Transcript Exercise Prescription For Seniors

Exercise Prescription For Diabetes
Robert Goldstein, MS;
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Health Educator
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Fitness Therapist
Disease Management
For Diabetes
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Health Fitness Instructor
American College of Sports
Medicine
Exercise Prescription For Diabetes
Your Moderate Exercise Program
Robert Goldstein MS;
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Your Optimum Program
Getting Started
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7 Major Components of Fitness
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1) Warm up
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2) Cardiovascular Fitness
3) Muscular Strength
4) Flexibility Fitness
5) Cool Down
6) Body Composition
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Disclaimer
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Today’s Lecture is for
Educational Purposes and
not Medical Advice. If you
have certain medically
related issues you should
speak to your physician.
Please Check with your
physician about starting an
exercise program
Blood Glucose
The Good The Bad and The Ugly
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Body Requires Glucose as Energy
Source.
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Broken down from food breaks
food down into sugar.
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Insulin is necessary to regulate
glucose from blood into cells.
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High blood Sugar harms the body.
May do eye, heart nerve and
kidney damage.
What are the Types Of Diabetes?
What are the Treatments?
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Type 1 Diabetes
Pancreas has a total
inability to produce any
insulin
Daily Insulin Injections
5 to 10% Of all diabetes
Diet and Exercise
Type 2 Diabetes
The Most Common
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Pancreas is able to produce
insulin but not enough to
register with cells.
90% of all Diabetes
Treated with oral
medication.
People over 40. High BMI
or family history.
Diet and Exercise!!!
Gestational Diabetes
Develops During Pregnancy
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Develops in up to 5% of all
Pregnancies.
May disappear after birth.
Large risk in future to
develop type 2.
Juvenile Diabetes
Walking Away From Disease And Disability
Childhood Diabetes
May be first generation to not live
longer than parents
Often genetic
200,000 cases nationwide
Large % have type 1
10 to 15 % children overweight
Type 2 more prevalent
Diet and Exercise Now!!
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Pre-Diabetes
Time To make Change
Your Wake Up Call
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1) Blood Glucose Higher than
normal.
Positive for metabolic syndrome
risk factors.
High risk to develop type 2
diabetes.
Estimated 54,000,000
Americans; many not diagnosed
Diet and Exercise Now!
Benefits Of Moderate Exercise
And Diabetes
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Benefits Of Exercise
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1) Weight Loss
2) Lower Blood Pressure
3) Reduce Risk for Heart
Disease
4) Improve Cholesterol Ratios
5) Control Blood Sugar
6) Reduce Back and Joint Pain
7) Improve Balance
8) Reduce Medications
9) Increase Self Confidence
10) Reduce Risk For Fall
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Warm Up
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1) Reduce risk for injury
2) Gradual increase of pressure
and heart rate.
3) Increases circulation in legs.
4) Warms Muscles.
5) Types of Warm up
Light Walking
Light Cycling
Balance Exercise
Movement and Light Stretching
5 to 10 minutes
Cardiovascular Fitness
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1) The heart, lungs and blood
vessels deliver adequate supply
of oxygen to large working
muscles.
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2) Also called aerobic fitness
uses the oxygen pathway.
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3) Examples- Walking, Cycling,
Swimming, , Recumbent Step
Machine.
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4) Perform 3 to 5 times a week.
May be done in short bouts or
duration.
Risk Factors for Heart Disease
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1)Family History of Heart Disease.
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2) High Blood Pressure 140/90 0r above.
3) Sedentary Lifestyle.
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4)High Cholesterol over 200
Low HDL under 35.
5) Cigarette smoking or those who have
quit within the past 6 months.
6) Impaired Fasting Glucose over 100.
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7) Obesity BMI over 30 and Men’s
waist 40” Woman’s 35”
8) Age 45 0r over.
Muscular Strength and Endurance
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Strength Training
1) Helps to maintain lean body
weight and muscle mass.
2) Perform 2 to 3 times a week with
a day rest in between.
3) Light Dumbbells, Thera- Band,
rubber tubing.
4) Exercise within range of motion
without pain or excessive weight.
5) Start with one set of 10 until
mastered and increase to two sets.
6 ) Extremely important and helpful
in reducing blood sugar.
Flexibility
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1) Flexibility Decreases after the
age of 25. Increasing risk for
injury.
2) The biggest reason for
missing work after the common
cold is low back pain.
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Stretching
1) Best when muscles are warm;
during and after workout.
2) Static Stretching. Holding
Stretch for 30 seconds on each
side.
3) Only stretch to comfortable
range of motion increasing as
muscle allows.
Cool Down
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1) Brings Blood Pressure and
Heart rates down gradually.
2) Aids in preventing muscle
stiffness or soreness.
3) Prevents pooling of blood and
promotes adequate flow to
muscles and heart. Increases
circulation.
Slow Walking
Stretching
Slow Movement
Blood Sugar Levels for Exercise
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Goal is to avoid hypoglycemia for people
who exercise.
Type I may have larger drops with
exercise and risk for hypoglycemia
Type II Lower risk of hypoglycemia but
still possible
Dizziness, Headaches, Weakness
Headache, Pale Skin
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Initially check blood sugar before and
after exercise
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Light snack as crackers, rice cakes,
pretzels are of low caloric content and
can help raise blood sugar.
How Hard do I Need to Work
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A great question
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1) Very individual prescription.
2)Heart rate % method 220
minus age. Safety is number
one concern.
3) Full evaluation of your
medical history, medications,
surgeries and orthopedic
conditions.
4) Doctors approval and
contraindications.
5) The good news, you can
exercise even if you don’t think
you can and if you never did
before.
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Intensity
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Exercise Prescription
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1) Mode – Type of exercise.
Determined on an individual basis.
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2) Intensity – How hard do I work.
Workload. Starting low and
graduating when perfecting current
intensity.
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3) Duration – How long. Also based
on individual needs. Short bouts to
start.
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4) Frequency – How many days per
week,
Rated Perception Of Exertion and Meds
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1) Beta blockers, Alpha blockers, Calcium Channel
and Diuretic Medications blunt heart rate and blood
pressure.
2) With this in mind heart rate end blood pressure
will not be the best indicator of how hard you
work.
RPE Borg Scale
6
7 very Very Light
8
9 very light
10
11fairly light
12 moderate
13 somewhat hard
14
15 hard
16
17 very hard
18
19 very very hard
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Other Methods of Rating Intensity
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1) The talk test- You should be
able to carry on a conversation
while exercising.
The Reggie test – Get a 4 month
old puppy and work until
exhaustion
2) Evaluating Range of Motion.
Stopping when feeling pain.
3) The no pain no gain mentality
is not appropriate. You should not
feel pain.
4) If you are feeling pain you are
possible hurting yourself and
preventing improvement.
Body Composition
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Body Composition and Risk
for Heart Disease.
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1) Body Mass Index.
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2) Body Fat Percentage.
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3) Waist Hip Ratio.
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4) Circumference
Measurements
Weight Loss
Taking it Slow
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How Weight Loss Works.
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1) Negative caloric expenditure.
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2) Negative expenditure thru diet
and exercise.
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3) 3500 calories one pound. 1 pound
a week is a reasonable weight loss.
4) Eliminate about 250 calories per
day thru diet
5) Another 250 calories through
exercise.
How Can I Start
Stages of Change
Pre-Contemplation
Contemplation
Action:
The Fierce Urgency of
Now!!
Maintenance
Relapse
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Smart Goals
KISS
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Specific
Measurable
Attainable
Realistic
Timely
Reduce Risk factors for Heart Disease
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Modifiable Risk factors
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Cigarette Smoking
Hypertension
Hypercholesterolemia
Impaired Blood Glucose
Obesity
Sedentary Life Style
Stress
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Pre and Post Exercise Blood Sugar Averages
1 Year
140
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120
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100
3-D
Column 1
3-D
Column 2
3-D
Column 3
80
60
40
20
0
Pre
Ex
Pre exercise 140
Post Exercise 100
Exercise Levels
Start and 20 Sessions On Treadmill
Starting Session
1.4 MPH 0% Grade
 20 Sessions
2.9 MPH 0% Grade
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48% Increase in
Workload
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3.5
3
3-D
Column
1
3-D
Column
2
3-D
Column
3
2.5
2
1.5
1
0.5
0
Start
First Session and 20th Session
Aerobic Time Minutes
Session One
9 Minutes Total
3 Minutes Bike
3 Minutes Treadmill
3 Minutes Bike
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Session Twenty
Total Time 29 Minutes
14 Minutes Bike
15 Minutes Treadmill
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300% increase
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30
25
20
15
10
5
0
Beg
Time
20
Sess
Thank You Very Much
Ready eXercise
Robert Goldstein MS
Exercise Physiologist
readyexercise.com
925-457-5346