Exercise From Aerobics To Zumba Lyle Hawes, PT

Introduction Medical/Surgical Rotation Liver Medicine/Liver and Kidney Transplantation In-Patient setting

PT Responsibilities Evaluate Muscular-Skeletal system Functional mobility Establish a Plan of Care

PT Responsibilities Co-ordinate with: MDs, PA-C/APRN Nursing and PCAs Social Work, Case Managers, Dietitians Make discharge recommendations

Benefits of Exercise Decreased Blood Pressure Cholesterol

Stress, Depression, and Anxiety Benefits of Exercise Decreased Fatty Liver Stress, Depression, and Anxiety

Strength and Flexibility Benefits of Exercise Increased Fitness Level Muscle Mass Strength and Flexibility

Benefits of Exercise Increased Liver Oxygenation Concentration

Helps control blood sugar Helps control weight Benefits of Exercise Other Benefits Helps control blood sugar Helps control weight

Delays or reduces effects of arthritis Improved sleeping ability Benefits of Exercise Other Benefits Delays or reduces effects of arthritis Improved sleeping ability Leads to a longer and healthier life

Post Transplantation Findings Liver transplantation patients demonstrate similar performance to other transplanted organs Reason for liver transplantation does not effect Health Related Quality of Life (HRQoL), let’s just call it QOL

Post Transplantation Findings Physical fatigue can lead to a downward spiral of less activity and more fatigue Physical fatigue is the most distressing post-transplant symptom

Post Transplantation Findings First 6-12 months post transplant are most sedentary and fatiguing Greater incidence of obesity

Post Transplantation Findings Decreased cardiopulmonary fitness Decreased muscle strength

Post Transplantation Findings Second and third years show increased activity and QOL QOL improves, but remains less than general population Increased age significantly effects QOL in all populations

Post Transplantation Findings Liver transplant patients are living longer Returning to work or volunteering promotes a greater feeling of worth and improves QOL

Getting Started Talk to your MD and get cleared for exercise, ask for specific precautions, check medication effects Determine type, frequency, duration, and intensity of exercise

Getting Started Plan to progress your exercise program This can be modified as you move along Consider the season and daily weather

Getting Started Start slow Ask for Help

Getting Started Exercise with a partner or group Encouragers/Motivators/Competitors Add technology (e.g. Fitbit, GPS trackers, etc.) Fitness professional

Getting Started Add technology (e.g. Fitbit, GPS trackers, etc.) Fitness professional

Getting Started Listen to your body Sleep Diet Supplements (check with MD, Dietitian, and/or Pharmacist)

Getting Started Listen to your body Rest for pain or swelling, inform your MD Establish a routine; time of day, day of the week Dress comfortably with proper clothing and footwear

Getting Started Stay with it! One week, One month, Three months, and continue Feel and appreciate the difference in your body and your energy

Classic Exercise Program Warm Up Three to five minutes Active range of motion

Classic Exercise Program Warm Up Walk around Gentle stretches

Classic Exercise Program Strength Training Every other day Upper extremities, lower extremities, core/trunk

Classic Exercise Program Weights, Machines, Bands, or Tubes Start with low weight and repetitions; 8-12 repetitions, two to three sets Gradually increase the weight/resistance

Classic Exercise Program Benefits Preserve bone mass Increased strength (and muscle mass), increased metabolic rate over a longer period of time.

Classic Exercise Program Aerobic Exercises Lower resistance Increased repetition, time, and intensity Many different choices Three to five times per week

Classic Exercise Program Aerobic Exercises Benefits Preserve bone mass Increased cardiopulmonary performance Decreased Blood pressure, cholesterol, blood glucose, stress, depression, and anxiety

Classic Exercise Program Aerobic Exercises Decreased Blood pressure, cholesterol, blood glucose, stress, depression, and anxiety

Classic Exercise Program Cool Down Three to five minutes Walk, active range of motion, stretch (muscles are looser and warmer)

Classic Exercise Program Cool Down For stretching, no bouncing motions, slow and hold positions Allows a gentle transition to baseline, decreased risk for dizziness or blood pressure drop

Classic Exercise Program Intensity Your body will warm up as you exercise Heart should beat faster

Classic Exercise Program Intensity It should be harder than everyday function, but you should still be able to carry on a conversation Sweating is good!

How Do you Start? Find something that fits into your schedule Find something that you will enjoy, and do Find things that fit the above criteria and… get started!

1 MET ≡ 1 kcal/kg/h ≡ 4.184 kJ/kg/h The Metabolic Equivalent of Task (MET), is the rate of energy consumption 1 MET ≡ 1 kcal/kg/h ≡ 4.184 kJ/kg/h MET values of activities range from 0.9 (sleeping) to 23 (running at 22.5 km/h; a 4:17 pace mile).

MET For example an activity with a MET value of 2 (walking at 3 km/h) would require twice the energy that an average person consumes at rest

Example Activities Nooky/sex 2-6 Orienteering 9 Paddle Ball 6 Aerobic Step 8.5 Bicycling, general 5.5-10.5 Cross Fit Training 8 Dancing, general 3-4.5 Excavating/shoveling 5 Fishing 2-6 Golf, cart/walk 3.5-4.5 Hiking 6 Inactivity, Sleep/Stand 0.9-1.2 Jogging 7-10 Kickball 7 Lacrosse Music Drums 4 Nooky/sex 2-6 Orienteering 9 Paddle Ball 6 Quilting/sewing machine 2.8 Rope Jumping 8-12 Ski, CC/Swim 7-14/7-10 Tai Chi 4 Using Crutches 5 Volley Ball 3-8 Walking 3-6 Xylophone 3 Yoga 3.2 Zumba 8.8

Thanks