Transcript Treatment of Vertigo Through Physical Therapy

STARTING AN
EXERCISE PROGRAM
Mary Ann Burke, P.T., M.S., G.C.S.
BENEFITS OF EXERCISE
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Weight Control
Combat Health
Conditions & Disease
Improve Psychological
Well-Being
Boost Energy
Improve Sleep
WEIGHT CONTROL
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Non-Dieting/Overweight
Controls gained weight
 Low-amount exercise groups
lost weight/fat
 High-amount exercise group
lost more of each in a
dose-response manner
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Slentz CA, et al. Effects of the amount of exercise on
body weight, body composition, and measures of
central obesity: STRRIDE-a randomized controlled
study. Arch Intern Med 2004 Jan;164(1):31-9
BLOOD PRESSURE
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A single episode of exercise
reduces BP in hypertensive
subjects
Regular aerobic exercise
reduces BP in hypertensive
subjects.
No proof of resistance
training reducing BP
Cardoso, CG, et al. Acute and chronic effects of aerobic and
resistance exercise on ambulatory blood pressure in
normotensive and hypertensive subjects. Clinics 2010
Mar;65(3):317-25
TYPE 2 DIABETES
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Structured interventions combining exercise and
weight loss have been shown to lower type 2
diabetes by up to 58% in high risk populations.
Most benefits of physical activity on diabetes
management are realized through acute and
chronic improvements in insulin action,
accomplished with both aerobic and resistance
training.
Colberg SR, et al. Exercise and type 2 diabetes. Diabetes Care 2010 Dec;33(12):e147-67
CANCER
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66% of cancer mortality in the USA can be
linked to tobacco use, poor diet and lack of
exercise.
Moreover, only 5-10% of most types of cancer
are caused by defects in single genes that run
through families, and only a similar small
percentage are because of occupational and
environmental factors.
Havard Report on Cancer Prevention. Vol. 1: Causes of Human Cancer. Cancer Causes Control 1996
CANCER
 Mounting
evidence indicates that
exercise may significantly reduce the
risk of some cancers.
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strongest evidence comes from research
on colon cancer, where physical activity has
been shown to reduce the risk by up to 50%.
Shepard RJ & Shek PN. Associations between physical activity and susceptibility to cancer.
Sports Med 1998;26:293-315.
OSTEOPOROSIS
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A number of studies with postmenopausal
women have shown that exercise can
increase bone density or prevent further
bone loss when compared to non-exercise
controls.
Dalsky GP, Stocke KS, & Ehsani AA, et al. Weight bearing exercise training and lumbar bone mineral
content in postmenopausal women. Ann Intern Med 1988;108:824-28.
IMPROVE PSYCHOLOGCAL
WELL-BEING
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Exercise is a lifestyle that
leads to improved physical
and mental health
throughout life.
Hillman CH, et al. Be smart, exercise your heart: exercise effects on
brain and cognition. Nat Rev Neurosci 2008 Jan;9(1):58-65
DEPRESSION
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Although antidepressant medication may
facilitate a more rapid initial therapeutic
response than exercise, after 16 weeks of
treatment, exercise was equally effective in
reducing depression among patients with
major depressive disorder.
Blumenthal JA, et al. Effects of exercise training on older patients with major depression. Arch Intern
Med. 1999 Oct 25;159(19):2349-56.
MEMORY
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Study on 120 older adults, half of whom started
a program of moderate aerobic exercise.
After 1 year, MRI scans showed that the brains
of subjects who exercised increased their
volume, while non-exercising subjects brains lost
up to 1.5% of their volume.
Further testing showed that increased brain
volume translated into better memory.
NPR Report of a study by researcher Art Kramer.
BOOST ENERGY
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Sedentary people who
completed a regular
exercise program reported
improved energy levels
compared to groups that
did not exercise.
Puetz T. News release of a study review from the University of
Georgia, 2006.
IMPROVE SLEEP
 Exercise
is a healthy,
safe, inexpensive, and
simple means of
improving sleep.
Youngstedt SD. Effect of exercise on sleep. Clin Sports Med
2005 Apr;24(2):355-6
DEFINITIONS
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Aerobic/Cardiovascular Activity
 Exercises that speed up
breathing and heart rate
Running, Cycling, Walking,
Swimming, Dancing
Typically performed for long
durations
Definitions
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Heart Rate (HR)
 Measured in beats per minute (BPM)
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Rate of Perceived Exertion (RPE)
 A measure of how hard you’re working
 Rated on a Borg Scale
Borg Scale
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6 – 20% effort
7 – 30% effort – Very, very light (Rest)
8 – 40% effort
9 – 50% effort – Very light (Gentle walking)
10 – 55% effort
11 – 60% effort
12 – 65% effort
13 – 70% effort – Somewhat hard – steady pace
14 – 75% effort
15 – 80% effort – Hard
16 – 85% effort
17 – 90% effort – Very Hard
18 – 95% effort
19 – 100% effort – Very, very hard
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20 - Exhaustion
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Definitions
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Flexibility Training/Stretching
 Enhances range of motion of joints
DEFINITIONS
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Strength/Resistance Training
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Improve strength and function of
muscles
Weight lifting, Resistance bands
 Body weight (push-ups, squats)
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Set
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Repeating the same exercise a certain
# of times
Repetition
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Number of times an exercise is
performed during a set
DEFINITIONS
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Warm Up
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Preparing for the stress of exercise
Light intensity aerobic activity
 Increase blood flow and heat up
muscles
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Cool Down
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Less strenuous exercise after more
intense workout
Slow down breathing and heart rate
 Stretching
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BASIC TRAINING GUIDELINES
(ACSM/Centers for Disease Control and Prevention)
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Warm Up
 Reduce the risk of injury
 10-15 minutes
 All major joints and
muscles should be
engaged
 Walking, stretching,
calisthenics
BASIC TRAINING GUIDELINES
(ACSM/Centers for Disease Control and Prevention)
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Aerobic Training
Frequency: 4-7 days/week
 Intensity: RPE 12-14
 Duration: 10-60 minutes
 Mode: Aerobic activities
 Progression:
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Phase 1: 6 weeks, low intensity
 Phase 2: 6 months, gradual increase
 Phase 3: Maintenance
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BASIC TRAINING GUIDELINES
(ACSM/Centers for Disease Control and Prevention)
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Strength Training
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Frequency: 2-3 days/week
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48 hrs of rest between
Intensity: RPE of 12-14
 Repetitions: 15
 Sets: 1-3
 Rest: 90-120 seconds between
sets
 Progression: RPE of 12-14
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reassessed every 2-4 weeks
BASIC TRAINING GUIDELINES
(ACSM/Centers for Disease Control and Prevention)
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Flexibility Training
Frequency: 2-7 days/week
 Intensity: Range gently increased
in each position
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Mild muscular tension, not pain
Duration: Position held for 5-40
sec
 Repetitions: 1-5 per stretch
 Progression: Develop fuller ranges
naturally with time and practice
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BASIC TRAINING GUIDELINES
(ACSM/Centers for Disease Control and Prevention)
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Cool Down
 Reduce the risk of injury
 10-15 minutes
 Slowed down
movements
 Continue until heart rate
is < 100 bpm
LAND BASED
EXERCISE PROGRAMS
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Gym Programs
 Aerobic and
strengthening
equipment
 Exercise classes
 Areas for stretching
 Trainers
LAND BASED
EXERCISE PROGRAMS
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Home
 Exercise Equipment
 Treadmill
 Stationary Bike
 Weights
 Exercise Ball
 DVD’s
 Walking
 Biking
 Hiking
POOL EXERCISE PROGRAMS
 Aqua-kinetics/Aqua-aerobics
 Group
exercise
 Swimming
FIVE TIPS TO HELP
YOU GET STARTED
1. Assess Your Fitness Level
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Consult with your physician
Record Baselines
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Heart rate before and after
walking 1 mile
Time to walk 1 mile
# of push-ups
Forward reach
Waist circumference
Body Mass Index (BMI)
2. Design Your Fitness Program
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Set goals
Balanced routine
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Aerobic activity
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Strength training
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150 minutes of moderate
intensity or 75 minutes of
vigorous activity per week
2 or more days/week
Go at your own pace
Schedule time
2. Design Your Fitness Program
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Include different activities
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Keep boredom at bay
Decrease risk of injury
Emphasize different body
parts
Allow time for recovery
Put it on paper
3. Assemble Your Equipment
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Athletic shoes
Pick shoes designed for the
activity in mind
 Pick shoes that are right for
your foot
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Choosing Equipment
Practical
 Enjoyable
 Easy to Use
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4. Get Started
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Start slowly, build gradually
Warm up and cool down
 Speed up to a pace you can
continue for 10 min
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Gradually increase amount of time
 Work up to 30-60 min of exercise
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Break things up
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Shorter but more frequent
exercise has aerobic benefits too
4. Get Started
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Be Creative
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Listen to your body
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Include various activities
(walking, cycling, rowing)
Take a weekend hike
Evening dancing
If you feel pain, shortness of
breath, dizziness, nausea,
take a break
Be flexible
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Give yourself permission to
take a day off
5. Monitor Your Progress
Reassess
 6 weeks after you
start
 Every 3-6 months
 You may need to
increase exercise time
to keep making fitness
gains
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SAFETY!!!
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Don’t over exert yourself
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Develop the habit
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4-6 weeks of light intensity, then
increase
Develop a schedule and stick to it
Make adjustments
Listen to your body
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If you feel pain, shortness of breath,
dizziness, STOP.
Moderately challenging but tolerable
Common Exercise Injuries
•
Shoulder Pain/Rotator Cuff Tendonitis
• Discrepancy between overworking the
power muscles of the shoulder at the
expense of the smaller rotator cuff
muscles
• Chest and incline press
• Overhead press
• Lateral raises
Common Exercise Injuries
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Back and Neck Pain
• Improper weight lifting technique
• Overloaded compressive forces
• Weak musculature
• Poor posture
• Jarring activities
• Exercises that compress the spine
• Flexion/extension machines
Common Exercise Injuries
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Elbow Pain/Golfer’s Elbow/Tennis Elbow
• Gripping & pulling a load that is too heavy
• Improper lifting technique (wrist motion)
• Cable pull downs
• Rows
• Biceps curls
• Triceps extension
Common Exercise Injuries
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Plantar Fasciitis/Achilles' Tendinitis
• Improper foot wear
• Weak hip musculature
• Over training
• Running
• Inclined Walking/Hiking
• Jumping
Common Exercise Injuries
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Knee Pain
• Anterior knee pain
• Tendinitis
• Meniscus tear
• Arthritis
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Deep squats
Knee extension
Bias toward quadriceps strengthening
Neglecting hamstrings and hip abductors
Treatment Strategies for
Minor Injuries
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Decrease exercise intensity
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Make sure all 3 components are present
• Cardiopulmonary
• Strengthening
• Flexibility
Treatment Strategies for
Minor Injuries
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Ice affected area 10-15 min/2-3 x day
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If swelling is involved…RICE
• Rest
• Ice
• Compression
• Elevation
Treatment Strategies for More
Severe Injuries
Physician
• Physical Therapist
• Orthopedic Specialist
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HAVE FUN!