Sunday, July 7, 2013

State Intervention in Childhood Obesity

In October 2011, a morbidly obese 8-year old boy was taken from his home and placed into foster care.   The young boy tipped the scales at over 200 pounds.  According to court documents, the mother lost custody of her son because she failed to maintain a healthy living environment.  Based on height and weight standards, an 8-year old should weigh approximately 60 pounds.

How fat is too fat?   At what point is obesity considered an imminent health risk?  Should obesity be considered neglect?  Should the government step in to assist young children who are at grave risk for major health issues such as heart disease, diabetes, and emotional stress?  Have American politicians and the judicial system taken the 'nanny-state' concept too far? 

The American Medical Association classified obesity as a disease last month (June 2013).  Based on the AMA recognition of obesity as a disease, rather than a lifestyle choice, are we likely to witness an increase in the removal of obese children from the care of their own parents?   What are the emotional repercussions on the children as well as the parents?   Is the state over-reacting to the obesity epidemic?  Or, is it about time that the courts stepped in to protect our most precious resources - the children.  You make the call!!!  

Obesity in America

Researchers at the Centers for Disease Control (CDC) report that 35.7% of Americans are obese. Fast food restaurants, processed foods, sedentary lifestyles, and a reliance on quick-fix remedies are some of the main contributors to America's war on obesity.  Thus, it should come as no surprise that over one-third of Americans are losing the 'battle of bulge'. 

In an age of information at the click of a button, the perils of obesity should be obvious to all Americans regardless of educational background.  Television shows, news reports, and pop culture magazines all warn of the health risks associated with obesity.  Heart disease, stroke, diabetes, and mobility issues are primary risk factors associated with Body Mass Index (BMI) numbers exceeding 30.  

Is obesity a lifestyle choice?  Can a person combat fat by exercising more and making better nutritional choices?  According to the American Medical Association (AMA) the answers may not be that simple. In June 2013, the AMA officially recognized obesity as a disease.   

Classifying obesity as a disease will ultimately affect medical research, public policy, health care, and insurance rates. Will the new disease designation aid in the fight to get Americans fit and healthy?  It's too early to tell, but we must be proactive in this war on obesity.  

Take a stand --- let us know what you think about classifying obesity as a disease!    


Wednesday, July 3, 2013

Garrett’s Fight – Success in the MMA Ring

As a future Physician Assistant (PA), I found ESPN’s story on 23-year old Garrett Holeve to be awe-inspiring. Despite the fact that he has Down Syndrome, Garret has used mixed martial arts (MMA) to find himself and become a champion MMA fighter; he is the epitome of what someone can do if only given a chance.
 
At first glance, Garrett is viewed as a kid with Down Syndrome – an outcast…not normal. Like so many others with intellectual and physical disabilities, labels are easily placed upon those who are different.  When asked ‘What do you think the world sees when they look at your son?’ Garrett’s father replied, ‘Unfortunately, I think they just see a kid with Down Syndrome.’  What an amazing world it would be if we could all look past what is visible on the outside and see the inner qualities that each person possesses.
 
Sports such as MMA can offer immeasurable physical, cognitive, and affective benefits for individuals with disabilities. While training for success in the MMA ring, Garrett lost 40lbs and in his own words has become a “rock-solid muscle guy”. Although he has a delayed reaction time, significant modifications to his training regimen are minimal thereby allowing Garrett to participate in competitions just like everyone else.
 
Garrett’s story filled me with mixed emotions and left me believing that anything is possible. My take-away from Garrett’s story is to see the good in people and to never put limits on someone with a disability.

CrossFit: A Model for the Next Generation

As a future professional in the Personal Training / Fitness Management industry, the CrossFit video shown below is by far one of the most inspiring and motivating videos I have watched in a while. The power of CrossFit is undeniable as it relates to fitness, health, and a community of support. 
 
Even though Kate wasn’t completely involved in the CrossFit Games due to her cancer, she never once doubted herself, got down, or gave up on loving the sport and what it stood for. With the help of huge-hearted people like Camille LeBlanc and others in the sport, Kate was left with a love of persistence and gratitude towards the sport. For someone like Camille to take time away from her busy CrossFit schedule and spend time with Kate, as a mentor and as a friend, was above and beyond inspirational.
 
The video showcased Kate’s passion and involvement in CrossFit and highlighted her ability to perform pull-ups and push-ups with the aid of a spotter. The beauty of CrossFit is that it can be modified for all individuals regardless of fitness or ability level --- all you need is someone in your corner for moral support. 
 
This CrossFit video reminds us how important it truly is to include EVERYONE in every sport. That doesn’t necessarily mean that they have to participate in each physical activity. But just look at Kate, she knew her cancer was holding her back. She knew she had to prepare for her life saving transplant. But through it all, with the help of her loving parents, Camille, and CrossFitters around the world, she was able to continue watching, supporting and loving the sport. With all of the CrossFit athletes keeping in touch with Kate and allowing her to be a sort of motivational spokesperson and ‘strength idol’, she was able to gain a sense of morale that kept her pushing and striving to get better and stronger each day so that she could hopefully participate in the games and help others one day. The CrossFit world also became stronger by witnessing Kate’s her love and motivating the athletes.   
 
In the video, Kate’s mom, Barb actually said something quite amazing, “I like to think that God is not done with her yet.” and that  is something that I highly believe in. We should never give up on dreams based on disabilities. There is always something greater out there for us!. This is a philosophy that I want to establish with my future clients --- my career will be about motivating people to push forward, better themselves and take it one step further toward a new and greater goal!   We are creating a new model of personal trainers for the next generation!
 
 

Adaptive Sports

As a future coach, my goal is to help others become better people and live a better life. The Adaptive Physical Education class, and the inspirational videos that we have viewed, have opened my eyes and heart to things I had never considered.  I guess I was always naïve about working with kids who have disabilities. In fact, I cannot remember seeing or participating with disabled athletes in my physical education classes or athletics. However, after watching the videos produced by the Sports Association of Gaylord Hospital (Adaptive Sports), I would say I am inspired to help others achieve their sport and fitness goals. 


The take-away from the previous video was a cognitive and emotional response that allowed me to see the benefits that these individuals achieved through exercise and sports. As a coach, I want to provide an opportunity for all my athletes to enhance their quality of life so that they can live a better life. Whether that includes aiding others through buddy system activities such as snow skiing, water skiing, tennis, and the para-triathlon, I want to take what I have learned throughout my education in Kinesiology and help others.  Using ideas such as the recumbent bike for individuals with cerebral palsy or spinal cord injury and adapting strategies, I have learned that it is important to fully include all individuals (with or without disabilities) in sports and fitness activities because movement is a natural part of life. I firmly believe everyone deserves a chance to live life to its fullest! 

Surf’s Up: Paraplegics Ride the Waves

Life Rolls On Foundation's program called "They Will Surf Again" is an adaptive surf program where people with disabilities, mostly with spinal cord injury, get the chance to surf! The surf boards have modified hand grips that allow the participants to hold on and pull themselves up from the water. Established in 2002, the Life Rolls On Foundation began as an idea to raise money for spinal cord research and awareness. Jesse, the creator of the Foundation, hopes to find a cure for paralysis - I don't want to sit and wait around for it but to go out there and try to enjoy life by still doing the activities you love.  The mission of Life Rolls On is to provide those with spinal cord injuries unfound joy and freedom from the constrictions of a wheelchair.
 
 
As a future professional in the Acupuncture Industry, the Life Rolls On video inspires me to make a difference in the lives of those living with physical disabilities  Limited scientific research has been conducted in the study of how non-traditional medicine, with the help of therapy, can make a positive difference in someone's life. Yet the benefits of acupuncture have been touted for centuries – improved circulatory function, enhanced pain management, and improved daily physical performance and function.  The positive attitudes that people project towards their physical condition touches my heart; no matter what life has thrown at them they still find joy and the need to help others.

I believe it is important to include everyone in physical activities and sports. No one should ever have to sit on the sideline and be told that they can’t fully participate. Adapting activities, as shown in the video, taught me that the impossible is possible. I hope one day I can be a part of making a difference in someone's life and change the stereotypes that society holds towards people with disabilities. Anything is possible if your heart and soul are behind the words you speak – I’m all in!!!

Motocross: Adapting the Sport for Paraplegics

Shane Shipley’s disabilities have not prevented him from living his dream of racing in the X Games.  Paralyzed from the waist down, Shane competes in the physically demanding sport of Motocross without the aid of major adaptations to his bike.  A cage-like structure was added to the bike to secure and protect his legs due to the fact that he can no longer use his legs to go around the turns like the other riders. 
 
Practicing for Motocross competitions gives Shane an emotional release as well as a physical break from his time in a wheelchair.  Competing against the other athletes seems to have restored Shane’s confidence that he can do anything.  Watching Shane reminds me that anything is possible for those that have the drive to succeed.  With the right modifications and support from friends and family, paraplegics can accomplish any goal.  As a future coach, I will be patient with my athletes as they strive to accomplish their goals on the field and in life.

Adaptive Winter X Games


The Winter X Games are extending its fitness and wellness opportunities to individuals with physical disabilities. According to Mike Schultz, creator of the Moto knee, “It’s kind of unlimited.” Mike, also known as Moto Mike, created the Moto knee as an adaptive prosthetic made for hardcore, impact sports. It allows for adaptive sliding, bending, and jumping. With MonoSkis and other adaptive gear, athletes like Josh Duek (2011 Mono X Gold Medalist), Andrew Kurka (Alaskan Sit-Skier), Evan Strong (Boarder X), and Moto Mike, can compete in sports that they might not have otherwise had the opportunity to compete in.

As a future Physical Therapist, I was truly inspired to see the determination these athletes possess which allows them to accomplish these amazing athletic feats. I can only imagine what they go through to train for the intense competition of the Winter X Games. Josh Duek solidifies their capabilities by saying, “You just go 100%, all the way.” Adaptations to the equipment and to the prosthetics used, along with their positive attitudes, allow these athletes to give their ‘all’ on the mountain slopes.
It is important to include individuals with disabilities in the Winter X Games because they are fully capable beings. The ultimate take-away is that the disabled must be allowed the right to compete, to fall, to fail, to suffer, to cry, to curse, and to despair – to protect them from these experiences is to keep them from life. When athletes (disabled or not) engage in competition such as the Winter X Games, they show others that you can accomplish anything that you put your mind to!

Tai Chi: Ideal Exercise for the Elderly

          Tai Chi is a mind-body exercise that originated in China, as a form of martial arts. It is a great exercise for the elderly population with a variety of disabilities because it can be modified to suit the needs of individuals. Tai Chi is appropriate for this population because of the gentle nature of the exercise. It is not about pushing through the pain, but rather, enjoying the workout.
Tai Chi has been touted as a mind-body exercise which has many benefits in the affective domain, especially when practiced in a group setting. The social aspect that comes from the group exercise is what many elderly people need in an exercise regimen. In an interview, a client in Tarleton State University’s Laboratory for Wellness and Motor Behavior gave a powerful testimony related to his journey from recovery of a stroke. His described this affective phenomenon of the benefits that occurs from the social aspect that comes when exercising in a group environment, and the importance of having a support network.
The client also explained the perceived and personal psychomotor benefits that occur from a normal exercise routine that involves cycling and range of motion exercises. These benefits include many aspects of physical health, but for the client it also meant defying the odds and gaining the ability to walk again. Tai Chi can provide similar psychomotor benefits that client received, but in real-world setting.
While Tai Chi is not as well-known as other forms of exercise in the United States, many people have misconceptions of the practice or feel like it cannot be beneficial because it is relaxing and slow paced. For many elderly people, slow paced exercise is just what they need. Despite the misconceptions, there are many different resources available on the internet and in books for learning Tai Chi as well as research about the benefits of Tai Chi with elderly.
Tai Chi instructor, Mark Johnson, has made some Tai Chi exercise videos. One of his videos,“Tai Chi for Seniors” is designed for the elderly population . This video includes several different slow, easy movements to get started practicing Tai Chi. One movement Johnson calls “picking fruit” is a great example of an activity for the elderly. It involves them reaching with one hand to the sky, and while bringing the other hand at elbow length. This motion can apply to the activities of daily living that many seniors need to work on to make daily task of reaching to a higher shelf, or getting dressed easier. The exercise involves shifting the weight from one leg to the next, and encourages the elderly to concentrate on their activity which can liberate their mind from focusing on stress.
While any age group and fitness level can practice Tai Chi, it is very appropriate for the disabled and elderly population. Tai Chi should be implemented in retirement homes, nursing homes, and rehabilitation centers. With the right modification to stimulate improvement, the elderly can use Tai Chi as an exercise routine. Tai Chi is very practical because it does not require any type of equipment. The possibilities of modifying Tai Chi activities to meet individuals’ needs are endless.
Sample Video of "Tai Chi for Seniors"


Tai Chi and the Elderly


Tai Chi & the Elderly

Tai Chi is a form of martial arts which originates from China. Tai Chi is different from most martial arts due to the slow speed and non-combative nature. Tai Chi is a slow moving, non-impacting series of flowing movements which make it an excellent exercise for elderly people. Tai Chi primarily requires the participants to focus on breathing techniques and perform moves in a meditative, peaceful state.
Increasing popular in the Western culture, the perceived benefits of performing Tai Chi make it a great alternative exercise for elderly people who might be limited in their physical movements. Special equipment and/or facilities are not required for this activity; Tai Chi can be practiced at home or in a park in an individual or in a group setting.
A holistic form of exercise, Tai Chi is a series of flowing moves which are performed gracefully and smoothly, linking the body, mind and soul. These moves are performed in a relaxed and calm manner with deep breathing and mental attention being the primary focus. The physical benefits include increased flexibility, improved leg strength, greater balance and improvements in range of motion. Tai Chi helps greatly with balance, which is very relevant for elderly people who have a real concern of falling. The affective benefits or social benefits of Tai Chi include an improvement in self-esteem and self-efficacy. Overall mood can be improved as well as decreasing anxiety and lowering stress levels.
This is particularly relevant for elderly people who may have health concerns and are looking for a higher quality of life.  Approach Tai Chi with an open mind and who knows where it might lead you!

 

Yoga Is For Everyone

Yoga is a universal activity that is applicable to a diverse population because of its adaptability to all ages and fitness abilities. For individuals with Cerebral Palsy, Yoga has become a commonly recommended activity due to the holistic benefits that are obtained.
Breathing exercises are a typical warm-up before actual yoga stretches and poses are executed. Breathing exercises such as the cleansing breath, the bellows breath, and the alternate nostril breathing exercise all are good exercises to help individuals with Cererbal Palsy deliver much needed oxygen throughout the body in order to help develop concentration as well as relaxation. These exercises also help strengthen the diaphragm which contributes to overall health.
Yoga may also enhance the development of feelings of self-worth. Specifically, Yoga poses and the related meditation releases endorphins throughout the body and relieves any stress that the individual may be facing at the current time. Poses such as the Downward Dog and the Cat stretch are both great poses that contribute to these beneficial effects.
Individuals with Cerebral Palsy may also experience increased muscular strength, develop better flexibility, and improve their posture through regular participation in Yoga activities. Often times people with this disorder suffer from stiff joints and obscured posture. Poses such as the Adho Mukha Svanasana actually lengthen the spine and hamstrings, as well as stretches and tones the arms resulting in less fatigue and greatly improved posture.
Yoga is an activity that helps all individuals in a variety of ways. It gives individuals with Cerebral Palsy a chance to go out and do an activity together with friends or family members which makes it a fun and enjoyable activity. Yoga is also a universal activity that gives people with Cerebral Palsy a chance to enjoy a simple activity without any pressure to perform. The atmosphere during Yoga sessions is very relaxing and provides all kinds of wonderful benefits to individuals with Cerebral Palsy. In order for a person with Cerebral Palsy to develop properly he or she must have both a healthy mind and body. Yoga just so happens to be an activity that targets both of these aspects with customized adaptive movements for each individual’s needs.

Center on Health, Physical Activity, and Disability.(n.d.). NCHPAD: Adapted Yoga for Children and Youth with Cerebral Palsy. NCHPAD: NCPAD Home. Retrieved June 19, 2013, from http://www.ncpad.org/297/1851/Adapted~

Yoga & Cerebral Palsy

Many individuals diagnosed with Cerebral Palsy can gain health benefits from participating in Yoga-based exercise. Cerebral Palsy is a condition that affects people both mentally and physically. Often the condition is diagnosed in young children while development is still prevalent. People with Cerebral Palsy are usually either born with the condition due to a traumatic occurrence during the prenatal period or they contract it from a brain injury within the first two years of life.

Yoga stems from a system of spiritual beliefs and practices derived from India. The word yoga stems from two root words; yug (to join), or yoke (to bind together, concentrate). Western cultures such as America are most familiar with Hatha Yoga which prepares the body for stillness (meditation) through breathing and physical exercise. Physical strength, stamina, and peace of mind are physical benefits that stem from Hatha Yoga through the use of pranayama (breath work), asanas (physical postures), of dhyana (meditation).

Yoga poses and breathing exercises are easily incorporated into fitness programs designed specifically for individuals with CP. For those that commit to practicing Yoga, the benefits are tremendous. Cognitive benefits include focus, calming of the mind, adaptation strategy, and learning new poses. Improved social interaction, confidence, releases endorphins, and stress relief are all benefits that impact the Affective domain.  The most commonly achieved physical benefits are increased muscular strength, muscular endurance, better posture, and strengthened immune system.

Although there are profession organizations that offer Yoga instruction certifications, there are not certifications for teaching Yoga to people with CP. With a little creativity and adaption, poses can be modified to meet the client at their ability, and allow everyone to participate. Yoga is an activity that can be modified to meet the specific needs of the client making success imminent for all who are willing to participate.

Paralysis and Xbox Kinect: Building a Foundation

I’m amazed every year when I go snow skiing in Colorado and I ski up to (or sometimes get passed by) a skier with a physical disability.  I think to myself, “How in the world is that dude still upright?”  I know it would be extremely difficult for me to ski on a seated mono-ski, and I assume it was at one time a similar experience for that person.  But to watch as someone with paralysis or limited mobility charge down a mountain like it’s second nature is beyond amazing. 
 
I recently researched adaptive downhill skiing and it really grabbed my attention.  Skiing is something I love to do. I realize how awesome it is to know that my brother, a C-4, C-5 Quadriplegic whom I’ve never seen walk before, could have the freedom to ski down a mountain just like anyone else!  And so I began to wonder how someone that has skied with a disability in a sit-ski feels emotionally and physically while skiing.  I wanted to try and find a workout that my brother, who only has movement of his shoulders, neck and head, could participate in from his own home.  Using a Xbox Kinect gaming system as a starting point. 
 
We decided to find a new way to play the Kinect Adventures game, not to make it easier, but to allow someone with any type of paralysis or cerebral palsy to use the game as a workout tool.  We took a rolling chair with a BOSU Balance Ball, core disc, Kinect Adventures video game and challenge our classmates who are able-bodied to play some of the games that didn’t require use of the lower body. 
 
I interviewed my brother to determine the type of rehab that he performs on a daily.  His main workouts included range of motion and balance activities.  After his injury the doctors and therapists had to make sure that he could sit in a wheelchair for long periods of time on his own.  This requires some serious core strength and it all relates back to our original amazement in Adaptive Skiing. 
 
The Kinect Adventures video game that was originally intended to entertain kids and families can also be used to help develop excellent core strength and range of motion in paralysis patients.  When I pitched the idea to my brother to see if he thought it would even work for our intentions, he became curious to know the outcome of our research.  Our goal is to find out if the Xbox Kinect can help provide better motor planning, strategy and focus as well as improve the overall posture, balance, and range of motion in participants with disabilities.   This workout could be beneficial to anyone that is confined to a wheelchair no matter what the disability may be.
 
This research has motivated me to find out what can be done using this kid’s game to link a family together in a way that has not been done in over 20 years.  WHEN this works, I will be able to, for the first time in my life play video games with my brother just like any other family.
 
 

Adapted Snow Skiing

The world we live in today is afraid to take the time to stop and find ways to help people with disabilities. I believe it is because, we as a society are afraid of affecting them even more. But we affect them by not including them at all. We see someone with a disability and shy away from them because the experiences and lifestyle they have or have been through. Over the past 3 weeks I have been able to be around a fellow classmate with Cerebral Palsy (CP) who is 30 years of age. Through this experience I have learned so much in what he goes through.  I have researched and read articles on people with CP getting to snow ski, as well as interviewing my classmate with CP about snow skiing.
The information that I found online about people with CP being able to snow ski was astounding. My classmate also gave me great information on how snow skiing for people with CP plays a major role in their life. It gives them the opportunity to get away from their everyday life of having a disability. For the longest time I thought it would be impossible for someone with CP to snow ski.  One might ask how someone with CP can prepare physically or be mentally ready to take on a challenge of snow skiing. When interviewing my classmate and doing some research, I came up with a few ideas to get them physically prepared for the slopes.
The fitness activity requires the following equipment:   CorDisc (24” diameter disc offers versatility by maximizing total body balance training for beginner as well as advanced users), Stool, and 2 Wiffle ball bats.  Place the CorDisc on top of the stool and having the individual sit on the CorDisc without letting their feet touch the ground. While the individual is sitting on the CorDisc and stool, hand them the two Wiffle ball bats to use as outriggers, which are used in downhill skiing to help with balance. The object of the activity is to simulate being on the slopes and working on balance, as well as strengthening the core and shoulder muscles.        
 
The benefits of this fitness activity include confidence, strength, piece of mind, and excitement to one day be able to snow ski. In adapted snow skiing there are two types of skis, the mono-ski and the bi-ski. Both of these skis have a seat that has a protective cover over the legs to protect the skier’s legs. The skier holds an outrigger in each hand as an aid for balance. My classmate with CP was thrilled to see this fitness activity in action and to see how well it would simulate snow skiing in a mono or bi-ski. His thoughts were that the activity best simulated someone being able on a mono-ski without being on the slopes. He also mentioned the physical benefits of this activity would play a major role in getting the patients prepared to mono- or bi-ski.
 
After the 3 weeks of this study, I have learned that people with disabilities do not have to be put aside when performing action sports. The wealth of research online celebrates the success stories of people with disabilities being able to participate in action sports with a little adaption. We as a society need to find ways include people with disabilities in the joys we have in action sports.
Check out the competitive adapted mono-ski X-games: