Seniors Benefit from Aquatic Exercise
Mary Poppins convinced us long ago that "a spoonful of sugar helps the medicine go down." For senior adults, the aquatic environment can be the spoonful of sugar which makes their exercise sessions enjoyable as well as beneficial.
Robert N. Butler, former director of the National Institute on Aging, once stated, "If exercise could be packed into a pill, it would be the single most widely prescribed and beneficial medicine in the nation." Unfortunately for some older adults, an "exercise pill" may seem to be the only solution to their fitness needs. Although enthusiastic in their quests to lead longer, healthier lives, exercise can be difficult, if not impossible, for senior adults, especially those with health problems.
In this light, several factors make water exercise an ideal fitness activity for older adults of all abilities. The growing popularity of water exercise offers aquatic professionals opportunities to expand programs to meet the individual needs of older participants. Water exercise can be designed for nonswimmers as well as swimmers. For seniors who have had difficulty exercising on land, the buoyancy of water exercise allows them to enjoy a stimulating workout with the feeling of weightlessness.
Who are senior adults? By the year 2000, there will be 35 million senior adults in the United States, half of whom will be older than 75. Some of this population will be active and in good health. Others will have chronic conditions such as arthritis, hypertension, hearing and vision impairments, heart and lung disease, and orthopedic conditions. Whatever the categories or classifications, whatever their health statuses, predictions of the Census Bureau for the aging population indicate that our profession will be challenged to provide suitable fun and fitness opportunities for seniors at all ability levels. The aquatic opportunities provided for exercise will not necessarily prolong life, but they will aid in increasing the years of feeling good.
What is water exercise? Water exercise, also called aqua aerobics, aqua exercise, aquatic dance exercise, water workouts, or hydro aerobics, is an activity which can leave participants feeling exhilarated (Casten, 1994). It is usually performed in the shallow end of a swimming pool and provides participants with an enjoyable physical conditioning program designed to improve overall fitness. Often performed to music, water exercise provides a workout for the heart and lungs, while strengthening and toning muscles. Free from the effects of gravity, senior adults can move more easily in water. Exercise in water can benefit almost everyone, including the healthy, the overweight, and those recovering from injury or who have other health problems. This form of exercise meets the needs of persons of all ages and conditions.
Why exercise in the water? Anyone can have fun in a water exercise class. Participants do not have to be able to swim and do not need previous experience to achieve success. Since the buoyancy of water supports 70 to 80 percent of the body's mass when submerged to the armpits, movements can be performed quite easily and will firm and strengthen muscles, strengthen the cardiovascular system, and improve flexibility (Casten, 1994).
Water is therapeutic. For senior adults with chronic medical problems, and for those recovering from surgery or accidents, water exercise is an excellent way to rehabilitate gradually. Water exercise helps participants regain fitness levels, mobility, strength, endurance, and flexibility in impaired body parts.
Individuals strive to satisfy basic human needs--psychological, safety, social, self-esteem, and self-actualization. In establishing relevancy to these needs, White (1992) states that water exercise promotes fitness and wellness through the exercise itself; allows participants to exercise safely and free from pain; allows social interaction through associations with others and promotes new friendships; promotes self-esteem by building confidence in exercise skills and learning skills to meet mobility needs; and encourages participants to develop a lifetime commitment to exercise.
Standards for Instructors
There are questions about the kinds of training and skills water exercise instructors should have (Koszuta, 1989; Sova, 1992). Are swimming, lifeguarding, and cardiopulmonary resuscitation (CPR) skills necessary? Can teachers without aquatic skills take land-based aerobic exercises and adequately transfer them to the water? Koszuta (1989) reports that experts from both areas agree that there should be a compromise. Some excellent teachers may not be strong swimmers and vice-versa. Most agree that although water exercise for senior adults is in shallow water, a lifeguard or other assistant should be on duty to allow the instructor to concentrate solely on instructing the class.
According to Sova (1992), fitness or aquatic certification is not mandated by any state. Without certification or training, however, misinformation, improper mechanics, and unsafe instruction occur. Many colleges and universities, as well as private organizations, offer aquatic exercise certification, with courses taught by knowledgeable instructors. Some of the largest, most recognized private agency certifications and opportunities for training are offered through the Aquatics Council, AAH-PERD; Aquatic Exercise Association; Council for National Cooperation in Aquatics; United States Water Fitness Association; and YMCA.
Qualities of a good instructor. When working with senior adults, instructors must reflect a caring attitude. Rikkers (1986) maintains that no amount of research data can motivate seniors into regular exercise participation as much as a caring instructor who provides a warm, cheerful, and supportive classroom atmosphere. Rikkers recommends that instructors possess the following qualities:
* Common sense and good judgment. Common sense is gained by being knowledgeable, and knowledge supports good decision making.
* Respect. Respect for older students is essential. Do not be condescending in the teaching approach. Remember they are mature and intelligent with extensive life experiences.
* Awareness and sensitivity. These qualities mean caring and concern for each individual.
* Openmindedness. Do not have preconceived notions about aging, or narrow attitudes and expectations.
* Sense of humor. Participants expect their experience to be fun. Sharing laughter makes being together special.
Theoretical knowledge and skill are important. However, the essence of a program--the caring that will encourage seniors to lead more active lives--comes from the personal relationship between the instructor and the participants.
To begin a water exercise program for seniors, a community, university, agency,
or other organization must have a pool accessible. Pools most conductive for senior programs are ones with easy access to parking and entry. Water temperatures should be warm, from 84 to 86 degrees (Sova, 1992). Cold water is uncomfortable for most senior adults and may result in their discontinued participation. Pool decks should have nonskid surfaces. Entry into the pool must accommodate all levels of mobility. In addition to traditional ladders, many pools have chairlifts for those unable to gain access by ladder. Sets of steps or ramps with handrails are ideal for this age group as they afford independence in entering the pool. All areas of the pool should be clean and well maintained. Adequate lighting and availability of safety equipment are also important.
Administrative concerns, marketing techniques, emergency procedures, and program costs are specific for individual organizations.
The Exercise Program Format
The class format for senior adults should include a warm-up period before beginning the more vigorous exercises. The intensity of the workout should be modified to fit individual fitness levels and aquatic skills. Exercises in which kickboards or other flotation devices are used for stability, and those in which the pool wall is used for support, are effective. (For examples, see references and resources listed at the end of this article.) Exercises which work major muscle groups as well as improve fine motor skills should be included. The format may also include time for water walking, partner exercises, and socialization.
Heart rate monitoring can also be part of the water exercise program. Instructors should understand the effects of medications and be aware of the effects of the aquatic environment on heart rates.
Music can be used effectively for motivation and relaxation. Seniors enjoy all types of music: big band, popular vocals, Broadway hits, country, contemporary.
Participants will follow along easily if the instructor remains on the deck where he or she can be seen and heard. Instructing from the water not only inhibits the participants' comprehension, but limits the instructor's ability to determine whether students are performing exercises properly, to observe signs of stress, and to maintain a safe atmosphere in general.
Overall, the class format should make the participants feel that they had fun, were safe, and were challenged to work to their capacities. It is important for the instructor to know the class participants and plan accordingly to achieve the desired results.
Many colleges and universities are discovering that programs for seniors, including water exercise classes, can provide service and goodwill to the community. These programs are most often housed in the departments of health, physical education, recreation, and dance. At Louisiana Tech University, a fitness program for senior adults has been sponsored by the Health and Physical Education Department since 1978. (As a result of state legislation, any citizen in Louisiana aged 60 and older may take three credit hours at any state university for the cost of admission to the university.) Recently, a small quarterly fee was added to assist in the cost of instruction. Participants are considered to be students at the university, receive academic credit, and may take advantage of any campus activity. Louisiana Tech currently offers five basic exercise classes and three water exercise classes designed exclusively for senior adults. Graduate assistants and/or undergraduate physical education majors are available to assist the instructors of the senior adult classes.
Upon entering the program, and once a year thereafter, participants are required to submit a health form signed by their physicians. These forms, along with other records, are filed in the Department of Physical Education office.
The Louisiana Tech program began with 12 participants in 1978 and has steadily grown since then. During the 1993-94 winter quarter, 377 senior adults were enrolled in the program. Of the total number, 147 were enrolled in the water exercise classes. The best advertising for the program has been through the participants.
Another successful university-based program for senior adults (over 60) is one at Ohio's Bowling Green State University (Gavron, 1993). This 13-year program is a joint effort of the School of Health, Physical Education and Recreation, the Student Recreation Center, and the Wood County Senior Citizens Center.
Alabama's Jacksonville State University conducts their own senior adult wellness exercise program. Margaret Pope, chair of AAHPERD's Council on Aging and Adult Development, conducts a class for university students in which they use the theory in a practicum with seniors 50 and older. Students from physical education, recreation, dance, sociology, and psychology spend five weeks in the classroom and the remainder of the semester providing activities for older adults in their community.
Preparing for the Twenty-first Century
The current popularity of water exercise, coupled with the growing number of aging adults, assure us of potential participants in water exercise for many years to come. Are professionals ready to fill the prescription for fun and fitness by providing the aquatic "spoonful of sugar"? Will seniors say they took their "medicine" on a regular basis "in a most delightful way"? To be successful, programs will need quality instructors, content which meets the needs of senior adults, and safe environments. Can we meet the challenge of providing quality water exercise programs which will endure into the twenty-first century--a time in which one in 20 of us will be members of the aging in our society? Let's get prepared to take our medicine!
Clark, Gail. "Water exercise for senior adults - prescription for fun and fitness." JOPERD--The Journal of Physical Education, Recreation & Dance. American Alliance for Health, Physical Education, Recreation & Dance. 1994. HighBeam Research. 28 Feb. 2011 <http://www.highbeam.com>.