Dual Tasking Exercise

Michael Hughes 00:07
Hello, and welcome to The Art of Aging, which is part of the Abundant Aging Podcast Series for United Church Homes. On this show, we look at what it means to age in America and other places around the world with positive and empowering conversations that challenge, encourage and inspire, oh, to age with abundance. And this is part of this is our this is part of our aging innovators series. And we’re back with Eric Levitin, founder and CEO of Vivo, which is an innovative online exercise company. I wrote that I don’t want to say that five times fast but innovative online exercise company that combines cognitive exercises and physical exercises. So exercise and brain games. I know that’s oversimplifying, Eric, I’m sorry about that. But welcome, welcome again. And it’s great to have you here.

Eric Levitan 00:49
Thanks so much, Mike, I appreciate the opportunity. Before we get started, we’re

Michael Hughes 00:52
going to do a disclaimer, we’re talking about exercise. And we’re also talking about exercising as you age. And before starting or modifying any exercise program, I’m going to ask you to check with your doctor, check your medical professional, before you start anything of that sort. So now that the legal stuff is out of the way, the subject for today is this world of what we call dual tasking exercise. I know that’s something that is a cornerstone of vivo. It’s an interesting concept. It’s a concept that was new to me, combining cognitive and physical. So I want to get into that as a subject. But you know, on previous episodes, you’ve shared a little bit about your background, how you come to found vivo, what was the most surprising thing though just it now that you’re in now that you’re actually running vivo is up and running, it’s growing a terrific NIH grant, what is the thing that’s really surprised you the most about running the company that so far, the biggest

Eric Levitan 01:47
The surprise that I’ve taken away is the stickiness of what we’ve created. And it’s very relevant for this conversation. And it’s all about this live and interactive experience with a small group, where we’re leaning into this social engagement. And it’s funny we built in and I know we’ll talk more about what dual tests exercises are. We built this in really to promote cognitive and brain health, and really focus on the science that’s evolving around that. But the amazing side effect is, we’re getting people talking, we’re getting people talking in small groups, which facilitates this opportunity to have social connection. And the social connection is driving accountability to the group, which is creating behavioral change. It’s very, very virtuous. It is this really wonderful thing. And when I first created this business, I knew there were two core challenges that we needed to solve. One was, how do we get people to try it? And the other is, how do we get people to stick with it. And I really thought that getting people to stick with it was going to be the true challenge of this business. And what we found is getting people to stick with it has been the natural outcome of these dual test exercises, and this live interactive, small group

Michael Hughes 03:01
and enliven interactive small groups. But on line two, we’re not talking about meeting you know, in a, you know, in a rec center somewhere, we’re talking about people building community, in small groups on

Eric Levitan 03:11
That’s right. And you know, it’s funny, I obviously, I talked about this a lot with people. And really, I would never say that being online is better than being in person, right? Being in person carries with it so much more from a communication and connection perspective. However, being in person also carries with it a lot of other things that sometimes make being in person not possible, whether it’s comfort in driving, traffic, whether worrying about what you look like, there are so many barriers that sometimes get in the way from people participating in person, that it actually doesn’t happen. And participating online, especially in a small group that you can really lead and facilitate that connection. A lot of those barriers go away. So I would never argue that being online is better than being in person. In some ways, it’s just a lot easier, it’s a lot easier to engage. And therefore, it kind of is just as good. Because, you know, again, engaging online, as opposed to not doing anything is absolutely better. And that’s what we’re seeing over and over again, is these communities that are cropping up within our program. Well, people

Michael Hughes 04:19
that are excited about it, and then people see if you’re seeing results and all that, you know, it’s motivating. And then you have this concept of dual tasks. And I’ve been excited to talk to you about dual tasking exercises for a while. But tell our listeners what this is. This is about I mean, is this. Is this a trend? Has this been around for a while? What is it? How did you come? Sure. So we’ll see I told you I asked five questions at once No, I

Eric Levitan 04:43
so you’re just keeping that consistency. I love it. So, dual task exercising, as a general concept is really all about as it relates to fitness is all about the simultaneous physical movement and cognitive recall. And we really saw it all a lot in programs for neurocognitive disorders like Parkinson’s, dementia, etc. If you know someone who has Parkinson’s, you may have seen boxing programs that are out there. And boxing programs do a couple things, they really work on balance and agility and movement and promote, you know, good fiscal health. But there’s also this cognitive component where they actually teach you, they associate numbers with punches. And so anything as in just give a little bit of a window into this, anything with an odd number might be your left hand anything with an even number, your right hand, and a number one might be a left jab and a number two is a right jab. And number three is a left hook. And a number four is a right hook. And they’ll teach the participants these associations between numbers and punches. And then they’ll call out numbers and they’ll say 124. And you have to remember, one is a left jab, two is a right jab, and four is a right hook. And that association is a dual task exercise, you’re recalling this information that you’ve been taught while you’re controlling the physical movement of your body. And we really took that concept. And there’s been a lot of science, especially over the last 10 years around how beneficial this is in delaying the progression, especially of cognitive disease of mild cognitive impairment, Alzheimer’s, dementia, etc. And that exercise alone is probably one of the single best things you can do to prevent cognitive decline. But incorporating these dual tests exercises, again, there’s a growing body of evidence that it is a really effective tool at delaying the progression of these cognitive disorders. And so we’ve learned very much that one of our scientific advisors works in the Department of Neurology at the Emory School of Medicine, and studies brain health and exercise for a living. And he really worked with us to incorporate this concept into our program. We do it in every single class throughout the class. I’ll give a very real world example because I had vivo this morning. With that I do with my mom. And this is what our dual test today was, is while we were going through a warm up circuit, their trainer actually read a story. And it was a very basic story about two friends, what their names were, how long they’ve been friends, where they live, what their hobbies are, what they enjoy doing together. And for the rest of the class, they would ask us questions about that story. And it’s really a kind of a silly thing to maybe imagine. But here’s what happens. A, you’re trying to recall this information that you just learned while you’re moving. It’s a lot harder than it sounds. But everyone starts laughing. It’s silly, it’s fun, it becomes this kind of collaborative exercise, because of course, no one can remember the names of these individuals or what their hobbies were, so you begin to crowdsource it. And what ends up happening is, before you know it, we’re having this very socially connected experience, this shared experience that is really driven by this dual task exercise, that also happens to be really beneficial for our body and our mind. And that’s just one small example. The other thing that really becomes even more meaningful is to ask people questions about themselves. Another moment that really sticks out in my mind as a wonderful example of this is, we just came back from the holidays earlier this year, in January. And the trainer asked us all while we were going through this warm up circuit, describe the most in as much detail as possible, describe the most delicious thing you ate for your holiday meal. And the very first person went and talked about the cranberry sauce that she ate at her Christmas dinner. And for the next 45 minutes or classes or 45 minutes. For the next 45 minutes. The whole class broke into two camps, people that thought cranberry sauce was delicious. And people who thought cranberry sauce was disgusting. And it was this wonderful social moment that again, it created this real connection that culminated with people texting, cranberry sauce recipes to each other after the class, right? So this community extends outside of the vivo class now, but it was this wonderful example of the kind of social connection you can provide when you prompt with these kinds of brain games and these dual task exercises.

Michael Hughes 09:15
Yeah, I mean, I just didn’t know I could play on so many different levels, you know, so on our last episode, we talked about the elements of an exercise program where it’s consistent that you have to be able to do it. You want everyone to do you know twice a week you know, challenge of eight to 12 reps, the last couple of reps should be hard, you know, variation mixing it up, like you’re just describing, and then and then commute with fun with the community. You know, and that’s just fascinating. And by the way, I just want to you know, I know that at least in the world, it my experience with the world of aging I know that you know outside of cognitive decline, loss of balance while you know falls that’s probably the number one number two fear of anyone who’s experiencing you know, functional limitations your body begins to disappoint you, you know, think things like that. So, fear of cognitive decline, fear of falling, you know, you’re kind of hitting them both here with the dual tasking exercise. But I don’t know, what do you mean? Is there any sort of scientific basis and how it works? Or why do people think that this is this?

Eric Levitan 10:19
Yeah, there’s a ton of evidence around this. And there continued to be more and more studies. And I just read a meta analysis where they go out, and they look at all the existing literature and kind of combine it together. And literally, it’s, it’s multiplying by the day, in terms of the organizations that are really focusing and studying this. And it continues to paint this very wonderful picture around improved cognition, improved balance, and improved function. And an even improved lower body strength, when you’re going through a dedicated strength training program that’s incorporating dual test exercises like vivo is. And so you know, you touched upon bounce bounce is a wonderful example. A lot of people think that falls happen as just this kind of natural course of walking. And it’s funny, there’s a couple of really significant reasons that falls happen. One of them is that we’re moving through a plane of space, and something distracts us. And we turn our heads, and we don’t see that we’re about to step up onto a curb or a carpet lip. That’s an actual dual task in real life that’s happening that’s causing us to fall. And the more that we practice this, the more that we are trained for this, the better we can adapt to that changing environment. Because we live in a changing environment, right? And the more that we are out there in the world, the more that we have to be adept at dealing with these things that happen. And so there’s, again, a lot of research that’s being done. And it is evolving science, by the way. And so I think they’re still learning what the true impact is. But again, it absolutely is, as someone who sees this every day, I not only see it in terms of the scientific literature, I see it in terms of what happens in the classes. And it’s just a wonderful thing to watch. And, you know, it’s funny, we talked about those four kinds of pillars of exercise: consistency, challenge variation, and community or fun. That last one, which we didn’t talk a ton about, but I think is very, you know, important to highlight, as we talk about this topic of dual test exercises, the number one indicator of whether you will stick with an exercise program is how much fun you have. And so we can’t ignore that, right, because you can have the best exercise program in the world, it can lean into all those core pillars, all those core principles, if it’s not fun, you will not do it. And so fun doesn’t mean the same thing for everybody. But again, for a lot of us fun really has to do with connecting with other human beings and having this be accountable to groups. And so this concept of dual task exercises really facilitates that experience within a vivo class.

Michael Hughes 13:03
That’s terrific, you know, and I’m just thinking also back to this concept of variation when you’re because, you know, if you’re talking about an exercise program, that is the same exercise program every single time and all that your body just kind of kind of goes on autopilot, right. But that’s not how the real world works, right? I mean, the real world is all full of different variations and surprises, and this and that. So bringing that into an exercise program is what I guess it mimics.

Eric Levitan 13:27
Absolutely. And even from a dual task exercise perspective. So some very common dual task exercises, as they’ll have someone from the scientific literature, they’ll have someone, you know, performing a physical exercise and counting backwards from 100 by seven. Again, if you do that only, over and over again, you’re not kind of creating that level of variation, that level of challenge. And that’s what we really try to lean into is incorporating that not only into the physical aspect of what we’re doing, but into the dual task element of what we’re doing and the cognitive element by constantly challenging the brain through variation. And this concept of periodization.

Michael Hughes 14:10
I love the example of counting back from 100 by sevens and all that, and I’m not, you know, for someone that may want to kind of try this out or try this at home. I mean, we can approximate a vivo class or whatever. But are there a couple of fun things that maybe folks can put into their exercise program that may give them a kind of insight into what dual tasking exercise? Yeah, absolutely. are really the experience of dual tasking extra sure.

Eric Levitan 14:32
And ultimately, by the way, we didn’t even really talk about some of the benefits outside of balancing and just kind of generically talking about cognitive health. It’s really about executive function. And that’s one of the in the frontal lobe of the brain. And that’s really where you see the most activity. And so to bring this into your own program, there’s different things that you can do and there’s different ways that we’ve leaned into incorporating this part of it is, is visual and So having, it may be something like a clock drill, where you can have prompts where the time, and you do a lunge back to that time. So if it’s five o’clock, you’ll take your back leg back to do a lunge, like it’s the big hand right at five o’clock, or actually the small hand sorry. Or if it’s 12 o’clock, you lunge forward into the 12 o’clock position, right? That’s one example. There’s also colors you can incorporate, will often bring this will do this in vivo classes, you can do this yourself will have four different colored sheets of paper. And when an exercise is time to do an exercise, you’ll actually incorporate that different color that is different. So if we’re doing push ups, then you go over by the red. And that’s your cue, that’s your visual cue. We do boxing, this is another wonderful thing, where we associate activities with numbers, and then basically create a list of numbers and try to recall what that what that is, we do the standard, like, Oh, I’m going on a picnic, and I’m bringing an apple, and then the next person goes, I’m bringing an apple and I’m bringing in a banana, right? Anything that starts to test your memory, and that ability to recall information are things that you can bring in for yourself, as you’re planning out what this exercise program looks like for you.

Michael Hughes 16:18
It’s just fascinating. And I know we can talk a lot about this. And, you know, it’s been what has excited you the most, as you’ve seen this be this get used and applied and all that I mean, what’s, you know, obviously, you’re getting up every day raring to go and wanting to see the next page of the book. But what’s been sort of the most satisfying part,

Eric Levitan 16:39
The most satisfying part of this is seeing the outcomes that we see and the longevity of people participating in this program. And those two, by the way, go hand in hand, right. So we certainly see wonderful results at the two month mark, again, we’re measuring outcomes, we’re measuring progress as a part of what we’re doing. So we see data on everybody and everyone. 100% of people that join this program show improvement between baseline, and two months. We’ve never had anybody who did not get stronger in the first few months. It’s not rocket science. It turns out if you consistently strength train, you get stronger, who knows.

Michael Hughes 17:12
And you can build muscle and flexibility and every, for you as against yourself, you can build that.

Eric Levitan 17:21
We have customers that are in their 90s, we have customers in their 40s. And everything in between. And there is no capacity, there is no limit to the point that you can engage in a program and exercise program generically or vivo, and see those gains. So the more that we collect data, the more we see this really compelling picture on what is possible. And it is fantastic, Mike, it really boggles your mind to know that we’ve got access to probably the single greatest thing that we can do for ourselves. There’s this wonderful quote from a gentleman named Robert Butler, who was the original director for the National Institute on Aging, who said if exercise can be packaged into a pill, it will be the single most widely prescribed medicine in the world. And that is so true. And we’ve known this for so long. Exercise is good for us. There’s nothing new or novel or innovative about that. But how to adopt this into your routine. And seeing what the impact of adopting into your routine is, is really wonderful. And the other side of that is, people continue to do this. It’s blowing me away that this has become such a meaningful part of people’s lives. And it’s because it works. Right? It’s they’re seeing the difference. We can measure it all day long. But if you don’t feel it yourself, then it doesn’t necessarily resonate. But people are doing things they couldn’t do before. The other wonderful thing that we hadn’t really talked about yet in this series of podcasts are the health benefits of strength training go beyond disease management, disease prevention, what we tend to see when people engage in a program like the thought, or a fitness program, or specifically a strength program, is you get better quality sleep, people tend to lose weight, you lose you drop blood pressure, your cholesterol goes down, your mood improves all these wonderful intangibles that happen as a result of engaging consistently in a fitness program, and specifically a program like vivo that’s focused on building strength. You see all these wonderful ancillary benefits that go beyond just fall prevention and type two diabetes management.

Michael Hughes 19:24
Well, Eric, that is a great place to end it. This three part series we’ve got with you. And we’ve got a you know that we always like to end with kind of a question about your personal reflections on aging. But before we do that, where can we find

Eric Levitan 19:36
you can find us at Team vivo.com That’s t a M like you’re a part of a team vivo vi vo.com. We believe that when you join this program, you are becoming a part of a team. We are all in this together. This is a very judgment free zone. We all are moving towards the same goal, which is to maximize our quality of life and independence as we get older. And that’s what we’re all about.

Michael Hughes 19:58
That’s awesome too. So team vivo Docker on. And now for our mystery question about aging. So all right, what has surprised you the most about yourself as you’ve aged?

Eric Levitan 20:10
What has surprised me the most is how inquisitive I have become about the world around me, I think. And this might be something that is not so surprising, we all may be experienced to a certain extent. But I had become fascinated by things that I never thought I’d be interested in. And I think part of it is just that maturity, and learning more about the world around us. But it’s really sparked something in me that’s created this drive toward more and more. And I don’t think I had this level of curiosity, when I certainly didn’t have it as a teenager, I’m pretty sure I didn’t have it in my 20s. But as I’ve gotten older, and especially as I’ve gotten into my 50s, I have this thirst for knowledge, and deep knowledge that I’m just shocked by how much research I do, how deep I go, and how interesting it is, to me and things like history that I never I can remember going to I’m a I’m an alumni of Duke University, you can opt out of different paths. And in order to get your degree, and I opted out of history. That was one of the topics that I had no interest in at all. And now it’s like the most fascinating thing in the world. And so it’s just this wonderful kind of awareness of how inquisitive I’ve become as I’ve gotten older. Yeah,

Michael Hughes 21:28
You know, I wanted to shout out to my neighbor, Jenny, who wouldn’t mind me saying that she’s in her mid 80s. And she has a bumper sticker on the car that says, curiosity never retires. And I just think that’s such a wonderful, wonderful sentiment. Yeah. Well, Eric, thank you very much for being such a wonderful guest on the show. And listeners. Thank you for listening to the show. You have been listening to the Art of Aging, which is part of the abundant aging podcast series for United Church homes. And we want to hear from you. What’s changed about you that you like as you age? What has surprised you the most? What do you think about exercise? As you grow older, you know, give us all your thoughts. We’re at abundantagingpodcast.com You can also find us on youtube under United Church Homes. And you can also find us on the web at UnitedChurchHomes.org. You also will want to take a special look at the Ruth Frost Parker center for abundant aging which can be found at UnitedChurchhomes.org. And just a reminder, you can find Eric and his gang team teamvivo.com Thanks, everyone for listening. We’ll see you next time.