Tag Archives: Stroke

OT Month 2018

OT Month 2018

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

OT Month 2018

Occupational therapists & physical therapists are similar but different.
Here’s why…

Occupational therapy focuses on a person’s ability to perform activities of daily living.

OCCUPATIONAL THERAPY (OT)
mainly focuses on activities of daily living (ADL’s). For example this would mean helping patients to eat and write again after a stroke. OT’s also modify movements or the environment so a patient can complete tasks safely. These modifications help patients lead full and active lives.

PHYSICAL THERAPY (PT)

focuses on treating the injury itself, through the use of orthopedics, manual therapy and modalities. With the goals of reducing pain and improving function.

occupational therapist

Both professions educate patients on wellness and injury prevention. In some cases, like those having suffered a stroke, the patient may see both an OT and PT during recovery.

Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.

Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes. Occupational therapy services typically include:

  • an individualized evaluation, during which the client/family and occupational therapist determine the person’s goals,
  • customized intervention to improve the person’s ability to perform daily activities and reach the goals, and
  • an outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan.

Occupational therapy practitioners have a holistic perspective, in which the focus is on adapting the environment and/or task to fit the person, and the person is an integral part of the therapy team. It is an evidence-based practice deeply rooted in science.

Eat Well

Eat Well, Exercise Well, Be Well: Dietary and Fitness Guidelines

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

Eat Well

When it comes to the secrets of living a healthy life, it seems that there are no secrets. From diet gurus to celebrities, everyone seems to have the answers on healthy living. Since the 1980s, the United States government has also weighed in, with dietary guidelines that it publishes every 5 years. The intent is to provide research-backed diet and physical activity recommendations to reduce the risk of diseases linked to poor diet and activity, such as high blood pressure, heart disease, and type 2 diabetes. Here is a round-up of the government’s latest key recommendations from the publication, 2015-2020 Dietary Guidelines for Americans.

EAT WELL

Calories, Calories, Calories
In recent years, obesity has been a national concern, since it has been associated with serious conditions like cancer, heart disease, and type 2 diabetes. Controlling total calorie intake is essential to maintaining ideal body weight. If you are trying to lose weight, you will need to expend more calories than you take in. This means getting plenty of exercise and cutting down on foods that are high in calories.

So how many calories should you be consuming? This depends on several factors, such as age, gender, height, weight, and physical activity level. To keep calories under control, you want to focus on eating foods full of many nutrients, especially potassium, fiber, vitamin D, and calcium. You may want to talk with your doctor or a registered dietitian about an eating plan that is right for you. In general, try to keep calories in check. Aim to meet calorie needs, but not exceed them. Reducing portion size and eating more meals at home are great ways to avoid exceeding calorie needs. In addition, eating foods high in nutrients but lower in calories can help.

Foods to Enjoy

  • Eat a lot of fruits and vegetables—Fresh fruits and vegetables are lower in calories compared to processed foods. Focus on color when eating fruits and vegetables. Dark green, red, and orange vegetables are especially packed with good-for-you nutrients. When preparing a meal, try and fill half your plate with fruits and vegetables.
  • Eat a lot of whole grains—Examples of whole grains are brown rice, oatmeal, bulgur, and whole-wheat pasta. Your goal should be to make half your grains whole grains.
  • Have more dairy—Focus on low- or non-fat milk, cheese, and yogurt.
  • It is okay to eat certain fats—Some fats are okay to consume in moderation. These are monosaturated or polyunsaturated fats, which are found in foods like nuts and fish.
    Power up on protein—Seafood, lean meats, poultry, beans, and soy products are good sources of protein. Be sure to choose protein foods that are low in saturated fat and calories.

Fruits and Vegetables

Food to Eat Less

  • Limit refined grains—Examples of refined grains are white bread, corn flakes, grits, regular pasta, and white rice. These foods tend to be high in calories and sugar but low in fiber.
  • Limit foods containing added sugars—This includes sugar-sweetened drinks and snacks.
  • Limit foods high in saturated fats—This includes certain kinds of meat and dairy products (whole milk, cream, and butter). Less than 10% of calories should come from saturated fats.
  • Keep trans fat consumption as low as possible—You can do this by limiting foods containing solid fats and partially hydrogenated oils, such as margarine and baked goods.
  • Limit salt intake—Too much of it can increase your risk for high blood pressure, which can lead to kidney damage, heart disease, and stroke. On a daily basis, adults should consume less than 2,300 mg of sodium.
  • If you drink alcohol, do so in moderation —Women should consume no more than 1 alcoholic drink a day, while men should consume no more than 2 drinks a day. Also, keep track of the calories in each drink. Mixed drinks tend to have higher calories.

Preparing Your Plate
Remembering which foods to limit, and which to eat more of, may be daunting. To help you remember, the United States Department of Agriculture created a simple image of a sectioned plate as a guideline for healthy eating. The Choose My Plate guidelines emphasize nutrient-dense foods and beverages, such as vegetables, fruits, whole grains, low- or non-fat milk, beans, and nuts. If remembering how much and what to eat is a chore, you can just keep these simple things in mind to ensure that you are eating well when you sit down for a meal:

  • Fill half your plate with fruits and vegetables.
  • When eating grains, make sure half your grains are whole grains.
  • Choose fat-free and low-fat (1%) milk products.
  • Avoid oversized portions.
  • Enjoy your food, but be mindful of how much you are eating. Try to eat less.
  • Drink water instead of sugary drinks.
  • When cooking, try to use less or no salt in the recipe. When you eat your meals, do not add any extra salt. Over time, you will adjust to less salt in your food.

You can find specific information on the ChooseMyPlate website.

Exercise Well
A nutritious diet and exercise go together for maintaining a healthy lifestyle. To achieve and maintain a healthy body weight, adults should aim for 150 minutes of moderate to intense physical activity each week. Some examples of activities are brisk walking, biking, and swimming. Before starting any kind of exercise program, be sure to check with your doctor if you have any health issues that may limit your exercise program.

Be Well
Guidelines provide the foundation for a healthy lifestyle. But living a healthy lifestyle takes discipline and a positive attitude. Working with your doctor and perhaps other professionals, like a dietitian or fitness trainer, can be helpful in keeping you motivated and on track for reaching your health goals. Also, a healthy lifestyle should not be a chore, but something enjoyable.

Make exercise fun—a weekend hike, a lunch-hour walk with co-workers, or a pick-up game of basketball with your neighbor are just some ideas. And when mealtimes roll around, put on your creative chef hat! Come up with new approaches to breakfast, lunch, and dinner menus that incorporate fresh, nutrient-dense foods, and get friends and family involved in preparing meals. Experiment with herbs and spices to flavor your meals instead of the old salt standby. Armed with guidance, support, and motivation, a healthy lifestyle is within your reach!

Written by Marjorie Montemayor-Quellenberg, MA

RESOURCES:
Choose My Plate—US Department of Agriculture
http://www.choosemyplate.gov

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Dietitians of Canada
http://www.dietitians.ca

REFERENCES:

2015-2020 Dietary guidelines for Americans. US Department of Agriculture and US Department of Health and Human Services. Available at: https://health.gov/dietaryguidelines/2015/guidelines/. Accessed February 14, 2017.

BMI calculator. ChooseMyPlate—US Department of Agriculture website. Available at: http://www.choosemyplate.gov/weight-management-calories/weight-management.html. Accessed February 14, 2017.

Dietary interventions for cardiovascular disease prevention. EBSCO DynaMed Plus website. Available at: http://www.ebscohost.com/dynamed. Updated February 5, 2015. Accessed March 9, 2015.

What is MyPlate? US Department of Agriculture ChooseMyPlate website. Available at: https://www.choosemyplate.gov/MyPlate. Accessed February 14, 2017.

Last reviewed February 2017 by Michael Woods, MD, FAAP

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Chronic Disease Relief

Exercise for Chronic Disease Relief

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin


For people in need of chronic disease relief, exercise can decrease discomfort, improve daily functioning, and enhance overall quality of life. There are many activity choices. Overall, find something that you enjoy doing and a place that is comfortable for you to do it in. Although being physically active is good for anyone, some exercises provide specific benefits. Here is how different types of exercise can help people with specific chronic diseases.

CHRONIC DISEASE RELIEF : TYPES OF EXERCISE
There are 3 basic categories of exercise:

Aerobic Exercise
These are exercises that raise your heart rate through repetitive movement of large muscles groups. The 2 types of aerobic exercise are:

  • Weightbearing exercise —Your muscles work against the force of gravity. Examples include jogging, walking, and dancing.
  • Non-weightbearing exercise —The force of gravity does not play a major role. Examples include biking, swimming, and rowing.

Strength Training Exercise
These are exercises that increase the power, tone, and efficiency of individual muscles by contracting isolated muscles against resistance. An example is lifting weights. The increase in heart rate is short-lived compared to aerobic exercise.

Stretching

These are exercises that improve or maintain the flexibility of your muscles. Good flexibility is important to keeping a full range of motion and decreasing your chances of injury. Ideally, you should stretch after each exercise session.

DISEASE IMPACT
Overall, all 3 types of exercises are important in a chronic disease relief program. However, the list below demonstrates how a certain types of exercise can directly impact your specific health condition.

Heart Disease
Researchers and healthcare professionals have found that regular exercise reduces the risk of having a heart attack, particularly for people with coronary artery disease (CAD).

Specific benefits of exercise for people with heart disease include:

  • Stronger heart muscle
  • Reduced cholesterol
  • Reduced plaque build-up inside the arteries
  • Better weight and blood pressure control

Type of exercise that can reduce risk of heart disease and heart attack: Aerobic

High Cholesterol
Cholesterol is found in cells throughout your body. Although it tends to get a bad rap, cholesterol is actually essential for life. It only contributes to heart disease when you have too much of certain types of cholesterol or too little of other types.

Exercise can help reduce cholesterol, and even better, it can help raise your HDL (good) cholesterol. Aim for at least 30 minutes of exercise most days of the week. Even short, 10-minute spurts of exercise can help. Exercise also has the added benefit of weight loss, which can also help to lower cholesterol levels.

Type of exercise that has been shown to improve cholesterol levels: Aerobic

Diabetes

Diabetes is a disorder of the body’s insulin production and usage, and it is a major risk factor for coronary artery disease. If there is not enough insulin, glucose (fuel for all cells) cannot get from the blood to the cells. As a result, the body is essentially starved and the glucose builds up in the blood. Exercise can make the cells more sensitive to insulin, and more glucose can move from the blood into cells.

Since exercise changes the way your body reacts to insulin, you may need to check your blood sugar before and after exercising. Talk to your doctor before you begin an exercise program to learn about what your levels should be.

Types of exercise that influence insulin sensitivity and cardiovascular risk factors: Aerobic and strength training

High Blood Pressure
The risk of high blood pressure increases as we age. Exercise can help to lower your risk and even control your blood pressure if it’s already high. Exercise helps with blood pressure by making your heart work more efficiently. This means your heart does not have to work as hard to pump blood, so there is less pressure on your arteries.

A good target for blood pressure is 120/80 mm Hg. Adding moderate physical activities to your normal routines can help you get there. You should aim for at least 30 minutes of aerobic activity on most days of the week. Even several 10-minute spurts throughout the day can help.

Types of exercise that have been shown to lower blood pressure: Aerobic and strength training

Stroke
A stroke occurs when not enough blood is reaching part of the brain. This causes the cells in that area to die. People who have already had a stroke are at increased risk for recurrent stroke or other cardiovascular problems.

A stroke can create some physical impairments. Exercise may improve strength and coordination of the affected muscles. Exercise recommendations may vary depending on the severity of the stroke and the person’s limitations.

Type of exercise for stroke recovery: Aerobic, strength training, and stretching

Cancer
Studies suggest that people with cancer who do not have depression have a better chance of survival than those who do. Exercise is a great way to avoid depression and improve your overall mood. It’s not clear exactly how exercise impacts mood, but it probably works by causing the brain to release chemicals, like endorphins, and increase body temperature, which can have a calming effect.

Types of exercise found to boost energy and mood: Aerobic and strength training

Lung Disease
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, is the most common form of lung disease in adults. Exercise improves activity levels and decreases symptoms.

Types of exercise shown to improve respiratory ability: Aerobic

Arthritis

Continuous motion is essential for the health of your joints, especially arthritic ones. Regular exercise promotes strength and flexibility, and helps preserve the resiliency of joint surfaces.

Types of exercise shown to improve joint health: Nonweightbearing aerobic, strength training, and stretching (water exercises are ideal)

Osteoporosis
Osteoporosis is a bone-thinning disease that can lead to fractures. Weightbearing exercises maintain bone density and strength by tipping the balance in favor of bone formation. Weightbearing activities include walking, jogging, hiking, dancing, stair climbing, tennis, and other activities that you do while on your feet.

Type of exercise shown to improve bone density: Weightbearing aerobic and strength training

In any condition, a well-rounded exercise program will have all 3 types of exercise involved. Aerobic exercise will increase your endurance and ability to get through longer workouts. Strength training will build muscle strength and allow you to tolerate higher intensities as well improve balance and agility. Stretching can decrease stiffness and increase mobility.

Talk to your doctor before beginning any exercise program. You can also consult with an exercise specialist to help you develop a routine.

by Carrie Myers Smith, BS

RESOURCES:
National Institutes of Health
http://www.nih.gov

The American Orthopaedic Society for Sports Medicine
http://www.aossm.org

CANADIAN RESOURCES:
Canadian Society of Exercise Physiology
http://www.csep.ca

Healthy Canadians
http://www.healthycanadians.gc.ca

REFERENCES:
Depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 11, 2016. Accessed March 23, 2016.

Exercises for arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/living-with-arthritis/exercise/. Accessed March 23, 2016.

Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 33. S484-S492; 2001.

Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, Shephard T. AHA scientific statement: Physical activity and exercise recommendations for stroke survivors. Circulation. 2004;109: 2031-2041. Circulation website. Available at: http://circ.ahajournals.org/content/109/16/2031.full. Accessed March 23, 2016.

Junnila JL, Runkle GP. Coronary artery disease screening, treatment, and follow-up. Primary Care: Clinics in Office Practice. 2006 Dec; 33(4).

Onitilo AA, Nietert PJ, Egede LE. Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry. 2006 Sep; 28(5): 396-402.

Physical activity for cardiovascular disease prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed March 23, 2016.

Physical activity guidelines for Americans. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 9, 2013. Accessed March 23, 2016.

Weightbearing exercise for women and girls. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00263. Updated October 2007. Accessed March 23, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 5/8/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Prediabetes

What Does It Really Mean to Have Prediabetes?

like what you see? share...Share on Facebook
Facebook
Tweet about this on Twitter
Twitter
Share on LinkedIn
Linkedin

Prediabetes_FBsize

Type 2 diabetes usually occurs as a result of genetics and lifestyle. It is marked by abnormally high levels of blood sugar, known as glucose. Glucose is the primary source of energy for our cells that the body makes from food we ingest. The onset of type 2 diabetes is triggered when the body is no longer able to properly use insulin, the hormone that helps cells take in glucose from the blood. When glucose stays in the blood stream instead of moving into the cells, nerves and blood vessels can be damaged. This increases the risk of cardiovascular disease, stroke, blindness, kidney disease, and circulation problems.

What Is Prediabetes?
Prediabetes is a condition that precedes the onset of type 2 diabetes. It is characterized by blood glucose levels that are elevated, though not high enough to be classified as diabetes. Doctors usually refer to prediabetes as impaired glucose tolerance or impaired fasting glucose. The American Diabetes Association (ADA) recommends screening for all adults 45 years old and older. Also, if you are younger than 45 and are overweight or obese and have risk factors for diabetes, you should be screened. Risk factors include:
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle
• History of gestational diabetes or giving birth to a baby weighing more than 9 pounds (4 kilograms)
• History of cardiovascular disease
• Having a condition associated with insulin resistance, such as polycystic ovary syndrome or metabolic syndrome

People of Hispanic American, Asian American, Pacific Islander, Native American, or African American descent are at higher risk.
Having prediabetes means that you are at high risk for developing diabetes and may already be experiencing adverse effects of elevated blood sugar levels.

How Do You Know If You Have Prediabetes?
During a routine office visit, your doctor can order tests, such as:
• Fasting plasma glucose test—For this test, you fast overnight and have your blood glucose measured in the morning before eating. Results in the range of 100-125 mg/dL (5.6-6.9 mmol/L) may indicate prediabetes.
• Oral glucose tolerance test (OGTT)—Again, you fast overnight and have your blood glucose measured after the fast. Then, you consume a sugary drink and have your blood glucose measured two hours later. Results in the range of 140-199 mg/dL (7.8-11 mmol/L) indicate prediabetes.
• Hemoglobin A1c (HbA1c)—This is an indicator of your average blood sugar levels over the previous three months. Results in the range of 5.7%-6.4% indicate prediabetes.

What Can You Do If You Have Prediabetes?
If you are diagnosed with prediabetes, it is important to take action to manage your condition. If you are overweight, your doctor may recommend that you lose weight. Reducing your body weight, even by 5%-10% can help improve your health. In general, changing your diet and being physically active and exercising at least 30 minutes a day will help you stay on track. Participating in a behavioral modification program may further help you achieve your weight loss goals.

Because many of the lifestyle-related risk factors associated with diabetes are also risk factors for other health issues, making lifestyle changes to reduce your risk of diabetes may have a positive effect on your overall health.

Some people can take medication to manage their blood glucose levels, though lifestyle modification should be the first approach to manage prediabetes. Medications that may be used include metformin, pioglitazone, and acarbose.

obese_man_gym

How Can You Prevent Prediabetes?
The same strategies that are used to lower your risk of type 2 diabetes can be applied to prediabetes, as well. The American Diabetes Association (ADA) recommends these strategies:
• Lose excess weight.
• Exercise for at least 150 minutes per week.
• Reduce your intake of calories and fat.
• Try to eat more fiber and whole grains.

If you do have prediabetes, you can take steps that may slow or avoid the progression to type 2 diabetes. It will take a lot of effort on your part, but the potential benefits—being healthy and living longer—are worth it.

by Julie J. Martin, MS

RESOURCES:
American Diabetes Association
http://www.diabetes.org

National Diabetes Education Program
http://www.ndep.nih.gov

CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:
Am I at risk for type 2 diabetes? Taking steps to lower the risk of getting diabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/risk.pdf. Published June 2012. Accessed April 26, 2016.

American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases. The prevention or delay of type 2 diabetes. Diabetes Care 2002;25:1-8.

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. NEJM. 2002;346:393-403.

Diabetes mellitus type 2 prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 22, 2016. Accessed April 26, 2016.

Diagnosing diabetes and learning about prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/are-you-at-risk/prediabetes. Updated December 9, 2014. Accessed April 26, 2016.

Kanaya AM, Narayan KM. Prevention of type 2 diabetes: Data from recent trials. Primary Care. 2003;30:511-526.

Narayan K, Imperatore G. Targeting people with prediabetes. British Medical Journal. 2002;325:403-404.

Nathan DM. Diabetes Care. 2007;30:753.

Prediabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2016. Accessed April 26, 2016.

Tuomilehto J, Lindstorm J. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2004;344:1343-1350.

10/21/2008 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Greaves CJ, Middlebrooke A, O’Loughlin L, et al. Motivational interviewing for modifying diabetes risk: a randomised controlled trial. Br J Gen Pract. 2008;58:535-540.

10/12/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-S61).

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-S69).

Last reviewed April 2016 by Michael Woods, MD Last Updated: 6/3/014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.