Evidence-Based Physical Activity Programs for Seniors: Preliminary Findings

1. 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

2. 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.

3. 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”.

4. 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 21stcentury.” • 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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 2007-2008 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.

12. 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.

13. Table 1 Percentage Changes in Muscle Strength and Joint Flexibility for Seniors In Motion Participants Assessed from September 2009 to March 2010

14. Table 2 Percentage Changes in Body Composition and Gait Performance for Seniors In Motion Participants Assessed from September 2009 to March 2010

15. 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.

16. 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.

17. 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.