Modern medicine has lengthened our lives, but unfortunately, many older people physically deteriorate to a level that makes them vulnerable to minor health setbacks. Frailty is a syndrome marked by weakness, poor mobility, a slow gait, and excessive fatigue. Frail individuals are unable to adequately recover from physical activity or a challenge to their health. Minor illnesses send them to the hospital, nursing home, or assisted living center. Frail individuals are often unable to tolerate beneficial medical procedures and must live with pain and physical restrictions. Frailty is a problem that responds very well to treatment.
In the 65 year old plus population, frailty syndrome is common. Fifteen percent of the non-nursing home population is frail and forty five percent is pre-frail. Frail individuals are far more likely to fall. Forty percent of the frail and twenty two percent of the pre-frail individuals are hospitalized every year. Frailty is a marker for adverse health outcomes and a means of identifying opportunities for intervention in patient care.
Physical activity has been shown to be the best preventative and treatment for frailty. Patients bounce back from surgery much better if they under take a program of prehabilitation exercise prior to surgery. Research on rehabilitation has demonstrated the benefits of exercise to restore strength and mobility in the frail population. Take the time to read, One Last Question Before the Operation: Just How Frail Are You? by Paula Span in the October 27, 2017 issue of the New York Times. Read the article here: https://www.nytimes.com/2017/10/27/health/elderly-surgery-frailty.html
In the senior population, fitness activities must focus on training that maintains functional mobility and an independent lifestyle. You need to stand up and train to be a more graceful and competent walker. Practice drills that improve your capacity to transfer from the floor to standing. Always include balance and reaction exercises that keep you free from falls. Foremost are strengthening activities that maintain bone density and restore capacity to lift, carry, push, and pull.
Michael S. O’Hara, PT, OCS, CSCS
* New York Times, One Last Question Before the Operation: Just How Frail Are You? Paula Span, October 27, 2017
March is National Colorectal Cancer Awareness Month. I can speak first-hand about the horror of this disease. Colon cancer, slowly and painfully, killed my father at the age of forty-nine. Everyone needs to learn the facts about colon cancer and get tested.
Colon cancer is the third leading cause of cancer deaths in the USA. The good news is that colon cancer can be beaten if it is caught at an early stage. The American Cancer Society recommends people over the age of fifty have a colonoscopy examination. Unfortunately, only about 60 percent of the fifty years plus population are up-to-date on their colon cancer screening, and many have never been screened at all. If you have a family history of colorectal cancer, you need to get tested at an earlier age.
A worrisome trend is a rise in colorectal cancers in young people. Take the time to read the attached article by Roni Caryn Rabin in the February 28, 2017 edition of The New York Times. Doctors are not certain why more 20 and 30 year olds are developing these cancers, but we need to be aware that this disease is no longer just an older adult issue.
Half of all colon cancer deaths could be prevented if people got tested regularly. That’s why the American Cancer Society, in partnership with several other organizations, has set a goal to increase colon cancer screening rates to 80 percent by 2018. This could save more than 7,000 lives a year.
More than 50,000 deaths from colon cancer are expected this year. That makes up 9 percent of all cancer deaths in the USA. Proactive screening for colorectal cancer works. We need to get more people involved.
Read the NY Times article here: https://www.nytimes.com/2017/02/28/well/live/colon-and-rectal-cancers-rising-in-young-people.html?_r=0
-Michael O’Hara, P.T., OCS, CSCS
Fracture Facts For Men
Jane Brody of the New York Times wrote a great article on the risks men have for osteoporosis related fractures. The general public views osteoporosis as a “women’s health issue,” but management of osteoporosis and prevention of falls is just as important for men. Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled, or die, from the fracture.
In 2012, an international team of researchers and clinicians launched Too Fit to Fracture, an initiative aimed at developing optimal exercise recommendations for individuals with osteoporosis. In October of 2014, they released a booklet that is available through osteoporosis.ca on managing osteoporosis through exercise. Everyone should read this booklet and osteoporosis patients should follow their exercise prescription. Their work brings clarity to an issue that is currently clouded with poor understanding and a lot of bad fitness advice.
The Too Fit to Fracture researchers recommend that individuals with osteoporosis (with or without vertebral fractures) should engage in a multi-component exercise program that includes resistance training in combination with balance training. Balance train for ten to twenty minutes every day of the week and strength train for 30 to 45 minutes twice a week. Make sure your strength training teaches you how to move correctly and improves the endurance in your back muscles. If you have mild to moderate osteoporosis, balance train and strength train first and foremost, and use any extra time on some low impact cardio training. If you have been told you are at high risk for fracture, keep your focus exclusively on balance and strength training and keep the cardio activities to a minimum.
We know that individuals who participate in consistent resistance training exercises are more likely to have better bone density. Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it. The best bone building exercise activities produce a growth promoting stimulus through your skeleton. Bone building exercises are easy to understand but they do require more effort than swallowing a pill or having an injection. Everyone can perform some form of bone reinforcing exercise. Proper exercise prescription and consistent progression can work wonders. See the trainers and physical therapists at Fenton Fitness and Fenton Physical Therapy for guidance.
-Michael S. O’Hara, P.T., OCS, CSCS
View the NY Times article here: http://www.nytimes.com/2016/10/04/well/live/men-get-osteoporosis-too.html?_r=0
Texting And Driving=Drinking And Driving
A Video Everyone Needs To Watch
I get to meet people injured in car accidents nearly every day. A car accident can change your life forever, so anything we can do to reduce the chance of a crash should be a top priority. I suggest that anyone who uses a cell phone watch the video about texting and driving directed by Werner Herzog (available on Youtube). Make your kids watch it with you.
The video, From One Second To The Next, was commissioned by cell phone carrier AT&T and released Aug. 7. It has already amassed more than 3 million views. The makers are also planning to provide a twelve minute short version to government agencies, safety organizations, and schools.
In the video, you hear how an accident caused by a texting driver traumatizes four families from across the country. The film was commissioned for an anti-texting and driving campaign also backed by Sprint, T-Mobile, and Verizon. (Learn more about the “It Can Wait’ campaign at www.itcanwait.com.)
University of Utah psychology professor David Strayer, who has conducted nationally recognized research on the effects of using cell phones while driving, said his studies show that texting while driving can result in an eight times greater chance of getting in an accident. In contrast, driving while legally under the influence of alcohol—a blood-alcohol level of .08 — results in a four-times greater chance of an accident.
38 states have outlawed texting while driving. My question is why the other states have failed to outlaw this very dangerous activity. Certainly the punishment for texting and driving should be equivalent to that of drunk driving.
Is there a technological solution to this dangerous telecommunication habit? Automobiles are incredibly complex machines and it must be possible to design and install text blocking computers in a car.
Michael S. O’Hara, P.T., OCS, CSCS