Saturday 18 April 2015

Lien Foundation’s Gym Tonic initiative for seniors

Gyms for seniors to boost health
Lien Foundation spending over $2m on machines for homes, eldercare centres
By Janice Tai, The Straits Times, 17 Apr 2015

MR TAN Cheng Hong may be 77 years old, but his exercise regime can put younger men to shame.

He does 20kg of weights on a leg-press machine and another 10kg to work out his chest muscles.

For a senior citizen who used to hesitate to go to the toilet because his arthritic knees may give way any time, his transformation is stark.

Lien Foundation believes that more elderly folk, like Mr Tan, should enjoy the health benefits that come with physical exertion.

It is partnering Finnish university Kokkola University to see how exercise can be tailored for the elderly to improve their physical and mental health.

Gyms for the elderly are the norm in eldercare centres in Finland, unlike the case here.

At a cost of $2.2 million, the philanthropic foundation is bringing in pneumatic gym equipment for 2,000 senior citizens in six nursing homes and six eldercare centres from next month.

These machines work on an air pressure system that is gentler on the elderly users' muscles and joints. Data on their exercise performance is captured and tracked with an IT system connected to the machines so that their next set of exercises can be tweaked to suit their needs and progress.

"Many of the residents in nursing homes are there because they are frail and not sick," said chief executive of Lien Foundation Lee Poh Wah.

"Why are we confining so many of them to wheelchairs instead of exercise machines? If you are on a wheelchair for a very long time, your physical strength deteriorates very rapidly," he added.

Exercise therapist Andrew Yeo from Peacehaven nursing home said physical inactivity is a big problem among senior citizens.

"The frail elderly are often caught in the vicious circle of inactivity where, because they are afraid of falling, they don't try to exercise and this in turn makes them weaker to the point of being bed-bound," he said.

Physical inactivity is the fourth-biggest factor contributing to deaths globally, according to the World Health Organisation.

Studies done in Finland using similar pneumatic gym equipment found improvements in the walking speed of patients with multiple sclerosis, as well as the sugar levels of diabetic patients.

A small three-month pilot done in Peacehaven last year, which compared the health of 15 residents after they used the machines with that of another 11 who did not, showed favourable results.

Residents who did the exercises had fewer depressive symptoms, reduced blood pressure and greater muscle strength.

"The machines improve the image of ageing and give them back their dignity," said Sister Geraldine Tan of St Joseph's Home, a nursing home for the aged. "Instead of having improvised exercises or improvised equipment, now they are getting almost the real stuff, like in gyms such as California Fitness."

Exercise as medicine
By Janice Tai, The Straits Times, 17 Apr 2015

A SPOONFUL of sugar helps the medicine go down, and a few sets of lunges may help a patient with weak knees get well.

More than 100 doctors from polyclinics, hospitals and private clinics have been trained since 2011 to dispense appropriate doses of exercise to their patients.

Another 100 fitness trainers and physiotherapists supervise patients as they do the exercises. They also plan exercises.

The patients' progress and outcomes are tracked under the Exercise Is Medicine programme started by the Changi General Hospital in 2011.

Healthcare professionals are trained to prescribe the right dose and type of physical activity to prevent and manage chronic conditions such as diabetes, high blood pressure, obesity, heart disease and asthma.

"We are in the process of tracking outcomes but preliminary results of our study show that there is a general trend of more doctors prescribing exercises to their patients," Dr Ng Chung Sien, staff registrar at the Changi Sports Medicine Centre, told The Straits Times.

The exercises could range from 150 minutes of brisk walking to a weekly one-hour session of taiji, a Chinese martial art form, for better balance.

Measurements are taken to gauge the effectiveness of the exercises. For patients who are prescribed exercises to lose weight, for instance, their weight, skin folds and waistline are measured routinely.

According to the 2010 National Health Survey, 54.1 per cent of Singaporeans do not exercise and one in four aged 40 years or above has at least one chronic disease.

Studies have shown that 150 minutes of moderate exercise a week halves the incidence of high blood pressure and diabetes and reduces the risk of heart disease by 40 per cent.

Said Dr Ng: "We are working with various partners to train more doctors locally and abroad, and one of the immediate goals is to incorporate exercise prescription as part of the medical school curriculum."

* More places for seniors to get strength training as gym programme opens to the public
Exercise just the tonic to perk up seniors
Strength training programme to be open to more people aged 55 and above
By Raffaella Nathan Charles, The Straits Times, 13 Dec 2017

Slipping on water and hurting her hips left 97-year-old Lau Soon Siang physically very weak and in pain last year.

After 12 weeks of strength training, however, the housewife has regained her muscle strength and balance. She can now resume her daily walks and go to the coffee shop to chat with friends.

More people can benefit from Gym Tonic - the strength training for seniors aged 55 and above that helped Madam Lau - when the programme is extended to the public at eight locations by next year, the Lien Foundation announced yesterday. The programme has been available only to residents in nursing homes and eldercare centres.

The public can go to ActiveSG Gym@Our Tampines Hub, Care Corner Senior Activity Centre (62B Toa Payoh), Methodist Welfare Services Senior Activity Centre (Fernvale) and St Hilda's Community Services, which will open this year, and Touch Community Wellness Hub and Bishan Community Club next year. Two other locations that already have Gym Tonic will also open to the public - Man Fut Tong-Hoe Yuen Hoe Senior Care Centre next year and Peacehaven Community Hub this year.

Lien Foundation will also select 300 seniors aged 65 and above for free Gym Tonic trials.

Joining fees vary, ranging from less than $10 to $50 a month. Fees for assessment of physical conditions range from $30 to $80.

The programme consists of 12 weeks of strength training using air-powered equipment from Finland. There are nutrition talks and health assessments. The seniors can tap a card on the exercise equipment, which will adjust automatically to accommodate their individual fitness levels. This data is stored in a digital cloud for them to keep track. The 30-minute, twice-a-week sessions aim to increase seniors' muscle mass and make them less frail or prone to frailty.


There are three categories of frailty, as measured by the Fried frailty criteria - frail, pre-frail and robust. Indicators include unintentional weight loss, weakness, exhaustion and slow walking speed. Pre-frail seniors have two or three of these symptoms while robust seniors have none.

Seniors can then stay on for weekly maintenance sessions, just like Madam Lau has been doing for the past five months. "Initially, I had no idea at all what the odd and new equipment I saw in the gym was for. But I just chose to follow my friends who did group gym sessions there and enjoyed it," she said at a press briefing in Care Corner Senior Activity Centre (62B Toa Payoh) yesterday.

"The pain in my hips and legs has gone, and I can fit into the pants I'm wearing today even though I struggled to put them on before."

A study by researchers from the National University of Singapore's Yong Loo Lin School of Medicine showed that half the elderly in Singapore are frail - and frailty comes with risks of depression, cognitive impairment, poor physical functions and premature death.

A study in April of 396 seniors who went through Gym Tonic showed that close to half reversed their frailty or pre-frailty.

Around 2,000 seniors have been actively using the equipment in 21 nursing homes and eldercare centres since Gym Tonic started in 2015. By 2019, about 4,500 seniors will have access to such machines.

The eight locations open to the public will target 1,400 new users.

Exercise as medicine
The Straits Times, 13 Dec 2017

Gym Tonic is an evidence-based, senior-friendly strength-training programme that improves the functional abilities of the elderly with advanced equipment and software.


It uses six air-powered exercise machines from Finland. These focus on strengthening the seniors' core muscle groups, namely their leg, abdomen, chest, abduction, shoulder and upper body muscles.

Being pneumatic, the equipment is gentler on the joints, and more suited for the elderly who are weaker.


There are also smaller resistance weights, from zero resistance to 100g, 200g and so on, whereas commercial gyms usually have weights in kilograms.

The air-powered resistance can thus be tailored to the seniors' needs more gradually.


The gym also collects large troves of data, allowing seniors to motivate themselves by checking on their progress, down to the number of repetitions of exercises they have done. Their progress data is all stored on a digital cloud. The seniors simply use one radio frequency identification card, which they tap on the equipment. The machine then tailors itself to the user's preference, adjusting the power according to their progress and saved data from previous workouts.

The Gym Tonic programme will be offered as a free trial to 300 seniors aged 65 and above. Those interested can sign up at

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