Highlighting Positive Change

Use a simple measurement scale to help older exercisers quantify their progress while in class.

By Ken Alan
Sep 20, 2016

When I teach older adults, I want them to feel better after they exercise than they did beforehand. A tool I use to measure this is the Exercise-Induced Feeling Inventory (EFI). The EFI is a subjective measurement scale that assesses how a person feels at any point during physical activity (Gavin & Rejeski 1993). The EFI can highlight and reinforce the immediate positive changes participants receive as a result of attending your well-designed and skillfully instructed class!

Individuals use a 0—4 scale to rate themselves on 12 feeling traits: refreshed, enthusiastic, energetic, revived, calm, relaxed, upbeat, happy, peaceful, tired, fatigued and worn-out (0 = no feeling; 4 = feel very strongly). I've garnered greater participation with a few tweaks, like substituting a simpler name—the Individual Rating Scale, or IRS (it's easier for people to remember); consolidating the physiological and emotional traits into one general assessment: "How do you feel overall right now?"; and using a 1—10 scale (1 = not good at all; 10 = the best ever). In some instances, participants document numbers on a tracking sheet, which can provide useful information about trends. The cool-down is an optimal time to incorporate the IRS.

Measuring Range of Motion

Since joint stiffness is more prevalent in older populations, range of motion (ROM) movements in the warm-up and cool-down aren't valuable only for their face-value benefit, but also for the awareness they provide of acute positive changes gained from exercise effort (Fletcher 2008). Lead the following ROM exercises unilaterally or bilaterally, seated or standing. The moves may be easy, but they effectively demonstrate improvements, which the IRS can track. Awareness cues (AC) help deepen the experience. Ask participants to focus on how the exercises feel in the cool-down compared with the beginning of class.

Extend & Clench

Spread fingers wide, hold for a few seconds, and then clench into a fist. Maintain regular breathing throughout. Repeat 3⨯—4⨯.

AC: "Extending your fingers wide should be easier now than when you first started. On a scale of 1—10, how does this feel?"

O-Fingers

On one hand, form the letter "O" with thumb touching forefinger. Repeat with each finger. Reverse the order, beginning with the little finger; repeat.

AC: "Your dexterity improves with exercise, making these movements easier. What is your IRS on this?"

Wrist Range

Maintaining a light fist, slowly flex and extend the wrist; repeat 4⨯. Slowly circle the wrist in one direction 4⨯, and then repeat in the other direction.

AC: "As circulation increases, joint stiffness usually decreases. Is your IRS different from when you did this earlier?

Finger Flex

Use one hand to stretch each digit of the other hand. Hold onto a finger and gently pull it up, then down. Clasp the next finger and repeat. Complete one hand before switching hands.

AC: "Carefully stretch each finger and stop the moment you feel any discomfort. Stay in your comfort zone. Has the IRS number gone up because there's not as much rigidity as there was earlier?"

Continue applying IRS to additional joints, or all major joints. This measurement makes it clear that you don't have to exercise for weeks or months to feel better. The IRS quantifies that numerous benefits occur immediately in each class. You can then strategically use the pleasant association of exercise with good feelings to promote adherence (Spivey 2014). Isn't that what we want?


References

Fletcher, J. 2008. Range of motion. In W.D. Bandy & B. Sanders (Eds.), Therapeutic Exercise for Physical Therapist Assistants (2nd ed., pp. 28—30). Baltimore: Lippincott Williams & Wilkins.
Gauvin, L., & Rejeski, W.J. 1993. The exercise–induced feeling inventory: Development and initial validation. Journal of Sport & Exercise Psychology, 15 (4), 403—23.
Spivey, K. 2014. Building rapport and the initial investigation stage. In D.J. Green (Ed.), ACE Personal Trainer Manual: The Ultimate Resource for Fitness Professionals (5th ed., pp. 145—46). San Diego: American Council on Exercise.

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Ken Alan

Ken Alan is a lecturer in the department of kinesiology at California State University Fullerton and has served on certification committees for ACE, ACSM and AFAA. The author of four book chapters, he is on the editorial review board for the Journal of Aging and Physical Activity. Ken co-stars in the Time-Life Medical Exercise video series and was the content developer, program designer and choreographer for Richard Simmons. A past recipient of the IDEA Fitness Instructor of the Year award, Ken’s workshops and lectures have educated and entertained trainers and instructor or many years.

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