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Instructor Showing Health Results On Clipboard To Senior Couple

Respiratory Disease and Exercise: How to help your clients not suck at exercise!

According to the World Health Organization (WHO), hundreds of millions of people suffer every day from chronic respiratory diseases (CRD).  Currently in the United States, 24.6 million people have asthma1, 15.7 million people have chronic obstructive pulmonary disease (COPD)2 while greater than 50 million people have allergic rhinitis3 and other often-underdiagnosed chronic respiratory diseases.  Respiratory diseases do not discriminate and affect people of every race, sex, and age.  While most chronic respiratory diseases are manageable and some even preventable, this is what is known about the nature of chronic respiratory diseases4:

  • Chronic disease epidemics take decades to become fully established.
  • Chronic diseases often begin in childhood.
  • Because of their slow evolution and chronic nature, chronic diseases present opportunities for prevention.
  • Many different chronic diseases may occur in the same patient (e.g. chronic respiratory diseases, cardiovascular disease and cancer).
  • The treatment of chronic diseases demands a long-term and systematic approach.
  • Care for patients with chronic diseases should be an integral part of the activities of health services, alongside care for patients with acute and infectious diseases.

Exercise and CRD

If you are a health and fitness professional, some of your clients may be suffering from a chronic respiratory disease and you may be an important source for relief.  Moderate exercise is known to improve use of oxygen, energy levels, anxiety, stress and depression, sleep, self-esteem, cardiovascular fitness, muscle strength, and shortness of breath. While it might seem odd that exercise improves breathing when one is short of breath, exercising really does help one with respiratory disease.  Exercise helps the blood circulate and helps the heart send oxygen to the rest of the body.  Exercise also strengthens the respiratory muscles which can make it easier to breathe.

Beneficial Types of Exercise

There are several challenges to exercise prescription and physical activity participation in this population, but a large body of evidence demonstrates important health benefits from aerobic exercise.  Resistance training has also been shown to increase muscle mass and strength, enhancing individuals’ ability to perform tasks of daily living and improving health-related quality of life.5

Aerobic exercise is good for the heart and lungs and allows one to use oxygen more efficiently. Walking, biking, and swimming are great examples of aerobic exercise. The guidelines are approximately the same as generally healthy individuals.  One should attempt to train the cardiorespiratory system 3-5 days a week for 30 minutes per session.  One should exercise at an intensity level of 3-4 on the Rating of Perceived Exertion Scale (Scale Rating from 0 Nothing at All-10 Very, Very, Heavy).

Resistance exercise increases muscular strength including the respiratory muscles that assist in breathing.  Resistance training usually involves weights or resistance bands but using one’s own body weight works just as well depending on the severity of the symptoms.  It is recommended that one should perform high repetitions with low weight to fatigue the muscles.  This type of resistance training also improves muscular endurance important for those with CRD.  Resistance training should be performed 2-3 days a week working all major muscle groups.

Stretching exercises relax and improve one’s flexibility.  When stretching, one should practice slow and controlled breathing.  Not only does proper breathing help to deepen the stretch, but it also helps one to increase lung capacity.  One should gently stretch all major muscles to the point of mild discomfort while holding the stretch for 15 to 30 seconds, slowly breathing in and out. Repeat each stretch 2-3 times.  Stretching is an effective method to warming up and cooling down before and after workout sessions.

When exercising, it is important to remember to inhale in preparation of the movement and exhale on the exertion phase of the movement.  An individual should take slow deep breaths and pace him/herself.  It is recommended to purse the lips while exhaling.

Use of Medication

If an individual uses medication for the treatment of respiratory disease, he/she should continue to take the medication based on his/her doctor’s advice.  His/her doctor may adjust the dosage according to the physical activity demands.  For example, the doctor may adjust the flow rate of oxygen during exercise if one is using an oxygen tank.  In addition, one should have his/her inhaler on hand in case of a need due to the increase of oxygen demand during exercise.

Fitness professionals can effectively work with those who have a chronic respiratory disease providing them with a better quality of life through movement.  You as their health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness.

Expand your Education to Work More Effectively with these Clients!

Check out CarolAnn’s 4 hour course with PTontheNet, Respiratory Disease and ExerciseThe goal of this course is to educate health and fitness professionals on how to effectively implement exercise training techniques and work with clients that suffer from various respiratory diseases to help develop strength, flexibility, balance, breathing, and improve their quality of life.  Click here to learn more about the course.


Known as the trainers’ trainer, CarolAnn has become one of the country’s leading fitness educators, authors, and national presenters. Combining a Master’s degree in Exercise Science/Health Promotion with several fitness certifications/memberships such as FiTOUR, ACSM, ACE, AFAA, and LMI, she has been actively involved in the fitness industry for over 25 years. She is currently the Founder and Director of Education for Chiseled Faith, a Faith Based Health and Fitness Program for churches. Visit her website, www.CarolAnn.Fitness

References

  1. 2015. NHIS Data; Table 3-1. www.cdc.gov/asthma/nhis/2015/table3-1.htm
  2. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
  3. CDC, Gateway to Health Communication and Social Marketing Practice. Allergies. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Allergies.html
  4. World Health Organization http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf
  5. Eves ND, Davidson WJ. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Applied Physiology Nutrition and Metabolism. 2011;36(Suppl 1):S80–100. [PubMed]

Use Exercise Bands to Boost Your Cardio Endurance and Reduce Inflammation

Researchers studied 1,544 people age 50-plus. Some of those in their 80s had the lowest inflammation levels in their bodies because they took care of their health. This included cardio exercises along with resistance – weight training with weights and bands, stretching for flexible joints and mobility. Even in extreme old age, centennials showed positive outcomes when they exercised. Low levels of inflammation were also an important predictor of people’s cognitive function, especially those in the oldest age group.

Lori Michiel in her studio

I’d have to say that of all the exercises I do, I love anything aerobic (getting my heart rate up) the most.  Walking, jogging, biking and dancing are the most common forms to get your motor running and is a great way to shake off the cobwebs. Any quick, sustained movement can increase your heart rate.

Before you start moving around, think about what motivates you to push a little harder. Are you interested in exercise to reduce stress and shake off the blues, lose weight, build a healthier brain (cognition), or make new friends?

Researchers say those who believed exercise was good for stress reduction valued it more with increased age. Motivation to move when reaching 60-plus can yield different benefits. For instance, people who exercise experience less inflammation in their bodies. Inflammation can lead to illness (stemming from a lower immune system) and difficulty losing weight. Losing weight can be especially troublesome if you have joint issues (hip, knees or back). With each pound you lose, the equivalent of four pounds of pressure can be released.

The combination of cardio mixed with bands is one solution for cardio exercise to keep inflammation at bay. It is fun. Be creative and you will never get bored. In this month’s Exercise Snack Video, I will show you a few quick examples. Pay close attention to my cues on form and technique and in the long run (pardon the pun), you’ll have fun!!

Side note: The familiar tune of the Bee Gees song “Stayin’ Alive” has been used for medical training for some time. It has the right beat — not to mention the perfect title — for providing CPR’s chest compressions at the right pace to revive a patient. Try playing it sometime when you exercise.

Reprinted with permission from Lori Michiel. Originally published on Lori’s Fitness Blog For Active Adults and Seniors.


Lori Michiel, NASM, has been assisting seniors in their homes since 2006 with customized exercise programs including those designed to address Parkinson’s, metabolic disorders, arthritis and diabetes. These adaptive programs are specifically designed to improve balance, circulation, flexibility, mobility and promote independence. Lori Michiel Fitness has over 40 certified trainers who are matched with clients in Los Angeles, Ventura and Orange Counties. Connect with Lori at www.LoriMichielFitness.com.

running-bleachers

Kick up the Cardio

Currently, health clubs offer a variety of cardio and strength options. They offer a plethora of equipment and classes yet attrition remains high. By combining the science of cardio and strength training with a motivated and energetic instructor new programming combining….

Instructor And Elderly Patient Undergoing Water Therapy

5 Simple Exercises To Help Symptoms Of Rheumatoid Arthritis

When left unchecked, rheumatoid arthritis can be majorly debilitating and cause real and continued pain. However, if you’re willing to do the research and put in the work, you can do certain exercises which can majorly reduce the symptoms, improve your overall mood and actually make you that much physically healthier, generally speaking, which can only be a good thing. The real question then is, what sort of exercises ought you be doing to try and achieve this. Well, let’s take a look at five ways to help improve those symptoms.

Start Stretching

Stretching is actually something which we all ought to do and can be a great way to start anyone’s day. Daily stretching reinforces a healthy sense in which the muscles are able to become increasingly limber and flexible across time. Stretching is a personal thing, and it will depend a bit on where most of your arthritis pain is concentrated. When you stretch you want to go slowly and thoroughly. Warm up for a few minutes and then stretch each of the muscles you want slowly, pushing yourself further in tiny intervals. To guarantee success, track down a physical therapist with an understanding of rheumatoid arthritis.

A Focus On The Hands

“It’s all too common that rheumatoid arthritis has an adverse and painful effect on the hands, meaning this is an area which ought to be focused on in terms of exercises that can be done”, advises Charles Tevesham, health writer at LastMinuteWriting and Writinity. There are only a limited number of ways in which one can move one’s hands, so you ought to do your best to try and explore the full range of stretches available. Using a stress ball and a small roller can help to achieve this as well.

Go For Walks

Sometimes when you are in pain, having to get up and go on a walk can be the last thing that you want to do. But, it’s hugely beneficial. The act of walking involves so many of the different muscle groups and makes it so easy to do something that will be beneficial for your arthritis. It is also a great way to boost your mood, since it is exercise and involves being outdoors. Make sure you drink water and try to slowly increase your speed across the duration of your walk.

Water-Based Exercises

Completing exercises, stretches and other forms of aerobics in a pool is a wonderfully forgiving way of going about your pain reduction routine. Being in water helps to reduce the impact of your body weight so it makes it very easy to do exercises without fearing that you are going to injure yourself. Furthermore, the act of swimming is actually a really good exercise that involves using all o the muscle types in your body in a way which is actually deeply therapeutic and relaxing. If the water is warm, that’s an even better way to soothe pain.

Get On Your Bike

Cycling is another good exercise option. “Cycling is definitely one of the more strenuous options available to you, but it’s one that will really help ensure that the increase in the risk of cardiovascular problems that rheumatoid arthritis involves, doesn’t get the better of you”, says Mary Simmons, health blogger at DraftBeyond and ResearchPapersUK. You ought to make sure that you have stretched thoroughly before you get onto a bike as the intense locational nature of the workout, in other words the amount of pressure it puts your leg muscles under, can cause you an injury. That said, it’s an incredibly good way to exercise the muscles in the lower half of your body and has long term benefits to flexibility and pain reduction.

Conclusion

Overall, stretching and various other exercises are actually vitally important to giving yourself the best chance of avoiding unnecessary and difficult to deal with pain. Rheumatoid arthritis is never going to be pleasant, but if you really commit to a routine of exercise you can be sure that the way you feel, physically and mentally, is going to improve and that steps towards managing the symptoms will be moved through quickly.


Harry Conley is a content editor at LuckyAssignments and GumEssays. He develops training procedures and manages the workflow to give writers supplemental support instruction. A man of many interests, Harry also works in providing supplementary materials and instructional support for contributors.

 

References

Charles Tevesham, health writer, LastMinuteWriting and Writinity.
Mary Simmons, health blogger,  DraftBeyond and ResearchPapersUK

Breast Cancer Survivor

Breast Cancer and Exercise

The most common issues that plague post-mastectomy patients are upper-crossed syndrome and range of motion limitations in the affected shoulder. Upper cross syndrome is the combination of protracted (rounded) shoulders, forward head, cervical lordosis, winged-scapula, and thoracic kyphosis. As a result of these postural deviations, mastectomy, lymph node dissection, and/or radiation, the chest muscles may become tight, shortened and spastic. This not only exacerbates the postural deviations, but may limit the ability of the patient to move their arm/shoulder through flexion, extension, abduction, and external rotation. While this is a general statement, the majority of patients will present with these symptoms. This is compounded even more if the woman undergoes reconstructive surgery. Not only with it further exacerbate upper-crossed syndrome, it will create a muscle imbalance in the area of surgery, if either the rectus abdominis or latissimus muscle are used for reconstruction.

a trainer helping a senior woman doing fitnessThe most important factor in the safety and efficacy of the exercise program is the initial assessment. At the very least this should include a comprehensive postural assessment as well as shoulder range of motion measurements taken with a goniometer. The well-trained fitness professional will be able to deduce, from the results, which muscles need to be stretched and which need to be strengthened. By selecting the wrong combinations of exercises, the results may not only be undesirable, they may in fact be detrimental. For example, if a client presents with moderate to severe upper-crossed syndrome, performing any kind of “pushing” exercise that would involve the chest muscles (chest press), could make the syndrome even more pronounced by causing the pectoral muscles to tighten and contract. Instead, the goal need to be on stretching the chest wall and strengthening the opposing muscles in the back; particularly the scapular stabilizers.

Prior to adding a load (resistance) of any kind, the patient should have close to full range of motion through the particular plane of motion. Without correcting the range of motion first, the patient will reinforce the negative movement pattern by performing strength training exercises throughout a limited pattern of movement. Therefore, initially the focus should be on range of motion exercises. These may include very basic exercises that the patient can do on their own; front wall walks, side wall walks, pendulum swings, and corner stretch, or active isolated stretching that can be executed with the assistance of a professional. The combination of both will increase the speed of improvement in most cases.

Once close to full range of motion is achieved, the emphasis can be on strength training. Not only will this help to correct the postural and range of motion deviations, it will help increase bone density and lean muscle mass. Many women will either be of menopausal age, or thrown into menopause from their cancer treatment. With estrogen no longer being produced, the risk of osteoporosis increases. To make things even more complicated, the long-term side-effects of chemotherapy include osteoporosis, diabetes, and damage to the heart and lungs; all of which can be avoided or improved through proper exercise recommendations.

The last part of the equation is the risk of lymphedema of the affected arm/shoulder. Lymphedema is the swelling of the extremity following the removal of, or radiation to the lymph nodes on that side. Even if someone has undergone a sentinel node biopsy, and only had one node removed, they can still get lymphedema. Lymphedema is progressive if untreated and can be very painful and disfiguring. It can happen at ANY time after surgery; one hour or fifty years. The risk doesn’t increase or decrease with time, however a higher percentage of body fat, infection, age, and poor nutrition can all increase the risk once someone is at risk. In my sixteen years of working with cancer patients, I would say this is the number one “overlooked” issue amongst cancer patients. More often than not, they will not even be told about lymphedema. Following lymph node dissection and/or radiation, the lymphatic pathways do not operate with the same efficacy that they did previously. Therefore, we no longer know what the individuals exercise threshold is. It is critical to START and PROGRESS SLOWLY. This allows for a gradual increase in frequency, intensity, and duration of the exercise program. If at any point there is swelling, the patient should be advised to stop exercising and see their doctor immediately to determine if, in fact, they do have the onset of lymphedema. They should come back with a medical clearance form and the exercise instructor should take a step back with the frequency, intensity, and duration to the point prior to the onset of swelling.

Putting all of these pieces together is very much like solving a mathematical equation. If you are missing any of the information, you will never solve the problem. A typical exercise session should begin with cardiovascular exercise. This too should be gradually increased at a rate that the client is comfortable with and their body responds favorably to. They should stay well-hydrated, they should not wear tight-fitting or restrictive clothing on their upper body, and they should not overheat (all of these factors can increase the risk of lymphedema). Following the warm-up they should be instructed to do a series of lymph drainage exercise to open up the lymphatic pathways and prepare the body for exercise. I reference these exercises in CETI’s Cancer Exercise Specialist Handbook and Breast Cancer Recovery with the BOSU® Balance Trainer Book.

Meta Slider - HTML Overlay - Women wearing pink tops and ribbons for breast cancer on white backgroundFollowing the warm-up and lymph drainage exercises, the exercise specialist should determine what the areas of “need” are for the client. Remember to begin with stretching and range of motion exercises until they have close to “normal” range of motion. At that point the goal becomes strength training and choosing exercises that will strengthen the weaker muscles and stretch the tight and shortened muscles. Weight/resistance should also be very gradually increased and attention paid to any potential swelling of the extremity. Typically I chose exercises that will stretch the chest (chest fly, corner or door stretch, assisted stretching) and will strengthen the back (low/high rows, reverse flies, lat pulldown). They often [present with winged scapula following a node dissection. If this is the case, I will incorporate exercises that will strengthen the serratus anterior. If they have undergone an abdominal TRAM procedure, core work will be of the greatest importance in preventing, or minimizing, low back pain.

Because every muscle in the body works synergistically, an imbalance in the shoulder can lead to a multitude of imbalances from the hips to the knees to the ankles etc… Choose your exercises carefully. Put emphasis on the areas of need. This is not and can never be a cookie-cutter workout. No two breast cancer patients are the same. Not only are you taking into consideration their surgery, reconstruction, and treatment, you have to also factor in the remainder of their health history and any additional orthopedic concerns. I urge anyone who wants to work with cancer patients to undergo specialized training. It is very complex and the untrained professional can end up doing more harm than good.


Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.