Posted by ProPortion Foods Blog on Nov 16, 2018 in Mobility
Television, technology, and transport have transformed our leisure time, communication and movement. These luxuries have also added to a global crisis of inactivity and chronic illness.
Regular physical activity helps ward off diseases that are now plaguing the planet, like heart disease, stroke, diabetes, cancer, mental illness and Alzheimer’s disease.
Yet more than one in four adults around the world—1.4 billion people—are not active enough, according to a new study published in the Lancet. And countries that are economically more advanced are also more inactive.
Beyond disease, the World Health Organisation warns that failing to increase physical activity will impact health systems, the environment, economic development, community wellbeing and quality of life.
To address this problem, members of the WHO met in 2009 to develop physical activity guidelines. Yet low activity levels have remained unchanged, according to the Lancet study.
Taking effective action, then, will need to be powerfully tackled at multiple levels, according to the WHO.
“Effective implementation will require bold leadership combined with cross-government and multisectoral partnerships at all levels to achieve a coordinated, whole-of-system response,” they declare.
The WHO has set a goal to bring global physical inactivity levels down by 10% before 2025 and 15% by 2030.
They say policy action on physical activity is intertwined with 13 sustainable development goals, ranging from healthy weight to environmental conservation and reduced fossil fuel consumption, academic achievement and equality to stronger communities and sustainable infrastructure.
Their recommendations include creating active societies by improving social norms and attitudes towards physical activity and creating active environments to enhance opportunities for people to move more.
As well as this, they recommend creating and promoting access to programs and opportunities across multiple settings, so individuals, families and communities can be active regardless of age or surroundings.
In support, active systems will be needed at government and policy levels to promote strong leadership and multisectoral partnerships that help mobilise resources and opportunities for physical activity.
The WHO recommends that all adults should do at least 150 minutes (two and half hours) of moderate-intensity physical activity each week, or at least 75 minutes of vigorous-intensity aerobic exercise, or a combination of both.
This includes people over 65. The importance of mobility in older age cannot be underestimated—even in adults with limited movement or dementia, who might benefit from a personalised activity program.
Physical activity in over-65s can take many shapes and forms.
Leisure time activities could include walking, dancing, bowling, hiking or swimming. Transport needs provide opportunities to be active by walking or cycling to the local shops, for instance. Even household chores and gardening rate as physical activity.
Recommendations say that aerobic activity—to get the heart pumping—should be done for at least 10 minutes at a time.
In 2015, Helping Hand aged care centres implemented an innovative, 12-week exercise program. They wanted to see if it could improve cognitive and functional abilities in older adults with significant memory loss or dementia.
The Exercise Physiology in Aged Care Project, led by exercise physiologist Alison Penington, prescribes individually tailored activities to match the skill levels and personal preferences of residents.
Gaynor Parfitt, associate professor in exercise and sports psychology at the University of South Australia, has been evaluating the program and says, “we’ve really been very positively blown away by the impact that the exercise has had.”
Listening to staff interviews, Parfitt said one worker was laughing as she described finding a “stand-assist” resident – who could not stand or walk unassisted – standing up and walking in her room. “She said afterwards, it’s that sort of OMG, I never expected to see that happen.”
Initially, some were sceptical about doing exercise with this population, who are 86 years old on average and “severely declined”. But Parfitt says, “overwhelmingly it’s dispelled the idea that these people are just on one downward trajectory”.
Staff reported improvements in residents’ behaviour, socialisation, communication and alertness. Even language started coming back. Residents became more communicative and started using fuller sentences.
They started socialising and smiling more, as they did some exercises together like passing a medicine ball around.
Family members described being able to hold conversations, and the exercises gave them a point of conversation – or even something they could engage in with them. One man who visits his wife, for instance, started doing the exercises as well.
Because the activities improved their mobility, dressing residents became easier, and they became more independent in activities of daily living, like brushing their hair or teeth.
The exercise physiologists who ran the program prescribe physical activities that individuals find fun and can achieve within their own limits.
“One of the reasons that people tend to stop being active,” Parfitt says, “is because of the fear of falling.” It’s important that they feel safe, and individually targeted activities can overcome this limitation to being active.
Moving beyond aged care, Helping Hand is developing a walking trails program for community dwelling adults that can be adapted to different skill levels; for instance with different trail lengths and difficulties and places for people to sit down and catch their breath.
The key message is to get up and move a bit more than what people are doing.
And the capability of patients who are thought to be severely incapacitated is more than staff believed was possible. “So it’s now actually challenging them to spend more time encouraging them to walk,” Parfitt reports.
This environmental transformation reveals the ripple effects of the program. “It’s changed how people perceived how life can be,” says Parfitt, “and I think that’s quite marked.”
Jane is 52 years old. She suffers chronic neck pain and impaired mobility, resulting from an occupational violence attack. But she needs to continue her activities in the domestic domain and understands the importance of staying active despite the pain.
This is not easy. Although Jane’s house was designed for her ageing parents, the surrounding footpaths are dangerous, and she has already tripped a couple of times. Jane is also a quiet person who enjoys intimate social interactions in the comfort of her own home.
John is a socially and mentally active 44-year old who admits to mildly excessive alcohol consumption and periods of depression. He stays physically active to keep fit and get around.
With an aversion to driving, cycling is his preferred mode of transport. He hopes his physical health will allow him to continue. John lives close to a natural enjoyment which facilitates outdoor physical activities.
As Jane and John age, mobility will become an increasingly important theme in their lives. Their independence will count on it.
A comprehensive survey of long-term studies covering 12.6 million older adults found that mobility improved quality of life and body function capacity and reduced medical expenditure.
Grocery shopping, housework, gardening, visiting friends and family, personal hygiene, going to appointments are things we take for granted. But impaired mobility and chronic conditions in aging can have a significant impact on these daily activities.
“Life space”, the space within which people move in their daily lives, impacts mobility – people who have restricted life space tend to be less mobile.
Walking is an activity that can easily be included in a daily routine as a form of transport to increase life space, thereby enhancing mobility and health.
John and Jane both identify Tai Chi as an activity that they could enjoy in 25 years. It is low impact, and as a bonus includes meditation and breathing for mental relaxation.
Global public health policies increasingly target healthy aging. To this end, a lifestyle index was developed to identify key factors related to aging well.
Core components of the index are vigorous and moderate physical activity, consuming fruit and vegetables, regular meals, plenty of fluids, and psychosocial factors – social engagement, networking and life satisfaction.
There is an interactive element to these. For instance, eating well reduces risk of overweight and chronic disease, both of which restrict mobility. Being socially active, like John, will enhance opportunities to be active.
In turn, higher mobility will enable greater engagement in social networks and activities.
Active aging policies could support people like Jane to be mobile by improving sidewalks and providing walking trails.
More broadly, policies across multiple sectors will empower older adults to remain independent, active community members – characteristic of a healthy, humane society.