Finland’s population is similar to Singapore’s in size, but the Nordic country has around 13,000 practising physiotherapists, which is 10 times the number that Singapore has. In just 15 years, Singapore will have the same demographic profile as Finland where one in five people are 65 years or older. This will cause a shortage of eldercare within the physiotherapeutic field.
To help make up for the future shortage in Singapore, a new initiative called Gym Tonic is taking place in Singapore at the moment. The purpose of the initiative is to introduce the Exercise-As-Medicine concept into Singapore’s eldercare facilities. It is a partnership between organisations from Singapore and Finland and will be introduced to approximately 13 eldercare facilities. The project will run for a period of 3 years.
One of the many people involved in the project is Annika Wohlstrom, Area Manager SEA at HUR Solutions Pte Ltd. – the Singapore representative for HUR Finland. HUR is a company that manufactures air resistance exercise equipment, and distributes them in over 30 countries. Annika has lived in Singapore for 18 years, and has worked at HUR Solutions for the last 5 years.She’s a physiotherapist herself.
“The machines were actually a result of a study project for sports activists at Helsinki University, not just for elderly,” she says.
Mainstream gym equipment is not really suitable for the elderly because mechanical weights do not provide consistent resistance and smooth control of motion. The equipment that Gym Tonic project will use are air pressure system which is developed in a way that mimics your movements, so it starts easy and becomes harder, whereas the start of a normal training routine is the other way around. This way the muscles build up and you become stronger and stronger.
“That’s why the machines are so good for seniors as well.”
The Gymtonic project is estimated to have about 2000 senior citizens as users in Singapore. Partners and sponsors in the project are Lien Foundation, HUR, Pulsesync, Raisoft and Kokkola University Consortium Chydenius. The project focuses on a broader range of health as it studies exercise as a means to improve emotional, physical and mental health.
Contrary to popular belief, the research shows that physical functions can be improved regardless of age. To achieve this, however, the elderly needs to engage in structured exercise routines focusing on strength training. Regular exercise reduces the likelihood of falls, which is one of the biggest challenges faced in nursing homes. In Singapore, the elderly who require the most healthcare services are the semi-ambulant, wheelchair-bound and bed-bound. Gym Tonic equipment is powered by smart technology that reliably measures the health-related attributes of the elderly – and how they improve over time.
“In the machines we have a performance recorder, and for example when preventing falls, it’s very important to have a good balance, and with the recorder we can find those weaknesses and then know what needs to be worked on,” explains Annika, but also emphasizes that even though the machines are easy to use for people of all ages and disabilities, you need professionals to analyse the outcome and development.
HUR has been in Singapore for more than ten years, and at the moment 25 Singaporean facilities have their machines. In 2013 they did a research project with their partners and their gym equipment in one of the senior centres. The result showed that the elders’ blood pressure dropped together with the need to take blood pressure medication and it showed that physical activity can help slow the process of dementia down and make the seniors less agitated.
“Some of them could also walk without a walking stick after taking part in the exercise program. One of the main reasons for why people end up in a wheelchair is actually the muscle strength. They are not sick, they just become weak,” Annika explains.
According to her, it’s been of a great importance, that research like this has been done in Singapore, to show that not only does the theory apply in Europe, but also in other cultures.
Gyms for the elderly are available in eldercare centres in Finland and other Scandinavian countries, but not in Singapore. The deterioration of elderly people’s health is often perceived as irreversible, or possible to address only through pharmacological interventions.
“Finland has actually been one of the forerunners for eldercare, because we started to rehabilitate early. Here in Singapore family members take care of the elderly at home but in Finland, when the elderly can’t take care of themselves anymore, they are often put in senior homes,” Annika explains. This is also why there’s more focus on the ways to make the elderly in Finland healthier and prevent falls as falls prevention will save money for the government according to Annika.
She believes that the Gym Tonic Program is creating awareness, and will help to overcome the prejudice that the elderly are too weak to do strength training. The program will run for the next three years, and will see both Singaporean physiotherapists going to Finland for training and Finnish physiotherapists coming to Singapore to observe and do tests. Annika and the rest of the people involved hope to reach some specific conclusions that will help further the development of the eldercare in Singapore: “Are they walking better now? Do they take less medication? Are they more independent?”
Physical inactivity is the fourth-biggest factor contributing to deaths globally, according to the World Health Organisation.