“Keep your tummies in. Arms up. Shoulders down. Up and over!” The sound of 25 pairs of feet thumping a wooden floor echoes through the Benton Center gym. On cue from fitness instructor Shelly Morris, the all-female class steps on and off platforms that range from four to 10 inches high, some participants moving quickly, lifting legs, planting feet, stepping to the side and going back in reverse.
Morris cheers on her students: “You’re looking great this morning! Best all week.”
“Of course. Women don’t sweat. We glisten!” one exerciser laughs.
It could be any exercise class anywhere except for one thing: Many of these women are the last people you’d expect to see in a gym. One celebrated her 88th birthday the previous week. If you saw a member of the class crossing the street, you’d be tempted to offer her a hand. “Nothing would annoy her more,” says Beth Lambright, one of Morris’ co-instructors, to the nodding agreement of several women in the class. “These women are more likely to help you.”
Fear of Falling
The class known as Better Bones and Balance has its roots in a 1994 Oregon State University research project and addresses one of the most significant health risks for older Americans. According to the U.S. Centers for Disease Control, one in three people over 65 falls in a given year. The results are too familiar: broken hips, concussions and other bone-rattling traumas that, in 2006, sent about 1.8 million seniors to emergency rooms. Accidental falls are the leading cause of injury-related deaths among the elderly.
Reducing those risks is the purpose of Better Bones and Balance. Through a prescribed routine of self-paced stretching and weight-bearing exercises that build muscle, bone mass and confidence, the class equips seniors to safely handle everyday chores — getting dressed, doing the laundry, vacuuming floors, carrying groceries.
“Most seniors in the United States cannot stand on one foot for 30 seconds,” says Lambright. “Mine can stand like that for two minutes. We do things forever on one leg so that if they start to fall, they have time to figure out where they want to go. Or we train their legs to go out to the side where they can catch them and break the energy of the fall.”
Next year, she plans to start a class for 90-year-olds.
Better Bones and Balance grew from research by Christine Snow, former director of the OSU Bone Research Laboratory, and by Ph.D. student Janet Shaw, now a professor at the University of Utah. “Christine saw that athletes who participated in high-impact sports such as gymnastics, where the landing forces are very large, had extraordinarily high bone mass in comparison to other athletic populations,” says Kathy Gunter, assistant professor in OSU Extension’s Family and Community Development Program and the Department of Nutrition and Exercise Sciences. Gunter did her Ph.D. work with Snow. “Obviously we can’t have older adults dismounting off the (balance) beam and the impacts associated with that. The question came down to: How can we safely increase the load on the skeleton in a group-exercise setting and effectively increase or preserve bone mass?”
Lunges and Heel Drops
Snow and Shaw developed a series of weight-bearing exercises and demonstrated in a controlled study that specific techniques (heel drops, chair stands, jumps, side and forward lunges) could increase strength and maintain bone density in post-menopausal women. It was first known as the weighted-vest program, says Gunter, because participants wore a vest whose weight can be adjusted. Weighted vests are now a common feature of fitness programs, but the researchers started with fishing vests and rolls of pennies.
The women who volunteered for the study were so convinced of the benefits that, after it was completed, they worked with Benton County Extension agent Donna Gregerson (one of the participants in the study) to continue the exercises through the Benton Center, part of Linn-Benton Community College.
The program allows seniors to work at their own pace and encourages socializing. It is now offered in senior centers and community colleges from Portland to Medford and in California and Washington state. In Corvallis, more than 300 people are enrolled in 19 separate classes at the Benton Center.
“Popular” may be an understatement. “When registration opens up each term at the Benton Center, the classes fill up in about 10 minutes,” says Lambright.
While this response pleases Gunter, she believes it’s not enough. She has taught exercise classes and, in the OSU Bone Research Laboratory, studied the impacts of jumping exercises across the lifespan, demonstrating the benefits for bone health in children and the elderly. Convinced that the practices need to be more widely available, she and Lambright (whom Gunter calls “a true champion of the cause”) have led workshops to train fitness instructors and women’s health program managers. They see a particular need in rural areas. “Not every rural community has a cadre of people who are going to be trained and take this back to their communities,” says Gunter. “I believe it’s our responsibility to create a toolkit that would allow communities, YMCAs or senior centers to have their personnel trained.”
Personal Virtual Trainer
In addition to instructor training, she is spreading the word through a Web site. And with an eye on physicians who could prescribe the program in a clinical setting, she is working with OSU engineer Ron Metoyer on technology to create a virtual personal trainer for people at risk of fall injuries. A patient could turn on her TV and watch a personal trainer lead her through the exercises, says Gunter. It could play over the Web, and responses to questions could be communicated to the clinician who would monitor the patient’s fall incidence and possibly the response to exercise while training. They have received funding for a pilot project from OSU’s Center for Healthy Aging Research and applied for a grant from the National Institutes of Health.
Gunter is also advising a graduate research project targeting more than 250 current Better Bones and Balance participants. In Ph.D. student Adrienne McNamara’s study, class participants will wear accelerometers (devices that measure acceleration) and heart monitors to quantify the forces their bodies encounter and time they spend in vigorous routines. Researchers and students at the Bone Research Lab will monitor the participants’ strength, balance and bone density. The goal is to see if there is a “dose-response” relationship, if benefits accrue like interest in a bank account the longer one participates. It could be, Gunter says, that participants encounter a plateau, that beyond a certain level of activity, strength and bone mass do not improve.
Among participants at the Benton Center, there is no doubt about the value of Better Bones and Balance. Many credit it with saving them from a fall or speeding their recovery from illness or surgery. Lois Osen, 83, recalls a recent visit to Portland. “I was looking up at a building, took a step and nearly fell off the curb,” says. “But I caught myself and didn’t fall.” Then she smiles. “As I was walking down the street, a man looked at me and said, ‘Nice recovery.’”
“I like the fact that she (the instructor) lets you go at your own pace,” adds Jean Marie Walker. After going through a round of chemotherapy for breast cancer, Walker found that the class helped her to regain strength.
The benefits show up in daily activities. “I was vacuuming at home with a canister vacuum and started to trip,” says Elaine Facto. “But I automatically did a side step over it and didn’t trip. I thought ‘Wow, how did that happen?’” Facto used to feel uncomfortable walking on a slope in her own yard, but now she feels safe and in control.
“The average senior can come in here and do this,” says Lambright. “Most seniors are terrified of signing up for an exercise class. They think it’ll be fast. They’ll have to wear spandex, and they won’t like the music. But you can come here and shuffle in and walk out stronger.”