Transcript Evidence-Based Physical Activity Programs for Seniors

Evidence-Based Physical Activity
Programs for Seniors: Preliminary
Findings
Jean A. Seward, BSPT, LPT. , Physical Therapist
and President
Seniors In Motion, Inc.
with help from:
Shigeaki Meguro, MBA, CSCS, Assistant Program
Director
and
James Swan, PhD, & Rudy Ray Seward. PhD
University of North Texas, Denton, TX 76203
Introduction
• Successful aging has become a message of the media.
• The media has bombarded us with good health
practices that have become the quantitative
parameters of our daily lives.
• “How many” health factors include hours of sleep,
many fruits and vegetables, many ounces of wine,
minutes of exercise, many steps walked, pounds of
weight lifted, etc.
• Factors could rise to a crescendo of exhausting
obligations leaving little hope for accomplishment.
Education versus Action
• Drum beat of staying active and healthy in aging can be
heard but how it is perceived and applied to our lives?
• Education is a component that can explain the
importance of diet and exercise in a healthy lifestyle.
• May lead to insight and understanding but not always
to good health actions.
• Most people know the dangers of smoking, poor diet,
being overweight and high blood pressure.
• “we don’t have a failure to educate, we have a failure
to motivate”.
Motivating and empowering older Americans to
be active and healthy mandated
• “The aging of the US population is one of the
major public health challenges we face in the 21st
century.”
• By 2050, 1 out of every 5 Americans will be over
the age of 65
• Living longer and chronic conditions identified as
predominantly age related have become a vital
focus of the health care delivery system.
• Most older Americans today will not die of
infectious diseases as in other generations.
Why a senior fitness facility?
• Preventative care is a solution many health care providers
have been reluctant to embrace.
• Treatment intervention defined as skilled is covered and
payable, prevention care is not.
• After 35 years of practice in community care difficult to
understand why it is more worthy to treat a broken hip
than to educate and prevent a fall.
• Health care reform will either address this inverted issue or
we will continue to search for cures or better treatment
options for conditions that could have been prevented.
• This problem and my experience in patient care is what led
me to establish a non-profit senior fitness facility in 2003.
The Story of Seniors in Motion (SIM)
• In 2003, a consensus realization emerged among the staff
therapists, nurses, and medical social workers with whom I
had been practicing in the Denton community since 1980.
• The realization was that an intervention program
encompassing physical fitness and education was needed
to promote a healthier lifestyle for older Denton area
residents.
• The idea that a community program could function as a
non-profit entity and provide an affordable wellness
opportunity to older residents grew with our concern for
increasing health care costs and the increasing demand for
our professional services.
The Story of Seniors in Motion (SIM)
• Intervention with education and exercise at an
earlier point in the aging process could make a
significant difference in preventing or
modifying a condition which would require
medical services at a later time.
• The benefits of exercise and staying active
would bring a quality of life to advancing
years.
The Story of Seniors in Motion (SIM)
•
Our vision was to promote FITNESS THROUGH EXERCISE AND WELLNESS THROUGH
EDUCATION.
•
A feasibility study conducted in 2003 surveyed physicians providing services to
older residents.
•
The response was overwhelmingly positive (98%) to the establishment of Seniors
in Motion.
•
Many physicians wanted to know how soon they could start recommending the
program to their patients.
•
•
•
SIM has grown from 3 participants in 2003 to over 150 in 2010.
We have performed over 700 assessments and are currently involved in research
projects with the University of North Texas and Texas Woman’s University.
The Story of Seniors in Motion (SIM)
•
The physical program design involves an individual assessment including areas of
vital statistics, body composition, muscle strength, joint mobility, balance, gait and
posture.
•
All participants fill out a self assessment which reports current activity status,
functional difficulties with activities of daily living and a brief health history.
•
Participants are also asked to define their individual goals for program outcome.
•
The individual fitness plan and workout regime is based on these assessments.
Assessments are performed by a physical therapist and a licensed trainer.
•
The educational focus includes areas of fall and injury prevention, safety
awareness, osteoporosis management, posture, pain management and balance.
The Story of Seniors in Motion (SIM)
• During the initial assessment there is an opportunity for teaching
when areas of weakness are discovered.
• Participants are provided with fall prevention information and
safety training if balance deficits are evident.
• An important program objective is to raise the consciousness of
participants to their role as health care consumers.
• In providing information on testing procedures, surgery, treatment
options, informed consent, and expected outcome from medical
care and treatment, we want to help our participants improve the
quality of communication with their health care providers and
increase the understanding of patient rights and responsibilities.
• SIM is designed to empower our participants to have the strength
and knowledge to age with dignity and confidence.
SIMRESEARCH PROJECT, SEPTEMBER
2009-MARCH 2010
• Opportunity to evaluate our program using quantitative methods
was initiated by faculty and students at the University of North
Texas.
• Results from a pilot study of SIM participants conducted in 20072008 is the basis of this study.
• In the summer of 2009, program participants were given the
opportunity to sign up for a research project designed to assess
individual progress and program effectiveness.
•
Fifty two seniors volunteered to be participants in the study. Of
these thirty six (36) were women and sixteen (16) were men.
SIMRESEARCH PROJECT, SEPTEMBER
2009-MARCH 2010
• Initial assessments were performed during
September 2009 and the follow-up
reassessments in March of 2010.
• The data gathered allowed for comparisons in
the areas of muscle strength, joint flexibility,
gait performance and body composition over
a 6 month period.
Table 1
Percentage Changes in Muscle Strength and Joint Flexibility for
Seniors In Motion Participants Assessed from September 2009 to
March 2010
Variables
Gain or
Remained
increase
same
Loss or decrease
Number
Muscle Strength:
Right hand grip
94%
4%
2%
52
Left hand grip
92%
2%
6%
52
Right knee extension
67%
2%
31%
52
Left knee extension
70%
8%
22%
51
Right knee flexion
62%
6%
32%
52
Left knee flexion
50%
4%
46%
52
Sit and reach
60%
6%
34%
52
Back scratch
36%
14%
50%
50
Joint Flexibility:
Table 2
Percentage Changes in Body Composition and Gait Performance
for Seniors In Motion Participants Assessed from September 2009
to March 2010
Variables
Loss or
Remained same
Gain or increase
Number
decrease
Body Composition:
Weight
35%
3%
62%
52
Body Mass Index (BMI)
40%
2%
58%
50
Percentage body fat
42%
2%
56%
45
27%
0%
73%
52
Gait Performance:
Get up and go
CONCLUSION
• In the years since 2003 this program has grown in
participants and importance.
• Our vision has taken on a new meaning with the
advent of health care reform.
• Staying active and healthy as we age is no longer a feel
good euphemism; it is a fact of life.
• The quality of our aging experience will depend on
how successful we are in achieving this goal.
CONCLUSION
• I knew we could make people stronger and more flexible
but what we didn’t know was the spirit of kinship and
community that would grow out of this program.
• We were recently featured in THE JOURNAL OF ACTIVE
AGING (January/February 2010; Vol. 9, No. 1) as a recipient
of the Nu-Step Pinnacle award
• In the end, the most valuable thing we learned was the
importance of community, kinship and the opportunity to
engage in meaningful social contact.
• Loneliness can be as devastating as any serious health
problems.
CONCLUSION
• Gerontologists speak of ‘aging in place’ but
truly this cannot happen if we do not see
ourselves as a community of people who
depend on our responsibility to care for one
another.