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The Roles of a Medical Fitness Specialist: Scope of practice, prevention and interprofessional collaboration

/9 March 2022/ All MFN blog/

Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.

Scope of Practice

Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.

An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.

Prevention

In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.

Interprofessional Collaboration

Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.

Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.

An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:

  • Knowledge of basic chronic disease pathophysiology
  • The use and side effects of common medications taken by someone suffering from a chronic disease
  • The knowledge to perform and analyze basic assessments related to movement and anthropometry
  • The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers
  • FITT protocols, exercise progressions, and regressions
  • The implications of exercise and activity for individuals with chronic disease
  • Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease
  • Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise
  • The ability to recognize a medical emergency
  • Current CPR and adult AED are required

Personal Trainers & Fitness Professionals: Prevent & Manage Chronic Disease and Collaborate with Clinicians

Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.

For a limited time, save 40% on this course by entering coupon code MFNBLOG40 at checkout.

This article was featured in MedFit Professional Magazine. 

Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program. 

aging-hands

The “Dark Side” of Parkinson’s Disease: Why Parkinson’s Changed The Way We See, Part 1

/4 March 2022/ All MFN blog/

The dark side of the moon is not considered a particularly exciting topic unless you are an astronomer or a Pink Floyd fan.  However, the dark side of the moon exists and is just as important as the front of it.

So, what are the conditions of the dark side of the moon? Does it ever see the light of the sun?  Why is it called the dark side?  These are interesting questions with answers that I will leave to space experts, BUT what I will say is that the moon is similar to Parkinson’s Disease (PD).  Yes, you read that correctly — the moon and Parkinson’s Disease are similar.

Parkinson’s Disease is most often characterized by a tremor and/or gait issues.  Just as the moon has a dark side, unseen but present, Parkinson’s Disease has a “dark side”.  As a fitness professional, understanding the “dark side” of Parkinson’s Disease and how it affects your “fighters” will enhance your program design skills, increase your confidence when counseling a “fighter” or care-partner and help build your relationship with other medical and fitness professionals.

The goal of this article series is to shed light on the “dark side” of PD. By incorporating the knowledge of medical professionals on my Bridges For Parkinson’s team, you will learn about research discoveries, resources for program design, useful tools for “fighters” and care-partners and ultimately, hope! 

Vision impairments in those with PD is our first topic in this series. People living with Parkinson’s Disease experience changes in their vision as they age. These changes may include cataracts, macular degeneration, dry eyes, floaters, glaucoma, diabetic retinopathy, detached retina, trichiasis, and blepharitis. NOW, People living with PD may experience one or several of these issues due to normal aging. However, due to the depletion of dopamine neurons in the substantia nigra, those with PD may also experience the following vision issues and/or impairments.

  1. Blepharospasm: uncontrollable eye twitching
  2. Blepharitis: Lack of blinking. On average, we blink 12-14x per minute. A person with PD may only blink 3-5x per minute. The result is inflammation on the edge of the eyelid. Eyelids may become irritated or itchy and appear greasy or crusty.
  3. Apraxia: “oculomotor apraxia” –  the absence of or defect in voluntary eye movement. This may result in trouble initiating movement and moving the eyes in a desired direction
  4. Diplopia (Double Vision): when a single object becomes two objects.
  5. Dry Eyes: eyes may feel sandy or gritty.
  6. Blurry Vision: MAY be related to dopamine depletion in back of the eye and within  the visual connections throughout the eye (Davis Phinney)
  7. Eye movement issues:
  8. Pursuit Movement: eyes are unable to work together to follow an object such as a plane flying across the sky.
  9. Saccadic Movement: unable to move eyes rapidly from one object to another such as completing a line in a book and going to the other side to the beginning of  the next line.
  10. Vergence Movement: as the target or object draws closer to the person with PD, the eyes are unable to converge to maintain focus on the object causing double vision. Approximately 30% of people living with PD suffer from Vergence Eye Movement problems.
  11. Depth/Distance Perception
  12. Photophobia (also known as Light Sensitivity): may wear sunglasses indoors due to bright lights.

Fitness Professionals should inquire about vision impairments before a “fighter” begins an exercise program and obtain specific information about the vision impairment. Each symptom listed above can potentially compromise gait/balance, increase difficulty with Activities of Daily Living (ADL) and cause those with PD to isolate or become depressed due to lack of independence. 

How We See 

When we use our vision, we’re doing a lot of simultaneous tasks. We have to sense and process the stimuli, perceive and make sense of the stimuli in the context of the situation, and translate those signals into a response (i.e. movement, bringing up memories, emotions) to the initial stimuli. 

For example, a stimulus such as a car passing by causes numerous neurological responses to take place in the visual system. First, that stimulus passes through the lens into rod and cone cells that make up light/shadows and colors to put the image together, which then reaches axons in the retina that extend through the optic nerve. Once that signal travels through the optic nerve, it reaches the optic chiasm, where the stimulus passes over to the opposite side of the brain from the visual field and eye. Interestingly, this car is not visually processed right-side up! Instead, it goes into your brain upside-down as the eye lens flips the image. That image then travels through the thalamus (our “sensory relay system”), and to the primary visual cortex, where the image gets processed and relayed to other sensory systems to prepare for a response.The Role of Dopamine in the Eye

You wouldn’t think that dopamine is involved in vision. We think of it relative to its impact on motor control and behavior reinforcement. However, even in ocular movement, lack of dopamine can impact a person with PD significantly, possibly resulting in apraxia. Dopamine also regulates light sensitivity in our retinas that helps to modulate our circadian rhythm, known as our “internal clock”. As dopamine decreases with disease progression, the sensitivity of the visual system decreases as well, hindering the ability to differentiate between light conditions such as day and night, potentially leading to other problems in circadian rhythm (Witkovsky, 2003). Over time, we see a loss of dopamine projections into the eye worsening vision such as blurry vision, light sensitivity, or even color vision deficiency as listed above. Unfortunately, there is not enough research on the involvement of dopamine in PD vision to give a clear-cut role of dopamine, but current research points to dopamine as a larger part of vision problems experienced by those with PD.  

Physicians

It is crucial to understand the connection between the brain and PD vision related issues.  Knowing when to refer a “fighter” to a vision specialist is critical to building your team of advisors and establishing a strong medical-fitness program in your community.

I highly recommend finding a neuro-ophthalmologist or a neuro-rehab optometrist to join your team. A neuro-ophthalmologist specializes in both fields of neurology and ophthalmology.  They complete a residency in either neurology or ophthalmology then continue to complete a fellowship in the complementary field.

Dr. Jamie Ho, OD, FAAO, FCOVD of Nashville, TN is a member of my advisory board and she is a neuro-rehab optometrist. Dr. Ho addresses the functional deficits that result from the neurologic changes.  You can learn more about Dr Ho’s practice at www.hovisiongroup.com.

To find a neuro-optometrist or neuro-ophthalmologist in your area go to www.noravisionrehab.org 

Medication

Medication for PD certainly improves PD symptoms however, visual side-effects can occur.

For example, according to www.healio.com, Anticholinergic meds such as Artane are used to address tremors but can also cause dry or blurry vision. The Journal of Parkinson’s Disease notes that dopamine agonists cause hallucinations, Levodopa may lead to ocular dyskinesia (involuntary eye movements), and MAO inhibitors to blurry vision. 

Fitness Professionals need to record all medications during the initial assessment and update any medication changes quarterly, at minimum

Click to read Part Two of this article, which offers some tips for fitness professionals working with PD clients with vision challenges.

Co-authored by Colleen Bridges, M. Ed, NSCA-CPT; Renee Rouleau-B.S., PhD student, Jacobs School of Biomedical Sciences, University at Buffalo; Kristi Ramsey, OTD, OTR/L.

Reviewed By: Dr. Jamie Ho, OD, FAAO, FCOVD

 

References

  1. Berliner JM, Kluger BM, Corcos DM, Pelak VS, Gisbert R, McRae C, Atkinson CC, Schenkman M (2018) Patient perceptions of visual, vestibular, and oculomotor deficits in people with Parkinson’s disease. Physiother Theory Pract. doi: 10.1080/09593985.2018.1492055 [PubMed].
  2. Borm, C., Smilowska, K., de Vries, N. M., Bloem, B. R., & Theelen, T. (2019). How I do it: The Neuro-Ophthalmological Assessment in Parkinson’s Disease. Journal of Parkinson’s disease, 9(2), 427–435. https://doi.org/10.3233/JPD-181523
  3. www.DavidPhinneyFoundation.org.
  4. Mayo Clinic, (2020)“Parkinson’s Disease Symptoms and Causes.” http://wwwmayoclinic.org20376055. 
  5. Nowacka B, Lubinski W, Honczarenko K, Potemkowski A, Safranow K (2014) Ophthalmological features of Parkinson disease. Med Sci Monit 20, 2243–2249.
  6. Witkovsky, P. Dopamine and retinal function. Doc Ophthalmol 108, 17–39 (2004). https://doi.org/10.1023/B:DOOP.0000019487.88486.0a.
trainer-resistance-band-senior-woman-client

So, your doctor told you to start exercising! Now what?

/2 March 2022/ All MFN blog/

Have you ever been given this very simple, yet incredibly complicated advice from your doctor? 

“You could really benefit from starting an exercise program.” 

If so, you are lucky to have a doctor who understands the power of exercise! In fact, exercise has been proven to help prevent diseases, reduce pain, decrease dependency on medications and improve overall quality of life. (1) The benefits are seemingly endless. However, are you someone who hasn’t the slightest clue as to what to do next? Where should you go? Who should you ask for help? Fear not, because you are not alone! Take a deep breath and follow these simple steps to begin a safe, effective and lasting exercise program today. 

Identify the Why! 

If a medical professional suggests you begin an exercise program, what is their reasoning behind it? While “obesity is linked to more than 60 chronic diseases”, your doctor may not be suggesting that you need to lose weight, but instead, suggesting that you need to address a specific weakness. (2) Do you have a medical condition where weight loss or improved cardiovascular health could add more quality years to your life or reduce your dependency on medications? Asking your doctor to fully explain these questions will help you understand how specific exercises can improve your physical and mental wellbeing. 

For example, if you have a heightened risk for falls, improving strength and balance is of utmost importance. However, if you are overly dependent on high blood pressure medications, your goal may be to improve cardiovascular health through aerobic activities. If you suffer from chronic pain or various forms of arthritis, the objective of your exercise routine will be more focused on enhancing mobility and flexibility, improving muscle imbalances and strength, as well as assisting with pain management through mindfulness techniques. Knowing your “why” is the first step towards clarifying your “how”. 

Invest in Yourself 

The most important things in life are NOT things. -Anthony D’Angelo 

It is rumored that Tom Brady, better known as the G.O.A.T. and the winningest quarterback in the NFL, spends over a million dollars a year on his health. Odell Beckham Jr., another famous NFL star, says that “I take care of my body each and every day. I put, probably, over $300,000 in my body in the offseason… It’s a lot to upkeep. I don’t ever want to decline.” (3) In all honesty, do you blame these athletes for spending so much money on their health when their health is their livelihood? 

When a medical professional suggests that you begin an exercise program, it is because they believe it will help your overall mental and physical well-being. While you may not be a professional athlete, you may be someone who wishes to remain active and independent for the remainder of your life. Therefore, it is paramount to invest in a certified fitness professional or medical fitness trainer to help create a program that meets your individual needs. 

Think about it like this, when your car needs to be fixed, do you try to fix it yourself or do you seek a certified specialist who will make an educated assessment, create a game plan and implement the necessary changes? I think it is safe to say that you will spend money on your car, but may scoff at the thought of hiring a trainer. What is more important? Things can be replaced, but people are irreplaceable. There are certified fitness professionals in your area you can find via a simple internet search or by posing a question on social media to your local chamber of commerce. With that being said, don’t be afraid to shop around and interview various trainers to make sure they are a good fit for you! 

Find a Match 

Find a job that you enjoy doing, and you will never have to work a day in your life. -Mark Twain 

Mark Twain was onto something when he spoke about the importance of enjoying what you do! This same principle applies when you set out on an exercise journey. If swimming scares you or you have nightmares about running, then pick exercises that you enjoy. Do you love to dance? Try taking some dance classes! Do you enjoy riding your bike? Let that be a part of your new exercise routine. If you dread your exercise sessions, loathe your trainer or hate every minute of your workout, then it is not going to last. If it feels like work, it’s not going to work! Exercise should be an enjoyable, yet challenging, part of your day! 

In addition, be sure that you take the time to assess how you are feeling and clearly communicate this to your trainer. If you are feeling run down, overly sore, or under-the-weather, your body is trying to tell you something. All of these signs are extremely important when it comes to enjoying the endless benefits of making exercise a part of your life. Now, let’s take action and begin to take control of your health. 

Christine M. Conti, BA, M.Ed, is an international fitness educator and presenter. She currently serves as the Director of Membership for MedFit Network, sits on the MedFit Education Advisory Board and is a course author for MedFit Classroom. She is also CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation and co-host of Two Fit Crazies & A Microphone Podcast. 

References

1 Roy-Britt. “How Diet and Exercise Can Prevent Disease. January 8th, 2020. www.elemental.medium.com How Diet and Exercise Can Prevent Disease | Elemental (medium.com)

2 Holland, Kimberly. “Obesity Facts in America.” Healthline. January 18th, 2022. www.healthline.com 

3 Zeegers, Madilyn. Tom Brady Inspired Odell Beckham Jr. to Invest in his Body. April 6th, 2020. Tom Brady Inspired Odell Beckham Jr. to Invest in His Body (sportscasting.com)

woman-plank-exercise

Power Up Your Planks!

/21 February 2022/ All MFN blog/

You know the importance of core strength — tone abdominals, obliques, and glutes. Thanks to spinal health, gone are jerky sit-ups. Ab crunches increase the “C” curve we have from sitting. New research says isometric planks are not effective. How can we improve our functional core stability? The answer is power! 

Power = Work X Speed 

We need power to avoid a fall. We use power to stand gracefully. What is a power plank? Consider Yoga — unison of breathing with posture and mental focus. Let’s skip the Sanskrit. Simply focus only on the exhale phase, to drive each outgoing breath with an abdominal contraction, about once or twice per second.

Plank Basics

Depending on comfort, support yourself on hands or forearms, and on knees or toes. Plank means straight hips. To protect your lumbar, lengthen it. Our sedentary lifestyle puts extra curve in the back. For neutral pelvis, slightly tuck your tail. Then, tuck your lower ribs. Don’t reference online photos. Society likes a curvy look, but it hurts your back. 

Your upper back should neither be rounded nor collapsed. Tuck your chin slightly and draw back to align your head with the spine.

A Power Plank

In your well-aligned plank pose, add quick, punchy exhales, like blowing out a candle. Use your nostrils or mouth but make a sound. As you draw your abdominals toward the spine, your hips may lift.

Once confident with the power plank, add a stability ball under the hands or forearms. Or place it under your shins or toes! This adds bounce to those abdominal punches.

To progress, add balance disks under your knees or toes, while the ball supports your hands or forearms. Nothing touches the floor! Use the disks under your hands or forearms, while the ball supports your knees or toes.

With a suspension trainer, start with ankles in the loops and hands or forearms on the mat. Progress to balance disks under hands or forearms.

Side Planks Anyone?

For obliques, do power side planks. Start on one forearm with the other hand on the mat, knees and feet on the mat. Hips straight, stacked vertically, with top foot in front. As you lengthen, slightly tuck the lower rib toward your lower hip. Use this action to power your exhales. 

Add a stability ball under the forearm or under the lower legs. If the big ball rolls, tuck it into a corner. Ready? Put the balance disk under your knees or feet while your arm is on the ball. Or place the disks under your forearm, while your legs are on the ball. Your top foot goes in front, to prevent rolling backwards!

Power planks are intense, so shorten your usual time. Then repeat. Of course, your simplest ab move is extended, deep, belly laughter! Either way, have fun and do these often. The abs “live in the pantry,” so they won’t tire easily. Keep it up!

ACE-certified Medical Exercise Specialist and ERYT-500, Emma Spanda Johnson designs fitness solutions for clients of all abilities. Watch her video demonstration of these techniques during a free trial at https://well.burnalong.com/pss/class/16318 . With an Orthopedic Specialty, Emma offers online personal training via www.FlightLive.US and your first 60 minutes are free.

 

References

  1.  James W, Kendra C, Erin E, Stephanie D, Nicole L. John H. Hollman. Magnitudes of muscle activation of spine stabilizers in healthy adults during prone on elbow planking exercises with and without a fitness ball. Physiotherapy Theory and Practice.2018:34:
  2. Escamilla RF, Lewis C, Pecson A, Imamura R, Andrews JR. Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball. Sports Health. 2016 Jul;8(4):372-9. doi: 10.1177/1941738116653931. Epub 2016 Jun 14. PMID: 27302152; PMCID: PMC4922527.
  3. Badau D, Badau A, Manolache G, Ene MI, Neofit A, Grosu VT, Tudor V, Sasu R, Moraru R, Moraru L. The Motor Impact of the Static Balance in the Up Plank Position on Three Different Balls in Physical Activities of Physical Education Students. Int J Environ Res Public Health. 2021 Feb 19;18(4):2043. doi: 10.3390/ijerph18042043. PMID: 33669792; PMCID: PMC7922917.

 

running-determination

The Moment of Truth

/16 February 2022/ All MFN blog/

According to the Advanced English Dictionary, © HarperCollins Publishers, “if you refer to a time or event as the moment of truth, you mean that it is an important time when you must make a decision quickly, and whatever you decide will have important consequences in the future. Both men knew the moment of truth had arrived. (As a sentence example)”

We all come to crossroads in life when we are faced with a decision that will change our life’s direction one way or the other. You have to make that decision quickly, without procrastination, and decide where you are headed. Sometimes, if you get old enough like me, these times come more than once. They are said to be our “moment of truth”.

In September of 2017, I started a closed Facebook Group called MS Fitness Challenge GYM for those of us with MS who are doing their best to beat MS through fitness. It is a platform for MSers to be educated on exercise, nutrition and mindset in the battle against this disease. It’s also a place where we can interact, share our goals, talk about our trials and victories and be able to connect with like-minded MSers who want to encourage and uplift each other in a positive atmosphere of health. We currently have, at the time of this writing, over 7,000 members.

Every day, I read a post about how hard it is to exercise and follow a strict nutrition plan from the members enrolled. The member’s post about the limitations, pain and issues of their symptoms that make it difficult to follow through with exercise. And, they talk about the mental blocks to sticking with an exercise or diet program.

I know. It’s not easy having MS or any challenge in life and dealing with our ups and downs let alone trying to push ourselves to get to a gym or work-out at home and follow a diet that is ONLY full of great foods and supplements for MS. I get it!

But what I’d like you to look at is the consequence of NOT getting into a regular fitness routine, NOT watching what you put into your body, and NOT setting your mindset to the positive dial. MS will not go away; it’s incurable (right now). And the disease symptoms will not improve unless you take a proactive stance against it. Exercise, nutrition and the thoughts in your mind has been proven, through programs such as my MS Fitness Challenge and many others, to help MSers in one way or another in this battle. You can read over and over again, in a multitude of platforms, the testimonials from MSers who have switched to an MS-based diet and implemented an exercise routine seeing great improvement in their quality of life. We are not talking cure here. We are talking a better day-to-day existence despite MS. And, really, this translates to any obstacle you have in your mental or physical health. The choice is yours. Do you want to choose the road that takes the work necessary to a more fulfilled lifetime, or let whatever your challenge is tell you how to live? This is the moment of truth.

The first step is getting your thoughts, motivation and determination in order. Your body will not go where your mind doesn’t take it. So fitness starts in the most influential muscle in your body… your brain. Getting revved up and ready to take on your barrier through fitness is a choice that has to be made. It is not something that most have waiting to come out. It is a desire found deep in your thoughts and feelings. You have to dig down and pull it out because there is a serious amount of action that needs to be put into play with the reaction of… “I want to beat MS” or “I’m tired of being obese” or whatever your challenge is.  And once you make this choice in your moment of truth, you do not want to look back.

When your choice to overcome your challenge is made, now it’s time to settle in on the exercise and nutrition programs that will kick start this new truth in your life. I understand the confusion of where to begin; what are the best programs for you; who helps you? This is where research and support comes in and why I founded my MS Fitness Challenge charity. We are the MS cause dedicated to educating, training and inspiring people with MS to live a lifestyle of fitness through knowledge.

So, who’s ready to stand at that fork in your road, look at it hard and tell it you are going down the road to fitness?  I’ve been traveling that road my whole life, without MS and with MS and there is no better path to follow. Your moment of truth has arrived…

Fitness Professionals and Personal Trainers: Improve the Lives of Those with MS

Become a Multiple Sclerosis Fitness Specialist! This MedFit Classroom online course, co-authored by David Lyons and CarolAnn, will prepare you to work with clients with MS to help develop strength, flexibility, balance, breathing, and improve their quality of life.

Multiple Sclerosis Fitness Specialist

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.

Senior woman with help of physiotherapist

Trainers Can Make a Difference: A Personal Trainer’s Effect on Knee Surgery Preparation

/14 February 2022/ All MFN blog/

One of my highest honors as a Personal Trainer has been to work alongside my clients in preparation for knee surgery and post-surgery rehabilitation. Working alongside a Physical Therapist (with the client’s permission to share information) to bring the client to a complete recovery has been a privilege and an excellent learning opportunity.  

Pre and post-surgery are two very different stages, but both require the client and trainer’s knowledge, trust, and commitment. Today I will focus on the preparation for knee surgery from the perspective of a Personal Trainer. 

First and foremost, the Personal Trainer must act within their scope of practice.  Most nationally accredited Personal Trainer certifying agencies have clearly outlined the scope of practice that a trainer must work within. 

Here are a few DO’s and DON’Ts from The American Council on Exercise (ACE) that apply to the subject of pre-knee surgery clientele. 

Personal Trainers DO receive guidelines from Physicians or Physical Therapists. They DO design exercise programs, refer clients to appropriate allied health professionals or medical practitioners if needed. Trainers DO design exercise programs after a client has been released from rehab, and as trainers, we work with clients, not patients.  

Personal Trainers DON’T diagnose, prescribe, treat injuries or disease, rehabilitate or work with patients. 

There was a time when I would stop working with a client as they were awaiting knee surgery for fear of causing more damage. Still, after going through my own knee surgery, I realized there is much I could have done to prepare appropriately and that trainers can do for clients as they prepare for surgery to help put them in the best possible position for a full recovery. 

One significant preparation step for any knee surgery, often overlooked, is upper body strength. The client will likely be on crutches or possibly a wheelchair post-surgery.  When your legs are not fully functioning, you rely heavily on your upper body to move from place to place, from sitting to standing and getting to your Physical Therapy sessions.  I found success doing body weight work for the upper body in preparation is very helpful and can prevent shoulder injury as the client needs to move their body from bed to crutches or crutches to toilet and the like. Lifting out of a chair and putting a large amount of body weight on the arms is exhausting and, again, can strain or injure those joints and muscles, which can put the healing process from the surgery leg on a slower rehab pace. 

Body weight exercises for the client pre-surgery can be as simple as lifting and scooting themselves laterally across a bench, or maybe learning to use rail support to lift themselves out of a seated position, sitting with legs extended on a mat on the floor, lifting their hips to clear the ground to shift around.  Engaging and strengthening the shoulders, biceps, triceps, and even strengthening the wrists and handgrip has excellent benefits.  Encouraging core work from all six sides (Rectus abdominus – front, erector spinae – back, Obliques internal and external – right and left, diaphragm – top, and pelvic floor – bottom) to support the upper body moving the body weight is very beneficial.  We also shouldn’t forget mobility and stability in the upper body to assist in recovery. 

The second important step to surgery preparation is strengthening the muscles that support the knee in all directions. This will allow the client to be in the best possible condition to rehabilitate well. It may be necessary to be creative in finding ways to do this without putting weight on the knee joint.  Place a high priority on mobility and strengthening in the upper leg; quadriceps, hamstrings, hips, glutes: the lower leg;  gastrocnemius, soleus, tibialis, and lower leg extensor muscles. 

Personal Trainers can make a difference. Stay within your scope of practice, educate yourself on knee health, and take advantage of every opportunity to collaborate with a physical therapist or medical practitioner to learn, grow, and serve your clients with the highest quality. 

With knowledge, trust, and commitment, trainers can make a marked difference in the clients’ recovery. 

Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30 plus years of experience to a long, fulfilling career in the fitness industry. In the past 13 years at the University of Texas at Austin, Shannon has led continuing education workshops in multiple group fitness formats and topics specific to personal training; she also has written the curriculum and manuals for numerous workshops accredited by the American Council on Exercise (ACE). Shannon is currently a monthly contributor to Campus Rec Magazine for Fitness and Wellness. 

wellness

The New PPE: Post Pandemic Era | Wellness Reimagined

/11 February 2022/ All MFN blog/

In an age where the words PPE, boosters, and “the new normal” seem to be a part of everyday vernacular, it is time to ask some essential questions:

  • Where do we go from here?
  • How do we best move from a Pandemic state of stress and inflammation to a new state of calm and boosted immunity?
  • How do we step into the New PPE, the New Post Pandemic Era in a way that brings about lasting change?

The answer to those questions lies within a Reimagined approach to “Wellness.”

Wellness, as defined in Dictionary.com[1], is “the quality or state of being healthy in body and mind, especially as the result of deliberate effort.” While this definition is suggestive of a more holistic approach to wellness, it is still does not adequately address the challenges now faced by the world community due to the devastating impact the pandemic has wrought.

As a result of COVID-19 and its resulting policies, there has been a profound impact on the mental and physical health of the world population resulting in higher instances of stress, depression, insomnia, PTSD, and anxiety.[2] Stress can activate inflammation in the brain and the body which is a common risk factor of 75%–90% diseases linked to morbidity and mortality (CVD, i.e., hypertension and atherosclerosis, metabolic diseases, i.e., diabetes and non-alcoholic fatty liver disease, and neurodegenerative disorders (i.e., depression, Alzheimer’s disease, AD and Parkinson’s disease, PD), cancer. [3]

The Wellness industry is booming, with people investing in their health more than ever before. But for some, this means they buy the latest fads and trends in hopes that it will lead to a healthier lifestyle. The truth is that unless you make a commitment to changing your life and taking control of your wellness goals, you’ll never see the results you want.

To move into the New Post Pandemic Era with a focus on long-term change, an integrated health approach is required. Understanding, not only how we move and fuel our bodies, but also how we relate and interact with the people, places and situations that make up our world is a key towards advancing beyond this pandemic. This New PPE approach will represent Wellness Reimaged, better positioning us to experience long-term health benefits.

There are countless programs – too many to name -that teach the what, when, and how’s of eating and moving. There are also an equal number of programs where mind set is in focus. While many of those programs provide essential information as to how to advance health, it is time to explore what may be missing to experience a state of “true wellness”. The road to attaining “true wellness” lies within the following 3-Step Process.

COMMIT:

  • The Yes! Mindset – a positive, purposeful Mindset focused on achieving goals and discovering the authentic you.

DO:

  • The Brain/Body Connection in how you Breath, Move and Eat, and
  • The A.G.E. Life Framework where you Age with Grace and Excellence.

LIVE:

  • The Yes! Life of Constant Challenge of the Brain, Body and limiting Beliefs where personal goals are reached and your Life Vision realized.

Are you ready to create a Wellness Revolution?

Free Webinar with Lisa Charles

Join Yes! Coach Lisa Charles for a free webinar from MedFit Classroom, The New PPE: Post Pandemic Era

Lisa Charles is a federal prosecutor turned singer/actress, wellness expert, certified health coach/consultant, and an acclaimed speaker. She served as the Fitness/Wellness Research Coordinator for the Rutgers University Aging & Brain Health Alliance, and is the CEO of Embrace Your Fitness, LLC, and the Author of YES! COMMIT. DO. LIVE.

 

References

  1. https://www.dictionary.com/browse/wellness
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689353/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689353/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/#B15