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Interesting Times for Interested People

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas New Wellness Areas
S-ocial Social – all interactions with people outside of ourselves
P-hysical Physical – our physiological status
I-ntellectual Intellectual – includes cognitive and emotional health
C-ognitive Career – includes educational and skill acquisition and financial health
E-motional Environmental (could include emotional) – clean, organized?
S-piritual Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

woman-video-chatting

Social Distancing – Not Social Isolation: Coaching for Connectedness

We all still need each other. Even in the age of COVID-19, our health continues to depend upon healthy supportive relationships. Our coach training company, Real Balance 1 has always stressed what we call Coaching for Connectedness.  We‘ve seen lifestyle improvement occur and last more often when people receive support for the changes they are making to live healthier lives.  When a coaching client sets up an action step we ask “Who/what else can help support you in this?”. Research on what makes health behavior last points primarily to two factors: a shift in self-concept and community support. (2)   It’s also a well-established fact that people who are more socially isolated have significantly higher rates of all major chronic illnesses. (3)

Our challenge in the midst of a pandemic situation is how we distance from each other while remaining connected to each other. Yes, follow the CDC guidelines for social distancing. We can still greet each other with elbow bumps, and then go for a walk, a bike ride, a cruise in kayaks, etc., and continue to avoid the proximity that puts us at any risk. We can connect via phone and receive the nourishment of live, interactive conversation that texting and e-mail don’t quite match. We can climb on board a web-based platform such as Zoom and Skype where we are face-to-face for our conversation. We also have all sorts of apps such as Facetime, WeChat, and many more that allow us to have face-to-face interaction for live conversations.

As coaches we can continue to work remotely with our clients, as the majority of coaching is already done. As we do, explore the feelings that the changes brought about by social distancing are bringing out in your clients. Empathize. Explore. When people talk about their fears, the intensity of those fears almost always lessens. As people become less afraid, their thinking improves. They aren’t so quick to jump into dismissive all-or-none thinking. They are then able to engage in strategic thinking with their coach to find unique solutions to staying healthy.

  • The fitness center is shut down. How can you shift to working out at home? Use stretch bands. Modify a spare room into a place to do Yoga, floor exercises, etc. Spring brings better weather allowing more cardio outdoors.
  • Do more outdoor exercise/activity with other people – just keep your proper distance.
  • Encourage clients to find new ways to electronically visit their friends, grandchildren, and others. Play online games together.
  • Check in with your clients to make sure they have CDC information/WHO information about how to stay safe during the COVID-19 pandemic. (5,6)

Take heart at how people are showing concern for each other during this time. Younger people who are at somewhat less risk are engaging in social distancing, handwashing, etc. not only for themselves, but for the older and more vulnerable people who could be affected by the contact they are having. People in neighborhood chatlines are volunteering to go pick up groceries and prescriptions for older or more sickly neighbors. Hopefully what will come out of all of this is a greater sense of how we are all in this together. Distancing does not mean isolating. The truism of wellness pioneer Jack Travis is still valid: Connection is the Currency of Wellness.

Be well and stay well!


Michael Arloski, Ph.D., PCC, NBW-HWC – A psychologist with over twenty-five years of clinical work, and more than 23 years as a professional wellness coach, Dr. Arloski is one of the key developers of the field of health & wellness coaching. He is the author of Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., and Masterful Health & Wellness Coaching: Deepening Your Craft.  His company, Real Balance Global Wellness Services, Inc., has trained over 9,000 health & wellness coaches worldwide www.realbalance.com.

References

  1. https://realbalance.com
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753403/  
  3. https://www.apa.org/monitor/2019/05/ce-corner-isolation
  4. https://www.cdc.gov/coronavirus/2019-ncov/index.html
  5. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

This article was published on Dr. Arloski’s blog. Reprinted with permission.

trainer-resistance-band-senior-woman-client

You Are The Solution

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.

This article was featured in MedFit Professional Magazine Winter 2020 issue. Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey

U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.

med-fit-client-doctor-exercise

Healthcare Through Fitness

A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.

Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.

If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?

The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.

What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:

  • Regular medical oversight by a medical director
  • Practitioners with nationally-recognized certifications and training in the care of chronic disease
  • Comprehensive health assessments and exercise prescription
  • Exercise classes geared toward specific medical conditions

These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.

The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.

Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.

This article was featured in MedFit Professional Magazine fall 2019 issue.

Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com

Mirabai New Year Article

Health Coaching: A New Way To Keep Those New Year’s Resolutions

So you go to your annual check-up and your doc says “whoops your blood pressure is up and you’re 15 pounds heavier than last year. I’ll give you some meds, but you’ll have to lose weight and get into shape, OK?

You say OK, you walk out and then what?

Join a gym, hire a personal trainer, go on a diet, take a walk? You might do one or several of these because, after all, it’s a new year and a new you.

Right? Right, and you try something. But how long is it till you throw up your hands and say, “ugh, I got started and now I’m off the track just like last year.”

What went wrong? Maybe nothing, except you might not have been psychologically ready to take those steps.

For any change there is a process. One of the models that are used is the transtheoretical model of behavior change (TTM) developed by James O. Prochaska , Ph.D

There are 5 stages:

Precontemplation – going along not aware of a need for, or not wanting a change.

Contemplation – recognizing a need to do something to improve your situation and considering making some sort of change.

Preparation – doing some research, making small changes, or at least thinking about what you’re going to do to help yourself.

Action – Actively making lifestyle changes,

Maintenance – Having made changes, keeping the healthy lifestyle going.

All too often we jump from contemplation to action without being ready for the change. It can feel like getting off a plane in Antarctica wearing shorts and a T-shirt. You wanted to be there but you weren’t ready for what that change would be like, and what you’d need to do to stay there comfortably.

But there is help, a new kind of help.

The health and fitness industry is rising to the challenge of our increased involvement with our own health care.

Many of us still think of fitness professionals as muscle heads with great bodies and not much else. Those types will always exist, but more educational opportunities including degrees and certifications are spawning a new breed of health & fitness professional, one that’s part of the health as well as the fitness industry.

Enter the Health & Wellness Coach

Not to be confused with a personal trainer, the Health & Wellness Coach is a consultant who helps you go, through, preparation, to action and on to maintenance. The coach helps you determine your health and wellness goals and needs. Once you have a path to your goals the coach continues to work with you to help you find the behavior modifications, activities, facilities and allied health professionals (MDs, Ph.Ds, Nurse Practitioners RDs, PTs, Personal Trainers, Exercise Instructors, etc.) to support your healthy lifestyle. You can do this on your own, but having someone with health industry knowledge who has your back, who is nonjudgmental, who just wants to help you focus and succeed can make all the difference.


Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities is the health and fitness industry. Her customer top rated exercise videos for Age-Onset health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available at www.mirabaiholland.com. Mirabai also offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com.

Prescription for good health diet and exercise flat lay overhead with copyspace.

A New Era Begins

The rallying cry is, “Let’s change healthcare!” From all corners of the medical universe, there is agreement that change is necessary. The biggest questions are, “What is the change?” and, “Who will make it happen?”

diabetesmanagement

Pre-diabetes – A Wellness Opportunity To Help

There is an opportunity for wellness and wellness coaching to impact the lives of millions of people in a life-saving way. 79 million Americans are estimated to have a condition called pre-diabetes. Usually symptom free, without intervention they will develop full-fledged Type II diabetes within ten years and possibly endure physical damage to their heart and circulatory system along the way. Yet, according to the American Diabetes Association, if a person is successful at lifestyle improvement they can completely avoid the onset of diabetes 70% of the time.

Health, fitness, wellness

Living Well with Arthritis

Although arthritis today is considered one of the leaders of the pack in the epidemic of chronic illness, millions of those affected are living fulfilling lives and living them well.

According to The Institute of Medicine’s New Report on Living Well With Chronic Illness, 8.6 million Americans are living with disabilities related to arthritis. The Arthritis Foundation reports it as “striking one in every five adults, 300,000 children and as the leading cause of disability in the United States.” Arthritis is a chronic illness that impacts many.

Depositphotos_39763765_xs(1)Those living with arthritis can live well and have a good quality of life by employing lifestyle interventions as medicine, in conjunction with, prevention, joint protection, weight management, physical activity, wise food choices, stress management and a good medical regimen. By combining all these necessary recommendations into a personalized Wellness Strategy and Plan, a coach can assist an arthritis patient in organizing what is important for them to live life well. The Wellness Plan then becomes a map by which to navigate toward managing and maximizing the patient’s best life possible.

A common factor also influencing quality of life for those challenged by arthritis or any chronic illness is what is called “adherence” or “medical compliance”. Lack of adherence to medical and lifestyle improvements is a large piece of the cost of healthcare today and contributes to the epidemic of chronic illness. Average patient adherence rates for prescribed medications are about 50 percent, and for lifestyle changes they are below 10 percent.

The World Health Organization reports “improving adherence also enhances patients’ safety because most of the care needed for chronic conditions is based on patient self-management, use of medical technology for monitoring, and changes in the patient’s lifestyle.” A coach assists in supporting patient compliance and self-accountability and works with the patient to forward the action toward their goals.

The same report goes on to say “patient-tailored interventions are required and must be customized to the particular illness-related demands experienced by the patient. There is no single intervention strategy that has been shown to be effective across all patients.” Therefore, working with individuals one on one is of primary importance for enhancing their quality of life. Coaches work with clients on a one on one basis assisting them in creating a wellness plan that is personalized to them.

Dr. Bennett and team’s article Health Coaching for Patients with Chronic Illness states “it is critical that those with arthritis understand, agree with and participate in the management of their chronic condition. Health coaching is one way to accomplish this function.”

A long-term study done at Stanford University indicates that interactions with a coach can significantly increase the health of people with chronic illness. Stanford’s Chronic Disease Self-Management Program brought patients (including those with arthritis) together with a coach. “Subjects who took the Program, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatient visits and hospitalizations.”

Young Couple Jogging in Park

It was found “This type of self-management, through coaching, is so effective it has been endorsed by the Surgeon General of the United States.”

“Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime.” Health & Wellness coaches work with a client to tailor-make a wellness plan that includes self-management, coordinating their medical regimen, and forwarding lasting lifestyle changes. Working together with a coach, a patient can successfully manage their condition and create a strategy to living life well with arthritis.

What Can Health & Wellness Coaches Do for You?

► Work with you to take an inventory of your current wellness status

► Guide and facilitate your personal well-life vision toward the life you would like to live

► Work with you to develop a personalized Wellness Plan that is tailored to your needs. The wellness plan becomes the map that integrates your important areas of focus including: self-management support, the medical regimen, and lifestyle improvements.

  • Self-management support:
    • Promote healthy behaviors
    • Impart problem-solving skills
    • Assist with the emotional impact of chronic illness
    • Provide regular follow-up and accountability
    • Encourage people to be active participants in their care
    • Assist in patient self-advocacy
  • The medical regimen – facilitation of a patient-directed approach
    • Scheduling and attending medical appointments
    • Asking your medical team the right questions
    • Following through on daily prescribed medications
    • Tracking your regimen to support success
  • Lifestyle improvements
    • Physical activity
    • Healthy eating
    • Eliminating risk factors
    • Promoting healthy behaviors

► Bridging the gap between clinician and patient.

  • Health coaches can bridge wellness-coachthese gaps between the medical team and patient by following up with patients and guiding a patient-centered approach, asking about needs and addressing obstacles, addressing health literacy, cultural issues and social-class barriers.
  • Health Coaches help patients become self-directed in navigating the health care system. Coaches can help with patient self-advocacy and coordination of care

► Provide accountability & support for you to be successful

  • Offer emotional support
  • Coping with illness is emotionally challenging. Coaches can offer emotional support and help patients cope with their illnesses. They also assist patients in seeking out additional emotional support that will help them achieve and maintain success.

► Provide ongoing evaluation of progress toward your goals

  • Re-evaluating success
  • Resetting goals & action steps as necessary
  • Provide acknowledgement & support of successes
  • Assist in maintaining forward momentum toward goals

► Serve as a continuity figure

  • Coaches travel with the patient as an ally and assist them with staying the course while implementing their wellness plan.

► Assist in patient-directed achievement of successful lifestyle behavioral change

  • Be your ally and walk shoulder to shoulder with you

Dr. Linda Gogl is a Doctor of Physical Therapy with Board Certification in Orthopaedic’s with over 20 years in healthcare. She currently serves as Director of Development and Team Member for Real Balance Global Wellness Services. Her professional experience includes outpatient Clinical Director, Developer/Director of an APTA Credentialed Orthopaedic Residency Program, Director of Quality Assurance for the largest physical therapy private practice in California, Credentialed Clinical Instructor, Adjunct Professor of Anatomy & Physiology, Research mentor and Clinical Coordinator for University affiliations. More recently she also served as National Director of Training and Implementation for OptimisPT, a physical therapy software system.

References

  • Arthritis Foundation. Arthritistoday.org
  • Bennett et al, Health Coaching for Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.
  • Harris et al. The Institute of Medicines’s New Report on Living Well With Chronic Illness. Centers for Disease Control and Prevention. Volume 9 – September 20, 2012.
  • Lorig et al. Chronic Disease Self-Management Program, 2-year Health Status and Health Care Utilization Outcomes. Medical Care. Volume 39, Number 11, pp 1217-1223.2001
  • National Prevention Strategy, Clinical and Community Preventive Services, National Prevention Council 2010. www.surgeongeneral.gov/initiatives/prevention/strategy/preventive-services.pdf
  • National Prevention Council Action Plan: Implementing the National Prevention Strategy www.surgeongeneral.gov/initiatives/prevention/2012-npc-action-plan.pdf
  • World Health Organization. Adherence to Long-Term Therapies. Evidence for Action. 2003.