It’s a beautiful thing to watch Natsumi Nomura work with 92-year-old Kimiko Hara. The physical therapist visits Kimiko twice a week in her home in Kobe, Japan, to take her through a 40-minute bodywork and movement session.

Natsumi works with gentle hands as she measures Kimiko’s blood pressure, heart rate and blood oxygen levels before massaging her elderly client’s back. Then, Natsumi takes Kimiko through a range of seated exercises to maintain the range of motion at her shoulders, elbows, hips, knees, ankles and spine. Sometimes they’ll take a short walk, if the weather permits.

However, it’s what Natsumi does in the second half of their session that shows the true power of understanding the intention of movement.

92-year-old Kimiko Hara keeps active and healthy with home exercise sessions.

Why we need to move as we get older

Aging is a double-edged sword. Each birthday that we make it to is celebrated, and rightly so, yet as the years creep up, our health often declines. We attempt to mask the aesthetic evidence of aging rather than addressing its underlying health-related causes. It’s not that we age that we should be concerned with but rather how we age. We’re getting older and living longer but we’re not necessarily getting healthier.

Despite plentiful research in the area, there are still question marks around the various theories that attempt to definitively explain aging. Yet one recurrent concept in the literature receives support time and time again: if we want to age well, physical activity is not a luxury. It is a necessity.

The anti-aging effects of exercise

⅔ of adults aged 60 and above sit for more than 8 hours every day. When we sit for long periods of time and don’t engage in enough physical activity, we age prematurely. Research from the University of California San Diego School of Medicine demonstrates that sitting for more than 10 hours a day and not engaging in moderate-to-vigorous physical activity aged elderly women by as much as eight years more than their active counterparts.

By contrast, older adults who are physically active have a reduced risk of:

• All-cause mortality
• Cardiovascular mortality
• Breast cancer
• Prostate cancer
• Fractures
• Recurrent falls
• ADL disability (limitations on the ability to carry out daily tasks required for self-care/independent living)
• Cognitive decline
• Dementia
• Alzheimer’s disease
• Depression.

Kimiko doesn’t need the research to tell her what she knows to be true. When asked why she believes her sessions with Natsumi are important, she’s clear on the benefits: she doesn’t want to depend on other people too much and wants to live a long, healthy life while doing the things she enjoys.

There is a long list of anti-aging effects from physical activity, covering everything from improved cognitive, cardiovascular and respiratory function, to preventing muscle and strength losses. Balance, motor control and joint mobility are also big winners for older exercisers.

Making ground-based exercise accessible to older adults

After taking the Animal Flow L1 workshop in late 2020 and becoming a Certified Instructor shortly after, Natsumi dove into her own personal practice.

By spending time on the movements every day, she saw the immense potential of the program to help her older adult clients.

Natsumi performs up to seven home visits every day, helping older adults in need of out-patient rehabilitation. In doing so, she saw the opportunity to apply what she had learned about the benefits of quadrupedal movement training for people of all ages and abilities.

“I love helping people,” explains Natsumi. “I want them to be healthy at any age so I’m always thinking about the different things I can do for them.

Natsumi began to explore ways to incorporate Animal Flow movements into her sessions with clients. By elevating their hands on a table or wall, or otherwise modifying the movement, Natsumi is able to maintain the intention of each move while also meeting the needs of the individual.

6 Animal Flow moves modified for elderly clients

When selecting movements for inclusion with Kimiko, Natsumi looks for ways to improve balance, mobility, flexibility, strength, coordination, and breathing. This is done with the overarching aim of keeping her clients functioning as well as possible for as long as possible.

Natsumi, who is now a Level 2 Certified Instructor, points out that it’s a good idea to start small to develop proficiency and confidence. When working with clients such as Kimiko, Natsumi only adds on more challenge only once they feel ready to do so.

Below are six examples of how to use Animal Flow with elderly or less mobile clients.

Lateral Traveling Beast

In Natsumi’s experience, she finds Lateral Traveling Beast to be a great choice for cognition.

“When I started, Kimiko was very confused about how to do it,” says Natsumi. “Now she’s doing great because we do it every time I visit her house. She’ll do some Lateral Traveling Beasts and I ask her to take a rest but she just wants to keep going!”

Front Step

As we experience age-related postural changes, our center of gravity shifts and we can have a tendency to keep our weight back in our heels, explains Natsumi. A supported Front Step modification can be helpful to safely teach older adults how to shift their weight into their forefoot, allowing them to build better strength, balance and confidence for walking and navigating obstacles like steps.

Side Kickthrough

By crossing the midline with one leg and pulling the opposite elbow back, Natsumi finds this Side Kickthrough modification valuable for Kimiko’s balance, rotation, and chest and shoulder mobility.

Ape Reach

“For older people, their normal daily movement becomes smaller over time,” explains Natsumi. “Their chests, shoulders, spine and ribcage get tight; they start to find it more difficult to breathe.

“I saw that Ape Reach could be used to help them improve their breathing and they could do it while sitting on the bed. With their arms out to the side (in Open Ape), it’s much easier for them to learn to use the right muscles for breathing.”

Scorpion Reach

Balance is an important part of falls prevention for older adults. Natsumi likes to use a modification of Scorpion Reach to challenge and improve balance for her clients. It’s also a valuable tool for improving hip extension which is often greatly reduced in older adults.

Beast Reach

Beast Reach is a great way to help clients develop upper body pushing strength, balance, and ankle and toe mobility. Ankle plantarflexion strength (where an individual ‘points’ their foot) plays an important role in balance, stability and falls prevention in older adults.

Training for the journey of life

Having trained together for a year so far, Natsumi is really happy with Kimiko’s progress. They complete a range of falls prevention tests every three months to measure Kimiko’s improvement. No change in test scores is a good thing–as we age, the primary aim is to arrest the expected decline in performance, something that Natsumi and Kimiko are achieving. Kimiko also reports that she has less back pain and less reliance on her walking cane for assistance.

Much to Natsumi’s delight, Kimiko plans to practice Animal Flow for a long time to come. It’s hardly surprising–watching their session is joyful even for the observer as they both laugh and smile constantly throughout their time together.

Having recently been widowed after her husband, Yasuo, passed away at the age of 99, Kimiko looks forward to Natsumi’s visits.

“Kimiko finds the movements fun and she’s always waiting for me to arrive,” smiles Natsumi. “She told me that her life has changed because she learned to care about her body more and she wants to continue to do it for as long as she can.”

Read the article Redefining Physical Activity for Healthy Aging to learn more about the benefits of quadrupedal exercise for older adults and why walking alone isn’t enough to keep us healthy and active for years to come.