Only 3 minutes of Exercise Need per Week?!

Really good news for those who don't have the time or desire to exercise!

Research in Exercise labs in the UK and North America have found that people only need 3 minutes of exercise per week to improve 2 important measures of health; the VO2 max and insulin sensitivity.

VO2 max is the maximum amount of oxygen that the body can use at the highest exertion of exercise. It is measured in milliliters of oxygen used in one minute per kilogram body weight and is considered to be the gold standard measurement for aerobic and cardiorespiratory fitness.

Insulin sensitivity is a test to determine how quickly the body can eliminate sugars from the blood. A decreased ability to eliminate sugars from the blood is caused insulin resistance and can lead to Type II diabetes.

The exercise is called High Intensity Training (HIT) it is broken down into 3 bouts of 20 seconds of max exercise with a period of rest in between,  and performed 3 times a week.  

Labs in the UK, US and Canada have shown that performing HIT has the same cardiovascular benefits as 3 hours of exercise per week.

Studies found that improvements in insulin sensitivity can be documented in as little as 2 weeks and improvements in VO2 max occurred in 6-8 weeks. 

The hypothesis is that maximum exercise for only 60 per session breaks down glycogen stores in the muscle and tricks muscle into thinking that it needs to get more glucose from blood. Additionally maximum exertion of exercise recruits 70 % of muscles versus moderate walking or jogging which recruits 20-30%. 

For obvious reasons a person should obtain clearance from their doctor before performing this type of exercise.   

This information was featured in a  fascinating documentary called "The truth about exercise with Michael Mosley",  clips of the show can be seen on http://www.bbc.co.uk/programmes/b01cywtq

The 86 year old gymnast

Johanna Quaas is an active gymnast from Germany who is amazing viewers on you tube with her strength and flexibility given that she is 86 years of age. 

She is what I consider to be one of the "elite elderly" who has manage to maintain her physical functioning rather than declining with age. Others members of this group include; Regis Philban (81), Clois Leachman (87), and Barbara Walters (83).  In the fitness industry we could consider the late Jack La Lanne who allegedly participated in his daily 2 hour work out the day before his death at age 96 and Joseph Pilates examples or elite elderly as well.

So is age really just a number? 

What makes the elite elderly different?

In researching their bios common characteristics include the following:

1. Proper nutrition and diet
2. Active lifestyle and exercise

In the case of Johanna her ability to maintain he level of gymnastic skill is is based upon a important principle that I believe to be true;

"If you don't move it, you lose it".

If you perform a task/functional activity consistently (at lease 1 time/week) throughout your life, you will never loose the ability to do it. 

One functional activity that older people lose is the ability to get up off of the floor from a position of supine and feel that it should be practiced at least 3 times a week by anyone over 50. Ideally one would alternate the leading leg when getting up. I like this skill as it involves many mini tasks that contribute to a person being able walk, balance and maintain independence. 

These tasks include:

1. Dorsiflexion of the ankle
2. Hip Extension
3. Quad/hamstring strength and control
4. Rolling/Abdominal Core activiation
5. Toe extension

I believe that if every person over the age of 50 did this one simple task every day, falling and consequences of falls would be diminished greatly.  

Becoming a member of the "Elite Elderly" is not easy but with some practice indeed possible. When one considers the alternative, it is definitely worth the effort. 

Alternative concept to improving Range of Motion

How often have we considered that our patient may be limited in their range of motion because they lack stability?

When I was in PT many years ago, I was taught that a person needs to have stability in order to have mobility. This is a well established rehabilitation concept and an often utilized principle with regard to positioning in the neurological patient population.

Stability within our system comes from our core muscles. They are the deep 1 joint muscles that are found in every joint and they must fire in order to allow our moving muscles to work. A good example of the this is the relationship of the rotator cuff  and shoulder flexion. If the rotator cuff is torn, the shoulder joint cannot flex.

If I had been given $100 every time that I gained range of motion with a patient only to find that it was lost on the next visit, I would be very wealthy.

The reason for this can be 2 fold:

• I didn't addressed or assessed the stability component of the joint that I was working on.  
• The patient became inflamed between visits and there was core muscle shut down. Remember for every cubic centimeter a muscle shuts down by 1 %. 

If you find yourself having difficulty gaining or maintaining range in your patient consider addressing the stability of that joint.

The Barrier to Good Posture

"STAND UP STRAIGHT"! 

If I had a dollar every time I heard that phase in a Rehab facility, I would be very wealthy. 

Don't you think our patients would like to have good posture if they could?

So why don't they?  

We are a manifestation of our compensations, meaning that when our body is not in alignment it will compensate to achieve function. 

I also believe that people become "Disabled" when their bodies run out of compensations. 

There are 2 main reflexes that dictate postural alignment in the human body. The body will contort itself by any means possible to achieve the following. 

1. Keeping the eyes on the horizon to facilitate the righting reflex and optimize vestibular function. A prime example of this is compensations due to a scoloitic curve. 

2. Weight bearing of the body over the hallux and medial foot. Examples of compensations include: rotation of the femur or tibia, medial shift of the talus, flat feet, genu recurvatum, genu valgum, anterior innominate rotation, and knee bending in standing. 

Diane Lee uses the term driver to describe the reason that there is a postural abnormality, the driving force behind the postural abnormality.

I feel the best way to determine is to place the bony structure in neutral and do the following: 

1. Observe compensations that occur as a result of this change. 
2. Ask our patients where they feel a resistance to allowing for movement to occur within the system. 
3. Feel through our tactile sense where there is a restriction to movement. 

I term this type of evaluation Diagnostic Static Evaluation. 

The ultimate way to achieve carryover and maximum functioning in your patient is to give your patient the best possible alignment in their system. 

The key to achieving this is to unlock the driver and treat the compensations. 

If you don't the patient will never physically be able to "STAND UP STRAIGHT"!