Simple `PUSH' spells improved senior health: basic exercise significantly reduces falls, fractures - Project Urging Senior Health

HealthCare Benchmarks and Quality Improvement, May, 2003

Key Points

* Seniors can achieve significant gains in strength and balance in weeks.

* Even the researchers find the results surprising.

* Study finds connections between mental state and physical performance.

One out of three seniors who breaks a hip this year will die as a result of complications from the fracture, but simple fitness measures can greatly reduce a senior's risk of falling, say University of Arkansas at Fayetteville (UA) researchers.

A pilot outreach project, sponsored by the UA Office for the Studies on Aging, proved that in a matter of weeks, seniors could achieve significant gains in strength and balance by following a simple exercise program that places minimal strain on the body or budget.

UA researchers developed PUSH (Project Urging Senior Health) to demonstrate the ease of establishing and maintaining senior exercise programs in the community. As a trial run, the researchers initiated simple fitness regimens at two senior centers in Arkansas.

Significant results achieved

But the results they noticed among seniors who participated were so significant, they now suggest that similar programs across the nation could significantly reduce the number of senior citizens who suffer from falls and fractures each year.

"Our scheme was to go into senior centers and teach the staff that exercise programs could be easily integrated into their services--that fitness could be inexpensive, easily administered, and fun," says Ro DiBrezzo, PhD, UA professor of exercise science and director of the Human Performance Laboratory.

"We didn't expect to see any statistically measurable changes in senior health in only 10 weeks, but when we looked at the data, our participants had made surprising gains," she adds.

Data collected

Though they regarded PUSH primarily as an outreach program, the researchers collected data, hoping results would bolster the case for providing exercise services to the elderly. They tracked 19 participants from the two Arkansas senior centers, conducting physical and mental assessments at the beginning of the program and then testing again at the end of 10 weeks. The participants ranged in age from 60 to 90 with a significant representation in the range of 80 and older.

The physical assessment led seniors through eight tests of strength, balance, flexibility, and dynamic balance--or the ability to balance while in motion. According to the researchers, initial results showed Arkansas seniors to be significantly below national fitness norms for the elderly.

For 40 minutes a day, three times a week, the seniors then performed stretching and strengthening exercises, using therabands and exercise balls and learning proper exercise technique.

At the end of 10 weeks, the physical assessment tests showed statistically significant improvement in measures of balance, strength, and dynamic balance. In addition, the participants improved their levels of HDL, the "good" form of cholesterol.

"According to fitness norms for the elderly, the participants in this program ranked in the 10th percentile in strength and dynamic balance when we started. But just performing simple exercises over a couple of months, they moved from the 10th percentile to the 65th,' DiBrezzo says.

"We had people on oxygen doing these exercises--people using walkers. That's a huge leap for people who are so frail," she continues.

And the benefits were not exclusively physical. The mental assessment the researchers conducted tested more than cognitive functioning.

The assessment included a questionnaire that asked how active the participants were on a daily--basis and recorded their general states of mind whether they usually felt anxious or calm, energetic or worn out.

"We found connections between mental state and both initial and final physical performance scores," says Barbara Shadden, a UA professor of communication disorders.

"Mind and body interact more than you'd think, and both are important to our quality of life as we age," she adds.

If senior centers across the nation were to offer simple exercises programs such as the one used in PUSH, elderly Americans could improve their overall health, reduce their risk of falling, and reap mental health benefits that could keep them active and involved in the community, the PUSH researchers say.

They intend to expand the reach of PUSH this spring by conducting a training seminar for individuals involved in senior services. The workshop will train people in how to properly implement senior exercise programs in a manner that is both safe and cost-effective.

"Pretty much anyone who works with older adults is in a position to implement this program," notes Shadden.

"Starting an exercise program in a couple of senior centers isn't going to fully serve the elderly population. The point is to train as many people as possible how to do it," she says.

Need More Information?

For more information, contact:

* Ro DiBrezzo, PhD, Professor of Exercise Sciences, Human Performance Laboratory, University of Arkansas, HPER 321, Fayetteville, AR 72701. Telephone: (479) 575-6762. Fax: (479) 575-2853. E-maih rdibrezz@uark.edu. Web site: www.uark.edu/admin/hplweb.