Hey Grandma, Way to Pump That Iron!

Positive reinforcement helps seniors stick with exercise programs

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HealthDay Reporter

THURSDAY, July 25, 2002 (HealthDayNews) -- Senior citizens who get periodic pep talks that help them see the upside to exercising are much more likely to stick with a fitness program.

That's the conclusion of a new study in the August issue of the American Journal of Preventive Medicine.

A second study in the same issue of the journal found that Tai Chi, in particular, helps older men and women who struggle with physical activity. Those with low perceptions of their health and high levels of depression tended to experience rapid improvements in physical ability after attending twice-weekly classes of Tai Chi, described as "an internal Chinese martial art." After six months, they were twice as likely as a control group to report being able to perform moderate to vigorous activities.

Adults over the age of 65 are one of the fastest-growing segments of the world's population, and many of them are inactive. Research has shown exercise will improve a person's physical and mental health, no matter how old they are.

In the first study, which enrolled 103 people over the age of 65, researchers assessed participants' confidence in their ability to stick with an exercise program, as well as the benefits they thought they would receive, the benefits they did receive and the social support they got from friends, relatives and fellow exercisers.

"We wanted to find out which things in this group of people were more related to long-term adherence, not just what gets them going," explains Glenn Brassington, lead author of the study and a postdoctoral fellow at the Stanford University Center for Research and Disease Prevention.

"It seemed that the things that encouraged adherence were problem-solving and perceiving fitness benefits, such as weight loss and improved energy and physical fitness," Brassington says.

Each individual was randomly assigned to one of two exercise routines, each of which included two classes and two home sessions weekly. The Fit & Firm class included low-impact aerobics to improve cardiovascular fitness, and resistance training to improve muscle strength. The Stretch & Flex class focused on improving flexibility with less attention to heart rate.

Trained health educators contacted participants by phone once a week for the first month, every other week for the next two months and once a month for the rest of the year. The purpose of the phone conversations was to discuss barriers to participation ("The grandkids are coming to visit next week," for example), and underscore any positive results, such as weight loss, more energy or improved sleep patterns.

"The idea is you want people to be able to overcome barriers very practically," Brassington says. "And the other thing is you want to notice how they're benefiting and reduce the downside, such as injuries. We try to build people's confidence by helping them problem-solve barriers. The idea is to get at that confidence."

Confidence stemming from what a person had already achieved was much more important than confidence before starting the program, Brassington says.

"Saying to Grandma or Grandpa, 'Wow! You really look like you've lost a little bit of weight', or, 'You're moving around so much better. Wow! That's great' -- instead of not paying attention -- is helping them overcome barriers," he says.

There's an important message here for people who want to help older adults exercise.

"You need to build on these successful experiences, but you also have to draw people's attention to the benefits," Brassington says. "They didn't need a whole lot of support. They just needed to build their own confidence."

If you want to help an older friend or family member get active, take the time to comment on any improvements you see.

"We don't have a lot of people focusing on older people and things that are important to them," Brassington says.

What To Do

For more information on exercise for older adults, visit Senior Health at the National Institutes of Health. Or read this article on strength training for senior citizens from the Delaware Senior Olympics.

SOURCES: Glenn Brassington, Ph.D., postdoctoral fellow, Stanford University Center for Research and Disease Prevention, Palo Alto, Calif; August 2002 American Journal of Preventive Medicine supplement

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