It’s no secret that our bodies feel tight and stiffer if we don’t stretch, especially as we get older. If you invest most of your exercise time into strengthening your muscles or working on your cardio routine, it’s easy to forget about stretching.
One of the greatest concerns for the aging population is cognitive decline which leads to loss of independence as well as an extreme burden on the caretakers. Individuals worldwide are fearful of being diagnosed with any of the various cognitive issues: Dementia, Parkinson’s, Alzheimer’s, and other forms of cognitive debilities. In 2015 there was an estimated 47 million people living with dementia and this number is expected to triple by 2050. In 2014, the Alzheimer’s Association reported that they believe there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.
Positive association between aerobic exercise or CV fitness and executive functions is highly consistent but cannot determine causality. Aerobic exercise (AE) has shown moderate to medium sized effects on executive function and memory. Resistance Training (RT) has improved executive function and memory. Combined AE and RT has the biggest (potentially synergistic) effect. It has been proposed that the physical and cognitive exercise might interact to induce larger functional benefits. Larger benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. “Claims promoting brain games are frequently exaggerated and at times misleading. … To date, there is little evidence that playing brain games improves underlying broad cognitive abilities, or that it enables one to better navigate a complex realm of everyday life (Consensus statement, 2014).
Neuroplasticity is the brain’s ability to reorganize and rebuild itself by forming new neural connections. The more neural pathways you have, the more resilient your brain is. Neurogenesis is the process of creating new neurons (brain cells).
Contrary to popular belief, neurogenesis continuously occurs in the adult brain under the right conditions such as with exercise. Substantial benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. It was also noted that the physical and cognitive exercise together might interact to induce larger functional benefits. “We assume, that physical exercise increases the potential for neurogenesis and synaptogenesis while cognitive exercise guides it to induce positive plastic change” (Bamidis, 2014). To maximize cognitive improvement, combine physical exercise with cognitive challenges in a rich sensorimotor environment that includes social interaction and a heaping dose of fun.
Brain health is becoming extremely important as individuals live longer. Today there is much more information available on how to train the aging brain.
Some great resources are:
Dianne McCaughey Ph.D. is an award winning fitness specialist with more than 35 years experience in personal training, group exercise, coaching, and post-rehabilitation. She is a master trainer for multiple companies and practices and teaches optimal wellness emphasizing the mind, body and spirit. She works with special populations and focuses on posture, gait, balance and corrective exercise programs for better function and health.
Cody Sipe, PhD, has an extensive background in the fitness industry with 20 years of experience as a personal trainer, fitness instructor, program director, exercise physiologist and club owner. He is currently an Associate Professor and Director of Clinical Research in the physical therapy program at Harding University. He is the co-founder and vice president of the Functional Aging Institute (FAI).
This article will look at evidence-based information about the role of exercise in prevention and intervention of Alzheimer’s disease and cognitive impairment.
Laymen (and even medical professionals) still often have difficulty recognizing dementia, as opposed to Alzheimer’s disease.
And while the symptoms and even some of the prevention methods may be similar, we need to find a better way to distinguish between the two if we are to provide the best level of care to patients.
Let’s explore some of the traits of each, and examine how we can prevent them:
Dementia is an umbrella term used to denote a decline in mental ability that is severe enough to interfere with daily life. As opposed to Alzheimer’s, it is not a specific disease.
Alzheimer’s is a degenerative brain disease, where plaques containing beta-amyloid form in the brain, causing cell damage and complex changes. This damage results in dementia symptoms that will get worse as time goes on. It is also one of the most common causes of dementia. Dementia can also be caused by Huntington’s disease, Parkinson’s disease, and Creutzfeldt-Jakob disease.
While it most often occurs in patients over the age of 60, early-onset Alzheimer’s can begin to show symptoms after the age of 30, typically in patients with a family history of the disease. It is believed these cases account for around 5% of the total number of patients with Alzheimer’s.
Alzheimer’s is currently the sixth leading cause of death in the US, and possibly third as a cause of death in the elderly.
One of the most typical early signs of Alzheimer’s is trouble retaining recent information, as the disease tends to affect the part of the cerebrum that is associated with learning first.
Other symptoms, in no particular order of severity and manifestation, include:
The main challenge we face in the treatment of Alzheimer’s disease is understanding its underlying causes. While we know it is caused by changes and damage to brain cells, the cause of these changes remains unknown to this day.
Patients suffering from dementia have trouble keeping track of time and space. They become repetitive, their judgment is impaired and they often forget to eat, bathe, and perform the simplest tasks.
The early warning signs of dementia include, but are not limited to:
Dementia patients are mostly unaware of their symptoms, and their loved ones are the ones to notice they’re losing their keys, mixing up dates, and forgetting to take the trash out.
There are several types of dementia we have been able to identify:
Dementia can also be caused by brain tumors, HIV, Niemann-Pick disease type C, progressive supranuclear palsy, and other diseases or conditions.
To sum it up: dementia, as a cluster of symptoms, and Alzheimer’s, as a specific disease (and the leading cause of dementia), naturally share the same symptoms.
The treatment of dementia will depend on its underlying cause. When caused by Alzheimer’s, there is no cure for it, and there is no treatment that can stop its progression. There are treatments that will combat some of the lesser or more severe symptoms, but we haven’t yet found a way to reverse or pause the ongoing damage.
This fact alone is the cause of much despair among the families of patients suffering from any form of dementia.
There are signs that the early detection and treatment of Alzheimer’s can improve patient quality of life. And when that’s all that’s left in the absence of a cure, it becomes even more imperative we do our best to prevent this disease.
Evidence has been found that the risk factors that cause heart disease, including high blood pressure, high cholesterol, and diabetes may also contribute to the development of Alzheimer’s.
However, there is no sufficient evidence to provide any substantial proof as of yet. The prevention methods recommended for dementia and Alzheimer’s focus on improving overall health and exercising your brain.
Some of the courses we can advise our patients include:
Naturally, this diet should focus on eating 80% of the foods that are actually good for us, and getting most of our nutrition from fruits, vegetables, and lean meats, as opposed to fast food choices and high-sugar options. Cutting down on caffeine and alcohol intake can also prove beneficial.
Movement is one of the keys to preventing any disease, and encouraging at least three 30-minute sessions per week should be imperative. As diets, exercise regimes should be tailored to a patient’s needs and preferences. Instead of being made a chore, regular exercise should be an enjoyment and a clear avenue to improved overall health.Alongside heart disease and cancer, Alzheimer’s and dementia remain the most explored and discussed diseases of our time. We may not see a cure for any of them in our lifetime, and that’s all the more reason to remain vigilant in trying to prevent them. A large part of these prevention efforts entails exploring different avenues in achieving a healthier body and mind, as this remains the only course available to us at the time.
Sarah Kaminski earned her bachelor’s degree in Health Sciences. Due to her parent’s declining health, she decided to become their full-time caregiver. Now, she takes care of her loved ones and writes about the things she learned along the way. Sarah is a life enjoyer, positivity seeker, and a curiosity enthusiast. She is passionate about an eco-friendly lifestyle and adores her cats. She is an avid reader who loves to travel when time allows.
References:
Given that in the United States alone, there are close to 30 million people who have diabetes and five to 10 percent of those have type 1 diabetes (and must use insulin), many of your clients may be insulin users…
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.
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.
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.
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.
“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.
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.
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.
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.
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
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.
The 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.
Following 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.
