March 2010

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Pilates and Alzheimer's Disease

by Connie Borho

I just got an invitation from the daughter of two of my clients, Bill and Adele (names changed), to attend a celebration of their 50th wedding anniversary. On the front of the invitation is a picture of Bill and Adele cutting their cake on their wedding day, smiling happily for the camera and looking healthy as can be.

Fifty years later, there’s not much difference in either of them, at least on the outside, but that couldn’t be said a mere five years ago. Bill was diagnosed with Alzheimer’s disease in l999. A retired engineer, his loss of memory and mental stability, muscle tone, and balance progressed so quickly that in 2004 Bill and Adele had to sell their beautiful waterfront townhouse and move into their daughter’s one-story house in the hopes of keeping Bill at home as long as possible.
 
The mother of three children, Adele had worked full-time in banking, juggling career and family until she turned 60. She had retired along with Bill, with plans of traveling the world with her husband. Bill began to develop memory loss and other health issues almost immediately after their retirements. With all the stress of her husband’s illness, Adele began to gain weight and heart and lung issues that had plagued her throughout her life became worse and worse.
 
Bill and Adele’s daughter came into my studio one day in the hopes of finding someone who could work with her parents. I immediately began researching Alzheimer’s disease and came up with a plan for Bill that would address all of his most prominent issues. First and foremost, his appointments needed to be consistent and he needed to work with the same trainer each time. My daughter Carly, young, but well-trained and with unlimited compassion, worked with Bob at first and then I took over his training as my time allowed. Five years later, he does very well when either of us trains him, but if for some reason I need to get another trainer, his work is disconnected and he has trouble following instructions.
 
Sundowner’s Syndrome, common in Alzheimer’s patients, involves restlessness and agitation and symptoms get worse toward the end of the day. Originally, Adele wanted to bring Bill to the studio after lunch, but we quickly saw that this wasn’t going to work. However, our studio is quite busy in the morning with classes and trainings, and this extra stimulation didn’t work for Bill either. We settled on a time of 11:30AM, which has really worked well.
 
Another symptom of Alzheimer’s is muscle contracture and general tightness. It’s almost like the muscles forget how to let go and release. Because many Pilates movements stretch as they work the muscle, Bill quickly saw an improvement in this general tightness and coordination of movement improve dramatically.
 
Of course, core and balance training was one of the most important components of Bill’s program. His stability was compromised as a result of the combined tightness and weakness of his powerhouse muscles, and falling was a problem. Again, Pilates movements have balanced out his tightness and increased his core strength, as well as his coordination. He can now stand on his own using the Ped-o-Pul and can even walk a BeamFit balance beam on his own (and do fancy footwork, too!).
 
Bill’s family and his doctors keep marveling about how well he is doing, and how the physical aspects of his disease have slowed tremendously. After only four months of working out three times a week, Bill’s doctor commented that his muscle tone and elasticity had improved and that whatever he was doing he should keep doing! He is in much better physical shape today than he was five years ago.
 
One of the most challenging things about working with Bill is that he sometimes has difficulty remembering exactly what we were doing only a second ago and also has trouble sometimes following progressive directions. As a Pilates instructor, my teaching skills have improved tremendously because of Bill. I have learned to be more concise with my cueing and so sharp in progression that I now carry this new-found skill into other teaching areas.
 
Working with Alzheimer’s patients is definitely not for everyone. However, with patience and mindfulness on the teacher’s part, practicing Pilates can be very beneficial. Adele told me the other day that Bill looks forward to his appointments with me, and that he actually remembers that on Mondays, Wednesdays and Fridays, he is going to be working out.  She believes that this is best benefit of all!  The pay-off for the teacher is increased skill levels, and a great deal of satisfaction as you watch the hope shine again in your client’s eyes and their family’s.

Connie Borho


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