Interview with Dr. Becca Jordre of the University of South Dakota

Dr. Jordre is an associate professor of Physical Therapy in the School of Health Sciences at the University of South Dakota (USD). She received her Doctor of Physical Therapy (DPT) degree from Duke University’s School of Medicine in 2002. She is a board-certified clinical specialist in Geriatric Physical Therapy and a Certified Exercise Expert for Aging Adults through the American Physical Therapy Association’s Academy of Geriatric Physical Therapy. Dr. Jordre spends her time teaching DPT students at USD and conducting research on successful aging. Dr. Jordre is originally from Minnesota and now resides in Vermillion, South Dakota with her husband and two children. In her free time, she enjoys spending time with her family and training to be a senior athlete.

How did you become interested in researching healthy aging?

My line of research happened somewhat accidentally. I was studying for board certification in geriatrics when our state physical therapy association was looking for a way to engage with the South Dakota Senior Games. I figured I could dig up a fitness screen for aging athletes and I volunteered to go conduct that. To my surprise, I learned that there were no screens for aging athletes. I was knee-deep in the literature studying for my exam, so I pieced together a fitness screen from what I was studying at the time. The first time I conducted the screen at the South Dakota Senior Games, I brought 8 students with me. We drove 3 hours for the event and we called it the “Elderly Fitness Screen”. No one participated. For some reason I decided this was still a good idea. I modified the screen to make it more challenging and changed the name to the Senior Athlete Fitness Exam (SAFE). When we went back the next year we screened 30 athletes who taught us a lot. After a couple of years I decided our results might be worth studying. I’ve now screened thousands of athletes. They are my inspiration.

What are some of the most important physical changes seniors need to consider as they work to prevent injury as they age?

So many things change with age that it is hard to pick just one. Balance is critical and is often overlooked with healthy aging as we just don’t feel it changing. Balance does decline with age and if we don’t attend to that we increase the risk for falls even if we have lots of other healthy behaviors in place. In fact, healthier older adults still risk injuries from falls even if they have relatively better balance, because they engage in more challenging tasks each day. The good news is that including balance training in an exercise routine does decrease fall risk and thus decreases the risk of injuries from falls.

The other major aspect of training I often see overlooked is strength training. Strength training becomes challenging with increased age for a variety of reasons. First, it simply becomes more difficult due to physiological losses and it is hard to motivate to work on aspects of fitness that are challenging. Second, pain is often a barrier. As a physical therapist I’ve had to become very creative in finding ways to promote strength training with those who are aging in a way that doesn’t cause pain or secondary problems. Yet, we know that maintaining and improving strength with age can really protect an individual from physical decline.

With both of these I think it is critical to note that improvements from addressing these issues only last as long as they are attended to. Exercise and balance training are like a pill. You don’t continue to see the benefits when you stop taking them. 

You have created screening tools for National Senior Games athletes. How did you develop these tools? How did you become involved in the National Senior Games?

When I decided to research the fitness screen for the South Dakota Senior Games, I called the National Senior Games to see if I was re-inventing the wheel. I figured I could just revert to their screen rather than testing my ‘home-made’ screen. They informed me that they didn’t screen athletes and didn’t have a screen. They invited me to bring my screen to their national competition. After that, we created a formal relationship and I’ve been screening athletes at their biennial competition now since 2011.

What are some of the challenges to getting seniors with injuries the best care possible?

I think healthy aging seniors are often overlooked by their healthcare providers. They don’t present with the typical comorbidities we associate with aging as they just look so good in comparison. They can get out of chairs on their own and they don’t need an assistive device so ‘minor’ aches and pains are something we expect them to brush off. We say, “good job” as they are doing better than their peers and we move them through their appointments too quickly. This is unfortunate as everything is relative. For the healthy senior, their aches and pains are important to address so that they can keep engaging in an active and healthy lifestyle. In a related way, I think healthcare providers often don’t know what to do with these relatively healthy older adults. We just don’t see enough of them to have a set plan or protocol in place. 

What aspect of your work are you most proud of?

I am proud of the work I’ve done so far with senior athletes. I don’t see it as a completed project but I’m proud of the work that is in progress. This population is, as I stated, often overlooked and I hope that my research brings more care to them as inspires others to be like them. 

What advice do you have for those interested in a career in physical therapy?

Physical therapy has so many layers. It is a more challenging profession than it may appear on the surface. I like to tell students that if they want to use their brain and their body maximally each day then this is the right profession to be in. Our practice requires lifelong learning. There isn’t a point where you can stop and say, “I know enough now.” There is always more to understand. 

How about those who have an interest in board certification in geriatric physical therapy?

Geriatrics is the place to be right now. With the growth in our aging population there is no shortage of work and no shortage of new ideas that could be implemented. The expectations of our currently aging population are quite high in terms of quality of life and continued activity. This population needs PT and even more, it needs innovative new ideas from PTs. I never expected to head down this path, but I am thankful that I did.