Muscling Up Against Disability Project
Resistance training is a powerful but under-utilised approach in the battle against later life disability. While more and more older adults are becoming proactive about their personal health, few are turning to weight bearing and resistance training exercises to promote and maintain their muscle mass and strength. Good muscle tone and strength are essential for common activities of daily living. For those who do become involved in this training, the benefits extend from reduced disability, falls risk and chronic disease symptoms, to increased bone mineral density and cognitive wellbeing. In effect, weight bearing and resistance training exercises offer an all-over head-to-toe tonic for better health!
The Muscling Up Against Disability (MUAD) Project has embraced this knowledge. Supported by a Healthy Aging grant from the Australian Government Department of Health (Aged Care Service Improvement), the MUAD Project delivers 24 weeks of twice weekly progressive resistance plus balance training to older Australians with Commonwealth Home Support Program packages. Participants train in a community gym-clinic, using age-specific HUR resistance training equipment, and are guided, supported and motivated by Accredited Exercise Physiologists. Over 240 adults 65 – 92 years have participated, experiencing on average greater than a 230% increase in upper- and lower-body, and core strength!
Within the MUAD Program group there have been some inspirational stories about how participation has led to incredible positive change in the individual’s life. Three of these are given below. Encouragingly, participants have experienced such benefit that over 80% now pay $10 per session to attend our follow-on program Club MUAD.
Case Study 1
Mrs Annette Barker is a 90-year-old woman, who became a professional dressmaker after leaving school early and married at 25 years of age to start her family. A highly driven woman, Annette unfortunately lost her husband last year during the exercise phase of the MUAD Program. Appreciative of the value to her health, after only one week of mourning Annette returned to the gym. Having had a stroke 6 years earlier, which left her with short-term memory loss, Annette is now more aware of the importance of a healthy lifestyle. While she has 4 other comorbidities, she is highly motivated to stay fit in her later years.
Mrs Barker joined the MUAD Project in 2015 and finished her exercise participation in December 2016. While always active, participation in the MUAD Project has opened a new doorway in her life. Annette can often be found teaching the exercise physiology staff ballet moves and stance as repayment for them teaching her how to ‘pump-iron’.
In addition, Mrs Barker experienced a:
- 11% increase in her normal walking speed, a measure reflective of her capacity in activities of daily living and her ability to stay socially connected.
- 41% increase in isometric leg extension strength, a measure reflective of her increased capacity to walk and step up, onto and over objects.
After a long affiliation with Burnie Brae (who delivered the MUAD Project), she was excited to receive a letter of invitation to join the program. Her family said “Go for It”, and so she did. Her global summary of MUAD was she “liked it” and wanted to “continue on with it”. She elaborated: “I liked the company of the staff who run it. So, I liked the social part of it and I did enjoy doing it (the exercise)”. Annette explained that her “balance is good” and acknowledged “that’s the part that has improved” and that her (61 year old) daughter, who was an Exercise Physiologist, “had read the report”, “liked it” and this is why “I’ve continued on with it (Club MUAD)”.
While the cost of continuing is not an issue for her, she did wryly warn others “it’s (the equipment) hard, a couple of machines make you work very hard”. But her message for any Minister for Health was simple: “It’s a wonderful project”.
Case Study 2
Mrs Karla Buchanan is a 78-year-old woman who was a check-out operator until 21 years of age after which she settled down and raised a family. Recently widowed and with increasing age, Karla has experienced an increase in chronic disease symptoms including a recent battle with bowel cancer that ended with a large portion of her bowel being removed. This, the recent heat and a lack of appetite means she has lost weight much to her doctor’s disproval and dismay.
Mrs Buchanan joined the MUAD Project in 2015 and finished her exercise participation in December 2016. In addition to an outspoken enjoyment of wearing K-mart sourced gym gear, Karla has experienced some notable results from participation.
In addition, Mrs Buchanan experienced a:
- 26% increase in her chair rising capacity, a measure reflective of her ability to remain independent and in her own home.
- 85% increase in isometric leg extension strength, a measure reflective of her increased capacity to walk and step up, onto and over objects.
- 19% increase in grip strength, indicating an improved total body strength and resistance to physical and cognitive decline.
In a conversation about the MUAD Project, Mrs Buchanan offered an emotional, inspirational reflection that captured the healing power of exercise that made realising a promise requested of her deceased husband possible.
Following her bowel cancer and bowl resection 7 years ago Karla was forced to give up bowls and confessed she “was in a bad way”. So when the invitation from Burnie Brae came through to participate in the MUAD program she said “Yes!” Mrs Buchanan saw this as a way “to get back to bowls, my goal was to get back to bowls”. For Karla, “at the end of the 6 months’ exercise, I could stand on one leg. This might not mean much to you, but for me, my balance … it was a great achievement”. Karla is adamant that MUAD made her “stronger with my muscles”.
During the conversation, Mrs Buchanan gave further examples of how the MUAD Program had changed her life. She recounted: “Now I can bend over to dig weeds, cut bushes, trim them. I love doing that at 4 am, so that when my daughter comes to do the garden, it’s not a big job. I can keep it to my height. I can do more cleaning. I can do that, in the house, and shopping. I can go shopping without my walker and I can do my shopping for longer than I could before.” She is adamant “Exercise gave this all to me!”.
Mrs Karla Buchanan’s key message for any Minister for Health was: “It’s been fantastic for me; and my family see the difference”.
Case Study 3
Mr Mark Smith is a 66-year-old male, who worked his entire life in the public service until retiring some 10 years ago. Due to advanced osteoarthritis Mark had a total knee replacement shortly before commencing the MUAD exercise program. In addition to osteoarthritis, Mr Smith had 4 other comorbidities that require daily medication. Mark’s wife (Margaret), a retired domestic cleaner, has been caring for him and her elderly mother. Mark’s mother-in-law also attended the program.
Mr Smith joined the MUAD project in 2015 and finished his exercise participation in December 2016. Participation has increased Mark’s ambulating capacity and he currently does not require the assistance of his walking aids.
In addition, Mr Mark Smith experienced a:
- 25% increase in his normal walking speed, a measure reflective of his capacity in activities of daily living and his ability to stay socially connected.
- 40% increase in his chair rising capacity, a measure reflective of his ability to remaining independent and in his own home.
- 36% increase in isometric leg extension strength, a measure reflective of his increased capacity to walk and step up, onto and over objects.
- 7% increase in grip strength, indicating an improved total body strength and resistance to physical and cognitive decline.
When asked about how he felt participation in the MUAD program had changed his life, he spoke often about his increased capacity around the home and community, and his wife Margaret had a few positive things to say also.
In Mark’s words, the MUAD Project “was pretty good, did us a lot of good”. He explained it led to improved mobility and strength, which meant he could do “handyman things such as mowing and doing the edges” and that he was “sleeping better and had better physical health”.
Mr Mark Smith’s key message for any Minister for Health was as follows: “The benefits outweigh the cost. It keeps people out of rehab’. We looked forward to going. We don’t have the equipment at home, so can’t do those exercises. It is worthwhile health-wise and saves the Government money in the long run.”
Mrs Smith would not let the conversation end there. As the carer to her mother (who also attended the MUAD program) and her husband Mark, she agreed that with the program she had seen great improvements. Importantly, for her as a carer she said she was less burdened by her role because “they (the pair of them) could do things!” Where family caregivers shoulder significant physical and emotional burdens in this role, Margaret described a positive story about her husband as “less frustrated” and how “it was wonderful to see my mother walking”. When describing the impact on her mother: “she changed her clothes to be more suitable, she lifted her feet, she loved the staff there. I noticed a difference in her mind, she looked forward to going there twice a week, to get out of the house. I noticed a difference”.
Benefits aside, both Mark and Margaret were concerned about the impact to their budget if they were to continue and have to pay the weekly gym fee.
The aged care system in Australia rewards disability. Aged care financial support increases with increasing disability, and few incentives exist for both service providers and the individual to positively modify their health pathway. The Muscling Up Against Disability Program (MUAD-P) gives proof to the sector that with targeted exercise, and in particular progressive resistance training, individuals can increase their health and wellbeing. Complementing what is presented above is other work showing reduced falls, fracture, hospitalisation and symptoms of chronic disease. When completed in August of 2017, the MUAD team will further this evidence by demonstrating the physical and cognitive benefits of participation, and how this model of care is more cost-effective than non-exercise usual care. Above are three good news stories about how participation in this innovative program can offer older Australian with aged care needs a pathway to improved health. In addition to these we have over 240 other participants with a multitude of other positive stories. Some have stopped needing a walking aid, some are more capable around the house, some take less pain medication, some feel they have more energy and some talk about experiencing life again in a positive way. However, if there is one thing all the older participants in the MUAD Project have experience it is an improved life. We believe that by sharing these how resistance training has led to an incredible positive change in my life stories, practitioners and policy-makers will start to reconsideration what healthy ageing can actually look like for older Australians.
Prepared by: Dr Tim Henwood, Dr Anthony Tuckett, Dr Sharon Hetherington, Kevin Rouse and Maddie Purss.