What do your bed-ridden Aunt Gladys and astronauts on the International Space Station have in common? It's not a trick question - the answer is “no gravity”. Being horizontal for extended periods of time impacts bodily functions, so much so that NASA paid test subjects $18,000 to lie in bed for 70 days while being poked, prodded, and monitored. And then they asked them to try standing up for 15 minutes. It sounds easy enough; but it wasn’t. Here’s how test subject Andrew Iwanicki described the experience: “As soon as the bed was tilted to the vertical position, my legs felt heavier than ever before. My heart started to beat at 150 BPMs. My skin became itchy; I was covered in sweat. Blood rushed into my legs, expanding the veins that had become increasingly elastic throughout the past several months of bed rest. I felt like I was going to faint. I was fighting to remain standing from the start, and it only became more difficult. Around the eight-minute mark, my pulse dropped from 150 down to 70. My body was about to collapse. As my vision started to go black, the staff saw my numbers drop on the machines and promptly returned the bed to the horizontal position. It was only later that they told me that none of the NASA bed-rest subjects have lasted the full 15 minutes.” (1)
Your body doesn’t like to be sedentary for so long, the organs and systems start to decay - this can include a decrease in blood volume, a reduction in bone density, loss of muscle strength, disappearance of fine and gross motor skills, and vanishing balance and mobility. Your heart has to pump harder to move your blood throughout your body, bed sores can develop on the skin, and your emotional well-being also takes a hit. (2)
The NASA study was an effort to determine the physiological impact of extended space travel to Mars, but, as with many NASA initiatives, the results have real-world implications on Earth right now. How can an older adult with physical limitations and mobility issues maintain independence when their body is fighting the effects of no gravity from extended bed time? Once your Aunt Gladys finally does return to the vertical position, can she balance on one leg? Japanese researchers have found that postural instability - as measured by the ability to stand on one leg for 20 seconds - may indicate stroke risk. (3)
Mobility in older adults is critical for maintaining independence and keeping costly, long-term care and health services to a minimum. A 6-month delay in admittance to a nursing home can reduce health care costs by millions, say researchers in the United States. (4) These same researchers are working to identify older adults at risk of disability and create customized exercise programs to prevent an inevitable downward slide. Balance and mobility are key to independence, and for seniors with a disability, “the most common hurdle is serious difficulty walking or climbing stairs.” So, how do we keep older adults active and independent? Core strength and leg speed: “a strong core and the ability to walk quickly can mean the difference between an elder being able to walk across the street before a traffic light changes, and being homebound, relying on someone else to run errands.” (4) The Essentrics Alphabet sequence is a great full-body exercise that will improve core strength, balance, and leg speed. And it’s easy to try it at home on your own: use your entire leg to trace the letters of the alphabet, trying to stay balanced on your standing leg as long as possible. Here’s the link: http://youtu.be/dPEvL0hfbmo.
Mini workouts are a great way to introduce exercise to a previously sedentary individual. And some doctors agree that advice on exercise guidelines may be unrealistic for older, immobile adults. (5) Researchers in the UK argue that “doctors should sometimes advise small increases in activity…with greater emphasis on making inactive people move more.”
Remember Andrew Iwanicki from the NASA study? Here’s his description of his first walk: “With a staff member on each side…I sat up on the stretcher and stepped down onto the ground. My feet tingled like they were sluggish and short as I dragged my feet across the ground and kicked my ankles. I lacked all the fine coordination skills that I hadn’t used for months. I felt sharp pains in my ankles and feet as I pivoted through the obstacle course, and I certainly couldn’t walk a straight line well.” It didn’t last, though: “Within a few days of casual strolling and formal reconditioning exercise, my balance returned and my endurance began to recover.”
Bottom line, go see your Aunt Gladys and stand beside her while you help her out of her bed. Let gravity work on her body, and slowly increase her movement and activity every day. It’s not too late, and she’ll thank you for it.
Amanda Sterczyk is a Certified Personal Trainer (ACSM), an Exercise is Medicine Canada (EIMC) Fitness Professional, and a Certified Essentrics® Instructor. She offers in-home personal training in central Ottawa. Amanda specializes in helping older adults maintain and increase strength, flexibility, and mobility. No fitness goal is too small, in her opinion.