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Fitness-Exercise-Data

The Top Big Data Issues – and How Wellness Can Do Them Better

Big data is here to stay within the healthcare profession.  More and more engineers and data programmers are being hired to sift through the myriad of data that consumes the field.  Of concern to executives at the top are certain attributes of healthcare that may need “fixing”.  The aspects of this report are to highlight what are perceived as the biggest concerns in healthcare, and how the wellness industry – if they can stay on track – can supersede all of these types of issues as they transition to the data analytics side of their health offerings.  

#1 – In network utilization.  

This is a very big concern for hospital systems and physician network groups, as patients have a tendency to switch providers if they think they will get better service, better medicine, or better prices.  One of the reasons is that most patient contracts don’t require patients to stay in a network – which puts the responsibility of good care, competitive prices, and follow ups squarely on the doctors.   If patients are unhappy with their doctor or practice for any reason, they can leave.  Now that these organizations are getting bigger and more complex – it’s easier to see why patients may become disgruntled, and try to find a better solution in a private practice, or smaller group or hospital practice. 

From the wellness side – it’s not uncommon for health club members to stay at their club or studio for years.  Prices don’t change that much, and most members have a very personal relationship with their instructors and club owners.  They have group classes, personal exercise programs, child care, plenty of free parking, and clean facilities that provide some of the latest in technology every few years.  So – should healthcare systems look to health clubs to see why people stay in clubs longer?  Perhaps they should be partnering with these health clubs for specific programs for their patients.

#2 – Customer satisfaction.  

This is a priority in most businesses.  Hospitals and physician practices are no exception.  However, most people still associate going to the doctors with being sick.  So there is already an inherent negative connotation to the doctor’s office.  Therefore physicians need more than a lab coat and a prescription to make sure patients are getting what they need.  They need a team-orientated approach that can help with the issue NOW, and use the team to follow up with the patient to make sure the situation and health concerns are taken care of over time.

Again – the health and fitness industry is concerned about customer satisfaction.  With cut-rate gym memberships, and a new club coming into communities almost every month, clubs and owners need to offer clean facilities, professional trainers and instructors, and technologically advanced equipment that doesn’t break down and that is easy for members to take advantage of.  The issue between the two programs – is that although some exercise programs push the body and may be painful – it’s a good pain and the rewards of long term participation should be better health and less risk of using the healthcare system over time.  It’s the old adage of “pay me now, or pay me later” axiom, and more people are willing to put their trust in health clubs – and the risk of injury or illness or death is extremely low compared to even trips to the doctor’s office. 

#3 – Looking at the mounting data to convene the best possible approach to patient care.  

Again – this is a huge concern in healthcare – that doctors can’t read the thousands of new studies that come out in their field each month, so they rely more and more on their clinical experience (which may be a good thing), but they will stick to the tried and true methods they have always been using, and may not prescribe the most effective type of treatment for their patients.  Big data in many instances can do two things – one is look over millions of studies in a particular field, and two – through machine learning, hone in on what may be the best type of treatment plan for a particular patient, based on their age, severity of disease, family history, weight, and other factors.  This is a powerful tool to help doctors prescribe and treat better.

However, it’s still the same paradigm.  They are looking over medical studies, many of which may not be in the best interest of the patient.  One of the most cited studies in medicine came in 2005 when Stanford epidemiologist John Ionnidis reported that the majority of medical research finding are false, because they have inherent bias from their authors, their findings are not statistically significant, they were published by industry officials, and are not relevant, and conclusions may not match the actual results of these very papers.  Ionnidis opened the floodgates for many professionals who have gone after medical research and institutions for publishing false studies.  It is estimated that almost 40% of medical research studies are false, in that their findings do not hold relevance regarding the enhancement of patient care.

In contrast, sports medicine has been methodological in its research for a century – from the basis of treadmill cardiac and performance testing in the 1930s, to the onset of physical activity studies in the 1950s and 60s, to cardiac rehab and exercise safety studies in the 1980s, to the onset of exercise for special population groups in the 1990s.  There are very few reports on sports medicine research fraud, and the foundation of this research usually shows some level of benefit to those who participate.  In almost all cases, no harm is done to subjects while performing these studies.  This has now transitioned into many successful clinical health club programs for persons with cancer (Sunflower Wellness, Cancer Well-fit, Fast Trac Cancer Program), spinal cord injury (Claremont Club), multiple sclerosis, diabetes, hypertension, weight management, bariatric recovery, and medical fitness in general. 

#4 – Cost savings. 

 One of the biggest attributes of big data and population health is to drive policymakers and physicians to deliver the highest quality care at the most competitive prices.  In many opinions, this is a misnomer of sorts, and medicine is continually advancing technology, which is very expensive, and works through a third party reimbursement system — which is many times more expensive than if they offered the service or procedure or product at market value.  Many hospitals are undergoing facelifts (no pun intended) and look more like five-star hotels than medical centers.  All of these amenities cost the patient and insurance pool more money.  This is why healthcare costs usually rise at more than twice the rate of inflation, and have some of the highest costs of any industrialized business model.

As far as health and fitness, the rate of price changes for the average health club has held steady at just below inflation for years.  The prices for café food, personal training, specialty exercise, or apparel has also held steady.  Even with the rush of new technologies for equipment and personal monitoring devices (such as FitBit), prices have remained constant. 

Big data in the health and fitness setting should be concentrated on health outcomes.  There are many software programs in the industry now that look at finances, front desk management, club administration, and human resources.  They do their functions well.

If big data is going to continue to look at all aspects of healthcare, and continue to miss the boat regarding improved patient health and well-being, then no amount of data can help repair the continual dysfunction that exists between an over-burdened and (in many opinions) under caring system, and the continued increase in poor health in the US.  Prescribing more pain meds, vaccines, or antibiotics will not help improve health – and in many cases is making health worse. 

The health and fitness profession is on the mark moving into the realm of special populations at every level.  As the amount of population health and data analytics becomes a more ingrained part of wellness, we will see at many levels how these types of interventions improve health, reduce costs, and vastly improve patient satisfaction and retention to their favorite health club, exercise program, or personal trainer. 


Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

 

References

https://www.optum.com/content/dam/optum3/optum/en/resources/gated/Optum_NYUPN_Topic_Spotlight.pdf

Ionnidis, JPA.  Why most published research findings are false.  2005.  PLoS Medicine.  Aug. 30. Doi: 10.1371/journal.pmed.0020124

 

family meal

Food, Athletes & Joy of Eating

Once upon a time (before WWII), daily life revolved around structured meals: enjoying a hearty breakfast, dinner (at noon), and supper (at night). When women entered the workforce, eating patterns changed — lighter breakfasts and lunches, with bigger family-focused dinners. Fast forward to pre-COVID 2020, youth sports and life’s busy-ness totally disrupted dinner-times; structured meals got lost in the shuffle.

Today (week #8 of COVID shut-down), our stay-at-home lifestyle has gifted many of us with time to cook breakfast, enjoy lunch, and have family dinners. Yet, many athletes are feeling confused and/or uneasy about how they are eating:

“I’m sleeping until 11:00 a.m. Should I eat breakfast — or lunch — when I get up?”

“I now have easy access to food given I’m working at home. I spend too much time grazing. Seems like I am hungry all the time.”

“My eating habits are weird. How should I be eating? What is “normal” eating?”

Sound familiar? To add a supportive framework, joy to meals, and answer the question What is normal eating?, I turn to eating authority Ellyn Satter, author of Secrets of Feeding a Healthy Family (a book every parent should read; EllynSatter-Institute.org).

Here is her definition of “normal eating”:

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it — not stopping eating just because you think you should.

That is, did you stop eating breakfast today because the oatmeal in your bowl was all gone? Or were you truly satiated? At the end of lunch, did you stop at your one-sandwich allotment, even though you wanted more? If you are “feeling hungry all the time,” you likely ARE hungry; your body is requesting more fuel. Trust it. You’ll end up eating more sooner or later, so please honor that hunger and eat more now.

Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. That is, have you put yourself in food jail and banned “fun foods” like cookies, cupcakes, and chips, out of fear of over-eating them? Ideally, your meal plan includes 85-90% quality foods, with 10-15% fun foods. You need not eat a perfect diet to have an excellent diet. Some “fun food” in the midst of a pandemic can be, well, fun!

Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored, or just because it feels good. Yes, food is a way we celebrate, mourn, and entertain ourselves. Sometimes we even need a hug from food, despite being not hungry. One bowl of ice cream will not ruin your waistline nor your health forever. That said, routinely overindulging in ice cream as a means to distract yourself from life’s pain will not solve any problem. If you are using food as a drug, to not start eating can be easier than stopping once you have started.

Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. Most athletes require fuel at least every 3 to 4 hours. Those who “graze all day” commonly under-eat at meals. If you stop eating because you think you should, not because you are satiated, you will feel the urge to graze. Solutions: eat the rest of your breakfast-calories for a mid-morning snack, eat an earlier lunch, or better yet, give yourself permission to eat enough satiating food at breakfast. Living hungry all the time puts a damper on your quality of life, to say nothing of impairs athletic performance.

Normal eating is leaving cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. If you are banning fun foods from your house because you can’t eat just one cookie, think again. Denying yourself permission to enjoy a few cookies boosts the urge to eat the whole plateful. I call that “last chance eating.” You know, “last chance to have cookies, because tomorrow I am back on my cookie-free diet.” Depriving yourself of cookies leads to binge-eating. Try planning in forbidden foods every day. They will soon lose their power.

Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Yes, even normal eaters overeat. It’s normal to have too much birthday cake, too much Sunday Brunch, too much ice cream. When competent eaters overeat, they listen to their body’s signals – and notice they take longer to get hungry again. That is, if you have a hearty brunch, you will be less hungry that evening. Trust me. Rather, trust your body.

Hunger is your body’s way of telling you it has burned off what you gave it, and now it is ready for more fuel. You want to honor hunger and eat intuitively, like kids do. Kids eat matter-of-factly; they stop eating when they are content. Adults (especially weight-conscious athletes), don’t eat when they are hungry, then don’t stop when content. Rather, they “cheat” and guiltily stuff themselves with forbidden foods —last chance before the diet starts again!

Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life. If you are spending 90% of your time thinking about food, you are likely hungry 90% of the time. (If humans didn’t think about food, they would never think to eat.) If you eat until you are satisfied, you will stop incessantly thinking about food. That said, food-thoughts can be a way to distract yourself from stuff you really don’t want to think about. In that case, talking with a counsellor might be helpful. Smothering your feelings with chocolate will not solve any of your problems.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food, and your feelings. Many athletes very rigidly eat the same foods every single day. A sports nutritionist can help add variety (more nutrients), flexibility, and more joy to eating. Food can and should be one of life’s pleasures, both when training and in the midst of the pandemic.


Boston-area sports nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes, helping them learn how to eat competently. Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a helpful resource. For more information, visit NancyClarkRD.com.

Doctor and patient

Health Coaches Don’t “Diagnose or Treat Disease”: Those Words and Others Don’t Belong in Our Vocabulary

It is nothing new that there’s inevitable overlap between the practice of medicine and providing sound health coaching. Ideally, there should be a seamless continuum between the two endeavors, but that could only exist where there is a continuum of cooperation and respect. Health Coaches need to be careful with how we describe and present our work. While health coaching is a vibrant movement, it is still a junior partner to “traditional medicine” and for self-preservation; we should seek to avoid direct “turf wars” with Physicians.

The most balanced approach requires continuous consideration of the distinctions between these complementary fields. While there will always be principled differences, the practical applications change steadily along with knowledge and technology. The most prudent approach is for Health Coaches to simply concede medicine’s proprietary terms. We need to understand them, and can use them, but anytime we do we must draw distinctions that educate our clients about the difference in objectives and procedures of these complementary endeavors. In that sense, there are no “forbidden words”, but there are plenty of places where lack of clarity in purpose and practice can cause problems. Some of the major terms that should be conceded include:

Patient, practice, diagnosis, cause, disease/pathology, prescribing, medicine, treatment, management, effectiveness, intervention and cure.

Health Coaches should strive to embody in our mission what comes from consideration of those terms. We develop relationships with clients, we are not in the practice of seeking responsibility for treating patients. We are helpful guides in exploring the vast, common sense resources of the field of wellness, not prescribing proprietary agents or using medical modalities to treat disease. We act as individual guides on a quest that prioritizes personalized discovery and anecdotal utility, not practitioners who prescribe antidotes approved by impersonal population-based investigations.

Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization.

We look for associated (natural) influences that can combine to re-establish balance, not for a cause or diagnosis that be controlled by the use of a foreign/artificial agent. Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization. Medicine predominantly lays claim to systems that don’t display those features.

“The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.”

Each term, of course, could be expanded upon greatly as time permits. Back in 1903, Thomas Edison said that “The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” Edison was simply wrong. Health Coaches should focus on care of the human frame and diet which are the wellsprings of function and flourishing. That’s a big task that requires ever-increasing knowledge and wisdom.

Unfortunately, the human “machine” is inevitably subject to decay of various sorts and severities. Medicine will always have a very important place in providing resources for comfort where nature has been pushed to failure – which is not an uncommon occurrence. The line between those positions shifts over time, but until utopia breaks out, reality will maintain a vast market for both types of emphasis. For now, it is up to the junior partner to hold up their banner while keeping the peace.

Originally printed on the FDN blog. Reprinted with permission.


Reed Davis is a Nutritional Therapist and has been the Health Director and Case Manager at a wellness clinic San Diego for over 15 years. Reed is the Founder of the Functional Diagnostic Nutrition® Certification Course, offering functional lab training, data-driven protocols, tools and leadership you need so professionals confidently solve your client’s health issues and grow your career.

brain-digital-image

The Neuroscience of Mind-Body

In an era where neurological disorders and mental illness run rampant, effective and scalable non-pharmacological interventions are desperately needed. Luckily, science continues to demonstrate the efficacy of exercise-based interventions in improving cognitive, neurobiological, and mental health outcomes in a variety of populations. Multiple modalities of exercise, such as aerobic training and resistance training, continue to demonstrate improvements in several measures associated with brain health. While aerobic exercise has received a majority of the spotlight over the past couple of decades, other forms of exercise have also moved to the forefront of the exercise-neuroscience literature.

brain-neurons

Parkinson’s Disease and Exercise

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease.  Unfortunately, the incidence of Parkinson’s disease has not declined, and its impact is seen in all races.  This is due in part to the fact that the population of the world is greater than ever before and increasing. In addition, people are living longer than in previous generations, and the baby boomer generation, one of the largest generations in history, has reached old age.

Risk factors for Parkinson’s disease include:

Age: Risk of Parkinson’s disease increases with age.  The average age of onset for this disease is 55 years and the rate of incidence increases steadily until the age of 90.

Gender: Men have a higher risk for Parkinson’s disease than women.

Family history: Individuals with a family history of Parkinson’s disease are at a higher risk for Parkinson’s disease. Moreover, it is said that those with affected first-degree relatives double their risk of Parkinson’s disease.

Agricultural work: Individuals exposed to pesticides and herbicides have a greater risk of developing Parkinson’s disease symptoms. Drinking well-water and living in rural areas have also been associated with an increased incidence of Parkinson’s disease.

Head Trauma: Head trauma can be a risk factor for Parkinson’s disease as is seen in the case of boxers. One study showed that trauma to the upper cervical region, head, and neck was a risk factor for Parkinson’s disease. However, in some cases it took years for these symptoms to appear.

The exact cause of Parkinson’s disease is unknown.  Regarding the molecular events that lead to the development of this disease, there is still some uncertainty in terms of what causes the neurodegeneration seen in Parkinson’s disease. The current hypothesis is that Parkinson’s disease may result from the interaction between environmental factors and genetic susceptibility.

The primary symptoms for PD are deficiencies in motor performance due to the loss of the dopamine pathways in the brain. Decreased dopamine production in the substantia nigra in the brain causes the 4 primary motor symptoms:

  • Bradykinesia: described as slowness in the execution of movements while performing daily activities.
  • Rigidity or Stiffness: caused by an involuntary increase in tone of the limbs and axial musculature.
  • Resting Tremor: Found primarily in the arms and hands and can be socially bothersome. Resting tremors are less disabling since they often vanish with the initiation of activity (especially in the early stages of Parkinson’s disease).
  • Postural Instability: manifested in a slow speed of walking, shortened stride length, narrowing of base of support, and leaning towards one side.

Exercise should be targeted for the primary motor symptoms with exercise and occupational therapy to improve quality of life. Recommended program components include:

  • Posture, gait, mobility
  • Fall risk reduction
  • Cardiorespiratory health
  • Strength and function
  • Depression and Anxiety
  • Joint health

Exercise prescription for clients with PD includes: (ACSM)

  • An individualized program
  • Cardiorespiratory: use guidelines for healthy adults
  • Muscular Fitness: use guidelines for healthy adults
  • Flexibility: slow, static exercises for all major and minor joints in the body including the upper torso, spine, and neck.
  • Neuromotor Exercises: help with balance, gait, and postural instability. Clinicians use a gait belt or parallel bars to ensure safety depending on the severity of the symptoms.  Include functional exercises to improve ADLs and quality of life.

PD exercise therapy includes intervention with many kinds of exercise modes. Both personal training and group fitness have been successful in helping to manage the disease and reduce the symptoms. There is not strong evidence at this point to show that exercise prevents PD, but it is believed that exercise may play a role.  Exercise is however the mainstay for symptom management and slowing disease development.

 


June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.

References and Resources:

pregnancy-fitness

High Altitude Sports During Pregnancy: Are the Risks Worth the Thrill?

Research in the field of prenatal fitness has conclusively shown that exercise during pregnancy provides health benefits to mother and fetus, and the American College of Obstetricians and Gynecologists encourages pregnant women without complications to continue or start a fitness routine during pregnancy. Although prenatal exercise is considered safe for most pregnant women, some activities are more controversial because of potential injury risks or because of the environment where they take place.

Many women enjoy downhill skiing, cross country skiing, and snowboarding, and have questions about whether it’s safe for them to continue these sports during pregnancy. The safety of these sports, as well as the effect higher altitudes, may have on pregnant women and their fetuses, are important factors to consider before taking part in high altitude snow sport activities.

Several studies have examined pregnancy outcomes and complications comparisons between pregnant women who were exposed to high altitudes versus pregnant women who did not travel to high altitudes. One study (1) that examined the association between high altitude exposure and self-reported pregnancy complications found that there is a low rate of complications for pregnant women who participated in activities and travel in high altitude areas.

Another study (2) suggested that pregnant women who traveled to high altitudes (determined as above 2440 meters, or 8,000 feet) did not have a higher risk of pregnancy complications when compared to women who did not have high altitude exposure. These women were more likely to have preterm labor than those not exposed to high altitude, but the percentage of preterm labor in the study were below the US population rate of preterm births. There was a statistical increase in newborn oxygen need at birth, but no complicating issues were associated with this.

Although these study results are reassuring, more rigorous research is needed to provide further information regarding the safety of high-altitude exposure and exercise during pregnancy.

There are key factors that may influence the degree of hypoxia-related pregnancy complications for the fetus and mother.

  • Duration of exposure
  • Intensity of activity
  • Degree of altitude
  • Difference between altitude at home and sport

These factors should be taken into consideration by a pregnant woman who is planning to travel to (and exercise in) high altitude. If she lives in a low altitude area, it’s a good idea to build in several days of progressive altitude increase to allow time for her to adjust. If possible, she should vary the duration of her exposure by sleeping at lower elevations. She should be aware of signs of hypoxia (see list below) and move to a lower altitude if she experiences increased symptoms.

Complications from exercise at higher elevations may be compounded by increased dehydration as a result of dry and cold air. Maintaining adequate fluid intake and allowing for rest breaks to hydrate can avoid this issue.

The key to avoiding altitude-related issues is being aware of how altitude is affecting the body and pregnancy and knowing the signs and symptoms of hypoxia.  As long as a pregnant woman continues to feel well and isn’t experiencing any issues while exercising at higher altitudes, she can feel confident that her pregnancy won’t be negatively affected.

*Signs of Hypoxia

  • Feeling dizzy and lightheaded
  • Persistent cough
  • Headache
  • Vision changes
  • Extreme fatigue
  • Nausea
  • Confusion and mental status change

It’s important also to consider the risks of some types of snow sports. Downhill skiing and snowboarding require good balance, and as pregnancy progresses, the changes in a woman’s center of gravity can affect her balance and make her more prone to falls. Also, the risk of collisions with other skiers and snowboarders is a concern, especially when slopes are crowded. Careful consideration of a woman’s skill level and difficulty of the ski slope should be weighed, and modifications such as switching to easier slopes and terrain can reduce risk.


Catherine Cram started her company, Prenatal and Postpartum Fitness Consulting, in order to provide current, evidence- based guidelines maternal fitness guidelines to health and fitness professionals. She was a contributing author for the textbook, Women’s Health in Physical Therapy and co-authored the revision of Exercising Through Your Pregnancy with Dr. James Clapp.  Her company offers the certification course, “Prenatal and Postpartum Exercise Design” which provides continuing education credits for over 30 health and fitness organizations, including ACSM, ACE, ICEA, and Lamaze.

 

References

Wilderness Environ Med, 2016 Jun;27(2):227-35. doi: 10.1016/j.wem.2016.02.010. Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies. Keyes LE1Hackett PH2Luks AM3.

Senior-and-Trainer

MS and Circuit Training

I was recently told that a very high percentage of people with Multiple Sclerosis (MS) DO NOT exercise. As a fitness professional with MS, that blew me away. I wish I could find the actual percentage but I don’t think that’s a statistic high on the priority list for any studies! But with all the time I spend in the MS community educating about fitness, I tend to believe that this is a fact, as I hear so many say they don’t exercise because they don’t know how. This is where I have found my niche to fill the gap.

According to Multiple Sclerosis News Today, The first study on the benefits that exercise can provide to people with MS was published by University of Utah researchers in 1996. The participants improved their cardiovascular, bladder and bowel function, increased their strength, experienced less fatigue, developed a more positive attitude, and suffered fewer bouts of depression”.

With information and proof like this, why don’t more people with MS get into the gym, exercise at home or do some form of fitness program? My answer is lack of knowledge and fear. When you don’t know where to start, don’t understand how to find an exercise program that fits you, or you are not educated on the benefits of exercise for MS, you become immobilized and therefore do nothing. I believe this is the main reason why the percentage of MSers who aren’t exercising is so high.

This is where becoming a MS Fitness Specialist makes a ton of sense. Providing a proper workout plan for those with MS is not just a great thing to do, but a much-needed service.

There is a very good selection of workouts that can benefit people with MS, and one of these programs is circuit training. This type of workout gets your heart rate up and strengthens your muscles at the same time. You will never get bored in a circuit training program.

With little rest between each exercise, you rapidly go from one exercise machine to another to work different muscle groups. Depending on the intensity of the workout, you may use 8 or 12 different machines performing a different exercise and muscle group each stop.

I have my clients do 10-12 reps at each machine, using a time under tension (TUT) pace, lasting between 120–144 seconds, before moving on to the next stop.

To keep things exciting and motivating, you can change it up a bit by switching the exercises you do for each body part. A circuit training workout can be done at the gym with equipment, at home with dumbbells and resistance bands, or on an outdoor fitness trail by alternating push-ups and squats with fast-paced walking, jogging or biking.

You will need 20-30 minutes to take a MS client through the workout. The great thing about circuit training is it is easy to adjust the level of intensity by the rest time spent, the pace you perform each movement (TUT), and the speed in which you go through the circuit. A program like this works all areas of your body so you get an effective full-body workout in a short amount of time, as long as you select an exercise for each muscle group: core, arms, chest, back, shoulders and legs. The cardiovascular aspect of the program is taken care of in the time spent at rest. The less rest between sets and exercises, the more your heart rate will be elevated and the more heart-healthy cardio benefits you will receive.

There are many benefits in a circuit training routine as it is aerobic, low-impact and strength training all wrapped up in one program. You get the benefits of muscle building and toning along with a cardio workout. So, if you’re looking for a full-body workout for a MS client that can be don in 30 minutes or less, circuit training checks off all the boxes. The exercise options are endless as well with the variety of machines, resistance bands, free weights and bodyweight movements that can be incorporated into this style of program. Circuit training is an excellent workout choice for MS once you completely understand how to do it at a level that is safe yet challenging for the client you put through this program.

I want to see the percentage of people exercising with MS to overshadow the percentage that do not. You have a tremendous opportunity to be a solution to avoid in the fitness industry by becoming a MS Fitness Specialist and working with a community that needs you.


David Lyons, BS, CPT, is the founder of the MS Bodybuilding Challenge and co-founder of the MS Fitness Challenge with wife Kendra. He has dedicated his life to helping people with MS understand and be educated on the importance of fitness in their lives. He is an author and sought after motivational speaker, dedicated to helping others by sharing the lessons gained from his life experience.  His most recent book, Everyday Health & Fitness with Multiple Sclerosis was a #1 New Release on Amazon at its release. He is the 2013 recipient of the Health Advocate of the Year Award; in 2015, he received the first ever Health Advocate Lifetime Achievement Award, and the Lifetime Fitness Inspiration Award in Feb 2016. In 2017, David received the Special Recognition Award from the National Fitness Hall of Fame.