Thursday, March 13, 2014

A Single Step

There is a paradigm shift which is happening in our understanding of human health and disease.  More and more, researchers are looking at how our everyday movement is impacting our health.

There is a difference between supervised exercise training, physical therapy, and "lifestyle activity".  For years, people with MS have been encouraged to seek physical therapy.  But they have not been encouraged to simply move more.  For those with MS who are still able to take steps and walk, I'd like to offer some information, encouragement and cheerleading.

The MS activity paradigm is changing.  Here is a recent abstract on this topic:

Lifestyle physical activity in persons with multiple sclerosis: the new kid on the MS block.


Supervised exercise training has substantial benefits for persons with multiple sclerosis (MS), yet 80% of those with MS do not meet recommended levels of moderate-to-vigorous physical activity (MVPA). This same problem persisted for decades in the general population of adults and prompted a paradigm shift away from "exercise training for fitness" toward "physical activity for health." The paradigm shift reflects a public health approach of promoting lifestyle physical activity through behavioral interventions that teach people the skills, techniques, and strategies based on established theories for modifying and self-regulating health behaviors. This paper describes: (a) the definitions of and difference between structured exercise training and lifestyle physical activity; (b) the importance and potential impact of the paradigm shift; (c) consequences of lifestyle physical activity in MS; and (d) behavioral interventions for changing lifestyle physical activity in MS. The paper introduces the "new kid on the MS block" with the hope that lifestyle physical activity might become an accepted partner alongside exercise training for inclusion in comprehensive MS care.

What is the difference between exercise training and "physical activity for health"? 
Many of us may exercise and train at the gym or at home.  We lift weights, swim, do yoga, stretching----but then, for the rest of the day, we are seated.  Doctors and researchers are noting that people simply do not walk anymore.  And this is a problem.
There is a new movement many of you may have been reading about.  For those who are still able to walk, it may be in your best interest to see if this program is something you can incorporate in your life.
It's called the 10,000 Steps A Day Program.  Walking 10,000 steps is the goal doctors and the surgeon general would like us to have. 
 If you're just getting started, 10,000 steps a day probably seems enormous. Don't worry––it won't take long to reach it! According to research into activity levels, anything under 5,000 steps a day is considered to be a sedentary lifestyle, and it isn't until you reach 10,000 steps a day that you're considered to be "active".[1][6] It is recommended that you begin walking as much as feels comfortable to you, then aim to walk in increments of 1,000 to 2,000 steps more each week until you're comfortably at 10,000 steps a day.[7] There is nothing stopping you walking more than this each day, but the aim is to always make 10,000 steps.

For me, 10,000 step equals about four miles of walking.  How do I know this?  I've been using a pedometer for a couple of months now. Mine is a free app called Pedometer++ on my iphone.  But you can use any type of pedometer that works for you.  I was surprised at how few steps I had been taking!  Getting to 10,000 a day has taken a real, concerted effort for both me and Jeff.  Jeff is active, but he spends most of his day at his desk, writing music.  And I spend most of my time writing or singing.  We really have to go on longer walks every day to reach the 10,000 step goal.  We're parking the car further from the store, taking stairs, simply moving more during the day.  And we're finally reaching the goal.  Our son is home for spring break, and he has the same pedometer.  He walks about 12,000 steps a day, getting around his campus....but since he's been home with his folks, he's been sitting around more.  We all went on a long walk last night, and made our goals.

The truth is, most people, even healthy people, are simply not taking enough steps.  We've become a sitting society.
Sitting has been getting a lot of attention lately, to the point that there’s a new adage: “Sitting is the new smoking.” In addition to encouraging everyone to sit less, people are specifically encouraging exercises during TV watching and during work hours, with walking meetings and standing desks, as ways to decrease sedentary time.
“The real problem is that we are raising sedentary children,” said one of the researchers, Pamela Semanik, assistant professor of adult and gerontological nursing at Rush College of Nursing. “It’s so insidious in our culture.”
At her workplace, where people see the results of not moving, people have changed their ways, she said, adding that she has sold her car and reads medical journal articles on a treadmill.
The researchers in the current study said as many as 5.3 million annual deaths worldwide are related to insufficient activity.

So, what to do?
I'd like to paraphrase a familiar quote.  The Journey of 10,000 steps begins with a single step.
Be encouraged!  Move more, to whatever extent you are able.  Get a pedometer, and follow your results.  And let me and our MS community know how you're doing!
We're all in this together,
Joan





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