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to News for CMCD folks
Staying on Balance, With the Help of Exercises
By JOHN HANC
STONE-FACED with determination, Margot Luftig was trying hard not to
fall.
She was standing on a foam cushion with her left knee raised about
four inches, attempting to stabilize herself on the right leg, which
was sinking into the squishy surface of the thick pad.
“Come on, Margot!” urged her personal trainer, Robert Morea, who was
at her side. “You can do it.”
Her eyebrows furrowed and she threw an “easy for you to say” glance
his way.
Over the loudspeaker at Mr. Morea’s studio — Great Jones Fitness in
the NoHo section of Manhattan — Mick Jagger sang “This Could Be the
Last Time,” as if challenging Ms. Luftig. A week earlier, Ms. Luftig
(who gives her age only as “55 or over”) was unable to maintain this
one-legged pose, stumbled off and got frustrated. This time, she
nailed it, holding herself upright and strong for about 45 seconds
with each leg. She then stepped gracefully off the cushion and back
onto the gym floor.
“Great job, Margot. You really showed up,” said Mr. Morea. “You didn’t
lose your balance.”
Ms. Luftig, a retired buyer for B. Altman’s department store, cast
another baleful eye at him. “That’s the point, isn’t it?” she
responded.
As a matter of a fact, it is. Balance is a critical issue to older
people. And more and more, at one-on-one training facilities like Mr.
Morea’s or at larger health clubs, whether in yoga and Pilates studios
or adult-education exercise classes for older adults, balance training
is becoming a priority.
With good reason.
Unintentional falls among those 65 and older are responsible for more
than 18,000 deaths and nearly 450,000 hospitalizations annually in the
United States, according to the Centers for Disease Control and
Prevention in Atlanta. Most of these falls are caused by a decline in
that complex and multidimensional human skill known as balance.
To remain upright and sure-footed, explained Dr. David Thurman, a
neurologist with the center and a spokesman for the American Academy
of Neurology, “there are several components of the nervous system, as
well as motor or movement functions, that need to be intact.” These
include the vestibular system of the inner ear, vision and
proprioception, the ability to sense where one’s arms, legs or other
parts of the body are without looking at them, as well as the strength
and flexibility of bones and soft tissue.
“All of these,” Dr. Thurman said, “tend to degrade with age,
particularly as people move into their seventh and eighth decades.”
Yet, unlike many effects of aging, balance can be improved, and the
age-related declines can be delayed or minimized with proper training.
“The preponderance of evidence,” Dr. Thurman said, “shows fairly
convincingly that strength and balance training can reduce the rate of
falls by up to about 50 percent.”
Hence, the Department of Health and Human Services in revising its
national physical activity guidelines, issued in 2008, added a
recommendation for the elderly to include balance exercises as part of
their overall physical activity regimen.
The problem, said Michael Rogers, an exercise scientist at Wichita
State University, is that while most major public health agencies
recommend 30 minutes a day of cardiovascular exercise for the heart
and two or three sessions a week of strength training, “there is no
real exercise prescription for balance.” So activities that promote
balance tend to become integrated into other activities. Mr. Morea
does this with older clients like Ms. Luftig in twice-weekly, 30-
minute strength-training sessions.
Of course, while it is good to have supervision by a certified fitness
professional, not to mention the benefit of a gym full of balance toys
(and there are many these days, including wobble boards, balls and
cushions), one does not have to work out with a personal trainer to
get the benefits of balance training.
“You can do it anytime, anyplace,” said Mr. Rogers, who is research
director at Wichita State’s Center for Physical Activity and Aging and
teaches exercise classes to older adults. “You don’t have to be
involved in a systematic program.”
He added, “You don’t have to be standing on one foot, which is often
too difficult for some older people. You can challenge your balance
while brushing your teeth.” Simply put one foot in front of the other
while you brush, or stand with your feet closer together.
Balance training is often seen as part of a larger trend called
functional fitness exercises, which are geared to helping one handle
the physical challenges of day-to-day life. Around holiday time, for
example, Mr. Rogers tries to prepare the elderly in his class for
crowded shopping malls. He has them walk between narrow gaps,
occasionally getting brushed by others. This, he said, “helps give
them confidence” to face the holiday throngs.
Trainers like Mr. Morea devise balance training drills for their older
clients. For example, a woman was having trouble bending down in her
kitchen to reach to the back of a floor-level cupboard and retrieve
cooking pots. So he developed “pot squat and reach” — a movement that
basically imitated what she was doing, except on an unstable surface,
so that she could develop the strength, neural connections and balance
to confidently perform that movement at home.
One of the nice things about balance training is that the results can
be evident fairly quickly.
“The nervous system has considerably more regenerative capacity well
into the senior years than we used to think,” said Dr. Thurman. “The
capacity for adjustment, compensation and even developing new skills
remains there.”
Which is exactly what Ms. Luftig, who lives in Greenwich Village, has
found. “I feel more confident,” she said. “In my neighborhood, you
have bicycles whizzing by you all the time. You could lose your
balance when they come so close. But when that happens now, I feel
more stable. I have this ability that I didn’t used to have.”