Showing posts with label cardiac. Show all posts
Showing posts with label cardiac. Show all posts

Friday, April 13, 2012

Why should Senior Citizens Exercise?


Welcome to one of the healthiest things you can do for yourself. Exercise!-The fountain of youth!

For the most part, when older people lose their ability to do things on their own, it is not because they have aged. More likely, it is because they have become inactive.

The human body is made for movement, and this applies to senior citizens too.
As you grow older, leading an active lifestyle is more important than ever. Regular exercise can help boost your energy, maintain your independence, and manage the symptoms of any illness or pain. Exercise can even reverse some of the symptoms of aging. And not only is exercise good for your body—it’s also good for your mind, mood, and memory.

No matter your age or your current physical condition, you can benefit from exercise. Reaping the rewards of exercise doesn’t require strenuous workouts or trips to the gym. It’s about adding more movement and activity to your life, even in small ways.

Don't worry if you've never exercised, or if you stopped exercising for some reason. Being physically active can help you continue to do the things you enjoy and stay independent as you age. In addition, the right kind of regular exercise can reduce your chance of heart disease, diabetes, and falls.
You may have a hard time starting an exercise routine. Once you do start, though, you will begin to notice the benefits, including improved sleep and self-esteem.

What can Exercise do for Me?

Most people know that exercise is good for them. Somehow, though, older adults have been left out of the picture -- until recently. Today a new picture is emerging from research: Older people of different physical conditions have much to gain from exercise and from staying physically active. They also have much to lose if they become physically inactive.
Exercise isn't just for older adults in the younger age range, who live independently and are able to go on brisk jogs. Researchers have found that exercise and physical activity also can improve the health of people who are 90 or older, who are frail, or who have the diseases that seem to accompany aging. Staying physically active and exercising regularly can help prevent or delay some diseases and disabilities as people grow older. In some cases, it can improve health for older people who already have diseases and disabilities, if it's done on a long-term, regular basis.

Physical Health benefits:

  • Helps maintain or lose weight: As metabolism naturally slows with age, maintaining a healthy weight is a challenge. Exercise helps increase metabolism and builds muscle mass, helping to burn more calories. When your body reaches a healthy weight, overall wellness improves. 
  • Reduces the impact of illness & chronic disease: Among the many benefits of exercise for seniors include improved immune function, better heart health and blood pressure, better bone density, and better digestive functioning. Seniors who exercise also have a lowered risk of several chronic conditions including Alzheimer’s disease, diabetes, obesity, heart disease, osteoporosis, and colon cancer. 
  • Enhances mobility, flexibility, and balance: Exercise improves your strength, flexibility and posture, which in turn will help with balance, coordination, and reducing the risk of falls. Strength training also helps alleviate the symptoms of chronic conditions such as arthritis. 

Mental Health Benefits:
  • Improves your sleep: Poor sleep is not an automatic consequence of aging and quality sleep is important for your overall health. Exercise often improves sleep, helping you fall asleep more quickly and sleep more deeply. 
  • Boosts mood and self-confidence: Endorphins produced by exercise can actually help you feel better and reduce feelings of sadness or depression. Being active and feeling strong naturally helps you feel more self-confident and sure of yourself. 
  • Exercise is good for the brain: Exercise benefits regular brain functions and can help keep the brain active, which can prevent memory loss, cognitive decline, and dementia. Exercise may even help slow the progression of brain disorders such as Alzheimer’s disease. 
Not sure if you can Exercise
You may be reluctant to start exercising, even though you've heard that it's one of the healthiest things you can do. You may be afraid that physical activity will harm you; or you might think you have to join a gym or buy expensive equipment in order to exercise. Or, you may feel embarrassed to exercise because you think it's for younger people or for people who look great in gym clothes. You may think exercise is only for people who are able to do things like jogging.

In fact, just about every older adult can safely do some form of physical activity at little or no cost. And you don't have to exercise in a public place or use expensive equipment, if you don't want to.

Even household chores can improve your health. The key is to increase your physical activity, by exercising and by using your own muscle power.

Benefits Everyday Life:
The most rewarding part of beginning a fitness routine is noticing the difference it makes in the rest of your life. Even if you begin exercising with a few simple stretches while seated or a short walk around the block, you’ll notice an improvement in how you feel as you go about your day.
  • House cleaning, gardening, shopping, and errands. Want to feel less winded while vacuuming or rushing to and from appointments? Doing just 15 to 20 minutes of heart-healthy cardio each day, such as walking, biking, swimming, or water aerobics will help give you the stamina you need. 
  • Lifting grandchildren, carrying groceries, household chores. Building muscle mass a few times each week through weight lifting, resistance exercises, and nautilus machines will help give you more strength. 
  • Tying shoes, looking behind you while driving, navigating steps. Incorporating basic stretching—even while seated—into your fitness routine will make the most ordinary movements easier. 
Check with you doctor if you have...
  1. Chest pain 
  2. Irregular, rapid, or fluttery heart beat 
  3. Severe shortness of breath 
  4. Significant, ongoing weight loss that hasn't been diagnosed 
  5. Infections, such as pneumonia, accompanied by fever 
  6. Fever, which can cause dehydration and a rapid heart beat 
  7. Acute deep-vein thrombosis (blood clot) 
  8. Hernia that is causing symptoms 
  9. Foot or ankle sores that won't heal 
  10. Joint swelling 
  11. Persistent pain or a problem walking after you have fallen 
  12. Certain eye conditions, such as bleeding in the retina or detached retina. Before you exercise after a cataract or lens implant, or after laser treatment or other eye surgery, check with your physician. 


DISCLAIMER: Always talk to your health care provider before starting an exercise program.

Saturday, March 24, 2012

Aquatic Cardiac Rehabilitation



Aquatic exercises are popular because of the buoyancy afforded by water which lowers joint stress and resistance created by moving one's limb through water.

Recently water based activity is also becoming popular in cardiac rehabilitation. But it’s still controversial because of the safety concerns put forth by many doctors.

SAFETY CONCERNS:
Physiological changes after immersion could jeopardize diseased myocardium.

Possible problems
Physiological changes
Possible clinical outcomes
Increase in central blood volume
Increase stroke volume and cardiac output and left ventricular   volume.
Decrease in heart rate
Increase in left ventricular wall stress, angina, ST depression.
Cold Water exposure
Increase in PaCO2 and decrease in heart rate
Increase in ventricular irregularity
Increase in arrhythmia


PRACTICAL CONCERNS:
Heart Rate:  As its difficult to monitor it, there might be a problem in deciding intensity for exercise prescription
Monitoring: ECG and Blood pressure monitoring also becomes difficult.

PATIENT SELECTION:
Exercise is most beneficial for LOW-MODERATE RISK cardiac patients who either like swimming or have orthopedic or arthritis problems which may increase by land based exercise.
Water based exercises are particularly beneficial for individuals with peripheral vascular diseases. Particularly if temperature is 30-33 degree Celsius.Warmer water facilitates vasodilation and added buoyancy afforded by water decreases lower limb stress, allowing longer exercise duration.

EXERCISE PRESCRIPTION CONSIDERATIONS:
Water temperature: 26- 33degrees
Temperature at lower end is better for heat dissipation while upper end temperature is comfortable for most of the patients. If patient has orthopedic or PVD better is upper end temperature. Temperature should never be less than 15 degrees.

INTENSITY:
40-85% of the functional capacity. Start with a 40-50% of the functional capacity.

FREQUENCY AND DURATION:
Perform exercise at least 3 days per week
Aerobic portion: 20-30min. If you are performing Swimming: 1000 yards (500-2000) and Walking: 400-700 yards/workout
Warm up and cool down is very important. Warm up can be done for 3-5 min of stretches and light calisthenics on pool deck And Cool down in water3-5 min free standing and wall stretches.

MONITORING:
Frequent monitoring of Blood pressure and heart rate.
ECG should be done during early stages

EMERGENCY PROCEDURES: The staff should be well trained for CPR and defibrillator should also be present.

AQUATIC ACTIVITIES /EXERCISES:

1) WATER WALKING
It’s one of the safest and easiest activity. Energy cost is determined by depth, speed, and degree of arm involvement.The depth of the water should be between thighs and chest so as to have a greater energy cost. Going deeper may decreased the cost as buoyant forces affordable by water offsets the increased resistance that comes from having water coverage over greater body surface area. Energy cost increases with increase in speed. To increase intensity involve arms. Arms can be used in simulated swimming motion either above (front crawl)or below breast stroke.

2) GAIT TRAINING
Gait training and submerged interval training help you gain benefits of jogging or running without added impact on joints.
Similarly stretching and extensions help in flexibility with help of underwater leg movements such as kicks, bicycling maneuver and lateral rises.

THE PLOW
It’s a type of gait exercises .Once you are comfortable walking and jogging in water try using a wide hand held exercise tool called plow to increase resistance of your gait.
According to study in Journal of Athletic training: plow exercise mimics physical demands of aerobic sports like football and should be completed in shallow water sprints of 6 to 10 sec interval.

3) BUOYANCY RESISTED STERTCHES
Basic stretches: recovering joint .more intense variety can be used to create aerobic effect
Begin with underwater kicks.
Added effect: stretch your leg as much possible during end of each kick and gradually increase power and speed. If it’s difficult perform lunge/lateral raise in shallow water.


3) SWIMMING
Variants of strokes. For modified backstrokes, side strokes and breast strokes intensity can be controlled by most of the patients.
Front crawl not recommended by many people.




4) SWIMNASTICS/ WATER AEROBICS
These are Upright group water exercises, essentially aerobic dance conducted in water
5-10 min warm up in water then a 15-20 min of aerobic arm and leg exercise and 5 min cool down, resistive movements can also be done with help of  water dumbbells, floats/paddles.

Aqua stepping: step aerobics using weighted steps can also be done.

5) WATER VOLLEYBALL
Fun alternative: Played in shallow end. Water level: waist to nipple level. It should not be replaced to aerobics.

RECENT EVIDENCE:
Training induced increase in NO metabolites in CHF and CAD : an extra benefit of water based exercise. (European Journal of cardiovascular prevention rehabilitation Aug 2009)

CONCLUSION OF THE STUDY:
The cardio respiratory capacity of patients was significantly improved after rehabilitation.Water based exercise seemed to effectively increase the basal level of plasma nitrates. Such changes may not be related to an enhancement of endothelial function and may be important for health of patient.

DISCLAIMER: Please consult your doctor before attempting any of the above exercises.