Four-Way Neck
Weak neck extensor muscles result in a forward and downward head position that makes it more difficult to eat, drink, talk, and see. Strengthening the neck extensor muscles on the Nauitlus Four-Way Neck machine enables participants to hold their heads erect, which typically eliminates these problems.

To ensure front-to-back muscle balance, the neck flexor muscles are also trained on the Nautilus Four-Way Neck machine. Strong neck flexor muscles make it easier to turn the head from side to side.

Results
Before and after the 14-week training period I traveled to Orange City, Florida to assess the research program participants. The physical changes that they achieved from 12 minutes of strength exercise a week were nothing short of amazing. As you will note in the accompanying table, these elderly nursing home patients added about 4 pounds of muscle and lost about 3 pounds of fat, for a 7-pound improvement in their body composition. They increased their lower body strength by over 80 percent and their upper body strength by almost 40 percent. In addition, they improved their hip flexibility by 50 percent and their shoulder flexibility by 10 percent.

Perhaps more important, these impressive physiological improvements resulted in greater functional capacity for the activities of daily living, thereby enhancing the patients quality of life. For example, their Functional Independence Measurement (FIM) score increased by 11 points, their mobility distance increased by 87 feet, and their falling rate decreased by 36 percent.

These functional improvements made life better for the patients, reduced cost of care, and positively impacted the professional staff. Consider that the 11-point increase in FIM score should result in a $38,000 cost of care reduction for these 19 patients over the course of a year. Consider also the following comments by the John Knox Village medical practitioners and administrators regarding the strength training program.

Dr. Pradeep Mathur, Medical Director
"The program participants exhibited better physical and mental fitness, more endurance and less low back pain."

Mr. Gary Brcka, Assisted Living Administrator
"Residents have shown notable improvements in gait, stability and stamina."

Ms. Carol Sullivan, Director of Nursing
"With more muscle strength, some patients could spend less time in wheelchairs, and one resident no longer needed a wheelchair after completing the strength training program."

Ms. Carol Ann McGovern, Director of Health Care Services
"The strength training program received positive feedback from the patients, therapists, and nurses who participated in the study."

Ms. Donna Califano, Physical Therapy Assistant
"The patients enjoyed doing the strength exercise because they felt they were really working and seeing progress as their weightloads increased."

Conclusion
Based on the results of this study, the excellent research conducted at Tufts University, and many years of working with senior exercisers at the YMCA, it is clear to me that older adults of all ages and ability levels can benefit from a simple program of strength exercise. I also believe the senior living facilities should provide supervised strength training programs to increase residents' physical fitness and functional capacity, and to decrease patient cost of care.