Olympic athletes are typically seen as the epitome of human strength, flexibility, and performance. Did you know that there are also Senior Olympiads? The National Senior Games run from July 24th to August 4th this year!

We don’t have to be Olympiads to be our strongest as we age, though! Lower body strength is one of the largest predictors of how well we function as we age and whether we may need to live in a nursing home. Did you know the average 90-year-old man living at home can sit to stand from a normal height chair 7-12 times in 30 seconds WITHOUT using his arms to stand? 

Below is a chart on the average number of times a man or woman can sit to stand in 30 seconds in each half decade of life after 60 years old. What a great way to measure whether we are aging typically in our strength, even if we aren’t as strong as an Olympic athlete!

30-Second Chair Rise Norms by Age

So, how can we make sure we are maintaining optimal strength as we age?

1. Establish a baseline: At Functional Pathways, we offer a Senior Fit Test that establishes a baseline and allows for continued screening for declines using the 30-Second Chair rise as part of a holistic battery of tests that can help in identifying declines.
2. Ongoing Wellness: Participating in Wellness activities is a great way to stay strong as you age. The simple exercise of sitting to stand can be a great way to keep your lower body strong.
3. Therapy Intervention: When a decline is noted, reach out to an exercise specialist who can help you design a specific program to meet your strength, flexibility and functional needs.

We don’t have to be an Olympic Athlete to achieve a gold medal in aging. Reach out to the Clinical team at Functional Pathways for further assistance in helping you or your residents age with grace and dignity at Clinical@fprehab.com.

Biting our nails, shopping daily on Amazon, prescribing treatment the same way we did 17 years ago….all three of these things are bad habits, but only one can affect the outcomes of our patients.

Therapists can agree that we all want to provide the highest quality of care, supported by the most current evidence. Yet, at times, it can be difficult to adapt our practice to new or different techniques. It takes, on average, 17 years for evidence to be translated into practice!

So why is it so hard to translate evidence into practice?

1. The complexity and expanse of our practice
2. Incomplete access to evidence
3. Difficulty interpreting evidence
4. TIME
5. HABITS

The Functional Pathways clinical team is here to help with the first four reasons! As part of each of our Core 4+ programs, we comb the intranet to include the current evidence, Clinical Practice Guidelines, and protocols from people much smarter than us. Outside of our clinical programs, we are here to find the most up-to-date and cutting-edge research and resources on any topic that you may need to support your patient outcomes.

Most importantly, our patients count on you to take this new information, form a new habit, and put it into practice!

How many of us have attended a CEU, thought the information was wonderful, but then did nothing with it (I am raising my hand too)? Here are a few steps to help you incorporate new clinical habits:

1. Write out a plan of what you want to change.
2. Start small (one new standardized test or treatment technique).
3. Set goals and mark progress towards them.
4. Realize that change causes discomfort. Changing means willing to be uncomfortable, which means a need for increased self-control, self-regulation and effort. Our brains reward us for routine and ease, so we have to work against our own brain.
5. Be willing to devote time and effort.
6. Create accountability through goal-setting with a buddy or support from clinical team.
7. Encourage curiosity.
8. Celebrate wins, even small ones.
9. Forgive yourself if you get off track, but set a plan to get back in motion.

If you want this level of support at your facility or community, reach out to the Functional Pathways clinical team at clinical@fprehab.com! Especially if you need help shopping on Amazon. We are really good at that!! 

As a physical therapist, I have written down the words “depression and anxiety” as part of a patient’s past medical history more times than I could even count. In 2020, the American Physical Therapy Association House of Delegates passed position #P06-20-40-10: “It is within the professional scope of physical therapist practice to screen for and address behavioral and mental health conditions in patients, clients, and populations.” Yet, as a physical therapist, what have I truly done to promote positive mental health for my patients? Yes, I have passively supported mental health through exercise and physical activity, but is there more that can be included as part of a proactive, thoughtful approach to my patients’ mental health?

Ways Exercise Helps Patients with Anxiety and Depression: What does the research say?

1. Exercise for Anxiety:  One of the primary methods of reducing anxiety is by using physical activity to reduce anxiety sensitivity. Many patients suffering from anxiety report the bodily symptoms they experience are the most debilitating and lead to the avoidance of exercise. Any stimuli that create a similar response to an anxiety attack (i.e., increased HR) are interpreted in a catastrophic way and avoided.

TO REDUCE ANXIETY SENSITIVITY, CLINICIANS CAN RELIABLY PRODUCE THESE SIMILAR PHYSIOLOGICAL RESPONSES THROUGH EXERCISE IN CONJUNCTION WITH CAREFUL AND THOROUGH INFORMATION TO ALLEVIATE THE CONCERNS. THE PATIENT WILL BEGIN TO DISSOCIATE THE EXPERIENCE OF THE PHYSICAL SYMPTOMS AND NEGATIVE, ANXIOUS FEELINGS.

Essentially, prescribed personalized exercises can help patients interpret bodily symptoms as normal signs of stress and not as indicators that a physical catastrophe will ensue.

2. Exercise for Depression: With respect to depression, exercise decreases and replaces passivity to create a sense of accomplishment and pleasure in patients. Feelings of achievement and mastery through exercise can help to enhance positive self-beliefs and buffer from negative self-perception worries. Furthermore, a patient is able to develop a social connection through physical activity to improve patient affect This is not a one-size-fits-all social connection. For some patients, the connection may be with the clinician, for some it may be with friends or family, and others may connect with fellow patients who can relate to their current experiences.

ALONG WITH EXTERNAL SUPPORT AND A SENSE OF ACHIEVEMENT, EXERCISE-BASED INTERVENTIONS HAVE BEEN CONSISTENTLY DEMONSTRATED AS HAVING AN ANTIDEPRESSANT EFFECT IN PEOPLE WITH CLINICAL DEPRESSION, WITH SOME STUDIES REPORTING A TREATMENT EFFICACY COMPARABLE TO ANTIDEPRESSANT MEDICATIONS OR PSYCHOTHERAPY.

Additional Ways to Support the Mental Health of our Patients:

1. Including alternative techniques such as mindfulness and acceptance-based interventions as part of pain management/chronic disease management programs.
2. Promoting stress management, coping skills, and trauma-informed care.
3. Providing education on lifestyle factors such as nutrition, wellness, and exercise, addressing disparities in health caused by social determinants.
4. Provide referrals to outside services when further support is needed.

We can no longer separate our patients’ physical health from their mental health. Rehabilitative professionals should aim to optimize wellbeing and empower the individual by promoting functional movement, movement awareness, physical activity, and exercises, bringing together the physical and mental aspects.

REFERENCES

1. Belvederi Murri, M., et al., Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Front Psychiatry, 2018. 9: p. 762.
2. Blake, H., Physical activity and exercise in the treatment of depression. Front Psychiatry, 2012. 3: p. 106.
3. Kandola, A., et al., Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety. Curr Psychiatry Rep, 2018. 20(8): p. 63.
4. Martinsen, E.W., Physical activity in the prevention and treatment of anxiety and depression. Nord J Psychiatry, 2008. 62 Suppl 47: p. 25-9