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Stroke Recovery – Functional Training for Stoke Rehabilitation

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Recovery

A Stroke is a Game Changer

Recovery from a stroke can feel daunting. Retraining the brain to complete actions that it used to take for granted means intense rehabilitation in hospital, with a therapist, and at home. While strokes are game changers, they don’t have to be a life sentence. The brain is adaptive and resilient, and with a focused stroke recovery plan, there is hope.

It’s a Marathon, Not a Sprint

Stroke rehab with a physical therapist is a well-supervised process, but rehab doesn’t end at discharge. Empowered independent rehab at home is a must to continue to improve mobility, strength and endurance to enhance the ability to perform activities of daily living (ADL).

High level goals of a post-stroke rehab program include improving functional ability, range of motion, balance, strength and cardiovascular endurance. Independent rehab training should be vetted and monitored by your medical team to ensure it is safe and effective given the effects of the stroke. That said, there is so much a stroke survivor can do at home to help their own recovery.

Set Realistic Goals and Set Yourself Up for Success

After setting stroke treatment goals with the health care team, some good options for post-stroke equipment include:

  • A rubber ball
  • Exercise bands or tubing
  • A set of ankle weights or light hand weights
  • A balance board
  • Portable exercise cycle

Below are some ways to incorporate this equipment and common household items into your stroke recovery program.

Functional Ability: Repetition and Coordination

Similar to learning a musical instrument or learning to drive, practice and repetition strengthens the muscle-mind connection after a stroke. Repeated use and practice will help regain functional ability in the affected side.

Some examples for upper body include:

  • Rolling a ball back and forth on a table with the affected arm
  • Gripping a door or drawer handle and opening it repeatedly
  • Squeezing a tube of toothpaste with the affected hand while holding your toothbrush with the unaffected hand
  • Turning on and off a light switch with the affected hand

Be aware of avoidance patterns! In other words, don’t stop using the affected side – practice to improve.

Range of Motion (ROM)

Prior to incorporating resistance training into the stroke rehab program, active range of motion exercises will improve joint flexibility, strengthening and increased muscular endurance.

Examples of lower body ROM include:

  • Heel slides laying on your back or sitting in a chair
  • Wrist and ankle circles
  • Toe raises using a chair with or without weight
  • Assisted or passive stretching of warm muscles and joints

Balance

Balance training is paramount to a post-stroke rehab program to improve unassisted mobility and reduce the risk of falls.

Balance training may include:

  • Supporting oneself against or near a counter, wall or walker for stability and lifting one foot off the ground and holding for 20 seconds.
  • For more advanced stroke recovery, try standing with two feet on a balance board in between a doorframe, bracing the doorframe for stability. Keep the board level, balanced and still; remove one hand; and then the other.

Strength: Resistance Training

Preventing secondary weakness due to inactivity is important in any rehab program, particularly post-stroke. Adding in resistance training 3-5 days a week will improve strength, reduce atrophy and promote recovery.

Resistance training can be incorporated at home using resistance bands or tubing, light hand or ankle weights, or by simply performing body weight exercises like squats, hip bridges or wall push-ups.

Fine motor skills can benefit from grip strength training. Try squeezing a rubber or stress ball with your affected hand for 15 reps a few times a day.

At the gym, weight machines or pulleys that isolate specific muscles are good options for strengthening and conditioning.

To begin the rehab resistance training program, choose a weight or resistance that allows for 6 to 15 repetitions with good form and will challenge the muscle without overtaxing the recovering muscular and nervous system.

Start with one set, eventually working up to three sets with a 15 – 60 second rest period between sets. During the rest period, it’s important to listen to the body and check in. While challenging recovering muscles is important, resting when needed is more important to avoid injury or overuse.

Cardiovascular Endurance

While functional training to improve ADLs is primary to recovery, preventing recurrent strokes through improved cardiovascular function is also important to long-term health and quality of life.

When coordination and function have improved enough to explore cardiovascular training, some options include:

  • Walking (assisted or unassisted) on solid ground
  • Supervised swimming (possibly with floatation support)
  • Indoor cycling with a portable exercise cycle (it rests on the floor or tabletop to allow for pedalling with either legs or arms while sitting safely in a chair) or on a recumbent bike.

Set small, realistic cardiovascular goals. For example, walking with or without a walker to the end of the driveway and back or doing 5 minutes on the portable exercise cycle, adding more time as you continue to improve.

No One Size Fits All Program for Stroke Recovery

Ultimately there is no one size fits all rehab protocol for stroke recovery as the variables are individual, but please consider that some movement, exercise or training is better than none at all.

While post-stroke rehab may be tiring or frustrating at times for the stroke survivor, by taking action every day in the journey to recovery, improved health, fitness and functional ability is within reach.

 

 

The Importance of Core Strength

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Core

When most people think about core strength, they picture six-pack abs and millions of sit-ups. But the core is made up of more than just abs, and core strength is about more than having a toned stomach or looking good. The core is exactly that—it’s the core of your body. And building those muscles will benefit you for the rest of your life, no six-pack required.

Your core is made up of more than just the abdominal muscles, the muscles in your stomach referred to as abs. The core also includes your obliques (the muscles in your sides), pelvic floor muscles, glutes and all the muscles in your back.

The muscles that make up the core play a central role in everything you do. Every movement you make stems from your core, since every muscle in your body is connected to the ones in the core. From everyday tasks like tying your shoes and cleaning to heavy lifting and athletic activities, you use the muscles in your core.

A strong core is also vital to balance and stability. Every time you walk on uneven ground or stand in one place, you use your core muscles to keep you there. The stronger those muscles are, the less likely you are to fall over.

Strong core muscles will also help improve your posture. If your core is weak, you’re more likely to slouch over, since it’s harder to keep yourself upright. That good posture is better for your spine, prevents and alleviates lower back pain, and allows you to breathe easier.

And, at the end of the day, a strong core will help you look slimmer, as well. Even if you never get six-pack abs, a strong core will help you stand taller and straighter, making you look instantly slimmer. The inner muscles of the core help tighten your stomach and give you a smaller waistline.

So now that you know why strengthening your core is so important, it’s time to learn how. While sit-ups are a great exercise for building abdominal strength, they don’t effectively work every muscle in your core. The good news about core exercises is that you don’t need fancy equipment, or even a gym, to do them. You can build a strong middle just using your own body weight. Try the exercises below to get started.

V-ups

This modified sit up works your entire from. Lie face down with your arms and legs outstretched. Keeping your legs and arms straight, lift your body into a v-shape, reaching your fingers as close to your toes as you can.

Russian Twists

Sit up with your knees bent and your feet flat on the floor in front of you. Lean back at a 45-degree angle, keeping your back straight. Using your muscles, slowly twist to each side as far as you can. For an added challenge, hold a weight in your hands as you twist.

Superman

Lie flat on your stomach with your arms and legs outstretched, palms toward the ground and toes pointed. Simultaneously lift your arms, legs and chest off the floor, then slowly return to the ground. Look at a spot on the floor in front of you so you don’t strain your neck.

Plank

On the floor, place your hands on the ground under your shoulders as if you’re going to do push ups. Pull your stomach in and engage your muscles, keeping your whole body in a straight line. Hold as long as possible.

What Is The Best Workout For Women Over 40?

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Women Workout

As the years pass by, you might begin to wonder what this means for your workout program. What are the best workouts for those in their 40’s and beyond? How should your workout change compared to that of someone half your age?

There’s no question that you do need to adapt your workout over time due to the changing needs of your body, but contrary to what many women might believe, it doesn’t need to change that much.

The Best Workout For Women Over 40

Hands down, the single best workout option for women in their 40’s is going to be a good resistance training program. It’s incredibly important for women at this age to start with a strength training workout if they have not yet already because at this age, you are at a higher risk of losing lean muscle mass. It’s the old principle ‘use it or lose it.’ If you aren’t putting sufficient stress on your muscles as the weeks pass by, slowly you’ll grow weaker, which can make everyday activities harder to perform.

Likewise, your lean muscle mass is the most metabolically active tissue in the body, so the more muscle you lose, the slower your resting metabolic rate will become, which can contribute to weight gain.

One of the biggest reasons why women start to gain weight into their 40’s and 50’s is because they are losing the lean muscle that helped keep their daily calorie burn higher. If you aren’t adjusting your food intake to account for this loss of muscle mass, it will result in weight gain.

Additionally, if you are in your 40’s and really looking to transform your body, weight lifting is the way to do it. While cardio training may help you burn fat, weight lifting will help you reshape your physique, adding curves and muscle in all the right places.

Finally, weight lifting is a great choice if you want to combat stress. Between a demanding career and family obligations, life can get stressful. A good weight lifting session will release a nice dose of endorphins, helping calm your body and combat that stress.

Getting Started With Resistance Training

So how can you get started? First, you’ll want to select the best exercises to make the most of your time in the gym. Chances are, you’re busy and don’t have hours to train, so you’ll want to get the most ‘bang for your buck.’

Compound exercises will work multiple muscle groups at once, help you gain functional strength, and burn the most calories per session. They should be your focus. These include moves such as bench pressing or push-ups, bent over rows, shoulder presses, squats, lunges, deadlifts and pull-ups (or pull-downs).

Focus on these first and foremost, then you can add other exercises such as bicep curls, tricep extensions, lateral raises, leg extensions, and hamstring curls if you’d like.

You should focus on lifting a heavy enough weight that you are fully fatigued by the time you finish around 8-10 reps without losing proper form. This will give you both the strength-training stimulus to help generate more lean muscle mass while keeping your metabolic rate and calorie burn higher.

Finally, rest for around 30-60 seconds between sets. You don’t want to rest too long or you’ll lose some of the metabolic boosting effects this workout provides. At the same time, don’t rest so little that you can’t challenge yourself with a heavy weight.

To help give you an idea how to implement this, let’s examine at what a full body workout for those over 40 would look like. Always begin with a brief five to ten minute warm-up and finish up with some light stretching at the end.

Full Body Workout For Women Over 40:

  • Squats – 3 sets of 8 reps
  • Bench Press – 3 sets of 8 reps
  • Bent Over Rows – 3 sets of 8 reps
  • Leg Press – 3 sets of 10 reps
  • Shoulder Press – 3 sets of 10 reps
  • Walking Lunges – 2 sets of 12 reps
  • Superset* Bicep Curls with Tricep Extensions – 2 sets of 15 reps
  • Superset* Lateral Raises with Front Raises – 2 sets of 15 reps

*Note that a superset is performing all the reps of one exercise and then directly moving to the next exercise, doing all the reps of it before taking a rest.

So if you have not yet started with resistance training, lean towards this style of exercise as you formulate your workout plan. It’ll serve you very well both in your 40’s as well as in the years beyond.

 

 

Outdoor Summer Workouts

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Summer Workouts

 

There are only a few weeks left of summer, which means that the long, warm days of the season are numbered. While some workouts are best when it’s not so hot, others require some sun and warmth. Below are some exercise and workout ideas to help you make the most of your summer.

 

Stand Up Paddleboarding

Stand up paddleboarding, also referred to as SUP, involves standing on a wide, flat board (bigger than a surfboard) and propelling yourself with a canoe-like paddle. It works your arms, shoulders and core, since it requires balance to stay upright. Don’t worry about falling off. That’s part of the fun! Some places even offer SUP yoga classes, doing a sequence of poses in the water on a paddleboard. It’s more difficult than doing yoga on land, and you will get wet, but you’ll have a lot of fun, too!

 

Riding Bikes

Riding a bike with the cold winter wind in your face is no fun. Enjoy your bike during the warm summer months. You can take your bike on a long, strenuous ride, or just cruise through the park or along the beach or boardwalk. When the weather is good, riding a bike can be a great way to commute or get around town and get exercise at the same time.

 

Swimming

Sure, you can swim in an indoor pool any day of the year, but why not take advantage of the sunshine and warmth while you can? Head to an outdoor lap pool for a low-impact cardio workout that also tones your entire body. For a serious challenge, take your swimming to the ocean. The water’s natural movement and currents will add an extra layer of difficulty.

 

Team Sports

The summer is a great time to join a recreational sports team. It stays light late into the evening, so there’s lots of time after work for practice and games. There are lots of different sports to choose from, including basketball, softball, kickball and flag football. Check your local recreation center or ask human resources if your company has a team. You could end up having so much fun, you don’t even realize you’re working out!

 

Boating

Rowing, sailing, canoeing or kayaking are all great, low-impact ways to get in shape while hitting the water. Sailing is a total body workout, since you have to steer and control the boat without an engine. Canoeing and kayaking will give you a great workout for your arms, chest, shoulders and back. Rowing, in addition to working your upper body, is also a killer exercise for your legs and core.

 

Hiking

While you’ll still want to head to the mountains to hit the slopes in the winter, give your favorite ski spot a chance in the summer. The warm weather is perfect for hiking, and you’ll get to see plants and wildlife you wouldn’t see with a blanket of snow on the ground. If you’re feeling really adventurous, turn your hike into a full-on camping trip.

Lunch Break Workouts

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Lunch Break Workouts

We’re all busy. Between work, family, friends, chores, hobbies and other commitments, it can be difficult to find time each day to exercise. One way to fit in a workout on a busy day is to take advantage of your lunch break. Instead of spending that time scrolling through Facebook or looking at your phone, use it to squeeze in some exercise. Here are some tips and suggestions for lunchtime workouts.

Focus on Strength

Since your lunch break is probably only an hour long, it can be tough to fit a whole workout in, especially if you have to shower and get ready all over again. Instead of trying to do a full routine in such a short amount of time, break it down and do part of your regular routine. Do cardio before or after work, and get your strength training done at lunch. You don’t even need a gym or lots of equipment. You can get a great strength workout with a pair of hand weights or even just your body weight. 

HIIT

If you really want or need to get your cardio done at lunchtime, try a High Intensity Interval Training (HIIT) workout. HIIT workouts are effective cardiovascular workouts. They alternate quick bursts of very intense work periods with recovery periods. You should be working as hard as you can and really getting your heart rate up during the intense periods. The recovery periods give you just enough time to lower your heart rate before jumping back in. Because of the intensity of HIIT workouts, they typically last only 20 to 30 minutes, so it’s the perfect lunch break cardio workout.

Stair Workouts

Stairs are a great workout tool that elevates your heart rate while strengthening your legs and glutes. If you have access to a gym, working out on the stair master is a great way to make the most of a short amount of time. Since the machine keeps going, you’ll be forced to keep climbing. You can take advantage of a stair workout without a gym, as well. If you work in a tall building, climb as many flights of stairs as you can in 30 minutes. Even if you only have access to one or two flights, run up and down each flight as fast as you can. Do a strength-building move, like pushups or burpees in between reps. 

Take a Walk

If you don’t have a gym nearby, or the weather is nice, head outside for a brisk 30 minute walk. Just thirty minutes of walking a day can decrease your risk of heart disease and diabetes, lower your blood pressure and help you lose weight. Plus, it’s a great way to get outside and enjoy some fresh air in the middle of the day. Spending time outdoors can improve your mood, make it easier for you to focus and even strengthen your immune system.

Of course, you don’t want to completely ruin all your hard work by eating fast food at your desk. Make sure to follow your workouts with a healthy, nutritious lunch.