Incorporating mental exercises into a physical fitness class is based on the idea that cognitive distraction drills can help improve balance.
The first part of the hourlong Standing Strong exercise class at the Linwood Senior Center in Wichita, Kan., proceeds pretty much as you might expect.
After a warm-up, the 25 participants are led through stretching and strengthening exercises. For some of the movements, the 22 women and three men — most in their 70s and 80s — are seated on aluminum chairs arrayed in a circle. Some use the chairs as support for standing exercises. The leader for the first 30 minutes of today’s class is a cheery graduate student. But when his professor, Michael E. Rogers, steps in, things really get interesting.
The participants are asked to stand with each foot on a 3-inch-thick foam pad. Each is then handed a yellow whiffle ball.
<>“I’d like you to hold the ball in one hand and drop it into the other,” says Rogers, an exercise physiologist who heads Wichita State University’s Center for Physical Activity and Aging. The class follows his lead. “Now expand the distance,” he says, raising one arm to show how far the ball must fall. “Change hands.” Arms swing up and down, brows furrow, and a few balls go rolling on the floor to titters of laughter.
As the balls are collected, Rogers directs their attention to an image projected on the wall of the rec room.“OK,” he says. “I’d like you to read the words.”
“Red. Green. Yellow. Blue,” the group says in unison, reading words that appear, each in the appropriate color, while standing on the unstable surface of the footpads.
“Good,” says Rogers, as the next PowerPoint slide is projected. The words appear again, but now in different colors, so that “blue” is in green type, “red” is in yellow and so forth.
“Say the color of the word, but ignore the word,” Rogers says. There is hesitation, as participants pause for thought. The unison of response is not quite as crisp. “Blue — no, wait, yellow.”
The brainteasers are part of the Stroop Test, typically used in laboratory settings to test a person’s capacity to direct attention. Incorporating mental exercises into a physical fitness class is based on the idea that so-called cognitive distraction drills can help improve balance — particularly when it’s needed most.
“Falls typically happen when you’re not paying attention,” Rogers says. “If I tell people to focus on their balance — on, say, putting one foot in front of the other — they really concentrate on it and move slowly and carefully. We want to get it to be a more reflective, unconscious process. So that if you’re walking out of the house on a cold morning, and there’s a patch of ice by the door …”
We know what happens then. Falls are the leading cause of accidental death among older people, and physical activity is one of four steps recommended by organizations like the Centers for Disease Control and Prevention to help prevent them. But compared with the other three — adjusting medications, having one’s vision checked and creating a safe home environment — exercise is often the most challenging and intimidating for seniors.
Rogers and his wife, Nicole, a psychologist who is director of Wichita State’s aging studies program, developed the Standing Strong program in 2008 as a way to help seniors improve fitness and balance through basic exercises. But in the last few years, they have introduced cognitive drills, such as the ball dropping and the Stroop Test, the idea being that improving the participants’ dual-tasking — their ability to maintain balance on the pads while attending to other stimuli — can reduce falls.
“This is pretty cutting-edge stuff,” says Robert Topp, a professor of nursing at Marquette University, who has researched the effectiveness of various forms of exercise among older people. The Standing Strong activities, he says, go beyond the kind typically used to improve balance.
“Mike’s trying to train people to concentrate on what they’re doing as well as retrain their balance,” he says. “I think he’s onto something really important when it comes to falls prevention.”
Regular participants in Standing Strong reflect that confidence.“I had trouble with my balance,” Betty Enright, 75, admits. “I couldn’t use the pads at first.”
Now she can stand on them while doing the cognitive drills. “My brain needed stimulating,” she adds with a chuckle.
Her friend, Betty Marshall, 86, says she enjoys the cognitive drills, too. Marshall has been taking the class for four years, three times a week, and says she believes that the combination of physical and mental exercises has benefited her. “I am absolutely standing stronger,” she says.