jueves, 4 de abril de 2019

Balanced approach to fitness is key

HEALTHbeat

Harvard Medical School

Balanced approach to fitness is key

A walking program is good for you; so is resistance or weight training; balance exercises help improve your athletic abilities and keep you independent.
 
Get your copy of Better Balance: Simple exercises to improve stability and prevent falls
 
Better Balance: Simple exercises to improve stability and prevent falls
Discover how you can prevent falls by improving your balance and mobility. Better Balance: Simple exercises to improve stability and prevent falls gives you step-by-step instructions for easy, effective workouts that will improve posture, increase muscle strength and speed, sharpen reflexes, expand flexibility, and firm your core. You'll also get tips for fall-proofing your home.

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The current U.S. physical activity guidelines emphasize all three aspects of fitness. Here are the recommendations:
  • All adults — including people with various disabilities — should aim for at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous activity, or an equivalent mix of the two throughout the week.
Twenty minutes of moderate activity is roughly equal to 10 minutes of vigorous activity. During moderate activities, you can talk, but not sing; during vigorous activities, you can manage only a few words aloud without pausing to breathe. Adding time — up to 300 minutes of moderate activity, or 150 minutes of vigorous activity, or a mix — increases the health benefits gained.
  • Twice-weekly strengthening activities for all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) are recommended, too.
  • Balance exercises are particularly important for older adults at risk of falling.
  • Flexibility exercises may be helpful, too.
This much activity is a pretty high goal, and can feel overwhelming. If you can't meet all of the guidelines, experts suggest doing as much as you can. Some activity is always better than none. Even short bits of activity, such as five minutes of walking several times a day, are a good first step toward meeting a bigger goal.
For more information on improving your balance and preventing falls read Better Balance, a Special Health Report from Harvard Medical School.
Image: Bigstock
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How medications can affect your balance

pills-affecting-balance
Medications can be lifesaving by performing critical tasks such as keeping blood sugar at safe levels, hearts thumping rhythmically, and moods afloat. Yet side effects and interactions between drugs (both prescription and nonprescription drugs) may increase your fall risk in numerous ways. Prime examples include blurred vision, dizziness or lightheadedness stemming from low blood pressure, drowsiness, delirium, and impaired alertness or judgment. Some medications may affect the inner ear, spurring temporary or permanent balance disorders.
Often, problems stem from the sheer number of medicines you take, rather than a single drug. According to a national health survey, a third of 45- to 64-year-olds and two-thirds of people 65 and older take three or more prescription drugs over the course of a month. And 16% of 45- to 64-year-olds, as well as 39% of people 65 and over, take five or more drugs. Some gerontologists say they rarely see patients who take fewer than six or seven. Taking many medications at the same time can boost the severity and frequency of side effects among people of any age. Older adults are especially vulnerable, because people's bodies absorb and respond to drugs differently with age.
While it's true that some medicines are more likely to play a role in falls than others, many of these drugs are surprisingly difficult to avoid. A review published in JAMA Internal Medicine looked at medication use in a four-month period before and after a hip, shoulder, or wrist fracture among 168,133 Medicare beneficiaries. Before the fracture occurred, three-quarters of study participants had been taking at least one drug known to increase fall risk or decrease bone density, such as those described below. Yet only 7% of these patients stopped taking the problematic drugs after the fracture, while an equal proportion of patients started taking such drugs.
The list of drugs that increase fall risk includes but is not limited to the following:
  • antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • anti-anxiety drugs, such as benzodiazepines
  • anticholinergic/antispasmodic drugs (used to treat stomach cramps)
  • antihistamines
  • blood pressure drugs, such as alpha blockers, centrally acting antihypertensives, ACE inhibitors, angiotensin-receptor blockers (ARBs), and beta blockers (including eye drops, which can lower blood pressure as a side effect)
  • diabetes drugs, such as insulin, glipizide, and glyburide
  • heart drugs, such as anti-arrhythmics, nitrates and other vasodilators, and digoxin
  • pain drugs, such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • sleep drugs, such as sedatives and hypnotics.
Generally, it's wise to keep the number of medications you take to a minimum. Routinely discussing your medications with your doctor is the best way to ensure this.
To learn more about the importance of understanding your balance systems and ways to stay steady on your feet, read Better Balance, a Special Health Report from Harvard Medical School. 
Image: ©BackyardProduction/Thinkstock
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Better Balance: Simple exercises to improve stability and prevent falls

Featured content:


How balance works
Balance problems
SPECIAL BONUS SECTION: Safety measures to prevent falls
Activities that enhance balance
Starting balance workouts safely
Balance workouts and your overall fitness plan
Using the workouts

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