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Pittsburgh center implement senior fitness programs

Tuesday, September 22, 1998

By Gary Rotstein, Post-Gazette Staff Writer

From their seats, the group of nursing home residents stretched, punched the air, laughed, kicked, complained and flexed - all while using muscles they may have ignored for months, if not years.

 
  For wheelchair bound residents at Villa St. Joseph nursing home in Baden, a game of catch with activity director Chris Donatelli is part of a six-month program of specialized exercise. (Lake Fong, Post-Gazette)

The 10 Villa St. Joseph residents in Baden displayed more smiles than grimaces in their first class in a six-month exercise program starting at nine locations this month through the Southwestern Pennsylvania Partnership on Aging. For at least one day, the frail participants became grudging converts to the theory that it's never too late to benefit from exercise.

"It'll help some, yes, of course," retired Jones & Laughlin Steel Corp. millwright David Clarke Ramsey, 84, said afterward from his wheelchair, "but it'll never help me get back on my feet."

The advocates for elderly exercise who set the regional program in motion don't promise to help Ramsey and the other less mobile members of the Pittsburgh area's aging population discard their wheelchairs and walkers. They don't rule it out, either.

They cite research that suggests people on into their 80s and 90s using regular low-intensity exercise can regain their muscle tone after either an acute illness or years of sedentary existence. At the very least, studies say, exercising their arms and legs regularly will stem physical deterioration of the frail elderly, and it may also help their mental outlook.

The improvements can come from repeated bending, lifting and stretching of appendages and joints for a half-hour rather than use of any fancy, expensive equipment. Researchers say such workouts can reduce potentially crippling falls by the elderly, a primary cause of hospitalization and nursing home confinement.

Dr. David Martin, a geriatrician now at UPMC Shadyside, conducted a study earlier this decade at The Western Pennsylvania Hospital that found elderly patients in an exercise program prior to discharge regained their walking ability better, performed better in a test of lifestyle functions and were able to leave the hospital sooner, compared to patients who merely rested in bed after illness or surgery.

"In one day of bed rest, you lose 1 percent of aerobic capacity and 2 percent of muscle strength. You can lose 10 percent of muscle strength in a week," Martin noted.

"Someone younger with a lot of reserve can overcome that, but for someone frail and older, it can mean the difference between being ambulatory and suffering falls."

Such findings have been increasing during the 1990s, as longer life spans and growth of the elderly population have led researchers to explore ways to upgrade seniors' quality of life.

The Jewish Healthcare Foundation spent $150,000 on Martin's research and liked his results, but its leaders wondered afterward what good it served if no one followed through to coax seniors into more exercise, explained Nancy Zionts, the foundation's senior program officer.

 
  Chris Donatelli, activity director of the Villa St. Joseph nursing home, helps Julia Giammaria, 87, twist her wrist during exercise class. (Lake Fong, Post-Gazette)

She and Mary Anne Kelly, executive director of the Southwestern Pennsylvania Partnership for Aging, said research on the elderly too often gathers dust on shelves instead of helping anyone. To address that, the Jewish foundation has funded the regional group's formation of the Community University Partnership for Successful Aging, with Martin's exercise study as the first of a series of projects in which local research will be put into practice.

"The thrust of this is not whether we can learn anything new, but whether we can implement what we have learned," said Martin, who serves on an advisory board for the new partnership.


Powerful motivation

Two nursing homes, two personal care homes, two senior centers, two congregate housing sites and an Alzheimer's personal care home have recruited about 10 participants each from among their frailer members for the three-day-a-week exercise program. Participants were assessed in physical abilities and mental attitudes before the program began, and they'll be evaluated again for progress after six months.

Jeff Jozwiak, an exercise physiologist serving as the project's coordinator, combined some of Martin's research with information he gleaned when working for the elder exercise program of Mercy Hospital's Center for Healthy Living. Jozwiak assembled a 30-to-40 minute program of stretching, bending, twisting and other arm and leg movements being tried simultaneously at the nine senior sites.

Those facilities, some of which offer less structured exercise programs already, all volunteered to take part in the program. Some gentle persuasion succeeded in rounding up the individual participants.

"They want to live in this setting as long as they can - they do not want to be in a nursing home or hospital. That's the main motive," said Roni Lucas, program manager for New Haven Court at Clearview, an assisted living complex in Butler County.

The Center in the Woods, a comprehensive senior center in California, Pa., is also taking part. It will use existing activities space, but the center is also embarking upon a $600,000 fund-raising campaign to build and equip special exercise facilities, said center Executive Director Mary Hart.

"Most places, whether a senior center or congregate housing or a nursing home, if they do exercising now, they've done it in a real low-key, almost childish manner. We believe that needs to change," Hart said.

Probably the most comprehensive exercise offered for seniors in the region is through Mercy's Community Exercise Program, formerly known as Fit N B Free and Elderfit. It provides strength conditioning in group settings at 21 sites.

Michael Morrison, coordinator of Mercy's program, said the older population often does well in such settings because they use it for socialization and they have more time to make it a priority.

"It's important for them to go slowly, not to progress too quickly," Morrison said. "What you normally see with a sedentary population that hasn't been exercising is dramatic improvement initially - some more than others - and then they plateau," though it may take 18 to 24 months to reach that leveling stage.


Aiming for a plateau

Jozwiak wasn't worried about that distant plateau when putting the 10 participants at Villa St. Joseph through the motions of their first workout. Seven of them were in wheelchairs. One of the wheelchair women slumped groggily and didn't take part. Another woman sitting upright in a chair complained loudly that she wasn't capable of the movements he requested.

Most of the rest followed along with Jozwiak's instructions, laughing occasionally and keeping their grumbling to the good-natured side.

"Whatever you can't do, don't worry about it," Jozwiak assured before coaxing them to extend their arms over their heads, followed by simulated rowing motions and then leg lifts and kicks. "Just do the best you can ... As you do it more, you'll get more conditioned and be able to do it longer."

Anna Hussar, 86, said from her wheelchair afterward that her arms were sore, but she thought it was worth it. She walks on her own part of the time now, and wants to do it more.

"It feels pretty good," she said, able to chuckle about her soreness. "I think it'll help me to get around a little more."

Other sites participating in the partnership's exercise project, which could be expanded to more locations after six months, include the Westminster Place personal care home in Oakmont, Woodside Place dementia center in Oakmont, Vintage senior center in East Liberty, Bellmead Apartments in Washington, Pa., and both the Sherwood Oaks nursing home and its assisted living site in Cranberry.



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