Harvard Men's Health Watch

Don't let mobility sneak out the door

Image: Thinkstock

A litmus test of overall mobility is simply being
able to shop for and carry bags of groceries
without assistance.

Regular exercise for endurance, strength, flexibility and balance can keep you living an active and independent life.

The ability to leave the home and move around without assistance strongly influences whether a person keeps living an independent life. Doctors call this mobility, and it's essential for healthy aging.

We do know what happens when mobility falters. Injuries, illness, and changes in hearing and vision can make a person more sedentary and home-bound. This leads to further disability and health problems, greater dependency on others, and a significantly higher chance of dying.

Recent research confirms that the best way to preserve mobility is regular exercise to maintain endurance, strength, flexibility, and balance. "If all you can do is walk every day, fine. Increasing physical activity can have important beneficial effects on health and mobility," says Dr. Shalender Bhasin, an endocrinologist at Harvard-affiliated Brigham and Women's Hospital and an expert in aging and metabolism in men.

LIFE lessons

A major clinical trial called Lifestyle Interventions and Independence for Elders (LIFE) recently evaluated how well regular exercise helps older adults stay mobile and independent.

The men and women in the LIFE study were 70 and older. Prior to their participation in the study, they exercised very little and already had some physical limitations, leaving them at high risk of reduced mobility. For the study, mobility was defined as being able to walk a quarter mile in 15 minutes. Completing this task normally requires a slow to moderate walking pace.

The study participants were split into two groups. The people in one group attended healthy aging classes, and those in the other participated in a supervised, multi-year exercise program. The exercisers came into a center twice a week for supervised exercise, and kept it up at home three to four more times per week. The supervised program involved the following:

  • walking for 30 minutes

  • 10 minutes of exercises for
    leg strength

  • 10 minutes of stretches for flexibility

  • targeted exercises to improve balance.

After several years, the regular exercisers were 18% less likely to have lost the ability to walk the quarter mile, compared with the health education group. That's good news, because it provides scientific proof that exercise preserves mobility. The exercisers were also less likely to have become chronically disabled, perhaps because they were able to recover better from illness or injuries.

Prevention is best

If you want to keep moving—just keep moving. Dr. Bhasin emphasizes that regularity of physical activity, not high intensity, is the key to preserving mobility. "Most of the health benefit accrues from increasing our overall physical activity," he says. "It doesn't require intense exercise. Just a mix of exercise, 150 minutes a week, spread out over three or four times a week, improves health and mobility enormously."

The exercises you do, and how often, depend on your current level of fitness. The best rule of thumb is "start low and go slow." A physical therapist or exercise trainer can offer detailed advice.

How to keep your get-up-and-go

The ability to sustain physical activity.

  • regular walking for 30 minutes, three to five times per week

  • cycling, lap swimming, or water aerobics

The ability to lift, push, or pull.

  • exercises to strengthen the large muscle groups of the trunk, arms, and legs, using hand or ankle weights, dumbbells, elastic bands, weighted vests, or one's own body weight to create resistance

  • include straight leg lifts to build strength in the upper thigh
    muscles (quadriceps)

The ability to bend a joint through its maximum range of motion.

  • "runner's stretches" to lengthen the hamstring muscles

  • light yoga for stretching all major muscle groups

  • stretches to loosen the "pelvic girdle" of muscles around the hips

The ability to avoid injuries from falls.

  • tai chi, a form of exercise that involves moving gently through a series of poses

  • "standing balance" exercises, such as standing on one leg while gently lifting the other