EnhanceFitness: Endurance, Balance, Flexibility, Strength and Healing

Eighty-two year old Mary Brown lost 35 pounds and lowered her blood pressure and cholesterol through EnhanceFitness. Now she teaches six classes each week at Des Moines Activity Center.

Toshiko Aramaki has been teaching EnhanceFitness at the Shoreline-Lake Forest Park Senior Center since 2005. Many of her participants have attended regularly since she first started teaching there. Over the years, Toshiko has seen participants recover from sickness, broken bones, and major medical complications. They rest, they heal, and they return to class. Participants tell Toshiko that their doctors attribute quick recoveries to regular exercise.

When one EnhanceFitness participant, Virginia, was diagnosed with stage III uterine cancer in 2013, her doctor wasn't sure if he should recommend strong chemotherapy and surgery. Virginia might have been 88 years old, but after attending Toshiko's EnhanceFitness class regularly for eight years, she was strong.

Toshiko Aramaki

Virginia attended Toshiko's class regularly after completion of each of four cycles of chemotherapy. Toshiko, also a cancer survivor, loaned Virginia scarves and bandanas and encouraged her to "be patient and keep moving."  

When Virginia's tumor shrank considerably from chemotherapy treatment, she endured a major surgery to remove it completely. She recovered and was back at EnhanceFitness five weeks later. Virginia's medical team suggested two additional rounds of chemotherapy and told her she could start exercising again the following week.

Earlier this month, Virginia returned the scarves and bandanas that Toshiko had loaned to her. After six rounds of chemotherapy and a major surgery, she said, "I don't need these anymore, because my doctor told me that I am cancer-free." 

Regular exercise does much more for our bodies than just shedding extra pounds. We can build a strong body to tolerate strong treatments and recover from invasive surgeries.

Safe, effective and evidence-based

EnhanceFitness was designed and tested by the University of Washington's Health Promotion Research Center in partnership with Group Health Cooperative and Senior Services. Owned and disseminated by Senior Services, the original class debuted 20 years ago at Northshore Senior Center in Bothell. Today EnhanceFitness is the most widely delivered evidence-based group-exercise program for older adults, having been offered in over 500 community-based settings in 33 states, reaching more than 40,000 people. Aging and Disability Services provides local funding.

Participants are encouraged to attend the one-hour class three times per week. Exercises focus on endurance, balance, flexibility and strength—all of which help participants live independently and longer. In addition to the physical benefits of participating in EnhanceFitness, the class also offers social and emotional benefits to participating. Classes average about 20 people, many of whom participate regularly for years. The upbeat and fun classes serve as an opportunity for participants to create strong social bonds and build community.

Many participants have found the group exercise class so beneficial that they serve as a role model to their peers and transition successfully from participant to skilled instructor. Mary Brown, an 82-year-old retired Equal Opportunity administrator in the aviation industry and grandmother of nine, is one such case.


Mary recalls how different her life felt 15 years ago, when climbing the 11 steps from her front door to her bedroom door felt challenging. "When I got to the landing my heart was beating fantastically, and I was out of breath," she said. A trip to the doctor that revealed high cholesterol and high blood pressure served as a wakeup call for Mary. She enrolled in EnhanceFitness after learning that exercise could improve her medical conditions.

After a year of attending class regularly, Mary's blood pressure and cholesterol improved significantly. Since she started with EnhanceFitness, Mary has lost 35 pounds. She also found her second career: teaching EnhanceFitness. Mary now teaches six EnhanceFitness classes each week at the Des Moines Activity Center, a career that allows her to maintain her own health while encouraging others to do the same.

EnhanceFitness participants and instructors aren't the only ones noticing the benefits of this evidence-based program. A recent report to Congress by the Centers for Medicare and Medicaid Services showed EnhanceFitness had driven down total healthcare costs, decreased unplanned hospitalizations, and decreased mortality rates for participating Medicare beneficiaries. In fact, EnhanceFitness had the most significant total health care costs savings of all programs studied—$945 savings per participant per year.

EnhanceFitness helps older adults at all levels of fitness become more active, energized, and empowered to sustain independent lives. For more information about Enhance Fitness, click here.

Contributor Sasha May, MSW, is assistant director of Project Enhance at Senior Services, a nonprofit organization serving older King County residents. She has coordinated evidence-based health promotion programs at a variety of sites and developed effective health behavior interventions for a variety of clients throughout her career.