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Improving through moving
- 1. Exercise and Rheumatic Diseases improving through moving Jennifer Horonjeff, MS, PhD Candidate Ergonomic Consultant, Certified Pilates Instructor jhoronjeff@gmail.com Program of Ergonomics and Biomechanics Occupational & Industrial Orthopaedic Center New York University
- 2. Some Considerations What are your complaints about the disease? What are your excuses for not to exercising? Do you feel comfortable talking about exercise with your doctor?
- 3. A little bit of history….
- 5. Bone Responds to physical demand Bone mineral density improves with exercise
- 6. Cartilage Cyclical loading shown to have anti-inflammatory properties and may dampen cartilage destruction
- 7. Muscle Rheumatic diseases affect muscles too!
- 8. Motor Control • Reaction Time • Muscle activation strategies • Proprioception • Balance THE BODY CAN REWIRE!
- 9. People with inflammatory arthritis and fibromyalgia who exercise regularly, complain of less pain and fatigue! Pain and Fatigue
- 10. Inactivity Cycle Lack of Physical Activity •Deconditioning of muscles •Increase weight •Activities require greater effort •Increase chance for injury •Increase in pain
- 11. Physical Activity Recommendations Centers for Disease Control and Prevention and American College of Sports Medicine Accumulate at least 30 minutes of moderate intensity physical activity on most, if not all days of the week. 30 MIN DOES NOT NEED TO BE CONSECUTIVE!
- 12. Start slow Listen to your body Find range where you feel good without over-doing it and you’ll be more likely to stick with it! No one program is right for everyone Is it safe?
- 14. Types of Exercise Strength-conditioning Alone not able to bolster bone mineral density Dynamic high-intensity exercise Reduction of disease activity greater than usual care Non-weight bearing exercises Best when baseline radiologic damage exists Hydrotherapy Some people have experienced feeling better than did with land exercises
- 15. Enjoy it! MUST BE ENJOYABLE! Fitness programs with social or self-efficacy component had greater compliance
- 16. Goals During a flare: PRESERVE! When under control: Improve fitness and participation in activities
- 17. Stretching Aids in release of tightened muscle bands and provides pain relief Stretch to point of resistance and hold stretch •Allows Golgi tendon to signal muscle fibers to relax DO NOT stretch to point of increased pain—causes muscle fibers to contract and have opposite effect. NO BOUNCING!
- 18. Physical Benefits •Weight loss •Improve aerobic capacity •Improve cardiovascular health •Improve range-of-motion •Reduction in pain
- 19. Overall Benefits •Improve functional abilities •Improve quality of life •Improve sense of well-being •Improve quality of sleep •Increase energy •Reduce anxiety and depression •Stimulate endorphins
- 20. What is your excuse not to exercise?
- 21. “The design of work in relation to the capabilities of people” People Ergonomics
- 23. Ergonomics Injuries Musculoskeletal DisordersMusculoskeletal Disorders • Acute Trauma Disorders (ATD’s)Acute Trauma Disorders (ATD’s) • Injuries which occur instantaneously due to a known cause • Cumulative Trauma Disorders (CTD’s)Cumulative Trauma Disorders (CTD’s) • Injuries occurring over time due to repeated exposure to various risk factors
- 25. Copyright 2008 © United States Ergonomics Normal and Maximum Working Area Work Envelope and ReachWork Envelope and Reach
- 26. Keyboard & Mouse The Neutral Wrist Position = StraightThe Neutral Wrist Position = Straight AVOID WristAVOID Wrist bendingbending
- 27. Hand Stress vs. posture
- 28. Shoulder Posture vs.Shoulder Posture vs. StrengthStrength Shoulder Abduction
- 29. Line of sight August 7, 2013 • The viewing angle will determine the head/neck posture
- 30. Neck Posture Headset Preferred Not as Effective
- 32. Forces on the Spine Spine Stress Vs. Lifting Posture Poor Good
- 33. Pressure on spinal discs
- 36. Around the house
- 37. Be kind to your feet!
- 38. Footwear
- 39. So, get up… …and get moving!
Notes de l'éditeur
- This slide sums it all up. These are the risk factor categories. When you look at a job it is important to break it down into each risk factor category. Force- Weight of an object, torque level on a bolt. Repetition – Cycle time, number of screws, overall hours of exposure per day Vibration – Hand arm vibration from tools, whole body vibration from vehicles (forklifts) Contact stress- Physical contact between your body and an object, for example leaning your elbow on a table. Posture – The position and motion of your body during work Environment – Lighting, temperature, humidity, noise Personal – Some diseases will increase risks of CTD’s; certain medications, a persons overall fitness will affect their risk level. Often it is not possible to reduce a category of risk. For example you may not be able to reduce the repetition rate, however, you may be able to reduce the force involved in completing each repetition. There will always be risk factors on jobs. This does not mean that all jobs produce injury. It is a question of the magnitude and overall exposure to the risk that will determine injury potential.
- CTDs are the focus of ergonomics. The good news is that they don’t happen suddenly. There will often be some discomfort, signs or symptoms BEFORE a serious injury will occur. It is important to address discomfort early to avoid developing a serious issue. May affect: Muscles Tendons Ligaments Nerves Cartilage Spinal disks Note: In the office, the common areas at risk include the lower back and the upper extremities (hands/wrists, forearms/elbows, shoulder).
- Anthropometry is related to: body sizes range of movement muscle strength clearances reach/vision envelopes. It is a fundamental tool necessary in the design and layout of the workplace.
- Look at how your keyboard and mouse are used. Adjust position to minimize the hand/wrist stress.
- Briefly describe the effects of posture & strength DEMONSTRATION: Biofeedback on the wrists w/ associated explanations.
- Reductions in strength due to abduction. The arms weigh 13% of our total body weight. This is why reaching becomes stressful… It is not the weight of the test tube we are concerned with, it’s the 13 lbs of arm weight that you are lifting. Not a big deal if done several times daily. However, 100’s or 1000’s of repetitions may be an issue!