Aging Alice…Aging Alice…

……A Time For ChangeA Time For Change

Introduction…Introduction… The Kinesiologist has decided that a one week span between the initial The Kinesiologist has decided that a one week span between the initial

assessment and the prescription was not sufficient; therefore the client has assessment and the prescription was not sufficient; therefore the client has been asked to schedule an appointment for 2 weeks from the initial meetingbeen asked to schedule an appointment for 2 weeks from the initial meeting

This allows time for the Kinesiologist to prepare the following:This allows time for the Kinesiologist to prepare the following: Allows time for submission of Alice’s food diaryAllows time for submission of Alice’s food diary Allows the Kinesiologist time to read and review with Alice some of the Allows the Kinesiologist time to read and review with Alice some of the

possible issues that arise from the food diary and make any necessary possible issues that arise from the food diary and make any necessary appointments with a nutrionistappointments with a nutrionist

Allows the Kinesiologist to assess Alice’s work office and workplace Allows the Kinesiologist to assess Alice’s work office and workplace surroundings for possible ergonomic issues that need to be addressedsurroundings for possible ergonomic issues that need to be addressed

Allows the Kinesiologist time to prepare proper exercises and make any Allows the Kinesiologist time to prepare proper exercises and make any modifications necessary to compensate for Alice’s illnessesmodifications necessary to compensate for Alice’s illnesses

Observed qualities that Alice possesses:Observed qualities that Alice possesses: She has a higher level of self-efficacy than mostShe has a higher level of self-efficacy than most

Proven through her willingness to seek help as she brought herself to usProven through her willingness to seek help as she brought herself to us She ranks herself (on a scale of 1 thru 10, 10 being the highest) very high She ranks herself (on a scale of 1 thru 10, 10 being the highest) very high

(9.3 and 8.87) on her willingness to make a change and her self-evaluation (9.3 and 8.87) on her willingness to make a change and her self-evaluation of how well she believes she will adhere to the program respectivelyof how well she believes she will adhere to the program respectively

Client ResourcesClient Resources Support systems; Mucho Mike, her grandchildren and her dogs (Walker, Texas Support systems; Mucho Mike, her grandchildren and her dogs (Walker, Texas

Ranger and the ‘spit-fire’ Medicine Woman)Ranger and the ‘spit-fire’ Medicine Woman) Overall, she appears to be motivated, driven towards success and has set Overall, she appears to be motivated, driven towards success and has set

realistic goals for herself…she exited last-day positive and ready to make a realistic goals for herself…she exited last-day positive and ready to make a change, overall she is excitedchange, overall she is excited

With our help and the following information we wish to attain these goals with AliceWith our help and the following information we wish to attain these goals with Alice

Client and Councilor Revised Client and Councilor Revised Objectives…Objectives…

Preparation for

Upcoming Surgeries Through…

Exercise Nutrition

A Healthy,Active

Lifestyle

An Overview…An Overview… ExerciseExercise

This will be an integral part of the intervention process as it will not only be a This will be an integral part of the intervention process as it will not only be a means for weight loss, it will help build a muscular tone which will aid in the means for weight loss, it will help build a muscular tone which will aid in the healing and rehabilitation process of the upcoming knee and hip surgerieshealing and rehabilitation process of the upcoming knee and hip surgeries

Also, as our client presents with osteoarthritis and a high risk factor for the onset Also, as our client presents with osteoarthritis and a high risk factor for the onset of osteoporosis, of osteoporosis, controlled controlled exercise prescription will help reduce the effects of exercise prescription will help reduce the effects of pain and further degradation of muscle tonepain and further degradation of muscle tone

NutritionNutrition Nutrition is another integral part of this program as extra calories and improper Nutrition is another integral part of this program as extra calories and improper

eating habits can lead to obesity and thus further hindering set goals of weight eating habits can lead to obesity and thus further hindering set goals of weight loss; even more importantly, it can help bring yourself to optimal health for loss; even more importantly, it can help bring yourself to optimal health for preparation for your upcoming surgeries and future yearspreparation for your upcoming surgeries and future years

Healthy, Active LifestyleHealthy, Active Lifestyle Practicing healthy, active lifestyle techniques will establish them as habitual Practicing healthy, active lifestyle techniques will establish them as habitual

behaviours and will be most beneficial not only in the present for our client’s behaviours and will be most beneficial not only in the present for our client’s overall health but later on in life, well after the surgeries; becoming aware of overall health but later on in life, well after the surgeries; becoming aware of one’s nutrition will be important as you become older as the proper balance of one’s nutrition will be important as you become older as the proper balance of vitamins, nutrients and minerals is of the utmost importance for remaining vitamins, nutrients and minerals is of the utmost importance for remaining healthy for many, many years healthy for many, many years

Addressing Physical Fitness Issues…Addressing Physical Fitness Issues…

First Off Concerns…First Off Concerns… Osteoarthritis in both Hip (Ishiofemoral Joint) and Knee Osteoarthritis in both Hip (Ishiofemoral Joint) and Knee

(Tibiofemoral Joint)(Tibiofemoral Joint) Is a local degeneration of the joint and Is a local degeneration of the joint and is characterized primarily is characterized primarily

by stiffness and pain within the jointby stiffness and pain within the joint Typically worse for the first 30 minutes after one wakes up and Typically worse for the first 30 minutes after one wakes up and

30 minutes before one retires30 minutes before one retires Although there are no treatments that reverse or slow the Although there are no treatments that reverse or slow the

process, supplementation of glucosamineprocess, supplementation of glucosamine and controlled and controlled exercise help reduce the effects exercise help reduce the effects

Potential for Onset of OsteoporosisPotential for Onset of Osteoporosis low calcium content of the bones and is another condition that low calcium content of the bones and is another condition that

does not directly cause but can lead to chronic pain in joints and does not directly cause but can lead to chronic pain in joints and bonesbones

more common in post-menopausal womenmore common in post-menopausal women bone mineral (calcium) loss may weaken bones in several parts bone mineral (calcium) loss may weaken bones in several parts

of the body, particularly in the hip and the spineof the body, particularly in the hip and the spine Treatments for osteoporosis and osteoarthritis differ a Treatments for osteoporosis and osteoarthritis differ a

substantial amount but both are important to be aware of and substantial amount but both are important to be aware of and compensate for both factorscompensate for both factors

Prescribing the Proper Workout…Prescribing the Proper Workout… Participation in cardiovascular exercises poses Participation in cardiovascular exercises poses

minimal to no problems in terms of joint loading and minimal to no problems in terms of joint loading and does not cause any further over-use injuries…it also does not cause any further over-use injuries…it also improves self-esteem and increases social improves self-esteem and increases social behaviours…behaviours…

Stationary Bike (maintains cardiovascular health)Stationary Bike (maintains cardiovascular health) Duration: 15-30 minutesDuration: 15-30 minutes Intensity: 40-60% of max. H.R. (~90-100 bpm)Intensity: 40-60% of max. H.R. (~90-100 bpm) Frequency: 2-3 days/weekFrequency: 2-3 days/week

Water-obics Class (cardiovascular as well as builds Water-obics Class (cardiovascular as well as builds muscle tone)muscle tone)

Duration: 30-60 minutes (depending on class schedule)Duration: 30-60 minutes (depending on class schedule) Intensity: varies (strive for 40-70% of max H.R.)Intensity: varies (strive for 40-70% of max H.R.) Frequency: 1-2 days/weekFrequency: 1-2 days/week

Prescribing the Proper Workout…Prescribing the Proper Workout… Flexibility is another integral part leading-up to Flexibility is another integral part leading-up to

your surgeries…flexibility will not only help your surgeries…flexibility will not only help improve joint range of motions, it will also help improve joint range of motions, it will also help keep joints mobile and help alleviate some of keep joints mobile and help alleviate some of the symptoms and overall onset of the symptoms and overall onset of osteoarthritisosteoarthritis

Yoga (flexibility and relaxing techniques)Yoga (flexibility and relaxing techniques) Duration: 60 minutesDuration: 60 minutes Intensity: RelaxationIntensity: Relaxation Frequency: 1 day/weekFrequency: 1 day/week

Stretches (Overall)Stretches (Overall)

Duration: 15 minutes in Duration: 15 minutes in morningmorning post-shower and post-shower and also to be performed before retiringalso to be performed before retiring Intensity: relaxation Intensity: relaxation Frequency: as much as possible (~ 5 days/week)Frequency: as much as possible (~ 5 days/week)

StretchesStretches Lying quadriceps stretchLying quadriceps stretch Seated hamstring stretchSeated hamstring stretch Hip-flexor and hip-extensor (discussed in strength section Hip-flexor and hip-extensor (discussed in strength section

as well)as well) Butterfly stretchButterfly stretch Pretzel Stretch Pretzel Stretch Arm circlesArm circles Neck Rolls Neck Rolls Wrist Flexor/ExtensorsWrist Flexor/Extensors Triceps StretchTriceps Stretch

Strengthening ExercisesStrengthening Exercises LegsLegs

Modified Standing Squat (One Leg) Modified Standing Squat (One Leg)

Hip Flexor & Hip Extensors Hip Flexor & Hip Extensors Kneeling Hip Flexor Stretch (modified for knee and hip compensation)Kneeling Hip Flexor Stretch (modified for knee and hip compensation)

Machine assistedMachine assisted Leg extension Leg extension Hamstring curlHamstring curl Abductor/abductor leg Abductor/abductor leg Calf raisesCalf raises Chair squatChair squat

Frequency: 1 day/weekFrequency: 1 day/week Intensity: 50% of max. lifting capacity / 2 to 3 reps & 3 to 4 setsIntensity: 50% of max. lifting capacity / 2 to 3 reps & 3 to 4 sets Duration: 1 hour workoutDuration: 1 hour workout

Prescribing the Proper Workout…Prescribing the Proper Workout… ArmsArms

Lying Biceps Push-up (modified for hip and knee)Lying Biceps Push-up (modified for hip and knee)

TherabandTheraband© Triceps Extension© Triceps Extension

Lat-Pull (Latissimus Dorsi) PulldownLat-Pull (Latissimus Dorsi) Pulldown Flat Bench-PressFlat Bench-Press Seated RowSeated Row

Prescribing the Proper Workout…Prescribing the Proper Workout…

RecommendationsRecommendations Use only low-impact activitiesUse only low-impact activities AvoidAvoid!!! unnecessary stair !!! unnecessary stair

climbing, jogging/running in full climbing, jogging/running in full weight-barring or high impactweight-barring or high impact

Condition muscles 1Condition muscles 1stst and and strengthen 2strengthen 2ndnd

Make sure to include your R.O.M. Make sure to include your R.O.M. exercises!exercises!

AT ALL COSTS, avoid direct AT ALL COSTS, avoid direct weight barring exercises!!!weight barring exercises!!!

Nutrition…mmm, mmm, good!Nutrition…mmm, mmm, good!Sally’s Food Diary(A week in review)

A.M. Noon P.M.

Monday(Grandchildren are over)

Coffee (2 sugar, 2 creamBagel w/ cream cheese (herb & garlic)Muffin (raisin bran)

Egg salad sandwich on white breadIced teaCombos© snack bag

Kraft© Dinner w/ wienersCookies (baked @ home) w/ 2% milk

Tuesday Tea (1 sugar, 2 milk) w/ toasted plain bagel (butter)

Missed lunch (snacked on salted crackers w/ cheese)

Wendy’s Spicy Chicken Sandwich© w/ fries w/ a frosty

Wednesday(Mucho Mike and

Grandchildren are over)

Cereal w/ milk (2%, Special K w/ berries©)Tea (1 sugar, 2 milk)

Tim Horton’s Soup and Bagel comboCoffee (2 sugar, 2 cream)Coffee to go

Delivered pizza x2Caesar salad w/ blue cheeseOne bottle of red wine

Thursday Cereal w/ milk (2%, Special K w/ berries©)Coffee (2 sugar, 2 cream)

Left over pizzaIced Tea

Sidekick’s© Fettuccini alfredoBoneless, skinless chicken breast

Friday(Mucho Mike & Alice go

out for dinner)

Oatmeal (peaches and cream)Coffee (2 sugar, 2 cream)

Skipped (but managed to put back about ½ dozen pickles and some cheezies)

2 Can Dine for $9.99 @ McDonalds© (afterwards) 1 bottle of red wine

Saturday(Mucho Mike and Alice out

for night on the town)

Missed (slept-in w/ Mucho Mike)

Fruit Bowl w/ cheez-it© snacks

Lasagna w/ ½ lb. of ground beef 8 vodka coolers at Scuttlebutts w/ Mucho Mike

Sunday(Mucho Mike and Alice spend a quiet evening

together)

Ate McGriddle© but threw-up b/c hung-over

took dogs out for a stroll through the country and ate only a sandwich (Bologna & cheese)

ate left over lasagna smoked a joint w/ Mucho Mikeheavy munch out session

The Canadian Food GuideThe Canadian Food Guide

Nutritional RecommendationsNutritional Recommendations Mini Fridge within your office spaceMini Fridge within your office space

Will allow you to bring pre-prepared meals for yourself for lunch timeWill allow you to bring pre-prepared meals for yourself for lunch time Could store nutritious fruits and vegetables for a few days for snack Could store nutritious fruits and vegetables for a few days for snack

time and they will keep freshtime and they will keep fresh Also, could allow for storage of water and other nutritious products Also, could allow for storage of water and other nutritious products

such as yogurt and/or cereal such as yogurt and/or cereal You should think of the health benefits associated with tea and You should think of the health benefits associated with tea and

how coffee and cream could affect your desired outcome of how coffee and cream could affect your desired outcome of weight lossweight loss

Tea, and more particularly green tea, prove to be very healthy and Tea, and more particularly green tea, prove to be very healthy and nutritious as they have been shown to aid in metabolism and assist nutritious as they have been shown to aid in metabolism and assist in cancer prevention by supplying one with anti-oxidantsin cancer prevention by supplying one with anti-oxidants

When cooking, prepare for 4 instead of 2 people and use left-When cooking, prepare for 4 instead of 2 people and use left-over food as a lunch for the next day (remember it would keep over food as a lunch for the next day (remember it would keep well in your mini-fridge!!!)well in your mini-fridge!!!)

Try and cut-back fast food consumption OR select a fast food Try and cut-back fast food consumption OR select a fast food place with a healthier choices menu; but be careful as some place with a healthier choices menu; but be careful as some things such as ranch dressing on a garden salad boost calories things such as ranch dressing on a garden salad boost calories through the roof!through the roof!

Overall, become more aware of your food choices and when you Overall, become more aware of your food choices and when you choose to eat; 5 smaller portions a day have been shown to choose to eat; 5 smaller portions a day have been shown to boost metabolic rates!boost metabolic rates!

Healthy, Active Living…Healthy, Active Living…

Ergonomics in the workplaceErgonomics in the workplace OrthodicsOrthodics Hormone replacement drug Hormone replacement drug

informationinformation Supportive web-sitesSupportive web-sites

Ergonomics Assessment Ergonomics Assessment Overall, the ergonomics in Alice’s workplace seemed to be greatOverall, the ergonomics in Alice’s workplace seemed to be great

She had an ergonomic chair which provides postural and lumbar She had an ergonomic chair which provides postural and lumbar support as well as arm-rest supportsupport as well as arm-rest support

Alice had a modified keyboard and mouse at her computer station to Alice had a modified keyboard and mouse at her computer station to aid with future problems of carpal-tunnel syndromeaid with future problems of carpal-tunnel syndrome

Only 50% of Alice’s work day was spent sitting at her desk; this Only 50% of Alice’s work day was spent sitting at her desk; this allowed her to move, stretch and keep the blood flowing to all areas allowed her to move, stretch and keep the blood flowing to all areas of her bodyof her body

This would allow time as well to complete assigned stretching This would allow time as well to complete assigned stretching and some of the assigned workouts as they were designed to and some of the assigned workouts as they were designed to be completed at work as wellbe completed at work as well

Therefore, as no intervention was deemed necessary, we will Therefore, as no intervention was deemed necessary, we will then express to Alice the importance of each one of these then express to Alice the importance of each one of these aforementioned observations and make sure that Alice is aware aforementioned observations and make sure that Alice is aware of their benefits and does what she can to include these of their benefits and does what she can to include these behaviours into her schedule everydaybehaviours into her schedule everyday

OrthodicsOrthodics Simply put, they are Simply put, they are custom foot supportscustom foot supports designed designed

specifically for your feetspecifically for your feet They are designed to fit your feet more efficiently than They are designed to fit your feet more efficiently than

over-the-counter arch supports and balance the over-the-counter arch supports and balance the biomechanical inadequacies of your feet and legs; by this biomechanical inadequacies of your feet and legs; by this we mean things such as posture, the arch of your foot and we mean things such as posture, the arch of your foot and how you walk, or your gaithow you walk, or your gait

Although some people adapt to foot Orthodics very Although some people adapt to foot Orthodics very quickly, you should gradually adjust to them by quickly, you should gradually adjust to them by wearing them a few hours more each day.wearing them a few hours more each day.

Will be most beneficial to you because it will ensure that Will be most beneficial to you because it will ensure that proper weight distribution on your feet is possible and this proper weight distribution on your feet is possible and this will assist greatly for your hip and knee issues will assist greatly for your hip and knee issues

Hormone Replacement Hormone Replacement

Your doctor should be consulted about this new lifestyle Your doctor should be consulted about this new lifestyle change prescriptionchange prescription

You should ask if there are any extra health risks you should You should ask if there are any extra health risks you should be aware ofbe aware of

Also, alternative methods of treatment should be inquired Also, alternative methods of treatment should be inquired upon to find out which best suits your lifestyleupon to find out which best suits your lifestyle

Alternatives include but are not limited to Alternatives include but are not limited to AcupunctureAcupuncture AromatherapyAromatherapy ExerciseExercise Food/dietFood/diet Herbal medicines (all natural)Herbal medicines (all natural) Etc…..Etc…..

Online Information…Online Information…

This is a website to Canada’s Physical Activity UnitThis is a website to Canada’s Physical Activity Unit Supplies information on how, why and what to do to keep active and Supplies information on how, why and what to do to keep active and

be healthybe healthy Allows to submit questions by email or read an FAQ sections on Allows to submit questions by email or read an FAQ sections on

questions that have detailed answersquestions that have detailed answers http://www.phac-aspc.gc.ca/pau-uap/paguide/older/why.htmlhttp://www.phac-aspc.gc.ca/pau-uap/paguide/older/why.html

This is a website to Canada’s Health NetworkThis is a website to Canada’s Health Network Here you will find information that has everything and anything to do Here you will find information that has everything and anything to do

with healthy, active livingwith healthy, active living You can sign-up online for ‘Health-link Newsletter’ which provides You can sign-up online for ‘Health-link Newsletter’ which provides

daily emails to you about healthy activities, events in your area or daily emails to you about healthy activities, events in your area or general information about healthy active livinggeneral information about healthy active living

Also has an FAQ sectionAlso has an FAQ section http://www.canadian-health-network.ca/servlet/ContentServer?cidhttp://www.canadian-health-network.ca/servlet/ContentServer?cid

=1041887104197&pagename=CHN-RCS%2FPage%2FGTPageTem=1041887104197&pagename=CHN-RCS%2FPage%2FGTPageTemplate&c=plate&c=Page&langPage&lang=En=En

The Slip-up PreventionThe Slip-up Prevention Preparation of goals for next-dayPreparation of goals for next-day

Prepare a nightly reflection journal Prepare a nightly reflection journal for next dayfor next day

Create a Slip-Up JournalCreate a Slip-Up Journal Include the time, the place and why Include the time, the place and why

you think it occurredyou think it occurred

***Remember******Remember***-stay focused, keep positive-stay focused, keep positive-“If it happens, it happens…”-“If it happens, it happens…”

ReferencesReferences

ACSM- American College of Sports Medicine. (1997). Exercise management ACSM- American College of Sports Medicine. (1997). Exercise management for persons with chronic diseases and/or disabilities. In S. Wikgren (Ed.), for persons with chronic diseases and/or disabilities. In S. Wikgren (Ed.), ()American College of Sports Medicine. ()American College of Sports Medicine.

Earle, Roger W. and Baechle, Thomas R. (2004). In Bahrke M. S. (Ed.), Earle, Roger W. and Baechle, Thomas R. (2004). In Bahrke M. S. (Ed.), Essentials of personal trainingEssentials of personal training. Hong Kong: NSCA. . Hong Kong: NSCA.

ExRx.net. (2006). ExRx.net. (2006). Exercise introduction and kinesiology.Exercise introduction and kinesiology. Retrieved November Retrieved November 17, 2006 from 17, 2006 from http://http://www.exrx.net/Exercise.htmlwww.exrx.net/Exercise.html

Public Health Agencies of Canada. (2003). Public Health Agencies of Canada. (2003). Physical activity unit.Physical activity unit. Retrieved Retrieved November 17, 2006 from November 17, 2006 from http://www.phac-aspc.gc.ca/pau-uap/paguide/older/why.htmlhttp://www.phac-aspc.gc.ca/pau-uap/paguide/older/why.html

Public Health Agency of Canada. (2005). Public Health Agency of Canada. (2005). Active living.Active living. Retrieved November Retrieved November 17, 2006 from 17, 2006 from http://www.canadian-health-network.ca/servlet/ContentServer?cidhttp://www.canadian-health-network.ca/servlet/ContentServer?cid=1041887104197&pagename=CHN-RCS%2FPage%2FGTPageTemplate=1041887104197&pagename=CHN-RCS%2FPage%2FGTPageTemplate&c=&c=Page&langPage&lang=En=En

Project Prepared and Project Prepared and Presented by:Presented by:

Jay TysoskiJay Tysoski Jay BradfordJay Bradford Erik CristensonErik Cristenson Chris CamarataChris Camarata Adam ClausAdam Claus Janna LevantoJanna Levanto