Exercise is Medicine

1. Exercise is Medicine Olivia Hector B.Kin CSEP-CEP January 24, 2019

2. Objectives Today: • Establish the benefits of increasing exercise and decreasing sedentary behavior • Learn ways to increase exercise • Canada’s Physical Activity Guidelines • Safety in the workplace through posture, proper lifting, and stretching • Setting SMART goals • The Reh-Fit Advantage • Take home exercises and stretches

3. ALittleBitAboutMyself

4. What if there was a drug? -up to 35% lower risk of heart disease or stroke -up to a 50% lower risk of type 2 diabetes -up to a 50% lower risk of colon cancer -up to a 20% lower risk of breast cancer -up to an 83% lower risk of osteoarthritis -up to a 68% lower risk of hip fracture -a 30% lower risk of falls in older adults -up to a 30% lower risk of depression -up to a 30% lower risk of dementia

5. If exercise could be packed in a pill, it would be the single most widely prescribed and beneficial medicine in the nation. Robert N. Butler, M.D. Former Director, National Institute on Aging

6. Benefits of Exercise • Decreases blood pressure • Increases HDL (good cholesterol) • Increases efficiency of heart and lungs • Aids in relieving general body discomforts • Decreases risk of diabetes • Decreases body fat / improves body composition • Improves circulation • Improves quality of sleep • Improves stress resistance, reduces anxiety and depression • Improves concentration

7. Side Effects Of Exercise • Improve quality of life • Improved immune system • Weight Management • Stress Relief • Longer Life • Prevent disease • Decreased blood pressure • Decrease depression as effectively as Prozac or CBT • Increase Energy and Self Esteem

8. Definitions Physical Activity: Any bodily movement produced by muscles that results in energy expenditure. Exercise: Physical activity that is planned, structured, repetitive and with the intension of maintaining or improving physical fitness. Physical Fitness: The ability to carry out daily tasks with vigor, alertness, without undue fatigue and with ample energy to enjoy leisure time pursuits and to meet unforeseen emergencies.

9. Areas of Exercise Cardiovascular Exercise: Also referred to as aerobic physical activity, cardiovascular exercise is continuous movement that increases your heart rate and breathing rate. Resistance Training: Also called strength training or weight training. If done correctly, increases muscular strength and endurance, improves balance and coordination, improves posture, increases lean body mass. Flexibility: refers to the range of motion in a joint or sequence of joints. Those with greater flexibility may have a lower risk of back injury. Balance: helps to reduce the risk of falling and improves stability.

11. How many Canadians do you believe are meeting these guidelines? Are you meeting these guidelines?

12. 23 ½ Hours Dr. Mike Evans

13. Increasing Safety in the Workplace • Safe lifting techniques • Strengthening Posture • Keeping good range of motion and flexibility

14. Low Back Pain 4 out of 5 adults will experience low back pain in their life. Factors Contributing to low back pain: -Muscle imbalance -Underlying medical condition -Improper lifting -Obesity -Sedentary Lifestyle This statistic demonstrates the importance of safe lifting and strengthening!

15. Factors That Affect Lifting 1. Load - how heavy is the object? 2. Distance - how far away am I holding the object? 3. Time - how long am I holding the object? 4. Frequency - how many times am I doing this lift?

16. HealthyLiftingGuidelines Prepare: Make sure the area is safe. Visualize the lift. Size Up the Load: Can I lift this on my own? Should I ask for help? Proper Feet Positioning: Stay close to load, feet hip width apart. Keep a staggered stance for larger loads. Arms: Keeping your arms close to you, with elbows bent. Using both hands and a powerful position versus a pinching position through your grip. Trunk: Use core muscles, keep back straight throughout the lift.

17. PoorPostureProper Posture

18. Poor Posture Lower Double Cross Syndrome Upper Double Cross Syndrome

19. Strengthening for Better Core and Posture Core: plank, dead bug, bird dog, hip bridge. Upper Body: Row, chin tuck. Lower Body: Hip abduction, lunge, squat.

20. FlexibilityisImportant! • Hamstrings • Calves • Glutes • Hip flexors • Quadriceps • Lower back • Upper body: traps, pecs, neck muscles

21. ExercisePrescription

22. “Too little exercise” is distinct from “too much sitting”. The results of sedentary behavior fall into a different paradigm than the results of exercise. The bottom line: sitting is an independent risk factor causing increased rates of death. Another problem: most recommendations focus on increasing moderate-to-vigorous physical activity with almost no recommendations relating to sedentary activities.

23. What is considered Sedentary behavior? it’s any waking activity with a low energy expenditure anda sitting or reclining posture1. In general, this means that anytime a person is sitting or laying down, they are being sedentary. Sedentary Behaviour Research Network. 2012. Standardized use of the terms “sedentary” and “sedentary behaviours”.  Applied Physiology Nutrition & Metabolism. 37: 540–542.

24. How many hours a day are you spending sedentary? On average, Canadians spend around 69% of their day being sedentary!

25. Effects of Prolonged Sitting Metabolic Dysfunction • Increased waist circumference and triglyceride levels • Decreased levels of HDL (good cholesterol) • Decreased insulin sensitivity – changes in carbohydrate metabolism Bone Mineral Density – Increased resorption without concomitant changes in bone formation. Vascular Health – Damage to cell walls affects ability of an artery to dilate increasing blood pressure

26. Looking at the Research

27. Looking at the Research… Twenty-eight males and females completed four consecutive bouts of sedentary behavior with and without interruptions of walking. Bout one contained no walking period. Bout two contained 1 minute of walking. Bout three contained 2 minutes of walking. Bout four contained 5 minutes of walking.

28. Looking at the Research

29. Ways to decrease sedentary behavior

31. Desk Stretches

32. Let’s Make Our Day Harder!

33. GoalSetting Setting Smart Goals! Specific- Well defined. Who? What? Where? When? Why? Measureable- Be able measure progress along the way. Attainable- Within your means, ability level, time, etc. Relevant- Within your resources, available time, and skill level. Appropriate for you? Timely – Makes small goals along the way, put a date/time to your goal.

34. Creating Healthy Habits Motivation: Travel, work, children, grandchildren, sports etc. Cues/Prompts: post it notes, runners by the bed, etc. Social Support: Friends, family members, co-workers, fitness instructors Anticipate Barriers: weather, travel, kids, lack of knowledge/skill, LIFE Planning: Schedule, record, goal setting Reward: new workout clothes, book, coffee, etc.

35. The Reh-Fit Centre Advantage

36. Reh-Fit Centre Restore your Health Programs: -Stronger Hips and Knees -Postural Analysis -Cardiac Rehabilitation -Improve Your Balance Along With: -Performance Programs -Health and Fitness Assessment -Dieticians -Degreed Professionals -Physiotherapy/Athletic Therapy -Massage Therapy

37. Exercise Is Medicine at Reh-Fit -Doctor or health professional referred exercise program -8 weeks in length -Initial and end coaching sessions -Weekly conversations with coach -Outcomes measurements taken EIM is a global health initiative that encourages primary care providers to include physical activity when designing a treatment plan.

38. Questions?

39. Resources Applied Physiology Nutrition & Metabolism. Canadian Cancer Society. Canadian Society for Exercise Physiology, PATH Manual. Ehrman J.K., Gordon P.M., Visch P.S., Keteyjan S.J, Clinical Exercise Physiology, 2013.