Most of us are in the enviable position of having a certain amount of control over our future and our health. We get to make the choices that determine if we are going to fall foul of a cold, to ensure we eat well, we nourish ourselves and we keep our inner health in good check. With all this in mind we are investing in our own health to ensure that if we are fortunate to be only at the mercy of our old age, that we get there in fairly decent shape.
But when we start to approach that idiom of ‘old age’ and whatever that entails, there are certain factors that come to light about how much quality of life we have. We all have ageing relatives, those who might be in their more senior years, and as we watch them develop we have to hope that they stay active, aware and independent. The ability to walk and be mobile, be out in the world and able to negotiate the daily tasks of life enjoying small pleasures, such as gardening, the ability to do domestics and cook for oneself. This independence is vital and the ability to be able to keep a hold of this as the body begins to find more challenges in daily tasks and actions that becomes the reality of the senior citizen.
At what point should we start being concerned about mobility and are there any signs that we should signal to ourselves? There are answers to this and one of the main points to consider is our ability to move without assistance. Simple feats of strength and balance are one of the first precursors to signal overall health. Our ability to move and stand, balance and lift (even the smallest items) all feed into our ability to maintain independent living and quality of life.
Overall conditioning is a signal to health. It influences how much control we have over our own systems, our own ability to generate health. If we can move, we can influence cardiovascular health. For example, being able to climb stairs or walk up a hill means that every now and then, we should try and keep this mobility and movement capacity going so that we can force our Cardiovascular system to function at a healthy rate. The minute we are denied the ability to walk up stairs say because of a knee means we have to find other ways to stimulate cardiovascular fitness.
Incidental exercise is a great factor in our lives. I’ll use my mother as an example here. Mum was a diligent housekeeper. She was one of those women that would put Hyacinth Bucket to shame. A pleasant image I have of her in her 50’s was this petite 5’2, slightly overweight and rambunctious woman, getting her shoulder behind a full bookcase and shifting it 3m along the wall. Why? To be able to get down on her hands and knees to clean the skirting boards of course. And then she would also get up on the ladder to wipe down the top of said bookcase. Diligent and obsessed.
Now for someone born in 1935 and having played the occasional game of netball with her Church group when she was 21 but not much else since, has never been an ‘exerciser’. Instead she has worked very hard in her occupations and kept a domestic home for much of her life. Now shifting a bookcase is no mean feat. It’s heavy. However, looking at her vigour for domestic prowess and the ‘clean home’, the incidental exercise that she gained from these chosen endeavours is a great comparative feat. Shifting the bookcase - that’s a sled push. Getting up her trusty 3 step stool, is a few Reebok Step moves. Reaching over the top of the bookcase - overarm extension with abduction. It’s the whole ‘wax on wax off’ Karate Kid concept. She is moving, and not just moving, but lifting, stretching and using her joints.
Perhaps the best likeness here is the fact that she had to get down on her hands and knees. Getting into squat position and rising up from the floor. Stressing her hips and forcing them to work in a full range of motion. This brings me to the iconic SRT - Sitting Rising Test developed by Brazilian Physician Claudio Gil Araujo. This test involves standing in the middle of a room and without assistance or using your arms, arrive at a cross legged position on the floor, sitting. Now without using your arms, come back up to standing. Simple. Points are deducted according to the ability not to use the arms, unsteadiness in standing on one foot, or having to use your hand to lever against your knees or forearms to get you upright.
This SRT test was designed as a measure of an individual’s proclivity to mortality. When you are faced with the onset of an ageing body, all of a sudden a minor mishap or issue that creates restriction takes on a whole new meaning. The more senior of us are more at risk of complications from a minor accident such as a fall that renders them incapacitated and in some cases - bedridden. When speaking to older persons, a primary fear is that first fall. That first time that they go down which then means they may not full recover their mobility and thus their independence. The ability to get back something which was reinforced and strong before an accident is one thing, to gain it back after you have not had it for years beforehand is another.
You can tell people to go and do their movement exercises until you are blue in the face. It doesn’t have that much of an effect and physiotherapist, rehabilitation trainers and therapists are often tearing their hair out when someone comes in saying ‘oh I didn’t remember them’. However, this simple test has a more of an insistent leverage - in that scoring low in this test puts you in a risk category that is 5-6 times more likely to die in the next 5 years.
A person’s flexibility, strength, range of motion and conditioning whilst not relating directly to their heart condition or organ health, is directly linked when it comes to an ageing person. Dangerous falls and accidents are predicators to quality of life and life expectancy and it is this fact that is the leverage of the SRT test. Whilst ‘correlation doesn’t equal causation’ (Greg Hartley - President of Academy of Geriatric Physical Therapy) these indicators do have a flow on effect to all over health and quality of life.
It seems very dramatic and is a slightly alarmist viewpoint. However that being said, the correlation between the ability to generate balance, core strength, co-ordination and power of working joints and muscles in this simple test do correlate to a life expectancy goal. Now this test was developed for use with those 51 and over. So there are many other factors that may and do come into account when you are comparing the results of this test with morbidity and other variable actors of health. But it’s a great simple way to generate leverage for those who may be challenged with this movement capability. It’s something that we should all hold onto. The ability to sit and stand is paramount to survival.
“It is well known that aerobic fitness is strongly related to survival, but our study also shows that maintaining high levels of body flexibility, muscle strength, power-to-body weight ratio and co-ordination are not only good for performing daily activities, but have a favourable influence on life expectancy.” Claudio Gil Araujo