Mind your P’s and Cues
2 years ago, I spent a month at Kripalu Center for Yoga and Health in western MA and earned a 200-hour yoga teacher certificate. While I don’t teach much yoga these days, I find that many of the principles I learned at Kripalu apply to personal training, particularly the training of seniors and frail seniors. One such principle is the principle of cueing.
What is cueing?
If you are someone who enjoys group fitness classes or if you ever worked with a personal trainer, you are already familiar with cues: it’s whenever the instructor or trainer tells you what to do with your body.
Take a look at this picture: that’s me demonstrating an exercise I do with many of my clients: the Standing Thera-Band Row. The main purpose of this exercise is to develop balance, upper body strength, and improve posture.
This exercise is not only a multi-function exercise, but it also is a fairly complex series.
This is the basic cue list for the exercise:
1) Hold one end of a theraband in each hand
2) Stand with your feet hip-width apart and slightly bend your knees
3) Tighten up your tummy, relax the tops of your shoulders, chin straight ahead.
4) Bend your elbows and pull back on the band, squeezing your shoulder blades together.
5) straighten your elbows.
6) Repeat 10-15 times.
(Notice that before I even cue the movement, I cue the correct form to minimize injury and to maximize muscle engagement.)
This is a fairly simple list of cues that seems fairly straight forward, right?
Imagine for a minute that you are a senior who has never participated in an organized fitness program or maybe you’re someone who is new to fitness. Do you know what I mean when I say “tighten up your tummy?” Many people think that I mean, “suck in your gut,” or they laugh in a self-deprecating manner and say, “there is NO WAY I could tighten this up.” I could try to say, “focus on your core…” many 80-100 year-olds don’t know what the “core” is. I initially took for granted that everyone knows what the core is since it is a fitness term bantered about so much these days that you could live in a fitness vacuum and still know where it is in the body.
So, does this cue work?
The short answer is no. Much of senior fitness is teaching (or re-teaching) a person how to move their body; it is teaching them proper anatomical terms; it is teaching them not to be afraid but to be confident; it is breaking down barriers of fitness myths; it is being attentive, kind, supportive and encouraging. Some clients may have Cognitive Impairment or Dementia and not be able to follow multi-step cues. Some clients might have Parkinson’s and need to be rhythmically and constantly coached. There are many variations!
According to a 1999 study published by the American Physical Therapy Association, reported, “Some aspects of prescribed exercise regimens, such as the complexity, intensity, and meaning of the exercise program, have an effect on [sic] compliance… treatments requiring more than one step or item task produced a higher rate of noncompliance (apta.org). Granted, this study deals with compliance of home-based exercise programs, but I find that verbose or overly complex cue lists can confuse and even frustrate. It’s a fine line between flowery language and functional description.
Some Simple Cuing Suggestions For Seniors
- Assign Functional Meaning – I have my client place their hands on their belly and ask them to pretend that they are zipping up a tight pair of pants; assigning a functional meaning to an exercise helps increase understanding.
- Visual Cues -I show them what I mean on my own body or I do an exercise with them so they can mimic me.
- Set a Foundation – I start with a simpler exercise that focuses solely on one muscle group so they know what I mean. (Before teaching Theraband Rows, I have to teach what the core is!)
- Suggest Modifications
- Repetition, Repetition Repetition!
- Use a Person-Centered Approach – what uniquely works for each person? (If the client has a background in dance, try to teach functional movement like dance.)
For more information on cueing, check out this link.
As always, I would love your thoughts and feedback about cueing or Senior Fitness!