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COVID-19 series: The importance of exercise during a pandemic

In the coming weeks, we will be profiling COVID-19 work and expertise from Djavad Mowafaghian Centre for Brain Health members. Our second story is about the importance of exercise, with expertise from DMCBH researcher Dr. Teresa Liu-Ambrose, Director of the Aging, Mobility, and Cognitive Neuroscience Lab. The second part of this story highlights the BC Brain Wellness Program, a unique Program offered in partnership with the DMCBH. 

It’s no secret that exercise is good for our brain health. But during the times of COVID-19, when gyms are closed and it can be difficult to get those steps in for the day, the irony is that perhaps exercise is more important than ever.

“Right now, people are in need of strategies to reduce stress and anxiety, which is where I think exercise is really beneficial,” says Dr. Teresa Liu-Ambrose, Director of the Aging, Mobility, and Cognitive Neuroscience Lab housed in the Djavad Mowafaghian Centre for Brain Health. “Regular exercise promotes mood, sleep and physical health, and is highly effective in managing chronic conditions such as diabetes. Engagement in regular exercise also gives people a sense of daily achievement.”

Dr. Liu-Ambrose’s research focuses on the impact of exercise on cognitive health. Her laboratory runs many different types of studies and recruits participants who are between the ages of 55 to mid-90s. Before COVID-19, one of their studies was comparing the effects of aerobic training versus strength training on cognition and brain health.

“Despite the fact that we largely accept the notion that exercise as a whole is beneficial for brain health, we don’t fully appreciate the impacts of different types of exercise,” explains Dr. Liu-Ambrose. “A better understanding will lead to more precise exercise recommendations.”

In this study, participants were allocated to either strength training, aerobic training or both, and were compared to a lower intensity stretch and balance group. Participants would attend classes up to four times a week for up to a year at VGH, where they were led through exercises by Dr. Liu-Ambrose’s team.

When research curtailment hit UBC in March, Dr. Liu-Ambrose and her team had to quickly find ways of encouraging people to continue exercising at home so that long-term data wouldn’t be lost. For the past 10 weeks, they’ve been providing small exercise equipment to participants and working with them via manuals, custom-made videos and phone calls. Soon, they will be offering online exercise classes and providing the necessary technology so that everyone can take part. Participants will also be receiving wearables as a way to better monitor their exercise intensity.

“We had to quickly learn how to remotely deliver exercise programming that mirrored in-person classes, and at the same time, we needed to ensure people remained safe while doing the exercises,” says Dr. Liu Ambrose.

The team set up calls to check in on participants, so if someone was supposed to come in twice a week, they receive a call twice a week. During these calls, exercises are reviewed in detail and the team answers any questions participants have. They are also asked about any barriers to exercise, like small spaces, so Dr. Liu-Ambrose’s team can work with them to find a solution. 

“People have been great—they really welcome the phone calls and the support quite a bit,”says Dr. Liu-Ambrose. “Many have said they really appreciate the efforts we have made to continue to keep them active and exercising.”

Denis McClure is a participant in one of Dr. Liu-Ambrose’s ongoing studies. At 72, McClure says he used to be very active, but hit a roadblock five years ago when the arthritis in his hands made it difficult to workout at the gym. This is the third exercise study he’s participated in, and he says that in many ways, he’s enjoyed the transition to at-home workouts.

“Working out from home saves me a lot of time because I don’t have to take the bus to the hospital and back,” he says. “I feel committed to the [study program’s] schedule, and the exercises are something I’ll keep doing in the long run because now I know I can do them at home.”

Cecile Lo is another study participant who says being able to do exercises at home during COVID-19 has helped her maintain a daily routine.  

“It gives me a sort of anchor point and because I’m doing different exercises on different days and because they call to check in on me, it helps me keep track of what day it is and what my goals are for the day,” says Lo.

For those who aren’t part of a research study and might be finding it hard to come up with creative ways of exercising at home, Dr. Liu-Ambrose says even a small amount of physical activity in the form of a hobby is helpful.

“You don’t need to be doing something very prescribed like going for a 30-minute run every day,” she says. “Even doing a bit of yard work or some balcony cleanup is beneficial.”


 

A unique program run out of the Djavad Mowafaghian Centre for Brain Health is finding creative ways of keeping people active during the times of COVID-19. The BC Brain Wellness Program launched last year and offers classes as a way to support and encourage brain wellness with lifestyle choices, one of which is exercise. The classes are intended for the healthy aging as well as those who access clinics at the DMCBH.

Prior to the global pandemic, people interested in exercise classes could simply sign up online for an individual assessment before being placed in an appropriate group. They would then come to UBC a few times a week for a one-hour class that worked on different aspects of fitness, ranging from cardiovascular fitness to strength training to weight resistance and balance exercises. The classes also incorporated cognitive tasks and challenges, such as counting backwards in 3’s while doing an exercise, as each class was meant to be both physically and mentally challenging.

In March, when in-group meet-ups were no longer possible, the program adapted and started offering exercise classes online. Today, there are more than 50 participants spread across six different classes held throughout the week.

“In the short gap where we were transitioning from in-person classes to Zoom classes, a lot of people were saying they felt quite isolated and were struggling to organize their day,” says Sally Stelling (pictured), a physiotherapist who leads the BC Brain Wellness exercise classes. “Having a regular virtual class puts structure in people’s day and helps keep them motivated.”

Stelling says the social aspect of the exercise classes is also very important. In some ways this is more challenging over a screen, but for some participants, these classes are their only daily social interactions.

“At the end of every class we go around and check in with each person as a group just to see how they’re doing and chit chat a bit,” says Stelling. “People will often say, ‘It’s so good to hear your voice and see your face!’”

Stelling hasbeen incorporating new aspects to the program since moving it online, including the creation of a Facebook group where she posts exercise videos. She’s also been doing one-on-one consults when necessary, for example if someone feels they’re struggling with certain exercises, and has recruited physiotherapy and kinesiology students to join in on the classes to keep an eye on participants and offer support if needed.  

Stelling says COVID-19 has proven it’s possible to run exercise classes virtually, which could allow the program to expand well beyond the boarder of UBC.

“Once we are able to go back to in-person classes, it’s clear that we’ll need to continue to support the wider community with virtual classes,” says Stelling. “Work commitments, transit, parking fees and geographic location make online classes a preferable option for many. While we might lose a degree of connection over Zoom and in-person classes tend to be preferable for instructors, we’ve learned that online classes are a pretty good second best.”  

Dr. Liu-Ambrose's team is still recruiting participants! If you're interested in joining an exercise research study, please email cogmob.research@hiphealth.ca

The BC Brain Wellness Program is open to everyone and you can simply register for any class that interests you by visiting their website. All programs are offered free of charge. For any questions, please reach out to brain.wellness@ubc.ca