balance & cognition

Week 13

The CogworxABC activity program provides all the instructional material needed to facilitate each weekly activity session. With your first eight week installment of the program we highly encourage that you first read through the content presented in the PDF’s and PPT’s to familiarize yourself with the activity descriptions, procedures, and materials. Subsequent sessions are delivered in four week installments.

Normal preparation for a weekly session takes less than thirty minutes to complete. This includes:
a) Reviewing of the session’s exercises, drills and PowerPoints (PPT’s)
b) Viewing accompanying video tutorials
c) Printing text from the PDF’s
d) Organizing PPT’s
e) Downloading of music

LET'S START

WEEKLY PREPARATION

Equipment Needed: 
PowerPoint Display – Laptop, Television or an A/V system
Music – Laptop/ Smartphone and speaker

Material Needed:
36 inch yardstick
Music as needed for #9 and #16

Review:
Review Activity Room Set-Up
Review Balance & Cognition Session Format
Open and print the CogworxABC Week 13 Session PDF

01.
Day/Date

Write in the Day and Date of the session onto your session document.

02.
Days/Weeks Used – Days/Weeks Left /

Open the Days used/Days left year PDF.
a. Write in the Days used/Days left onto your session document.

03.
Joke du Jour
Stevie Wonder and Tiger Woods meet at a fund raiser. Woods turns to Wonder and says, “How is the singing career going?” Stevie Wonder replies, “Not too bad! How’s the golf?” Wood replies, “Not too bad, I’ve had some problems with my swing, but I think I’ve got that right now.” Stevie Wonder says, “I always find that when my swing goes wrong, I need to stop playing for a while and not think about it. Then, the next time I play, it seems to be all right.” Tiger Woods says, “You play golf?” Stevie Wonder says, “Oh yes, I’ve been playing for years.” Woods says, “But you’re blind. How can you play golf if you’re blind?” Wonder replies, “I get my caddy to stand in the middle of the fairway and call to me. I listen for the sound of his voice and play the ball towards him. Then, when I get to where the ball lands, the caddy moves to the green or farther down the fairway and again I play the ball towards his voice.” “But, how do you putt? Asks Woods. “Well,” says Stevie, I get my caddy to lean down in front of the hole and calls to me with his head on the ground and I just play the ball toward his voice.” Woods asks, “What’s your handicap?” Stevie says “Well, I’m a scratch golfer.” Woods, incredulous says to Stevie, “We’ve got to play a round sometime.” Wonder replies, “Well, people don’t take me seriously, so I only play for money, and I never play for less than $10,000 a hole”, Woods thinks about it and says, “Ok, I’m game for that, when would you like to play?” Stevie says, “Pick a night.”
04.
History Trivia

Open the History Trivia One Year PDF.
a. Read the History Trivia description.
b. Print the page(s) of the History Trivia information for the session date.
c. Read all history items of the day to your class.

05.
Deep Breathing Exercise #5: Neck Rotation Breathing

If needed review: Deep Breathing PDF

  1. Follow the deep breathing procedure steps.
  2. Guide the participants with their inhaling and exhaling by providing verbal prompts.
  3. Have the participants fold their arms across the chest.
  4. Tell the participants that they will be turning their head while inhaling and exhaling upon returning to center. Also physically demonstrate by moving your head in a slow manner while you are describing the process.
  5. Mention the importance of keeping our necks strong and flexible for proper balance.
  6. Begin by telling the participant that “we’ll begin by turning our head to the right”.
  7. Then give the prompt of “Let’s smell the roses” and slowly give a four count of “ One and Two and Three and Four”
  8. “Hold” (for two seconds) and remind the participant to stretch their neck muscles.
  9. “Now return to center, One and Two and Three and Four”.
  10. Repeat the breathing cycle five times.
  11. Finish by making a big sigh!

1. Have the participants sit comfortably, being upright with knees bent and feet flat on the ground. Keep shoulders, head and neck relaxed.
2. Place one hand on the upper chest and the other just below the rib cage and above the belly button. This will allow the participant to feel the diaphragm move as they breathe.
3. Use the phrase “Lets smell the roses” to give the participants a cue on initiating the inhalation through the nose. As the participant breathes in slowly through the nose, instruct them to move the stomach out against the hand. The hand on the chest should remain as still as possible.
4. Tighten the stomach muscles, bringing in the belly button toward the spine as the participant exhales slowly through pursed lips. Keep the hand on the upper chest as still as possible.
5. Repeat the breathing cycle five times.
6. When completed, tell the participants to take one more deep breath and to substitute the “exhale” with a big “sigh”. The participant will enjoy this fun form of stress relief!

Deep breathing or diaphragmatic breathing, is a breath that is done by contracting the diaphragm. The diaphragm is the most efficient muscle used for breathing. It is a large, dome-shaped muscle located at the base of the lungs. Using the abdominal muscles help move the diaphragm which gives us more power to fill and empty the lungs. This action also improves core muscle stability. As we inhale, we bring fresh air in and as we exhale we get carbon dioxide and other gases out of the lungs. This helps increase how much oxygen’s in the blood. The brain is very oxygen dependent, using 20% of the body’s oxygen supply. By providing larger amounts of oxygen to the executive center of the brain (frontal cortex), this allows for an increased ability to focus, clarity in thinking and relaxation.

06.
Concentration Drill #1: Yardstick Counting

If needed: Review Concentration Drills PDF

Equipment needed: 36 inch yardstick for each participant (preferably ones with dark lettering for easier viewing)

Description: A cognitive, visual-spatial drill where the participants will be touching a yardstick and recalling sequential number pairs.

 

  1. Have the participants place the yardstick on their lap (or on the arm rests of their chair) with the numbers upright.
  2. Number pair progressions: 18/18,17/19,16/20,15/21,14/22,13/23,12/24,11/25,10/26,9/27,8/28,7/29,6/30,5/31,4/32,3/33,2/34,1/35,0/36
  1. There will be two rotations of the drill.
  2. Facilitator will initiate by verbalizing each number sequence.
  3. With each finger touch, have the participants verbalize the number.
  4. Touch the number 18 with the Right forefinger, then remove it.
  5. Touch the number 18 with the Left forefinger, then remove it.
  6. With each subsequent number pair, continue touching each number to the Left of 18 with the Right forefinger and each number to the Right of 18 with the Left forefinger, removing the finger after each touch.
  7. After completing the first progression (12/24, 6/30 or 0/36) reverse the sequence and return to 18/18.
  8. Second rotation: the participants will not touch the yardstick, but will verbalize each number pair.
  9. Instruct the participants that they may continue to use the yardstick (as a cue) to remember the number pairs.
  10. Progression: encourage the participants to close their eyes during the drill and to mentally think of the next number pair sequence. One helpful cue to tell the participants is that all the number pairs equal to 36.
  11. Print the number pairs from the Drill Appendix document to use as cue tool to assist in facilitating the number pair recall.
07.
Cross-Lateral Drill #1: Ear to Nose Cog. and Bal. PPT’s: Cross- Lateral: Ear to Nose PPT

If needed: Review Cross-Lateral Drills PDF 

Description: A cross-lateral concentration drill where each hand alternately touches the nose and ears.

Material needed: Cross-Lateral: Ear to Nose PPT

  1. Sit tall in the chair with feet flat on the floor.
  2. With the forefinger of the right hand, touch the left ear and hold.
  3. With the forefinger of the left hand, touch the bridge of the nose and hold.
  4. Release the left hand.
  5. Release the right hand.
  6. As a prompt, remind the participants that since the left hand last touched the nose, the left forefinger will now touch the right ear and hold.
  7. With the forefinger of the right hand, touch the bridge of the nose and hold.
  8. Release the right hand.
  9. Release the left hand.
  10. Perform 10 repetitions.
  11. Progression: 1) Discontinue the PPT after 10 repetition. 2) Count out load with the two finger touches and the two releases i.e. 1,2,3,4. 3) Perform with eyes closed.
08.
Standing Exercise #1: Sit-to-Stand

If needed: Review Standing Exercises PDF

Repeat proper technique before allowing the participants to stand anytime.

Description: The sit to stand movement is an excellent exercise for leg strengthening and its proper form is crucial in the safe transition from sitting to standing.

 

  1. Sit tall in the chair with the feet flat on the floor.
  2. Move the hips forward approximately 6 inches.
  3. Bring toes beneath the knees.
  4. Have feet pointed forward and at hip width.
  5. Position the chin parallel to the floor.
  6. Depending upon the conditioning level of the participant they may utilize one of the following arm positions in order of diff A) Hands placed on arm rests. B) Hands placed on thighs. C) Arms positioned outstretched in front of body. D) Arms positioned across the chest.
  7. Slight forward bend at the waist bringing the chin over the balls of the feet.
  8. With the eyes looking forward, stand straight up to the ceiling.
09.
Toe Tapping Activity

If needed: Review Toe Tapping PDF

  1. Have the participants take a deep breath before the exercise with a reminder to breathe throughout the activity.
  2. Begin by having the participants stand behind their chair utilizing the “piano touch” technique (where the fingers are lightly touching the top of the chair).
  3. The participants are reminded to begin the activity by placing their weight on their left leg and to keep the leg slightly flexed as to not “lock” the knee as in keeping the knees “soft”.
  4. Emphasize the point that left leg (weight bearing leg) remains still while the right leg moves in the direction of the arrows.
  5. Demonstrate the toe tapping action by moving of the foot upward and downward (flexion and extension). Encourage the participants to tap with their toes and not with their whole foot.
  6. A series of diagrams consisting of Arrows and X’s are shown for a duration of 30 seconds to allow for equal attention to the leg strengthening component of the activity for each leg.
  7. Facilitator: Keep time and advance the PPT slide every 30 seconds, in addition to verbally prompting the participants to change to the other foot.
  8. The diagrams are used as prompts for the participants to toe tap to the X’s and to move the leg in direction of the arrows to the beat of the music.
  9. Remind the participants not to look at their feet, but to keep looking at the diagrams.
  10. Between each diagram another slide is presented that tells the participant to switch legs by shifting their weight to the opposite leg and to toe tap with the other foot.
  11. When switching feet, also provide a verbal cue to allow the brain and body to reset.
  12. Time approximately 30 seconds per slide.

“Jump, Jive and Wail”, Louis Prima, 1945

10.
Standing Exercise #11: Grounders

If needed: Review Standing Exercises PDF 

Description: A thigh strengthening two legged stance exercise that is easy on the knees.

  1. Have the participants stand behind their chair.
  2. Place feet apart wider than shoulder width.
  3. Keep Left foot pointed forward.
  4. Position the Right foot to where the heel is pointing to the instep of the Left foot.
  5. Place hands on the hips.
  6. Keep head, torso and pelvis facing forward (to the facilitator).
  7. Bend the right knee and “glide” in a straight line.
  8. Bring the right knee no further than to the front of the foot.
  9. Hold for 2-3 seconds.
  10. Return to upright position.
  11. Complete 5-10 repetitions as tolerated.
  12. Repeat with Right foot forward.
  13. Position the Left foot to where the heel is pointing to the instep of the Right foot.
  14. Place hands on the hips.
  15. Keep head, torso and pelvis facing forward (to the facilitator).
  16. Bend the left knee and “glide” in a straight line.
  17. Bring the left knee no further than to the front of the foot.
  18. Hold for 2-3 seconds.
  19. Return to upright position.
  20. Complete 5-10 repetitions as tolerated.
11.
Standing Exercise #10: Leg Stances: R/L- Staggered, Semi-Tandem, Tandem

Description: A progressive series of altered bases of support utilizing a two legged stance.

  1. Have the participants stand to the right of their chair.
  2. Place the left hand on top of the chair using the “piano touch technique” by keeping a light grasp.
  3. Have the participants begin by standing in the neutral position where the feet are pointed forward and are positioned at shoulder width.
  4. Instruct the participants to relax and to take a deep breath.

 

Staggered Split Stance with eyes closed:

  • Slide the Left foot forward so that the heel is even with the toes of the right foot.
  • Shift weight in a forward direction approximately 3-4 inches until the hips are between the heel of the left foot and the toes of the right foot.
  • Instruct the participants to relax and to take a deep breath.
  • Close eyes and hold for 15 seconds.
  • Repeat the split stance with the Right foot forward.

 

Semi-Tandem Stance with head turns:

  • Slide the Left foot directly in front of the right foot where there is 4-5 inches of space between the heel and the toe.
  • Instruct the participants to relax and to take a deep breath.
  • Instruct the participants to lead with their eyes first before turning their head.
  • Turn eyes/head to the right and hold.
  • Return eyes/head to center.
  • Turn eyes/head to the left and hold.
  • Return eyes/head to center.
  • Turn eyes/head upward toward the ceiling and hold.
  • Return eyes/head to center.
  • Turn eyes/head downward to the floor and hold.
  • Return eyes/head to center.
  • Repeat the Semi-Tandem stance with head turns with the Right foot forward.

 

Tandem stance with arm release:

  • Slide the Left foot directly in front of the right foot where the heel and toe are touching.
  • Instruct participants that the Tandem stance is one of the most challenging balance exercises.
  • Instruct the participants to relax and to take a deep breath.
  • When the participants feel comfortable enough, instruct them to lift their left hand from the chair backrest.
  • Count backwards from 10 to 1 as the participants “surf”.
  • Repeat the Tandem stance with the Right foot forward.
12.
Standing Exercise: Stand-to-Sit

If needed: Review Standing Exercises PDF

Repeat the proper technique before allowing the participants to sit anytime.

Description: The Stand-to-Sit movement is the reversal of the Sit-to-Stand exercise. It reinforces the mindset of using ones legs as much as possible in a safe and controlled manner. Utilizing its proper form is crucial in helping the participants keep their legs strong by not “plopping” back into their chair.

  1. Have the participants stand in front of their chair facing forward.
  2. Position both legs so that the edge of the seat is slightly touching the back of both legs.
  3. Have feet pointed forward and at hip width.
  4. Position the chin parallel to the floor.
  5. Depending upon the conditioning level of the participant they may utilize one of the following arm positions A) Arms positioned outstretched in front of body. B) Arms positioned across the chest.
  6. Remind the participants that the chair is directly beneath them and that it is safe.
  7. With the eyes looking forward, engage the core of the body.
  8. Release the knees and “slowly” bring the body to the seat of the chair.
  9. The participants are now in the exact position they would be in to initiate a “Sit-to-Stand”!
13.
Attention: Stroop Test Colors 5 PPT
Language: Word Links PPT
14.
History Trivia Recall: “Who”, “What”, “When”, “Where” or “How”

If needed: Review History Trivia PDF

For the History Trivia Recall activity ask questions that are prefaced with “Who”, “What”, “When” or “Where” or “How”. Whereas some of the trivia items may only lend themselves to one or two questions, you may be able to utilize three or four questions for others. For example: On June 6th, 1944, known as D-Day, 160,000 Allied troops landed on Normandy in Operation Overlord during WWII. You may ask; What happened on June 6th 1944? “When was Operation Overlord? How many troops were involved? Where did the Allies land on D-day?

15.
Standing Exercise #1: Sit-to-Stand

If needed: Review Standing Exercises PDF

Repeat proper technique before allowing the participants to stand anytime.

Description: The sit to stand movement is an excellent exercise for leg strengthening and its proper form is crucial in the safe transition from sitting to standing.

  1. Sit tall in the chair with the feet flat on the floor.
  2. Move the hips forward approximately 6 inches.
  3. Bring toes beneath the knees.
  4. Have feet pointed forward and at hip width.
  5. Position the chin parallel to the floor.
  6. Depending upon the conditioning level of the participant they may utilize one of the following arm positions in order of diff A) Hands placed on arm rests. B) Hands placed on thighs. C) Arms positioned outstretched in front of body. D) Arms positioned across the chest.
  7. Slight forward bend at the waist bringing the chin over the balls of the feet.
  8. With the eyes looking forward, stand straight up to the ceiling.

 

16.
Music Memory Activity

If needed: Review Music Memory Activity

Description: A balance and concentration activity where the participants listen for a specific word or phrase, perform a single leg stance when it occurs then recall the number times they heard the word or phrase at the songs completion.

Equipment: Audio set up for the playing of the song recording.

  1. Have the participants stand to the right of their chair.
  2. Place left hand on the top of the chair and use the “piano touch” by keeping a “light” grip on the chair.
  3. Tell the participants the title of the song, name of the group and date released.
  4. Tell the participants the word or phrase that they will need to listen for (usually the title).
  5. Have the participants perform a single leg stance whenever they hear the selected word or phrase and to hold the leg stance.
  6. When the word or phrase occurs again have the participants change legs.
  7. Let the participants know that if they can’t hold their leg up for the duration, that it’s ok to move the leg to do toe taps.
  8. At the completion of the song have the participants verbalize how many times they heard the selected word or phrase.

“Please No Squeeze da Bananas” (10) Louis Prima, 1945