Reconnecting with Real-Life Skills: Task-Based Training for Older Adults

I had a very good chat with one of Sarah, founder of WildStrong Berkhamsted, today. She’s recently started offering Explore & Play sessions and is seeing a lot of interest from older members in her town. 

Although Explore & Play sessions are not explicitly designed for older members, they do complement the needs and considerations of older clients. They provide more space for socialising, there is less emphasis on intense conditioning and we have more time to build a broader collection of skills and abilities. Because we practise capacities like mobility, getting down to and up from the floor, balance, crawling, carrying objects and other Movements for Life, we find that Explore & Play classes are more appealing to the 60+ crowd. That being said, before we developed Explore & Play, our oldest member was about 64 years old and happily participated in our Strength & Conditioning sessions. There is a world of difference between people in their early 60s and those in their mid 70s. Now that we have members pushing 80, it’s important to think about the ‘why’ of explore and play sessions and to consider the needs of the 65+ cohort.

Everyone is different. I know people in their 70s who are still much faster distance runners, swimmers and cyclists than I am. They’re still competing in triathlons and wild swimming. While it’s true that there are many fit and mobile 70 year olds, it’s best to assume general limitations and to refocus on different degrees of capabilities.

As with any member at WildStrong, our goal is still to build up capacities and broaden peoples’ choices and affordance perception. I believe that for older people, movement can be less abstract. What I mean is, we know exactly what our goals are. We have a very clear picture of what abilities we’d like to maintain and hopefully improve with time. Unlike working with 30 year olds who might like to generally ‘get stronger’ or ‘improve in their sport’, we can think of very specific feats that older people would like to complete for as long as possible.  

Over the course of our chat, we quickly sketched out a mind map of the various abilities and capacities we’d like to improve:

• Standing/getting off of low sofas, chairs and toilets.

• Basically some sort of modified squat or staggered squat position.

• Tying and untying shoes.

• Half kneeling/deep lunge and also lifting leg up to a comfortable position.

• Getting off of the floor.

• This can include all sorts of positions: technical get up/tripod positions, planks, press ups, lunges, side planks, reverse planks.

• There are loads of variations and we don’t need to immediately think about weighted get up variants.

• Walking up and down stairs and up and down steep grades like hills.

• Balance, stability, unilateral lower body strength.

• All sorts of step up and carry variations.

• Hip flexion, ankle dorsiflexion,  quadriceps strength, glutes, hamstrings etc.

• Carrying things.

• Grandchildren, recycling bins, bags of dog food or potting soil.

• Many large bags weigh 10, 15, 20 kg.

• Picking up heavy objects and finding a practical carrying position.

• Core strength for carrying things away from midline. (Think dirty bins or muddy bags of soil etc.)

• Holiday: suitcases carrying over a distance.

• Upper body strength.

• Opening and closing stuck windows.

• Stacking cupboards and wardrobes.

• Again, moving bags of dog food etc, but now in higher positions.

• Core stability especially anti flexion and anti extension.

• Overhead compartments.

• Helping other people. Imagine a partner has fallen down and needs help getting back up.

• Maybe not as intense as fireman carries or soldier drags, but similar skill set.

• Falling, but done in a careful and gradual way.

• We know about the ‘fear of falling cycle’, but how to scale for older members.

• Finding the right balance of challenge and moderation.

• Maintain gait patterns.

• Developing the balance, proprioceptive, strength and mobility requirements for normal, confident walking.

• Avoiding the gradual loss of gait and preventing the geriatric shuffle.

• Thinking also about marching and crawling.

• Balance and everything it entails. 

• Developing multiple aspects of balance, one legged standing, walking on narrow paths, reactive balance.

This wasn’t meant to be exhaustive, but rather an exercise to think about all the abilities that are required for daily living. 

I found myself thinking about a Dan Edwarde’s article covering task oriented training and the importance of doing, rather than ‘training to do’. So much of ‘exercise’ is about abstraction. ‘Maybe if I train on this machine or strengthen these muscles I’ll get better at doing something’. This makes sense in certain contexts but it’s often not that useful when you’re actively training to get a task done.

I believe that older clients benefit from less abstract movement, especially isolating gym exercises like bicep curls or tricep pushdowns. This isn’t the isolation vs multi joint exercise debate, it’s about the basic assumptions of exercise, especially in the context of gyms and gym-specific implements. Again, I’m not saying these are absolutely bad movements, but they’re not appropriate for our goals here. We want to get people moving and engaging with their environment in a practical and socially relevant way.

I like Edwardes’ distinction between task based and instructional based training. It’s tied into the current debate over ecological training methods vs prescriptive training. Anyone who has coached for a while has sensed that sometimes we miss the forest for the trees. It’s too easy to fall into the trap of focusing on the process of ‘exercising’ instead of thinking about what capacities you’re helping to  develop in your community. We often find ourselves adding complexity to basic movements; mistaking it for progress.

Over the next few weeks, we’ll be thinking about how to reframe some of our favourite drills and movement sessions so that they’re immediately relevant to older populations and keeping the social focus of our peer-coaching segment of every session.

Instead of finding ways to challenge and expand on key capacities and movement patterns, we want to distil some of our progressions down to the absolute basic needs of older adults.

Once someone achieves these abilities we can always challenge them across multiple dimensions, but for now I see a lot of room to try and think about what tasks are immediately relevant and how we can start building capacities to engage with the world around us.