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Effective Verbal Feedback for Older Clients

How to factor the effects of aging into how you talk clients through their exercises.

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Senior exercisers learn differently than younger ones do. They also process information differently from younger exercisers, and they react differently to the same information. This means trainers need to know

  • whether to give feedback, and how to give it;
  • when to give feedback—whether during a movement or once it’s completed; and
  • what exactly to focus on and what to say.

Giving effective verbal feedback during exercise—knowing what to say and when to say it—is essential to the fitness success of older clients.

Understand
Age-Related Changes

Aging decays a client’s balance, hearing, vision and touch, causing declines in exercise performance. Furthermore, a lot of older adults take medications that degrade proprioception, the body’s unconscious perception of movement and spatial orientation. All of these factors change how people learn and execute motor skills as they get older. Aging also significantly influences how people process and use your feedback.

Like body awareness, mental awareness changes as people age. To understand how these mental changes affect motor skills and to learn how to provide effective feedback, first recognize these three key varieties of memory:

  • Implicit memory is nonconscious and cannot be easily verbalized. A basic example would be getting dressed in the morning. Motor skills like walking are implicit-memory activities that can be more difficult for senior exercisers. Although walking is natural and easy for younger persons, older adults may need a minute to recall the motor program that initiates walking. They might also need to think about it a bit while doing it, unlike a younger person who can jog on a treadmill at a good speed, carry on a conversation and watch several TVs at once.
  • Explicit memory is conscious and can be verbalized. An example would be remembering what you ate for lunch. Explicit memory could also relate to how well seniors remember the exercises used during a previous session.

Implicit memory and explicit memory are impaired in the elderly, affecting their learning and their execution of motor skills (Harrington & Haaland 1992). These memory changes will also determine the most effective methods of delivering feedback to older exercisers. Now consider a third variety of memory:

  • Working memory is the number of things we can pay attention to at one time. This variety of memory also changes significantly during aging (Stevens 2003). For example, a seated knee extension exercise might be easy to do, but the difficulty of the exercise would increase dramatically for older adults if you asked them to explain which muscles they were working as they were doing it.

These changes in the ability of older adults to process multiple streams of information as they exercise will greatly affect the kind of feedback they need.

Design Your
Programs and Sessions

The biological and cognitive changes of aging make it more difficult for older exercisers to perform rote motor skills and learn new ones. Seniors have the greatest difficulty with sequential tasks (Humes & Floyd 2005). A sequential task can be as basic as a walking lunge, but it can also include exercises in which one or more movements are combined, such as pairing a biceps curl with an overhead press. In a gym setting, sequential tasks can include moving quickly from one exercise to the next, as in a circuit or a giant superset.

Older exercisers cannot store as much information in their working memory, so they will have greater difficulty executing compound movements and rapidly changing from one movement to the next. Sticking with a multiple-set, lower-repetition paradigm or building a simple circuit of familiar movements will be most effective for mature clients who are new to exercise or are having difficulty with transitions.

To make your job easier and to increase your older clients’ success, choose the exercises best suited to them before their sessions begin. As you make your choices, keep these exercise selection tips in mind:

Limit compound movements. Initially, stay with single-joint movements; this limits the total degrees of freedom or the number of joints and muscles the exerciser must control during a movement. Increasing the degrees of freedom requires more working memory.

Use machines. Machines control the mechanics, reducing the amount of working memory required. However, be aware of the biomechanics and stay away from extreme joint angles during each exercise. Decays in proprioception decrease older clients’ ability to detect extreme ranges of joint motion.

Use building blocks to help clients advance. This means teaching each component of a compound movement alone, then putting the parts together in a logical, sequential order. For example, if you feel your client is ready for a squat with an overhead press, first review each movement separately and then have the client perform the actions without weights. Add weight and larger ranges of motion last.

Break larger movement components into smaller ones. For example, you might want to advance from a wall squat to a dumbbell squat. Review the mechanics of the wall squat—focusing on the knees and hips individually—before you move away from the wall and add weights.

Stick with the same exercises from session to session until your client achieves mastery and verbally agrees to a change in exercise(s).

Choose Your Words Wisely

Now that you have ideas for workouts based on the changing physiology of aging clients, you can work on exactly what to say when you are offering those clients feedback. Feedback focuses on knowledge of results and knowledge of performance. Depending on what you say and when you say it, feedback falls in these main categories:

Descriptive. In this type of feedback, you describe errors the client made during the movement. For example, during a biceps curl, you might make this observation: “Your shoulders rotated forward a bit during that last rep.”

Prescriptive. With this feedback you develop a plan to correct errors. To provide prescriptive feedback for the biceps curl above, you might say, “On this next set, let’s try to keep the shoulders still and move only the elbows. That will better isolate the biceps.” Here’s another example, for a triceps cable push-down: “Let’s try to better isolate the triceps by stopping in the middle of the rep and squeezing the muscle.”

Averaged. In this case, after a set you average the total feedback and then focus on the most important variable. For example, during abdominal crunches you might see a variety of ways to improve the efficacy of the exercise; but most important, you do not want clients pulling on their neck. This would probably be your first priority for providing feedback and offering corrections.

Bandwidth. This is feedback within a range. For example, before instructing a client to do lunges for the first time, you have to decide how much deviation from ideal form is acceptable. You must decide when immediate feedback is required, and when feedback can wait. For instance, it is critical to say, “Make sure you keep your knees behind your toes.” However, a statement like “I would like to see you widen your total stance by 1 inch” would not be critical, and it might be confusing.

Delayed. This is feedback that you give after the movement is complete. Research shows that people do better at learning motor skills when feedback is delayed a few seconds after completion of the movement (Schmidt & Wrisberg 2007). Delayed feedback will be especially effective for older clients, because they have trouble processing multiple streams of information. The better strategy is to give them an opportunity to finish the exercise and rest for a second or two, and then deliver corrective feedback.

With mature clients, the most effective feedback consistently pairs verbal cues with visual cues. Stick with the same verbal feedback for the same movement. For example, if the person is doing a biceps curl and tends to rotate the shoulder forward versus isolating the elbow joint, always say, “Keep the shoulder still,” versus alternating “Isolate the elbow” with a statement about the shoulder for the same movement.

Carefully select exercises that are best suited to seniors, and pair those exercises with key feedback statements delivered at just the right time. This will greatly influence your senior clients’ success as well as your own.



Trainer’s Tips

Cognitive flexibility is the brain’s ability to restructure knowledge when a situation changes (Spiro et al. 1992). In an exercise setting, a changing situation might be an increasingly difficult motor skill or the environment itself. Cognitive flexibility decreases with age, and the inability to adapt to change often elevates a client’s anxiety level. The following are ways a trainer can minimize client anxiety:

Decide upon feedback before a session. Create consistency by developing your own phrases to connect exercises to specific verbal feedback.

Practice feedback delivery and tone of voice. Remember that some people lose their hearing as they get older. Keep your pitch low and your tone consistent, calm and patient.

Communicate information in chunks. Provide a block of instruction on what is about to happen, how it should happen and why it should be this way.

Allow ample time to process information. Provide instructions and/or feedback, pause for a few seconds, wait for an acknowledgment and then move on.

Get the timing right. If your business model allows, train earlier in the day. Most seniors self-report that they prefer this, because mornings are when they feel their best. Also, try shorter but more frequent training sessions to prevent memory decay.

Feedback Delivery

Feedback has two primary varieties:

Knowledge of results (KR), focusing on the outcome of a movement. Here is an example of KR feedback: “Great! You completed eight triceps cable push-downs.”

Knowledge of performance (KP), addressing the form or mechanics of a movement. KP feedback on the above example might be this: “The movements were a little fast. You might be using momentum. This will reduce the work your triceps do.”

The following example uses squats to illustrate the difference between KR and KP:

KR: “Great. You completed 15 solid reps.”KP: “That was a good set, but I would like to see your feet about 2 inches farther apart on the next set.”

References

Harrington, D.L., & Haaland, K.Y. 1992. Skill learning in the elderly: Diminished implicit and explicit memory for a motor sequence. Psychology and Aging, 7 (3), 425-34.
Humes, L.E., & Floyd, S.S. 2005. Measures of working memory, sequence learning, and speech recognition in the elderly. Journal of Speech, Language, and Hearing Research, 48 (1), 224-35.
Schmidt, R.A., & Wrisberg, C.N. 2007. Motor Learning and Performance (4th ed.). Champaign, IL: Human Kinetics.
Spiro, R.J., et al. 1992. Cognitive flexibility, constructivism and hypertext: Random access instruction for advanced knowledge acquisition in ill-structured domains. In T.M. Duffy & D.H. Jonassen (Eds.), Constructivism and the Technology of Instruction: A Conversation. Hillsdale, NJ: Erlbaum.
Stevens, B. 2003. How seniors learn. Center for Medicare Education, 4 (9). www.mathematica-mpr.com/PDFs/howseniors.pdf; retrieved Apr. 4, 2012.

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