Use it or lose it!" For decades, health and fitness experts have chanted this mantra to promote fitness and good health. And it is sound advice, especially as we age. Unfortunately, the idea of walking, bicycling, kicking, stepping, running, "feeling the burn," or wriggling into a leotard becomes less attractive with each passing birthday. But there is one activity that is so universally enjoyable and beneficial few people consider it exercise: dancing. Every generation has a tempo of its own--big band, jazz, or rock and roll, for example. It doesn't matter if a person's favorite dance was the Charleston, the fox-trot, the jitterbug, or the hustle, hearing that music today brings a smile and a dream of days gone by.

"A year ago, our rehab and physical therapy departments got together to combine the concepts of wellness and memory into programs to serve nonambulatory and ambulatory residents, as well as those with Alzheimer's or other dementias," says Maxine Hochhauser, executive vice president/COO, Delivery System of New York City's Metropolitan Jewish Health System (MJHS). The results were a dance therapy program and a hip-hop stretching class. These exercise programs, she explains, are intended to improve balance, strength, coordination, and awareness, and to awaken muscle memory while having fun.

At MJHS's 360-bed Shorefront Jewish Geriatric Center and its 510-bed Metropolitan Jewish Geriatric Center skilled nursing facilities in Brooklyn, residents are stimulated by music, motion, and memories. Awakened muscles help to facilitate a person in regaining strength and range of motion in muscles that haven't been used regularly during the resident's facility stay, Hochhauser explains.

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Dance therapy is a blend of dynamic, free-flowing, and impromptu movement. Under the watchful eyes of a physical therapist and his or her assistants, the dance therapy group gathers to feel the beat. Some ambulatory residents come to dance, while others enjoy watching, listening, and even doing a little chair dancing. However, they participate, residents feel warmth, comfort, and a positive glow. When the music from the residents' generation is played, it triggers memory, especially long-term memory for people with dementia. They are transported back to a particular starlit night at a beachfront ballroom, or they can relive dancing cheek-to-cheek with a special someone at a swanky supper club, for example. Ambulatory residents, of course, become more physically involved than wheelchair-bound residents. Although these residents are confined to a chair, they, too, reap the benefits of exercise even if it is limited to just clapping their hands or keeping time by tapping their fingers or toes.

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Resident Sophie Nahan, once a professional singer and dancer, feels that dancing is good for the body and soul. "It helps you keep your balance. It helps you walk better. You forget everything when you dance," she remarks.

During the session, the instructor goes around the room to customize the stretches and movements to address each person's need. For example, the instructor might try to increase range of motion for a person in a wheelchair by holding a resident's hands and rhythmically swaying them back and forth. Or perhaps the dancer is a subacute resident with a total knee replacement. In this situation, Hochhauser explains, the therapist will work on customized knee exercises that can be done to the music. "We've noticed that while the music is playing, residents achieve a greater range of motion than when doing the same exercises without musical accompaniment," observes Hochhauser. She credits this to the subliminal effect of awakening unused muscles. "You really never know what's going to happen," laughs Hochhauser. "If the resident wants to get up and wiggle a bit, the instructor is right there with her."

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If the music of the '30s, '40s, and '50s isn't a resident's cup of tea, MJHS facilities offer hip-hop stretch classes. This stimulating program provides a pleasant break from day-to-day facility life by incorporating therapeutic stretching with Top 40 music. Residents gain physical improvement in an upbeat, energy-charged atmosphere. It's a positive experience for them as witnessed in their enthusiasm and weekly participation.

Classes are tailored to each attendee's ability and individual fitness goals. For example, if an attendee spends a lot of time in a wheelchair, most of the exercises help to alleviate joint pain. If a resident can stand, the movements help to improve balance and endurance. One Shorefront resident, Abraham Friedman, 91, says, "We have different stretches every week. We don't get bored because it's something new every time." Pacing their movements to the more wholesome recordings of contemporary artists like Will Smith, residents reach for the sky, touch their toes, and do neck rolls to limber joints and maintain or regain strength and range of motion. When subacute patients return home, they can use the routines to continue therapy or work on fitness on their own.

Whether music-based exercise is used as a tool for reminiscence activity or as a chance to let residents share the fun and excitement of today's beat, dance therapy and hip-hop stretch can be easily worked into a facility's recreational therapy or wellness exercise program.
Best of all, no leotards are required.

Metropolitan Jewish Health System (MJHS) provides integrated healthcare programs through its various agencies in the New York City area, which include skilled nursing facilities, hospice, adult day care, and home care. For more information on dance therapy and hip-hop stretching, contact Janet Rothman, Vice President, Corporate Marketing and Public Relations, at (718) 921-8831. To learn more about the Metropolitan Jewish Health System, visit www.mjhs.org. To send your comments to the author and editors, e-mail 2hoban0405@nursinghomesmagazine.com.

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