focus on women: physical activity from pregnancy to menopause parc 2007 building momentum
TRANSCRIPT
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Focus on Women:Physical Activity from Pregnancy to Menopause
PARC 2007
Building Momentum
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Women and Physical UnderActivity
Current Recommendations Current Population Trends Understanding the Gap Exercise Medicine Strategies for Success
Dr. Julia Alleyne
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Exercise through a Women’s Lifecyle
Frequency 2-5 x week
Intensity Moderate
Time 30-90 minutes
Type Cardio- Flexiblity- Strength
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Healthy Self Esteem
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Low Risk Healthy Pregnancy
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Work Life Family Balance
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Increased Quality of Life
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Reality
Activities of Daily Living: 95% of Canadians engage in Light Physical effort during their usual daily activities
Leisure Activity: 20% of Canadian were involved in high energy activity, 22% were moderate activity, 57% Low energy Activity
National Population Health Survey
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Energy Expenditure Calculator
Activity Energy Expenditure
Relaxing in Lying 70 kcal/hour
Driving a car 120 kcal/hour
Sitting and Typing 138 kcal/hour
Walking Pace 230 kcal/hour
Gardening in Standing
350 kcal/ hour
Golfing 320 kcal/hour
Swimming 500 kcal/hour
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Fidgeting Fights Fat: NEAT
Sitting: Increase by 29% Standing : Increase by 38%Walking: Increase by 45%
A.J.of Clinical Nutrition, 72(6), 1451-54,Dec. 2000 JA Levine et al.
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Weight Control
McMaster University, Dr. Oded Bar-Or Obesity and Youth Physical Activity must increase while sedentary
behaviour decreases and food is moderated Accumulated Daily Activity Slow but sure weight loss Measure inches not just pounds
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Nomogram for Women’s Fitness
Fitness Norms for Women
Lower than Men 1% loss per year Less than 85% capacity
were 2x more likely to succumb to CV disease
NEJM August 2005
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Ethnic Background & Physical Activity
Surveys and Studies- U.S. stats on Physical InactivityAfrican-American: 57.2%Hispanic 55.2%Asian 42.6%Caucasion 36.1%
- Strong Bones in New Canadian Women- Exercise and Pregnancy Education in Asian Women
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UnderActivity and OverWeight
Challenge is the greatestWeight is higher with lower education levels Overweight increases with age & disease
2/3 of Overweight adults use activity for loss, Only…1/5
meet guidelines of 3 x week for 30 minutes.
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Walking Programs
University of Manitoba, Dr. E. Ready 12 month monitor after walking supervision 30% walked 4 hrs/week, 50% walked 2-4
hours Frequency decreased not duration Barriers: Time, Injury, Motivation Enhancers: Felt better, positive feedback
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Stages of Change Theory
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Self-efficacy
The belief in one’s ability to actually carry out the actions required to achieve a certain outcome.
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Cox, R, 2003
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Vellicer et al, 1996
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Identifying Stage of Change with Key Questions
Pre-ContemplationContemplationPreparationActionMaintenance
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Pre-Contemplation
Patient Characteristics Not interested in exercise Does not believe that it will help,thinks it may hurt
Goals Encourage patient to discuss fears and disbeliefs Assist patient in knowing where resources are available if they
want to see Strategies
Personalize health goals of strength and endurance Offer factual information that dispels myths Don’t pressure, create emotional awareness
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Contemplation
Patient Characteristics Considers exercise but presents barriers Acknowledges benefits but concerned regarding risk
Goals Discuss concerns and offer alternatives Find personal value
Strategies Summarize the patients views Ask what is important to them Establish their goal
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Preparation
Patient Characteristics Ready to start, wants to accomplish Requires guidance and assistance
Goals Reinforce Commitment Provide concrete resources and game plan
Strategies Provide specific instructions Review barriers strategy Set-up personal trainer, buddy or follow-up
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Action
Patient Characteristics Exerciser – new or renewed Coping with inconsistencies
Goals Reinforce Goals Refine program for success
Strategies Review Training Log Increase motivation resources
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Maintenance
Patient Characteristics Well established routine Wants to lead others
Goals Allow patient to see risk reduction findings Assess for Consistency
Strategies Develop Long term planning Provide fitness feedback
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Precontemplation Contemplation Preparation Action Reinforcement
Frequency ADL ADL 2-3 x week 3-5 x week Daily
Intensity ADL ADL Light to Moderate
Moderate 10/20
Moderate to Somewhat Difficult 13/20
Time Moving5 minutes every hour
Moving 10 minutes every hour accumulated
10 –15 minutes of walking
30 minutes 30-45 minutes
Type Reduce Sitting Walking Errands
Dog or Neighbourhood walks
WalkingCyclingSwimmingTai Chi* Add Lower Body Resisitance
Variable intensity High/Low Full Resistance program
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Dose-Response Exercise
Arthritis Diabetes Cardiovascular Disease Depression and Anxiety Cancers Immune Disorders Infertility
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Exercise used as a treatment
Irritable Bowel Syndrome Fibromyalgia Asthma Obesity Sleep Disorder Chronic Fatigue Syndrome
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Treating Disease more Effectively Exercise is Medicine Benefits outweigh Risks Low Side Effect Rate Multiple benefits and targets Low cost intervention
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Reducing Risk with Exercise
Exercise Heart Diabetes Arthritis Cancers
Aerobic **** **** ** ****
Strength *** ** **** **
Flexibility ** ** **** **
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Treating Disease Effectively
Exercise Heart Diabetes Arthritis Cancer
F 4-5 x 7x 2-3x 3-4 x
I Mod.-High
Mod-High
Low-Mod
Mod
T 45-60 30-45 20-30 30-45
T Aerobic Aerobic Low impact Aerobic
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Physical Activity linked with improved Mental Health Perception of Fitness is a predictor of
psychological well being Depression, anxiety, obsessions and
substance -abuse studies are positive Weight training, aerobics and mind-body
activities Walking away the blues
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Risk of Cancer and Exercise
Colon Cancer decreased with moderate, consistent exercise
Prostate Cancer is decreased with moderate exercise
Limited evidence to support blood cancers Breast Cancer may be reduced with
moderate consistent exercise
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Addressing Key Barriers
Injury: Soreness, Strain, FatigueStart Low, Go SlowStart Low, Go Slow
Cost: Memberships, Equipment, Cost: Memberships, Equipment, Start with Home-based ActivityStart with Home-based Activity
Time: Work, Family, TransportationTime: Work, Family, Transportation Accumulated Daily ActivityAccumulated Daily Activity
Social ActivitiesSocial Activities
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Tips for Success
Supervision is training ground Monitor emotional not physical parameters Focus on Frequency of Activity Shoes are key supporters Formula for Progression Full environment must incorporate activity
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10 Quick Tips
1. Get Good Shoes
2. Invest in a Pedometer
3. Waiting Time Work-Outs
4. Housework Energy
5. 5 Easy Stickers
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10 Quick Tips
6. Start with a ‘Cycle
7. Buddy Up
8. Fridge Door Prescriptions
9. Count your Calories OUT
10. Telephone Tightners
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