Month: October 2018

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Physical Activity for Polio Survivors

Taking Steps to being Active: Facing the Challenges for Polio Survivors

Dr. Deirdre Murray, PhD

Clinical and Research Physiotherapist, Beaumont Hospital and Trinity College Dublin

 

Polio Survivors Ireland is a charity that provides support to people who contracted polio when babies or young children. Polio survivors have overcome enormous adversity but still need help, including customised shoes. Waiting lists for shoes can be up to 2 years or the alternative is to pay from €600 – €1,200 for special footwear essential to keep them mobile. Wednesday 24th October is World Polio Day and this year, we want to raise awareness on this season’s must haves for polio survivors- customised footwear. There are thought to be 7,000 polio survivors in Ireland, many of them suffering with Late Effects of Polio. Exercise is additionally an issue for those who are impacted, given mobility, fatigue or weakness, which are impacts of Post Polio Syndrome. Below is information on exercising, from Dr Deirdre Murray, Clinical and Research Physiotherapist, Beaumont Hospital and Trinity College Dublin.

Physical inactivity contributes to many health problems including diabetes, obesity and heart disease. Taking one of the key positive steps to improve health – being active – can be very challenging for a person with limited mobility, often due to pain, fatigue and a lack of access to professional advice or equipment.

‘Healthy Ireland’ was established to promote health and wellbeing for the Irish people (http://www.healthyireland.ie). The National Physical Activity Plan, launched in 2016 recommends at least 30 minutes of moderate physical activity 5 days per week for adults over 18. The recommendation for adults with disabilities is ‘to be as active as your ability allows’. The ‘National Exercise Referral Framework’ was published to provide a vision for the structures and resources required in meeting the needs of people with chronic conditions to be active.  Unfortunately, there has yet been limited progress in implementing this vision.

A polio survivor, who needed two callipers to walk short distances, once told me her story of receiving a diagnosis of Type 2 Diabetes along with some leaflets about taking a 30 minute walk every day. Clearly this was a ridiculous recommendation for her. However, she figured out that exercising in the pool was a way to get this physical activity in a manageable, safe and pain-free way.

There is some research evidence that pool based exercise (not necessarily swimming) is beneficial for polio survivors and many regularly enjoy this activity. However, for many others, finding an accessible pool or the fatigue associated with getting to the pool and safely home again, prove too much. Clearly, other convenient ways to exercise are needed.

Research completed in Beaumont Hospital looked at arm cycling using a small pedal exerciser placed on a table. Participants in the programme received individual recommendations about how hard and for how long to exercise and slowly progressed over 8 weeks. The group who exercised had lower blood pressure and the majority had no increase in pain or fatigue after 8 weeks of exercise. This research was funded by Polio Survivors Ireland and has been published internationally.

Other researchers looked at using exercise bikes at home. The participants were able to complete the programme and although there were no huge changes in fitness, there was no worsening in fatigue or pain. In some (lucky) European countries there are structured supervised exercise programmes available to polio survivors which are well tolerated and allow access to the benefits of exercise.

The key messages are:

  1. Before making a big change to your activity level get the ‘all clear’ from your doctor and some personalised advice from a health professional such as a Chartered Physiotherapist.
  2. ‘Some activity is better than none’. 30 minutes is rarely the starting point for anyone – so aim for as much as you can do. Maybe 2 minutes to start, then slowly working up to 10 minutes. (Increase by 20% once comfortable with the level you are at).

If you can, try to take a 10 minute walk. There is evidence that 10 minutes of continuous walking benefits health. Choose a flat, smooth and safe surface and consider a walking pole or stick if needed. The Irish Heart Foundation has ‘Sli na Slainte’ routes all over the country, mapping short walking routes for those who are suited to this.

  1. If you like technology, use it to help get motivated. Many people like activity watches (set your own realistic level – it doesn’t have to be 10,000 steps!). The UK health service promotes an app called the ‘Active 10’ which tracks two 10 minute walks a day.
  2. Do something that you enjoy – or listen to music to distract you, e.g. when using an exercise bike or arm pedals.
  3. Everyone is different so the key is to do what you can do and keep it up.
  4. Do not exercise when you are tired and don’t push to fatigue, muscle ache or worsening pain. Listen to your body!
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Exercise and Non Communicable Diseases

WHO Release exercise toolkit to help prevent and manage Non Communicable Diseases.

Recently the World Health Organisation released a brand new initiative called Active: a  toolkit for countries to increase physical activity and reduce non-communicable diseases.

What are non-communicable diseases (NCDs)?

Diseases which cannot be transmitted from one person to another are called Non Communicable Diseases. The main examples include stroke, cardio vascular disease, cancer, diabetes and chronic lung disease. NCDs are driven primarily by four major risk factors

  • tobacco use
  • harmful use of alcohol
  • unhealthy diet
  • physical inactivity

Worldwide NCDs account for about 70% of all deaths, however in Ireland in 2014, NCDs accounted for 88% of all deaths.

The Let’s Be Active is an initiative set to use a very simple tool to help prevent and manage NCDs,exercise! Exercise is proven to help prevent people from contracting NCDs such as heart disease, stroke, diabetes, breast and colon cancer. However as we become more advanced technologically there is a decrease in physical activity levels. With improved transportation systems, increase in computer usage and urbanisation we are becoming less active and therefore increasing our risks of developing certain NCDs.

The Let’s Be Active framework was developed as a response to a request from governments for updated guidelines for physical activity and feasible policy guidelines to help increase physical activity levels to help prevent and manage NCDs. The goals are to reduce physical inactivity by 10% by 2025 and by 15% by 2030. You can read more about the policy here.

What can we do to help prevent or manage NCDs on an individual level?

Increasing your own physical activity levels is a good place to start. For older adults the WHO recommends 150 minutes of physical activity per week. However it can be daunting to know what type of exercise to do or where you should turn to. Why not check out a few of our previous blog posts about exercise for older adults or motivating yourself to get active.

You’re Never Too Old to Start Exercising 

Taking the First Step to Exercise

Motivating Yourself to Exercise

At Siel Bleu, we also offer exercise programmes to help managed certain NCDs such as our award winning Exercise, COPD & Me programme, our Stroke Survivor Classes  and our work with Parkinson’s Ireland. Watch this space for a cancer programme coming 2019.

 

 

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Managing Arthritis Through Exercise

World Arthritis Day – The importance of exercise to manage Arthritis.

 

What is arthritis?

Arthritis is the terminology used to describe inflammation of the joints. There are approximately 915,000 people living with arthritis in Ireland. While there are 100 types of arthritis, the most common are Osteoarthritis which is caused by the sea and tear of cartilage that protects the joints and rheumatoid arthritis which is a long term autoimmune disorder which causes painful and swollen joints.

Arthritis is the leading cause of disability in Ireland, accounting for one in three GP visits and costs the exchequer €700million per year in lost earnings and forced retirement, according to Arthritis Ireland. While there is no known cure for arthritis, there are multiple ways to help deal with the effects.

Regular physical activity can have a a tremendous effects on people living with arthritis, specifically when it comes to reducing pain and helping to maintain mobility. It is probably the best thing that you can take charge of to help with the condition. The current World Health Organisation recommends 150 minutes of exercise per week for people aged 65+, however it can be difficult for people living with arthritis to meet this guideline due to complications with the condition.

When it comes to arthritis, even a little exercise can be beneficial. A resent study from Northwestern University Feinberg School of Medicine in Chicago tested the effects of exercise for people with Osteoarthritis affecting one knee. Results showed that people who engaged in longer sessions of physical activity were more likely to have greater physical abilities, however, people who reached just 45 minutes as opposed to the 150 minute per week guideline, are 80 per centre more likely to maintain or improve their physical abilities than those who only exercised from under 45 minutes.

But what type of exercise can do you with arthritis? While exercise is really one of the best medicines for arthritis many people are afraid to do any type of physical activity for fear of exacerbating the condition. We recommend speaking to your doctor to get advice on the best type of exercise for you. At Siel Bleu we also offer physical activity classes for people with arthritis, led by our professional physical trainers. If you would like to join our class in Killiney or to set up a class for you Arthritis support group call 01 209 6889.

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