Lynbrook | New Hyde Park | NY

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Returning to Exercise After a Heart Attack

Myocardial infarctions, better known as heart attacks, are one of the leading causes of death in the United States. Generally, heart attacks are a result of coronary heart disease (CHD). With CHD, plaque begins to buildup in the coronary arteries leading to a reduction of oxygen-rich blood to our heart. If the plaque builds up too largely and the heart does not receive enough blood, the heart muscles start to die. At this point, heart damage is not obvious and severe or long-lasting complications can occur, including a heart attack.

Symptoms are not always present in CHD and but there are a few major symptoms associated with a heart attack. These include chest pain, upper body pain above the belly button and shortness of breath. Thankfully, heart attacks and CHD are preventable and many risk factors can be controlled. The risk factors include:

  • Smoking
  • High blood pressure
  • High blood cholesterol
  • Obesity/Overweight
  • Lack of physical activity
  • Unhealthy diet
  • High blood sugar due to insulin resistance or diabetes

*Items in BOLD can be further controlled by increased physical activity

In the event that someone has experienced a heart attack, it is possible to return to normal activity. Most people that do not experience chest pain or discomfort or other problems will typically return to normal activities within a few weeks and walking can start immediately.

When programming for an individual that has had a heart attack it is important for them to ease back into exercise. The key is to slowly build up to being able to withstand 30 minutes of moderate intensity activity. During this period, low-impact movements like walking or light gardening are preferred. As the individual gets stronger and gains stamina, others activities like swimming, cycling or non-contact sports can be added.

Strength training is not recommended in the short-term and, apart from light weights during the early recovery period should be avoided until a physician or cardiac rehabilitation team confirms approval to begin. This is due to the spike in blood pressure that is associated with heavy lifting.

If you would like information pertaining to CHD or myocardial infarctions be sure to check out my.clevelandclinic.org. Also, be aware that most patients will receive a prescription for cardiac rehabilitation, which has been an effective program for recovery post-myocardial infarction. Feel free to ask any of our fitness professionals any questions you may have.

 

 

By Julian C. Lee

Signs, Symptoms, and Exercise Considerations for Stroke Victims

Although exercise has many benefits, a high amount of stress on the body can trigger negative events that one should look out for.  It is of vital importance to understand the signs and symptoms of cardiac events, such as the occurrence of a stroke.  Strokes occur when a blood vessel that is connected to the brain becomes extremely blocked from plaque build-up, causing a lack of oxygenated, nutrient-filled blood being delivered to the brain.

Stroke is the fourth leading cause of death in America today and can also cause long term changes leading to disability or lack of mobility/neuro-motor functioning.  This type of cardiac event can happen at any age but generally affects those ages 55 and older, and as we age our risk of having a stroke become greater.  Of all populations men, African Americans, and people with diabetes or heart disease are at the highest risk.

Some of the warning signs of having a stroke include sudden weakness of the face, arms or legs (especially on one side), sudden confusion or inability to speak, lack of vision, dizziness or coordination problems, and a sudden, severe headache.  If you have any of these signs, stop exercise immediately and get to the hospital or call 9-1-1.

The major goal of exercise after a stroke should be to improve the overall quality of life for the victim.  In addition to improving measures of quality of life, other measures such as functional capacity and mobility (i.e. increasing gait velocity), neurological impairment, and motor function (i.e. lowering the energy cost of a hemiparetic gait), will also benefit from regular exercise. The three major rehabilitation goals for the stroke patient are preventing complications of prolonged inactivity, decreasing recurrent stroke and cardiovascular events, and increasing aerobic fitness.

Before beginning an exercise program, the two most important things to consider are if the benefit outweighs the risk, as well as, the severity of the stroke.  A stroke victim should be evaluated by a medical professional before initiating a program—performing strength and aerobic training can lead to serious musculoskeletal injury.

To prevent muscle deterioration from prolonged inactivity, performing exercises that mimic movements of everyday life activities (i.e. standing from a seated position, squatting down, walking, reaching overhead) should performed regularly.  Moreover, moving the entire body throughout its full range of motion should also be considered.  In terms of aerobic fitness, stroke patients have been shown to achieve significantly lower maximal workloads and heart rate and blood pressure responses than control subjects during progressive exercise testing to volitional fatigue.

Setting reasonable goals to return to pre-stroke fitness levels as opposed to above baseline levels should be aimed for.  Exercising will be significantly harder post-stroke, but is of vital importance for the individual in order to improve their quality of life.

 

By Anthony Locast

 

Sources
Gordon, Neil F., et al. “Physical Activity and Exercise Recommendations for Stroke Survivors.”Circulation, American Heart Association, Inc., 27 Apr. 2004, circ.ahajournals.org/content/109/16/2031.

Exercise and Osteoporosis

Osteoporosis is a bone disease that develops when the body loses too much bone mass, makes too little bone, or both. As a result, bones become weak and worst case, may break as a result of a fall. Peak bone mass is determined by sex, heredity family history, race, diet and exercise and about 60% of bone growth occurs during adolescence. Moderate exercise protects against osteoporosis, but too little exercise may cause osteoporosis. Inactivity may also cause bone loss, whereas weight-bearing exercises may maintain or help improve bone mineral density. There is a significant correlation between muscle strength and bone mineral density. Weight-bearing exercises have been proven to increase bone mineral density over time. These exercises include activities that make you move against gravity while staying upright. Weight-bearing exercises can be high-impact or low-impact.

High-impact weight-bearing exercises help build bones and keep them strong. If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises. Examples of high-impact weight-bearing exercises are:

  • Dancing
  • Jogging/running
  • Jumping Rope
  • Stair climbing
  • Tennis

Low-impact weight-bearing exercises can also help keep bones strong and are a safe alternative if you cannot do high-impact exercises. Examples of low-impact weight-bearing exercises are:

  • Using elliptical training machines
  • Walking (on a treadmill or outside)
  • Low impact aerobics class

Strength Training Exercises

These activities include moving your own body, weights or other resistance against gravity. Examples include:

  • Lifting weights
  • Using elastic exercise bands
  • Using weight machines
  • Lifting your own body weight

Balance Exercises

These improve your ability to hold yourself upright and help prevent falls. Examples include tai chi, yoga, and supervised stability exercises.

Remember to always check with your doctor before implementing an exercise routine.

 

By Louise Mills-Strasser, M.S., EP-c

Recipe of the Week: Springtime Asparagus Medley

Yield: 8 servings

INGREDIENTS:

  • 1-1/2 pounds fresh asparagus, trimmed and cut into 2-inch pieces
  • 2 small tomatoes, cut into wedges
  • 3 tablespoons cider vinegar
  • 3/4 teaspoon Worcestershire sauce
  • 1/3 cup sugar
  • 1 tablespoon grated onion
  • 1/2 teaspoon salt
  • 1/2 teaspoon paprika
  • 1/3 cup canola oil
  • 1/3 cup sliced almonds, toasted
  • 1/3 cup crumbled blue cheese, optional

DIRECTIONS:

  1. In a large saucepan, bring 1 cup water to a boil. Add asparagus; cook, covered, until crisp-tender, 3-5 minutes. Drain; place in a large bowl. Add tomatoes; cover and keep warm.
  2. Place vinegar, Worcestershire sauce, sugar, onion, salt and paprika in a blender; cover and process until smooth. While processing, gradually add oil in a steady stream. Toss with asparagus mixture. Top with almonds and, if desired, cheese.
  3. Note: To toast nuts, bake in a shallow pan in a 350° oven for 5-10 minutes or cook in a skillet over low heat until lightly browned, stirring occasionally.

NUTRITION FACTS:

Serving Size: 3/4 cup

Per Serving: 154 calories

11g fat, 159mg sodium, 12g carbohydrate (10g sugars, 1g fiber), 2g protein

 

 

Original recipe from Taste of Home can be found here!

What’s my RMR? More importantly, what is an RMR?

Okay, what is an RMR? Why is it important? Is it the ‘secret ingredient” to help put on muscle or lose weight? Let’s start from the top and work our way in.

RMR is an acronym for Resting Metabolic Rate. Your RMR is a sum of all the calories your body burns in order to keep itself alive; i.e. heart beating, breathing, and digesting food. On a surface level, that’s it. Your RMR will not be all the calories you burn in a day because you also have to factor in your daily activities. These are going to be everything else you need to do, such as walking, the gym, laundry, brushing teeth… you get the point.

What factors influence your RMR? Can it be changed?

The RMR is completely unique to you. It is influenced by things like body composition, height, weight, gender, muscle mass, and age. A bigger person, with more muscle mass will tend to have a higher RMR than someone who may be shorter, lighter and have less muscle mass. There are also ways to change your RMR, for example, losing weight (both fat and muscle) will yield a lower RMR while putting on muscle will increase your RMR (how much energy you burn).

Is my RMR the golden ticket to changing my body composition?

Not entirely. There are many calculators online you can use to find an RMR, but the numbers vary and may not always be accurate. At Peak, we have a calibrated metabolic cart that will calculate your RMR more accurately. Once you’ve completed an RMR, how can this information be used? Now is when you contact a health professional to move forward with a caloric range based on your future goals. Utilze this information in conjunction with your nutrition and exercise plans. Put in the effort and stay consistent toward your goals to feel better and healthier!

 

 

By Matthew Rhodes, MS

 

 

Strength Training with Orthopedic Limitations

 

Strength and conditioning and physical therapy go hand-in-hand in the rehabilitation process, but they are often seen as separate or opposing entities. Physical therapy helps individuals to recover from injuries, surgeries, impairments with the use of manual therapy (massage, myofascial release, joint traction etc.), electrotherapy (used for pain relief and passive muscle activation), and the implementation of an exercise program (depending on the severity of the injury/impairment). Most patients enjoy the benefits of the manual therapy and hands-on treatment from the therapist and feel better after relaxing with ice and electric stimulation. However, building the strength required to return to daily activities and beyond comes from performing resistance exercises with periodical progression.

Injuries, surgeries, and diseases leave us weakened and/or physiologically imbalanced. The initial focus following a diagnosis is to alleviate the impairment, enhance tissue repair, and improvement of range of motion. When appropriate, basic therapy exercises can be progressed by adding resistance to increase overall strength and correct imbalances. Both physical therapy for injured or orthopedically limited population and strength training for healthy individuals use the same principle of progressive overload to achieve the common goal of strength improvement.

Outside of the physical therapy office, individuals should continue to follow a resistance training program to continue the recovery process and make improvement even beyond where they were pre-injury. Although it is important to isolate a single muscle or muscle group during the recovery process, total body and bilateral exercises should be performed to prevent further imbalances and to improve overall fitness. Building strength in the muscles surrounding a joint can lead to less pain in joints during certain activities. Strengthening opposing areas of the body and learning better techniques/ movement patterns can lead to better habits that will aid in future injury prevention.

 

By David McCalla, CSCS

Strength Training with Kids

Once a controversial topic, strength training within the younger population has been proven to be beneficial in a number of ways. There are several positive effects of strength training including, teaching the “mind to muscle connection,” improving coordination, and injury prevention. When done properly, young athletes can greatly benefit from a properly constructed strength training program. However, the right programming is essential to keeping kids healthy and injury free.

Most children have yet to develop muscular coordination and therefore will find it extremely difficult to maintain proper form under the stress of outside resistance. Free weights or machines may not be appropriate in many cases, this is where body weight comes into play. A proper program for a child should be comprised of several body weight exercises and avoiding complex exercises; meaning excluding those that involve lifting free weights in a complex manor. Body weight exercises are not only good to help build them a muscular foundation, but to help develop their coordination and highly mitigate the risk of injury. Risk of injury in young athletes is very high and this is frequently due to lack of muscular development which does not support their joints and ligaments. This injury risk can be prevented by starting to develop strength and sport specific skills at an earlier age. The following are some example of body weight exercises that may be appropriate to incorporate into an adolescent strength training program: squats, walking lunges, wall sits, box jumps, push ups, dips, planks, and/or leg lifts.

Not only will beginning an exercise routine early on help kids to develop muscular coordination and strength, but it will help them excel at their sport. The decreased risk for serious injury will give them a great foundation to further develop later into their teenage years.

Keeping Up Physical Activity through the Holidays

With the holiday season approaching, it is more important than ever to stay physically active. Not only will physical activity/exercising help to burn off the calories from all the delicious food, but it has also been proven to improve our long term health. The Centers for Disease Control and Prevention and the National Institutes of Health, along with other health offices and organizations, have established a set of physical activity guidelines for all age groups to explain the benefits of physical activity and set a baseline for exercise.

Studies carried out by these organizations have proven that exercise creates healthy individuals, and healthy individuals living longer lives with less risk of chronic disease. Here is a list of the major outcomes of their combined research:

  • Regular physical activity reduces the risk of many adverse health outcomes.
  • Some physical activity is better than none.
  • For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration.
  • Most health benefits occur with at least 150 minutes a week of moderate-intensity physical activity, such as brisk walking. Additional benefits occur with more physical activity.
  • Both aerobic (endurance) and muscle-strengthening (resistance) physical activity are beneficial.
  • Health benefits occur for children and adolescents, young and middle-aged adults, older adults, and those in every studied racial and ethnic group.
  • The health benefits of physical activity occur for people with disabilities.
  • The benefits of physical activity far outweigh the possibility of adverse outcomes.

Children (ages 6 – 17)

The Guidelines recommend that children and adolescents ages 6 to 17 do 60 minutes (1 hour) or more of physical activity each day. They suggest that children should participate in aerobic, muscle strengthening, and bone strengthening activities on at least three days of the week.

  • Aerobic activity- moderate to intense running, biking, or playing a sport
  • Muscle- climbing trees, using playground equipment, and or resistance training depending on age and level of experience.
  • Bone Strengthening- jumping, playing a sport, lifting weight if appropriate

Adults (ages 18 – 64)

The Guidelines for most men and women ages 18 – 64 are as follows:

  • 150 minutes (2 hours and 30 minutes) each week of moderate-intensity aerobic physical activity (such as brisk walking or tennis)
  • 75 minutes (1 hour and 15 minutes) each week of vigorous-intensity aerobic physical activity (such as jogging or swimming laps)
  • Or some combination of the two.

Moderate intensity aerobic exercise being described as an activity that increases both heart and breathing rate to some extent, and has an RPE (Rate of Perceived Exertion) of about 5 to 6 on a scale of 0 – 10.

Vigorous intensity aerobic exercise being described as an activity that increases ones heart and breathing rate, and has an RPE of about 7 to 8 on a scale of 0 – 10.

In addition, it is recommended that adults include muscle strengthening/ resistance training exercise that involves all the major muscles groups at least twice a week.

Older adults (aged 65+)

This age group has the same requirements as the younger adult group with only a few stipulations based on the capabilities of each older individual; if they have any chronic conditions or age related disabilities.

  • When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow
  • Older adults should do exercises that maintain or improve balance if they are at risk of falling
  • Older adults should determine their level of effort for physical activity relative to their level of fitness
  • Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely

So during this holiday season, while you are enjoying the dinner spreads and desserts, don’t forget to stay as active as possible for your current and long term health!

 

By David McCalla

 

2008 Physical Activity Guidelines for Americans. Washington (DC): U.S. Department of Health and Human Services; 2008. http://www.health.gov/paguidelines