Exercise and HealthExercise and HealthRonan Donohoe, Student

Physiotherapist 21st August 2007

Learning ObjectivesLearning Objectives

•To have an awareness of the risks associated with a sedentary lifestyle

•To understand the importance of exercise in the health and well being of family carers

•To be able to set goals to improve overall fitness levels through a regular physical activity

Main causes of Main causes of premature death in premature death in

IrelandIreland•Heart Disease

•Stroke

•Cancer

•Respiratory system

Died Young

-

Never

Exercised

Risk factors for Heart Risk factors for Heart Disease & StrokeDisease & Stroke

•Things you can’t change• Age• Gender• Heredity

•Things you can change• Smoking• High Blood Cholesterol• High Blood pressure• Obesity • Diabetes• Stress• Physical inactivity

Physical Activity and Physical Activity and Well BeingWell Being

• Decreased physical activity is linked to the development of obesity.

• Obesity can place individuals at risk of coronary heart disease, hypertension, diabetes and cerebrovascular disease.

• Increasing levels of childhood obesity are, therefore, putting future generations at greater risk of developing these diseases.

What is BMI?What is BMI?• BMI = Body Mass Index

• “A measure of the relationship between weight and height that is associated with body fat and health risk”

• BMI Ranges: BMI Less than 18 — Under Weight

BMI 18-25 — Normal Weight

BMI 25-30 — Over Weight

BMI 30-40 — Obese

BMI Over 40 — Severely Obese

Calculating your BMICalculating your BMI

Use it or Lose itUse it or Lose it

• Muscles not used regularly become “de-conditioned” & unfit.

• They become:

• - smaller - feel heavy

• - shorter - tire quickly during normal activities

• - stiffer

• - weaker “getting old” syndrome

Benefits of ExerciseBenefits of Exercise

•Physical

•Increased Muscle strength

•Endurance

•Cardiovascular fitness

•Flexibility

•Balance

•Stability

•Coordination

• Caregivers who devote themselves to their loved ones to the exclusion of their own needs become ill.

• In a study of spousal caregivers, (Schulz, et al, 1999) caregivers who experienced mental or emotional strain had a 63 percent higher risk of death than non-caregivers.

Impact of CaregivingImpact of Caregiving

Benefits of ExerciseBenefits of Exercise

•Psychological

•Decreases stress

•Decreases anxiety and depression

•Increases self esteem and confidence

•Aids relaxation

•Promotes physical self worth and improved body image.

Mental HealthMental Health

• 80 million working days per year are lost due to anxiety and depression.

• Physical activity is associated with positive mood, improved motivation, self esteem and psychological wellbeing (Grant, 2000).

• Physical activity reduces depression, stress and anxiety scores, however, many studies lack rigour and further research is needed to assess long term outcome (Lawlor and Hopker, 2001)

Benefits of ExerciseBenefits of Exercise

•Personal

•Involvement in sporting activities encourages:

•Social interaction

•Team work

•Discipline: adhering to rules and regulations.

•Promotes feelings of achievement and motivation

CardiologyCardiology

•Regular exercise can reduce the risk of heart disease by:

•Reducing blood pressure

•Reducing resting heart rate

•Altering blood lipid profiles

• The above are all risk factors for the development of heart disease (NHS, 1998).

NeurologyNeurology

• A study investigating the relationship between stroke and activity has shown that the incidence of stroke is inversely related to physical activity. (Salonen et al., 1982).

• Physical activity can reduce hypertension (high blood pressure) the main risk factor of stroke.

•makes the heart to work more efficiently during exercise and resting•increased capacity for exercise•reduction of high blood pressure

•helps weight reduction by mobilizing excess fat from the body•decreases total and LDL cholesterol ("bad cholesterol")•raises HDL cholesterol ("good cholesterol")•controls / prevents diabetes - improved ability to metabolize glucose

•improves flexibility and builds muscle•decreases risk of injury / falls improving balance & coordination•can reduce the risk and reverse effects of osteoporosis•reduces the risk of colon cancer

•increases energy store in the body•increases tolerance to anxiety, stress and depression•aids relaxation and helps people sleep

The Case for The Case for ExerciseExercise

Is it safe for me to Is it safe for me to exercise?exercise?• You shouldn’t exercise without consulting a GP if you have:

• dizziness • chest pain

• irregular, rapid, or fluttery heart beat• severe shortness of breath• significant, ongoing weight loss that hasn’t been diagnosed• infections, such as pneumonia, accompanied by fever• fever, which can cause dehydration and a rapid heart beat• acute deep-vein thrombosis (or “DVT”) i.e. blood clot• a hernia that is causing symptoms• foot or ankle sores that won’t heal• joint swelling, persistent pain, recent or existing injuries• certain eye conditions, such as bleeding in the retina or detached retina.

Types of ExerciseTypes of Exercise• Aerobic e.g. running, cycling, swimming...

• Anaerobic e.g. sprinting, weight lifting.....

Physical FitnessPhysical FitnessFour components of physical fitness:

• strength,

• endurance,

• co-ordination

• and flexibility

How much should I How much should I aim for?aim for?

• “FITT” principle:•Frequency (how many days per week)•Intensity (how hard)•Time (how long)•Type (what kind of exercise)

• Recommended activity level:

“Moderate aerobic exercise of 30 minute duration is recommended 3-5 days per week”

Basic Exercise Basic Exercise Session StructureSession Structure

• Basic Exercise Session Structure 

• 1.Warm up - light exercise for 5 minutes

• 2.Stretch - muscle groups you will use during the workout

• 3.Workout - Start light, ease into hard work. Resist the temptation to do more than you can. Take time to master the correct form.

• 4.Stretch - muscle groups used

• 5.Cool down - 5-10 minutes of total body light intensity exercise to help prevent build up of toxins in the muscles and give the body time to return to normal functioning.

• 6. Recovery - Hydrate and feed the muscles depending upon the intensity of the workout. Avoid hot showers until your body temperature is back in a normal range.

What is my target heart What is my target heart rate?rate?• Maximum Heart Rate (MHR) = the maximum heart

rate a person can achieve during maximal exertion

• Generally: 220 - age = MHR

• Target Heart Rate:

• 50-60% of MHR = maintain healthy heart

• 60-70% of MHR = lose weight / burn fat

• 70-80% of MHR = increase stamina / Aerobic zone

• 80-90% of MHR = performance training / Anaerobic zone

• e.g. A 50 year old would have a MHR of 220 - 50 = 170bpm

• 170 x 70% = 119bpm

How do I take my How do I take my pulse?pulse?

1. Lightly with two fingers at base of wrist below thumb or side of neck under jawbone

2. With a watch, count the number of beats in 15 seconds and X 4 to get BPM (beats per minute)

3. Normal resting heart rate for an adult is 60-90 beats per minute

How do I monitor my How do I monitor my activity level?activity level?

• Borg Breathlessness Scale:

• rates how “out of breath” you feel during exercise

• closely related to heart rate (x by 10) e.g. fairly light is10 x 100 = 110bpm

The Borg Rating Scale

6no exertion at

all

7extremely

light

8

9 very light

10

11 fairly light

Endurance Training Zone

12

13somewhat

hard

14

15 hard (heavy)

16

17 very hard

18

19extremely

hard

20maximal exertion

S M A R T Goals

• Specific “I will walk”

• Measurable “to the shops / for 15 mins”

• Acceptable “does it make sense?”

• Realistic “feasible? - to stay motivated”

• Timed “will review after 3 attempts”

General Advice• Start Slowly

• Pick something you enjoy

• Make sure you’re safe

• Dont forget to warm up, stretch and cool down

• Wear appropriate footwear

• Try to build up to 30 mins most days of the week

• Eat sensibly & don’t become dehydrated

• Don’t overdo it

• Consult your doctor if you’re unsure or have health problems

Useful Contacts• Irish Society of Chartered Physiotherapists (ISCP) ph 01

402 2148

• Irish Heart Foundation. ph 01 6685001

• Dublin City Council Leisure Services. ph 01 222 2222

Weblinks• Calculate your BMI ( http://tinyurl.com/ywk95j )

• Calculate your Target Heart Rate ( http://tinyurl.com/2laq8j )

• Dublin City Council Leisure Services. ( www.dublincity.ie )

• Evening & night courses, Dublin ( www.nightcourses.com )

• This presentation ( http://tinyurl.com/2gwr45 )