PATIENT’S GUIDE TO CHRONIC DISEASE SELF MANAGEMENT WITH EXERCISE AND DIET
Aerobic exercise
Frequency: 3-5 days per week
Intensity: RPE (Rate of perceived exertion) 6-7 out of 10
Time: Start at 15 mins and increase up to 30 minutes daily
Type: Treadmill, bicycle, elliptical, swimming, water aerobics, walking outside or doing a fitness class.
Aerobic literally means with oxygen. The American College of Sports Medicine (ACSM) defines aerobic exercise as “any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature.” It is a type of exercise that overloads the heart and lungs and causes them to work harder than at rest. The important idea behind aerobic exercise today, is to get up and get moving!! There are more activities than ever to choose from, whether it is a new activity or an old one. How will your body respond to aerobic exercise?
You will breath faster and more deeply. This will maximize the amount of oxygen in your blood. Your heart will beat faster, which increases blood flow to your muscles and then back to your lungs. It all starts with breathing. The average healthy adult inhales and exhales about 7 to 8 liters of air per minute. Once you fill your lungs, the oxygen in the air (air contains approximately 20% oxygen) is filtered through small branches of tubes (called bronchioles) until it reaches the alveoli. The alveoli are tiny sacs (they kind of look like bunches of grapes, and you have about 300,000,000 in each lung!) where oxygen diffuses (enters) into the blood. From there, it’s a beeline direct to the heart.
How your body responds to aerobic exercise.
During aerobic exercise, you repeatedly move large muscles in your arms, legs and hips.
You’ll notice your body’s responses quickly.
You’ll breathe faster and more deeply. This maximizes the amount of oxygen in your
blood. Your heart will beat faster, which increases blood flow to your muscles and back
to your lungs. Your small blood vessels (capillaries) will widen to deliver more oxygen to
your muscles and carry away waste products, such as carbon dioxide and lactic acid.
Your body will even release endorphins, natural painkillers that promote an increased
sense of well-being.
What aerobic exercise does for your health?
Regardless of your age, weight or current health condition, aerobic exercise is good for
you. As your body adapts to regular aerobic exercise, you’ll get stronger and more
efficient. Consider some of the many ways that aerobic exercise can help you feel better
and enjoy life to the fullest.
- Regular aerobic exercise can:
Reduce health risks. Aerobic exercise reduces the risk of many conditions, including obesity, heart disease, high blood pressure, type II diabetes, stroke and certain types of cancer. Weight-bearing aerobic exercises, such as walking, reduce the risk of osteoporosis.
Help you manage chronic conditions. Aerobic exercise helps lower high blood pressure, control blood sugar and relieve chronic muscle pain. If you’ve had a heart attack, aerobic exercise can help prevent subsequent attacks.
Maintain ideal weight. Combined with a healthy diet, aerobic exercise can help you lose weight — and keep it off.
Improve immunity. Aerobic exercise activates your immune system. This leaves you less susceptible to minor viral illnesses, such as colds and flu.
Improve heart health. Aerobic exercise increases the concentration of highdensity lipoprotein (HDL, or “good”) cholesterol and decreases the concentration of low-density lipoprotein (LDL, or “bad”) cholesterol in your blood. The potential result? Less buildup of plaques in your arteries.
Strengthen your heart. A stronger heart doesn’t need to beat as fast. A stronger heart also pumps blood more efficiently, which improves blood flow to all parts of your body, which can help with the healing process
Boost mood. Aerobic exercise can ease some forms of depression and reduce stress associated with anxiety, as well as promote relaxation.
Increase your stamina. Aerobic exercise may make you tired in the short term. But over the long term, you’ll enjoy increased stamina and reduced fatigue.
Stay active and independent as you get older. Aerobic exercise keeps your muscles strong, which can help you maintain mobility as you get older. People who engage in regular aerobic exercise appear to live longer than those who don’t.
Start slowly
We start slowly. You might walk five minutes to start and then increase this by 5-10%
each session with our aim being at least walking biking or water aerobics at least 30
minutes 3- 7 times per week, and reaping all the benefits of regular aerobic exercise.
If you have arthritis or chronic conditions, aquatic exercises may give you the benefits of
aerobic exercise without stressing your joints.
Live longer and stay healthier with just 30 minutes of aerobic exercise a day!
Examples of Types of aerobic activity:
Swimming/Water aerobic: This is an excellent alternative if you can’t walk or use the stationary bike, because it improves your cardiovascular fitness while at the same time strengthening your body with the resistance from the water. It is also non weight bearing
exercise (which takes the load off your joints and body). There are many community centers that offer these classes either free or at a very reasonable price.
Balance and proprioception training
Frequency: 2 days per week added to your program as you get stronger and reach an appropriate physical level.
Time: 10 – 15 minutes
Type: balance and coordination exercises
Balance: A biological system that enables us to know where our bodies are in the environment and to maintain a desired position. Normal balance depends on information from the inner ear, other senses (such as sight and touch) and muscle movement.
Our sense of balance is specifically regulated by a complex interaction between the following parts of the nervous system:
- The inner ears (also called the labyrinth) monitor the directions of motion, such as turning or forward-backward, side-to-side, and up-and-down motions.
- Our sight (the eyes) observes where the body is in space (i.e., upside down, right side up, etc.) and also the directions of motion.
- Skin pressure receptors such as those located in the feet and seat sense what part of the body is down and touching the ground.
- Muscle and joint sensory receptors report what parts of the body are moving.
- The central nervous system (the brain and spinal cord) processes all the signals and information from the four other systems to make some coordinated sense out of it all.
Proprioception: is a critical component of balance. Proprioception refers to the body’s ability to sense movement within joints and joint
position, enabling us to know where our limbs are in space without having to look. Proprioception underlies everyday movement and coordination. When a joint or other body part is injured, one’s ability to properly coordinate muscular efforts is inhibited and body-spatial perceptions are altered. Such skewed perceptions limit the ability of a patient to perform therapeutic flexibility, strength and endurance exercises correctly.
Therefore, re-establishing proprioception is critical to a functional rehabilitation program. When you lose proprioception because of an injury, you may complain of an unstable sensation of the joint – a feeling like the joint may give-out. Proprioception exercises teach your body to control the position of an injured joint.
Proprioception exercises:
One-leg balances.
1. Stand in neutral spine with both legs shoulder width apart and knees relaxed
2. Stand on your left leg while maintaining proper posture; abs must be engaged, shoulders back and down with a slight pelvic tilt (see standing neutral spine). Lift your right foot up about 3- 5 inches and work your way up to a 90 degree angle
3. Your left, weight-bearing leg should be lightly flexed at the knee, hip, and ankle, as they would be when your left foot is on the ground during the act of running. Simply hold this position for 5-10 seconds and work your way up to 60 seconds, rest for 10 to 20 seconds, and then repeat 8-10 times. After a brief rest, complete three similar reps with your right leg as the weight-bearing limb.
Lying Super-Mans (works on proprioception and lower back strengthening. Do not do if you have degenerative disc disease or are unsure about your present back health).
1) Lie face down on the floor with your arms stretched out directly overhead( think of superman flying)
2) Raise your left arm and right leg simultaneously off the floor about 2-5 inches. While also lifting your chest slightly off the mat.
3) Hold and squeeze your glutes for 2 seconds then lower your body slowly to the floor.
4) Now switch sides and raise the right arm and left leg off the floor. If this is too difficult at first just continue on the same side until you feel ready to advance.
Rest and relaxation
Frequency: Daily
Intensity: Very low intensity
Time: Aim for at least 15 minutes daily
Type: Meditation, deep breathing, and guided imagery.
Rest is very important between exercises for at least 30 to 60 seconds as well as to take 2- 3 days off a week from any of the strength or stability exercises. Mild aerobic and stretching exercises can and should be performed daily to keep the body moving and keeps the joints flexible. Relaxation can be performed daily and can really help with stress relief and pain management. There are many techniques that can be applied to your life to help you cope such as guided imagery, deep breathing, meditation, and taking a warm bath with sea salts just to name a few.
