Creeping Disability --- How to Avoid Physical
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Last updated May 22, 2017, originally published October  28, 2015

By Susan Callahan, Associate Editor and Featured Columnist

[Health and fitness articles are reviewed by our team of Registered Nurses,
Certified fitness trainers and other members of our Editorial Board.]

Take a little test.  If you sitting down, just stand up. Now, did
you use your hands to touch the chair and push yourself up?  If
so, you are using what scientists call a “compensation “.  The
process of using little compensations is a tell-tale sign of a
process that is making you, little by little everyday, more
disabled.  You really don’t need your hands to stand up, you only
need your legs and a sense of balance. When we are youngsters,
we never use anything but our legs to stand up. In fact, we
practically leap, bound, out of a chair.  

But gradually, and almost imperceptibly, we change over time
until one day we notice that we no longer just use our legs to get
up. We use our hands to push off or we use the arms of the
chair.  When did all this happen? How did we become less “able”?
And more importantly, what steps can we take to avoid the
slippery slope of physical decline as we age?

We Are All  in Stages of Pre-Clinical Disability

We all know what full-blown disability looks like. A person is in a
wheelchair is clearly disabled. A person who is bed-bound is
clearly disabled.

But here’s a shocker. Eventually, we all become disabled. Some
of us become disabled all at once perhaps because of an accident
or a disability we’ve had since birth.  But disability catches up
with us all, eventually, scientists say.  This gradual disability is
what is known as “pre-clinical disability”. You’re not disabled
enough to stop you from doing what you need to do yet.

But each day, you use what scientists call “compensating
strategies”. These compensating strategies are little props we
use every day and, as we get older, we use more and more of

Think of it this way. If you are pre-clinically disabled, you still
may be able to walk up the stairs. But you need to lean heavily
against the rails. If you are pre-clinically disabled, you may be
able to get up from a chair. But you need to use both arms to
push yourself up, rather than using your legs only.  If you are on
the floor, you may be able to get up. But you need to first roll
over, maybe prop yourself up on one knee, then push up with an
arm, rather than getting up in one fluid motion as you once did
as a child.

The fluidity and dynamic balance and strength that you once had
when you were a child, and that you lose, gradually, is not --- I
repeat is not ---  an inevitable part of aging.  But it
is an
inevitable consequence of being unaware of the changes
affecting your body and not combating these changes.

What’s The Big Deal If You Are Pre-Clinically Disabled?

So what’s the big deal about using these little compensating
strategies or little props?  The big deal is that scientists have
learned that people who use these compensating strategies are
at higher risk for becoming
fully disabled.  

This was the startling finding from a study in 2000 led by
researchers from Johns Hopkins University School of Medicine.
Under the guidance of Dr. L.P. Fried, the research team studied
436 women between the ages of 70 and 80 who were not
cognitively impaired (no
Alzheimer’s and dementia). At the start
of the study 69% of the women used no compensating strategies
at all or at most used just one prop.

But what a difference a year makes.

At the end of  18 months, the researchers evaluated the same
group of women to see how many became fully disabled. A full
16% of the women now had trouble walking half a mile.  And
almost 12% (11.7%) could no longer walk up 10 steps.  
Comparing the women who became disabled to those who did
not led the researchers to the surprising finding that using
compensating strategies --- props --- makes you 300% to 400%
more at risk for becoming disabled within 18 months.

The Modification Scale -- How Disabled You Are Right Now?

How do you measure which little props help predict your risk for

Scientists measure how many props you are using with a tool
called the "Modification Scale".

For each prop you use, you should give yourself 1 point.  What
scientists have learned that is people who are hampered in any
way, say by
obesity, are 18 times more likely to have 6 points or
more on these tests. If you collect more than 6 points on the
following test, you’ve got work to do to get off the slippery slope
toward disability:

Get Up from a Chair.   Give yourself 1 point for each prop you
use (resting hands on the seat of the chair to push off; using
hands to push off on arms of the chair; resting hands on your
knees as you get up)

Kneel Down on One Knee.  Give yourself a point for each prop
(using a hand; touching furniture nearby; if you can’t do it at all;
give yourself 6 points)

Climb the Stairs.   Give yourself 1 point if you use the
handrails. Give yourself 6 points if you can’t climb 10 steps at all.

Go Down the Stairs.  Give yourself 1 point if you use the rails.
Give yourself 6 points if you can’t go down at all

Lie Down on the Floor and Get Up. Give yourself 1 point each
for using one hand, 2 points if you use both hands, 1 point for
each knee you use, 6 points if you can’t get up at all.

Walk. Can you walk half a mile? If you walk but you need a
prop ( a cane etc) or you have to stop, give yourself a point for
each stop.

Top 7 Tips to Reverse  or Avoid Pre-Clinical Disability

Just being aware of your subtle decline is the most important
step you can take to reversing or avoiding that decline. You’ve
taken that step by seeking out articles like this one.

Now, here are the other steps that scientists have found effective
in bolstering your defences against the declines of advancing age:

Walk -- Fast

Walking is such an important exercise for healthy aging. Walking
is both aerobic, so it works and conditions your heart Walking is
also weight-bearing, it forces your skeletal frame to bear your
weight, so it strengthens your bones.  

What scientists have learned is that your gait speed --how fast
you walk ---is a key determinant of whether you will become
vulnerable to a range of disabilities and health conditions,
including heart disease, diabetes and stroke.

Walking fast even helps to extend your life (read more about
why fast walkers live longer).  It may take some effort but you
should consciously try to speed up your gait, if you are a natural
slow stroller. Your goal should be to get your normal walking
speed up closer to what a person looks like when they are
“walking in a hurry”.

Climb the Stairs

Of all the ways you move your body during the day, climbing the
stairs may be the one that most people avoid most. It is also
probably the one exercise that word most effectively at keeping
you young.  Climbing the stairs challenges your biggest muscle
group -your thigh muscle (quadriceps), your calves and your
back side (hip flexors on your derriere’).  Why is it so important
to keep these three muscles strong as you age?

There are two critical reasons. First, these muscles in your thighs,
backside and calves are important because scientists have
learned that they  help you avoid falling. Falling is the great
common disaster of aging. Those who fall fracture hips.

And those who fracture hips tend to never walk again. In fact,
29% of people who have a hip fracture die within a year,
according to the University of Maryland Medical School. That’s
right, hip fractures kills a third of us within a year of the fracture.

Another reason you should avoid falling has to do with the
response of the medical community to your fall. Once you fall,
you are probably going to be prescribed a walker, scooter, cane
or some other mobility device. So what's wrong with a mobility
device? Nothing, in a sense, because these devices help to
stabilize you as you recover from hip fractures or falls and they
certainly reduce the risk that you will fall again.  Doctors are
sensible in recommending the to you.  But there is a downside to
using walkers and scooters. You become dependent on them,
long after you may not really need them. And, as a result, you
never recover the ability to walk independently.

The second reason these 3 muscles are so critical is that they are
big. Your thigh muscle is the single largest muscle in your body.
Most people think of muscle as only a resource for doing things --
you need muscles to lift things or climb.

But muscles have a more important function. Muscles are the
storage tanks, the “banks” for your body’s protein. And when
you get sick or you are immobile, your body draws down from
these protein banks to help you recover.

Those with more muscle mass are more likely to survive all forms
of illness, including cancer and even burns, according to
numerous studies discussed here.

Do Squats -- They're Critical

You should schedule 3 days a week to do squats at home. Squats
work your big muscles in your thighs and, like stair climbing, help
you to build your protein banks for that rainy day.

And when that rainy day comes --- you’re on your back in the
hospital --those squats will be one of the main reasons that you
will be one of the lucky ones to get out of that hospital bed and
make it back home, alive.

If you have done squats regularly, start slowly. Aim for 6 to 8
squats, rest for two minutes, then do another 6 to 8. Rest two
minutes, then do your last 6 to 8.  That’s it. You’re done for the
day.  Take the next day off. Then do your squats again. It’s best
to have a set schedule, say Mondays, Wednesdays and Fridays
for squats.

Get Down on the Floor

When we are babies, the floor is our entire world. Other than
sitting on Mommy’s or Daddy’s lap, we are at home only on the
floor. It’s safe down there, because we can’t fall. On that floor,
we spend our time crawling and exploring. Even when we
become walking children, we still plop down regularly on the
floor to play with friends. I still remember all the games of
“jacks” and “checkers” and “dolls” I played on the floor as a
child. We could have just as easily played on the sofa but we kids
naturally just plopped down on our floor and had fun.  

As we get older, our lives move off the floor, to chair level. We
go to school and sit in chairs. We graduate to jobs that have us
in chairs.  We come home tired and sink into our favorite ...chair.  

And that is when our troubles begin. For chairs are not our
friends, when it comes to our health.

In fact, it’s more accurate to say  that a chairs are the enemy of
our well-being.  

Here is what scientists have learned. For each hour of you sit
during the day, you increase your risk for calcium deposits
blocking your coronary arteries by 10%, according to a 2015
study by Dr. Jacquelyn Kulinski  of the Medical College of

Getting back down on the floor will re-acquaint your body with
the mechanics of navigating your way back off the floor.
Navigating your way off the floor activates the muscles and
tendons of your legs, arms and the muscles supporting your back
as well as your abdominal core muscles.


Many people who are physically active spend little to no time
stretching. And yet, stretching is almost as important as the
exercise itself. Stretching restores elasticity to your muscles and
movements. It also helps you avoid falls as it trains your body to
bend, not break when you encounter an unexpected obstacle.

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