A programme of personalised physical exercise reverses functional decline in the over-75s

A programme of personalised physical exercise implemented over a three-year period and involving 370 people over the age of 75 admitted to the Geriatric Service of the Hospital Complex of Navarre (CHN) has turned out to be “safe and effective” in reversing the functional deterioration associated with hospitalisation to which patients in this age group are subjected. Other aspects such as cognitive status and life quality also benefitted.

This is the conclusion of a research project coordinated by Nicolás Martínez-Velilla and Mikel Izquierdo-Redín, researchers at Navarrabiomed, the biomedical research centre of the Government of Navarre and the Public University of Navarre (NUP/UPNA); its results have just been published in the Journal of the American Medical Association (JAMA Internal Medicine).

These findings open up the possibility of medical hospitalisation units changing their traditional paradigm to focus on functional status as a clinical sign that may be negatively affected by traditional hospitalisation classically based on bed rest.

Programme of physical exercise involving strength, balance and walking

Subjects participated in a controlled, personalised programme of strength, balance and walking exercises adapted to their abilities, even during the acute phase of their diseases. Depending on the status of each patient, training intensity ranging between 30 percent and 60 percent of their muscular capacity was specified, so they did leg and arm exercises. These sessions lasted 20 minutes twice a day (morning and afternoon), for between five and seven consecutive days (including weekends and public holidays) under the individual supervision of experts in the field of physical exercise for the elderly.

The programme of physical activity adapted from the VIVIfrail training programme was adapted to the clinical circumstances of each patient; it was found to be “a significant support in preventing frailty, a factor in eliminating complications linked to passive stay in hospital and a means of motivation for overcoming disease,” according to Nicolás Martínez-Velilla and Mikel Izquierdo.

“Our study shows that intervention involving, innovative, personalised multicomponent physical exercise that includes moderate intensity endurance training over a very short period of time, five days on average, has a significant benefit on routine care and may help to reverse the functional and cognitive deterioration associated with the hospitalisation of the elderly,” said the NUP/UPNA professor.

The results of the study show that when discharged from hospital, the group that had participated in the prescribed programme of exercise achieved, in comparison with those who had not done it, a total of 2.2 points above the average on a maximum score of 12 in the SPPB (Short Physical Performance Battery) functional assessment tool, which measures balance, walking speed and leg strength, and 6.9 points above the average score in the Barthel Functional Index for Activities of Daily Living, which has a maximum score of 100 points. These results are particularly important, as there is scientific consensus that regards a one-point increase on the SPPB scale and five on the Barthel scale as clinically significant.

In comparison with the interventions carried out with patients that fit this profile, this constitutes significant progress in dealing with functional aspects when abandoning hospitalisation models that encourage the bed rest and sendentarism of the patient. “Until now, no one had suggested that patients of this type (elderly people with a range of diseases) could benefit in just five days from a personalised exercise programme far removed from the usual message of ‘get up and walk along the corridor a little’ or ‘rest in bed or in an armchair,'” explained the head of the Geriatric Service at the CHN.

Significant benefits of the intervention from the cognitive and life quality perspective were also found. The above-mentioned improvements were achieved without any side effects or increase in hospital stay, as the researchers point out in their article.

“Nevertheless, this intervention did not change the rate of re-admittance or mortality three months later. In such an elderly population as those in the study and with a theoretically short life expectancy following hospitalisation, the aim of our intervention was not to increase the quantity but the quality of life,” said Nicolás Martínez-Velilla.

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A hot bath can partially replace physical exercise

Treatment hot baths helps to reduce inflammation and blood sugar levels in people unable to perform physical exercise, according to a new study published in the Journal of Applied Psysiology.

The physical stress in the form of exercise can cause a transient increase in inflammatory markers. After a workout increases the level of interleukin 6 (IL-6) chemical substances associated with inflammation. In the process of so-called inflammatory response triggers the release of anti-inflammatory substances to counter the unhealthy high levels of inflammation, known as chronic nonspecific inflammation.

Recent studies have shown that the increase in body temperature enhances the inflammatory response and provides a basis for alternatives to the exercises that reduce non-specific inflammation in the body. Previous studies also found a link between the sharp increase in body temperature and the formation of nitric oxide, a substance which promotes blood flow and helps to carry the glucose throughout the body.

The researchers studied markers of inflammation, levels of sugar and insulin in the group of sedentary men with overweight. Participants volunteers were immersed in hot water or sitting for the same time at room temperature (control), between these two types of tests took place at least three days.

The researchers took blood samples before and after staying in the room at a temperature of 27C for 15 minutes. Then, participants either continued to sit in the room, or took a bath with hot water (39S) for 60 minutes, plunging neck-deep into the water. The researchers measured heart rate, blood pressure and body temperature every 15 minutes throughout the period of control and immersion. Blood samples were taken again two hours after each session.

The researchers found that one session of immersion in hot water causes an increase in levels of IL-6 in the blood and increases the production of nitric oxide, but does not change the expression of heat shock protein HSP72 (also important for health). However, a two-week period of treatment by daily hot baths showed a decrease in the level of fasting blood sugar and insulin levels, and reduced nonspecific inflammation at rest.

Men reported discomfort during immersion in hot water that could be associated with high water temperature or length of time in the tub. The researchers acknowledge that these conditions may impede alternative treatment of this kind. However, the positive results of inflammation reduction and the increase in insulin sensitivity suggests that immersion in hot water can improve aspects of the inflammatory profile and improve the metabolism of glucose in sedentary men who are overweight, and may have implications for improving metabolic health in a group of people unable to meet recommendations for physical activity.

Valeria SEMA

'I Lost More Than 135kg After Cutting This From My Diet'

I was heavy my entire life, but honestly, I never realised how heavy I was until I lost the weight.

At my heaviest, I weighed 220kg and was eating at least 6,000 calories per day. Cooking at home was never the norm, and neither were vegetables. I was eating out multiple times a day, and because I Ioved anything fried, it was usually greasy fast food.

Yes, 6,000 calories a day sounds like a lot, but I don’t think I’m exaggerating: Fast food breakfast sandwiches were usually my breakfast of choice (with hash browns and a large soda), followed by fast food tacos for lunch (and even more soda). For dinner, I could easily eat half of a large stuffed-crust meat lover’s pizza, along with breadsticks, cookies, and, yep, more soda.

Nothing in particular sparked my decision to lose weight–I was honestly just fed up with being 220kg.

So, on January 1, 2016, my husband and I made resolutions to change our unhealthy lifestyle.

To help me meet my goal, my best friend challenged me to 30 days of cooking for myself (without cheat meals), cutting out alcohol and soda, and exercising five days a week—the complete opposite of what I was doing before. I figured I needed all the help I could get, so I accepted.

By the end of that month, I’d achieved every single goal she’d given me. I’d taught myself to cook, I was learning to count calories with MyFitnessPal, I was going to the gym and actually making progress using the elliptical (using it longer, adding resistance).

While, yes, I dropped some weight, the most important takeaway was that I had actually become addicted to my new, healthy routine.

During this time, I also started up my Instagram account, @FatGirlFedUp.

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Back at it after an active rest day yesterday! Feeling pretty confident about the work I've put into this body of mine in July. This month I set a goal to lift more weights. I think it's important to always set new goals and work on the things that may not be your favorite or that you're not comfortable with so that you can improve. We all start somewhere whether that's with weights, cardio, or even walking into the gym. This journey has no destination so never settle and keep moving on the path to be better than who you were yesterday. . Shirt available via link in bio or teespring.com/stores/fatgirlfedup ——————————————————————————– No more slacking this summer! Fedup & ready to spend the rest of this year fighting back for your health? Vacation time and Summer are almost over so time to get back to our goals! Next dietbet starts 8/6! I joined my first dietbet in January 2016 when I started my journey & it helped me change my life! Time to change yours too & make those resolutions stick! Lose weight, share tips/recipes, giveaways including skype session with me, @fedupfam tees, & get paid!  Link in bio or dietbet.com/fatgirlfedup #goals #motivation #fit #fitfam #obesetobeast #weightloss #weightlossjourney #motivation #fattofit  #dietbet #diet #plussize #fitspo  #motivation #fitness #gym #anytimefitness #fitspo #losingweight #fedupfam #weightlosstransformation #transform #gymlife #fitnessmotivation #fedupfam #fedup #fatgirlfedupsdietbet #extremeweightloss

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My account started off as a personal diary. Soon after, I started making T-shirts since a lot of us (me and my followers) couldn’t find clothing we felt good in, and my Instagram account just grew from there.

I consider my followers friends and family, and together we’ve created a community for people who, like me, were fed up with existing rather than living. I don’t ever want that to change. I make sure they know that it is okay to flaunt their bodies, as long as they’re being kind to themselves.

As I continued my new, healthy routine, my taste in food started to change, too.

As far as my current diet goes, I don’t restrict myself because that would make me want that food more. I just started taking the foods I loved and making them healthier (my go-to meal is oven-roasted blackened salmon and asparagus). I focused on tracking my calories to make sure I was eating more protein, a lot of vegetables, and fewer carbs. And because I wasn’t eating until I felt sick anymore, the weight just started coming off, and it still is.

Here’s what I eat in a typical day:

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Made my favorite healthy meal for dinner and leftovers for meals this week. Blackened Salmon & roasted asparagus! I love asparagus and I always roast it in oven with olive oil, garlic, and pepper. For the Salmon I always use blackened seasoning and cook in skillet or oven. 😍 If you are new here I count calories and currently eat 1400 calories a day. I dont follow a meal plan but aim to eat more protein, veggies, and less carbs. I do however still have carbs every single day. Find what works for you and remember it's a lifestyle, not a diet! Sharing more of what I eat in my next dietbet, link in bio! #weightloss #weightlossjourney #food #foodie #foodisfuel #salmon #fish #protein #gains #dietbet #fattofit #obesetobeast #fatgirlfedup #dietbet #fitspo #diet #losingweight #fit #fitness #goals #countingcalories #fedupfam #fatgirlfedup #extremeweightloss #lowcarb

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Maintaining all of this wasn’t easy. I had to start being able to say “no.” If my friends wanted to eat out, I had to find different ways to spend time with them that didn’t revolve around food, like hiking or watching a movie.

I also enlisted my husband to join me at the gym—a once intimidating place for me.

There’s no getting around it: When I went to the gym, people would stare at me—so I made sure to be the hardest worker in the room. I’d just remind myself that I was in charge of changing the rest of my life. I was there for me, not them.

When I first started out, the elliptical machine was my best friend—it allowed me to manipulate the intensity and incline of my workout. It was ideal because it didn’t hurt my joints like most other machines did when I was at that weight.

Once I got comfortable with that, I also started going to a local class called Pulse Fitness, which is like Zumba. I stood in the back of the class and did as many moves as I could. I challenged myself to be better every time.

Even today, at 78kg, I can’t say whether or not I’ve reached my goal—I’m still on my journey.

And it hasn’t been easy: I’ve often had to rearrange my schedule in order to avoid adjusting my weight-loss goal. I was working 10-hour shifts, for example, which meant that I’d have to work out before, or try to incorporate creative ways to get in extra movement throughout the day.

For example, I would leave my phone on the other side of the room, which forced me to get up to turn off the alarm in the mornings. Other days, I’d lay out my gym clothes the night before, or take them with me to work and forbid myself from going home until I exercised. I had to have a game plan in order to save my own life.

Also, as a result of my weight-loss, I’ve been dealing with lots of excess skin. Right now, my next step is having my loose skin removed through surgery, which I’m actually getting done in the near future. I’ll be getting the skin on my stomach, hips, butt, and back contoured, removed, and lifted. I’m nervous, but excited about the result. (Yes, I’ll be posting about my recovery process for the FedUpFam to follow.)

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My most vulnerable post EVER ON this account & dressing room reminders that this body has beautiful battle wounds of losing over 300lbs. I have a ton of loose skin but however my skin doesn't hold me back from the new life I'm living. My skin doesn't hold me back from being proud of myself, loving myself, or taking care of myself. My skin doesn't make me sad or regret I lost weight, but proud. My skin is a reminder of how far I've come and can be removed if chosen. My health however can't be replaced and is a reminder when I see my beautiful battle wounds. Speak nicely to yourself because you're always listening! Skin is skin so love the body you're in and don't let something so small be such a big excuse. Health is wealth! —————————————————————————– Lets get paid to get lean in  Summer 2018! Fedup & ready to spend the rest of this year fighting back for your health? Start summer strong with our tribe! Next dietbet starts 6/25! I joined my first dietbet in January 2016 when I started my journey & it helped me change my life! Time to change yours too & make those resolutions stick! Lose weight, share tips/recipes, giveaways including skype session with me, @fedupfam tees, @doughbardoughnuts, & get paid!  Link in bio or dietbet.com/fatgirlfedup #goals #motivation #fit #fitfam #obesetobeast #weightloss #weightlossjourney #motivation #fattofit  #dietbet #diet #plussize #fitspo  #excessskin #fitness #gym #anytimefitness #fitspo #losingweight #fedupfam #weightlosstransformation #transform #gymlife #fitnessmotivation #fedupfam #looseskin #fatgirlfedupsdietbet #extremeweightloss

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Overall, it took a long time to feel confident enough to post photos of my body on Instagram, but I’ve gotten to a place where I’m comfortable in my skin. Now that I am, I can motivate my followers, in addition to myself. Though my journey, I’ve realised it’s not about the weight you lose, but the life that you gain.

Lexi Reed as told to Aryelle Siclait. This article originally appeared on Women’s Health.

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