An Occupational Therapist’s Guide to Community Fitness for Older Adults

Community fitness and the aging U.S. population.

Nearly 10,000 Baby Boomers turn 65 every day. As the U.S. population grows older, access to quality wellness and physical fitness is a priority. Older adults are looking for fun, engaging programs that help them maintain their independence and optimal health. There is an increasing demand for skilled instructors in community fitness programs who have expertise in exercise, functional skills training and wellness education for older adults.

Occupational therapists, who work to promote productive activity and independence throughout the lifespan, are well-trained in these areas and may want to consider the rewards of becoming older adult group fitness instructors.

Recommended course: Therapeutic Exercise and the Older Adult: An Evidence-Based Approach, 3rd Edition

The value of an OT in community fitness

My more than 25-year career in occupational therapy has taken me from rehabilitation hospitals to outpatient settings, acute care, and home health, with a special interest in older adults with neurological and orthopedic conditions.

More than a decade ago, I was invited to train in a program for older adult fitness called Body Recall. The program was based on the idea of engaging brain and body through exercise and movement activities. It placed an emphasis on explaining the functional applications for each exercise and the importance of fall prevention and recovery.

This directly reflects the values of OT. Once I started teaching classes for older adults, it became so rewarding that I grew committed to learning all I could about older adult fitness through books, videos, certifications, CEUs, and my certification through the National Academy of Sports Medicine (NASM) as a personal trainer.

As an OT, I bring a holistic approach to physical, emotional and cognitive health, which has guided me throughout my practice and continues today with my career focus on older adult fitness. The group fitness and personal training courses have provided instruction in a wide variety of exercises, program design, safety considerations and a structure upon which I have applied my own skills and OT background.

Recommended course: Supporting Aging in Place: An Occupational Therapist’s Toolkit

Certification and training programs

Occupational therapists meet the criteria to participate in most group fitness training programs to teach classes for older adults. While Body Recall is no longer taught, there are a variety of excellent certification and training programs available.

• Silver Sneakers requires instructors to hold a two- or four-year degree in health, exercise science, or a physical activity-related field, or to maintain a nationally recognized fitness certification. The program requires both online and in-person training and offers classes such as Classic, Cardio Fit, Circuit, BOOM (geared to fit Baby Boomers), Yoga and a new class titled Stability, which focuses on balance, agility and fall prevention.
• Silver & Fit is a circuit interval training program that provides three skill levels for older adult participants. Occupational therapists are eligible to take the online training, which emphasizes safety, core stabilization, and a functional approach to exercise.
• Drums Alive combines physical activity with rhythm and percussion using drumsticks and stability balls. The benefits of learning new movement patterns, fine-motor coordination and cardiovascular exercise together with fun and socialization are medicine for the mind and body.

Helping seniors stay active

These programs and others reflect the current trend in older adult fitness, which is to help people stay active and safe and allow for modifications and progressions to meet the individual needs of participants. Classes emphasize exercises that relate to overall functional goals, such as getting up from a chair, maintaining independence with climbing stairs, gardening, leisure and sports, and taking on the role of caregivers for grandchildren, spouses and elderly parents.

Exercise programs often incorporate brain health with activities that offer physical and cognitive challenges. One example is a dual-tasking activity, which requires both motor planning and a long-term and working memory task. In this drill, students are challenged to recall their childhood phone numbers, then recite them backward while performing a more complex motor task such as a grapevine step.

I designed and taught a class titled "Bodies in Balance" at a local senior center with a focus on functional fitness and active aging. We follow an interval format of weight training and cardio exercises, in addition to flexibility, core exercises and evidence-based wellness information.

We also focus on brain health with fitness activities, memory strategies, research updates and brief cognitive puzzles. Agility is also featured, at times using balls, hurdles, agility dots and dance steps such as the Mambo for fall prevention, coordination and motor planning skills.

The unique rewards of community fitness programs

Working as a group fitness instructor is deeply rewarding. I see progress as my students become stronger and more confident in their abilities. The opportunity to work with motivated participants and the close relationships that develop in the class are also tremendous benefits. One student said, "I almost fell off a curb, but with those ankle exercises, my legs just 'danced.’ I was fine."

Another student commented that her doctor was amazed at how fast she recovered after surgery. She attributed it to exercise. Recently, a reporter from the local newspaper came to class and wrote a story about husband-and-wife participants who were about to celebrate their 70th wedding anniversary. They stated that exercising together over the years contributed to their long life and happy marriage.

The emerging role of community fitness programs for older adults is an exciting field. Seniors are increasingly recognizing exercise as an important factor in health promotion and preventive medicine. Recent developments in fitness include:

• Pre-habilitation to improve outcomes post-surgery
• Exercise classes to motivate clients once discharged from home health or outpatient services
• Group exercises for specific conditions such as arthritis, Parkinson's disease and cancer
• Creative and expressive group fitness programs that feature dance and music

Contributing to older adults’ health and fitness

Occupational therapists can make a significant contribution to older adult fitness and community-based wellness. The community fitness model may take the instructor to a variety of venues. These include senior centers, assistive living, YMCAs and even libraries and outdoor parks.

There are endless opportunities for occupational therapists to promote life-long fitness for the growing population of older adults.

This article was written by Anne Graff, OTR/L, NASM-CPT.