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Go4Life – Maintaining good health and function

Chhanda Dutta
Chhanda DUTTA,
Chief, Clinical Gerontology Branch,
Division of Geriatrics and Clinical Gerontology (DGCG)

This month, NIA is celebrating our second annual Go4Life Month. As part of that celebration, we’re reaching out to our Go4Life® partners and the research community to help us find ways to encourage older people to exercise and lead healthy, active lives. This year’s theme is “Fit4Function.”

Exercise training is important for everyone, whether you imagine yourself competing in the next Olympics, simply love the great outdoors, or relish the competition of indoor sports. And the reasons we exercise and the goals we set for ourselves can be quite different. Some people want to run faster and longer, whether it’s during a marathon or on the treadmill. Other people focus on their strength, balance, and flexibility because they want to get better at ballroom dancing or master an advanced yoga pose. Yet, none of us would be able to face these physical challenges safely and successfully if we weren’t Fit4Function in the first place.

So what is Fit4Function all about, anyway?

In the traditional sense, being fit refers to good cardiorespiratory function and good health. Being Fit4Function is different, but equally important. For some of us, Fit4Function means being in shape to enjoy our passion for nature or love of the game. It also means that we’re strong enough to carry the bags of groceries in from the car, that we can maintain our balance when walking on uneven surfaces, that we have the endurance to climb up and down stairs, and that we have the flexibility to reach a jar on the top shelf of the pantry. Being Fit4Function is not only the ability to accomplish everyday activities, it’s what enables us to pursue our own physical activity aspirations at any age.

Prehab vs. rehab

Too often, we find ourselves at a physical therapist’s office doing exercises to improve or recover lost function. How did that function slip away? What if we see training as “prehab”—staying in shape rather than needing bursts of rehabilitation?

This idea isn’t new, but it still needs more attention from researchers in exercise and aging. Whether you refer to it as functional, neuromuscular, or neuromotor training, the goal is to perform exercises which mimic movements used in your everyday life. These exercises usually involve the coordinated use of several muscle groups, incorporating directional changes while challenging gait and balance skills. The underlying concept is that this type of exercise training may help to prevent injuries, functional impairments and disability, enabling everyone to function better in everyday life and work towards their physical activity aspirations.

For example, the NIA-supported LIFE trial (Lifestyle Interrventions and Independence for Elders) showed that a structured physical activity program was effective in preventing mobility disability in older adults. Although the NIA currently supports a variety of exercise studies seeking to improve muscle strength, balance, flexibility, and endurance in older people, we don’t know whether such gains will actually translate into improved performance of daily activities and help avoid injuries, particularly those related to falls.

A new goal for exercise studies

We need to make improved daily function a primary goal of exercise studies. We need to consider not only whether we’re increasing muscle mass and core strength and improving neuromuscular function, but also whether and how these factors contribute to overall physical function and promote functional independence.

As NIA continues to promote Go4Life to older people, the research community can help us add to the information we provide. We need to identify different strategies to promote the functional independence of older people and to empower them to reach higher—to explore their physical activity aspirations. The current Go4Life materials are an important beginning; we have so much more do to.

Do you have any suggestions for us? What will help older people remain fit and independent, participating in the lives of their families, friends, and communities? What will truly help older people become Fit4Function? We welcome your ideas, suggestions, and comments.