Three equipment options better than the BOSU for mature clients

The BOSU has quickly become one of the most popular and beloved pieces of fitness equipment with trainers today and frankly that baffles me a little bit.  I’ve watched many videos and presenters showing hundreds of “creative” uses of the BOSU that just leaves me scratching my head because I just don’t get what they are trying to accomplish.  They use all of the right terms, such as balance, proprioception and reactive stability, to support their choice of exercise movements but usually I see a physiological disconnect between what they are saying and what the movement actually accomplishes.

In my personal opinion the BOSU is more of a toy than a tool.  Now don’t get me wrong there are definitely some beneficial movements that can be performed on the BOSU but they comprise just a fraction of all of the movements that are actually performed with it.  This is all doubly true for mature clients.  The BOSU, and instability training in general, seem to be overused and misapplied with this population.  For example, I recently completed the BOSU Mobility and Stability for Active Aging program (home study materials) and, as someone who has studied mobility and balance extensively for older adults, I was completely underwhelmed.  A large portion of the exercises either didn’t use the BOSU or could have used any number of other pieces of equipment in its place with the same result.  And while several components critical for balance and mobility are addressed in the program (e.g. hip and leg strength, ankle stability) others are either insufficiently addressed (e.g. multisensory training; center of gravity control) or not addressed at all (e.g. postural strategies).  However, the program could potentially be useful as a basic introduction to balance training for instructors who are new to these concepts.  I am concerned, though, because it does not fully nor accurately represent the individual balance components included in a comprehensive program since the focus is on using the BOSU.  (I would also state that none of the exercises presented in the program were inherently dangerous or “wrong” for mature clients and I am sure participants would get some results by doing the program but it is generic and sub-optimal.)

Unstable (or labile) surfaces, like the BOSU, need to be used purposefully and selectively with mature clients.  Their best use is for vestibular training because in order to fully engage the vestibular system you either need to reduce/remove both somatosensory and visual input OR move the head quickly.  A compliant surface reduces somatosensory input so its use is warranted in this situation.  Another beneficial use is for ankle and hip stabilization (although some argue against this).  Instability definitely turns on the proprioceptors and causes muscular co-contraction.  This can be beneficial for those that have deficits in these areas although the proprioceptors can also be turned on using stable surfaces and muscular co-contraction is not always a good thing.  So there are pros and cons.  The bottom line, though, is that there are other equipment options, like the ones I’ve identified below, that, in my opinion, are more beneficial than the BOSU in accomplishing these tasks.

Number One:  High-Density Foam Pad

There are two primary advantages to using foam pads over the BOSU.  The first is that foam pads provide a broad, flat surface as opposed to a curved surface.  As many before me have stated the curved surface presents some concerns for the ankle and knee joints and its functional relevance is questionable.  The flat surface allows for a variety of stance positions including shoulder-width, narrow, side-by-side, semi-tandem, tandem and one-legged.  It creates equal instability in all directions instead of “from the center out” with the BOSU.  The variety of stance positions possible and the equal instability is really critical in effective vestibular training because we are able to scale/modify the base of support according to the individual’s needs.

Airex Balance Pad

The second advantage is the lower level of instability with the foam pad.  The BOSU has a greater degree (moderate level) of instability compared to the foam pad.  The foam pad will be more appropriate (and much safer) for those who have more severe balance deficits.  To increase the amount of instability two foam pads can be stacked together so the instability can be easily and quickly modified.  This is very important when working with a group who has varying levels of balance and fall risk.  In my opinion it is typically much more appropriate to perform dynamic movements with lower levels of instability compared to moderate or high levels of instability for this population.  Performing the mCTSIB test (modified Clinical Test of Sensory Interaction in Balance) also requires stacking two foam pads to assess vestibular control.

Number Two: SPRI Step 360

What I really like about the Step 360 is the broad, hard, flat surface which provides somatosensory feedback in addition to instability.  Plus, it allows for a number of different stance positions while providing multi-directional instability which is much more akin to a wobble board.  However, it is a little more stable than a wobble board.  Some people would argue that the BOSU can be turned hard-side up as well.  However, there are some challenges with using the BOSU in this position.

SPRI Step 360

 

For one, just like a traditional wobble board, mounting and dismounting are difficult because it tilts quite easily and to a significant degree.  This is not the case with the Step 360 which can rather easily be mounted by placing one foot closer to the middle of the stepping surface to reduce instability, stepping up with the other foot and then adjusting foot position as necessary.  Because of its unique design it doesn’t tilt nearly as much nor as easily.  Secondly, there is more of a “dump out” risk.  That is, when users allow the BOSU to tilt too far in a given direction (especially forward or backwards) there comes a point where recovery is impossible and the person gets “dumped out”.  They must step off the BOSU in order to maintain their balance.  This poses a significant fall and injury risk for lower-level clients.

(For more details on the Step 360 visit www.spri.com)

Number Three: The Floor

Yes the floor is one of the best pieces of equipment (if not THE BEST) you can use for comprehensive balance training.  It is a broad, firm, stable surface and functionally relevant.  We can effectively work on most components of balance with using only the floor and the client’s own body weight.  Postural strategies (ankle, hip and step), static and dynamic center of gravity control, multisensory (visual, somatosensory and some vestibular), lower body strength (including ankle, knee and hip stability), gait enhancement, mobility and more can all be trained safely and effectively just by using the floor.  It’s not very sexy.  It’s not a cool toy or widget.  It doesn’t get a whole lot of credit.  But it absolutely works!

Ankle Strategy
Ankle Strategy on Floor

As I stated earlier, unstable surfaces are really overused and misapplied.  Plus the scientific evidence demonstrating their effectiveness for most people is really lacking.  This is also true for mature adults.  Don’t get swept away by all of the “creativity” that goes into selling a particular piece of equipment when typically the basics are all you really need.  Remember that for every “fitness expert” pushing pieces like the BOSU there are just as many other experts who would advise against them.  There is really no end to the creativity of fitness professionals but creativity must be balanced with a strong physiological rationale and, ultimately, scientific evidence.

Take Home Message

So, should trainers throw their BOSU out the window?  Certainly not.  It is important to have tools (not toys) that meet the diverse needs of their clientele and the mature population is the most diverse clientele of all.  The BOSU, like many other pieces of equipment, must and can be used safely, purposefully and effectively.

If you want to learn more about evidence-based functional training methods for mature clients then become a certified Functional Aging Specialist.  The course is packed with over 10 hours of online content that will teach you how to develop safe and effective functional aging exercise programs.  Earn CEU’s from ACE, ACSM, AFAA or NFPT.

For Mature Clients, Power is the Glass

Dan John in his book “Never Let Go,” uses a “glass” as an analogy to illustrate how strength serves as a foundational modality
comported to others. He suggests that strength should be the glass and all other physical modalities are what go into the glass. For
example, flexibility, power, mobility, balance, speed, cardiovascular, core are all things that support the foundation of
strength. Interestingly enough, when real strength is achieved then all of the other physical aspects occur. Lets look at the Front Squat
or Goblet Squat for strength. If you focused on that one move with real intent to improve strength then you will increase strength in
your core, improve hip mobility, anaerobically, power, speed and balance.

I believe that there is a second glass just as important if not more important than strength when training older adults. Because we
lose Type II muscle fiber at twice the rate as Type I muscle fiber it is imperative that we target Type II muscle fiber in our training.
Stephen Sayers found that with two different groups of older adult strength training groups had different outcomes related to speed of
movement. He used an automobile simulator to test the foot braking speed of two groups. One group, slow-speed strength
training, lifted weights with a traditional 2-3 seconds in both directions, concentric and eccentric at 80% of 1RM. The other
group, high-speed power training, performed an explosive move as quickly as they possibly could on the concentric phase and then a
eccentric phase count of 2-3 seconds with a 40% of 1RM.

High-speed power training and traditional slow-speed strength training both improved peak muscle power after 12 weeks of
training; however, high-speed power training increased velocity compared to traditional strength training. Two interesting findings
were that muscle strength was not comprised in the high-speed power training group, and more importantly, the breaking speed,
foot on accelerator to break, was faster with the high-speed training group.

The improvement of our movement speed becomes critical the older we become. A young person can function just fine with their
speed of movement but because of the rapid decline in our Type II muscle fiber over the years, recapturing our ability to move quickly
is imperative and should be a foundation piece of older adult programming.

FAI’s Functional Aging Specialist Certification teaches trainers how to incorporate power training exercises into the exercise routines of mature clients.

Paul Holbrook, MA, CSCS
FAI Advisory Board Member

When did we stop listening to our bodies?

Every human has an internal wisdom which guides and directs us. Our belief systems are like computer programs. When we are old enough to hear and see, we begin to program ourselves. We believe anything our role models tell us, even if what they tell us goes against our own feelings or bodily impulses. For example, if the child is hungry and tells the caregiver, and the caregiver says, “How could you be hungry, you just ate,” the child’s computer programming will take in that information and register that the child’s bodily impulses are incorrect. This is one way we lose our mind/body connection. We begin to live in our heads and totally reject contradictory messages communicated by our physical bodies, which, paradoxically, happens to be the most innately wise part of our entire being. Our body wisdom is shaped by our experiences and our bodies are the vehicles we use to travel the path of life.

Our wisdom tells us if we are doing the right things for the right reasons. Is this a pain we should work through or does it indicate to modify or stop? If we listen and act accordingly, we will know much more about our health. We tend to concentrate on specific athletic endeavors as opposed to a variety of activities that create a balanced body. This comes from following fitness fads, competitions, or body dysmorphic disorders.

The body begins to compensate for various reasons including, over tight muscles, weak muscles, over rotation, limb length changes, etc. Continual compensation leads to dysfunction and more compensation. Anatomical dysfunctions can interfere with the body’s ability to perform both physical and mental tasks. When there are postural changes, the whole kinetic chain is interrupted and the whole skeletal system is affected.
These misalignments also affect the performance of other body systems, including the cardiovascular, digestive and respiratory systems.

When developing program design both clients and trainers need to understand a systematic approach using a four stage progression model which will ensure proper body mechanics and correct kinetic chain firing.
Stage one evaluates stability and the ability to maintain or control joint movement or position without compensation. This is achieved by synergistic actions of the components of the joints and the neuromuscular system without compromising joint mobility.
Stage two evaluates mobility and the range of uninhibited movement around a joint. This is achieved by the synergistic actions of the components of the joint and the neuromuscular system without compromising joint stability. There are 5 fundamental movement patterns which include: bend and lift, push, pull, rotation, and one leg movements.
Stage three incorporates loading using traditional programming to achieve muscular strength and endurance. This phase should not be implemented until phase one and two are achieved.
Stage four addresses skill-related components of fitness which help improve the functionality of performance and include: agility, balance, reaction time, coordination, speed, and power.

Dianne McCaughey, PhD
FAI Advisory Board Member

Strategies for Successful Aging

In the process of working on my doctorate in gerontology, I discovered, rather than studying physical health, I was more interested in understanding and evaluating the mental, emotional and spiritual health of people who were getting up in age. I collected and analyzed data to learn more about the participants’ experiences with their life crises, how they responded to a particular crisis, coped with the crisis or learned from the crisis, and how they had applied this learning to their later lives. By understanding the importance of these other areas you will become more effective working with mature clients.

Our satisfaction with life and our self-esteem are on average as high in old age as they are at any other time in adulthood. As we age, our earlier expectations of life change and more and more come to match our current realities. We become in some ways wise, mellow and more able to enjoy the present moment.

As people grow older and have fewer years left, they become more concerned about enjoying the present and less concerned with activities that prepare for the future. Less time, attention and energy are devoted to casual acquaintances, long-term marriages grow closer, and partners enjoy each other more and spend less time trying to improve, impress and dominate each other. Ties with family and old friends grow closer while social networks shrink in size. Surveys show that our fear of death typically peaks in our fifties but lessens as we age. Older individuals are less fearful of death, more likely to accept it because they know they have lived a full life.

Life changing processes in human development have been studied for years. Erik Erikson was one of the pioneers of this research, and he believed adults continue to grow and mature throughout their entire lives, not just the early years. Erickson believed wisdom is the end result of any healthy crisis resolution and is evident in a person’s proverbially seeing the glass half full rather than half empty. Wisdom has been considered from the earliest of times the pinnacle of human development because of its positive qualities and its helping us to understand the life we have had, the life we have, and life in general.

Taking Action
Believing that one’s efforts can influence an outcome increases the likelihood of the person’s actually selecting goals to act upon, investing the necessary time and energy in achieving those goals, and experiencing a personal sense of well-being. The basis for healthy growth in all stages is that as long as people try, they can succeed. A wise person weighs the known and unknown and resists overwhelming emotion while taking appropriate action. Successful aging was found to be an end result for those who had coped well, found an opportunity and proactively dealt with their stressors. Personalities that were more confident had positive beliefs, assertive behaviors, and, in the end, enjoyed themselves more. Not taking action, on the other hand, or deflecting responsibility for their actions prevented individuals from learning, from introspective analyses, and frustrated the potential of their futures.

Action must be taken for learning to occur. Real change takes place from the inside out. Once individuals begin to recognize the ineffective methods they have used in their lives to cope with the stress of challenges, they can begin to correct the faulty methods and make positive changes. Those who choose to take control of their lives take action. They work on things they can do something about.

Each of us must take the initiative and responsibility to make things happen. And making things happen keeps us from seeing ourselves as victims and helps us to move from reactive to proactive behaviors. In this way, purposefully reconnecting with the self enriches a person’s life experience and helps people learn to be their real-selves. In fact, data from my research concluded that being one’s real-self was a desire that three-fourths of the participants acted upon after their first crisis. They learned that to be truly happy, they had had to follow their hearts, to be themselves, and they learned that real joy in life did not come from their trying to be what everyone else wanted them to be.

While the majority of the participants believed that each day should be lived to the fullest, they all expressed it in different ways. Some suggested that living each day to the fullest is a way of practicing gratitude for the life they have. Others indicated that even after the earlier crisis, their awareness of the value of living each day to its fullest became more clear.

But, to change requires flexibility. Deepak Chopra indicates that flexibility can reverse biological aging and that flexibility comes from letting go of attachments and being resilient when facing inevitable challenges in life. The crisis itself may not be forgotten, but the sense of urgency to change is remembered. Healthy forgetfulness involves moving on, but only after the appropriate changes have been made. If there is no change, there is no moving on.

After a crisis occurs, and the coping is completed, and time passes, individuals have choices. They come to a crossroad at which they must choose between continuing life as it had been or moving on to what the future promises.

Virtually all research data suggests that moving on with one’s life is the appropriate action to take once the value of embracing change has been established. There was a letting go of some kind for all who wish to be the most complete version of their true selves, and there is a period of grieving for what is left behind or let go of, but those who move from the past to the present eventually acquire hope for the future.
Purpose

Successful aging is a result of a balanced exchange of energy between the individual and the social system in which the individual finds himself or herself. Almost all older persons living in private homes engage in some form of productive activity. Freud indicated that love and work are essential to successful living. Sadly, many retired elders have lost their sense of purpose and productivity and feel cynical, bored and empty. The definition of work is larger than the job and thus suggests work is not governed by a paycheck or a time clock. Work might include weeding a garden, baking bread, teaching a skill, or volunteering in one’s community.

Having a purpose in life has been found to create a passion for life and gives meaning to life. Older individuals who still believe they can improve themselves need a sense of creative tension that cancels out the lack of challenge and depression that has been found to cause disease. Thus, the key to successful aging is to redefine our purpose and move from a self-centered world to an altruistic world of caring for fellow human beings. The challenge is to find that kind of caring that creates a sense of aliveness and purpose in us, to find what stimulates us to continuing growing and developing our better selves.

Satisfaction with one’s life was found to be predicated on our sense of having achieved our goals, be they socioeconomic status, employment or self-actualization. Yet, many healthy and happy elders had to re-create their definition of success from security, advancement and retirement to greater commitments to family, community, nature and spiritual growth. To make a contribution is one of the most popularly cited reasons for why people choose their work, and the reward for giving to something larger than themselves is not only valuable to others but also invaluable to the giver. It is not enough to be kept busy, study participants reported, but that their work had to be directed toward some pragmatic end, to help others or themselves, in order for the work to have meaning.

Well-Being

Self-worth and confidence are components of well-being and personal happiness. Successfully moving through crises, learning life’s lessons and acquiring the wisdom necessary to create an improved self, increases our sense of well being and happiness and leads to a healthy sense of self-worth.

Growing old is an enriching experience that involves our appreciation of our personal significance and our coming to terms with losses and changes. Personal growth is just that, a maturation of the self, which evolves or is spirited on in many ways, through introspection, the altering of values and perspectives, and action. By committing ourselves to being our best selves, we help ourselves and everyone around us.

By knowing why you are, and who you are, you can begin to make yourself into the person you want to be.

Dianne McCaughey, PhD
FAI Advisory Board Member

Functional Longevity Exercises

Here is some great information you can repost to your list of older clients or on your blog or even print out and post in your facility!

When it comes to increasing physical function for a long time which exercises are the best?  I’ve assembled some of the top functional longevity exercises that I could come up with.  These are the same types of functional longevity exercises that I use in the Never Grow Old Fitness Formula – a follow-along exercise program for mature adults.  But first let me give you a few common characteristics of high-quality functional longevity exercises.

Functional Longevity Exercises:
1.         Challenge many aspects of physical function such as strength, balance, endurance, coordination, proprioception and stability

2.         Use many muscles and limbs simultaneously

3.         Focus on completion of a task rather than training a specific muscle

4.         Are easy on the joints

5.         Use a variety of equipment options

6.         Are rarely performed in a seated position (unless standing is not possible)

So here are some of my top functional longevity exercises for you to try:
•          Power Stand (stand up from a chair as fast as possible and lower back down slowly)
•          Lunge with reach to toes (both hands)
•          Side lunge with reach toe (opposite hand to toe)
•          Standing 1 arm row with tubing
•          Standing 1-arm chest press with tubing
•          Standing diagonal lift with DB (or medicine ball)
•          Plank Series (front, side, back)
•          Obstacle Course
•          High-Intensity Interval Training (cardio)

If you want to not only live a long life but also able to have a high functioning body in order to enjoy all of those extra years then try out these functional longevity exercises for yourself.  If you are already an avid exerciser but you perform the basic strength training movements on exercise machines at the gym then I dare you to try these functional longevity exercises instead.

Ready to start a Functional Longevity Exercise program?  Then click here!

Cody Sipe, PhD

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