When all this Covid-19 madness started, my first thought was that my clients are going to lose all the progress that we have made.  The majority of my clients are 65 and older, and most of them feel intimidated by the internet.  The thought of using a computer to exercise, forget it!  In fact, a few of them do not even have email addresses!  Crazy right?!  Well, not really.  None of us like to feel overwhelmed, dumb or frustrated.  Those feelings can be magnified by some Seniors when their friends having an easier time grasping the new world of computers and the internet. 

One observation that I have made during this time of quarantine about my senior clientele and the internet, they have many questions about all the phases that exist of accessing the internet.  They are certainly not dumb!  I don’t think anyone believes that.  However, I do believe that a lot of our Seniors feel as though there are too many complicated steps to access their exercise and trainers online.  Along with this belief, we must remember that our seniors did not grow up with text messaging, FaceTime and Xbox live.  They grew up in a time where real, face to face contact was the main way of communicating or a phone call.  If you’ve worked with Seniors, even if it's only a few clients, then you understand what I am saying.  Let’s just say, I have clients I can text and clients I need to call!  Honestly, I think our Seniors are on to something with the calls vs. texts, but that’s another subject for another time.

So how do we convince our Seniors to hop online (pun intended) and train with us via the internet?  I have found that by breaking down the process into phases, and then further breaking the phases down into simple steps allows for thorough understanding while limiting frustrations.  I have also discovered that when explaining virtual sessions in this particular blueprint, I inadvertently answer questions that a Senior may have, but doesn't necessarily want to ask for fear of feeling insecure and unknowledgeable.  Remember, for a lot of our Seniors, many responsibilities have been taken, or redirected from them (I.e. driving, cooking, etc.) for a number of reasons.  The last thing I want to do, is make someone feel as though this is one more thing they cannot do or understand.  This is the blueprint, or process, that I follow and that has had success with my clients.  The motivation to actually exercise, that’s up to you!  Lastly, both parties need to be PATIENT!  We all have loads of time right now, so lighten the mood, make a joke and relax. Remember, with every mistake made, you’re closer to the answer.

A few things to consider before you start...
-  You want them to pick a place that provides enough lighting so you can be seen by your trainer or client.  Typically, I like to use the natural light of the sun, so anywhere next to a window is great.  It is a good idea to have the camera facing away from the window so you can avoid any wash out that will make you appear dark.
-  Also, make sure you have plenty of room to move around and do the movements and exercises.

The Blueprint:

1. Power button: The computer has a power button. So does the platform you, as a trainer or Senior, choose to use for these virtual (online) sessions.  ZOOM, Skype or FaceTime are great platforms and there are many more similar ones out there.  I like to use ZOOM because they have a “free” option and it's super easy to access.  Learn how to turn the “power” on to the app or platform first.

2. Access (this is the hardest step for most):  There are a few steps we need to cover to access the session.  Now, the app is on and we need to get into the “room” or session so that we can see our trainer or instructor.
- Room numbers/codes:  Think of this as the address. This number or code is what we need to enter into the computer that will give us access to session.
- Video/Audio:  Hopefully, the default (original) settings are still set and not much needs to be done other than adjusting the volume to suit our needs. There are many tools available to both the trainer and the client such as YouTube and Google that can help us troubleshoot any issues and provide videos of the solutions.  Don’t hesitate to utilize one, or both for information.

3.  You've got the lights, the camera and now the action:  Now it's time to get moving!  Make sure the camera is adjusted so that you can be seen and heard clearly.

Good luck!  I hope that everyone is staying safe and healthy during these "quarantine days"!

You can find exercise videos and more information about Emeritus Health and Balance University at:
Website:
https://www.emeritushealthfitness.com/

YouTube:
https://www.youtube.com/channel/UCFZBCssysteSE_QDxsKa58w?view_as=subscriber

Facebook:
https://www.facebook.com/EmeritusHealthFitness/

Recently, I was interviewed by Kimberley Fowler about the steps assisted and indepedent living facilities are taking to prevent residents from falling.  We discussed several topics including common myths associated with senior falls, what should families look for when placing a loved one and how Balance University is making an impact by providing education on fall prevention for residents and empoyees!

Here are some of the questions I was asked.

Learn more about Kimberley by clicking the link below.

How assisted and independent living facilities are designing their communities to prevent senior falls.

1. Why are seniors at a higher risk of falls than other segments of the population? 
As we age, the synapses (space between two nerve cells) in our brains become further apart thus slowing our recognition and reaction time as a result.  Neurotransmitters, such as acetylcholine, norepinephrine and dopamine are responsible for carrying those signals that tell our legs, feet and body to correct itself before we reach a point of “no return” and fall, across these synapses.  This is the same thing that happens when playing golf, tennis or pickle ball and the wind is really blowing and whipping around.  The game just became that much harder.  But there is HOPE!  With consistent practice in proprioceptively enriched environments, your balance can improve significantly.  There are factors that can impact the rate and overall capacity of improvement such as neurological disorders, neuropathy and macular degeneration to name a few.
2. Are there any common myths associated with senior falls that you think should be addressed?
One issue that bothers me is the cloud of embarrassment the seniors tend to feel when they fall.  This becomes a problem when seniors choose not to tell anyone that they have fallen.  I see this a lot with those that live at home, either alone or with a spouse.  The typical concern is that a family member or members will “gang’ up on them and try to convince or force them to move into a place they do not want to be.  Also, the potential move would take a spouse, who has become a caregiver, away from and leading to the separation of the couple.  In most cases, the most frustrating component of this issue is the fact that they can so something to improve their balance, but when nothing is said, no answers are sought which leads us further down the road in the wrong direction.
3. In what ways are assisted living communities making accommodations to reduce the risk of falls that you’ve seen or know about?
I know that many, if not all at this point, assisted living communities offer balance classes to their residents.  Also, I have seen quite a few, newly built facilities with fitness centers that are staffed by certified personal trainers.  This is great to see!  Strength training and group fitness classes are a great way to improve balance, flexibility, improve osteoporosis and positively impact the cardiovascular system.
4. How does your program work and what are the benefits of your program for the assisted living communities that use it? How does your program help these communities reduce the risk of falls?
Balance University includes the four pillars that are necessary to address when it comes to improving one’s balance.  Leg and core strength, postural exercises, improving flexibility and balance exercises.  BU has created the Position Of Confidence (POC) which creates a safe and stable foundation in a proprioceptively enriched environment.  This just means that an individual is in a position where they are stable but just slightly unstable.  This is done in order to improve neuromuscular efficiency, another key to improving one’s balance.  As you can see, improving balance is a multi-faceted issue that Balance University has recognized and guides students in a step by step manual.  Assisted living facilities can utilize the program in a few different ways.  They can offer classes on a weekly basis that follows the exercises in the guide/book throughout the 10-week program.  Residents can purchase the program and follow the 10-week program in the comfort of their own home.
5. As families and seniors tour assisted living communities, what things should they look out for that may indicate the community is proactive when it comes to reducing the risk of a fall?
If I were looking for a facility for a family member, there are a few things I would look for that would indicate that this particular facility was being proactive in their approach to fall prevention.
1.  Is there a fitness facility available?  And if so, is there a staff of certified personal trainer(s) or physical therapists to ensure the safety and proper use of equipment.
2.  Does this facility offer balance classes?  If so, what are the credentials of the instructor?  What specific program are we following to ensure improvement?
3.  Does the facility offer lectures/classes to educate residents on how to prevent falls throughout the year?
4.  Are there grab bars and other fall preventive steps taken in the bathrooms of each residence?  70% of all falls occur in the bathroom, so we want to make sure that steps have been taken to make the bathroom a safe place.  Also, if a fall were to occur, is there a system available that would alert staff that a fall has taken place?
5.  Has the staff taken any type a balance course so that they are knowledgeable about exercises to improve balance and methods to prevent falls?

This is a question I get quite often. Typically, it begins with me sitting with a potential client at a table in their home as they take advantage of our FREE, in-home assessment. We talk a bit about what their goals may be, what the expectations are, and then the question, "I've done physical therapy and that didn't seem to work very well, how is your program different?"

I love this question! The short answer is simple. Physical therapy is great and it does work for a lot of folks. The shortfall may come in the patients line of thinking. For some individuals, they will have very high, sometimes unrealistic, expecatations of where their balance should be at the end of three to four weeks. The problem with those types of expectations are solved by one statement my Uncle would say to me sometimes, "You can't walk into the woods five miles, turn around and expect to walk out in one!" Second, PT doesn't always address all of the under lying issues such as, lack of leg strength, poor posture and lack of flexibility. Any of these three issues will change the way the body is built to move. If you lack leg strength, you typically can't stand or walk for long periods of time. If your posture is not great and you hunch over, this changes your center of gravity and the way the body was built to align itself through movement. If you lack flexibility, this will prevent muscles (particularly the hamstrings) from moving through there entire range of motion they are responsible for moving through. This can shorten the gait length and force other muslces to pick up the "slack". Also, at the end of PT, the patient is given a sheet of exercises they are responsible for perfoming on a daily, or every other day schedule. By show of hands, how many of us have kept that schedule? That's what I thought!

It's funny how you always showed up for all of your PT appointments though. And you executed all the exercises, sets and reps. Most would even admit that therapy did work, at least a little bit. Then, your insurance stops covering your sessions and you get your sheet of exercises for you to do on your own. For most, they have great intentions but life gets in the way. There's golf, pickleball, The Price is Right, happy hour and then hair appointments... the list goes on!

Balance University forces you to show up to a one-hour class, one time per week for 45-60 minutes. The cost is only $99 ($9.90/class) and you will be guided through the program by a Balance University certified trainer (at the moment, we do not accept insurance.). So, to answer the question, why should you try Balance University, even though you've tried physical therapy because:

1. Balance University is built on four core pillars: improve leg strength (which is a life indicator), improve posture, increase flexibility and balance exercises. We focus on the entire problem, not just balance. We fix the underlying issues.
2. The BU course lasts 10-weeks, not three or four.
3. The program focuses on neuromuscular efficiency. That's a fancy term we use so that people think us "experts" know what we're talking about. Neuromuscular efficiency is the communication network between the brain and the muscles. The more you work on their "marriage", the better they will communicate, the better balance and life you will have!
4. You don't have to deal with insurance!
5. You can take the 10-week course over and over again. You could possibly end up with two or more doctorate's in balance!
6. The BU program can be modified for anyone in any condition. From healthy on two feet to wheelchair or bed bound. This program has alternative exercises to make everyone successful.
7. BU is a progressive program. The next week is always tougher and more challenging than the previous.
8. You do NOT need a bunch of fancy, expensive equipment to complete the program.
9. BU helps improve osteoporosis by utilizing many of the same exercises that you would find on the Osteoporosis Foundation’s website.
10. Instead of just a sheet with exercises, BU is a book that gives you the "what's next" exercise. So, after you have mastered a exercise, there's no guessing on what to do next. Just flip to the following week.

I would love for everyone 65 and older to go through the Balance University program! It will help you stay mobile, independent and healthy!

Do want to know the most common question that I am asked from people?  It doesn't matter what the venue or how big or small the group I'm speaking to, inevitably, I get the same question everywhere I go. 

The question?  "Why am I able to balance better on one foot than the other?"

I am willing to bet that we all have experienced this, or most of us have in some capacity.  So, what is the reason for this phenomenon?  It's not exactly a short answer, however, I do have one.

I have asked many healthcare professionals regarding this issue.  I have spoken to physicians, therapists, colleagues and everyone else that I thought would have some knowledge as to why we all seem to have a side that we are better with balancing than another.  What is more baffling, it's not always the dominant side!  Now explain that?!  No one seems to have a scientific answer to this question.

So, here's what I know...  For the last seven years, I have observed folks and how they stand, walk, shift their weight from side-to-side and move overall.  Also, I have watched people who are standing and in casual conversation and how they shift their weight and position themselves when talking.  When most folks are talking and standing, possibly with a freind in a casual conversation, they will stand with the majority of their weight shifted to one side or another.  This results with one side becoming more comfortable handling 70%-80% of your bodyweight, while the other side is not.  So, it's not much of a stretch to shift 100% of your bodyweight to that particular side and your body feeling equipped, comfortable and strong enough to handle the weight versus the other side.  The muscles in your leg become stronger and joints become better equiped to handle the entire load of your body.  Also, your brain (nervous system) and all the muscles (muscular system) involved in maintaining that particular position create a significant amount of nueromuscular effeciency.  This means that the pathways between you brain and muscles create a great and very effecient communication network that allows you to maintain that shifted position with ease so you can focus more on the content of your conversation rather than balancing on one side. 

Here is something fun to do.  Start watching your friends and family when you talk with them and both of you are  standing.  Could you identify which side they would have an easier time standing and balancing with on one foot?  

Some folks may think it's common sense when it comes to beginning a workout routine.  For others, it's not so simple, especially if you are dealing with a lack of balance.  My focus and objective when I was developing "Balance University" was to create a simple to follow but very effective, results driven balance program.  And that's what I've done!!

One of the easiest and more simple exercises you can do to improve your balance is called the Single Leg Lateral (pictured above).  This exercise will strengthen your ankles, lower legs and hips creating a more responsive system that can adjust and redirect misteps quickly.  This movement will also greatly improve the communication network system between your brain, spine and muscular system.  This is ,otherwise, known as neuromuscular efficiency.  The benefit to increased neuromuscular effeciency means that when your brain detects your body becoming unstable and unbalanced, you will be able to adjust and adapt quickly.  This improved system will result in less falls, which means more confidence and less worry for you and your loved ones.

You can find this exercise, along with others like it, in Balance University!

When you work, results follow!