HUR Australia hosted the following Webinar Apr 29, 2021
Muscles and mobility matter: Lessons from research to inform practice
Why and how to best look after your muscular health
Date: Thursday April 29th Time: 2-3 pm AEST
Post webinar: Click here to view the webinar video and other material.
For many decades we have been discussing bone loss, osteoporosis; its importance, consequences, prevention, and proper management. Whilst osteoporosis is widely discussed these days, a similar and an equally devastating disease describing muscle loss, sarcopenia, is still largely unknown for many clinicians, underdiagnosed and mistreated.
There is overwhelming evidence from research over the past decades highlighting the importance of strength training to optimise muscle mass, strength and function, and its importance to maintain health and prevent disease. It has been shown that muscles have a direct liaison to many functions beyond locomotion, such as metabolic rate, glucose metabolism, cognition, blood pressure, and blood lipid levels. Indeed, muscle mass and strength has been directly linked to the treatment and prevention of almost all chronic diseases, and when exercise is properly prescribed, it can work as an efficient medicine to optimise muscle health and reduce the risk of many conditions.
Skeletal muscle is the largest organ system in our body, second to water itself. Our muscles are our main movers but also have a role as endocrine organs with many responsibilities in the management of general health. Furthermore, skeletal muscle makes up almost half of the protein reserves in the human body. Proteins are the main structural components of cells with the responsibility for many physiological tasks such as building and repairing cells including muscle tissue and assisting in the fight against any viral and bacterial infections. Muscles behave as our protein reserves – the “banks” we can withdraw from when our body needs to fight viruses and rebuild cells. Understanding that muscles could act as an immune organ by producing acute phase protective proteins, regular strength training might be a crucial preventive action to fight against diseases.
Muscle health matters. As the average person can lose around 30-40% of their muscle mass from between 20 and 80 years, it is time to get into action and preserve the strength we have, despite the age.
After the year of COVID related inactivity, it is time to get into action to fight Sarcopenia. It is such a pleasure to welcome everyone to our first webinar of 2021, Muscles and mobility matter: Lessons from research to inform practice, and present our speakers, Professor Robin Daly, a Deakin University Researcher with a long research profile on Sarcopenia, and Richelle Street, from Blue Care, and exercise physiologist with a passion for health and wellness, especially in older adults.
Professor Robin Daly is the Chair in Exercise and Ageing at Deakin University, Melbourne.
Robin has more than two decades of research experience in conducting clinical, public health and translational intervention trials evaluating the role of exercise and nutrition for preventing and managing common chronic diseases such as osteoporosis, sarcopenia, falls, type 2 diabetes, certain types of cancer as well as cognitive related disorders.
Robin is an active national and international contributor of clinical guidelines in the area of exercise, calcium and vitamin D for osteoporosis and fracture prevention. He is Immediate Past President of the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSFR), a fellow of Sports Medicine Australia and the American Society of Bone and Mineral Research, a member of the medical and scientific advisory committee for Osteoporosis Australia and a board member of Active Geelong. He is also the founder of the ‘Osteo-cise: Strong Bones for Life’ community-based osteoporosis prevention exercise program.
Richelle Street is as an Accredited Exercise Physiologist with over nine years of work experience in Aged Care and currently working and coordinating the Exercise Physiology Allied Health Discipline within Blue Care.
Richelle has affiliations with the University of Queensland, Queensland University of Technology, University of Southern Queensland and the Australian Catholic University as a lead clinical educator for several exercise physiology students. Richelle has also developed numerous tools for AEPs to use across their work within the Aged Care Sector.
Richelle’s compassion, dedication and professional practice as an accredited exercise physiologist has been recognised in its highest regard by the industry, whereby Richelle was awarded Australian Exercise Physiologist of the Year in 2014. In the past 3 years; 2020, 2019 and 2018 Richelle has been a finalist nomination for this award again respectively. Richelle’s work and Aged Care journey as an AEP has also featured in multiple national magazines including ESSA activate and The Australian Aging Agenda.
Our freshly published Newsletter 1/2021 includes a summary of our last year's webinar, with an introduction of this year's program. You can read the extended interview of our first speaker, Professor Robin Daly below, with also a client story from our clinical expert, Richelle Street.
In preparation for our webinar, we interviewed Professor Robin Daly from Deakin University about muscle loss, sarcopenia.
Q: What are the consequences of muscle loss, both short term and long term
A: A loss of skeletal muscle mass is associated with a decrease in muscle strength and impaired functional performance which have been associated with an increased risk of disability, falls, osteoporosis, fragility fractures, frailty, loss in independence, reduced quality of life and premature mortality. Skeletal muscle also has important metabolic functions. During times of illness, it can serve as the main reservoir for amino acids to support the metabolic needs of vital tissues and organs in the body and for energy production. Muscle is the largest mass of insulin sensitive tissue in the body and the primary site of glucose disposal, and thus critical for the prevention and management of type 2 diabetes. In addition, muscle loss has been associated with cognitive impairment and an increased risk of dementia as well as impaired immunity and various hospital complications (e.g, an increased risk of infection and poor outcomes post-surgery).
Q: Why is it so important we prevent muscle loss?
A: Skeletal muscle is the largest organ in the body accounting for around 40-45% of body mass and is critical for both movement and metabolic functions. The average person can loss around 30-40% of their muscle mass from the age to 20 to 80 years. Since this loss in muscle has been linked to almost all common chronic diseases, it is important that strategies are implemented early to prevent muscle loss which can start around the age of 40-45 years. Of particular concern are people who are immobilized due to injury or illness, especially older people and the elderly who can lose up to 1 kg of muscle mass from their legs in just 3-10 days whilst bedridden, which has been linked to poorer recovery outcomes.
Q: What are the best ways to keep up muscle - what should we do?
A: Currently there are no available pharmacological agents (drugs) available to prevent muscle loss. Progressive resistance (strength) training is the most effective strategy to improve muscle mass and strength, with marked benefits observed after only 12 weeks of training. For older people, the gains in muscle mass and strength observed after just 12 weeks can be equivalent to regaining the muscle loss that typically occurs over a decade. Maintaining an adequate intake of dietary protein, particularly when undertaking resistance training, is also important to maximise skeletal muscle mass and strength benefits. In terms of optimising physical function (e.g, improving balance, mobility, gait), challenging balance, stepping and mobility activities and/or include high speed resistance or functional training focused on improving muscle power appear best.
Q: Why is muscle power so important as well age?
A: Muscle power represents the ability to produce force quickly (e.g, move your foot quicky to put your foot on the brake in your car or step quickly when balance is perturbed). This is different from muscle strength which represent the ability to generate maximal muscle force. Muscle power has been shown to decline earlier (around the age of 35-40) and more rapidly (with up to a 50% loss with age) than muscle mass or strength. Clinically this loss is muscle power is important as it has been shown to be more directly related to functional limitations and disability than either strength or mass. The good news is that we can improve muscle power. An effective approach involves performing high speed resistance training, in which you perform the lifting phase of lower limb exercises as rapidly as possible.
Our clinical expert Richelle Street was also featured in our Newsletter. Stay Active, Stay Strong and Stay Independent
When COVID-19 first had implications on the Australian society in March 2020, there was never a more important time to exercise. Although group training was rightfully put on hold for indefinite months, Blue Care client, 88-year-old Bob knew the implications that months of inactivity and unstructured training would have. Bob continued to attend weekly gym sessions with Aged Care Specialist AEP Richelle Street, under clinical supervision with a strict COVID-19 safety routine that included regular cleaning and temperature checks.
The improvements in Bob’s results are fantastic; from 12 to 19 unsupported chair stands in 30 seconds, from 8 to 11 alternate steps in 15 seconds, a 7 cm improvement in reach test and a 7 second improvement in unsupported heel to toe stance in 10 seconds.
The results speak for themselves. No matter the barrier, keep active in whatever way you can, with whatever resources are available, at every age. Let us ensure that every day is lived to its fullest with a level of independence and strength that can only be obtained through exercise as we age. Exercise can reverse the natural process of ageing; exercise truly is medicine.
Post webinar: Click here to view the webinar video and other material.
HUR Australia has so far hosted the following webinars:
Strength, Health and Wellness – From Epidemiology to Service Delivery (Dec 4, 2020)
Covid-19 Exercise, Nutrition and Health in Isolation (May 29, 2020)
Keys to success - Leading with exercise (September 4, 2020)
LASA 2020 Online - a summary of the webinars
HUR Australia's webinar MC Dr Tuire Karaharju-Huisman, presented at the recent LASA online conference a summary of the webinars. This presentation tells the story behind the webinars and also discusses the importance of keeping everyone healthy by sharing knowledge with all. Click here to view the video on HUR Australia's YouTube Channel.
More information about the webinars:
Keys to success - Leading with exercise;
Best Practice exercise programs and management perspectives
Registration has ended. Please see webinar video and other material here.
While chronological ageing is inevitable, what we do to combat the physiological changes is another matter. World Health Organization (WHO) has identified three factors that influence trajectories of ability: the intrinsic capacity of the individual, the environments they inhabit, and the interaction between them. A key aspect of health and wellness is physical activity. The benefits of the inclusion of exercise at older age are clear; From prevention of falls and improvements in cognitive function to reduced mortality, exercise is a key aspect in improving quality of life.
To maximise the health and wellness benefits of exercise, planning and exercise prescription must be performed accurately. Thankfully, research projects and clinical reports from both residential and community care have provided details on how to create, manage and run, successful programs that provide better health and quality of life to all.
The global COVID-19 Pandemic has forced us all to isolate and whilst we are slowly re-opening society, we are facing setbacks after months of reduced activity. One day this second wave will also end, and then it is time to return to training, with even more motivation to be healthy.
We have invited people to share their knowledge on Exercise prescription and program creation and management, to maximise the benefits of exercise and wellness programs.
Dr Jennie Hewitt – "Exercise in residential care; practical tips on success factors from the Sunbeam Program and beyond"
Jennifer is a practicing physiotherapist, educator and academic researcher with a passion for delivering best practice to her clients, and leading research that informs health care policy. She was recently awarded the ACSA Australian National Lifetime Achievement Award for services to aged and community care, a National Commendation Award from the Aged Care Quality Agency, and the 2019 Morley Award for the paper most likely to influence policy and practice from the Journal of the American Medical Directors Association.
Her work has been used successfully to advocate for Australian Aged Care Funding Reform. Her most recent collaboration designed and delivered an intervention that resulted in a 55% reduction in falls rates for residents of aged care, an internationally recognised, ground-breaking result. A cost-effectiveness analysis of the intervention identified a potential AUD $120M saving to the health economy. Most importantly to Jennifer, those that conducted the intervention improved their physical performance and functional ability, allowing them to participate more fully in life. Jennifer has attracted national and international investment into the Australian research sector and is a Keynote and Invited Conference Speaker within Australia and abroad. She has a Master of Health Science (Sports Physiotherapy) and a PhD from the University of Sydney.
SUNBEAM research and results, including details of the protocol have been published as follows:
• Hewitt J, Goodall S, Clemson L, Henwood T, Refshauge K. Progressive Resistance and Balance Training for Falls Prevention in Long-Term Residential Aged Care: A Cluster Randomized Trial of the Sunbeam Program. (2018) J Am Med Dir Assoc. Apr;19(4):361-369.
• Hewitt J, Refshauge KM, Goodall S, Henwood T, Clemson L. Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program. (2014) Clin Interv Aging. Feb 21;9:369-76.
Dr Justin Keogh - “Optimising outcomes from exercise programs for community dwelling older adults”
Justin Keogh is an Associate Professor within the Faculty of Health Sciences and Medicine, Bond University where he teaches motor control and learning, exercise prescription and more recently research design. He is currently a Fellow of the Australian Association of Gerontology and the International Society of Biomechanics in Sport.
Dr Keogh’s research focuses on better understanding the acute and chronic responses to exercise, in particular resistance and motor skill training; with the ultimate aim to improve physical performance for athletes as well as older adults at risk of disability and poor health outcomes.
With respect to the older populations, his research focuses on the geriatric condition, sarcopenia and its potential relationship to aged care utilisation and cancer survivorship. In order to translate this evidence into usual care practice, some of his health research examines the determinants of exercise and physical activity in older populations as well as the determinants of exercise promotion by the medical and allied health professionals.
In conjunction with Dr Tim Henwood, Dr Keogh was the winner of the 2019 Sustainable Healthcare Awards: Research Category for their joint work in this area.
MUAD research and results, including details of the protocol have been published as follows:
• Hetherington S, Henwood T, Swinton P, Keogh J, Gardiner P, Tuckett A. (2018) Engineering improved balance confidence among older adults with complex health care needs: Learning from the Muscling Up Against Disability study. Arch Phys Med Rehabil. Apr 4.
• Keogh JW, Henwood T, Gardiner P, Tuckett A, Hodgkinson B, Rouse K. Examining evidence based resistance plus balance training in community-dwelling older adults with complex health care needs: Trial protocol for the Muscling Up Against Disability project. (2017) Arch Gerontol Geriatr. Jan - Feb;68:97-105.
Paul Johnson - “Creating a new business opportunity”
Paul’s career in the ageing industry has spanned two states, over two decades and across the spectra of service provider, industry adviser and public servant. With qualifications in human services and management, Paul is passionate about exceptional customer service, redefining ageing, enjoying life and a great cup of coffee. Paul is the Chief Opportunity Officer at BallyCara and has performed a lead role in the design and implementation of their Health and Wellness services which has exercise as a core pillar of intervention.
BallyCara’s SONA™ methodology ensures a commitment to embracing each person as an individual, enhancing their independence and enabling people to prosper with real happiness. This has provided solid foundations from which to successfully implement Short Term Restorative Care across two Queensland regions since 2017. BallyCara is the Active Ageing Partner for Netball Queensland and Major Partner of Walking Netball across South East Queensland.
Paul actively engages with key stakeholders across Australia and continues to contribute to national policy development and reform of Australia’s aged care system through his involvement with LASA. Paul is a member of the LASA Members’ Advisory Committee in Queensland and is Deputy Chair of the ADA Australia Board.
Jo Boylan - “Keeping people better for life through exercise”
Jo Boylan is the Executive of Services at Southern Cross Care SA & NT. She holds a Bachelor and Master of Nursing and a Master in Public Health, and is undertaking her PhD focusing on the promotion of healthy ageing in residential aged care.
She aims to influence a vision of improved health across the life cycle and compression of morbidity through practicing active and healthy ageing for health improvement, despite age or illness. Over the past 10 years Jo has been leading organisational reorientations toward healthy ageing across residential, community and retirement living communities. With her operational team, Jo has led the implementation of over 25 gyms into residential homes. Her health ageing achievements include development and implementation of a healthy ageing model, presentations at international conferences, appointments to national and state aged care advisory groups, adjunct teaching positions with SA Universities and winning 10 national better practice awards for the delivery of healthy ageing into residential aged care.
Jo has significant aged care and management credentials from a 25 year career within the aged care industry which spans companies such as ACH Group and Lutheran Homes. She has also had close involvement with a range of policy issues affecting the aged care sector as an advisor to government departments and as a member of aged care sector reference groups and programs. In addition, Jo has travelled the world studying and presenting papers at international forums on a range of matters pertaining to best practice in care and support for older people.
Covid-19 Exercise, Nutrition and Health in Isolation
Date May 29, 2020
Registration has ended. Please see webinar video and other material here.
While the COVID-19 Pandemic is forcing us all to isolate at home, it is important that we try to remain positive and healthy. The evidence is clear on the key factors; with the right nutrition and exercise we can maintain our muscles and give our bodies the best chance to fight illness. To provide you with the best information, to look after yourself and everyone around you, we invited people to share their knowledge on these key messages on how to eat and exercise well.
Dr Tim Henwood – “Muscle health”. With an extensive research publication list on strength training in people over 65 years of age, Tim will discuss the evidence on strength training, right exercise modes and how to avoid muscle loss, sarcopenia.
Ngaire Hobbins – “Nutrition”. As a clinical dietician and an author of three books on nutritional advice to fight the physiological changes of ageing, Ngaire will talk about the importance of protein intake and a balanced diet.
Dr Sharon Hetherington – “Home exercises”. With both research and clinical experience in community exercise in both gym and home settings, Sharon will give us advice on how to keep exercising at home.
Bob Barnard - “Health in isolation” with more than 40 years of clinical knowledge on patient management, Bob will discuss the transition of exercise management from clinic to home with clinical cases and considerations.
Dr Tim Henwood is a special population exercise physiologist with a wide research publication record on targeted exercise programs for adults 65 years and over. He currently holds a role as the Group Manager for Community Wellness & Lifestyle with Southern Cross Care SA & NT and with a specific interest in older adults with complex healthcare needs. Tim is a strong advocate for targeted exercise and therapy - with correct exercise prescription even the oldest and most unhealthy adults can be re-abled back to better health and wellbeing.
Ngaire Hobbins is an Accredited Practising Dietitian specialising in gerontology, cognitive health, aged care and dementia in the past two decades. She wishes to help all older people enjoy independent, productive and fulfilling lives in their later years. As a clinician, she enjoys the chance to translate complex science into language and sensible, practical advice for everyday people. Ngaire has published three books giving everyday people advice on sensible, practical eating, based on scientific research.
Dr Sharon Hetherington is an accredited exercise physiologist with a doctorate in the field of exercise and healthy ageing. She has a keen interest in using adaptive technologies to help people exercise safely at home. Her work with Exercise & Sports Science Australia and with Burnie Brae Ltd have helped to progress an understanding of how exercise at home can improve the health and independence of older people.
Bob Barnard is an exercise physiologist who manages the Centre for Physical Activity in Ageing within the Central Adelaide Local Health Network. He has held that position for 17 years in an over 40 year career in various health and rehabilitation settings within the South Australian Department of Health and Ageing. He has a major interest, including research, in the benefits of prescribed exercise interventions for adult and especially older populations with chronic disease including chronic heart failure and renal failure into dialysis.