Falls in the aging American Population represent one of the most serious and complete-
ly overlooked cause of serious injury, loss of independence and early death. In fact, the
focus on Osteoporosis and its pharmacological treatment is misplaced in that the way
that Osteoporosis often manifests itself is with a fall, and pharmacological treatment of
Osteoporosis does nothing to address fall risk which is a more significant risk factor
than bone density for fracture risk (see below). We will provide a program and method
to significantly reduce fall risk by increasing strength, balance, muscles mass and bone
density with a minimal amount of commitment of time and little to no formal exercise.
A brief look at some statistics on falls and osteoporosis will illustrate just how signifi-
cant falls are and just how large an impact they have on quality and length of life for
• Falls are the #1 cause of death as a result of unintentional injury among people
75 and older, (motor vehicle accidents are #2), and falls are the #2 cause of death
as a result of unintentional injury among people age 65-74.
• Falls are the # 1 cause of non-fatal unintentional injuries treated in hospital
emergency rooms in every individual age group except ages 15 – 24, and overall
falls are the # 1 cause of non-fatal unintentional injuries treated in hospital
emergency rooms among all ages.
• Falls result in the second most expensive worker’s compensation claims costs. The
average cost of a claim due to a fall or slip is $23,929. (Claims due to motor
vehicle accidents are first, at an average cost of $46,033.)
• Very few people are ever screened by their physicians (or anyone else) for balance
issue until AFTER they fall.
• Very few physicians have any training or tools to adequately assess fall risk.
• One out of every three people older than 65 will fall this year.
• 50 percent of people older than 65 who have fallen will fall again in the next 12
• Most falls are unreported (even serious falls) because seniors fear losing their
• Loss of independence is the most common fear of seniors, and in fact many seniors
would rather die than lose their independence.
• Strength and balance training can significantly reduce the number of falls.
• The pharmacological treatment of Osteoporosis using biophosphonates drugs
reduced vertebral fractures when 90% of patients complied with drug use
during three years of treatment. For T-score less than -2.5, the cost of preventing
one hip fracture is about $45,825, yet 70% of fractures still happen.
• There is even less evidence for hip fractures. For example, in an ideal world 577
post-menopausal women must be treated for one year to avert one hip fracture
at a cost of about $234,000, and outside of clinical trials, drug treatment is less
effective since only 50% of patients will use the drugs for one year.
• Must be very careful when interpreting drug company studies. For example in a
study on Raloxifene, authors cite a 75% reduction using relative risk vs the
actual reduction at 0.9%, BUT this translates into treating up to 270 women for
three years to prevent ONE vertebral fracture.
• Among older people, falling, NOT Osteoporosis is the strongest risk factor for
• The type and severity of fall determines if fracture occurs.
• 1 SD decrease in BMD increases facture risk by 2-2.5 times while a sideways fall
increases it by 3-5 times, up to 30 times if you hit the head of the greater
• 15% - 50% reduction in falls can be attained with proper training.
• Must do Fall Risk Assessment in adults over 50.
• Earlier tests such as stand and go are too subjective.
• Modern computerized tools now available.
• Up to 50-60% of all persons screened over 50 will fail screening.
• To date, the prevention of bone loss has been approached through drug intervention.
• Long term safety is uncertain.
• This approach ignores that bone structure changes in response to mechanical stimuli
which, until recently, has been ignored.
• Our program will utilize state of the art computerized fall risk screening to provide a
baseline and system to accurately measure initial fall risk and subsequent
improvement in fall risk utilizing the CAPS Computerized Dynamic
Posturography System by Vestibular Technology which represents the gold
standard for fall risk evaluation.
• The combination of vibrational training with the Impulse Training System and other
proven balance modalities will provide the most comprehensive system
to date to simultaneously address muscular strength, stability, balance,
proprioception, muscle mass, bone density and reduction of fall risk utilizing an
extremely time efficient protocol that will result in maximum compliance and
results with a very, very low cost.
• Our program will involve a total of 45 minutes of time (3 fifteen minute visits) per
• And we will provide a home-based option utilizing vibrational exercise combined
with other balance training.
• Increases bone blood flow.
• Increases muscle strength.
• Increases balance.
• Increases bone strength.
• Improves lymph flow.
• In one study BMD increased by 4.3% compared
to no change with walking.
• Relieves back pain.
• Strength training also led to no BMD changes.
• Elderly women complied to use at 93%.
• 95% reported satisfaction with using vibration.
• 57% preferred vibration over using oral medications.
• Increases muscle strength and nerve-muscle function.
• Improves hormonal profile.
• Slows aging.
• Safe even in heart transplant patients.
• Everyone over 50 should receive vibration stimulus for at least 20-30 minutes/week.
• Easy to perform with no perceptible effort required.
Impulse Training System
• This system allows people of all ages and
levels of health, access to increased
strength, improved organ function,
and greater bone density. The propri-
etary software uses exceedingly accu
rate load cell data, processes it for
dynamic display to support sessions in real time. User exercise data moves via
the internet to a network operations center for analysis and algorithm driven
recommendations for user recovery, fortification, and exercise timing.
• With conventional resistance training, a person picks up a weight (or moves a bar
that’s connected to a weight stack) and imposes load on the body. In the course
of the range of motion there is a risk of injury. With Impulse Training however,
the load used is created by the individual exerciser. This means that no matter
how hard one exercises the load that is being dealt with is never beyond what is
• After a client finishes an exercise session, he or she gets a printout representing all
sessions and including an analysis and recommendation section so the software
can prescribe the proper recovery timing.
What Medical Doctors Say Following Bone Density Testing of Female PHS Clients:
• Dr. Baldwin: “3% increase in BMD, please continue PHS exercise program.”
• Dr. Kako: “3.5% lumbar, and 3% neck increase in BMD since 2005.”
• Dr. Hetrick: “6.0% BMD increase from the prior examination of 11-02-04.”
What experts (Medical Doctors) say after 36 months of operation:
• Dr. Hynote: “Can I have one of these machines in my clinic?”
• Dr. Sakakihara: “My muscles have turned from flab to rock.”
• Dr. Shifflett: “I couldn’t be more enthused about this training and exercise program.”
• Dr. McCoy: “There is a good scientific foundation for what PHS is doing.”
Client results after 36 months of operation:
• Active 2005 Clients Average Strength Gain (3 years) 123%
• Active 2006 Clients Average Strength Gain (2 years) 63%
• Active 2007 Clients Average Strength Gain (1 year) 42%
• Average age 2005 Clients 52
• Average age 2006 Clients 46
• Average age 2007 Clients 51
Design and Implementation
• A Clinic location has been
secured at the
• HAC is a 120,000 square
foot state of the art
complex with over
13,000 members ages 1 – 95.
• The HAC geographic market (12 minute Drive Time at rush-hour) contains 33,000
households with projections of over 35,000 by 2012 with an average household
income of $110,000.
• The HAC geographic market contains 30,361 adults over the age of 50.
• In its Geographic Market HAC has penetrated many carrier routes to the point that
35% of the homes are members of the club so is uniquely positioned to bring a
new program to market.
• The StandStrong™ Clinic within HAC will have its own private entrance so that
non-members can utilize the clinic without joining or in fact ever having to use
• StrandStrong will be marketed directly to the public and through HAC’s network of
• The primary sales/marketing tool will be computerized free fall risk screens.
• Roger Ralph – Principal Hockessin Athletic Club (see attached bio)
• Bob Carpenter – Principal Hockessin Athletic Club (see attached bio)
• Greg Maurer – General Manager Hockessin Athletic Club (see attached bio)
• Dr. Gregory Ellis – PhD., CNS (see attached bio)
• Ed Trainor – Executive V.P. Fitness Town Sports International (see attached bio)
• Fred Seabright – Strength Training Consultant
ROGER RALPH is a 1963 graduate of Middlebury College where he majored in
history. Roger holds a Masters Degree in International Affairs from Columbia
University and was a Loeb Fellow at Harvard University. He began his career in the
health club industry at the age of 37 when he quit his job as a Vice President of the
Columbia Association in the new town of Columbia, MD to seek financing to build a
health club. After a year’s effort and rejection by most banks in the State of Maryland,
Roger and his wife Elaine obtained an SBA guaranteed loan and in 1980 opened a
25,000 sq. ft. racquetball club and fitness center in Bel Air, MD.
When the Ralphs sold the Bel Air Athletic Club to the Wellbridge Company in 2000, it
had grown incrementally to 120,000 sq. ft. on eight acres and from 15 employees to 350.
It made the International Health, Racquet and Sportsclub Association’s (IHRSA) list as
one of the top five health clubs in the United States. Roger is a past recipient of
IHRSA’s Distinguished Service Award. He and his wife Elaine were honored by Ernst
and Young as Entrepreneurs of the Year for the State of Maryland and by the Small
Business Administration as an outstanding small business model.
Prior to partnering with Bob Carpenter on the Hockessin Athletic Club, Roger worked
with Cal Ripken, Jr. assisting him in organizing his post career businesses and
launching the Cal Ripken, Sr. Foundation. Roger is a Board Member of the Maryland
Mentoring Partnership and the Cal Ripken, Sr. Foundation. He is a former Board
Member of IHRSA, the Harford Community College (HCC) Foundation, the Harford
County Boys & Girls Clubs, and the Columbia Foundation. Roger has been a faculty
member at IHRSA’s Management Institute, the Harford Leadership Academy, and in
2005 the Commencement speaker at HCC.
(For related information view www.RogerRalph.com)
Roger and his wife have three grown children and live in Stevensville, Maryland,
a few miles from the Chesapeake Bay Bridge.
BOB CARPENTER went to the University of Delaware where he played varsity base-
ball and graduated with a degree in Criminal Justice in 1986. Two years later Bob and
his family took over the Pike Creek Fitness Club in Pike Creek. Under Bob’s leadership,
the club was modified and improved substantially. Bob sold the facility in 2007 in order
to devote 100% of his time to his new venture, the
105,000 sq. ft. Hockessin Athletic Club.
In 2003, Bob and his family entered into a contract with local auctioneer and
property owner John McGrellis to purchase 11.5 acres that was being used primarily as
a mushroom processing site. The purchase was contingent on having the land appro-
priately rezoned in order to build a large scale family and community oriented health
club. With virtually unanimous community support, the property was
successfully rezoned. After a complicated and lengthy planning process--which includ-
ed the construction of a shared use 337 space parking deck and coordinated efforts
with the Delaware State Department of Transportation, owner of Tweed’s Park--the
Hockessin Athletic Club (HAC) opened its doors to members on
June 10, 2007.
Bob is proud that HAC is positively impacting the health of thousands who use the
club regularly and the economic benefit the club is bringing to New Castle Country as
employer of more than 350 men and women. His personal interest in yoga led him to
provide for the public and HAC members the only “hot” yoga studios within a U.S.
health club in the United States.
Bob is active in the community and supports various charitable causes. He is a member
of a national Executive Roundtable for health club owners and managers. He and his
wife Lynn and their three children live in Wilmington.
GREG MAURER is a summa cum laude graduate of Temple University, which he
attended after four years in the Marine Corp. Greg holds a Practitioner's Certificate in
Homeopathy from the British Institute of Homeopathy and is a Certified Nutrition
Prior to becoming HAC’s General Manager, Greg held similar positions at the Pike
Creek Fitness Club, and the Tilton Fitness Club in Mays Landing, New Jersey. In
addition to managing health clubs, Greg was the inventor of the Training Camp Slide
which he also marketed and manufactured. In this capacity he created and edited five
instructional videos for instructors and users, and managed a network of 75 Lateral
Motion Trainers who trained and certified instructors in the correct use of the slide.
After selling the rights to the Training Camp Slide which was distributed in Europe,
Japan, Canada, South America, and the U.S., Greg developed a proprietary weight
management program used in 12 centers and managed a team of 15 trainer/instructors.
Greg’s professional experience combines in-depth functional knowledge with "real
world" business experience. His hard work, leadership, passion, and knowledge of
health and fitness have provided HAC members and staff with the opportunity to
experience some of the most advanced technology used in the health club industry.
His role in StandStrong Clinics™ will be to act as the day-to-day onsite business
director of the initial StandStrong Clinic™ being located in the Hockessin Athletic
GREGORY ELLIS, Ph.D., CNS has extensive knowledge in many and varied areas of
health improvement and fitness. He received his Ph.D. degree from the Temple
University School of Medicine’s Department of Physiology. He has a graduate level
certification in nutrition from the American College of Nutrition (Certified Nutrition
Fascinated with weight training since childhood, he opened one of the first Nautilus
exercise centers in the country in the early 1970’s. Dr. Ellis has consulted with
professional and amateur athletes. He has extensive knowledge about weight control
and muscle building and has completed pioneering research in body composition. He
specializes in the biochemistry of energy metabolism, nutritional supplementation, and
advanced techniques such as contemporary homeopathy.
Another area of interest is the effects of environmental pollution (including industrial,
agricultural, and pharmaceutical pollution) and their negative impact on health
maintenance. Dr. Ellis believes in integrating research with its ultimate goal: applica-
tion for use by individuals. In addition to lecturing and writing, he has developed
cutting-edge nutritional products, exercise equipment, and monitoring devices for
weight control and fitness. Dr. Ellis operates a large clinical nutrition practice in the
suburban Philadelphia area.
ED TRAINOR came to Town Sports International in 1983 from Washington DC after
working the prior two years with Roger Ralph, both at the Bel Air Athletic Club, and
the Washington Sports Club. Previously, Ed was a tenured teacher and coach in the
Maryland School system. His ten years of experience, along with his BS and MS in
Physical Education, qualified him as TSI Fitness Director until 1989 when he became
Vice President of Fitness Services and Product Development, a title he holds today.
In his twenty-five years with TSI, Ed has contributed to the team effort of building
the company from three squash clubs to the dominant 165 club chain in the
Ed's current role is to help TSI continue develop the best fitness industry product for
its 500,000 members through innovation and research. TSI and Ed have developed
industry recognition and networking strategies with manufacturers and other club
operators worldwide that give the company its first alert status, helping it stay at the
forefront of today’s consumer-driven market. Ed's daily responsibilities include annual
evaluations of club needs in new and replacement equipment, as well as the manage-
ment and maintenance of all fixed assets related to the fitness product, from the
developmental stages of club layout, through the purchasing, installation and