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When we look back at 2020, well probably see this as the year where everything went completely bonkers. This is the year where many of us had to change our daily routines and become warier of how we interacted with people and public equipment. A good example is a gym where many people can touch a single piece of equipment without sanitization. Not only that, but many cities are also still forcing gyms to stay closed which means your once lean and buff bod is looking a little flabby right now. Thats why we are seeing an increase in products such as the Hyfit Gear 1 that allows you to work out in the comfort of your own home using scientifically proven, resistance training and technology.

So what is the HyFit Gear 1? Its basically a two-part system. The first part is the equipment which is the Gear 1 itself. The gear 1 is a highly modular piece of equipment that can be used in a variety of different ways that allow for a complete body workout from just about anywhere. It can be anchored to a door or any sturdy object, or worn on the body using the ankle and wrist bands. The resistive bands themselves can be adjusted to increase or decrease resistance, depending on your needs. The pice de rsistance of the equipment however are the sensors embedded within the resistance bands.

The sensors deliver workout data in real-time and users can view stats like the number of reps completed, exercise duration, speed, and resistance used. All this is possible too due to the second part of the system and thats the HyFit mobile app. The mobile app is a true workout companion, providing the platform where all the data the sensors collect are stored. Not only that, but the app also provides detailed workouts and exercise programs you can follow along with through video. There are extensive videos for programs, workouts, and individual exercises.

The app however doesnt seem to let you export any of the collected data to sources like Google Fit or any other popular platform.

The HyFit Gear 1 is very simple to set up anywhere. As stated above, the Gear 1 includes two smart resistance bands with handles that can be attached in a variety of ways. Theres a door anchor that mounts to the top of any door. Theres a foreign anchor that is used to attach the bands to objects like poles or anything else that is sturdy. Lastly, there are body anchors that can be attached to your wrists or ankles.

As you can see, Gear 1 is very versatile which also means you can use it anywhere and not just your home. The entire package fits inside a small carry bag which means you can also take it with you when youre away from home. Combine that with the HyFit App and you have a full-body, portable gym and personal trainer.

Those who are itching to get back to the gym but cant, should really check out these home workout options. The HyFit Gear 1 is the perfect solution to working out from home, or from anywhere really. I like the fact that it is not permanently attached to anything and I can easily move it around my house. I can attach it to any door that isnt being used or use it in any space that is open. I can even use the Gear 1 outdoors.

There arent really any limitations as to where you can use this and thats what makes it so appealing. I also really like how the app is set up with the exercise tutorials and workout programs you can follow. The videos are very clear and concise and teach you the proper form you should take for each activity. And since were all about smart devices these days, its great to see that the Gear 1 can automatically track metrics such as your reps, sets, weight used, and how many calories you burn per exercise.

The HyFit Gear 1 makes for a great portable gym that really seems to work. While there are probably some exercises you still cant do without hitting the gym, this is a great alternative for the ones you can. The Gear 1 is also the only true smart resistance training system on the market with sensors that can track all your workouts. Gear 1 believes that if you can measure it, you can improve it. This what sets Gear 1 apart from others.

With that said, the Hyfit Gear 1 is also relatively affordable, when compared to how much you would spend for a gym membership. The whole kit is priced under $300 and its a small price to pay if you want to stay fit while the gyms are closed.

You can pick up your own HyFit Gear 1 on Amazon here.

Continued here:
HyFit Gear 1 Bypass the Gym and Stay Fit Anywhere [Review] - Gstyle magazine

Posted on September 17, 2020 at 7:23 pm by A. Campbell

New equipment and rules.

By A. Campbell

Last month, Governor Andrew Cuomo announced that gyms throughout New York State would begin reopening in late August and early September. Since the Covid-19 pandemic hit the city in mid-March, Upper West Siders have managed to get exercise through a variety of means including virtual programs, private training sessions, and outdoor group fitness classes. In lieu of gyms, Central Park and Riverside Park have welcomed an increasing number of runners, cyclists, rollerbladers, yogis, and others.

As infection rates have continued to decline and outdoor fitness enthusiasts begin to wonder what theyll do during the coming cold winter months, the reopening of gyms has prompted questions about what safety measures and precautions businesses are taking on behalf of their members. Under the current guidelines, gyms are limited to 33 percent of their total capacity. Members and staff are required to wear masks at all times and gyms must undergo inspections by local authorities to ensure that air filtration systems and sanitization techniques are in accordance with CDC recommendations.

For now, Mayor Bill de Blasio has allowed gyms like New York Sports Club, Equinox, and the Marlene Meyerson JCC health club to move forward, but he has not yet approved the reopening of some boutique fitness studios, indoor pools, or group classes within gyms. A group of smaller fitness businesses have sued the city.

With these changes in mind, the West Side Rag decided to investigate what Upper West Siders can expect as they return to fitness facilities around the neighborhood.

New York Sports Club West 73rd StreetOn a recent Saturday afternoon, approximately a dozen members could be seen working out on the first floor of the New York Sports Club on West 73rd Street. According to the gyms Fitness Manager, Jimmy Chen, the clubs capacity in adherence to the official 33 percent limit is 55 people. In recent days, Chen said the gym occupancy tends to hover around 40 45 members inside at one time. Upon entry, members undergo a touch-less temperature check as well as a brief survey with questions about their recent travel history, contact with others, and whether they have experienced any Covid-19 symptoms.

In order to ensure that the gym does not exceed its 33 percent capacity limit, Chen explained that staff members require each member to check in and check out at the front desk, allowing the NYSC personnel to maintain a real-time tally of how many individuals are inside the facility. He confirmed the gym had passed a ventilation test administered by the city and that staff members were maintaining rigorous cleaning and sanitation practices every two hours by completing a disinfection checklist of all equipment, locker rooms, and high-touch surfaces such as door handles and faucets. In adherence to the new guidelines, showers, steam rooms, and saunas remain off limits. Chen noted the gyms reopening has received an enthusiastic response from members and newcomers alike. I expected a lot of people to be scared to come back to the gym, but we actually signed up about 35 people for new memberships in the first two days we were open, he said.

As of Monday, September 14th, Town Sports International, the parent company of New York Sports Club and other gym chains, filed for bankruptcy.

Marlene Meyerson JCC ManhattanJCC members can look forward to the facility reopening on September 21st. According to Melissa Donovan, Chief Operating Officer, Health and Wellness, the facility has gone to great lengths to ensure members will benefit from thoughtful and efficient safety measures. One thing weve done is to focus on our values, Donovan said. Taking responsibility for the health and wellness of our community is a core value at the JCC. We have taken reopening very seriously by establishing new protocols, developing an online reservation system, and remapping our spaces to support social distancing.

Members will be asked to make a reservation during 90-minute exercise blocks throughout the day using the JCC website or the JCC/MindBody app on their phones. Following each 90-minute workout block, all members will exit the floor and the JCC will close for 30 minutes to conduct a deep cleaning before the next 90-minute workout block opens to the following group. Members can expect touch-less temperature checks and enhanced cleaning and sanitization procedures which incorporate the use of electrostatic spray disinfection.

JCC visitors will also notice updated entry and exit protocols which are meant to reduce traffic crossover between children and adults. The JCC nursery school will utilize one entrance while fitness members use another. Timed workout reservations and health declarations will be required of each individual in advance of their visit to the JCC health club. We have the greatest members, Donovan said. Of course, they are asking lots of questions about reopening timelines and what to expect when they arrive at the building, but by and large, our members are expressing confidence and excitement to return to the JCC.

Margo McCann in the Pure Barre studio.

Pure Barre Columbus AvenueWhile large gyms like New York Sports Club, Equinox, and the JCC have been granted approval to begin reopening, boutique fitness studios like Pure Barre on Columbus Avenue between W. 79th and W. 80th Streets have not. Margo McCann, Franchise Owner of Pure Barre Columbus Avenue remarked that she and other boutique fitness studio owners are anxiously awaiting the green light from city authorities.

McCann felt that the delay in reopening boutique fitness studios like hers was based on a misconception of what a Pure Barre class entails. I think what a lot of government officials dont seem to understand about indoor classes is that they arent all highly aerobic, deep breathing, sweaty classes, McCann said. Classic barre is low impact. Theres no jumping. Youre working to your own ability and focusing on small, isometric movements to create muscle tone. I think thats where the frustration comes from that you might hear from [fitness studio owners] versus the gym. The fact that you can come into a space without touching anything but your own shoes to me seems safe, or just as safe if not safer, than getting on a treadmill at the gym where you are getting hot and sweaty and you are breathing deeply.

McCann has made adjustments to the studio in recent months and is prepared to move forward as soon as boutique fitness studios are permitted to reopen. Pure Barre clients will check themselves in to a class using an app on their phones. The check in process will include a Covid health survey and waiver that students must complete, as well as an in-person contactless temperature check. McCann has remapped the studio space by placing tape on the floor to mark the boundaries of nine separate 77 foot squares. No one is going to be in that block but you, she said. Each block will include a plastic bin with hand sanitizer, weights, balls, and other workout accessories where students can also store personal items during class. All equipment, as well as the barre and high-touch surfaces, will be cleaned before and after each class.

Other Upper West Side GymsWhile other large health clubs around the Upper West Side including the West Side YMCA and Equinox on Columbus Avenue and W. 67th Street did not respond to inquiries for comment for this article, both have updated their respective websites to provide information about new safety and sanitization procedures. The West Side YMCA reopened on Tuesday, September 15th with updated hours for routine cleanings. Equinox has published new house rules for all members.

Link:
Some Big UWS Gyms Are Reopening; Here's What To Expect - westsiderag.com

In his 72 years, Brad Veloz has risked his job and overcome health issues to fight for LGBTQ+ and Latino rights. The coronavirus wasnt going to stop his activism.

A year ago, the self-described in-your-face activist had never even used Zoom online video conferencing, but it is now a constant presence in his life in lockdown to connect with fellow activists instead of taking to the streets.

Velozs newfound digital lifestyle reflects the demand on seniors to move their lives online because of the threat of Covid-19. The adults with the least exposure to the internet, people 65 and older, are also at higher risk to the illness from Covid-19, which has still not been controlled in the US.

Velozs virtual routine also includes online bill pay, grocery orders and restaurant deliveries. He is especially excited about being able to use shared Google documents to collaborate on group letters to city officials and other activist matters.

It really took the pandemic, being homebound, to really wake us up to the real world, Veloz told the Guardian in a video call from his home in San Antonio, Texas.

In a lucky coincidence, Veloz took a tech literacy course at the beginning of the year, leaving him more prepared for the pandemic. But roughly a third of internet users over 65 described themselves as only a little, or not at all confident in their ability to use computers, smartphones or other devices to do necessary online activities in a 2015 Pew Research Center survey. Of the group surveyed, just 26% said they were very confident using electronic devices to get online.

But once seniors get online, most make the internet a standard part of their daily routine, according to Pew.

The ability to go online has been a lifesaver, emotionally and socially, said Ronda Russick, 75. Russick is the president of the Academy of Senior Professionals at Eckerd College (Aspec), a group of more than 300 people aged 55 to 95 who attend courses and discussion groups at the St Petersburg, Florida, college.

Aspec successfully moved online after the campus shut in March. Last week, sessions included discussions about medical phone apps, the themes of the Mexican artist Diego Riveras work done in the US and Say Nothing, a non-fiction book on the historical conflict in Northern Ireland.

At the end of the day, I feel like Ive been on campus because were doing so much Zooming and youre able to see people, Russick said.

Before the pandemic, some members would go to campus early to sip coffee and chat on a patio where fans circulated the Gulf coast breeze. Now, that group lives on in a 24/7 video chat channel called the Fan Club.

The weekly social hour has also moved online and separate social groups have sprung up, including a group of 17 women who gather in their own Zoom room to drink wine and talk about their lives.

Aspec had avoided doing online classes before the pandemic, except in special circumstances, but members now see new opportunities. In post-pandemic life, they hope to continue including speakers and members from outside Florida in discussions.

Ashok Kalro, 76, was instrumental in organizing courses to teach Aspec members how to get online and said while getting the group connected didnt happen overnight, it was easier than expected. One of the things we learned is people are scared of technology, but when it comes to something they are very interested in, they pick it up fairly quickly, he said.

Tom Kamber, executive director of Older Adults Technology Services (Oats), said that anecdotal finding was consistent with what researchers know about what motivates seniors to learn new things. While you can tell a child to learn about dinosaurs, and they will learn about dinosaurs, older adults are motivated to learn new things that will help them meet their goals.

That has been a motivation at Oats, an organization which for 15 years has offered in-person tech classes for groups of about 12 to 14 seniors through its Senior Planet program. In the year leading up to the pandemic, the organization had been moving towards making these classes available online.

Now, Senior Planets plentiful free virtual courses include contacting lawmakers online, how to spot fake news and virtual grandparenting.

Kamber said participation had skyrocketed in the pandemic from 30,000 people taking in-person classes to 60,000 people in the virtual programs. This is in part because of the not-for-profits partnerships with groups such as the 38 million-member interest group for people older than 50, AARP.

We went from 12 to 14 people in a classroom where you could literally see if the person had tape on their eyeglasses in the back row to doing a class together with AARP with 14,000 people on a Zoom call, Kamber said.

At Senior Planet, too, social spaces are developing around virtual classes, such as the morning exercise program. People login early, and stay late, to chat with their friends.

Kamber, 53, is pleased to see the flood of support for their programming, but said it was a symptom of ageism that such classes hadnt been backed more strongly before. We are really horrified it took this kind of a tragedy for people to get aware of the priority of getting older people online and to commit the kind of resources they needed to, Kamber said.

Despite seniors increased interest in getting online, the US digital divide has left millions without the services needed. The Federal Communications Commission (FCC) says 21 million Americans lack high-speed internet access but other studies have estimated the number at close to 42 million.

Already underserved populations are the least likely to have internet access, while seniors with a college degree and a household income of $75,000 or more are the most, according to Pew. Seniors who report that they have a disability are also less likely than those who do not to use the internet, smartphones or tablet computers.

Brad Veloz in San Antonio said he didnt know how he and his husband would be getting by without the Senior Planet tech classes they took at the beginning of the year.

The couple decided to enroll in the classes in January when they offered by San Antonios Pride Center. The pair were weeks away from graduation when the pandemic hit and classes were shut down. Luckily, this was after they had their first introduction to Zoom.

Veloz said: I would urge seniors to really look at technology and to learn how to navigate with technology because it can help us, it can connect us to our family, to our friends, conduct business and just connect us to the world.

Continue reading here:
'A lifesaver': US seniors turn to Zoom to connect with friends and family - The Guardian

Every year, about a third of older adults fall. About one in five of those falls result in moderate to severe injury. What can we do to help not only prevent those falls but also the complications of them?

What did it show? Well, the conclusion of the NEJM abstract states that this multifactorial intervention "did not result in a significantly lower rate of a first adjudicated serious fall injury than enhanced usual care." We talk to Tom about whether that is the right take home from this pragmatic study and how should we think about fall prevention in our own clinical practices.

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TRANSCRIPT

Alex: This is Alex Smith.

Eric: And Alex, we have Mr. Disability on our podcast.

Alex: We have Mr. Disability. We have Tom Gill, who is Professor of Medicine and Geriatrics, and Director of the Program on Aging, and the Director of the Pepper Center at the Yale School of Medicine. This is his second appearance on the GeriPal Podcast. Welcome back to the GeriPal Podcast, Tom.

Tom: Thank you Alex. Thank you Eric. I'm delighted to have a second chance.

Eric: We're going to be talking about your New England Journal of Medicine study, the randomized trial, the multifactorial strategy to prevent serious fall injuries, or the Stride Study. But before we do that, do you have a song request for Alex?

Tom: Right, I had selected Losing My Religion by R.E.M. I know you want a story about that, but I had lots of CD ROM, or CDs, back in the late '80s and early '90s, and I transferred them all onto my MacBook, and that's how I listen to my music is on my MacBook. I have a couple of the R.E.M. albums and I thought, "Oh, that would be a good choice." And then I listened to songs, and gave Alex a few options, and I think we settled on Losing My Religion. I just like the melody, and the lyrics.

Alex: Mm-hmm (affirmative), this is a great one for people to sing along, if you're listening in the car, sing along. It also has maybe a little bit about falls. Consider this, the slip that brought me to my knees failed. Maybe? A tenuous connection?

Tom: I didn't catch that, but I commend you for it.

Alex: Here's a little bit.

Alex: (singing)

Tom: Excellent.

Alex: Love R.E.M., love R.E.M., great choice. Thank you.

Eric: So, let's jump into it. The Stride Study. First of all, congratulations on this study for you and your colleagues. This was huge. How, before we get into the study, how did you get interested in the topic of falls and starting to think about interventions for it?

Tom: Right, well my long-standing mentor, Mary Tinetti is the world's expert on falls, and she'd done most of the seminal epidemiological work, and that led to intervention research in a more traditional efficacy study, and she demonstrated the benefit of a multifactorial approach to preventing falls. It was a relatively small study, the results were published in New England Journal in the '90s, but she didn't have sufficient power to look at injuries. And then she followed that up with a state-based study in which she divided Connecticut into two parts, implemented a similar intervention, more in a real-world settling, and that demonstrated benefit with about a reduction of 8% in serious fall injuries. But it wasn't a randomized trial.

Tom: So PCORI released an RFA. This made it to their top list in terms of priorities, and I was part of a group that responded to this RFA. I think at that point, Mary had moved on to other research endeavors, so she left us to pursue the opportunity that was presented by PCORI.

Alex: That's great, and we should welcome Ken Covinsky back to the podcast. Ken, how are you doing?

Ken: Hi, good to see you all. Hi Tom.

Tom: Hi Ken. Not a good night last night.

Ken: No it was not, we can't lose to the worst team in baseball.

Alex: What is the Cubs' record right now?

Tom: Something like 18-12, or something like that? Ken may know precisely.

Ken: Yeah, I was keeping track for awhile, but then we went on a losing streak, so I stopped monitoring quite as closely. So we're still number one in the NL Central, but we're not, we don't have an .800 record anymore.

Alex: So here's the analogy. Early returns were incredible, right out of the gate, right? The Cubs were, I don't know, 6-1 or something like that. Looked so promising, right? This was a sure thing, just like Mary Tinetti's early studies were incredibly promising.

Eric: Great job bringing it back to falls, Alex. I think Ken thought we were doing a Cubs podcast. [laughter]

Ken: That's right. [laughter]

Alex: So, back to the study. So falls, why are falls a big deal in older adults? Why should we care?

Tom: They're common. So about 30% of persons over 65 will fall every year, and about 30% of those will lead to significant injury. So that's almost 10% of persons over 65 will have a significant injury from a fall in a year, and those values increase with age. So, it leads, at least in our work, our own epidemiologic work, fall-related injuries are one of the most significant, precipitating events in terms of disability and functional decline.

Eric: What do we know, before the STRIDE Study, what did we know about trying to prevent fall-related injuries? You talked a little bit about Mary Tinetti's work. If you kind of had to sum it up, what we knew before this study, what would it be?

Tom: I think it was fairly well-established that falls are preventable, and there are different approaches. There's a literature about different types of exercise, whether it's physical activity or gait and balance, and gait training, generally have been effective reducing falls. And then the alternative approach has been this multifactorial risk factor reduction approach in which focusing on the totality of factors that make an older person susceptible to falls, including sensory impairments, footwear, the environment, medications, in addition to gait and balance problems. So, well-established literature about the reduction of falls, but not ... even the large meta analyses that have pulled the result from the smaller studies, haven't had sufficient power to establish whether fall-related injuries, particularly serious fall injuries, could be reduced from an intervention.

Tom: ... so that was the genesis of, I think PCORI's call for a proposal.

Alex: Mm-hmm (affirmative).

Eric: So that's where this study kind of fits into this environment. Can you tell us a little bit about kind of what you did in this study? How was it set up?

Tom: Right, well, it was quite large. There were 10 clinical sites across the country, from the east coast to the west coast, and there was the data coordinating center and the recruitment and assessment center were based here at Yale. We didn't have one of the clinical sites, and the administrative coordinating center was in Boston. And most of the recruitment and followup in ascertainment of the outcomes was done centrally at Yale. So it was a different model, and this was even pre-COVID, in which the recruitment for nine of the 10 sites was done centrally, and the followup for all the participants, the 5,600 plus participants, was done centrally at Yale. And, that's on the recruitment and followup front. The interventions were implemented at the clinical sites, but they were implemented kind of in real world practices. There wasn't a budget to implement the interventions at each of these sites. We did have support for a fall care manager at each of the site, and this was kind of the ringleader for doing the risk factor assessment to identify the factors that made the participants susceptible to falls and fall-related injuries, and then developing a plan and partnership with the participant that was done by the fall care manager, and then who would then follow the participant over time.

Tom: It was a much longer intervention than we're accustomed to. For those who enrolled early, it was up to 40 months. So, and the followup went to 44 months. So it was very large in terms of number of participants, the number of sites, the duration of followup and the duration of the intervention.

Eric: So you had multiple different sites, the patients that you were enrolled all had risk factors for falls, right?

Tom: That was part of the screening that was done, it was based on three screening questions that whether they've had a fall-related injury in the past year, whether they've had two or more falls in the past year, or whether they're have had ... or, if they're afraid of falling because of a gait or balance problem. So, one or more of those questions, if they were answered yes, was the primary entry criteria for the study, in addition to age. We started with age 75 and older, and over time we had to reduce that incrementally to 73, and then to 70, in large part because these populations were fixed at each of the 10 sites. We didn't have an opportunity to recruit an 11th site when, not surprisingly there were challenges in implementing a large scale trial such as this in terms of recruitment.

Alex: And let's hear a little bit more about the intervention itself. So you had these nurses who were trained as fall specialists, and can you tell us a little bit more about what they did? I understand it was a multi-component intervention. What were the key components of this intervention?

Tom: Right. Well they're fairly standard factors that had been part of prior multifactorial interventions, and one of them is medications. So they were, and I know that's an area of great interest at UCSF, with the deep prescribing network. We probably, if that had been in place before Stride, we probably could've taken advantage of some of the discoveries that will likely be made there. So medications were a big focus; impairments in gait, balance, and muscle strength; there was osteoporosis, was a third area, because we were interested not just in reducing falls, but fall-related injuries, and up to half of the injuries that are related to falls are fractures, at least serious injuries. Posture of hypotension was a fourth area, a fifth was vision impairment, a sixth was home safety, or home hazards, and in fact ... missing one here. Oh, footwear, primarily footwear.

Alex: Right. So critically important areas that we all think about as major risk factors for falls and injury related to falls, and then what, after they'd assessed these areas, what did they do? So, what did the participants do, or what were they asked to do?

Tom: Right. Well, this was what Dave Ruben, who was in charge of the intervention component of the study, called a chronic care model and so for individual participant would identify if there are, which of those seven areas were flagged as being relevant for them, and then they would negotiate and try to prioritize the risk factors, so not try to do everything at once. Try to prioritize. If there were four risk factors were identified, try to identify which ones the participant was interested in starting with. And then they would work together, there was a plan, a series of interventions that were linked to the identification of the risk factor. And these are all fairly standard practices. We didn't develop new interventions, these are interventions that are already available in clinical care. They may not be implemented routinely, but there are standard approaches for postural hypotension, that's often linked to medications.

Tom: And so we just, the fall care manager will work with the participant, try to implement the intervention for the risk factors that were prioritized. And then they would have followups on a semi regular basis. I believe there was at least quarterly, some of those followups would be over the phone. I think the annual assessments were done in person. The initial assessments were done in person, but a lot of the other activity between the fall care managers and participants were done over the phone.

Alex: Ken, jump in here, you got a question?

Ken: Yeah, no, just I think one thing that just seems to ring through with this, Tom, is just the intricate, massive effort of this study. I mean, I think you could teach a whole course on clinical trial design looking at Stride, and just the way you incorporated the best practices of pragmatic trials but also really, everything we know about preventing falls in real world practices, but really moving beyond the kind of typical experimental setting to the real world. So, I can't ... I wonder if there's anything you think maybe, with the post hoc knowledge of the study you would've added, but I don't think anyone ... it's hard to find anything that you could've done better. But I'm wondering if you think there's anything.

Tom: Right, well thanks for pointing out, I neglected to say this earlier, that this was designed as a pragmatic trial because we already know from efficacy studies that aren't necessarily based in real world practice that falls can be prevented. So this was a trial design to see if similar strategies, more in real world settings, could be equally effective. In terms of what could've been done better, we've had a lot of discussions internally about that, and I ... behavioral interventions are challenging to implement. It's not as straightforward as opening your pill bottle and taking a single pill once or twice a day for some period of time. It's not easy to change behaviors, and particularly in this setting with multiple different providers, because the gait and balance, the physical component of the intervention, was really done in partnership with home care services, and outpatient physical therapy groups, and senior programs, and things like that. There wasn't an intervention that the fall care manager implemented him or herself for that risk factor. This is taking advantages of the resources that were available through that clinical site or that surrounding community.

Tom: I think giving patients the opportunity, the participants the opportunity to prioritize the factors, at least to start with, is probably wise, and this being PCORI, we worked in partnership with patient stakeholders both on a national level and each clinical site had their own patient stakeholders committees, and we learned a lot from them. But I think we perhaps weren't as attentive during, as the intervention was being implemented, in monitoring how the intervention was being implemented, as carefully and as closely as we might have done otherwise, given-

Alex: Meaning that you're worried that you may have recommended somebody go take an exercise program, but they may not have followed through and done the exercise program, particularly since you weren't paying for the exercise program, you were referring them to some community class.

Tom: Or in part, that's part of it. I mean I think the fall care manager would monitor that, and then would encourage them, but yeah, there was some limitations on our part of what we could actually do ourself for that specific risk factor. There are certain things, I think there's a tendency probably for the participants and maybe the fall care managers together to focus on the low-lying fruit, things that aren't as difficult.

Eric: Give them some vitamin D, call it a day.

Tom: Right, and that's one thing, and for the osteoporosis, calcium vitamin D, so you can see that that had pretty good uptake. But when we looked at bisphosphonates, not that they're without risk or harm, but they're much more effective in terms of reducing fall-related fractures. So, I think we probably could've done a better job in retrospect of pressing the participants more aggressively to try to reduce the and focus on the factors that were going to be most potent in terms of reducing the outcomes.

Eric: Well maybe we can talk about what outcomes you actually saw. We can talk about kind of what we've learned from afterwards a little bit more. What did you find?

Tom: Right, well the primary outcome was defined as a serious fall-related injury, and that could either be a fall-related fracture, a laceration, or a joint dislocation. That was one set of outcomes. The other was a fall-related injury that led to hospitalization. But even then, there was a finite number of reasons for that. This was an interesting, I know you have mostly a clinical audience, but if we were designing the trial or the protocol, initially any fall-related injury that led to hospitalization was going to be included as the outcome. But as we worked through the details, we realized that that could lead to some bias in that we're working in partnership with the primary ... fall care manager's working partnership with the physicians, the patients' physicians. So, and the fall care manager's obviously not blind to the treatment group, and the physicians wouldn't be blinded.

Tom: So, if a participant had a fall and some type of injury, they would more likely ... we were concerned that they were more likely to be sent to the emergency department, and once you go to the emergency department, the more likely to be admitted, and that would be a conservative bias. So we thought we had to limit the hospital-related injuries to injuries that no one would dispute warranted being hospitalized. We had to omit the ones that could be discretionary, and that's one of the reasons why our outcome rate was lower than we had originally projected. Now that's kind of the backstory, that's not in any of the manuscripts.

Eric: And early on you said about one out of 10 older adults will have a serious fall, fall-related injury over the course of the year. Is that what you found, or sounds like maybe a lower number.

Tom: Well, it's not just, I mean it's moderate to severe injuries, and it's always a challenge to, how do you define a serious fall injury? And there's a lot of different definitions out there, and in the end, we had to select one that was going to reduce the possibility of biased ascertainment, which is often an issue in the context of a behavioral intervention, in which it's not possible to ... blinding is of concern, to the other clinicians that are part of the equation.

Eric: Yeah, so-

Tom: It's probably less than 10%. We were projecting I believe, and it's per 100 the way that the statisticians worked this out was on a per 100 year basis, and I believe the projections were somewhere along the lines of 20 fall-related injuries per 100 person years. And we ended up with rates probably a third of that. And part of it may have been because we had to modify the primary outcome, but also, and this is almost for any trial, the outcome rates are lower than are projected because the outcome rates were often based on epidemiologic studies, and trials notoriously recruit persons that have a lower risk of the outcome of interest.

Alex: Right.

Tom: That's the nature of the beast.

Alex: Yeah. We'll get to who was in the study and do they look like geriatrics...clinic patients, but before we do, I want to ask what the control condition was.

Tom: Yeah, usual care got some education. We had a brochure, we took advantage of the information that was available through the CDC, there's a well-established program called Steady and there are materials that we pretty much pulled off the CDC and we provided them to participants, but they didn't have access to a fall care manager. We also had training for their primary providers, or primary care providers, but that was-

Alex: And the primary care providers also got the result of the risk assessment?

Tom: That's true, but all ... that was in both treatment groups. Yes.

Alex: So, do these patients look, we asked Jeff Williamson this question when we did a podcast with him about Sprint Mind. We said, "Jeff, we did a journal club on your paper, and we looked around the room, and we said, 'Did anybody see any patients like this in clinic?' And nobody saw any patients like that in clinic." And he responded honestly, like, "Yes, this is really designed for a primary care population, the well older adults. How about your study? Are these patients who you might see in a geriatrics clinic?

Tom: I think these patients more so than in Stride, the one characteristic that I think would perhaps not as generalizable was education. About 50% of the participants were college educated, and that's higher than you're probably accustomed to in most settings. That's often the case in clinical trials. But when you look at other indicators of frailty or physical limitations, I believe a third of our participants were using a mobility aid. They had the whole panoply of chronic conditions. A significant proportion had had a prior fall-related fracture. I'd have to look for the details here, but-

Alex: I think one other piece that stood out to me is it's really laudable that you went after people who had cognitive impairment. You didn't exclude them from the trial, as is often done, and yet even by trying to recruit them, I think it was only like 3% or something.

Tom: Right, yeah, you're right, 3-4%. They weren't excluded. We had, again, all the recruitment was done over the phone, so we used the Callahan Cognitive Screen, and if they had four or more errors on that, we had to identify a proxy who could assist on the intervention side of the equation, and in the ascertainment of the outcome of the every four month followup interviews, because we obviously couldn't rely on the participant to accurately report about falls or injuries that they had had over the prior four months.

Ken: Yeah, so Tom, it seems like the intervention really dealt ... if you were to sort of classify the two big probably in primary care practice with respect to falls, the first is that they're not identified. So we're just not trained much to ask about falls in a review of systems, and I think a lot of primary care physicians who are sensitive to falls will tell you that they don't really know what to do when they identify a fall. So it sounds like really, I mean two central features here are that you had a systematic way of identifying either people who are at risk for falls, so fall risk, which of course included a previous fall. But then you really, you had a structure for what to do.

Tom: And that was the kind of the rationale for the a fall care manager. If the intervention led to more robust findings, and then ultimately was shown to be cost-effective, this is a model that could be implemented in real-world practice. You could have a fall care manager responsible for a panel of 200 at risk older patients, and this could be their job, and that was kind of the frame of reference when we developed the intervention was the selection of these 10 clinical sites, they all had their own healthcare system. So this could be implemented in real-world practices without a lot of additional time and effort.

Eric: I think that, one of the things is, I love that. When we look at the results though, the primary results are really negative. There was no difference between the groups as far as first time to serious injury fall. So when I see the results, and I see the ... how am I supposed to interpret it? Am I just supposed to say that a nurse led multifactorial fall intervention doesn't work, so what do I do now?

Ken: And actually Tom, I'm going to ask Eric's question, because I'm very curious, I'm going to ask this question, the exact same question Eric asked in a different way. So, that momentous day when the three PIs of this study got together and results were unsealed, and you found out the results of the study, what was the mood in, I guess it was a Zoom room, but what was the mood in that room? Was it happiness, sadness, oh my God? What was it like?

Tom: I think we were disappointed that the findings weren't as robust as we had expected. And yes, in the traditional sense, this was a negative trial. And that's, we interpreted the results a little differently because the intervention group had some reduction, a much smaller reduction in fall-related, serious fall injuries, than the usual care, or enhanced usual care group to the effect of about a 8% reduction. We were postulating a 20% reduction, and we didn't have the power to detect an 8% reduction, and it would've taken a trial three times the size to detect a reduction that low. So, when we were trying to put these results in the context of prior literature, this is about the size of the reduction that Mary Tinetti had reported in her earlier New England Journal paper for the Connecticut Collaborative Fall Prevention Network, which is not a randomized trial. I alluded to it earlier, in which she implemented this intervention in the northern part of the state, and then the southern part of the state was the control, and it was not, it was an intervention that was more ecologic. It wasn't on a per participant level, and she reported a reduction of about 8%.

Tom: So, and then we took, had some solace in the self-reported fall injury outcome, which was a predefined secondary outcome, and that, the reduction was about 8-10%, and that was statistically significant because the outcome rates were much higher than for the adjudicated serious fall-related injury outcome. And the adjudication process was quite rigorous, and I think that led to a lower than anticipated outcome rate of somewhere, as I mentioned earlier, five per 100 year.

Eric: I'm also trying to think about this like if this was a drug, would this be clinically an important difference? When I look at that primary outcome of first adjudicated serious injury fall between the two groups, the intervention group was 4.9, the control group was 5.3, so a difference of .4 for time to first event. Is that a big difference? Again, it's always hard to wrap my head around in 100 years. How am I supposed to think about that?

Tom: Those numbers aren't based on 100 years, but I mean I think that's a small difference, and it depends on what intervention is necessary to get an effect at that level. And I think the intervention is not, would not be cost-effective for an effect that small. So I don't think we would ... if there was a pill that gave that same reduction, and that's all you had to do? It would probably be meaningful, and maybe cost-effective.

Tom: A behavioral intervention can be much more expensive, and it's very, they're time consuming and it required repeated touchpoints between the participant and the intervention, it was not nearly as easy as Jeff Williams Sprint Study, which you take a pill.

Ken: So Tom, could I ... a thought, and I'd be interested in what your reaction to this, is that one of the things that strikes me about Stride is it was this incredibly well-done study, and it makes me wonder if it's time for the field of geriatrics in our field to have a little bit of introspection that everything was really done well and right. And you could point to a few things maybe you would've don differently, but nothing's been as good as Stride in terms of fall reduction, or for that matter, any geriatric syndrome. Yet, we could not prevent fall-related injuries, at least we couldn't prove it, and even if it was there due to lack of power, it's on the order of a very small amount, like 10%.

Ken: So the thought is, does our field need to be a little bit more humble about the ability to really prevent things like fall-related injuries and prevent fall-related syndromes? And at the same time we're trying to move forward there and keep moving the needle there, also say well, irrespective of fall-related injuries, this is a phenotype of patient where there's lots of suffering, that patients who fall, and their families, suffer a lot, and clinical geriatricians deal with this a lot, and should we focus as much on the palliative aspect of that? So in addition to preventing falls, should the next study on fall prevention also say even if we can't prevent fall injuries, can we prevent the life space constriction that people have with falls? Can we prevent the caregiver stress and the levels of depression patients have who fall? Should we really actually be looking beyond falls itself, but looking more to the wide spectrum of suffering that really geriatricians and palliative medicine providers are expert at dealing with, even if we can't change the fall outcome?

Tom: That's an interesting question. Let me, and I think there's two components to that. First, in terms of what clinicians should do with this information, I think there's a distinction here between what might be done at the systems level and what might be done at the level of the patient and physician. I think on a patient level, I would not want to discourage physicians or providers from trying to work with their patients to reduce risk factors for falls, because I think on a per patient basis, falls and fall-related injuries are preventable. But when you take a step back and try to implement that on a systems basis, it doesn't work as well as we would like, and I think that's an important distinction, and this is an intervention that won't be picked up by health systems. But I think there's useful information here for physicians and other providers in terms of working with their older patients who are at risk for falls and trying to reduce those risks and improve their outcomes. So that's part one.

Tom: Part two, I think you're right that you can also address the consequences of fall-related injuries as part of a more expansive intervention, although that's going to be even more challenging to design and implement, because you're broadening the scope, and to do that from a trials perspective, I think would be maybe a challenge that the UCSF Pepper Center might be willing to embrace. Now we did include other outcomes that were secondary, and they're labeled as wellbeing outcomes, and there's a manuscript under review now providing the results of the wellbeing outcomes, and they pretty much mapped the results of the primary outcome. So, there's no evidence that in an expanded array of outcomes that the intervention provided meaningful benefits.

Eric: That was one of my questions, especially to Mr. Disability, is that you have this group of people, vast majority were afraid of falling on trial enrollment. So we give them potentially physical therapy, exercise, you correct vision, you help with orthostasis, you do all of these things, so maybe they're just going out more and when you're exposed to going out more, to a hazardous outdoor environment in those cities, maybe that's why they're falling more because they're actually doing more. Sounds like that may not be a correct assumption.

Tom: I mean it's a fair point, and a trial like this doesn't have an opportunity to account in that level of detail in terms of the opportunities to fall and be injured. Now, Yale was previously a site for the life trial, and which was a physical activity intervention that was, showed that major mobility disability could be reduced by a fairly aggressive physical activity intervention, and we published a followup report I think in BMJ about fall-related injuries, and whether this physical activity intervention could reduce the likelihood of fall-related injuries. And again, it was a mixed picture that overall there was no reduction in serious fall injuries, but for reasons that we could only speculate on, there was a significant reduction in men, but not in women. And we were concerned in the life trial about the possibility that by making folks more physically active, they would be more likely to fall and become injured.

Tom: Now what we did find is that there was a slight increase in the number of falls, but generally, a reduction in fall-related injuries that was significant for men. Women had some reduction in fall-related injuries, but there wasn't a significant finding. So, it's a valid point, but I think that there's probably no evidence that by increasing physical activity alone you're going to increase the likelihood of having a serious fall injury.

Alex: That's great. I just want to point out for our listeners who may be wondering why are we calling Tom Gill Mr. Disability, that Tom Gill Tweets @mrdisability. Time for one more question, Ken, you got a last question?

Ken: Well, yeah, no, I mean I think I like the way you've been thinking about this at system and patient, individual levels, because I think you're right, the effect may well be different. And I think one thing you are implying is that if ... it's basically the your group at Yale who've basically showed that there's unifying risk factors for falls, functional dependence, incontinence, all the geriatric syndromes have similar risk factors, so presumably if you're trying to prevent falls, you're trying to do other things that are going to be good in other ways so that these ... I think that you're right that this type of intervention is likely to be good regardless. Yeah, but I do wonder though at the same time we're trying to offer physical therapy and trying to reduce the number of medicines, we should also have the social worker involved and teach our patients how to use paratransit, so at the same time we're trying to prevent falls, we're also making sure they can do all the things that are important to them, fall or not.

Tom: Again, I can't dispute that. I think those are valid points taking a broader perspective. Just maybe a final comment about the distinction between systems and patients, about 14% of the participants in Stride who are in the randomized intervention group didn't get anything at all. So they didn't even get that first visit by a fall care manager. That's just the reality of clinical trials. So you take those 14% off the equation, and then you have to account for adherence to the recommendations that were provided by the fall care manager, and that's why these trials, behavioral trials, are just so darn complicated. And that's why I maintain hope and expectation that this intervention, if implemented on a case by case basis when an opportunity to optimize adherence in the context of a patient-doctor relationship has a high likelihood of demonstrating benefits.

Eric: This is my last question for you Tom, is did anything in this trial change your clinical practice? Bringing back down to doctor-patient relationship and how you think about it, anything change there?

Tom: My practice is not a primary care practice, so I can't put myself in the shoes of a primary care provider. I think I have a greater appreciation of the challenges of implementing an intervention that has multiple components, and have somewhat envious of our colleagues who are implementing pharmacologic trials. They have their own challenges, but ....

Eric: But it sounds like from a geriatric syndrome perspective, while it doesn't, from a systems based standpoint, didn't seem to work as we'd hoped. From a patient perspective standpoint, when we're in there with our patients, that we shouldn't lose our religion about the importance of fall reduction...

Alex: There we go. [laughter]

Eric: You like that Alex? [laughter]

Alex: All right, let's just do a little bit more of the song to close it out, and then we'll thank our guests and wrap it up. Here's the last couple verses of We Won't Lose Our Religion.

Alex: (singing)

Ken: Bravo.

Tom: Excellent.

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Reducing serious fall-related injuries: an interview with NEJM STRIDE Study author Tom Gill - GeriPal - A Geriatrics and Palliative Care Blog

Its always advisable to avoid large assumptions after college footballs Week 1. This maxim is rare: Its mostly agreed upon by coaches, analysts, statisticians, and even players. Of course, every September everyone knowingly and willfully ignores this in the name of hype, and it almost always backfires in hilarious fashion.

But most everyone gets it: This is a highly volatile sport in its base setting, with no preseason and a penchant for sudden change. Accordingly, in 2020 [waves at everything], every week is essentially Week 1.

This is not the year to create context. This is not the year to draw sweeping conclusions, at least based on what happens in the football parts of football. One of the best programs currently playing refuses to disclose COVID testing figures. A Navy team that finished 11-2 last year lost its opener to BYU 52-0 after its coaching staff decided against live tackling in practice to help guard against potential transmission. The very first game played in August featured a linebacker trotted out as long snapper because of quarantine restrictions on travel.

Consider Georgia Techs 16-13 spoiling of Mike Norvells Florida State debut, your typical Week 1 exercise in narrative-building: Is Tech back, just one year removed from Paul Johnsons triple option, or is Florida State, who lost four offensive linemen during the game, still in shambles after Jimbo Fisher and Willie Taggart? Remember that the Noles made a lot of people think an eventual 6-7 Virginia Tech team was something special after Taggarts debut.

Now add the additional mitigating circumstances of 2020 to the how good is Tech / bad is FSU exercise: Just like Navys abdication of tackling, Tech head coach Geoff Collins said after the game the team didnt run full kicking drills because of virus concerns. The Yellow Jackets had two field goals and a PAT blocked. Was this game a one-possession upset or a hidden statement win?

This will be a season of bad faith assumptions and terrible context creating messy conclusions if the data points are utilized as anything other than outliers. That of course wont happen one program has already parted ways with its coach based in large part on how his team looked after one game in 2020.

There is a need among fans and professionals to draw inferences, to build conclusions and gather up facts in defense of an idea. To some degree this is a natural behavioral pattern. So if you need to surmise something in 2020, I can offer one certainty free of any pandemic-era qualifier or context:

Kansas football is forever broken.

The Jayhawks lost at home on Saturday night to Coastal Carolina, 38-23, and at one point trailed 28-0 before kicking a field goal as time expired in the first half. This was the second win over KU in as many seasons for the Chanticleers, both over new head coach Les Miles. Miles was brought to Lawrence by his Michigan buddy, A.D. Jeff Long, to resurrect its moribund football program; through 13 games, he now has as many losses to Group of Five programs at home as he does FBS wins as KUs head coach.

This is not a referendum on Miles or Long. This is not a dogpile on the Big 12, which suffered a trio of losses to the Sun Belt on its opening weekend. But those games Kansas State losing at home to Arkansas State and ranked Iowa State getting thumped by upstart Louisiana are subject to interpretation, to 2020 context. Kansas getting dragged is a lighthouse, an anchor, a steady hand to balance oneself in an ever increasing world of uncertainty: The Jayhawks are inexplicably bad. We know this and it has not changed.

Through four head coaches and a variety of on-field systems, Kansas has been so easily attainable a P5 pelt for G5 programs that the excitement of such an upset is wearing off. In eight of the last ten years the Jayhawks have lost to either a G5 or FCS opponent (or both). Kansas is 4-10 against Group of Five since 2011; in the same span the Jayhawks are 2-3 in Power 5 non-conference games.

Thats how bad it is: You could make a convincing argument that its smarter for KU to schedule equally woeful P5s like Rutgers and Boston College, both of whom the Jayhawks beat on the road in recent years, than bringing in a perennially humming mid-tier program like Louisiana Tech or Central Michigan.

But you could even argue its smarter for KU to seek out a fellow P5 doormat than schedule G5 flotsam like Rice or the Chanticleers (who have yet to post a winning season in FBS ball) since both schools have swept KU in the last ten seasons. And despite recent losses to FCS programs Nicholls and South Dakota State, the Jayhawks are 6-2 vs. FCS teams in this timespan. So while their original opener New Hampshire cancelled their season, it wouldve been far more prudent to find any other FCS team to play rather than Coastal Carolina. (That or Rutgers.)

Read this article:
You cant predict anything about 2020, but you can depend on Kansas - Banner Society

Olympic weightlifting is the original strength sport. Before powerlifting and bodybuilding were officially recognized, Olympic lifting was a popular activity.

There are two official Olympic weightlifting disciplines, the clean and jerk, and the snatch. Both of these moves involve lifting a weight from the floor to overhead, albeit with very different techniques.

There used to be a third Olympic lift the clean and press, but this was dropped in the 1960s because of safety concerns. The press was done strictly, with no extra leg drive. To lift more weight, athletes would often lean back and do a sort-of freestanding bench press. Injuries and difficulties in judging meant this lift was dropped from competition and never replaced.

In modern Olympic lifting competitions, athletes get three attempts at each of the two movements. The winner is the weightlifter with the highest total from their best snatch and clean and jerk. The snatch is always done first.

While Olympic lifting is a stand-alone sport, a lot of athletes use the Olympic lifts in their training, even if they dont lift competitively. Thats because both the clean and jerk and the snatch offer so many benefits.

Those benefits are:

Power is force generated at speed. In other words, its your ability to move heavy weights quickly. Its the difference between a slow, heavy squat and a high-speed squat jump. The Olympic lifts are performed explosively, and that will increase muscle power. Power is an integral part of most sports, which is why a large proportion of athletes include Olympic weightlifting exercises in their workouts.

More muscle power will help you run faster, jump higher, and throw, kick, and punch harder.

You should not expect to master the Olympic lifts overnight. The snatch and clean and jerk are complicated, full-body exercises that involve a lot of coordination. But, with practice, youll get better at both of these moves as you get stronger, and your coordination improves. Coordination is your ability to control your limbs and move them accurately.

The Olympic lifts involve large ranges of motion, especially at the knees, hips, and shoulders. Successful Olympic lifters are very flexible, and simply doing these exercises will increase your flexibility and mobility. However, if you are very tight, you may find aspects of the Olympic lifts hard to master until you improve your flexibility.

Both Olympic lifts are full-body movements. They start with a powerful knee and hip extension and also involve the lower back and core, shoulders, and arms. The only muscle group that doesnt do a lot of work in the Olympic lifts is the chest.

If you are short of time but still want to train most of your major muscles, an Olympic weightlifting workout could be the solution.

Because the Olympic lifts are explosive, they target your type 2b fast-twitch muscle fibers. These are the muscle fibers responsible for size and growth. Olympic weightlifters arent usually as big as bodybuilders, but they arent too far behind, and thats in spite of the fact that they dont typically do any traditional bodybuilding exercises.

While the Olympic lifts can definitely be beneficial, there are a few drawbacks to consider too. The main ones are:

The snatch and clean and jerk can be hard to learn. Youll need to develop a decent technique before you think about lifting heavyweights. That means, initially, at least, youll have to settle for easy workouts because lifting too much weight too soon could result in injury.

The good news is that there are simplified versions of the Olympic lifts that are easier to master, such as the power clean.

If you are serious about learning the Olympic lifts, you may need to work with a qualified coach.

A lot of gyms dont have the equipment required for Olympic lifting. Youll need:

Olympic lifting training invariably involves dropping weights from overhead to the floor. Improper equipment will break, and no lifting platform means youll also damage the floor. Because this equipment is specialized (and expensive), you probably wont find it anywhere apart from proper Olympic lifting gyms and some CrossFit boxes.

As well as this equipment, youll also need weightlifting shoes. Weightlifting shoes have a raised, solid heel that allows you to squat deeper. They wont distort under heavy loads, so you should also find it easier to maintain your balance. Most also have metatarsal straps to keep your feet stable and locked in position.

While Olympic lifting is not the most dangerous sport, lifting and balancing heavy weights overhead can cause injury. If you lose your balance while squatting or standing under a heavy bar, you could be seriously hurt. Unlike powerlifters, Olympic lifters do not use power cages, so a missed lift could be catastrophic.

Most established lifters are very good at dumping the bar if they are unable to complete a lift. This means dropping the bar as they jump out from beneath it. Such a maneuver requires a lot of mobility, good timing, speed, and even bravery!

While its beyond the scope of this article to teach you how to snatch and clean and jerk with perfect form, well provide you with the basics to get you started. Entire books have been written about these movements, so we cant do justice to them within the confines of an article.

That said, if you are serious about learning and mastering the Olympic lifts, you should seek out an International Weightlifting Federation coach or join a weightlifting club.

The snatch is arguably the hardest of the two lifts to learn. It involves lifting the bar from the floor to overhead in one movement, often catching the weight overhead while in a deep squat. Its such an athletic movement that the snatch is sometimes referred to as gymnastics with weights.

Things to remember that will improve your snatch include:

The clean and jerk is a two-part lift. The clean involves lifting the weight from the floor to shoulder-height, while the jerk is a sort-of push press during which the bar goes from shoulder-height to overhead. Its a little easier to learn than the snatch, but still a challenging lift to master.

Note: The split jerk is the most efficient way to get the weight up and overhead, but some lifters prefer a push-jerk. This requires less flexibility and balance, although it may ultimately limit the amount of weight you can lift.

Things to remember that will improve your clean and jerk include:

The best way to get better at the Olympic lifts is to a) practice those lifts, and b) do accessory exercises that will positively impact your strength/technique.

With those factors in mind, here are two Olympic lifting programs designed for beginners, one for snatches and one for clean and jerks. They both include the specific Olympic lift as well as more common strength training exercises to boost your performance.

A lot of Olympic lifting programs specify how much weight you should lift based on your current one repetition maximum or 1RM for short. Thats fine for experienced lifters who know their 1RM, but impractical for novices who dont know how much they can lift.

For this program, with the Olympic lifts, increase weight set by set until you notice your speed starting to slow down as you near the specified number of reps. If you feel like you are grinding out the reps, the weight is too heavy.

Its better to lift a lightweight quickly than a heavyweight slowly. Initially, at least, you should focus more on your technique than the amount of weight you are lifting.

Youre only going to do sets of three reps in the Olympic lifts, but six sets in total. This means you wont have to worry about fatigue affecting your technique, but will still get plenty of practice at each lift. Repetition is the best way to master a new exercise something a lot of coaches call greasing the groove.

For the other lifts, choose a weight that takes you close to failure within the specified rep range.

Do each workout once per week, e.g., Monday and Thursday, or, if you want to train more frequently, hit the gym three times per week, alternating workouts each time you train, i.e.,

Before each workout, spend a few minutes warming up. Do some light cardio, followed by dynamic stretches and mobility exercises for all your major muscles and joints. Also, practice the Olympic lift day using an empty barbell or just a wooden pole.

*AMRAP = As Many Reps As Possible

Whether you are looking to improve your performance for sports, build muscle in a new way, or take up and compete in weightlifting, this article should help. The Olympic lifts arent easy to master, but they are very rewarding. Like heavy deadlifts and squats, theyll help build a body you can be proud of. Including them in your workouts will add a lot to your overall development and athleticism.

As with any new lift, the Olympic weightlifting exercises take time to learn. In fact, the snatch, and clean and jerk could be two of the most technically challenging exercises you can do. But, with practice and perseverance, you should be able to do them with at least passable form and impressive weights.

But, when learning these lifts, light and fast is always better than heavy and slow. Leave the grinders for big squats and bench presses. If you cant lift the bar explosively, its too heavy for you. Build your speed and power first the heavyweights come later!

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Olympic Weightlifting Guide and Beginners Program - FitnessVolt.com

Barry Dempsey no longer considers himself a survivor of cancer, but a thriver, thanks to the Thrive Centres cancer and exercise program at the University of Calgary.

Youre exercising and not dwelling on your problems, and everyone is pulling for each other we have a support network of people and thats why we are called thrivers, which is beyond being just a survivor. We are not laying down for this disease, says Dempsey.

Dempsey participated in a free12-week exercise program geared for those with cancer, and cancer survivors, called Alberta Cancer Exercise (ACE). The program is co-led by Drs. Nicole Culos-Reed, PhD, Faculty of Kinesiology and Cumming School of Medicine at the University of Calgary, and Dr. Margaret McNeely, PhD, Faculty of Rehabilitation Medicine, University of Alberta. ACE has also been adapted and called ACCESS in Halifax, N.S., under the direction of Dr. Melanie Keats, PhD.

Culos-Reed, pictured above,now plans to expand the program beyond urban settings, to remote and rural communities across the country, with $2.5 millionin research funding provided by a Canadian Cancer Society/Canadian Institutes of Health Research Cancer Survivorship Team Grant (English and French), in partnership with the Alberta Cancer Foundation.

Exercise has physical and mental health benefits for cancer survivorship, but it hasnt moved into practice in the health-care system, says Culos-Reed.

Its always been my passion to go beyond the lab to build and implement community-based programs for cancer. With this funding, we can reach more cancer survivors, who may have limited access to cancer care resources.

People in non-urban areas (defined as a population offewer than 100,000 people) face more barriers to cancer care and support resources because of limited access, long travel distances and lack of trained personnel to implement the services. Culos-Reed says as a result, people in rural areas report having poorer health and lower quality of life.

In general, Canadians arent active enough to gain health benefits, and the rural cancer population is even less active because of barriers, including access to exercise-oncology specific programs, says Culos-Reed.

Culos-Reed will recruit more than 2,000 participants over the next five years. She will build off the success of current programs in Alberta and Nova Scotia to include other Atlantic provinces, and then build resources in British Columbia, Saskatchewan and Ontario. This will include partnering with exercise providers and health-care facilities in rural communities, and training exercise professionals to adapt fitness programs for those with cancer.

Physical data will be collected from rural participants using accelerometers and a new app so participants can track their progress, monitor their well-being, and researchers can monitor the progress of the program.

We are also building evidence to show there is value in funding exercise physiology positions in the health-care system, to screen, assess, and support cancer survivors in the right exercise program, says Culos-Reed.

This is a viable model that can be adapted to every community to increase the health of this population, and in the long run, reduce health-care costs.

In May, the ACE team adapted the in-person programs to online sessions, to ensure wellness through remote exercise can be provided to cancer survivors while at home. This is equally important due to COVID-19. For more information about the programs, please contact the Culos-Reed labor visitthe Health and Wellness Lab.

Culos-Reed has also started a petition to gather support to make exercise a standard part of cancer care. To sign the petition, please visit Change.org.

Nicole Culos-Reed is a professor in the Faculty of Kinesiology and an adjunct professor in the Department of Oncology at the Cumming School of Medicine (CSM). She is a member of the Alberta Children Hospital Research Institute, the Arnie Charbonneau Cancer Institute, and the OBrien Institute for Public Health at the CSM.

Research funding is provided by the Canadian Cancer Society/Canadian Institutes of Health Research Cancer Survivorship Team Grants, in partnership with the Alberta Cancer Foundation. With a joint investment of $13.4 million, these grants represent the largest, first-of-its-kind cancer survivorship research initiative in Canada.

Six grants were awarded across the country, two from Alberta, including Dr. Nicole Culos-Reed, PhD, Faculty of Kinesiology and Dr. May Lynn Quan, MD, Cumming School of Medicine. Each team grant is nationwide in scope, bringing together researchers, clinicians, survivors and caregivers to address key questions in cancer survivorship. With integrated strategies for patient engagement and knowledge translation, teams will work collaboratively to deliver results that will make a real difference in the lives of people affected by cancer.

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Cancer survivors thrive through exercise | News | University of Calgary - UCalgary News

Philadelphia --Gavin Perrin has his work cut out for him this semester. The Susquehanna University sophomore is taking a hefty 22 credits in a demanding accounting program. But as he planned to head back to campus this month, the pandemic permitting, Perrin was thinking about the fun stuff: seeing all the friends he made last year, moving in with his new roommates, playing sports.

It's a far cry from Perrin's high school days.

"I was that type of kid in high school who would rather be anywhere else," Perrin said.

It's not that his high school was a bad place. The difference is him: "I feel like a new man."

Between his junior year of high school and his freshman year of college, Perrin lost more than 200 pounds. At 5-foot-10, the 19-year-old from Turbotville, Northumberland County, is down to 230 pounds. He says he feels healthier, more confident.

Gavin Perrin is photographed at his Turbotsville, Pennsylvania home Sept. 3, 2020. He has lost a substantial amount weight through bariatric surgery.(Photo: TOM GRALISH, TNS)

Perrin accomplished that through a lot of hard work that included diet change and exercise. But it probably wouldn't have happened so quickly without another strategy that's used to help only a small number of the estimated 4.5 million American children and teenagers with severe obesity: bariatric surgery. That's despite growing research that it is an effective, safe way to deal with a health problem that has reached epidemic proportions. Obesity increases the risk of hypertension, liver disease, diabetes, sleep apnea, and many other health problems, even among teens.

The American Academy of Pediatrics in December came out in support of bariatric surgery as an "evidence-based effective treatment of severe obesity" and said greater access to the surgery for pediatric patients ages 13 and older "is urgently needed." There is no authoritative count of how many of these surgeries are performed each year on teenagers, but estimates range from 450 to about 1,600. Most experts agree it's less than 1% of the youngsters who might benefit.

"It's definitely underutilized," said Elizabeth Parks Prout, medical director of Children's Hospital of Philadelphia's Adolescent Bariatric Surgery Program, a joint effort with the Hospital of the University of Pennsylvania. "We're not treating everyone who needs treatment, unfortunately."

'A tool for change'

Most teens who undergo bariatric surgery, like Perrin, have the gastric sleeve procedure, in which 70% to 80% of the stomach is permanently removed. Not only is the size of the stomach greatly reduced, but, especially significant, the surgery also affects hormonal balance, including the production of ghrelin, often referred to as the hunger hormone.

Surgery along with lifestyle changes result in a 20% to 30% average weight loss for adolescent patients, Prout said. Lifestyle changes alone aren't effective for long-term obesity treatment, many experts say.

A growing body of research shows there are few post-bariatric surgery complications, though many programs recommend nutritional supplements in response to concerns about postsurgery deficiencies.

Money, not safety, is one reason few teens get this surgery. It's not unusual for insurers to turn down adolescents for the surgery, according to the AAP, especially children from low-income families and children of color who may be stymied by complex, and at times costly, insurance appeals, or inconsistent coverage policies. These families may also lack access to a bariatric surgery program near them.

Some parents and patients fear going under the knife for something they might think could be handled without surgery. In addition, doctors involved in bariatric programs say other physicians often hesitate to refer younger patients, in part due to misunderstanding about the surgery.

"It's a surgery to help you to be able to be effective in the changes in your diet and exercise," Prout said. "The surgery is not a cure. The surgery is a tool for change."

Ann Rogers, director of the Penn State Surgical Weight Loss Program, said she thinks the stigma of obesity can extend to its treatment.

"Obesity isn't a choice. It's not a lifestyle people want to embrace," Rogers said. "It's a chronic and recurring medical condition, just like cancer. So if we have medical therapies that are designed to treat medical problems, we should use them."

'What am I waiting for?'

Lyndsey Gibb, 17, said she's always been "a bigger kid," at least since she was a toddler. "It was something that continued to get out of control as I grew when I hit the teenage years. That's especially when it got bad," she said.

The Dillsburg, York County, teenager tried various diet and exercise programs and went to multiple nutritionists, but nothing ever kept the weight off. Then a couple of years ago, her father had bariatric surgery. As her dad shed weight, she noticed other changes in him. He was more confident, less self-conscious about what he wore, less restricted in the things he would do. She decided she wanted that for herself.

Gibb had her surgery last December at Hershey Medical Center with Rogers. Since then, she's lost 115 pounds and intends to shed another 60. Her BMI went from almost 53 to 36. (Severely obese is considered to start at a BMI of 35 to 40.)

"I definitely feel a lot better, more so confidence-wise than health-wise," Gibb said. "Health-wise, I feel like I can do more, but just being more comfortable with what I look like and what I can wear makes me feel a lot better."

Gibb said she is excited that she can now wear stylish brands like Simply Southern that she always liked, but didn't come in her old size. She gave up riding horses because of her weight. She thinks that could be an option again. Just walking is more enjoyable.

She's beginning her senior year at Northern York High School. COVID-19 permitting, she's looking forward to the prom. Growing up in a rural area, Future Farmers of America is an important activity for her. It involves speaking in front of large groups of people.

"It will help if I feel better about how I look," she said. "I'll be more confident in what I'm doing, and hopefully I can even be better at what I'm doing because of it."

To those who would say she was too young to have this kind of surgery, she has a ready answer.

"What am I waiting for in my life? I've dealt with this for how many years now? My dad got it when he was 40-something years old. It's either I live with how I am and continue to go up and down, or give this a shot and be able to improve my quality of life sooner."

Gavin Perrin is photographed at his Turbotsville, Pennsylvania home Sept. 3, 2020. He has lost a substantial amount weight through bariatric surgery.(Photo: TOM GRALISH, TNS)

A new start

Perrin started his battle with weight at a young age, too. From ages 4 to 15, he participated in a medical weight-loss clinic program where he was given nutrition counseling. Finally, he was told there was nothing more they could do for him. By the time he got to the CHOP bariatric program, his BMI was 65.

"I had high blood pressure. I was borderline diabetic. Even walking around, my feet would burn up. I'd get tired really quick. I did try to play sports, but I couldn't last," Perrin said. "My size definitely bothered me. I could tell from a young age there were these differences, and I wasn't the same as everybody else."

Eating in public places made him feel self-conscious. "Even if they're not looking at you, you felt as if all eyes were on you."

In elementary and middle school, he had temper problems. He thinks his weight had something to do with it.

In high school, he found himself not wanting to go most of the time. He didn't ask anyone to the prom, and no one asked him.

He was a sophomore when he entered CHOP's program. He spent about a year in the presurgery program, which included education and lifestyle changes like a high-protein diet, vitamins, and medication. He had his doubts, given his past experiences. But for the first time, the pounds started coming off _ and staying off. He also was no longer prediabetic, and his blood pressure returned to normal.

"I thought, 'These are people I can trust.'"

By the time he arrived for freshman year at Susquehanna University, Perrin was very different from the kid who underwent weight-loss surgery.

"No one knew me. I could kind of reinvent myself," Perrin said.

After taking charge of his body and his health, "I felt like I could really talk to anybody. I didn't have trouble going out and meeting new people."

The high schooler who preferred to stay in his room became a college student who set goals of meeting as many people as he could. He was a regular at the campus gym. He joined the rugby team and played pickup basketball.

Last month, classes at Susquehanna started online, and Sept. 20 is his back-to-campus day. His roommates will be waiting. He's got a new job as an academic coach for freshman business students. Perrin's ready for whatever the future might bring.

"As long as coronavirus doesn't get in the way," he said, "I think these next couple years are going to be the best time of my life."

___

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For teens with severe obesity, bariatric surgery works, but is rarely used. Experts say that needs to change - The Detroit News

In a recent telehealth visit, a patient presented alongside her husband, who was concerned that she had become a shell of herself. She previously enjoyed reading, spending time with family, and attending a water aerobics class at her local YMCA. Since the pandemic began, she has suffered from isolation; her aerobic classes were suspended, and their children had stopped visiting in an effort to protect them from contracting COVID19. She hadnt left the house in months, stopped reading books, and seemed disengaged when her family called. He observed that she spends her days watching television and sleeping, and he was concerned that her memory had dramatically worsened in the past four months.

Social engagement and intellectual stimulation are critical to ones wellbeing, memory, and mood. Numerous observational studies demonstrate that social engagement and cognitive stimulation can delay or prevent onset of dementia. Even before the pandemic, social isolation was a threat to the well-being of older adults. Social isolation and loneliness were identified as serious public health risks by the National Academy of Medicine in 2020 [1]. Older adults are at particularly high risk of social isolation for a number of reasons, including sensory impairment that may limit mobility or ability to drive, cognitive impairment, geographic separation from friends and family, and the risk of widowhood and loss of loved ones that increases with age. The pandemic has amplified these barriers, and caused a staggering increase in reported loneliness and social isolation, particularly among older adults. Clinicians in practice may represent the only point of contact for some older adults and, therefore, should be prepared to recognize signs of social isolation and respond with suggestions for activities and resources with which they might engage. We have compiled a list of free or low-cost resources for older adults that provides for social engagement and intellectual stimulation during this period of physical isolation and social distancing.

Overcoming Technological Barriers

A recent study by Lam et al found that approximately 30% of the US population over the age of 65 had barriers to engaging with virtual technology due to lack of internet access, lack of internet-accessible device, and/or inexperience utilizing technology [2]. Overcoming these barriers are vital to allow older adults to engage with their communities. Although some older adults are reticent to learn new technology, the Coalition to End Social Isolation and Loneliness emphasizes the importance of virtual connections during the pandemic era [3].

For older adults on a fixed income who dont have access to the internet, there are a number of very low cost ($5-10/month) options available. Daily Caring compiled a list here. There are also a number of resources available to teach older adults how to utilize various virtual platforms:

Senior Centers

Senior Centers are community-based organizations that promote the health and wellness of older adults. They receive federal, state, and sometimes local funding, as designated through the Older Americans Act. Senior Centers have varying minimum age requirements (typically between 50-60), and offer a wide variety of services, including adult education courses, fitness courses, volunteer opportunities, social groups, and more. Many services are free or available at low cost; if services have fees, they often exist on a sliding scale based on the participants income. During the COVID pandemic, many senior centers have converted their enrichment courses to an online format, making it even easier for adults in the community to engage. AAAs are an excellent resource to help older adults connect with local senior centers and explore their offerings.

Adult Education and Learning Opportunities

Religious Communities

Faith and spirituality are important to many older adults, who may be struggling to engage with their religious communities while maintaining social distancing. Many places of worship have embraced virtual technology to record and broadcast sermons or offer community engagement activities. Older adults should reach out to their local place of worship to see what options are available.

There are also a number of virtual resources for various religious communities. A small sampling is included below:

Museum and Zoo Tours

Many national landmarks and tourist spots have begun offering online experiences. These virtual visits can be more engaging if performed with a companion. Loved ones sheltering apart can participate in these experiences simultaneously while communicating with each other by phone or interactive video platform, allowing them to make observations, discuss what they see, and learn together.

A small sampling of free experiences:

Fitness

There are a number of fitness course offered virtually. Older adults should always discuss the safety of initiating a new exercise program with their primary care providers and consider a physical therapy evaluation if they have significant impairments in balance or mobility. If safe to participate in an exercise program, a number of older-adult specific programs exist:

Mental Health and Counseling

There are a number of resources to address mental health needs during the COVID crisis:

Creative Activities at Home

Active participation in creative, structured, goal-oriented activities can provide variety and cognitive stimulation.

Conclusion

Loneliness has affected people worldwide during the COVID pandemic, and older adults are one of the hardest-hit demographics. We have mentioned only a handful of high level options for older adults to stay positive, engaged, and healthy during the pandemic. While many of these are national programs, more specific and accessible options may exist at the local community level. Contact local AAAs or Councils on Aging for more information. Regardless, we urge everyone to reach out and check in with the older adults in their lives, think outside the box, and be creative to find solutions to address this critical issue.

References

Read more here:
Virtual Resources for Older Adults during the COVID19 Pandemic - GeriPal - A Geriatrics and Palliative Care Blog

Are you and your family looking for new fun in-person programs? The Suffield Parks and Recreation has planned a variety of new programs for you with enhanced safety measures. Register today and join in on fun!

Mindfulness, Resilience and Relaxation Sampler- NEW (Wednesday's)

Join us for this new outdoor program at the beautiful Bruce Park Pavilion as you learn some great mindfulness, resilience and relaxation exercises guided by certified Yoga Instructor Laura Dromgold. Take some time for yourself and leave class feeling refreshed, de-stressed and renewed. Mindfulness, Mediation and some gentle Yoga movements helps calm the mind, body and spirit. This class is for everyone and all levels are welcome. Instructor: Laura Dromgold Registration closes on Tuesday, September 15 and/or earlier if enrollment reaches maximum capacity. Limited enrollment. Dates: September 16, 23 Day: Wednesdays Time: 4:45-5:30 p.m. (Perfect for after work or for family exercise evening!) Location: Bruce Park Pavilion (Heavy rain and thunderstorms will cancel the program that day by the instructor, class will be held on Wednesday, September 30 if there are any cancellations.) Ages 12 and up Fee: $20.00

Powerburn NEW Outdoor Program (Ages 14 and over) Get an incredible workout in this fun high intensity step class. Class is designed to help build lean muscle while burning tons of fat all while having a blast. It is a total body cardio and strength workout. Combining step, HIIT, and dumbbells, this ultimate thirty-minute workout will get and help keep you in shape. Come get your heart pumping and the calories burning with a personal trainer. Beginners to Advanced are welcome! Instructor: Joseph Hicks, Certified Personal Trainer, ISTA Teamjtraining.com Dates: September 17, 24, October 1, 8, 15, 22 (October 29th as a bad weather make up day as back up. Day: Thursday Time: 10:30-11:00 a.m. Ages: 14 and older Location: Meet at Bruce Park Pavilion. (Heavy rain and thunderstorms will cancel the program that day and will be rescheduled if possible. Instructor will contact you by 10:00 a.m. the day of the program if the class needs to be rescheduled due to weather) Fee: $50.00 Registration closes on Tuesday, September 15 and/or earlier if enrollment reaches maximum Fun Fall Crafty Creations - NEW (Grades 3-5) Your child will have a blast in this fun and creative class while making a variety of quality fall and "spooky" Halloween craft projects and treats. Please have your child bring or wear an old T-shirt/clothes to class. A small snack will be provided. Please indicate if your child has any food allergies. Registration closes on Tuesday, September 15 and/or earlier if enrollment reaches maximum capacity. Instructor: Donna Carney-Bastrzycki Date: September 16 Day: Wednesday Time: 3:30-5:00 p.m. Location: McAlister School Cafeteria Grades: 3-5 Fee: $15.00 Non-Res: $20.00

Fitness Squad Fun Is your child ready to have fun while getting fit? Do they love a good challenge that is motivating? This heart pumping, enjoyable fitness class is for girls and boys in grades 3-8 at various fitness levels. Children will engage in core, strength, agility training, plyometrics and other important training exercises. The class's focus is to motivate with positivity and fun activities in a safe nonjudgmental environment helping to make fitness a lifestyle! Your child will have a blast in this class. Children must bring and wear a mask when social distancing is not feasible. Instructor: Joseph Hicks, Certified Personal Trainer, ISTA. Teamjtraining.com Registration closes on Wednesday, October 14 and/or earlier if enrollment reaches maximum capacity. Limited enrollment. Dates: October 19, 26, November 2, 9, 16, 23 Day: Monday Time: 3:30 - 4:30 p.m. Grades: 3 - 5 Location: McAlister School Gym and fields Fee: $50.00 Non-Res: $55.00rescheduled due to weather)Ages: 3-5 and caregiverFee: $50.00 per child and one adult

Pre-School Storytime, Games and Fun Craft Party (Pre-Schooler with a Parent/Caregiver) - NEW

Come join this fun Storytime and Craft party with your little one! Participants will have an enjoyable time during our Fall Themed party where we will read an engaging story, make some creative crafts and end with a dance party all while social distancing at the beautiful Bruce Park Pavilion. This class is designed for parent/caregiver and will be loads of fun! Limited enrollment. Instructor: Wendy Taylor-Kent Memorial Library and Donna Carney-Bastrzycki-Suffield Parks and Recreation Department Registration closes on Tuesday, September 15 and/or earlier if enrollment reaches maximum capacity . Date: September 17 (Back up bad weather make up day is Thursday, October 8-only heavy rains and Thunderstorms will cancel) Day: Thursday Time: 1:00-2:00 p.m. Location: Bruce Park Pavilion Ages: 2-5 and caregiver Fee: $10.00 for participant and caregiver

Adult Healthy Happy Hour-Mix it up at the Barre - NEW Outdoor Program and Zoom Option! Join in on our enjoyable Barre inspired workout. Are you looking for a great program that incorporates Yoga, Pilates and Aerobics in a super fun way? This class is for you. The Barre portion of this class incorporates specific sequencing patterns and isometric movements that target specific muscle groups. This pattern of exercise helps to improve strength, balance, flexibility and posture. The "MIX" portion of this class will add strength training and cardiovascular fitness using dumbbells and other equipment at the studio. Class will be held outside to help ensure social distancing. This class is also available on Zoom if you do not wish to go to class in person and will also be held via zoom if there are any bad weather days. Visit- https://us02web.zoom.us/j/5436018790 to join the class via zoom. The meeting ID is 543 601 8790 Instructor: Sarah Supino/Unique Fitness Studio Staff Registration closes on Wednesday, September 16 and/or earlier if enrollment reaches maximum capacity. Limited enrollment. Dates: September 21, 28, October 5, 12 Day: Mondays Times: 4:30-5:00 p.m. Ages: 14 and up Location: Unique Fitness Studio Fee: $50.00

We look forward to seeing you at upcoming programs. For more info and to register please visit- suffieldrec.com

Written by: Donna Carney-Bastrzycki

Director of Special Programs, Suffield Parks and Recreation Department

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Register today for Fall Programs that start this week! - Patch.com

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