10-sec 1-leg stance duration predicts survival in middle-aged/older individuals
bjsm.bmj.com
bjsm.bmj.com
I think a yoga instructor said this, but it’s the reason I do tai chi. Death certificates don’t say “died from a fall” but many many people do. Breaking a hip is the beginning of the end for most people. The wound takes so long to heal and you are immobilized for so long that secondary health issues become primary. Many people with a broken hip die from pneumonia. So if you can avoid a broken hip by improving your balance you are better off. If improving your balance improves leg bone density, then you are saved twice over.
We’ve circled around this discovery a number of times. Those exercise programs for retirement homes know this. Water aerobics is just an arthritis- and obesity-friendly way to accomplish the same.
This makes me feel better and it kills three hours a week.
I’m assuming most of the population does not engage in serious exercise regiments, but we rarely have studies performed solely on a highly athletic/strong cohort, so I have to be the glib one and ask if bodybuilders are exempt from these “frail in old age” studies.
One great study we’ve had done recently is how the heart is sculpted as pertaining to exercises that are done, namely cycling, swimming, lifting heavy weights, and rowing all exhibit their own reconfiguration of heart walls/chambers.
Very few datapoints right now, but my knees seem to feel better, not worse, after sprinting exercises. I've been very athletic my whole life and never had knee problems before.
Once upon a time I helped fit people for bicycles. The rule for Chen and bicycles is that there is a little bump of bone below the knee cap, it’s where the tibia flares out and I think a tendon attachment. That should always stay behind the ball of your foot. And your knee should be 95% straight at the bottom of the stroke. Not quite straight, but if you flex your ankle you can just hit fully locked. This engages the lowest bulb of the quad which also helps avoid injury.
The problem with cyclists is the tendency to lean foreword when they walk, which exacerbates the knee over ball problem. You need to lean back a bit, relax the hips. As an experiment, try walking without locking your knees. Also keep your feet farther apart, like there’s a board on the ground, though that help more with fallen arches, and will make some hip muscles sore while they become less atrophied.
And if your knees are sore after a workout, that is cartilage inflammation and you need ice and ibuprofen and think hard about how not to do that next time, because you are doing damage. For me where the tai chi helped here is that by shifting my weight back I’m using cartilage around the injury more, which is still fairly healthy.
Ice and cold therapy has been largely debunked for the conditions you mentioned. Your advice is generally outdated and not aligned with evidence based medicine or successful endurance sports coaching.
If you're getting sore joints you fucked up, please stop doing that. Take some anti-inflammatories for today and sort your shit out.
Also I'm pretty sure you're wrong about the ice. If anything they're using more of it (but for different reasons).
https://wwnorton.com/books/Good-to-Go/
Acute inflammation isn't something to be prevented. It's a helpful part of the healing process. Ice might feel good, but it doesn't produce improved medical outcomes.
My first injury was knee cartilage. My last was wrist, which makes lifting and even yoga hard. But tai chi helped stabilize my knee, and made me feel 10 years younger. Also it made me “need” 30 minutes less sleep a night, and I stuck with it once I realized that the time in class paid for itself.
Or did you mean some second order effect like "the focus granted from half an hour of tai chi allowed me to finish my tasks half an hour earlier"
The bad thing about tai chi and also a class I took from a PT on biomechanics is how often I have to not blurt out advice. I’ve only just stopped analyzing the gait of people walking in front of me. The sympathetic pains were rough.
I just liked being strong! Fortunately, I managed to avoid any injuries, so I count myself lucky. Now I just jog (not run) for cardio and do yoga for mobility. I look forward to it and don't have to wait in line at a gym (or go at ungodly hours).
Thinking about it more, there is probably a more general U curve for exercise. For example, I used to see an ex-NFL running back in the gym sauna. He could barely move most days before 30+ minutes in the heat.
I power lifted for almost 15 years before scaling back because of age. I feel like I ended up hitting a sweet spot, but was always careful. Even before I really cut back I had quit doing singles for awhile.
This. Anecdotally, I know a retired NFL Offensive lineman. He is on a full NFL disability pension at 35 years old because of knee and shoulder injuries. Moving anywhere is very difficult for him.
I doubt it's the exercise that causes most of their health issues.
I do miss it though. After with computers and abstract complexity all day, there is something relaxing about the simple task of picking up a heavy weight :)
If you look at a lot of competitive athletes and bodybuilders, they tend to be pretty broken in their old age. E.g. Ronnie Coleman - former Mr. Olympia - could barely walk after tons of spinal and back surgeries.
Maybe you have the bone density - but if you are immobile with tons of joint and arthritis issues, it probably will not help.
Lifting weights doesn't mean trying to max it out every session. It's still "lifting weights" to go in and do a half hour of compound lifts with moderate weights. Most people can keep that up for a long time.
I don’t consider body builders who use steroids to be healthy people, I lift weights everyday.
But yes, clearly if you manage to maintain a level of strength training that is strenuous enough to promote better than baseline bone density and muscle strength, but not so strenuous as to injure yourself beyond what you can heal from, there are going to be benefits and one of them is likely to be not dying because you can't consistently stand up in old age.
There was a USC running back maybe 15 years ago or so whose name I can't remember any more who somehow managed to drop a barbell loaded to 360 lbs on his throat while bench pressing, and survived. The doctors at the time mentioned that an accident like that would have killed almost anybody, but he survived because his neck musculature was so thick. But I nonetheless suspect, if you survey the average lifespan of everyone who ever makes it to the NFL versus everyone else, the NFL players are not going to come out on top.
But before reaching that point you can obviously improve bone density/strength/balance/athleticism in general to raise how high your peak is where you'll start declining from. In lieu of bad injuries I don't think there are any down sides to pushing these variables upwards while you still can.
the only caveat is that it's really important (even more with age) to also work out your heart, blood vessels, lungs, and abdomen, so you need something that ups the intensity for at least 15-30 minutes 3× a week: running, biking, tennis, etc. for older folks, swimming is really great since it's low impact.
we generally all need both types of exercise (full body and more intense) to maintain fitness throughout our lives. some activities can fulfill both needs at the same time (i still play basketball for this very reason).
source?
The other issue is that digestive systems become less effective at extracting protein as we age. So many elderly people ought to increase their protein intake to prevent muscle atrophy.
the combination of these two goals should naturally lead to exercise with enough resistiveness for whole-body fitness (like basketball) without having to focus on each system separately[0], as you do with weight training, which primarily focuses on muscle mass. compound athletic movements naturally approximate what we do with our bodies daily anyway, which is what makes it intrinsically more holistic. you're right that walking by itself is probably inadequate[1] for musculoskeletal fitness, but 60+% of americans would benefit from walking daily. add swimming/cycling a few times a week and you're done!
the bigger point might be that good fitness doesn't require heavy equipment (ha) or a gym.
[0]: note that pain is a natural feedback mechanism that tells you where the imbalances are, to stretch, exercise, and/or rest more in that area.
[1]: it depends on what type of walking, yoga, or tai chi you're doing; for instance, competitive walking can be enough for some folks.
How much tai chi have you done? Yoga? I'd invite you to do a couple classes of either and see how much they do or don't kick your ass.
Have you ever done static holds on the chin-up bar? Tai chi is static holds for 45+ minutes out of an hour and a half. My calves are bigger than when I was a cyclist, and my hams are granite. The first time I ever tried a plank, I held for 90 seconds. No gym, no situps, no crunches, just tai chi 90 minutes a week, plus walks and gardening.
Sounds like total cruft to me sorry. How would a full body exercise like a barbell squat do all of this ?
Of course if you run a careful program, you can make sure to work opposing muscle groups equally and avoid this. But the fact is that a lot of people who lift weights don’t run careful programs.
Another factor is the elasticity of your muscles. If you don’t up your stretching efforts as you up your lifting, you risk trading range of movement for strength. Again—totally manageable but that doesn’t mean everyone does it.
My sister is a nurse and told me that we SAY "fell and broke a hip" but ACTUALLY it was "broke a hip and then fell". You can tell that from where the break was, and once the hip breaks you are guaranteed to fall.
The cause of hearing this was that my mother had exactly this accident, broke her hip them fell. In the hospital she got some serious drugs, and this triggered severe dementia for the rest of her life.
Actually in her case it WAS more delirium. At first she had a sense of humor about it - the floating cake she was seeing looked quite delicious and she regretted that she couldn't eat it. But later, well, she honestly believed she was sleeping outside under the stars even though she emphatically wasn't.
My grandmother was prescribed Wellbutrin for a few months after my grandfather died. A decade later she suffered a fall and was hospitalized. In the hospital the doctors for whatever reason started giving her Wellbutrin again. She spent the next month subject to intense psychosis, not knowing where she was or who was in the room with her, thinking she was being attacked, thinking there was a party going on in the hallway. We were probably less than a week from institutionalizing her when my aunt noticed the unneeded medicine she was being given. After they stopped giving it to her she was back to normal in less than 48 hours.
Something similar happened with my grandma, she had to sell her house and move into a nursing home because what was diagnosed as dementia. Afterwards, a specialist realized that it was her medications causing dementia-like symptoms, and after adjusting them, she became a completely normal again.
Nobody here is claiming that psychosis = dementia. Almost the exact opposite.
The only way your comment could be relevant is if you’re trying to claim that nobody has ever been misdiagnosed with dementia due to psychosis-like side-effects from prescription medications.
Some people do well on it. A huge number of people become very stupid on it. (I managed to run myself over with my own car)
Tons of drugs cause cognitive issues.
I actually started taking a simple test daily to map my cognitive ability on various treatments.
Another not too uncommon one can occur in older people even when they aren't on drugs: dehydration. The tests they do in hospital to see if you have dementia can easily misdiagnose as dementia when you're simply being dehydrated. Now imagine giving this test to a 30 year old vs. a 75 year old. I've personally seen it attributed to "this person is old, must be dementia". Made sure to hydrate regularly while in hospital (which nurses couldn't/wouldn't/didn't) w/ perfect recovery from their "dementia".
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"Anthropometric, clinical and vital status and 10-s OLS data were assessed in 1702 individuals (68% men) aged 51–75 years between 2008 and 2020."
"No adverse medical events or accidents occurred during the 10-s OLS testing."
In other words, osteoporosis causes brittle bones that break at odd times, and that makes you fall. If that's the case, bone-strengthening exercises and diet would be more effective at preventing this catastrophic scenario.
But I'm not a medical doctor.
You don't need an app to tell you someone is frail.
Remember the inverse DOES NOT hold. If you train to do 180 second one leg stands you aren't like increasing your survivability.
-- edit
One additional note though,
> Deaths from unintentional injuries are the seventh leading cause of death among older adults (1), and falls account for the largest percentage of those deaths.
It might be that one legged balance doesn't improve 'balance' and so doesn't improve your health outcomes. Or 'balance' is irrelevant, and it's just that 'fitness' means you're less winded at the top of the steps, and so you're less likely to fall down at the top.
I'm gunna need a citation on that one. Training you balance is likely to increase your overall balance. Like, by definition. If you can stand on one leg well, then you have the muscles and the equilibrium to balance yourself. Therefore you are less likely to fall.
I'm saying that this experiment:
1. Does not define 'balance'
2. Does not show that the test they applied predicts or correlates with 'balance'
3. Does not show that 'balance' causes good health outcomes.
Perhaps 50 years of dance/yoga/gymnastics/core strength/martial arts leads to both fewer falls and greater 1-leg stance duration. A much shorter course of balance training much later in life might be insufficient to replicate the same benefits.
If you have ever tried meditation and found it physically too painful, I highly recommend you try a tai chi class. I found it quite easy to turn the warmups into standing meditation, having failed many times before.
1. As a child I drew bad attention regularly, but genes and life choices have put me into a privileged place. It took walking to lunch with coworkers through a “bad” neighborhood for this to really hit home. Nobody was going to bother me, but I’d seen other people get bothered, and it hit me that nobody bothered them only because I was walking in front of them. It certainly could be the case that tai chi helps you with such things, but that was not so for most of my fellow students, and certainly not for some of the bigger guys.
The body mechanics of Chen is more obsessed with avoiding locked joints, and when I see videos of people who make me want to complain, it’s either Yang or someone who has split off from Chen more recently.
The legend of Yang Style is that it was started by one of the first outsiders ever allowed to study at Chen village. As with most things Eastern, the early expats we’nt always representative of the way things were done back in China.
You’re right about the sweat. It’s as hard a workout as you make it. My sifu joked once, “this is difficult at the beginning but don’t worry, as you progress it will get harder.” The interesting thing is laugh response. When you don’t know how on earth you’re going to hold this pose, people end up laughing nervously.
Pro tips for anyone thinking of dropping into a class: I highly, highly recommend starting the next morning with as vigorous a walk as you can manage. Even a brief power walk will blow a lot of the lactic acid out of muscles you aren’t used to using. And you are going to fart. Everyone goes through it at first. You are going to engage your core in ways you never have before, and some of that pressure is going to escape. Maybe avoid spicy foods the day before though.
I'd hope so if you are learning tai chi.
Tai chi is up close, and most adults who don’t want to get arrested aren’t likely to escalate past shoving or maybe one swing. It’s very good for that level of altercation. But like every other art, if you’re being mugged just give them your damn wallet.
My first trip on a bird scooter confirmed this.
This depends on the exact nature of the correlation between the survival and the "one leg stand up time" (OLSUT).
Even if we treat the second as a symptom of some debilitating, death causing disease, say cancer or heart ischemia then it is plausible that with stronger legs one will succumb to such malady a bit later.
More likely OLSUT is a more reliable indicator of a physical activity of a person than a questionaries directly asking for it. Unless cornered even alcoholics seldom confess drinking in excess. Sedentary persons probably do not divulge that they have not walk 2km a day in a last year or so.
Last but not least, as mentioned by many above: OLSUT can lower the risk of falls. And with 70+ falls -> broken bones -> bed -> pneumonias and/or thrombosis.
The Bosu. A physical trainer showed it to me.
When you first get on it, you'll panic and probably fall off. But I found I improved pretty rapidly, and now I routinely stand on one leg and rotate side to side.
If you have a friend who also has one, you can throw the heavy ball back and forth to each other. Big fun. Do it on a soft surface so if you do fall you won't get hurt. Most likely, though, if you feel you're about to fall you'll probably just step off.
(source worked in a funeral home back in my youth)
Focus your eyes?
Or do you mean your attention?
[0] https://www.professionalptandtraining.com/balance-strategy-b...
[1] https://www.neurolab360.com/blog/balance-and-proprioception
Can someone better versed in stats than I translate the conclusion into plain english? I'm curious how much life expectancy loss a NO result implies.