A lifetime of wear and tear, the effects of a sedentary lifestyle(too much sitting) and other poor lifestyle choices catches up when we reach midlife and accumulate in those later years with chronic health and medical problems, causing dis-function and pain, and eventually loss of independence or early death. Pretty bleak outlook, right?
However; THE GOOD NEWS is that it is never too late change improve your habits and begin regular exercise and reap the benefits. No matter what your age, most of us have the ability to restore and regain function, improve health and prevent or postpone development of additional chronic medical conditions. Beginning an exercise program when you are having medical problems can help offset the immediate and long term effects.
Exercise programs specifically designed to improve your medical condition can help you better manage and even treat the condition( i.e. arthritis, diabetes, osteoporosis and osteopenia, heart disease, stroke, joint replacements, back problems, etc). Even seniors well into their 90's can benefit from beginning regularly performed targeted exercises and can add years to their life and improve quality of life with improved strength, stamina, balance and mobility, and just feeling just feeling better.
Unfortunately, many seniors have given up and have accepted that life must end in pain and disfunction, disability and dependency. Most older adults beginning with a targeted exercise and physical activity plan can make dramatic improvements in functional health, such as the strength to get up from a chair, walk the stairs, getting in and out of a car, basic self care and performing recreational activities that require balance and mobility with less pain and confidence.
In general, the more medical conditions you have and more severity increases the more targeted your exercise program needs to be to receive desired results.
Staying healthy and free of injury is essential for older adults who desire to stay independent for as long as possible. It takes good strength, balance and mobility to protect our independence from falls and related injuries. One-third of people 65 and older falls annually, and 1 out of 5 falls causes a serious injury such as head trauma, hip or other bone fracture. More than two-thirds of deaths from falls were at home and 40% of older adults receiving chronic or long-term care are due to fall injuries.
When a client contacts us to begin an exercise program to help him/her restore and optimize strength, vigor, balance and mobility for optimal health and to perform with ease activities of daily living, we get excited! Helping people achieve health, function and fitness beyond their imagination is our specialty. How we get you started:
- Client request a Medical Release for Exercise Testing and Exercise Training from healthcare provider
- Client completes a Health Medical History Questionnaire so we learn more about the you
- When client has available, we also request a copy of the most recent blood test as well as bone density scan results
- We review client medical release, completed questionnaire, blood test and bone density information
- Client goes through Take-In Screening, this includes taking vital signs such as blood pressure, pulse, body weight, BMI and a Fall Risk Screen.
- The Fall-Risk Screen can tell us if the client is at risk for falling and at risk for losing independence
- The next assessment will be a Balance and Mobility Assessment which can identify the type of balance and mobility exercises to select to provide optimal benefits
- The last assessment will be the Senior Fitness Test, this functional fitness test shows the client’s strength and weakness and if he/she is at risk for losing independence
- We analyze all data and develop a Physical Activity Plan, an Exercise Program with a Personal Training Workout Program and Independent Exercise Recommendations.
- Personal training for optimal results is recommended to be performed at a minimum of two to three times per week.
- Re-assessments of the Fall Risk Screen, Balance and Mobility Assessment and Senior Fitness Test is performed at 3 to 6 month intervals to make sure the individual is on track in keeping their functional health, to track changes over time where we can readjust the exercise program, and when medical status changes.
When you have been diagnosed with pre-diabetes type 2 or have diabetes type 2, physical activity and targeted exercise can improve the condition and can reduce the risk for developing related medical condition. Targeted exercise and physical activity and often leads to needing reduced dosage of medication which avoids the side effects many medications bring along with them.
The ‘Magic Pill’ called exercise helps reduce body fat, better manage bodyweight, boost bone health (helps in prevention of osteoporosis and osteopenia), reduce blood sugar, lower Hemoglobin A1c, improves overall health, increases functional fitness level, improves mood, feeling better, among older adults a reduced risk for falls and related injuries, and maintain and sustain a higher quality of life.
Prevention and improvement of chronic medical conditions such as diabetes type 2 is possible with targeted exercise training combined with lifestyle physical activity which reduces daily blood sugar levels and lower hemoglobin A1c. Regular targeted exercise has also proven to have the same effects on blood sugar as several commonly prescribed diabetes drugs. Being able to reduce the dosage of medication and even eliminating the medication all together results in less or no side effects. Side effects, especially in older adults often lead to increased fall risk, injuries and disability, and death.
Prevention: Healthy life style habits can prevent the development of most chronic medical conditions common in the United States. Adopting regular exercise, healthy, sensible nutrition and stress relief can reverse Diagnosed Pre-Diabetes condition by preventing the development of full blown diabetes.
Management: In persons with type 2 diabetes, a reduction in daily blood sugar and a lower A1c can dramatically reduce development of the many diabetes related medical conditions (i.e. dementia, heart disease, peripheral neuropathy in hands, leg and feet, balance problems, falls, Charcot, amputations, and loss of vision) which not only affect quality of life due to long term disability and high healthcare costs, but also the length of one’s life.
Benefit: Physical activity and targeted exercise increases muscle strength and thus increases your blood sugar uptake, this lowers your daily blood sugar levels and over a period of several months’ results in a reduction in Hemoglobin A1c. That ‘Magic Pill’ is within your reach, it starts with a ‘single step and movement’.
What we can do for you: after we receive a Medical Release for exercise and you have completed your Health Medical Health History Questionnaire, we will ask if you have available your most recent blood test and bone density test, and schedule you for initial screening and assessments.
After a careful review and evaluations, we develop your Recommended Physical Activity Plan and design your Exercise Program. If needed we also seek the assistance of our Certified Diabetes Educator to help you better manage your blood sugar and make sure you thoroughly understand how to manipulate your food intake, physical activity and exercise regime to best manage your blood sugar and avoid spikes of hypoglycemia and hyperglycemia which can damage your nerve and brain cells.
Living successfully with diabetes and avoiding development of this disease in the first place is possible.
When preparing Exercise Prescriptions and Physical Activity Plans for new clients I often include daily walking as part of the weekly exercise program.
Many clients however tell me that they do not like to walk without a purpose.
What bigger purpose is there than walking to improve your personal health and well-being?
Below are some more ideas to walk with a purpose:
• Boost your energy level
• Expend energy to better manage your body weight
• Improve and strengthens functions of the heart
• Improves oxygen flow throughout the body
• Reduces the hazardous effects of sitting
• Transport yourself
• Enhances brain function and problem solving skills
• As you age, a brisk walk can help you avoid incontinence
• Extend your independence
As a variation Nordic Walking can bring you daily walk into 4-wheel drive walking mode with an even higher boost in energy expenditure and boost in muscle strength and endurance.
How long for health improvements? 30 minutes on most days of the week
How long for weightloss? up to 90 minutes on most days of the week is recommended to lose weight and better manage body weight.
How many steps? for the average person 10.000 steps are receommneded, for the older adult it is 6000 steps
Exercise professonals serve as extensions of a Healthcare" Team"- working with the clinical care team on the other side of the healthcare system-to-community bridge. Exercise is Medicine (EIM)is focused on encouraging primary care physicians and other health care providers to include physical activity when designing treatment plans for patients and referring their patients to EIM Credentialed Exercise and Exercise Professionals.
Physical acvtivity and exercise are integral in the prevention and treatments of diseases and should be regularly assessed and "treated" as part of all healthcare. Exercise is a powerful complement to traditional medical intervention, and in many instances, allows a physician to significantly reduce a patient's drug dosage or eliminate the need for medicine altogether.
Unfortunately the media and our society bombard us with drug advertisements on TV and many magazines with many causing more serious side effects than the condition for which it is to be taken.
We are all familiar with the Declaration of Independence, why become dependent on drugs that are unnecessary, harm your body and decrease your quality of life?
Sign your own Declaration of Independence and adopt lifestyle habits that include physical activity, exercise, healthful and sensible nutrition. It is called Lifestyle Medicine! Free yourself from unnecessary and damaging medications and drugs, and Live the American Dream "Let Freedom Ring"
Hot of the press!!! I knew it! Late last year, the North American Menopause Society published a position statement that did not recommend exercise to offset symptoms of menopause because the research was “insufficient or inconclusive.”
Recently, an article in the Menopause journal indicated a value for exercise. Among 6,079 women, ages 40-59, who attended one of 20 urban health centers in 11 Latin American countries, 64% reported having a sedentary lifestyle (fewer than three sessions/week of physical activity, such as walking, jogging or swimming, for 30 minutes or longer). More of the women who were sedentary (and more likely to be obese) reported experiencing severe symptoms of menopause (16%) compared to the physically active women, 11% of whom reported severe symptoms. The sedentary women were also more likely to have higher scores on scales of depression, anxiety and insomnia.
My personal experience: when I perform regular cardiovascular exercise such as jogging/running, go for a vigorous walk or energetic Nordic Walk, I do not experience hot flashes at all. However, when I don’t have the time to do this type of exercise my hot flashes appear again (payback for not exercising as I should).
To all my female midlife friends and clients: I advise you to put your walking or running shoes on, and most of all USE them as they should be used, so you don’t’ have to take pills to reduce your uncomfortable hot flashes. INSTEAD be the flash yourself and take off to a new level of health and fitness!
ACSM recommendations for cardiovascular exercise for healthy adults under age 65 with no apparent chronic disease or condition: Start with 10 to 15 minutes of cardiovascular exercise daily. Each week, add five minutes to your exercise routine until you reach 30 minutes of moderate-intensity for a minimum of five days per week. Alternately, you may do 20 minutes of vigorous-intensity exercise three days per week.
The 30-minute recommendation is for the average healthy adult to maintain health and reduce the risk for chronic disease. It should be noted that to lose weight or maintain weight loss, 60 to 90 minutes of physical activity may be necessary.
Exercise Recommendations to Achieve a Higher Level of Fitness or Performance
When your goal is enhanced fitness or exercise to maintain and maximize athletic performance you need to exceed the minimal recommended guidelines for improving health. You need to invest more time and effort into your workout program and pay strict attention to nutrition.
ACSM recommendations for adults with chronic conditions: develop an activity plan with a health fitness professional with advanced certifications such as an Exercise Physiologist or Medical Exercise Specialist to manage risks and take therapeutic needs into account. This will maximize the benefits of physical activity and ensure your safety.
Story source from the ICAA February 2016 newsletter
SOURCE: Menopause, published before print (January 19, 2016) [Ed comment: As noted in the Menopause Society position statement, research is inconsistent on the value of exercise for reducing negative symptoms of menopause. However, the value of exercise for many aspects of health and well-being is established in many studies, and urging older adults to exercise (without promising a “cure”) is a good idea. Just as each woman has an individual experience of menopause, so does each research study supply a piece of information using protocols that probably do not match those in other studies. As more research is conducted, the story may evolve. PR]
The last thing you want to think about while going through cancer treatment and after cancer treatment is the possibility of losing balance, falling and getting injured such as a hip fracture or traumatic brain injury (TBI).
Neuropathy from chemotherapy not only impacts survivors physical function for years after treatment has ended, it puts them at much higher risk for falls and the morbidity associated with those falls. When additional risk factors such as bone loss or osteoporosis are present, the risk of injury such as a hip fracture or traumatic brain injury is much higher.
A common side effect of cancer treatment ‘chemotherapy-induced peripheral neuropathy (CIPN- is damage to nerves that are far from the brain and spinal cord). CIPN can interfere with sensation and movement in the arms, legs, bladder and bowel. The article in Curetoday.com explains that nearly half of all women treated with chemotherapy for cancer report symptoms of peripheral neuropathy long after their treatment has ended, and those with the condition have a significantly higher risk of falls, altered walking patterns and other difficulties in physical functioning.
Women with peripheral neuropathy reported significantly lower physical functioning, significantly more difficulty with tasks of daily living, and nearly twice as many of the women with neuropathy experienced a fall in the last year. Women who have CIPN take longer to rise five times from a chair, they scored worse on the physical performance battery, their walking (gait) speed is slower, they take fewer steps and have shorter strides.
Women with CIPN have specific underlying impairments that put them at risk for falls, limitations that may differ from those that occur with old age, for example. CIPN does not cause muscle weakness but, rather, can have a specific effect on movement and gait patterns. In this study, women with CIPN had difficulty rising from a chair, possibly because their brain does not get enough information from their feet about how quickly or forcefully to stand up.
Physicians and researchers recommend strategies to reduce the likelihood of developing the symptom and to improve rehabilitation for those who get CIPN. Balance and mobility training can often be improved by increased leg strength, however machine-based resistance training may not be as beneficial, because neuropathy does not decrease leg strength. Instead, rehabilitation efforts should focus on improving balance during upright movement and specific gait(walking) training.
Health and fitness professionals who specialize in balance and mobility training are able to provide exercises that optimize the other sensory systems (visual and vestibular) to help compensate for the loss in the somatosensory system that is affected by CIPN.
Walking exercise may be safer for individuals with CIPN when done on a treadmill with handrails instead of outdoors, because their altered gait puts them at increased risk of falling.
Compromised immune system: When immune system is low due to low blood count it is not advises to exercise in public places like the fitness center.
Chemo brain may also pose problems by the patient not being able to remember correctly how to perform an exercise safely and effectively.
One out of every three older adults 65 years and older falls annually, CINP significantly increases this risk. Most falls happen in and around the home, thus falls prevention and intervention with balance and mobility training are therefore very appropriate when the can be performed in the home.
Jacqueline is a certified ACSM/ACS Cancer Exercie Trainer (CET), EP-C and Fallproof Balance and Mobility Specialist Instructor who can provide targeted in-home exercie traning to cancer patients and survivors.
Read the full research article: http://www.curetoday.com/articles/women-experience-long-term-neuropathy-after-chemotherapy-leading-to-falls
The Stay Well At Home program is a 6-month long multifactorial fall risk reduction program aimed to help older aduls to stay safely and independently at home. The program includes twice weekly in-home exercise training visits that gradually tapers down to once weekly exercise training visits to weekly phone consults with a qualified health and fitness professional.
Initial assessments and screening are performed in home after which the client receives a targeted exercies program and training aimed to enhance balance and mobility, muscle strength, flexibility circulation, and joint range of motion.
This is a great program for the older adult finishing up with Home Health or Physical Tharapy and desires to maintain as well as further improve strength, balance and mobility, and build up a higher level of reserve to continue living independently.
Program includes a in-home personal training exercise sessons, independent exercises, and phone consultations, environmenal and home safety assessmens, exercie workbook, with infomation on optimal hydration, discussing medications and their possible side effects, DVD for copntinud independent exercise, exercie equipmnt, and much more.
Stay Well At Home program is suitable for older adults 65 and older at high risk for falls, with 1 or more falls in previous year. with or without injury, normal to mild cognitive impairment.presence of 1 or more known ris factors for falls, limited or no access to community programs.
Fitness & Function is an authorized provider for the Stay Well At Home program.
All our balance and mobility programs (individualized and tailored program FallProof; Otago-provided by physical therapist only; Tai Chi Movement for Better Balance; Stepping On 7-week workshop; outpatient phyical therapy, and now also the Stay Well At Home program) provide our clients with a wide range of options in their desire to stay safely independent at home (age in place) with the right tools to do so.
Clients choose the program that fits them best and provides them with optimal benefits.
Early 2015 it was suggested to me by a Geriatric Care Manager(GCM) to prepare a proposal to speak at the Western Regional Geriatric Care Manager's Conference November 5-7, 2015 for the first time offered in Portland Oregon. The GCM mentioned that the targeted exercise training that I had provided for her father in law provided him with the opportunity to stay at home with the strength and mobility to live out his life at home longer rather than having to move to a care facility. The in-home exercise service beyond physical therapy has not been widely recognized as a choice for older adults not only to restore function, improve fitness and health, but also as a palliative exercise choice so that the individual can maintain function or slow down functional declines due to the disease process.
I decided to develop the proposal and enlisted the additional expertise of our PT Bayla O'Brien as well. The topic name "Aging in Place: Long-Term Solutions to Independence and Fall Risk Reduction".
Falls are the main reason older adults lose their independence, one out of three older adults fall annually and most falls occur at home. GCMs are continually weighing risk/benefit of aging in place for a given individual. This session provides assessment tools the GCM can integrate into client care plans to minimize fall risk and improve balance, mobility and strength- all keys to independence and quality of life. The Medicare Annual Wellness Visit provides valuable information the GCM can use to strengthen care plans and collaborate with client’s family and healthcare providers for simple, practical interventions. This session will broaden the GCM’s resource base for health and fitness professionals who help clients develop and practice basic safety and ADLS in their own home –decreasing falls in the location of highest risk.
I am very happy to report that every seat was taken in the room and that this topic was very important to GCM's who's main interest is to maximize their clients functional potential and quality of life.
Lifestyle Medicine is a branch of medicine dealing with research, prevention and treatment of disorders caused by lifestyle factors such as nutrition, physical inactivity, and chronic stress. The leading causes of mortality and healthcare costs worldwide are chronic diseases, resulting from lifestyle and environmental factors. The economic burden of poor lifestyle choices is no longer sustainable and impossible to ignore. Most chronic diseases are preventable!
To treat the causes of these diseases and to be successful in prevention, a strong focus must be placed on lifestyle medicine aspects. Lifestyle Medicine encompasses research, prevention, diagnosis and treatment of dysfunctions caused by a non-physiological lifestyle (lifestyle-related diseases, LRDs) and morbidogenic environments conducive to promoting such lifestyles.
Primary goal of lifestyle medicine: The ultimate goal and primary focus of Lifestyle Medicine is to promote healthier lives through salutary environments and healthier lifestyle choices. Treatment of LRDs includes nutritional, exercise, psychological, social, economic and environmental interventions.
To successfully do this requires education, training and communication about Lifestyle Medicine at the professional and general public level, while avoiding the trap of ‘victim blaming’ of individuals whose lifestyles are influenced by circumstances beyond their control.
EXERCISE IS MEDICINE: In 2007, the American Medical Association (AMA) and the American College of Sports Medicine (ACSM) co-launched Exercise is Medicine (EIM) - a United States-based health initiative that has since been coordinated by ACSM. The initial purpose of EIM was to make the scientifically proven benefits of physical activity the standard in the U.S. healthcare system. The new world of healthcare is focused on at-risk population groups that require interventions to slow, stop and reverse the progression of chronic diseases. In any particular community, healthcare stakeholders will depend on trusted EIM exercise professionals, as part of their community care team, to meet the demand for engagement in interventions
Physical activity (PA) is a powerful complement to traditional medical intervention and, in many instances, allows a physician to significantly reduce a patient's drug dosage or eliminate the need for medicine altogether. A great example of this is that targeted exercise has the same effect on reducing blood sugar as many diabetes drugs, and thus reduced medication or dosage is expected. Medications often have a large number of undesireble side effects for which patients take addiinal mediation which often all can be eliminated with targeted exercise.
Exercise professionals serve a continuum of client needs: Some clients wish to optimize their athletic performance; some wish to improve their fitness; and, increasingly, many wish to elevate their physical actiity levels to prevent or manage chronic disease. Exercise professionals play an integral role in educating clients about the benefits of becoming more active and in communicating how clients can speak with their primary care physicians about ways to increase their physical activity.
Exercise professionals are extensions of a healthcare “team” -- working with the clinical care team on the other side of the healthcare system-to-community bridge. Organizations and locations that are designated as EIM Places are also becoming a part of this shift.
American College of Sports Medicine Fitness professionals are EIM credentialed and are trained to work with patient populations that have been stratified by chronic diseases, levels of risk, motivational readiness and personal preferences. The ACE Medical Exercise Specialist holds similar credentials and are also powerful extension to their clients' healthcare team.
Jacqueline Sinke and her team of health fitness professionals have the required certifications, qualifications and have the experience and expertise to optimize your function, health, fitness and performance, enhance quality of life with targeted and beneficial exercise training. Best of all; We Come To YOU with IN-HOME Exercise Training.