What is fitness?
Fitness is best defined as the reserves on which you can call when a challenge is made on your body. It is difficult to assess the fitness of someone sitting in a chair, even if they are not overweight. However, if they were asked to meet a challenge – to touch their toes, or walk up four flights of stairs, or lift a heavy load or stand on one leg with their eyes closed – it becomes very clear how fit they are and the more extensive the challenge, the more obvious does their level of fitness become.
Fitness is often associated with the word ‘sport’ but in fact fitness becomes increasingly important to us all the older we get and the more diseases and conditions that develop.
The reason for this is that for most people apart from professional athletes the decline in their top level of functioning, for example how fast they can run or their maximum heart rate, starts in the early twenties, not because of ageing, because we can see professional athletes still functioning well into their late thirties, but because of the environment in which we live.For most people a gap opens up between their best possible level of ability and their actual level of ability and we call this the fitness gap.
What we also understand now is that fitness becomes even more important once an individual has developed one or more than one long-term health problem.
Sometimes, of course, the health problem itself makes it difficult to maintain fitness by limiting movement but it is often a change in attitude, both on the part of the person diagnosed and on the part of friends, family and, all too often, health professionals who have the wrong beliefs and attitudes which mean that people with a long-term condition are helped primarily by having things done for them rather than being encouraged to do things for themselves and given help and support to increase their fitness.
For this reason the fitness gap gets wider faster after the onset of disease for many people, and the loss of ability may be such that they can no longer carry out the key tasks for independence, for example getting to the toilet in time, as shown in the diagram below.
Fitness, therefore, is one of the four key processes that affect us as we grow older, along with ageing, disease and our changing beliefs and attitudes.
Why is it important?
For young people fitness is only important if they want to play sport but as we grow older our level of fitness becomes increasingly important to help us feel and function well. There is now good research evidence that fitness can be recovered in the seventies, eighties and nineties.
However, if fitness has not been lost in the first place to such a degree, then the recovery of lost fitness is quicker and easier.
In mid-life fitness may not seem all that important until a challenge comes along. This is usually in the form of some health problem which means that the ability of the individual is no longer up to the task required, for example climbing a flight if stairs or walking to the shops.
Obviously the disease needs effective treatment but what the individual also needs is advice, support and encouragement to become fitter and this is where the professions of physiotherapy, occupational therapy and, increasingly, personal trainers have such an important part to play.
It is conventional to focus in four different dimensions of fitness:
- strength and power,
All four of these are important and become increasingly important as the years pass.
We certainly need top class health services but of at least of equal importance is to maintain and improve our fitness, to increase the reserves on which we can call when challenges come.
Who is there to help?
Firstly, we need to look at the health service to make sure that any diseases that are present are diagnosed accurately and treated effectively.
Specialised health services such as rehabilitation teams are also very helpful but only a small proportion of people who would benefit make contact with rehabilitation teams, including physiotherapists and occupational therapists.
Increasingly other groups are playing a part in promoting fitness. These may be gyms and fitness centres, personal trainers, or charities such as the charity OOMPH which has set up training programmes in care homes. These are received with great enthusiasm, and are making a considerable impact in environments which previously would have had residents sitting in chairs around the walls and moving only to the lunch table.
There are also really good voluntary organisations like Age UK and the Centre for Aging Better and they both run face to face and online programmes.
A particular challenge is faced by people who cannot get out and they are the ones who are most in need of fitness improvement, but fitness improvement by yourself at home is difficult. Increasingly, therefore, clubs and centres to which housebound people go or are taken are adding exercise to their list of activities but there is also growing interest in the use oft he internet and digital means of helping people feel and function better.
What can you do for yourself or for someone you love?
Perhaps the most important thing is a positive outlook and a positive belief that you will function better if you become more active. For people you know and love this might be a difficult message but it is now becoming generally well-known and if we recognise that many people face obstacles to becoming fitter, for example being housebound, it is not a matter of blaming the person but of encouraging and helping them develop routines and activities that will increase their fitness.
For people who are of necessity inactive, the gift of lessons at a fitness centre or with a trainer or with a class for pilates or yoga or tai chi, may break the mould.
The Ramblers run excellent health walks designed specifically for people who have lost their confidence or enthusiasm for walking and for whom walking would be of vital importance as one of the first steps they could take to getting fitter.
Paradoxically, if you are someone aged 50, 3kg weights might do but when they reach 60 consider 5kg weights.
Every year people need to focus a little more and become a little MORE active.