Fitness Professionals – Page 41

Physio assisting elderly woman during exercise with power band a

Treating Chronic Health Conditions: A Guide for the Fitness Trainer

Sharon Bourke/11 March 2019/ All MFN blog/

The biggest question fitness trainers need to ask themselves is “Why do you want to work with the chronic populations?” Is it because:

a) The stats (IDEA, IRHSA) out there say it is the fastest growing population/market?

b) You really want to help people that tend to have multiple issues because it is rewarding?

c) You feel drawn to it because one of your clients now has a condition?

d) You like figuring out puzzles?

e) All of the above.

All of the above factors play a role in working with chronic conditions. It takes a much different approach than working with the general population. For starters, what defines a chronic condition, besides something that is ongoing?

The Center for Managing Chronic Disease defines it as such:

“A disease that persists for a long time. A chronic disease is one lasting three months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. Eighty-eight percent of Americans over 65 years of age have at least one chronic health condition (as of 1998). Health damaging behaviors – particularly tobacco use, lack of physical activity, and poor eating habits – are major contributors to the leading chronic diseases.”

What I find so fascinating is in the last sentence: “health damaging behaviors”. That is the core of working with chronic conditions; you want to impact a person’s or client’s health damaging behavior. If they are coming to you with a condition, we already know they have one, if not more, behaviors that need to be addressed and changed. This means you not only have to work with the biomechanical/physical implications of their condition, but the emotional/psychological aspects of it as well. Welcome to the world of medical exercise, a very rewarding and extremely challenging area of the fitness industry–a part where you will need to wear several different hats: health coach, sleuth, guide, emotional supporter, cheerleader, and fitness professional. Therefore, you need to be prepared.

Be Prepared

Start by deciding which medical conditions you are interested in; a great list can be found at Chronic (Medicine) on Wikipedia. Next, find out if any of these support organizations offer a certification–National MS Society, Arthritis Foundation, and Cancer Training Institute are some out there. Visit websites and request information. Most support organizations have a lot to offer on their websites, or try googling the condition itself. It may take some time, since with search engines today advertisements tend to come up first. Research support groups in your area, and ask to attend a meeting. This will expose you to the emotional side as well as the physical limitations of their condition, and what difficulties they face on a day to day basis. This will aid you in designing an appropriate exercise program for their specific needs. Read, read, and read some more, and then be critical. A lot of information is very general; dig deep, and if an article or website does not have the information you need, ask a professional.

Create a Board of Advisors

As a certified fitness professional, I did not go to medical school or physical therapy school, nor do I have a degree in nutrition. But I have learned a lot over my 20+ years working with special populations–and as a person who has fibromyalgia–but I don’t come close to knowing enough. As clients with conditions come through my door, many on numerous medications with eating habits that would make most trainers cry, medical questions come up. For example, “Can I eat dairy products if my medication says not to take calcium supplements with it?” Or “I find every time I walk upstairs I get out of breath–does that mean it is my condition or am I just out of shape?” And “Have you heard that Maltitol is bad for you, and what is Maltitol?” At this point, unless I feel there is a huge medical issue that needs addressing (then they get sent to their doctor immediately), I contact the appropriate person on my board and ask them the question. The board also helps with disseminating and understanding clinical test results that clients give me, or any other physiological question that is beyond my knowledge. It also builds your credentials as a professional when dealing with the medical community.

Scope of Practice

Most fields in the medical community are clearly defined by a scope of practice. From having spoken with more than a few doctors, they are very hesitant to refer to personal trainers, mostly because of injuries as a result of improper exercise programming or what they have observed in the gym. In the medical fitness industry, it is even more imperative to be precise and transparent with what you are doing. When a new client comes to me, I contact their doctor or physical therapist–usually via e-mail or letter–detailing what I have found from my assessment, the condition, and what kind of program I am designing. This gives them the opportunity to comment or change it accordingly. It also opens up lines of communication. The professional knows I am not going to have a spinal fusion client performing kettle bell swings right out of the gate; they will see my progressions and know that if something is off, I will refer back to them.

One of the hottest issues in the fitness industry is licensing; for it, against it, I am not going to argue it here, but as a fitness professional, I need to make sure I do not prescribe or diagnose. Even if I am 99.9% sure a person has impingement syndrome because of all the presenting symptoms, I am not going to say it. I am going to refer them to a medical professional. Especially with this population, there are a lot of cross over issues, and it is not our responsibility to diagnose but to help manage and improve their condition.

Empathy and Trust

Working with chronic conditions requires a lot of empathy and the ability to set boundaries. You need empathy more than sympathy; if you cannot get inside what they are going through pain- and limitation-wise, it will be hard to establish trust. Establishing trust is the biggest tool you can develop–my clients trust I will not hurt them, make them worse, or ask them to do anything they cannot accomplish. If you get the opportunity to attend a support group or speak with people who have chronic conditions, most want to get better, but don’t know how. They are afraid of making things worse; even the avid exercisers who have tried to “fight through the pain” find it doesn’t work, and are at a loss as to how to proceed. You have to understand how life changing their condition is, where they started, and where they are right now. It can help to take courses in health coaching or read up on behavior modification– even better if you can find something geared toward the specific condition you are dealing with.

Avoid the “over-empathy” trap, because people with chronic conditions can use it as a crutch, too. Balance in sessions is important; include activities they really like to do in with the exercises they hate.

I guarantee the exercises they hate are the exact ones they need to do the most! Offer rewards, if they do their homework exercises, or it could be just to get through a session. It can be difficult to manage both their emotions and their physical selves; if you don’t feel prepared, refer to an outside professional. Yes, you may lose your client, but in the long run, it gains you credibility and more trust.

Recharge Yourself

Recharging and recovering are the new buzz words in the health and fitness industry. It is even more important in the chronic condition realm, for both clients and professionals. More than in any other population, chronic conditions will sap your energy, your strength and sometimes your emotions. Most of this community will not see huge improvements like general exercisers; in some instances you will observe regression. They will have good days and bad days; they have challenges every day of their lives–just getting out of bed and getting ready for the day can seem like climbing a mountain. Then we come through the door and want them to do exactly the last thing on earth they want, which is to move more. They may be cranky, and in the case of depression or mental illness, downright nasty, leaving you to pull all your happy tools out just to make it through the session. In this case, what do you do to recharge your batteries? Funny as it seems, pay attention to the advice you are giving your clients–often times it can go both ways. I tell my clients to meditate, get a massage, plan a fun outing, or simply review their happy journal. These are the exact activities that recharge me!

It is easy to work, work, work, and this clientele is more demanding of our time and attention. Don’t ignore yourself; make sure you work in time to rebalance. Put it on your calendar as faithfully as you do your workouts or doctor’s appointments. All work and no play will bring on the exact condition in yourself that you are working hard to alleviate. If you really want to serve the chronic condition population, lead by example, and make time to recharge.

Sharon Bourke is an MFN member and the owner of Life Energy Fitness. At Life Energy Fitness, her goal is to identify where the compensations are and to help your body relearn proper movement patterns. The results are more energy, less chronic pain, an ability to participate in activities you love, and to prevent other problems from forming.

Senior woman with help of physiotherapist

Knowledge (Alone) is Not Power

Jason Karp, PhD/1 March 2019/ All MFN blog/

A number of years ago, I applied for a job as a personal trainer in a gym. During my interview with the manager, he called me “book smart.” It wasn’t a compliment, since he was suggesting that I only knew the information in books, and that what really mattered was a person’s experience. “We really want someone who has been doing this for a while,” he said, before sending me on my way. Ouch. I left the interview frustrated, because it seemed as if my education precluded the gym manager from seeing what I could do. Or perhaps I hadn’t shown him. I had not yet proved to him that I was more than just book smart, that I could actually use my education to train someone to get fit and lose weight.

Knowledge alone is not power. One must be able to apply the knowledge one has. This is where a formal education fails us. I have met many brilliant scientists who have no idea how to train someone. (I once spoke to the scientist who studied cyclist Lance Armstrong for years in his laboratory at the University of Texas, and when I asked him about Lance’s training, he acted like a deer caught in headlights.) Universities do a great job of supplying us with knowledge, but a poor job of showing how to apply that knowledge. That part is up to us to learn on our own.

Too much of the knowledge gained from the great research done by my academic colleagues remains in academic circles, never reaching the fitness professional or the general public. Academic conferences are nothing more than scientists communicating their research to other scientists. Scientists need to do a better job at communicating the results of their research to the people who can benefit from it and showing them how to use it, and fitness professionals need to do a better job at acquiring and applying the education. It is not enough to know how muscles contract; we need to know how to design and administer resistance workouts to help our clients’ muscles get stronger and look better. It is not enough to know how the heart works; we need to know how to design and coach workouts to help our clients’ improve their cardiovascular systems.

Wouldn’t it be great if all fitness professionals were required to have an education that consists of book knowledge and practical knowledge? The latter can be obtained from “rotations” akin to those in medical school. We would all spend a couple of years taking the science courses and then do rotations in health clubs like medical students do in hospitals, to learn how to work with different populations and conditions. Upon graduation, we either become a fitness general practitioner or choose a specialty. I choose running. But you already knew that.

Reprinted with permission from Jason Karp.

Jason Karp is the creator of the REVO2LUTION RUNNING certification, 2011 IDEA Personal Trainer of the Year, and recipient of the 2014 President’s Council on Fitness, Sports & Nutrition Community Leadership Award. A PhD in exercise physiology, he has more than 200 publications, mentors fitness professionals, and speaks around the world. His sixth book, “The Inner Runner”, is available in bookstores and Amazon. Visit his website, Run-Fit.com

Parkinson’s Disease and Resistance Training

Laurie Urbanski/5 February 2019/ All MFN blog/

Parkinson’s Disease is a brain disorder that causes individuals to have difficulty with balance, coordination and walking. They can also become shaky or stiff and some people even develop tremors. It is a common disease that can….

Adaptive Health Paradigm: A Principle-Centered Perspective for Medical Fitness

Dr. Mark Kelly/4 February 2019/ All MFN blog/

I hope to give you some insights to both how the human body works as well as why medically-based fitness is not only valid, but absolutely necessary to reverse, assist, or prevent various chronic and acute disease conditions. Wow, that is a “mouthful” to say the least. I feel so strongly about this perspective that I hope to create the Adaptive Health Model as a major “brand” of fitness. My company (Principle-Centered Health) for the past couple of decades has always had a systems-based approach to health and fitness. This approach ties a lot of different facts into a common theme, usually called a theory in science. Even my dissertation looked at how people adapted to the physical, mental and social issues in their lives using exercise, self-efficacy, and social support, respectively, and levels of strain and burnout. How humans adapt to the stresses put on them is very specific and can go in good or bad directions.

What is the Adaptive Health Paradigm?

Like most theories, paradigms or what people consider “original thought”, this “adaptive” paradigm builds on the “regenerative medicine” framework, and some disease models; thus, is not original at all. What may be new, or unique about the adaptive perspective is taking the old phrase from physicist Isaac Newton and his third law of motion, “for every action there is an equal and opposite reaction.” The body will respond to stresses by reacting in a “defensive” manner. If we break something down, the body builds it up (opposite reaction). If we are too low or too high in some function, the body will try to correct this. This negative feedback loop controls most systems in our bodies. I have often described our bodies as fragile but resilient. It is our fragility that signals the resilience to kick into gear!

Luckily for us, fitness is based on this exact principle. If we do endurance training, we are going into a lower oxygen state and there are many mechanisms or functions that kick in (sympathetic nervous system) when we push or stress our bodies. The body is responding to what is known as an “acute insult” by increasing the ability to transport and use oxygen, so that this “insult” doesn’t hurt us next time. The same “specificity of training principle” occurs with resistance training. We breakdown muscle and the body builds it back stronger to tolerate that “insult” the next time. When multiple acute exercise stresses are added up, the body changes and we call this “training”.

If stresses are really high, either too intense, too long, or too often, the body gets injured due to this overload, or it needs a lot more time to heal back up. This is why overload needs to be done gradually and progressively. Even our brains use this idea as a guiding principle. We push our mental capacities to learn more, but if we stress it too much, it will repress memories or shut down (burnout).

This same principle applies when we give our body bad things, or a lack of good things, it adapts with a dysfunctional state or disease state. Chronic inflammatory diseases, diabetes, metabolic syndrome, coronary artery disease, emphysema and heart disease are just a few of the examples of how the “garbage in and garbage out”, or “use it or lose it” works. If we sit and work at the computer too much we develop dysfunctional postures and upper cross syndrome may develop. If we do not constantly stress some system, it reverses the training changes, and goes into the “default” state, which is untrained and unable to respond to daily stresses. We simply need to obey our bodily blueprints, we need to constantly use our bodies to maintain function, and overload it to improve function. We need to have the right nutrients in place to allow this to happen, and then basically – get out of the way!

Intelligence in the Body: Applications the Adaptive Health Paradigm

The perspective being proposed in this article shares much with the more holistic medical practices. The human body is really good at healing itself when is it given the right factors to do so, and when we “get out of the way” for it to do so. I know many people who strongly believe in using alkaline water to “cure their ills”. They believe that the body does not know how to regulate itself with its own pH. Most of these same people don’t know what pH even stands for! They don’t know that it is actually the inverse log of the hydrogen ion concentration relative to the hydroxide ions, and that the respiratory system and renal system will go into action as soon as blood pH goes 0.05 pH units high or low!

In other words, these people believe their own bodies are naïve or incapable of curing itself, and like a young child or baby, their body needs constant care and guidance. Most people are so stressed about “taking care” of their bodies that they are doing more harm than good via the stress hormones, especially cortisol being constantly secreted and their adrenal gland is getting fatigued. In reality, the body is really good at healing itself, when we keep it strong and in good operating condition (via exercise and movement) and when we give it the right components to do the healing (via nutrition), and we get out of the way of the immune system (by managing our daily stress levels).

The mind works very much like a muscle. It must be trained and kept strong and when injured it will react in dysfunctional ways, and fight to protect itself. I recently heard an expert in human behavior change speak on how to keep a resolution. He said, we can’t keep a resolution without changing the underlying behaviors which caused the bad habit or lack of a good habit in the first place. By changing the way we think, we change the way we act, and changing our actions will change the way we think!

“What Goes Around, Comes Around”

The quote often stated by Thomas Edison in 1903, which was to give rise to the HMO concept, “The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease.” Medical doctors (M.D.s) upon completing medical school and prior to practicing take the Hippocratic Oath, which is to do no harm. Even back in Ancient Rome, Hippocrates understood the importance of individualized medicine and the power to “get out of the way” (#5) and give the body what it needs to take care of itself. He had five rules that are still relevant in today’s medical practices.

Walking Is Man’s Best Medicine.
Know What Person the Disease Has Rather Than What Disease the Person Has.
Let Food Be Thy Medicine.
Everything in Moderation.
To Do Nothing Is Also a Good Remedy.

Integrative and Functional Medicine – Highly Inclusive and Holistic Perspectives

A philosophy of practice using these practices is integrative medicine. A brand of medicine created or at least popularized by Andrew Weil. The University of Arizona has this “brand” of medical school. Again, the academic requirements are similar to the M.D. and D.O. but expands its scope to other areas. From the website, Integrative Medicine (IM) is defined as a “healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies. many different ways in the patient.

A new type of medicine is emerging from this functional perspective which is called personalized medicine. Again, the two are basically two sides of the same coin.

Figure 1: A diagram above showing the greater scope of each medical perspective- Integrative and Functional medicines are close in their holistic perspectives, with differing points of emphasis

What is going on within the individual to cause the disease or prolong its existence?

Sometimes disease hits simply because we were genetically predisposed to get it. However, very often if our system is strong and in good operating condition, we resist it from every occurring or overcome it quite quickly. Cancer is a prime example of this. We all have cancers in our bodies all the time. It is the strong immune system that fights it off. This is amongst the reasons that many, many chronic diseases hit us when we are old. The various system have lost their capacity to fight the dysfunction off, or recover from its destruction. Soon cell death (necrosis or apoptosis) or neoplastic (cancer) growth kicks in.

Harnessing the Power of Exercise and Diet to Fight Chronic Disease

Many, many chronic conditions that the MedFit Network and MedFit Classroom address are helped by exercise and diet because the ability of body to adapt and regenerate itself is enhanced. Most systems in our body fall under the “use it or lose it” scenario. High sugar, alcohol, smoking, and lack of movement are culprits in our health. Our body is not designed for an overload of these factors and across time, many different symptoms will develop because our body can no longer compensate or regenerate.

It is important for the medical fitness professional to understand the power of exercise and nutrition, and the proper application of these tools given the client’s or patient’s current condition. The field of physical therapy developed because many musculoskeletal conditions are helped by movement therapy or exercise. Many chiropractors believe that proper spinal alignment delivers proper neural signals throughout the body, which allows the body to optimize its regenerative capacity. Thus, an expert in medical uses of exercise to combat disease is critical to a healthcare team.

Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.

References

Center for Integrative Medicine, Univ. of Arizona (n.d.). What is IM/IH? Retrieved from: https://integrativemedicine.arizona.edu/about/definition.html

Science Daily (n.d.). Personalized medicine. Retrieved from: https://www.sciencedaily.com/terms/personalized_medicine.htm

Good Reads (n.d.). Retreived from: https://www.goodreads.com/quotes/13639-the-doctor-of-the-future-will-give-no-medication-but

Kalish, N. (2018). Hippocrates’ Diet and Health Rules Everyone Should Follow. Reader’s Digest. Retrieved from: https://www.rd.com/health/wellness/hippocrates-diet/

Aligning with Medicine

Phil Kaplan/28 January 2019/ All MFN blog/

I’ve been to the mountain. Yes, I’ve been in the world of medicine. I’ve run my programs in hospitals, collaborated with physicians to address chronic disease, and spoken at medical conferences on topics ranging from “emotion and the patient” to “the healing powers of synergy.”

Between you and me, I’ve been to nicer mountains. While I have nothing but praise for doctors, when we lift up the medical curtain, the overall system, the collective mindset, and the impotence of the treatment of chronic disease provide an open door. For who? For fitness professionals, and I say that with qualification.

The challenge in great part is a naivete. Our “industry” is not well versed in the living dynamics between medical institutions, health insurance, and pharmaceuticals, so these lobbying giants are viewed by personal trainers as purely corrupt, as the evils that plague our population. Yet, when the mirror of honesty is confronted, the limitations of conventional exercise and eating are not by any means the panacea trainers profess them to be in the midst of a population struggling with health compromise.

YES, THERE’S AN OPPORTUNITY BUT . . .

. . . it requires a re-education, an enhanced skill set.

Physical therapists are not thrilled with the idea of personal trainers working to address muscular imbalances and injury recovery. Nutritionists approach trainers who coach their clients nutritionally with caution. The trainer is not deemed a player on the Allied Health Care Team.

We therefore hear assertions from “trainer island” with limited foundation.

“Insurance should pay for our client sessions, after all, it pays for medical treatments that don’t work.” Wow, is that a slippery slope, one I wouldn’t approach if it showed up in my backyard and I was equipped with anti-slip cleats.

“Doctors should refer clients to us.” That is best responded to with a simple, “why?”

“Doctors don’t care about their patients.” There’s a globalized bias that fails to account for a system that makes “exploration of the client condition” one of the greatest challenges in the field, regardless of the physician’s heart.

* * * * * * The opportunity lies in humility, in a willingness to step up and learn, and in providing a true complement to the system that is flawed. It isn’t an “us or them,” but it also shouldn’t be a one way street of elusive referrals. It’s a recognition that we have the per-session time to invest. We can gain the trust of clients. We can see clients regularly and facilitate programs that require joint responsibility.

The most important piece of creating an industry wide recognition of the trainer’s power is perhaps the dismissal of ego, the acknowledgement that trainers deemed competent in prescribing safe and effective exercise, have not learned to address metabolic imbalance, hormonal disruption, and inflammatory issues that underlie the most common conditions.

It’s in the spirit of betterment that I’ve committed to learn and teach, to isolate practices fully within the trainer scope of practice that address the sources and causes of the plagues that impact 65% of our adult population. It’s time, not to urge doctors to respect trainers, but for trainers to create a legitimate platform of respect, one where chronic dis-ease is treated as a self-induced condition with patient / client empowerment as the greatest vehicle for true opportunity, as the vehicle for collaborative respect, a vehicle for the trainer to serve as a bona fide health catalyst.

Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment. He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease. His dual passion combines helping those who desire betterment and helping health professionals discover their potential. Email him at phil@philkaplan.com

Exercise and Dementia: Thinking Differently about Thinking

Dr. Mark Kelly/25 January 2019/ All MFN blog/

Many people are aware of the devastating effects dementia and Alzheimer’s disease (AD) has on families. I know this devastation personally, as my mother suffers from advanced stages of AD. It is very sad to have only the body present of someone you have known and loved your whole life! This article will discuss some of the newer developments in understanding and possibly reducing the disease, as well as the positive role exercise may have in slowing the onset and development of symptoms, and disabilities for any form of dementia.

The impact on family units and caretakers is even greater and can’t be measured by financial impact. Dementia is a group of symptoms that affect mental tasks like memory and reasoning. Dementia can be caused by a variety of conditions, the most common of which is Alzheimer’s disease. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases (http://www.alz.org). Much of the recent attention to professional football players and the repeated brain trauma is due to the increased incidence of dementia, not Alzheimer’s. Dementia is characterized by loss of memory, intellectual capabilities and executive functions.

Alzheimer Concept. According to the Alzheimer’s Association, in 2015, 5.3 million Americans are believed to have this incurable disease. The cost of Alzheimer’s to the U.S. is $226 billion, and this figure is estimated to more than quadruple to $1.1 trillion by 2050 unless some major discoveries are made. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented. One in three seniors will die with some form of dementia. Alzheimer’s is far more prevalent in women, with about 3.2 of the 5.1 million people, or 2/3rds, being women. The Baby boomer generation should cause the number of those affected to swell to 7 million, which may double by 2050. (http://www.alz.org/facts/overview.asp).

Factors Associated with Alzheimer’s Disease

While no one really knows exactly what causes Alzheimer’s disease (AD), there are several factors that are highly associated with it, and even some treatments that seem to slow its progression and onset. The two most prominent factors associated with AD are age and family history.

After age 65, the risk of Alzheimer’s doubles every five years. After age 85, the risk reaches nearly 50 percent. A type of AD is known as early onset or younger onset. This term actually is used for two types, a risk and deterministic form. Both may start in someone’s 30s or 40s and if someone has the gene it is 100%. This “determined” form is rare, accounting for only 5% of the total cases. Research has shown that those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness.

Biomarkers of Alzheimer’s Disease

APOE genes
Neuro-tangles associated with the Tau protein
Beta amyloid plaques- a protein clump found in the brain- disrupting communication
Inflammation
Decreased brain size

(http://www.alz.org/research/science/alzheimers_research.asp)

When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. There are two categories of genes influencing a person developing a disease: risk genes and deterministic genes, both of which are present in Alzheimer’s disease.

Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Researchers have found several genes that increase the risk of Alzheimer’s. Apolipoprotein (APOE)-e4 is the first risk gene identified, and has the strongest impact on disease risk. APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3.

Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s and those with two copies have an even higher risk, but still not a certainty. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual (early onset). Scientists estimate that APOE-e4 is implicated in about 20 to 25% of Alzheimer’s cases.

Brain Size and Function

We often associate brain size with cognitive capacities and for the most part this relationship holds true. While it is very difficult to measure any increase in mass due to neuroplasticity, we can measure increase activity in the brain due to exercise, or decreased activity from AD and other dementias.

How can Exercise and Diet Help

senior-exercise-trainer It is important to understand some of the limitations of exercise and diet in helping either dementia or AD. First of all, one must separate non-Alzheimer’s dementia from Alzheimer’s, and then must understand what stage of AD the individual is in. Finally, one must realize if the symptoms have already manifested (onset), and then monitoring the progression.

Exercise has a more pronounced effect on helping decrease progression and even reversing some symptoms with non-Alzheimer’s dementia. In addition, the earlier someone is able to perform preventative actions, the greater the effect those therapeutic actions will have. Exercises that really activate the brain such as dance, yoga, and new sports or techniques are the best for prevention.

By exercising regularly throughout your life you will lower your incidence of getting Alzheimer’s by 50% and by doing mental exercises with the physical exercises may lower your chances by 70%! This reduction would not apply to those with deterministic genes but it would for others. Some researchers believe exercise can both delay onset and reduce symptom severity no matter what the cause.

Aerobic exercise in particular causes a release of brain derived neurotropic factor, which has been labeled as “Miracle Gro for the Brain” by the author of SPARK, John Ratey, M.D. In addition, aerobic exercise causes some angiogenesis or the development of additional circulation to the brain. When the brain cells receive more blood, they get more oxygen, and thus function better.

Other side benefits of exercise are the muscle strengthening and enhanced balance and activation of postural muscles. Many Alzheimer’s patients will be at risk for falls and disturbed gait patterns. A consistent exercise program can delay and slow these issues even in somewhat advanced stages.

The dosage is the same as that for the general public or 150 minutes of moderate activity a week. It is important not to push an Alzheimer’s patient into exercise. Many AD victims can become agitated quite quickly and the stress is unwarranted. Simply walking is the best exercise. Make sure the walking path is smooth and not filled with obstructions or difficult terrain.

In an article from Science News, “Walking slows progression of Alzheimer’s”, Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania, mentions, “We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer’s and MCI, especially in areas of the brain’s key memory and learning centers. We also found that these people had a slower decline in memory loss over five years.

The type and magnitude of exercise needs to be carefully monitored with advancing Alzheimer’s or dementia but in those with mild cognitive impairment, a “healthy dose” of both resistance and aerobic exercise is advocated.

Trainers and Nutrition

Phil Kaplan/21 January 2019/ All MFN blog/

It was 1995. I sat on a panel at the Club Industry conference in Chicago and made a fully convicted argument that “personal trainers MUST talk about nutrition.” I had been told by assorted experts, club owners, and educators that ‘it’s illegal for trainers to talk about nutrition.’ Absurd.

In referencing that event from 20 years ago, I’m realizing how far we’ve come in the field of personal training. I’m also reminded of the Diet Ginger Ale Lady.

I was in the checkout line in Publix supermarket and the woman in front of me had only 3 items. She had 3 cases of diet ginger ale. Period. The cashier eyeballed her purchase and quipped, “you must like diet ginger ale.” The response was surprising.

“No, I don’t like it at all, but it’s a great diet!”

Now the visibly overweight cashier’s ears perked up, “Diet? How does it work?”

“Well, the ginger gives you all the nutrients you need and the carbonation makes you feel full, so for two days you only have diet ginger ale. On the third day you have all the soup and salad you want. You repeat the 2-day 3-day regimen until you’ve lost the weight.”

I was sure somebody was going to show up. Maybe the FBI. At the very least, the local police. After all, if it’s “illegal” for personal trainers to talk about nutrition, this woman had to be committing extreme violation!

No cops came. No SWAT Team or sting operation. The diet ginger ale lady left with her purchase and went on her way.

I share this to make a point. The advice people are receiving related to nutrition runs from relatively sane to outwardly dangerous. If we are going to guide our clients toward health, we have an obligation to help them make better choices.

I understand why some opted to believe that nutritional advice from trainers violated the law. Personal trainers without nutritional credential should NOT be prescribing diets, nor should they be recommending supplements. There are far too many risks, and in that, there have been lawsuits and judgments.

Let’s not, however, go to a full pendulum swing and prevent trainers from speaking truth.

I said earlier we’ve come a long way, and we have, and many trainers have become educated in nutritional practices, have aligned with software programs or continuing education courses, and the stigma is lessened significantly.

That doesn’t mean I believe the entire field of personal trainers should be spewing the nutritional beliefs they most attach to.

While many trainers have become responsibly educated, others haven’t and that presents a challenge.

My anecdotal experience has shown me that many personal trainers with limited education in clinical nutrition, marry themselves to one of two approaches and those approaches become a blanket touching each and every client.

They adhere to the old school teachings of “calories in vs. calories out” and reference mathematical formulas to estimate “ideal” caloric intake.
They profess that a bodybuilding type plan, generous in protein, and ample in both meals and energy substrates, is the way to go, failing to recognize the uniqueness of each client.

Many today scream Paleo, others yell Keto, and there’s very little unity.

Here’s my suggestion. While science will reveal new subtleties in food intake for specific groups, demographics, and performances, and food will continue to change as genetic modification, commercial livestock rearing, and food preservation techniques will challenge nature, the basics of “The Macro” won’t change.

Amino acids are the building blocks of tissue and we obtain them from dietary proteins.
Essential fats are essential with a host of vital benefits.
Starvation is NOT an effective weight loss strategy.
Processed foods will disrupt pancreatic hormones and metabolic processes if consumed often over time as staples in a nutrition plan.
Sugar intake can lead to a host of chronic and debilitating conditions If it isn’t well managed and kept modest at best.
Natural (organic) foods, grass-fed, pasture raised, and wild caught are going to provide more of nature’s “life force” than anything removed from sunlight, anything chemically modified, or anything hybridized for resistance to pests or weeds.

The bullet points are nothing but generalities, and this doesn’t pretend to be a complete list of important points, but a trainer equipped with some consistently valuable guideposts for their clients seeking health and betterment are certainly more powerful than those who avoid nutrition altogether.

Dr. Joel Fuhrman, Physician, Nutritional Scientist New York Times, Best-Selling Author

There are a great many leaders opening new doorways in the field of nutrition. One of them is Dr. Joel Fuhrman. We’re privileged to have him sharing his powerful insights at the MedFit Tour stop in Irvine, CA on February 9. It’s only one of the many reasons you should attend.

Dr. Fuhrman will share eye-opening research about the impact of fruit, specific vegetables, fats, and common foodstuffs on human health. . . and I guarantee two things. One, you’ll be blown away as so much of his study reveals the misinformation that plagues our population. Two, you’ll be far better equipped to deliver thrilling outcomes for your clients, whether you train athletes, regular folks, or the chronically afflicted.

Dr. Fuhrman is only one of a dozen extraordinary speakers slated to share insights in the wide-open and opportune field of Medical Fitness. It’s the future. It should be a part of yours.

P.S. Here’s a gift, see Dr. Fuhrman live on video for free. Click here to access.

It Still Hurts. Why?

Jay Weitzner, MS/16 January 2019/ All MFN blog/

Hurt. Ouch. Pain. These three words are oft used to describe a feeling or sensation that we don’t like somewhere in our body….

Pulmonary Hypertension and Mind/Body Medicine?

Robyn Kade/9 January 2019/ All MFN blog/

To understand how Pulmonary Hypertension reacts to Mind/Body Medicine, you must understand what is going on biologically. Mind/Body Medicine, such as meditation and exercise, can help to give these clients a better quality of life. As a fitness professional, it is important to know how, when and why you are using certain mind/body modalities.

Pulmonary Hypertension is a very rare disease of the lungs and right side of the heart. Sometimes there is no known cause except a change in the cells that line the pulmonary arteries. There is no cure, so managing the disease is the best most people can do. Some clients may be on multiple medications, which is normal. The changes in the pulmonary cells cause the artery walls to be thick and stiff. Extra tissue may form and the arteries may become tight. Young individuals usually become diagnosed by the age of 36 and women are diagnosed more often then men. Each year, 10 to 15 people per million are diagnosed in the United States. It is important to note that life expectancy is about 3 to 5 years if not diagnosed and treated.

Hypertension, as most people know, is a blood pressure which is 130–139 over 80–89. Individuals with hypertension can usually come off of medications with eating healthy and exercising. There are instances where the client will never stop taking medications, due to genetics. The client can eat healthy and exercise, but the blood pressure does not come down. A primary doctor may try to get the blood pressure under control, but can’t.

In this situation, the individual would be sent to a Cardiologist who specializes in Pulmonary Hypertension. There are four types of Pulmonary Hypertension and they each have their own symptoms and treatment. It is important to obtain a doctor’s clearance before working with this population.

Types of Pulmonary Hypertension

Group 1: Pulmonary Arterial Hypertension
This group is usually classified as having no known cause. It can be genetic or develop from someone having Lupus, Scleroderma or HIV. Symptoms for this classification can be chest pain, dizziness, fatigue, inability to exercise, low blood pressure, chronic cough, shortness of breath, swelling or swollen legs.

Exercise is very important for this group by strengthening the heart and lungs. Clients will initially go to cardiac rehab for four to twelve weeks. When rehab is over, remember to obtain a clearance prior to working with your client. Start your client out by doing their cardiac rehab program. The goal is to strengthen the heart and help the client to build cardiovascular endurance.

Group 2: Pulmonary Hypertension due to left lung disease
The heart does not pump blood or relax effectively. Medications are used for this group to help lung functioning. Blood pressure medicine and diuretics may also be prescribed. The physician may also ask their client to lose weight or use a CPAP if they have sleep apnea.

Group 3: Pulmonary Hypertension due to lung disease
This group of individuals may have COPD, Interstitial Lung Disease, Sleep Apnea, chronic high altitude exposure, and pulmonary fibrosis. Treatment consists of improving lung function, proper sleep breathing and staying away from high altitudes.

Group 4: Chronic Thromboembolic Pulmonary Hypertension
In group four, clients have blood clots in the lung. The blood clot restricts blood flow causing hypertension. It is important to work closely with the client’s physician for this type of hypertension.

Overall, exercise is thought to be good for individuals with Pulmonary Hypertension. There are, however, some guidelines to follow. Clients should never over exercise or become overheated. If you are working with someone who presents with symptoms, do not exercise upper and lower extremities at the same time. Exercise in extreme hot or cold environments should be avoided.

Stress management techniques will not help with bring blood pressure or heart rate down. For these clients, it is important to concentrate on the symptoms. Many individuals with Pulmonary Hypertension develop anxiety, depression and chronic stress. Clients may sit in a chair or lie on the floor for mind/body classes. It depends on what is comfortable for each client. It is important that the client knows to not get discouraged because they are not seeing a drop in blood pressure.

Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 18 years of experience in medical based fitness.

References:

http://www.tsmihfp.com
https://pulmonaryhypertensionnews.com/pulmonary-hypertension-who-classification/
https://phassociation.org/medicalprofessionals/consensusstatements/exercise/
http://pulmonaryhypertensionrn.com/types-of-pulmonary-hypertension/