GET A MOVE ON EXERCISE IS KEY TO KEEPING SENIORS MOBILE - BOTH PHYSICALLY AND MENTALLY.

Byline: Mariko Thompson Staff Writer

After recovering from two open-heart surgeries and two knee-replacement surgeries, 71-year-old Carol Smith would be left gasping for breath as she struggled to get across the room with the aid of a walker.

But now as part of a pilot project, the Burbank resident has been doing stretches, arm and leg lifts, and walking in her community pool. The results have been positive. After six months of exercise, Smith, who suffers from congestive heart failure, says she hasn't experienced severe shortness of breath.

``What helped me more than anything was to find out that I could do it,'' Smith says. ``That made me feel like I wasn't so useless.''

Smith's case illustrates what researchers tell us: Exercise is a key to healthy aging. The challenge is finding safe and effective programs for the elderly in poor health.

``When you look at your grandmother and she's having trouble getting in and out of the chair, you don't think to tell her to exercise, but she should,'' says June Simmons, president and chief executive officer of the nonprofit Partners in Care Foundation in Burbank. ``You can restore and rebuild muscles at any age.''

The impact of physical activity is wide-ranging, cutting the risk of high blood pressure, heart disease, stroke, diabetes and osteoporosis. It also improves mood, staving off depression and anxiety, says Lynn Lamka, a registered nurse and health educator with Kaiser Permanente in Woodland Hills.

``The list of benefits goes on and on,'' Lamka says. ``A brisk walk is exercise. We don't need special equipment.''

For seniors in good health, exercise isn't limited to jogging around the track or bouncing to loud music in the gym. Tai chi, yoga, strength training and pool classes all are popular offerings at senior centers and hospital-based fitness programs. Even housework and gardening count toward physical activity.

Lamka suggests that mobile seniors exercise for 30 to 45 minutes at least three or four times a week. The time spent exercising can be broken up throughout the day if needed. Exercise routines should work on four areas - balance, flexibility, strength and endurance, she says.

Declines in those areas because of lack of activity can lead to physical frailty and loss of independence once seniors can no longer perform basic daily tasks. Frailty can't be prevented entirely, but it can be slowed, says Dr. Dennis Villareal, assistant professor in the geriatrics and nutritional science division at Washington University School of Medicine in St. Louis. Medical conditions accelerate the rate of frailty, but exercise is the safest way to counteract it, he said.

``You want to be physically active as much as possible,'' Villareal says.

Ditch that walker

Exercise shows improvements in short periods of time. According to the National Institute on Aging, a study of seniors over the age of 80 who relied on walkers were able to progress to canes after doing basic muscle-building exercises over a 10-week period.

Despite the known benefits, frail seniors often face many obstacles to exercise. Medical conditions can cause pain or fatigue. Medications can cause side effects, including wooziness, depression and lack of energy. Seniors who have already suffered a fall may be fearful of physical activity, says Celeste Bocian, program director of Specialized Ambulatory Geriatric Evaluation (SAGE) at Sherman Oaks Hospital.

``These are just some of the issues that are complicating factors,'' Bocian says. ``There are (chair exercise) tapes if the person can't leave the house. If they can get out a little bit, we have them go to adult day-care programs for the socialization and the exercise programs. Exercise is easier to do around other people than in front of your TV.''

Once seniors are discharged from a hospital and complete their physical therapy sessions, few community exercise programs exist to help them maintain their progress, says Jessie Jones, co-director of the Center for Successful Aging at California State University, Fullerton. Health insurance plans typically don't cover the cost, she says.

``It's a revolving door into the hospital,'' Jones says. ``They go home, they don't get a maintenance program, they end up falling and go back in the hospital.''

Frail seniors tend to require more individualized exercise programs. The CSU Fullerton center runs a balance and mobility program called FallProof at 18 community centers, mostly in Orange County. Improving balance is about more than building muscles. Balance exercises also target visual and other sensory systems that assist in spatial orientation, says Debra Rose, the center's other co-director who developed the FallProof program.

Falls are the leading cause of accidental deaths among seniors. In California alone, about 100,000 falls each year have serious consequences, including fractures, head injury and death, according to a report on fall prevention sponsored by the Long Beach-based Archstone Foundation.

``It's unlikely we're going to stop falls altogether,'' Rose says. ``We provide them with strategies to avoid high-risk situations, to get themselves up when they do fall or to fall with less injury.''

For safety reasons, exercise programs for the frail should have smaller class sizes and additional aides, Jones says. In the FallProof program, trained aides serve as spotters while participants work with resistance bands on unstable surfaces.

Jones says the demand for services will only increase - the over-65 group is the fastest-growing segment of the U.S. population. Medical and health organizations tout physical activity as a way of reducing health care costs. Yet there's little money for programs and nothing that requires instructors to receive specialized training in order to work with the frail elderly, she said.

``You're working with people with various medical conditions on various medications, and their exercise needs to be adapted,'' Jones says. ``We have a huge need and a huge problem.''

Motivation to go

The Healthy Moves pilot program that the 71-year-old Smith participates in hopes to fill some of that need. The goal of Healthy Moves is to allow seniors to live in their homes longer, says Simmons of the Partners in Care Foundation, which serves as the lead agency for the project.

After Smith agreed to participate, she did tests that measured her strength, flexibility and walking pace. The instructor then designed an exercise plan for her. Smith returned home with the plan, a handbook, an exercise log and a videotape. A volunteer coach calls to review her progress and provide motivation.

For Smith, the coach makes all the difference.

``I was really a sedentary person until I went to this program,'' she says. ``It got me going and motivated to continue on. I know someone is going to call, and I feel like I should do something.''

Mariko Thompson, [phone]

mariko.thompson(at)dailynews.com

Resources

Center for Successful Aging, California State University, Fullerton, [phone], hdcs.fullerton.edu/csa

National Institute on Aging, www.nia.nih.gov, visit health information publications to view their free exercise guide

Partners in Care Foundation, [phone], www.picf.org

Specialized Ambulatory Geriatric Evaluation (SAGE), Sherman Oaks Hospital, [phone], www.shermanoakshospital.com

CAPTION(S):

5 photos, box

Photo:

(1 -- cover -- color) Genevieve Denny kicks up her heels during the Rise and Exercise class at Valley Presbyterian Hospital.

(2 -- 4) Weight and resistance training is doing the trick for seniors Liz Schofield, top, Maxine Tenney, above, and Anna-Marie Jensen, left, in the Rise and Exercise class held at Valley Presbyterian Hospital's Health Education Center.

(5) Linda Sarnataro shows seniors how to use hand weights correctly in the Valley Presbyterian class, which aims to help participants stay healthy and mobile as long as possible.

David Sprague/Staff Photographer

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Resources (see text)