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Sticking To Your Exercise Program

Don’t fall off the treadmill (or bike, or rower, or…)

Sticking To Your Exercise Program
Used with permission from the American Physical Therapy Association Private Practice Section

New year’s resolutions around fitness and exercise are incredibly popular. The excitement and hope generated by the start of the year makes starting an exercise program easy.

Now that it’s February, staying with it gets hard. Life gets busy, motivation drops, and suddenly you’re back on the couch, wondering how you’re 6 episodes into The Golden Bachelor instead of at the gym.

You know the benefits of exercise – they’re probably what motivated you to start exercising in the first place.

Knowing that you should exercise or why you should exercise isn’t the problem. Actually getting up and doing it is.

Top tips for making sure you stick to your exercise plan:

Set realistic goals. Don’t try to go from zero to hero overnight. Start with small, achievable goals and increase them gradually. Make it easy to win – that helps you build motivation and an exercise habit. For some people that might mean starting with a daily 10 minute walk. For some people, that bar is too high.

When we say make it easy to win, we mean easy. Your goal could be to scan your card at the gym 3 times a week. It might be putting on your walking shoes and going out the door. It might be one pushup. Start tiny.

Do activities you enjoy. Exercise ins’t punishment. Choose activities that are fun. It could be running, walking the dog, dancing, swimming, kickboxing, or playing a sport.

Schedule it. Schedule your workouts like you would any other important appointment. When people ask you to do something else during that time, say “sorry, I’ve got an appointment.” The more you make exercise a routine, the less likely you are to skip it.

Don’t go it alone. Having someone waiting for you at the gym really motivates you to get there. Having support helps push you to work harder, and motivates you when you’re feeling down. Your support could be a friend, the other people in a group fitness class, or a trainer.

Mix it up. Try a new class. If you usually run at the same pace, try intervals. Walk a different route. Doing the same thing over and over again gets boring and leads to burnout. Keep things interesting to stay interested.

Track your progress. Bonus points if you find a way to make it visual somehow. Our brains love to see tasks checked off, a chart or numbers going up, and rings closing. Seeing how far you’ve come is a great motivator. Keep track of your workouts in a journal, make a spreadsheet, use an app or fitness tracker.

Bribes work. Celebrate your successes, no matter how small. Set a goal to work out 3 times this week and treat yourself to your favorite coffee when you do. Buy yourself a new workout outfit, get a massage, or anything else that will help you stay motivated when you reach milestones.

Adjust. Don’t push yourself too hard, especially when you’re starting out. If you’re feeling tired and sore, take the intensity down. Plan rest days into your routine. Don’t make your goal and plan so rigid that it’s impossible to complete in the real world.

Forgive yourself! Everyone has setbacks. You’re going to get sick. You’re going to miss a workout. That’s ok. Pick yourself up and get back on track. With the right mindset and a little perseverance, you can reach your fitness goals.

Top tips for making sure you stick to your exercise plan:
Used with permission from the American Physical Therapy Association Private Practice Section
Top tips for making sure you stick to your exercise plan:
Used with permission from the American Physical Therapy Association Private Practice Section

References:

  1. Updating ACSM’s Recommendations for Exercise Preparticipation Health Screening. Medicine & Science in Sports & Exercise 47(11):p 2473-2479, November 2015. https://journals.lww.com/acsm-msse/fulltext/2015/11000/updating_acsm_s_recommendations_for_exercise.28.aspx
  2. Benefits of exercise for older adults: a review of existing evidence and current recommendations for the general population. Clinics in geriatric medicine 8.1 (1992): 35-50. https://www.sciencedirect.com/science/article/abs/pii/S0749069018304968
  3. Exercise Acts as a Drug https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1476-5381.2012.01970.x
  4. Perceived Exercise Barriers https://doi.org/10.1002/art.22098
  5. The Benefits of Exercise on Brain Health https://www.choosept.com/podcast/benefits-of-exercise-on-brain-health
  6. Exercise Assessment and Prescription in the older adults and individuals at risk for functional decline https://learningcenter.apta.org/products/exercise-assessment-and-prescription-in-older-adults-and-individuals-at-risk-for-functional-decline?_gl=11c4v900_gaMTEwNjIzMzg2MS4xNjgxODQyODcw_ga_ZZJK74HXNR*MTY5NzE5NzczNy4xMS4xLjE2OTcyMDAzODMuNTguMC4w&_ga=2.223614619.1495021570.1697197738-1106233861.1681842870
  7. 23 and ½ hours: What is the single best thing we can do for our healtt. https://www.youtube.com/watch?v=aUaInS6HIGo
  8. Time Magazine: How To Keep New Year’s Resolutions: https://time.com/6243642/how-to-keep-new-years-resolutions-2/
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Physical Therapy for Dementia

Dementia is a group of conditions that affect the brain, causing problems with memory, thinking, communication, and behavior. Dementia has many forms, including Alzheimer’s disease, vascular dementia, Lewy body dementia, and more. It’s a big deal. According to the WHO, it’s the seventh leading cause of death worldwide and one of the major causes of disability among older people. While there is no cure for dementia, there are ways to manage the symptoms and improve the quality of life for people living with this condition.

Physical activity is one common recommendation. While exercise is certainly beneficial to everyone, the evidence for exercise’s effect on dementia symptoms is mixed. Most studies do show that exercise can help delay or reduce symptoms like depression, or apathy. Some studies also show a benefit in delaying or reducing cognitive declines. If you’re familiar with the benefits of exercise, this all makes sense. We know exercise has a positive effect on mood and depression. When your heart pumps harder during exercise, it increases blood flow throughout your body, including to your brain. 

Does Any Type of Exercise Work?

For people with dementia, it doesn’t appear as simple as “exercise and symptoms improve.” Studies have shown that the type of exercise, duration, and frequency all make a difference. For example, one study showed that people with dementia who engaged in dance movement therapy had less depression and better physical function. A second group who performed other types of exercise at the same intensity did not see those benefits. This is where a physical therapist can be incredibly beneficial. 

Physical therapy for dementia is tailored to each individual’s needs, goals, abilities, and preferences. The physical therapist will conduct a thorough evaluation of the person’s medical history, physical condition, cognitive status, functional level, and personal interests. Based on this information, the physical therapist will design a personalized treatment plan that includes specific exercises and activities that target the areas that need improvement.

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The treatment plan may include:

  • Aerobic exercises to improve cardiovascular health, oxygen delivery to the brain, mood, energy levels, and cognitive function.
  • Strength exercises to build muscle strength and power.
  • Balance exercises to challenge the person’s ability to maintain equilibrium and prevent falls.
  • Functional exercises that mimic or practice daily activities that are important or meaningful to the person, such as climbing stairs, getting in and out of bed or a car, or using utensils.
  • Coordination exercises or more complex movements like dance or tai chi. Evidence shows more complex movements like these have larger effects on more dementia symptoms than a simpler exercise like riding a stationary bike. 
  • Dual – task or cognitive exercises like combining walking with doing math out loud, or solving puzzles while on a stationary bike or treadmill. Again, research shows that combining physical and cognitive challenges can have an effect on dementia symptoms. 

The physical therapist will monitor the person’s progress and adjust the treatment plan as needed. They’ll also provide feedback and encouragement. The physical therapist will also educate and advise the person and their family or caregivers on how to continue or incorporate physical activity into their daily routine and lifestyle.

Physical therapy is a safe and effective way to help people with dementia improve their physical and mental health, as well as their quality of life. Physical therapy can also provide support and guidance to people with dementia and their caregivers, helping them cope and adapt to the changes and challenges that come with this condition.

References:

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How Physical Therapy Helps People with Parkinson’s Disease

Parkinson’s disease (PD) is a progressive neurological disorder that affects movement, balance, posture, and coordination. It can also cause non-motor symptoms such as pain, fatigue, mood changes and cognitive impairment. While there is no cure for PD, there are treatments that can help manage the symptoms and improve the quality of life of people living with PD.

Physical therapy is one of these treatments. PT can help restore or maintain physical function, mobility, and independence. Physical therapists are trained professionals who can assess, diagnose, and treat movement problems related to Parkinson’s disease. They can also provide education, advice, and support to people with PD and their caregivers.

Benefits of Physical Therapy for People with PD

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Physical therapy can help people with PD in many ways, such as:

Improving muscle strength and endurance. Both age and PD can weaken and decondition muscles. A physical therapist will prescribe exercises to improve strength. More strength helps with balance and mobility.

Enhancing amplitude of movement PD can cause people to reduce the size and speed of movements. This can affect walking, speech, facial expressions, and gestures. Physical therapy can help increase the amplitude of movement by teaching overexaggerated physical movements, such as high steps and arm swings. This is a way to retrain the muscles and brain to compensate for the reduced movement that Parkinson’s can cause. The LSVT BIG program is a specific set of exercises and activities that has been shown to improve mobility and quality of life.

Reinforcing reciprocal patterns. Reciprocal movements are side-to-side and left-to-right patterns, such as swinging your arms while taking steps as you walk. PD can affect these patterns, which makes walking slow and unstable. Activities can help to reinforce reciprocal patterns by using machines like a recumbent bicycle or elliptical machine. Practicing walking with arm swings is another activity that can help restore reciprocal movements. This can improve coordination, rhythm, and fluidity of movement for people with Parkinson’s. Dance and tai chi are other activities that involve reciprocal patterns.

Improving balance and posture. PD commonly impairs balance. Your brain uses a complex mix of what you see, your inner ear and sensations from your feet and joints to maintain balance. Physical therapy can help to improve balance using exercises which challenge stability, such as standing on one leg or walking on uneven surfaces. PT will also focus on specific components of the balance system by doing things like having a person close their eyes to focus on the sensations from the feet and joints. Physical therapy can also improve posture by correcting any muscle tightness or weakness that may cause stooping or learning sideways.

Increasing flexibility and range of motion. PD also often causes muscle stiffness and rigidity. Physical therapy can help increase flexibility and range of motion with stretching exercises that target specific muscles. Common areas of issue are the hip flexors, hamstrings, and calves. Stretching regularly can also help to reduce pain and spasm.

Providing education and self-management advice. Physical therapy can help people learn more about PD and how it affects their movement. A physical therapist can provide tips on how to maintain safety when exercising, how to cope with fatigue or pain, how to use assistive devices if needed, and how to prevent or manage complications such as falls or freezing.

Sounds Great. Is There Proof?

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Yes. Research backs up all these claims. One meta-study (a study that combines the results of many other studies) that covered 1827 participants found that when compared to no intervention, PT significantly improved:

  • gait speed
  • two- and six-minute walk test scores
  • Freezing of Gait questionnaire
  • Timed Up & Go test
  • Functional Reach Test
  • and the Berg Balance Scale

These results indicate improvements in mobility, endurance, strength, and balance. Gait speed is an especially important measurement. Physical therapists often consider gait speed a “vital sign.” This is because low gait speed has been linked to:

  • declines in functional mobility
  • higher rates of hospitalization
  • higher fall rates
  • cognitive decline
  • increased disability
  • higher risk of death

A larger meta study that included 191 studies with 7998 participants found that PT significantly improved motor symptoms, gait, and quality of life. Specifically:

  • Resistance and treadmill training improved gait.
  • Strategy training improved balance and gait.
  • Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait.

Conclusion

Physical therapy is a valuable treatment option for people with PD, as it can help to improve or maintain their physical function, mobility, and independence. Physical therapy can also enhance their quality of life, confidence, and well-being. If you have PD or know someone who does, consult with a physical therapist who specializes in PD to see how they can help you.

References