Preventing Falls in Seniors with the Otago Exercise Program

Preventing falls in older adults can save them from significant health consequences. A study revealed that more than 1 in 4 adults over 65 years of age had a fall in 2014. From those falls, 27,000 adults died because of their falls and 2.8 million were treated in emergency room departments for fall-related injuries.

According to the Centers for Disease Control and Prevention, some conditions that are more likely to cause older adults to fall include lower body weakness, difficulties with walking and balance, as well as foot pain or poor footwear. 

The Otago Exercise Program was developed in New Zealand and has been shown to reduce falls between 35-40% for frail older adults. Research at the University of North Carolina at Chapel Hill School of Medicine and Center for Health Promotion and Disease Prevention has shown statistically significant improvement in as little as 8 weeks.

The Otago Exercise Program can be found in the PT-Helper exercise library inside the Geriatric category. Some exercises from the program are shown below:

• Ankle Pumps - While sitting or lying down, pump your ankles up and down.

  

  

• Seated Marches - While seated in a chair, lift one knee up and return it to the ground. Lift the other knee up and return it to the ground. Repeat.

  

• Hamstring Curls with Support - Standing with good posture in front of a solid table, bench or kitchen sink. Look straight ahead. Rest your hands on the bench. Start with your legs together. Lift one heel up bringing your foot towards your bottom. Then bring it back down. Repeat. (If you lose your balance, grasp the table, bench or kitchen sink to regain your balance.)

The Otago Exercise Program is meant to be delivered in the home and doesn’t need any special equipment to complete.

Reminder: Please consult your physician or physical therapist before engaging in any physical activity and stop if you experience pain or discomfort.

Start your Free 30-day Trial of the PT-Helper CONNECT service for physical therapists and other wellness professional, to prescribe Home Exercise Programs.

Download the PT-Helper mobile app for patients and exercise enthusiasts to create your exercise program.

How to Create a HIIT Program on PT-Helper

After attending the National Strength and Conditioning Association’s 2018 Personal Trainer conference, it has become obvious that there is an incredible array of exercise options that personal trainers or wellness coaches can recommend to their clients. Variations include weight training, suspension trainers, kettlebells and many others. High Intensity Interval Training (HIIT) continues to be a very popular approach to improving athletic conditioning in a short period of time.

This blog will show how to easily create a HIIT program in PT-Helper CONNECT that you can prescribe and customize for each client.

We will use this article “The Ultimate HIIT Workout For Weight Loss — No Equipment Needed” as a reference guide to our HIIT program. To simplify this how-to, we will only include 3 exercises into the HIIT program: high knee skips, plank jacks, and lateral bunny hops.

When creating a HIIT program within PT-Helper, it is best to define the Hold time to correspond with the high intensity anaerobic interval period while the Rec. Time (within PT-Helper) would correspond with the low intensity recovery periods within the HIIT. With this in mind, you would add the exercise pictures to the program in the following manner:

You will want to add your exercise pictures in a similar order of rest (or starting position), interval, recovery, interval, recovery, …. The program will follow the sequence of images from left-to-right and top-to-bottom.

In the example above, the program will start with high knee skips, recovery, plank jacks, recovery, and lateral bunny hops, and recovery. If there is more than 1 repetition specified for the program, the sequence will repeat after the recovery following lateral bunny hops. Then the program will start the second repetition with high knee skips.

In the article, the author recommends 30 seconds intervals and 30 seconds recovery times. Following this recommendation, the exercise parameters would be set to

If you are following a Tabata regiment, you would set Hold Time to 20 seconds while Rec. Time would be set to 10 seconds.

The number of Reps represents how many times your client would repeat the HIIT sequence.

For the demo video below, we have set Hold Time to 6 seconds while Rec Time is set to 4 seconds to keep the video short.

If you have any questions on how to create exercises within PT-Helper CONNECT, please contact us at info@pt-helper.com.

The Path to Exercise Adherence

I had the wonderful opportunity to attend Dr. Mike Israetel’s presentation “From Inspiration to Passion” at the National Strength and Conditioning Association’s 2018 Personal Trainer conference. I believe that the points he made are also valid from the perspective of getting physical therapy patients to adhere to their home exercise program.

Dr. Israeltel’s presentation addressed adherence in diet and fitness clients. He highlights that the client’s desire to adhere to the plan will fluctuate over time and psychological states. He identifies six constructs that clients/patients go through that coaches/therapists can utilize to maintain exercise compliance.

1. Inspiration
2. Motivation
3. Intention
4. Discipline
5. Habit
6. Passion

Inspiration: Inspiration represents the patient’s first step towards recovery. For PT patients, an illness, injury, significant pain, or functional mobility issues are the typical sources of inspiration to visit you, the physical therapist. Unfortunately, inspiration doesn’t last long and can quickly disappear when the patient realizes that you actually want them to exercise to get better and can’t wave your magic wand or give them special pills to suddenly make them better.

To help inspire your patients, you can educate them about the benefits of home exercise and provide them with relatable success stories.

Motivation: Motivation is the desire to do something about a goal and begins after inspiration. It is a less intense emotion compared to inspiration but longer lasting. Motivation will rise and fall but is not dependable in the long term.

From a physical therapist’s perspective, recognizing that your patient’s inspiration may end before the completion of their initial evaluation, you need to start helping them activate their motivational emotions by helping them set specific and realistic goals in their first visit.

As motivation will fluctuate, it is important to add another layer of structure to overcome the periods when motivation is low.

Intention: Intention is a commitment to actually do something and can give your patient the impetus to fill in the adherence gap when motivation is low. Intention develops within days of beginning the program and is especially important in the first month of the program.

To help develop intention in your patients, you can help them create a plan to execute their exercises to achieve their goals. Plan details don’t matter nearly as much as having a plan.

Discipline: When your patient’s motivations are low, they need discipline to fulfil their intentions. Your patients can use willpower to execute the plan.

You can help your patient by cultivating their discipline. You can remind your patients that motivation will wane and sometimes it will be tough to get through their home exercises. Remind them that it will get better but they have to continue with their plan.

Unfortunately, willpower is exhaustible and can be consumed by other aspects in your patient’s life. If your patient is experiencing high level of stress or other demands on their life, they may not have any willpower left to apply to do their home exercises.

Habit: After more than a month, activities soon start to become habits. The longer your patients regularly do their home exercises, the stronger the habit becomes. Maintaining a habit requires less discipline resulting in better compliance.

An exercise plan that suits your patient’s preferences are more likely to become habits. Understanding your patients and creating a home exercise plan that is sustainable and convenient for them is more likely to become a habit. Asking non-active patients to suddenly allocate an hour a day towards home exercise is likely not going to become a habit.

Passion: Passion is a deep love for the process of exercising.

Most physical therapy patients will not be under treatment long enough to develop a passion for exercising. However, physical therapy can lead a patient towards a passion for wellness and fitness that they pursue with a health and fitness coach.

Recognizing what your patients are passionate about may help you motivate them to exercise to get back to doing what they love to do.

Making Exercise A Habit In Your Kiddo

Guest blog by Richa Kohli

Like many other moms, it was also my concern that my kid is not involved in any outdoor sports or do any kind of exercises. Kids nowadays are very much involved in video games and mobile games that they refuse to go out of the house to play. During a recent visit to the doctor for a routine checkup, I came to know that my 8-year-old is overweight. That was the time when I decided to search for smart ideas to keep my kid engaged in fitness activities.

1. Set a goal – Setting up a goal can be really motivating. Set small goals, not unachievable ones. Once your kid is capable to reach for small goals, raise the bars.
2. Let’s dance together – Enroll in a dance class together as dancing is a very good exercise and fun too,
3. Park trips – Take them to the park and play with them. This will increase your fitness and is good for your kid as well.
4. Bike buddies – Be a bike buddy with your kid. It is a good cardio exercise.
5. How about a work out video – Do the exercises together while watching a fitness video. Choose the one who does not have complicated exercises. Go for the simple one so that your kid can also do it. You can take a consultation with board-certified physical therapists at TheraNow.
6. Get competitive – Get competitive in a healthy way. This can act as encouragement in kids and the kid tries to give their best.

Encouragement plays a very important role while you are trying something new with your kids. Do not get angry or scold them. Be patient, talk and tell them to know the importance to stay fit, what you are trying to do is good for them. Analyze your kid and see what are all their area of interest and how you can use them to incorporate fitness into them. You also share a special bond when you spend quality time with your kid while exercising. You should also monitor that your kid does not overdo anything as this can lead to injury. You can give rewards on the achievement of conquering a short-term goal. This will keep them encouraged and they will try to give their best every time.

Richa Kohli, CEO of TheraNow, is a young female entrepreneur and innovator with a vast knowledge of Physical Therapy field. Richa has a vision of making physical therapy services digitally available for everyone in the USA, provided by board certified and experienced therapists, ensuring convenience, effectiveness and lower cost of treatment. She is an avid healthcare blogger and also loves traveling the world.