Specificity
    • Overload
    • Protocols
      • Mode, Intensity
      • Frequency, Duration
    • Outcomes
  • 7. Specificity
    • Finding the right targets
      • Specific to tasks
      • Appropriate systems
  • 8. Overload
    • Stress that is more than normal
      • Individual
      • System(s)
      • Engaging, challenging, safe
  • 9. 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
  • 10. Balance Protocols for Fragile Elderly
    • Specificity
    • Overload
    • Protocol
      • Modes
        • Specific to goals
        • Engage relevant systems
        • Multiple modes
        • Layering
      • Intensity
        • Challenge system
        • Engage the Individual
      • Frequency & Duration
        • Still researching
  • 11. Understand the Overall Picture . . . Specific components for balance in the elderly
    • Strength
    • Posture
    • Flexibility
    • Vision
    • Vestibular
    • Somatosensory
    • Reflexes
    • Experiences
    • Skills
    • Learning
  • 12. What Tools Will You Need in Your Tool Box?
    • Posture & Flexibility
    • Strength & Endurance
      • Purposeful strength
        • Legs, core muscles and triceps
    • Balance and Mobility
      • Visual, vestibular
      • Somatosensory
      • Automatic systems
      • Gait training & ADL skills
    • Confidence & Trust
    • Educate and engage their mind
    • Good, clean fun
  • 13. Where to Start?
    • Tools
    • Critical thinking skills
  • 14. Assessments
    • Identify & Explore Problems
      • Observe
        • Posture
        • Flexibility
        • Agility
        • Strength
      • Written evaluations
        • Existing
        • Balance Confidence
    So Ma’am, What seems to be the problem?
  • 15. Assessments
    • Flexibility & Posture
      • Modified Sit & Reach (Rikli, Jones)
      • Back Scratch Test (Rikli, Jones)
      • Grids
    • Strength
      • Chair Stands
    • Endurance
      • 2-minute Step Test (Rikli, Jones)
      • 6-minute Walk (Rikli, Jones)
    • Power
      • Max Gait Speed (Rose)
  • 16. 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
  • 17. Balance Training Progressions and Layering . . .
    • Gradual increases in difficulty
      • Resistance
      • Balance required
      • Complexity of the task
      • Number of systems involved
      • Makes each exercise or activity more productive
  • 18. Flexibility
    • Improves range of motion in key joints
    • Better posture
    • More efficient movement
  • 19. Flexibility
    • Ankles & Calves
    • Hamstrings, Gluteals
    • AB/ADDuctors
    • Chest & Back
    • Shoulder girdle
    • Triceps
    • Axial skeleton
      • Head turns, tilts, rolls, chin dips
  • 20. FLEXIBILITY Tools
    • Conceptual Activities
      • Enhance cognitive learning
      • Learn with their bodies and their minds
        • Inside out Learning
      • Build confidence & trust
    • Physical Activities
      • Target key joints
      • Provide somatic cues & sensations
  • 21. Conceptual Flexibility
    • Venus Di Milo Arms
    Inside-Out Learning A sense that their arms can reach much further
  • 22. Flexibility Activity
    • Supple Spine
    Relaxercise - Zemach-Bersin and Reese, 1990 Even gentle flexibility can improve function
  • 23. Whole Body Flexibility Farmer’s Stretch Carry the Baby Gentlemen’s Bow
  • 24. Posture & Core Stability
    • Inter-related, Complimentary
      • Proper alignment
      • Braces posture
    • Steadies against balance disturbances
      • Jostling crowds, perturbations
      • Head turns, arm swings
  • 25. Conceptual Posture Tools
    • Parts of the Whole
    • Breathe Easy
    • Posture Affects Function
  • 26. Conceptual Core Strength Tool
    • Torso as a Cylinder
    • Take Home Message
      • Posture affects balance
      • Renewable
  • 27. Conceptual Tool for Core Stability
    • Mohammed & the Mountain
  • 28. Training Core Strength
    • Target Muscles
      • Scapula & Head Retractors
      • Abdominals & Obliques
      • Back Extensor
    • Simple to Complex
      • Parts to Whole
      • Resistance
      • Task Complexity
      • Elements of Balance
  • 29. Sample Strength Progressions
    • Tall Sits
      • Add 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
  • 30. Posture & Core Strength Training
    • Rows
      • Seated w/ a tall a sit
      • Alternating arms or obliquely
      • Seated on a Balance disc
      • Combined with small squats
    • Knee Lift, Abs in
      • Seated
      • Curl up and sit tall
      • Standing
      • Dyna disc or ball w/ holder
  • 31. Core Stability – Back Extensors
    • Up & Ups
      • Stretching
      • Reaching w/one arm
      • Add Venus Di Milo Arms
      • W/ balloon
      • W/resistance
      • YMCAs
      • Standing
  • 32. Strength with a Purpose
    • Target Muscles
      • Posture and Back Extensors
      • Whole leg
      • Triceps
    • Movement patterns mimic ADLs
      • Flag Salutes
      • Teeter Totter Chair Stands
  • 33. Progressions & Layering for Strength Training
    • As tolerated
    • To fatigue (within 6-15 reps)
    • Parts of motion before whole motion
    • Single muscles groups to multiple muscle groups
    • Seated, Standing, Moving
    • Music
    • Secondary tasks
  • 34. More Examples: Heel & Raises
  • 35. Balance Training
  • 36. Balance Safety & Confidence TAKE TURNS!
  • 37. Systems of Balance
    • Visual
    • Somatosensory
    • Vestibular
    • Automatic
    • Integrated
      • Many systems are used simultaneously
      • Layers of systems, skills, experiences
  • 38. Vision - Visual Targets
    • Look ahead
      • Horizon
      • Next turn
      • Look away
      • Flash Lights
    • Layer
      • Posture & Core Stability
      • Balance Challenge
  • 39. Kinesthetic – Somatosensory
    • The Ball Game
    • Coming to our Senses
    • Belly Button Training
    • Sways and Circles
    • Tai Chi
    • Reduced vision
    Inside Out Learning Cue for sensations
  • 40. Vestibular
    • Head & or Eye Motion
      • Seated
      • Discs, Balls
      • Standing
      • Walking
    • Examples
      • Seated
        • Head moves
        • Eyes move
      • Walking
        • Words on the Wall in the Hall
  • 41. Transitions – Control CoM
    • Already covered
      • Sit to Stand
      • Belly Button Training
      • Sways
      • Heel Toe Rocking
    • Traffic School
      • Change of Pace
      • Change Directions
      • Red light, Green Light
      • Obstacle Course
  • 42. Transitions – Controlling C of M
    • Walk the Line
  • 43. Transitions with Music
    • Side Stepping
    • Heel Toe
      • Heel touches
      • Back touches
      • Both
    • Marching
    • Toe Taps
      • On the ground
      • To a line
      • On a step
      • On a higher step
    Mind - Body Connection
  • 44. Gait
    • Rock n Walk
    • Stride Length
    • Obstacle Course
  • 45. Automatic
    • Dual Tasks
      • Verbal
      • Motor
      • Cognitive
  • 46. The Need for Better Balance Programming
    • In 2004
    Best Practices Statement Physical Activity Programs and Behavior Counseling in Older Adult Populations MSSE 36:11; 2004 Found just 6 exercises to improve balance in frail elderly
  • 47. Background: How Did I Get Here?
    • Sue Scott, MS
      • Masters & Bachelors in Exercise Science
      • ASCM certified
      • Exercise Prescription, Kinesiology at PSU
      • Specialize in balance & mobility for older adults
        • Frail Elderly
        • Parkinson's Disease
  • 48.
    • 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
  • 49. Exercise Enables
    • Capable, Able, Active
      • To do whatever we enjoy
      • More self-reliant, independent
      • Connected to families, communities & values
  • 50. Achievements
    • Achievements
      • 2000 Developed a balance training program
        • Designed for Frail Elderly
          • Posture
          • Flexibility
          • Strength with a purpose
          • Balance Challenges
      • 2003 Grant from National Blueprint Active Aging Partnership
        • Tested ABLE BODIES® techniques
        • Significant improvements Balance, strength, flexibilty and daily activity
  • 51. Blueprint Momentum
    • IAHSA
      • Trondheim, Norway
    • ACSM
      • Annual Meeting, Nashville
    • APHA
      • Philadelphia
    • OHCA
      • Portland, Oregon
    • Human Kinetics
      • Due out next year