All MFN blog Archives - Page 101 of 142

Pregnant woman using exercise bike at the gym

Prenatal Exercise Program Design: Exercise Type

Catherine Cram/17 October 2017/ All MFN blog/

Choosing the type of exercise that is best tolerated during pregnancy depends on the following considerations:

Which activities the client enjoys or is skilled at performing
Whether the activity poses any risk to the mother or fetus
Is she is able to do the activity without being compromised by balance and center of gravity changes
Can the activity be easily modified as pregnancy progresses

Weight-bearing exercise such as walking, dancing, and running help maintain bone mass and some studies suggest they are more effective for keeping pregnancy weight gain within normal limits. As pregnancy progresses some women may not be able to continue weight-bearing exercise because of back or round ligament pain. If modifications such as wearing a belly support don’t relieve discomfort, switching to non-weight-bearing activities such as swimming, stationary biking, or other types of stationary exercise equipment is recommended.

Absolute and relative contraindicated activities for pregnant women are listed below. Pregnant women should always consult with their healthcare provider before taking part in any exercise program and assess the risk/benefit ratio whenever there is a question about the safety of any activity during pregnancy. Keep in mind that activities such as downhill skiing must be assessed for risks that are not controllable, such as the effect of high altitude on oxygen delivery to the fetus.

Contraindicated Activities for Pregnant Women

High-altitude sports
Water-skiing
Hockey
Gymnastics
Horseback riding
Absolute
Downhill skiing
Scuba diving

You can also view Catherine’s previous articles on exercise intensity and duration.

For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com

Article reprinted from Catherine’s Maternal Fitness blog with permission.

Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.

Objecting to Aging

Adrienne Ione/16 October 2017/ All MFN blog/

In the above court case, “Persons who Object to Aging v. United States of Aging” plaintiffs filed this action challenging the Aging’s Executive Order on natural processes. The People seek a finding that certain sections of the Executive Order are contrary to their desires to live forever, be young and abstain from societal objectification. Constitution and laws of the United States of Aging, and enjoining Defendants from implementing or enforcing those sections of the natural aging process. The People further seek entry of a nationwide temporary restraining order against all acts of aging – biological, social, cultural, internal and political. The judge presiding over the matter: Honorable Time, concludes “Before us today is present not a case of wanton and reckless behavior. Rather, we witness an unveiling of the beauty of time in all of its folds and uncertainties.” A bench warrant has been issued on the grounds of the written accusation of United States of Aging being guilty for a natural act. The case has been relegated to collections until further notice.

Seated in the courtroom, among a group of people diverse in ages and thoughts, you quickly rise to your feet and let out a screech, “Objection your Honor.” Also seated in the courtroom is Stevie Nicks who exclaims, “I want to be age appropriate. I don’t want to be that girl you see walking away and she looks 25 and then she turns around and she looks 90.”^[1]

In an era that is ripe with resisting, anti-everything, detesting and protesting, perhaps we can find comfort in shared experiences. It may behoove us to seek out similarities rather than differences. Discussions in the courtroom among proponents of objecting to aging, are quick to rely on arguments that are toothless tigers. They quip, “Hey, objecting beats the alternative. You know, succumbing to the decay.” In the United States of Aging, no one wants to be seen waving their white flag, a symbol of surrender, and more pointedly, weakness. However, what if we change the script? And shift the meaning of what it means to be old. What if the images and the bodies of aging were more closely aligned with models in advertisements for Benetton?^[2] On an individual level, how would a social and cultural aging situate the way people internalize their aging process?

Perched on high, Honorable Time demands, “Please be seated.” Proponents of your objection turn the volume up on their snickering and clamor and the commotion and fracas crescendos until, “Order in the courtroom,” gruffly and vehemently reverberates among the walls from the booming voice of Honorable Time. Honorable Time delivers the verdict:

Today, we have been presented an incomplete case. It is unclear whether the plaintiff is requesting youth be on trial, the mind, the demeaning social inculcations of aging, the cultural misunderstandings of aging, or everyone else who does not object to aging. Therefore, it is in our dutiful interest, as a civilized United States of Aging, to further investigate the true and whole indecency of the quasi-crime presented before us today. At this point, it is paramount to understand the complexities and total gravity of the aging process and the social and cultural extensions of roots. I have not been convinced, beyond a reasonable doubt that aging is indeed a crime. I have heard witnesses from all sides, and yet it is still not clear to me how the plaintiffs would be satisfied in this situation.

Steven Tyler once wrote, “You have to lose to know how to win.”^[3] In a similar vein, perhaps you need to be old to know how to be young. Or maybe old and young are purely made up categories that reinforce the social construction of certainty and uncertainty. As previously noted, perhaps it is time to write a different script on what it means to be old. The current working definitions of old, predate contemporary technologies and social categories. Prince concurs with his remarks on time. “Time is a mind construct.”^[4] Times change. Minds change. Let us come together in our shared experiences. Rather than resist, give a hug. Hug yourself. Hug your old self. Hug your young self. Old and young are constructs. To the sun, we are all young.

Adrienne Ione is a cognitive behavioral therapist and personal trainer who integrates these fields in support of people thriving across the lifespan. As a pro-aging advocate, she specializes in the self-compassion of dementia.

Website: yes2aging.com
Guided Meditations: insighttimer.com/adrienneIone
Facebook: silverliningsintegrativehealth

References

[1] Stevie Nick did not actually appear in this hypothetical courtroom. Rather, her comment was from an interview that appeared in Rolling Stone.

[2] For an example of United Colors of Benetton advertisements, please visit Benetton.com

[3] Steven Tyler, American singer-songwriter for Aerosmith, wrote these lyrics for “Dream On.”

[4] Dorian Lynskey, “Prince: ‘I’m a musician. And I am music.’” The Guardian (June 23, 2011).

Exercise and Endorphins

Jaclyn Chadbourne/11 October 2017/ All MFN blog/

Feeling too grumpy or stressed out to exercise? Think again.

A little exercise can go a long way in reducing stress and making you feel good, along with its many other health benefits, like improving/maintaining physical fitness, preventing disease and treating symptoms.

Life is complicated. We are all busy with our own personal challenges and to-do lists. Not to mention the winter months, which can make even the hardiest New Englander want to curl up into a ball and stay in bed until spring finally arrives. But, as tempting as that sounds, it’s not likely to improve your mood at all. If you’re feeling down, resist the urge to mope and get moving.

Studies have shown that moderate to intense exercise can help…

Minimize stress or improve ability to handle stressful situations
Minimize anxiety and reduce of depression
Improve self-esteem and perception of self
Improve sleep patterns and hence energy during awake hours

For those interested in the science behind it, when your body is subjected to certain stimuli (including exercise) your hypothalamus calls for the release of endorphins, and the cells in your body that contain them respond. When endorphins lock into special receptor cells, they block the transmission of pain signals and also produce feelings of euphoria. But endorphins can’t do it alone…. exercise also raises levels of other mood-boosting chemicals like serotonin, dopamine and norepinephrine. The combination of endorphins and these other neurotransmitters produces and effect often referred to as “the runners high”.

In reflecting back on my time as a distance runner, I remember saying many times that it wasn’t always the act of running that got me out there day after day – but rather, the tremendous feeling that I got after my run that had such a positive impact on my outlook. But you don’t have to be a runner to enjoy the benefit of the runners high….just 30 minutes of physical activity can elicit this effect on the body and improve our mood on a chemical level.

How else can it affect us?

During a fast-paced tennis match or an intense kickboxing class, you’ll find that you concentrate more on your body’s movements than on the things that are irritating you or stressing you out. Redirecting your focus can help calm and clear your mind. This is referred to as “Active Relaxation” or the capacity to focus on rhythmic motion that can produce a relaxation response within the body.
By reducing our levels of stress, anxiety and depression, we can also sleep better at night, thus improving our energy during our awake hours and reducing irritability and depression often associated with inadequate sleep. How to get started? Consult your doctor or an exercise professional if you’re new to exercise or have health concerns. Safety first! Start with small, manageable goals and choose an activity that you enjoy. Exercise shouldn’t feel like a chore. Then make room in your schedule! Make your health a priority and set aside time each day to focus on you. You’ll be glad you did.

Jaclyn Chadbourne, MA is a Clinical Exercise Physiologist and Principal, Director of Research and Development – ‎Universal Medical Technology, LLC and United Medical Gym, Inc in South Portland, ME. With a passion for sustainable healthy living and desire to advocate for patient-centered care, Jaclyn works to help support community resources for all special populations and to implement and oversee clinical protocols.

References
http://www.nbcnews.com/id/18043835/ns/health-fitness/t/getting-high-exercise/#.UwJ-wvldXtI
http://www.mayoclinic.org/healthy-living/stress-management/in-depth/exercise-and-stress/art-20044469
http://www.webmd.com/fitness-exercise/features/runners-high-is-it-for-real

Still a Gym Rat: Exercise & MS

Mitch Sturgeon/10 October 2017/ All MFN blog/

Before I was diagnosed with MS, and for the first few years afterward, I was dedicated to my exercise programs. My ideal workout time was early morning, because all I had to do was wake up, get my feet on the floor, and lean forward. The next thing I knew I was at the gym.

After my MS diagnosis, I continued to visit the gym on a regular basis. Eventually, when my legs became too weak, I had to give up on the aerobic exercise and the lower body weight lifting. But I still maintained my upper body workouts – even when I started using a cane, two forearm crutches, and then a scooter. Finally, it became too much, and I stopped going to the gym in 2006.

MOG Fast-forward to 2013. My neurologist told me about a facility in South Portland called the Medically Oriented Gym, or MOG. Saco Bay Physical Therapy works one-on-one with patients like me at the MOG. In September, I had my first appointment with Gabe, a physical therapist. We talked about goals. I wanted to maintain or improve the range of motion and strength in my upper extremities. Also, I would welcome anything they could do for leg strength and flexibility, but I knew that would be a more difficult task.

Gabe measured my strength and range of motion to establish a baseline. He then worked with his associate, Jodi, to develop a program for me. Over the past nine months Jodi has incorporated a variety of stretching routines and exercises to strengthen specific muscles and maintain or improve my flexibility. Gabe has evaluated my progress on a regular basis. I have at least maintained and even improved in some of his measures. It’s a beautiful thing.

Gabe, Jodi, and the rest of the team are consummate professionals. Not only do they understand the mobility issues I’m facing, but they exhibit sincere empathy. They know when to push me hard and when to back off. They constantly come up with creative new ways to challenge my muscles to do anything and everything they are still able to do.

I generally have two one-hour sessions per week, and I plan to keep this up indefinitely. In my case, insurance is picking up 100% of the costs.

The benefits I experience from my workouts at the MOG are more than physical. There is an emotional component as well. I always feel more positive about my life when I am fighting back against this creeping paralysis. And even in the days before I became disabled, I experienced a boost from my gym workouts if for no other reason than I was getting out of the house and moving around. That still applies.

This physical therapy program isn’t going to overcome the relentless attack that MS is waging on my central nervous system. My overall physical well-being is continuing to deteriorate, and I don’t expect it to stop. But the work I am doing at the MOG allows me to maintain as much strength and flexibility as I possibly can, for as long as I possibly can. I encourage everyone with MS or other similar conditions to “use it or lose it.” If you live in the greater Portland area, I recommend Saco Bay Physical Therapy and the MOG. If you live elsewhere, find a physical therapist and a gym that you can work with.

If you’re a healthy person, and you’re not getting regular exercise, are you just trying to piss me off? You enjoy such good fortune, yet you do nothing to nurture and protect it. Don’t make me come over there and kick you in the ass, because I will.

One of the exercises Jodi has me do is to lie on my back (which is no small feat) and execute bench presses. Before MS, I could do three sets of ten with a substantial weight on the bar. I would grunt and strain and put everything I had into each repetition. When working with free weights, I always had a spotter, because if the weight were to land on my chest or neck it could have been dangerous. But today I am bench pressing a broomstick, and I still grunt and strain and put everything I have into each repetition. Last week I said to Jodi, “You better stay here and spot me, because if I get pinned by this broomstick I’m not sure I’ll be able to breathe.”

We laughed and laughed. I’m a funny guy.

Read more from Mitch at his blog, Enjoying the Ride.
Learn more about the MOG on their website.

“Still a Gym Rat” From Enjoying the Ride
Copyright Mitch Sturgeon, May 2014

Why Am I Not Getting Leaner…?

Nancy Clark, RD/9 October 2017/ All MFN blog/

“I religiously track my food and exercise. I’m eating 1,300 calories (the number my tracker told me to eat if I want to lose 2 pounds a week). I’ve been following a strict diet and the scale hasn’t budged. My friends tell me I am eating too little. I think I must be eating too much because I am not losing weight. I feel so confused… What am I doing wrong?”

I often hear this complaint from weight conscious people who don’t know if they are eating too much or too little. They believe fat loss is mathematical. Exercising 500 calories more, or eating 500 calories less, per day will result in losing 1 pound (3,500 calories) of fat per week, correct? Not always. Weight reduction is not as mathematical as we would like it to be.

Is it a diet or a famine?

If you are already exercising like crazy and are eating far less than you deserve—but the scale doesn’t budge—you might wonder if something is wrong with your metabolism? Are you eating the wrong kinds of foods? What’s going on…?

When athletes have excess body fat to lose, they tend to lose it relatively easily. But when they get close to their race- and/or dream-weight, fat loss can slow to a crawl. That’s when frustration sets in. You might think reducing your calorie intake even more would be a good idea. No. You would deprive your body of too many nutrients, to say nothing of lack energy to perform well.

When you significantly restrict calories, your brain perceives the lack of food as a famine. Doing extra exercise makes the situation worse, especially when your body is at a low weight. With no excess fat to lose, your body conserves energy and maintains weight at a calorie intake that historically would have resulted in fat loss.

Nature protects the body from losing weight during a (perceived) famine by slowing your calorie-burn: The heart rate slows (not due to fitness but rather to lack of fuel). Blood flow to extremities slows in order to keep your organs warm. Your hands and feet feel cold all the time. The stomach/intestinal tract slows; constipation can become an issue. The hormonal system reverts to pre-adolescence. Women produce less estrogen and stop having regular menstrual periods. Men produce less testosterone. You feel excessively tired. You can muster up energy to exercise, but then are droopy the rest of the day. Fatigue becomes your middle name.

Role of genetics

When an athlete complains about lack of fat-loss despite rigid food restriction, one of my first questions is “How do you look compared to others in your genetic family? Are you leaner—or far leaner—than they are? The standard response is far leaner. Remember, the apple doesn’t fall too far from the tree. Nature’s blueprint for your body might differ from your dream physique.

Pay attention to what others say about your body. If your mom or partner says you are too thin, listen up and stop striving to be leaner yet. Rather than struggle to lose those last few pounds, gently accept your physique and be grateful for what your body does for you. It is strong, healthy, powerful, and able to do what you ask it to do (run a marathon, raise a family, train for and complete an Ironman, bike 100 miles, etc.). It is a resilient vehicle that carries you through each day. It’s good enough. Hopefully, you will not have to experience a broken leg or be diagnosed with cancer before you learn to be grateful for your body and how it allows you to walk, run, and live an active lifestyle—regardless of your size or shape.

Eat more, get fat?

You can stop the diet/famine by eating more; you will not instantly get fat. Rather, your metabolism will quickly return to normal. If your body is too thin, it will strive to restore itself to a genetic weight. This is why athletes can have a hard time staying at their “racing weights.” Being too thin is very hard to maintain.

If you believe you still have excess flab to lose, yet the scale doesn’t budge despite your strict diet, what can you do? I generally recommend eating more and exercising less. To the shock of many of my calorie-deprived clients, this tends to work better than exercising more and eating less. Sounds counter-intuitive. How can that be true?

Think of your body as being a campfire. When it has three logs to burn, it generates a lot of heat. When it has just one log, it produces just a small flame. The same with your body, the more fuel it has, the more calories you will burn.
While adding calories, focus on the benefits: how much better you feel, the power in your workouts, your happier mood, and better quality of life. If you don’t trust your body and are fearful that eating more will end up with your regaining the weight you worked so hard to lose, get help. A sports dietitian can guide you through this process. Use the referral network at SCANdpg.org to find your local expert.

Are fitness trackers helpful?

Fitness trackers offer information that is interesting but not precise. Something strapped on your wrist can sort of measure what your legs are doing, but many variables impact accuracy. For example, pushing a baby jogger with straight arms gives a different step count than if you were to run with freely swinging arms. (1)

As for energy expenditure, note that some of the calories reported as being burned during your workout include calories you would have burned in that hour regardless of exercise. Knowing calories burned can be dangerous… “Oh, I just burned 500 calories, so now I deserve to eat ice cream!!!” Tracking might not enhance fat loss. (2)

Your body is your best calorie counter. Instead of tracking calories to determine if you have eaten the correct amount, try listening to your body. Before you eat, ask yourself, Am I eating because my body needs fuel—or because I am bored, lonely, or stressed? … Am I stopping eating because I am satisfied? Or just because I think I should? By eating mindfully, you will not over-eat nor under-eat. You’ll simply relearn skills from childhood, when you ate when you were hungry, stopped when you were content, maintained a good weight, and never ran out of energy. Life is better when you are free from being in food-jail.

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at nancyclarkrd.com. For her online sports nutrition workshop, co-presented with exercise physiologist John Ivy, see www.NutritionSportsExerciseCEUs.com.

References

1. Nelson et al. Validity of Consumer-Based Physical Activity Monitors for Specific Activity Types. Med Sci Sports Exercise, 48(8):1619-28, 2016.

2. Jakicic et al. Effect of Wearable Technology Combined With a Life-style Intervention on Long-term Weight loss. JAMA 316(11):1161-71, 2016

A Population in Need of Trainers

Jane Curth/3 October 2017/ All MFN blog/

No one looks forward to the day when they need to have a joint replaced. It can seem intimidating, and for good reason. Many patients can have a fairly extensive recovery period with some never regaining full use of the joint in question. But this doesn’t have to be the case. If they prepare properly, they can avoid a great deal of pain and frustration from recovery.

Every year in the United States, there are over 600,000 knee replacement surgeries alone. Hip and knee replacements are very common in those suffering from osteoarthritis, and they are in need of a critical professional — personal trainers.

The Need

Osteoarthritis primarily affects older adults over 50. As opposed to most millennials today, this generation of adults didn’t grow up with exercise being a regular part of life. As such, there is a high degree of sedentary people who also suffer from osteoarthritis and needing joint replacement.

The research is pretty clear — those who are more physically fit have fewer complications in surgery and, above all, require significantly less time to recover afterward. The problem is that a significant portion of this population do not exercise and do not know how to do so safely. Thus, the special skillsets that personal trainers have are incredibly valuable to them.

Training Focus

For most people facing joint replacement, there is a two-fold objective: weight reduction and muscle strengthening. This is because the less the patient weighs, the less pressure is placed on the recovering joint. Furthermore, the stronger the supporting muscles are around the rest of the body, the better-able the patient is to regain mobility.

As such, the training program should include:

Cardiovascular training
Upper and lower body muscular development
Core strength
Range of motion development

Above all, the key to training these clients is SAFETY FIRST. These clients are already suffering from joint pain, and excessive training can make the situation that much worse.

Helping a Growing Network

The population of older adults suffering from osteoarthritis and needing joint replacement is on the rise. It’s estimated that in 20 years, there will be as many as 4 million procedures a year. There is a definitive need for personal trainers who know enough about osteoarthritis and joints in the body to make a difference in these patients’ lives. Word of mouth referrals from successful outcomes are a likely possibility and the opportunity to collaborate with healthcare professionals is extensive.

Learn the Essentials

I have worked with Dr. Irv Rubenstein to put together a course like none other that will get personal trainers up to speed as quickly as possible on the essentials. We go over what happens in the joints and how they deteriorate as well as what happens during and after joint replacement surgery.

In this course, you will learn:

The basics of Osteoarthritis and how it affects the body
Exercise programming to prepare the client physically for surgery
Contraindications for post-surgery and how to avoid re-injury
Programs that will work in the home or at a gym
An overall approach to helping clients prepare and recover safely.

Most importantly, we discuss what is safe and effective for this clientele as well as what to avoid at all costs — exercises which increase the likelihood of injury and exacerbation of pain. We look forward to empowering personal trainers to use their skills and expertise to benefit older communities that they wouldn’t normally think about when looking for new clients. This is a population in desperate need of a personal trainer’s ability, especially in the delicate days before surgery and continued work with the client once their physical therapy time has ended.

Jane Curth is the co-founder and CEO of FitFixNow. Helping people on their wellness journey is her passion; Jane has helped clients and students with their diet and fitness struggles for over 20 years.

Member Spotlight: Robert LoFaso, Expert in Fitness, Movement, and Static Stretching

MFN/29 September 2017/ All MFN blog/

Robert has extensive experience with conditions of all ages, having worked with clients with heart conditions, obesity, stroke, diabetes, spinal stenos and cancer.

Health & Wellness Coaching for Diabetes

Linda Gogl/28 September 2017/ All MFN blog, Conditions/

Managing Diabetes can be very complex. How can the diabetes patient be successful at creating a solid lifestyle plan involving healthy nutrition, increased activity and effective medical management? A study published by American Diabetes Association, Clinical Diabetes, state’s “Controlling diabetes to reduce the incidence of its complications rests largely on individual patients and requires vigorous self-management of the disease. Unfortunately, without sustained support, few people achieve their goals or master the tasks that will allow them to live healthfully and reduce their risk of costly complications.”

Diabetes management According to the New England Journal of Medicine, “Type 2 diabetes is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. It was concluded that the reduction in the incidence of diabetes was directly associated with changes in lifestyle and that Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects.”

Diabetes self-management can be very overwhelming for the diabetic patient often leading to a sense of failure but there is help. A Health & Wellness Plan created together with a coach has proven to increase success in achieving healthier lifestyle behaviors and a greater quality of life.

While diabetes management can be overwhelming the Clinical Diabetes study results “revealed broad agreement among participants that their coach helped them figure out what to do to better control diabetes, that their coach’s encouragement was important in controlling diabetes, and that coaching was an important part of the overall program.”

Studies performed by Duke University, published by the New England Journal of Medicine, and the American Journal of Lifestyle Medicine suggest that working with a Health Coach improves medical management, patient engagement, social support, physical activity, diet, decreases stress, and reduces A1C scores. In addition, patient perception indicated positive improvements in overall personal health status, as well as, accomplishment of their goals when working with a health coach.

The Affordable Care Act recognizes that focusing on wellness and prevention is key to improving the health of Americans. The National Prevention Strategy is moving us from a system of sick care to one based on wellness and prevention. Many of the programs and initiatives now being funded include coaching. An example is the YMCA Diabetes Prevention Program that now includes Health Coaches within their team. We are now also finding coaches within insurance companies, such as UnitedHealth Group, Optima Health and Aetna due to success in improving diabetes control for the patient.

What Can Health & Wellness Coaches Do for You?

Coaches work with diabetes patients in a variety of ways. In one example of coaching in a healthcare setting Dr. Heather Bennett and her team (in an American Academy of Family Physicians publication) described Health Coaching for patients as encompassing five principal roles:

Providing self-management support
Bridging the gap between clinician and patient
Helping patients navigate the health care system
Offering emotional support and support resources
Serving as a continuity figure.

In Bennett’s model the role of health educator and the role of health and wellness coach was combined.

Providing self-management support
Self-management support is essential for patients to extend their health care outside the clinic walls and into their real lives. Coaches assist patients in seven domains of self-management support: providing information, teaching disease-specific skills, promoting healthy behaviors, imparting problem-solving skills, assisting with the emotional impact of chronic illness, providing regular follow-up and encouraging people to be active participants in their care. Patients have better health outcomes when provided with disease-specific knowledge and skills.

Bridging the gap between clinician and patient
Throughout the care process, there are plenty of opportunities for disconnects between the clinician and the patient. Prescribing medications is one example. It is a two-part endeavor: 1) writing prescriptions and 2) making sure patients obtain, understand and actually take the medications as prescribed. Physicians perform part one but lack time to address the critical second part. Health coaches can bridge these gaps by following up with patients, asking about needs and obstacles, and addressing health literacy, cultural issues and social-class barriers. Health Coaches help patients navigate the health care system. Many patients, particularly the elderly, disabled and marginalized, need a navigator to help locate, negotiate and engage in services. Coaches can help coordinate care and advocate with patients when their voices are not heard.

Offering emotional support
Coping with illness is emotionally challenging. Well-intentioned but rushed clinicians may fail to address patients’ emotional needs. As trust and familiarity grow, coaches can offer emotional support and help patients cope with their illnesses. They also assist patients in seeking out additional emotional support that will help them achieve and maintain success.

Serving as a continuity figure
Coaches connect with patients not only for office visits but also between visits, creating familiarity and continuity. This is particularly helpful in practices where clinicians work part-time or see one another’s patient. Coaches travel with the patient as an ally and assist them with staying the course while implementing their wellness plan.

Health & Wellness Coaches Can Help

Coaches facilitate a patient-directed process of evaluation and assessment, exploration, tracking and accountability to and assist in co-creating a plan that is tailored to the patient Health & Wellness Coaches work with a patient individually or in small groups. They help create a whole-life integrated wellness plan toward managing diabetes and bringing about the lifestyle changes needed for a healthier life. Coaches serve as an ally to help those challenged with diabetes follow through with their health & wellness plan so they can achieve their goals toward their best life possible.

References

Affordable Care Act – Department of Health & Human Services: www.hhs.gov

Bennett et al, Health Coaching for Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.

MacLean et al, Telephone Coaching to Improve Diabetes Self-Management for Rural Residents. Clinical Diabetes. January 2012 vol. 30 no. 1 13-16.

Melko et al, American Journal of Lifestyle Medicine, March/April 2010; vol. 4, 2: pp. 187-194.

National Prevention Strategy, Clinical and Community Preventive Services, National Prevention Council 2010. www.surgeongeneral.gov/initiatives/prevention/strategy/preventive-services.pdf

National Prevention Council Action Plan: Implementing the National Prevention Strategy
www.surgeongeneral.gov/initiatives/prevention/2012-npc-action-plan.pdf

National Prevention Council, National Prevention, Health promotion, and Public Health Council, 2013 Annual Status Report. June 25, 2012. http://www.cdc.gov/features/PreventionCouncil

Sacco et al, Effect of a brief, regular telephone intervention by paraprofessionals for type 2 diabetes. Journal of Behavorial Medicine. August 2009, Volume 32, Issue 4, 349-359.

Tuomilehto et al, Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance .N Engl J Med 2001; 344:1343-1350.

Wolever et al, Integrative Health Coaching for Patients With Type 2 Diabetes A Randomized Clinical Trial. The Diabetes Educator July/August 2010 vol. 36 no. 4 629-639.

The Benefits of Adding Tai Chi to Your Exercise Regimen

Dianne Bailey/25 September 2017/ All MFN blog/

“Tai Chi is better than a glass of wine!”

The above quote is an actual proclamation from one of my students at the end of class one night. Let’s take some time to look through all the things that you can expect from learning this relaxing, slow martial art.

Because Tai Chi offers a slow, meditative approach to movement, some people question it as an exercise modality since the aerobic component is not high. You should not dismiss it, however, simply because you might not break a sweat doing it! The intensity of this form of exercise can be increased or decreased depending on the depth of the postures and the duration of practice. It is certainly a low-impact form of exercise which is beneficial to people with existing joint issues and to people who want to avoid joint issues.

Let’s take a look at both the scientifically proven benefits and the anecdotal benefits that occur with the regular practice of Tai Chi.

Physical benefits

As you would expect, there are many physical benefits when one practices any form of exercise over a period of time. The benefits that research has proven with the regular practice of Tai Chi are surprisingly far-reaching, especially in our current climate of anti-aging remedies. The Mayo Clinic lists some of the benefits of Tai Chi as:

Improved aerobic capacity
Increased energy and stamina
Improved flexibility, balance and agility
Improved muscle strength and definition
Enhanced quality of sleep
Enhanced functioning of the immune system
Reduction in blood pressure
Reduction in joint pain
Improved symptoms of congestive heart failure
Reduction in the risk of falls in older adults

That list is impressive just by itself! There are other studies that have proven improvement for those who live with chronic conditions such as fibromyalgia, Parkinson’s disease, osteoarthritis, COPD and others. It has also been proven to improve bone mineral density in elderly women. One study (Tai Chi Chuan: an ancient wisdom on exercise and health promotion) even stated that, “The long-term practice of Tai Chi Chuan can attenuate the age decline in physical function . . . .” It’s no secret that we are living longer now due in part to medical advances. It can be argued that we are not necessarily living better, however. The practice of Tai Chi can possibly be one of the ways we are able to increase the enjoyment of our later years because of the improvements it provides in physical function.

One of the biggest concerns of aging is falling. Obviously, the physical detriment of broken bones or concussions or even just severe bruising are difficult for the aging population to deal with. The mental effect of being scared it will happen again is even worse, however. There are many studies that show a rapid decline in independence after just one fall. Clearly, working on balance is an important concept to help prevent falls. In a meta-study, authors Wong and Lan wrote in “Tai Chi and Balance Control” that, “recent studies substantiate that Tai Chi is effective in balance function enhancement and falls prevention.” They also concluded that, “Tai Chi improves static and dynamic balance, especially in more challenging sensory perturbed condition.” A different study on the effect of 4-and 8-week intensive Tai Chi training on balance control in the elderly concluded that, “even 4 weeks of intensive Tai Chi training are sufficient to improve balance control.” Anecdotally, I have witnessed this in the classes I teach. Many of my students comment on the marked improvement in their balance. One student in particular related the story of how she and her husband were hiking and she was getting frustrated because she felt unstable going over the rocks. Then she remembered her Tai Chi training and started to incorporate some of the principles of columns and weight shift, and she immediately felt more balanced and in control on their hike!

One of the other anecdotal effects that I have seen in my classes is weight loss with Tai Chi. It is not something that people express as a goal when they start Tai Chi, however, I have had several students who have admitted that beneficial weight loss has been a side effect of their training.

Mental benefits

The benefits of Tai Chi are not only substantiated as physical benefits. There are important mental and emotional benefits as well. Let’s return to the list of benefits from the Mayo Clinic. They also list the following as resulting from practicing Tai Chi:

Decreased stress, anxiety and depression
Improved mood
Improved overall well-being

And I would add the following to that list:

Increased mental focus
Improvement in working memory/executive function
Social enjoyment and interaction

The studies concerned with the effect of Tai Chi on psychological well-being are not as conclusive as the studies on the physical benefits due in part to the obvious reliance on subjective measures. In general, however, the studies do demonstrate beneficial effects in regard to practicing Tai Chi for depression, anxiety, stress management and mood disturbance. One study on the therapeutic benefits of Tai Chi exercise (Kuramoto AM) states that, “Tai Chi can influence older individuals’ functioning and well being . . . and the positive effects of Tai Chi may be due solely to its relaxing, meditative aspects.” Just the other day, I had a student comment to me after class that, “It always seems that whatever I’m dealing with on a particular day just eases back into the proper perspective when I’m done with Tai Chi. It obviously doesn’t make the problem go away, but it feels like I can approach it with a better mindset and a healthier attitude.” That’s really the beauty of Tai Chi. It’s not some mystical, magical force or religion. In one study that measured heart rate, adrenaline, cortisol and mood during Tai Chi (Jin P), “Relative to baseline levels, subjects reported less tension, depression, anger, fatigue confusion and state-anxiety. They felt more vigorous and in general, they had less total mood disturbance.” In another meta-analysis regarding Tai Chi exercise and the improvement of health and well-being in older adults (Yau MK), “There is considerable evidence that Tai Chi has positive health benefits; physical, psychosocial and therapeutic. Furthermore, Tai Chi does not only consist of a physical component, but also sociocultural, meditative components that are believed to contribute to overall well-being.” This same study concluded that, “It is recommended as a strategy to promote successful aging.” That’s quite an endorsement! You might say that Tai Chi comes close to being a fountain of youth for those that practice it!

In my own experience, I have seen the improvement in mental focus and working memory. If you are not “in the moment” and really thinking about your movements and how to apply the principles of Tai Chi . . . you will get lost! You can’t think about what’s for dinner that night, or the fight that you had with your spouse the night before. You must focus your mind on the task at hand and that actually causes a relaxation and meditative effect. Because many of the movements force you to cross the midline, you are also forcing your brain to function in a different pattern by making the left side talk with right side. Jean Blaydes Madigan, a neurokinesiologist states that, “Crossing the midline integrates brain hemispheres to enable the brain to organize itself. When students perform cross-lateral activities, blood flow is increased in all parts of the brain, making it more alert and energized for stronger, more cohesive learning. Movements that cross the midline unify the cognitive and motor regions of the brain.” Wow! You are actually making your brain function better on all levels with the simple practice of Tai Chi!

In two different meta-studies concerned with the cognitive performance in healthy adults (Zheng, G, et. al and Wayne PM, et.al), they both concluded that “Tai Chi shows potential protective effects on healthy adults’ cognitive ability. Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning.” Executive function is defined on WebMD as “ a set of mental stills that help you get things done.” Who doesn’t need to get more things done in their life?? And unfortunately, if we don’t work at it, executive function declines as we age https://holisticdental.org/klonopin-for-anxiety/.

The last point I want to mention about the benefits of practicing Tai Chi is the most subtle, but certainly a very important point, especially as we age. I see a community develop in my classes that is so strong, it supports each member and provides a social interaction that is rare in our society. Many studies have shown that for successful aging, people need to be involved and to interact with each other. My students come to class to enjoy the benefits of Tai Chi . . . but they also come to class to enjoy the social interaction and support from their classmates. This kind of support and interaction can happen in any number of different venues, of course. I think the combination of the relaxing atmosphere, a non-intimidating, simple to move kind of exercise and the joint experience of learning something new that has a calming influence on your mood is un-paralleled in the exercise world. Tai Chi brings together your physical well-being with your mental and social well-being in a unique experience that can be practiced for years. Better than a glass of wine, indeed!

Dianne Bailey has been providing professional weight management and sports conditioning training for individuals since 2002 and opened The Conditioning Classroom, a private personal training studio, in 2006. She earned the prestigious designation of Certified Sports Conditioning Specialist from the National Sports Conditioning Association in 2007. In addition, Dianne is a Certified Tai Chi Instructor (level 1) through the American Tai Chi and Qigong Association and leads the Tai Chi program here at the studio.