Mo-Bility: Walking Your Way Into Forces and Motion

Mo-Bility: Walking Your Way Into Forces and Motion

Mo-Bility: Walking Your Way Into Forces and Motion Linda Pruski MaryAnne Toepperwein Cheryl Blalock Olivia Lemelle National Science Teachers Association March 31 to April 3, 2005 Positively Aging/M.O.R.E. Choices and Changes Project

Michael J. Lichtenstein, Principle Investigator Carolyn Marshall, Project Director Linda Pruski, Education Specialist MaryAnne Toepperwein, Education Specialist Cheryl Blalock, Research Associate Yan Liu, Programmer Analyst Olivia Lemelle, Graphics Designer Kathleen Boehme, Administrator Steve Owen, Statistician Kacy Vandewalle, Research Intern Michelle Wang, Teacher Intern

SEPA & MKITS funding from National Institutes of Health: National Center for Research Resources, National Institute on Aging, National Heart, Lung, & Blood Institute Positively Aging/M.O.R.E. Collaborative Curriculum Development Secondary Teachers UTHSCSA Researchers

Positively Aging/ M.O.R.E. Goals To help teachers . . . prepare and implement researchbased curricular materials that explore interdisciplinary opportunities in health science, physiology, and gerontology prepare students to make critical health decisions for extending and enhancing their lives

Positively Aging/ M.O.R.E. Goals To help teachers . . . develop sensitivity to the needs and concerns of the aging population foster an enduring interest in health science research and medical careers

National Institutes of Health National Center for Research Resources Science Education Partnership Award National Institute on Aging National Heart Lung and Blood Institute National Institute of Dental and Craniofacial Research Walking Much of the study of walking has its

roots in the early 1800s and in early cinematography Walking was once defined as a movement of falling forward, arrested by the weight of the body thrown on the limb as it is advanced forward. Weber brothers, 1836 Walking Benefits

Strengthen the heart and lungs Control weight Prevent osteoporosis Increase stamina Improve sleep

Strengthen/Loosen joints/connective tissue Tone/Strengthen muscles Relieve stress & improve mood Lower blood pressure, blood lipids Walking Prescription 30 to 45 minutes 3 to 5 times a week May take months to work up to maximum minutes and days per week Swing arms forcefully Comfortable rate and consistent rhythm

3 to 4 mph; 140 strides/minute Can talk with companion while walking Do not fatigue Can be repeated the next day without pain Take pulse; mind target heart rate To Begin Walking Consider personal fitness level and goals Get a good pair of walking shoes Learn to take pulse; determine target heart rate

Plan what you are going to do How far, where, keep a record (time/miles) Progress at steady pace with specific goal in mind Gradually introduce wrist/ankle weights, gentle inclines or hills Warm up and cool down! Talk with physician (need medical exam before starting walking program?) Target Heart Rate

The rate at which exercise is the safest yet most beneficial for you Between 70% and 85% of your maximum heart rate Warm Up Cool Down Warm Up 5 to 10 minutes Slow walk and simple stretches Get heart ready for exercise Limber up muscles, ligaments, tendons

Cool Down 5 to 10 minutes Easy, slow, relaxed stroll and stretching Body adjusts back to resting state Balance, Mobility, and Gait Why? Components of walking - an excellent exercise promoting CV fitness Lower limb function related to health,

disability, and mortality Look for causes of gait change and impaired balance Determine proneness to falls Determine specific treatments, exercises, precautions, or interventions to improve gait and balance Balance, Mobility, and Gait Why? Lower limb function related to health, disability, and mortality

Under reporting of illness due to age Non-specific presentation of illness confusion, anorexia, falls Masking by co-morbidity arthritis may mask angina back pain may mask kidney disease Polypharmacology too many meds, interactions unclear

Informal Assessment Tools from Everyday Materials? Difficult for seniors to come in for regular assessments Uncomfortable in exam room Need quiet and adequate furnishings Need adequate TIME to talk with provider Cost Mobility Location Fearful White Coat Syndrome

Informal Assessment Tools from Everyday Materials? Informal geriatric assessments conducted by caregivers, friends, and family facilitate early intervention in elder care and in maintaining a good quality of life Medication control Environmental adaptations Promoting interaction/Reducing isolation Preventing falls

Comfort & dignity Falls Among Older Adults Falls are the most common cause of injuries 1 out of 3 adults 65+ fall each year Falls are most common reason for traumatic hospital admissions among older adults 1 in 20 requiring emergency treatment

Falls translate into fractures, spinal cord and brain injury Falls and Fractures About 3% of all falls cause fractures pelvis femur vertebrae humerus hand/wrist forearm ankle

hip joint Impact of Hip Fractures Half of all older adults with hip fractures cannot return to normal life or live independently Hip fractures in an aging population will increase over next four decades By 2040, hip fractures may exceed 500,000 Lead to severe health problems and cause the greatest number of

deaths Falls and Deaths Falls are leading cause of injury deaths among people 65+ years Fall-related deaths are more common among men (particularly white) than women Where do people fall? For adults 65+ years: 10% occur in health care institutions

30% occur in public places 60% of fatal falls occur at home What Examine Elderly You can observe a lot just by watching. Yogi Berra

Activities of Daily Living Physical (BASIC) ADLs (ex. bathing, dressing, toileting, mobility) Instrumental ADLs (ex. telephone, shopping, food prep, housekeeping, taking medications, transportation, finances) Discretionary ADLs (ex. hobbies, social functions, golf)

Assessing Mobility Get Up and Go Test Hands Behind Head Pick up Coin Gait feet touching each other?

wider base between feet to compensate for balance compromises? Waddle weakness in muscles need protein, good nutrition, and regular exercise Balance & Gait Stations Mobile Marvin Gauge Your Gait A Well-Turned Ankle

Could You Please Stand Still? Gymnastic Joints Locomotion Describe & determine Stance Posture Stride Pace Gait Balance

Strike Cadence Station 1 A Well-Turned Ankle See-saws, fee-faws! Walking is just losing and regaining the center of gravity over your feet! Use a homemade balance board test endurance and see how quickly your center of gravity shifts. Role assignments: PT (Timer), Test

Subject, Technician (Referee) Station 2 Could You Please Stand Still?! Feel out of balance? Then use your head get a bicycle helmet and homemade stabilometer to check your sway! Estimate area from a stabilogrid to compare changes in balance & sway Role assignments: Measurer,

Balancer, Timekeeper, Reader Station 3: Get Up & Go, Whoopee! How fast can you get up and go from one place/position to another? Use your height and speed to examine your muscle response, coordination, and energy output. Role assignments: PT (Timer), Test Subject, Technician (Recorder)

Station 4 Gymnastic Joints ROM on you; not a computer! Use your homemade goniometer (gonia = angle; metron = measure) to assess flexibility of useful joints Stationary Arm on part that doesnt move Movable Arm on part that moves Role assignments: PT, Test Subject, Technician

Station 5 Carry My Books, Please Overdoing? Muscles will punish you with pain if you exceed their limits! Isokinetic strength force required to keep muscles and bones moving at a steady rate Isometric strength force required to hold your muscles and bones in one place Role assignments: PT, Test Subject, Technician

Station 6: Gauge Your Gait Tickle your toes with talcum then step out on the blue carpet to analyze your gait Apply mathematical formulae to interpret gait information cadence, stride length, and velocity Possible application of Tenetti Rubric Role assignments: Walker, Reader, Measure Master, Timekeeper

Frailty Recognize & Label It Markers include Extreme old age (85+) Disabilities (Interference w/ ADLS) Multiple diseases (2+) Multiple medications Geriatric symptoms dementia, incontinence, hip fractures Fighting Frailty as You Age Nutrition

Wide variety of plant foods cereals/grains, vegetable & fruit Vitamins, minerals, fiber Healthy snacks & small meals Fighting Frailty as You Age Physical Activity Begin gradually; build up Get going and enjoy doing! Reduce risk of injury by lifting correctly! Reduce osteoporosis to reduce risk

of fractures Stronger cardiovascular system Fighting Frailty as You Age Physical Activity for Mobility Challenged Sit & be Fit Tai Chi Yoga Physical Therapy Design of replacement limbs

Fighting Frailty as You Age Vision/Hearing Use ear plugs around loud noises to avoid damage Wear protective lenses when in sunlight to avoid damage to eyes Adaptive devices to compensate for vision or hearing loss Fighting Frailty as You Age Education across the early years can develop early intervention awareness

and skills helping to improve the quality of life throughout the life span The Positively Aging/M.O.R.E. Curricular Projects

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