Sensory losses, particularly those affecting vision and hearing, are common among older adults and can have a profound impact on their ability to participate safely and effectively in chair-based exercise classes. As health professionals and exercise instructors, it is essential to recognise how these impairments may influence engagement, safety, and overall experience, and to adapt your teaching methods accordingly.
Visual impairment: Challenges and adaptations
Visual impairment encompasses a spectrum, from total blindness to partial sight, where individuals may perceive shapes, light, or colours but have difficulty with clarity. Common symptoms include reduced visual acuity, loss of visual field (such as central vision loss in macular degeneration or peripheral vision loss in glaucoma), impaired depth perception, and changes in colour or contrast sensitivity. These challenges can lead to difficulties with balance and an increased risk of falls, even in a seated exercise environment.
For participants with visual impairments, clear and detailed verbal instructions are essential. Describe body positioning, movement patterns, and the layout of the environment in a step-by-step manner. Where appropriate and with consent, tactile guidance can help participants understand specific movements. Ensure the exercise space is free from obstacles, with clear pathways and consistent, glare-free lighting to minimise hazards. Avoid exercises that require rapid changes in direction or complex navigation, as these can be disorienting. Positioning visually impaired participants close to the instructor can also help them benefit from auditory cues and guidance.
Hearing impairment: Communication and safety
Hearing loss may be partial or total and can be classified as conductive (affecting the outer or middle ear) or sensorineural (involving the inner ear or auditory nerve). Sensorineural hearing loss is often permanent and may also affect balance. Hearing impairment can make communication challenging, reduce spatial awareness, and increase the risk of falls or injuries.
To support participants with hearing loss, rely on clear visual communication. Demonstrate exercises from multiple angles and supplement instructions with non-verbal cues, such as hand signals or written prompts. Good lighting is essential to facilitate lip-reading and the interpretation of visual cues. Reduce background noise as much as possible to help participants focus on your instructions. Establish a consistent method to gain attention before giving instructions, such as a gentle tap on the shoulder or a visual signal, to ensure everyone is ready to follow along.
Practical tips for instructors
Foster an inclusive environment: Creating an inclusive environment begins with building trust and openness within your class. Encourage participants to share information about their sensory needs, preferences, and any challenges they may face. This can be achieved by regularly inviting feedback, both in group discussions and one-to-one conversations, and by reassuring participants that their input is valued and confidential. Use inclusive language and ensure that everyone feels respected and heard. Establishing clear ground rules for communication and behaviour can help foster a sense of belonging and safety, making it more likely that individuals will disclose their needs and participate fully.
Use multi-sensory teaching methods: To accommodate a range of sensory abilities, integrate multiple teaching modalities into your instruction. Combine clear verbal explanations with visual demonstrations, ensuring that movements are shown from different angles and at a slow, deliberate pace. Where appropriate, use tactile cues, such as guiding a participant’s hand or providing textured objects to help them understand movement patterns. Written instructions or visual aids, such as diagrams or cue cards, can also be helpful. This approach ensures that if one sensory channel is limited, others can compensate, making the class more accessible and engaging for everyone.
Check understanding regularly: It is important to pause at intervals during the class to check that all participants have understood the instructions. Ask open-ended questions or invite participants to repeat or demonstrate the movement. This not only clarifies understanding but also gives you the opportunity to provide individual support where needed. Encourage participants to signal if they are unsure or need further explanation, and be patient in responding to questions. Regularly checking understanding helps prevent confusion and reduces the risk of injury or disengagement.
Adapt the pace: Allowing extra time for transitions between exercises is essential, especially for those with sensory impairments who may need longer to process instructions or adjust their position. Avoid rushing through activities, and be mindful of the group’s overall pace. If necessary, break down complex movements into smaller, manageable steps and provide additional practice time. This approach helps ensure that all participants can follow along safely and confidently, without feeling pressured or left behind.
Promote peer support: Encourage participants to work together and support each other during the class. Pairing individuals can be particularly beneficial, as peers can offer guidance, repeat instructions, or provide reassurance. This not only fosters a sense of community but also helps participants feel less isolated in managing their sensory challenges. Peer support can be formal, such as assigning exercise buddies, or informal, by encouraging a culture of mutual assistance and encouragement.
Monitor for signs of difficulty: Remain vigilant for any signs that a participant is struggling, such as confusion, hesitation, or visible distress. These may indicate that instructions have not been understood or that the participant is experiencing discomfort or anxiety. If you notice these signs, discreetly check in with the individual and offer modifications or additional support as needed. Being proactive in identifying and addressing difficulties helps maintain safety and ensures that everyone can participate to the best of their ability.
By understanding the impact of sensory losses and implementing these practical strategies, you can help ensure that all participants are able to engage safely, confidently, and effectively in chair-based exercise classes. This not only reduces risk but also enhances the enjoyment and health benefits of physical activity for everyone involved.
