Fall Prevention and Reduction of Fear of Falling

1

Fall Prevention

and

Reduction of Fear of Falling

Proactive Approaches to Health & Wellness

Helen Emge Shymanski

St. Mary’s Wellness Center

USI 7th Annual Mid-America Institute on Aging

August 14,2014

Take Out Your Pens…

QUIZ TIME!

1) True or False: The United States is a worldwide leader on

average life expectancy

2) Regarding Healthcare:

Per Capita Spending to Average Life Expectancy

Rank United States: Ahead, Behind or Approximately Same

a) Australia b) Italy c) Cuba

2

3) Causes of Illness Total = 100%

Genetics Causes _____%

Unable to Access Care Causes _____%

Environmental Causes _____%

Health Behaviours / Lifestyle Choices Causes _____%

© (Copyright) 2008 Duke Integrative Medicine/Duke University Medical Center

4) What % of US healthcare costs are spent on chronic

– largely preventable diseases?

a) 35% b) 75% c) 25%

5) What % of all physician visits are related to stress?

a) 30-50% b) 60-90% c) 10-35%


6) According to The New England Journal of Medicine

(2007), Angioplasties and stents do not prolong life

or prevent heart attacks in -----% of stable patients

who receive them

a) 95% b) 65% c) 35%

and

Bypass surgery prolongs life in less than

a) 3% b) 20% c) 55%

7) Changing lifestyle behaviours could prevent

___________ of all heart disease (Lancet. 2004 Sep)

a) 90% b) 20% c) 65%


3

8)

__________ is the leading cause of hospital admissions

and injurious death for age 65 and above, with annual

direct medical costs associated with it totaling nearly $30

billion dollars in the US (2010) (Center of Disease Control Prevention)

9) Check health problems now seen in children, due to

obesity, that culturally in the past were regarded as adult

or later-in-life conditions:

High Blood Pressure

Type 2 Diabetes

Elevated Blood Cholesterol Levels

Depression

10)

One in a) Five b) Three c) Ten

American kids and teens are currently overweight or obese

which is

a) One b) Two or c) Three times the rate in 1963

11)

True or False: Approximately 50% of the states in the US

have an obesity rate of 10-20%

12) True or False:

Obesity issues are rather simple. Obesity occurs

when a person consumes more calories from food

than he or she burns; overeating and under

exercising/sedentary behavior.

4

13) The average sugar consumption per person per year in

America is _______

a) 150 lbs b) 75 lbs c) 35 lbs

14) True or False: Cardio exercise has consistently by proven

through research to be the most effective way to lose

weight.

15)

Please Put “T” or “F” for true or false;

What conditions/symptoms have been linked to Stress

and/or High Levels of Hormone Cortisol/Low Levels of DHEA:

1) Impaired function of The Immune System

2) Decreased Bone Density

3) Fat Deposited in Abdomen

4) Increased Blood Sugar

5) Increased Triglycerides

6) Impaired Wound Healing

7) Increases Sensations of Pain

8) Problems with Memory

9) Weight Gain

10) Increased Resistance to Insulin

11) Increase Cholesterol

12) Increased Blood Clotting

13) Poorer Sleep

14) Increased Performance

ANSWERS

5

1) True or False: The United States is a worldwide leader

on average life expectancy

2) Regarding Healthcare:

Per Capita Spending to Average Life Expectancy

Rank United States: Ahead, Behind or Approximately Same

a) Australia b) Italy c) Cuba

UC Project for Global Inequality

The Economics and

the Outcomes

U.S.


3) Causes of Illness

Genetics causes

Unable to Access Care causes

Environmental Causes

Health Behaviours / Lifestyle Choices causes

20%

10%

20%

50%


6

4)

What % of US healthcare costs are spent on chronic –

largely preventable diseases?

b) 75%

5)

What % of all physician visits are related to stress?

b) 60-90%



6) According to The New England Journal of Medicine

(2007), Angioplasties and stents do not prolong life or

prevent heart attacks in -----% of stable patients who

receive them

a) 95%

and

Bypass surgery prolongs life in less than

a) 3%

7) Changing lifestyle behaviours could prevent

___________ of all heart disease (Lancet. 2004 Sep)

a) 90%

8) ----- Is the leading cause of hospital admissions

and injurious death for age 65 and above, with annual

direct medical costs associated with it totaling nearly $30

billion dollars in the US (2010) (Center of Disease Control Prevention)

Falls

7

9) Check health problems now seen in children, due to

obesity, that culturally in the past were regarded as

adult or later-in-life conditions:

YES - High Blood Pressure

YES - Type 2 Diabetes

YES - Elevated Blood Cholesterol Levels

YES – Depression

10)

One in b) Three

American kids and teens are currently overweight or

obese which is

c) Three times the rate in 1963

11)

True or False: Approximately 50% of the states in the

US have an obesity rate of 10-20%

Obesity Trends* Among U.S. Adults

BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk factor Surveillance system, CDC

8



No Data <10% 10%–14%




No Data <10% 10%–14% 15%–19%




No Data <10% 10%–14% 15%–19% ≥20%


9



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


12)

Obesity issues are rather clear & simple. Obesity occurs

when a person consumes more calories from food than

he or she burns; overeating and under

exercising/sedentary behavior.

11)

False….no states at 10%-20%

12) Not so simple or clear….

The issue is: regulation of Fat (Adipose) Tissue.

Fat accumulation is regulated fundamentally by insulin and

carbohydrates (sugars)

Hormones/Insulin/Fat Storage.

Paradigms: A disorder of excess fat accumulation

13) The average sugar consumption per person per

year in America is ______________

150 lbs. (Institute of Integrative Nutrition Presentation, Mark Hyman, MD)

10

14) Cardio exercise has consistently been proven through

research to be the most effective way to lose weight.

False

Three month study, women did 45 minutes of cardio a day, 5 days a

week, and lost no more weight than those who dieted alone.

Utter AC, et al. Influence of diet and/or exercise on body composition and cardio respiratory

fitness in obese women. Int J Sports Nutr. 1998 Sep; 8(3) 213-22.

Subjects did 50 minutes of cardio, 5 days a week, and once again

lost no more weight than those who dieted alone.

Redman et al. Effect of calorie restriction with or without exercise on body composition and fat

distribution. J Clin Endocrinol Metab. 2007 Jan 2

One year study, subject performed aerobic exercise for 60 minutes/day,

6/week and only lost 3.5 pounds on average in an entire year. McTierman et al. Exercise Effect on Weight and Body Fat in Men and Women. Obesity 2007 June

– 15:1496-1512.

15) Please Put “T” or “F” for true or false;











9) Weight Gain




13) Poorer Sleep

14) Increased Performance

Research - those who are regularly stressed have:

•A five-fold increased risk of dying from heart-related problems

•Double the risk of developing diabetes in men

•A 65% increased risk of developing dementia

•Double the chance of developing obesity

Obesity (Marin 1992)

Diabetes (Nestler, 1992)

Hypertention (Shafagoi, 1992)

Heart Disease (Barret-Conner 1986)

Cancer (Bhatavdekar, 1994)

Alzheimer’s (Nasman, 1995)

High Cortisol – Low DHEA

Linked To:

National Concern

Relevant to Falls?

11

Sobering

Macro Healthcare Change

&

Micro Healthcare Change

http://www.google.com/imgres?imgurl=http://www.colourbox.com/preview/1747134-437534-human-figures-holding-hands-in-a-circle.jpg&imgrefurl=http://www.colourbox.com/image/human-figures-holding-hands-in-a-circle-image-1747134&usg=__xAWfx0AYM3G3SS7yoACXtr0sBF0=&h=406&w=480&sz=89&hl=en&start=6&zoom=1&tbnid=ahhgjg-26FzsfM:&tbnh=109&tbnw=129&ei=KeJ2UJENpaLZBYfSgJgG&prev=/search%3Fq%3Dcircles%2Bof%2Bpeople%2Bfigures%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1

http://www.google.com/imgres?imgurl=http://cloud.graphicleftovers.com/11014/661531/one-out-of-ten-people.jpg&imgrefurl=http://graphicleftovers.com/graphic/one-out-of-ten-people/&usg=__bIub1CfKbOUoizP9S0R0iLrWpuw=&h=500&w=500&sz=93&hl=en&start=4&zoom=1&tbnid=1hBP7SrnNceH3M:&tbnh=130&tbnw=130&ei=1OJ2UNKwJOOy2wXaq4GABw&prev=/search%3Fq%3Dten%2Bpeople%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1

http://www.google.com/imgres?imgurl=http://bp2.blogger.com/_iJP_wg6Tnag/R6nzUePSscI/AAAAAAAAA4g/3lwnCx5T4NQ/s400/manicule.png&imgrefurl=http://mleddy.blogspot.com/2008/02/manicule.html&usg=__R6hYdpWsBaqcRQHliKYa9B5thLE=&h=179&w=322&sz=15&hl=en&start=3&zoom=1&tbnid=A4XLIrrgK_tYvM:&tbnh=66&tbnw=118&ei=COR2UPZX5oLbBcSUgLAG&prev=/search%3Fq%3Dpointing%2Bfinger%2Bicon%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1

http://images.google.com/imgres?imgurl=http://www.ewu.edu/Images/URC/IMG_0784.JPG&imgrefurl=http://www.ewu.edu/urc/fitness-center.xml&usg=__HX7of9XsiadmDE1U2Ko0cpDa0Hg=&h=960&w=1280&sz=443&hl=en&start=4&zoom=1&tbnid=66kw-dRQSQdHBM:&tbnh=113&tbnw=150&ei=kVrDUZLbKZLW8gTb34BQ&prev=/search%3Fq%3Dfitness%2Bcenters%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDIQrQMwAw

http://images.google.com/imgres?imgurl=http://yoga108.org/images/blog/2006/fitness_escalator.jpg&imgrefurl=http://yoga108.org/blog/posts/99-escalator-outside-fitness-club&usg=__C1QDCkNU8nu0-ysngKPB2K4aTvI=&h=302&w=450&sz=44&hl=en&start=33&zoom=1&tbnid=nYNCHg2_3UAOYM:&tbnh=85&tbnw=127&ei=0VrDUbywK4He8wSu64CgAg&prev=/search%3Fq%3Doutside%2Bpicture%2Bof%2Bfitness%2Bcenters%26start%3D20%26safe%3Dactive%26sa%3DN%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CEQQrQMwDDgU

http://images.google.com/imgres?imgurl=http://www.train2win.org/images/6ec600fee2bd4b88_personal_trainer_A.jpg&imgrefurl=http://www.train2win.org/index-1.html&usg=__Lywe4feXT8_EQwsPhI-Wn_cveLc=&h=400&w=300&sz=28&hl=en&start=1&zoom=1&tbnid=tJnyzRKgVGgBnM:&tbnh=124&tbnw=93&ei=0VvDUanxH4_29gTlk4Bg&prev=/search%3Fq%3Dprivate%2Btrainer%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CCwQrQMwAA

http://images.google.com/imgres?imgurl=http://www.beyonddiets.com/storage/post-images/Diet%2520books.jpg%3F__SQUARESPACE_CACHEVERSION%3D1298614740141&imgrefurl=http://www.beyonddiets.com/beyonddiets-blog/tag/diet-books&usg=__4mqyKrbA-oGwRXsUNfJpokxwITE=&h=1206&w=1782&sz=357&hl=en&start=5&zoom=1&tbnid=cxYvyRUqCM5AOM:&tbnh=102&tbnw=150&ei=VVrDUfLINoj48gTD84EQ&prev=/search%3Fq%3Ddiet%2Bbooks%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDQQrQMwBA

http://images.google.com/imgres?imgurl=http://www.womenshealthmag.com/files/images/0612-weighty-words-1283.jpg&imgrefurl=http://www.womenshealthmag.com/weight-loss/the-most-and-least-promising-diets&usg=__Ui8ivfrki7-R5SQnlelUAYqiui4=&h=800&w=800&sz=131&hl=en&start=8&zoom=1&tbnid=CyzEtkkXeMH_TM:&tbnh=143&tbnw=143&ei=VVrDUfLINoj48gTD84EQ&prev=/search%3Fq%3Ddiet%2Bbooks%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDoQrQMwBw

http://images.google.com/imgres?imgurl=http://www.transformyouaz.com/sites/transformyouaz.com/files/imce/low-fat-foods.jpg&imgrefurl=http://healthed.info.yorku.ca/2013/03/nutrition-for-yu-low-fat-foods/&usg=__X-TrTX2GVon1PdOgvkSPdkZmJ34=&h=300&w=324&sz=20&hl=en&start=14&zoom=1&tbnid=RYtq0ceAHJ71RM:&tbnh=109&tbnw=118&ei=-1rDUaK8FZD49gT4wYHYDQ&prev=/search%3Fq%3Dlow%2Bfat%2Bfoods%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CEYQrQMwDQ

http://images.google.com/imgres?imgurl=http://cdn2-b.examiner.com/sites/default/files/styles/image_content_width/hash/41/e8/41e83f45dc9b5ba6484356b880fb4d48.jpg%3Fitok%3D-YpDDmtR&imgrefurl=http://www.examiner.com/article/the-truth-about-low-fat-and-no-fat-foods&usg=__1KNviLMd7K2DPBlKljKSnuizNGw=&h=262&w=380&sz=16&hl=en&start=93&zoom=1&tbnid=ApHgTlqeEUaoBM:&tbnh=85&tbnw=123&ei=XlvDUYL7NIve8ASgpIGQCA&prev=/search%3Fq%3Dlow%2Bfat%2Bfoods%26start%3D80%26safe%3Dactive%26sa%3DN%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CEQQrQMwDDhQ

http://images.google.com/imgres?imgurl=http://www.drphoenyx.com/wp-content/uploads/2013/04/no-carbs.jpg&imgrefurl=http://www.drphoenyx.com/are-carbs-the-enemy/&usg=__WKywspaCP-hbMeAYqJ-REgPnnDk=&h=350&w=350&sz=18&hl=en&start=2&zoom=1&tbnid=pIlFOhB_d4WHSM:&tbnh=120&tbnw=120&ei=d1vDUaPAOpTW9ASb0IGgAg&prev=/search%3Fq%3Dno%2Bcarb%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CC4QrQMwAQ

http://images.google.com/imgres?imgurl=http://c4.soap.com/images/products/p/dcs/dcs-2639_1z.jpg&imgrefurl=http://www.soap.com/p/kelloggs-low-fat-frosted-brown-sugar-cinnamon-pop-tarts-8-ct-316352&usg=__jHTEbOuIPHDKGKNHtSDmr0iSNo0=&h=1600&w=1300&sz=421&hl=en&start=51&zoom=1&tbnid=MtcJhS51TexZyM:&tbnh=150&tbnw=122&ei=MFvDUeKUHoq69QSY94DADQ&prev=/search%3Fq%3Dlow%2Bfat%2Bfoods%26start%3D40%26safe%3Dactive%26sa%3DN%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CEAQrQMwCjgo

12

The Real Healthcare Recovery Plan

Chronic conditions consume more than

75% of healthcare costs and

are largely effected by health behaviors

Our current model is problem based and disease oriented.

The current healthcare model doesn’t work because

we do not have a core competency in optimizing health


Approximately

95 cents of every dollar

spent to treat disease after

it had already occurred © (Copyright) 2008 Duke Integrative Medicine/Duke University Medical Center

Reactive…vs…Proactive…

Short Term/Long Term Healthcare

Dis

ease B

urd

en

Time

Cost

1/r

evers

ibili

ty

Opportunities for Intervention

Typical

Current

Intervention

Earliest

Clinical

Detection

Earliest

Molecular

Detection

Initiating

Events

Baseline Risk


Source: Ralph Snyderman, MD, Chancellor Emeritus, Duke University

“MACRO”

13

Micro…

Reactive vs. Proactive

Micro Healthcare Change

Individuals do not change their lifestyle choices and health behaviors until we know

what matters to them

Behavior changes are sustainable when they have deeply personal significance


Micro

CHANGE….Reactive vs. Proactive

& Deeply significant

https://www.google.com/url?q=http://www.ishn.com/articles/91712-emergency-treatment-for-heart-attack-improving-&sa=U&ei=OAdtU9WmDsel8QHB_oEQ&ved=0CDgQ9QEwBA&usg=AFQjCNHVt20QwMmd6VzAwFjyJKnuOv1B6g

https://www.google.com/url?q=http://dukephotography.photoshelter.com/image/I0000RYhVmrnaFHw&sa=U&ei=OAdtU9WmDsel8QHB_oEQ&ved=0CDoQ9QEwBQ&usg=AFQjCNG7IJypZ8cFXi0uI4_w2EfBHpsOlg

https://www.google.com/url?q=http://365barrington.com/2010/08/15/137-make-a-trip-to-the-emergency-room/&sa=U&ei=sAdtU6ztLYea8gH8w4DIDg&ved=0CE4Q9QEwEA&usg=AFQjCNEwdPrqvPP7by3YVlWHMOsh_lh9pw

https://www.google.com/url?q=http://accuratepsychicreadingsnow.com/psychic-elizabeth-are-you-always-depressed/&sa=U&ei=HQhtU5vDEKmc8gG8g4DYDg&ved=0CDgQ9QEwBQ&usg=AFQjCNEPSZvy4W1_a1zJVgzckaLi9zBomw

https://www.google.com/url?q=http://www.nobledrugstore.com/blog/diseases-condition/type-2-diabetes-self-care-tips&sa=U&ei=VQhtU6SIJIL18AH68ICQCA&ved=0CFQQ9QEwEw&usg=AFQjCNFuqWBLEphzwRaaRymDrbq_cK5DBw

https://www.google.com/url?q=http://gastricbypasssanfrancisco.com/morbid-obesity-causes-san-francisco-ca.htm&sa=U&ei=XAltU4_4LIqC8AGu_4CgAw&ved=0CFQQ9QEwEw&usg=AFQjCNGWYwIF23hzfgxwGgK3Q779LkYF_A

http://www.google.com/url?url=http://britainisnocountryforoldmen.blogspot.com/2011/06/britain-is-no-country-for-old-men-with.html&rct=j&frm=1&q=&esrc=s&sa=U&ei=Kj3lU-SbKoz98AGng4CoBA&ved=0CBYQ9QEwAA&usg=AFQjCNH8bV9UYjjI-Qf3rZHPsyGwXDVp4w

http://www.google.com/url?url=http://britainisnocountryforoldmen.blogspot.com/2011/06/britain-is-no-country-for-old-men-with.html&rct=j&frm=1&q=&esrc=s&sa=U&ei=Kj3lU-SbKoz98AGng4CoBA&ved=0CB4Q9QEwBA&usg=AFQjCNH8bV9UYjjI-Qf3rZHPsyGwXDVp4w

https://www.google.com/url?q=http://www.shutterstock.com/s/%2522climbing%2Bstairs%2522/search.html&sa=U&ei=YAptU5HwLaW58gG8uoBQ&ved=0CEgQ9QEwDQ&usg=AFQjCNEp5rxw1dqchiGTg1gfaPkO3wlriA

https://www.google.com/url?q=http://www.thenorthernecho.co.uk/entertainment/beauty/10818929.What___s_making_you_breathless_/%3Fref%3Drss&sa=U&ei=tAptU-aJDueL8AGM7IDYBg&ved=0CEgQ9QEwDTgU&usg=AFQjCNEVIRb4X0hzI1V37fYiF4tz6pjeHQ

https://www.google.com/url?q=http://blog.weddingcrowd.com/shaping-up-for-the-big-dayno-longer-just-a-womans-game/1-15-13-man-playing-with-kids/&sa=U&ei=-AptU8aAOKKV8QHEjoDQAw&ved=0CDwQ9QEwBw&usg=AFQjCNHBw_JvQMBamrhdLB6JKHPmEOldvg

http://www.google.com/url?url=http://www.topnews.in/health/fear-falling-linked-real-falls-older-people-28430&rct=j&frm=1&q=&esrc=s&sa=U&ei=sDzlU8a0NoL08AGjkoAY&ved=0CCgQ9QEwCQ&usg=AFQjCNHBAtCjNh2VXprPsWsoMXSXeE03zQ

http://www.google.com/url?url=http://britainisnocountryforoldmen.blogspot.com/2011/06/britain-is-no-country-for-old-men-with.html&rct=j&frm=1&q=&esrc=s&sa=U&ei=Kj3lU-SbKoz98AGng4CoBA&ved=0CBYQ9QEwAA&usg=AFQjCNH8bV9UYjjI-Qf3rZHPsyGwXDVp4w

http://www.google.com/url?url=http://www.theguardian.com/society/2008/jun/11/longtermcare.socialcare1&rct=j&frm=1&q=&esrc=s&sa=U&ei=qD7lU9r8GcKK8QGMl4DAAw&ved=0CBgQ9QEwAQ&usg=AFQjCNF0WjPCyloq38ubcLG7lEWvT8no2Q

14

There is Research

There are

Options

There Are Choices


A Transformative Model

Healthcare /“Health” “Care”

Disease oriented

Find it, fix it

Biomedical interventions

Reactive

Sporadic

Individual left to enact

Physician-directed

Health oriented

Identify risk, minimize it

Whole person approaches

Proactive

Lifelong planning

Support in implementation

Partnership-based

Contemporary Integrative Care


Source: Ralph Snyderman, MD, Chancellor Emeritus, Duke University

https://www.google.com/url?q=http://www.differencebetween.info/difference-between-pressure-and-stress&sa=U&ei=mwhtU5ANifPwAavcgLAL&ved=0CFAQ9QEwEQ&usg=AFQjCNFdkHQ9XzpOac18JZ2bEVkpIdKshg

https://www.google.com/url?q=http://www.mad-1.com/Insomnia.htm&sa=U&ei=eQxtU_eGF6qj8gGc_IHwBg&ved=0CDwQ9QEwBzgU&usg=AFQjCNFQTXBM-lQ5DHjmIy6u8uG6-DTjyA




http://www.google.com/url?url=http://www.ccal.org/connect-with-others/home-safer-prevent-falls_09-04-2012/&rct=j&frm=1&q=&esrc=s&sa=U&ei=0sLoU7feC8n18AHOt4HQDg&ved=0CCQQ9QEwBzgU&usg=AFQjCNFC-BpAjoPhiPQyZNzxp5yFpt8NIQ

15

No quiz…

just questions….

If you were just made aware of a medically researched

“technique” that has clinically shown to:

Reduces pain

Reduces stress

Improves quality of life

Improves sleep

Enhances immune system

Shown to be beneficial for lowering blood pressure

Wisconsin Medical Journal

Mayo Clinic has included “another new technique”…

as one of the three central action step plans their promoting on their DVD Wellness Solutions Line

Mayo Clinic Wellness Solutions for Diabetes

Mayo Clinic Wellness Solutions for Heart Health

“ Mayo..” High Blood Pressure

“ Mayo..” Fibromyalgia

“ Mayo..” Arthritis

“ Mayo..” Menopause

“ Mayo..” Irritable Bowel Syndrome

“ Mayo..” Back Pain

“ Mayo..” Insomnia

16

Prescribing “-” Hayes M. Chase S. Prim Care Clin Office Pract 37 (2010) 31-47

EVIDENCE RATING

Decreases stress and anxiety A

Improved physical and quality-of-life measures in elderly A

Improves functional status and symptoms in low back pain A

Improves subjective and objective outcomes in asthma A

Improves oxygen saturation in patients with COPD B

Decreased fatigue in Multiple Sclerosis patients B

Is beneficial in patients with eating disorders B

Harvard Medical School & Bringham & Women’s Hospital: 2012

Juniors and Seniors:

Control Group 1) scored higher for mood problems or anxiety

2) self-reported more negative emotions

Experimental Group reported

1) self-reported fewer negative emotions

2) scored lower for mood problems and anxiety

-------------------------------------------------------------------------------------------------

2003 study of 5th graders:

reduced feelings of helplessness and aggression

increase emotional balance

reduced fears

Hope for brighter tomorrows…

Other Kid/Teen Studies:

Teens who had suffered traumatic abuse,

showed significant decreases in depression & anxiety

Food disorder teens- 75% reported an increased sense of well-being

Anorexic adolescents

reduced starvation-induced stress

safely reintroduced physical activity for weakened body

minimized fatigue

corrected distorted self-perceptions

Teen musician performance anxiety and mood disturbance reduction

17

What if there were easy tools & techniques that had to do with

the power of the heart /emotions

heart function and cognitive performance

20 + years of published research including peer-reviewed journals such as

American Journal of Cardiology, Stress Medicine, Preventive Cardiology and Journal of the American College of Cardiology

Increase in cortical facilitation (brain’s ability to process information)

Increase in creative problem solving, intuition.

Increase functioning in the Immune System

A decrease in the level of stress hormone (Cortisol)

An increase in vitality hormone (DHEA) (di-hydro-epi-andro-sterone)

Studies:

Blood Pressure in Hypertensive Employees (HP)

20% reduction in diastolic and systolic blood pressure

Stress and Health Risk Reduction in Correctional Officers

Significant reductions in

total cholesterol

mean heart rate

blood pressure.

http://images.google.com/imgres?imgurl=http://yogakids.com/images/header/yk_00000006.jpg&imgrefurl=http://yogakids.com/about-pose-of-the-week.htm&usg=__vpyIYNVNYS25OU2Qsnt65Qk6b-U=&h=266&w=185&sz=70&hl=en&start=7&zoom=1&tbnid=eVEC2tKq-FhQeM:&tbnh=113&tbnw=79&ei=Hm7DUaH7Boj68QSsgIG4Ag&prev=/search%3Fq%3Dkids%2Byoga%2Bposes%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDgQrQMwBg

http://www.google.com/url?url=http://www.npr.org/blogs/health/2012/10/12/162782583/classroom-yoga-helps-improve-behavior-of-kids-with-autism&rct=j&frm=1&q=&esrc=s&sa=U&ei=EEniU7qHLoyLyAS984DICA&ved=0CBgQ9QEwAQ&usg=AFQjCNHPvwDWhURiRtpfiXmokuFk_mr3fg

http://www.google.com/url?url=http://lifeinc.today.com/_news/2013/05/13/18229052-more-brands-find-its-not-a-stretch-to-offer-plus-size-yoga-attire%3Fd%3D1&rct=j&frm=1&q=&esrc=s&sa=U&ei=O9boU8fuD8PC8QGfnoGwDg&ved=0CCwQ9QEwCw&usg=AFQjCNHarkEJSE7v0oq4zKYeUjPbXTSL8Q

https://www.google.com/url?q=http://www.uncommonage.com/HeartMath.html&sa=U&ei=UcpeU9XRK4O38AG1-YCoDQ&ved=0CDIQ9QEwAg&usg=AFQjCNGKYpbdhPaVYD7Bs3BUbSg1VKCJPg

18

Patients with Type 2 Diabetes who received --------

reported a host of improvements:

Far more likely to take their medication

Their blood sugar levels improved

They felt more engage in their own health, with a greater

understanding of the resources available to them and

more confidence that they could impact their health.

They had an increased sense of social support and

tangible support

Were more likely to exhibit “benefit finding”

Stress and depression went down

Exercise went up

Duke Integrative Medicine, Duke University Medical Center

Supported by drug maker GlaxoSmithKline.

Integrative Health Coaching for Patients with Type 2 Diabetes

Randomized Clinical Trial

Spurred by the fact that 50% of people with Type II diabetes do

not take their medication as prescribed and 90% of them do

not adhere to all aspects of their overall treatment regimen.

Stress Reduction Programming

Self Awareness/Mindfulness Practices

Health, Wellness, Well-being Programs

Integrative Practices

Complimentary Practices

Holistic Practices

Holistic Care

Body Mind Spirit Practices

19

Leading Medical Publications

JAMA – Journal American Medical Association

New England Journal of Medicine

Archives of Internal Medicine

New England Journal of Medicine

Duke

Harvard

Stanford

University of Massachusetts

National Institute of Health

US Dept of Health & Human Services

American Journal of Psychiatry

Journal of Nursing Administration

Journal of Affective Disorders

Neurology

Biological Research for Nursing

Journal of Gerontology

Journal of General Internal Medicine

American Journal of Hypertension

Experiential

There is Research

There are

Options

There Are Choices







http://www.google.com/url?url=http://blog.safetytubs.com/234/home-improvement-tips-for-the-aging-and-elderly-part-3/&rct=j&frm=1&q=&esrc=s&sa=U&ei=0sLoU7feC8n18AHOt4HQDg&ved=0CB4Q9QEwBDgU&usg=AFQjCNFj2XZ3JCFvSMk1-G-HXUTo-izJOw

20

FALLS..Leading cause of hospital admissions for people age 65 and older:

with 1 in 3 experiencing a fall each year

Older adults are hospitalized for fall-related injuries

five (5) times more often than they are for injuries from other causes

2.4 million nonfatal fall injuries treated in Emergency Dept.

(2011); 689,000 had to be hospitalized

20-30% suffer moderate to severe injuries that make it

hard to get around or live independently and increase their risk of early death

Center of Disease Control Prevention

FALLS

Average hospitalization costs for a fall injury is

$34,294 (2012)

Annual direct medical costs associated with falls

$30 billion dollars in the US (2010)

Significant U.S. challenge; elderly population is

expected to double by 2030

Center of Disease Control Prevention

FEAR OF FALLING

Major health problem among

community-dwelling older persons

Prevalence of this fear ranges from 29%-77%.

Indicates importance of developing effective strategies to

reduce fear of falling among elderly adults Journal of Advanced Nursing, Nov. 2010

21

Elderly fallers – as compared with nonfallers, have:

significantly weaker muscles strength

in ankle dorsiflexors, hip flexors, or knee extensors

marked decrease in ankle range of motion

greater postural sway

have significantly more disabilities in performing activities of daily living than nonfallers

A PERSONS ABILITY TO BALANCE CAN BE INFLUENCED BY MANY FACTORS SUCH AS:

Vision

Inner-ear functioning

Blood Pressure

Muscle Strength

Posture

Brain integration

Medical Condition

Medication

Depression

Diabetes

GOOD NEWS

22

Although Risk of Falls

and

Fall Related Injuries

Increases With Advancing Age

They Are Not Inevitable Consequences of Aging

(Carter et al., 2001; Nied & Franklin,2002)

There is Research

There are

Options

There Are Choices

National Institute on Aging & Emory:

Tai Chi program reduced risk of falling by 47.5%.

Oregon Research Institute:

Risk for multiple falls in Tai Chi group 55% lower

than that of stretching control group

Tufts:

Tai Chi is effective in treating knee osteoarthritis



23

Tufts:

Tai Chi Improves Pain & Functional Status in Adults with Rheumatoid Arthritis: Pilot single-Blinded Randomized Controlled Trial

American College of Rheumatology (ACR) 20 response criterion, functional capacity, health-related QOL & depression index. 12 wks/Tai Chi,. ACR 20% response compared to 0% control.

New England Journal of Medicine: Tai Chi beneficial in easing the pain of fibromyalgia

Wisconsin Medical Journal: Therapeutic

Benefits of Tai Chi Exercise Research

Review:

Improved Balance & Fall Prevention

Pain Reduction - Stress Reduction - Improved Quality of Life

Improved Aerobic Capacity

Blood Pressure Reduction

Improved Sleep Quality

Physical Function including activity tolerance &

cardiovascular function

Enhancing immune system

Improving flexibility & strength

Research In Sports Medicine: An International Journal: Review of Tai Chi as an Effective

Exercise on Falls Prevention in Elderly, Jan 2012

24 Articles Reviewed

All studies reported significant improvement with the Tai

Chi intervention except for one study*

Majority of the studies demonstrated

Significant improvement in number of falls and fear

of falling and

Significant improvement in laboratory-based balance

measures.

24

Journal Advanced Nursing, Nov 2010

In addition to reducing risk of falls and Fear of

Falling (FOF), improving balance…

Tai Chi has benefits in physical and

psychological functioning

Tai Chi found to reduce FOF significantly

more than other exercise programs for older

adults

Journal Advanced Nursing, Nov 2010

94% of the elders who participated in a 12-week Tai

Chi intervention improved their functional status and

confidence

100% of participants agreed that the Tai Chi

movements were appropriate and safe to perform

and they intended to continue doing the activity and

to recommend it to others

STUDY RESULT

Yoga education has a positive effect on pain, physical

functions, social functions, general health

perception and balance.

European Journal of Physical and Rehabilitation

Medicine (Tuzun et al.,, 2010)

Title: Yoga might be an alternative training for the quality of

life and balance in postmenopausal osteoporosis

http://www.google.com/imgres?imgurl=http://www.cnyhealingarts.com/wp-content/uploads/2011/06/warrior-2.jpg&imgrefurl=http://www.cnyhealingarts.com/2011/06/01/the-health-benefits-of-virabhadrasana-ii-warrior-ii-pose/&usg=__T67vtcSV8eX11VSRNmX-xEimXVA=&h=365&w=567&sz=106&hl=en&start=9&zoom=1&tbnid=VVnHdT0wlY87kM:&tbnh=86&tbnw=134&ei=QiI3UuusEKHZ2AXW74HgCw&prev=/search%3Fq%3Dyoga%2Bwarrior%2Bpose%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDwQrQMwCA


25

YOGA-BASED EXERCISE PROGRAM TO REDUCE THE

RISK OF FALLS IN SENIOS: A PILOT AND FEASIBILITY

STUDY The Scripps Research Institute, La Jolla, CA, Brown et al.,

Division of Arthritis Research Division of Biomathematics,

Dept of Molecular and Experimental Medicine

45 minutes, 8 weeks ( 68-97 years old)

14 of 22 Improved Berg Balance Scale

13 0f 22 Improved Activities-Specific Balance Confidence Scale

15 of 22 Improved One Leg Standing Test

Exit Questionnaire:

Improvement in posture (25%)

Improvement in Breathing (21%)

Stepping or Walking Improvement (15%),

Coordination (13%), Flexibility (13%).

Health Benefits Within Blood Pressure Reduction

Circulation Improvement

Pulse Rate Reduction

Immunity Strengthened

Gastrointestinal Function Improve

Post Surgery Pain Decrease

Respiration Rate Decrease

DISEASE PREVENTION Reduction in risk of heart disease

Osteeoporosis

Type II Diabetes

Possible slowing on Alzheimer’s onset

Symptom Reduction/Alleviation Asthma

Arthritis

Headaches

Fibromyalgia

Chronic Fatigue

Eating Disorders

Parkinson’s

Migraines

Scoliosis

Chronic Bronchitis

Epilepsy

Sciatica

Obsessive Compulsive disorders

Back pain

Menopausal Symptoms

Improves Birth Outcomes

Shortens Labor

Health Benefits External:

Improve posture

Increase strength

Increase energy

Sleep pattern improvements

Balance Improvement

Body Chemisty:

Lowers Chloesterol

Supports strong lymphatic system

May lower gluclose levels

Lowers levels of triglycerides

Increase red blood cells

ENERGY

http://images.google.com/imgres?imgurl=http://www.snopes.com/politics/graphics/vitamins.jpg&imgrefurl=http://www.snopes.com/politics/medical/vitamins.asp&usg=__CDFqfoDb-rtiU-ID3qP_vxc7_pE=&h=248&w=240&sz=12&hl=en&start=6&zoom=1&tbnid=qCOFn5Qt8p9KDM:&tbnh=111&tbnw=107&ei=7C5zUNuYFaOC2AWv64HQAw&prev=/search%3Fq%3Dvitamins%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1


http://www.google.com/imgres?imgurl=http://www.cnyhealingarts.com/wp-content/uploads/2011/06/warrior-2.jpg&imgrefurl=http://www.cnyhealingarts.com/2011/06/01/the-health-benefits-of-virabhadrasana-ii-warrior-ii-pose/&usg=__T67vtcSV8eX11VSRNmX-xEimXVA=&h=365&w=567&sz=106&hl=en&start=9&zoom=1&tbnid=VVnHdT0wlY87kM:&tbnh=86&tbnw=134&ei=QiI3UuusEKHZ2AXW74HgCw&prev=/search%3Fq%3Dyoga%2Bwarrior%2Bpose%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDwQrQMwCA

26

ENERGY

•Immersed/surrounded

•Take it for granted

MEDICINE

Reading Energy….

http://www.google.com/url?url=http://www.shestokas.com/legal-news/fourth-amendment-victory-cell-phones-cannot-be-searched-without-a-warrant/&rct=j&frm=1&q=&esrc=s&sa=U&ei=akTiU9GGAZWnyASXs4EY&ved=0CCgQ9QEwCQ&usg=AFQjCNGX7pPzkpY4Lf3uJRpFUQ8pQYx-SA

http://www.google.com/url?url=http://www.kogan.com/au/buy/28-led-tv-hd/&rct=j&frm=1&q=&esrc=s&sa=U&ei=okTiU9XCEYKmyASftICIDg&ved=0CBoQ9QEwAg&usg=AFQjCNHd6dz7TMlnEgXb48BsYcm6biHaDQ

http://www.google.com/url?url=http://www.thebestofthebesttours.com/Tour-3-Windmill-Tour&rct=j&frm=1&q=&esrc=s&sa=U&ei=wUTiU7iVKM-3yATSt4DQCw&ved=0CCwQ9QEwCw&usg=AFQjCNEp7dgpX08KVy7rBQJIMv_y2vpE4A

http://www.google.com/url?url=http://commons.wikimedia.org/wiki/File:XRay_machine_for_the_captives,_Guantanamo_-b.JPG&rct=j&frm=1&q=&esrc=s&sa=U&ei=IUTiU5jxFcOWyATYgYKICw&ved=0CBwQ9QEwAw&usg=AFQjCNHYIjqgrUv1M5lxOekJDcuHqR1AAg

http://www.google.com/url?url=http://www.hittingthestage.com/spotlight-on-workshops-creativity-defibrillator/&rct=j&frm=1&q=&esrc=s&sa=U&ei=R0TiU8eUDYyYyASuzoGACQ&ved=0CBoQ9QEwAg&usg=AFQjCNF0SLKm5wjbD07YOB8FOSg0xEr2HQ

27

Awareness of Energy

Moving Energy

Generating/Releasing Energy

Balancing Energy

Energy Management

Energy

Experiential

http://www.google.com/imgres?imgurl=http://3.bp.blogspot.com/-kJbUJWg_CFY/Tm4mtBOUQTI/AAAAAAAAA8U/fz8OX3delfg/s180/Beach-Sunset-Wallpapers-.jpg&imgrefurl=http://pzc-piclink.blogspot.com/2012/08/beach-sunset.html&usg=__zFIXUANafhscKYDJ6-qH4W4L1oU=&h=768&w=1024&sz=186&hl=en&start=4&zoom=1&tbnid=RZx3WjrHEhcbFM:&tbnh=113&tbnw=150&ei=olgCUoDaFI-MyAHquYGwBw&prev=/search%3Fq%3Dbeach%2Bsunset%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CDIQrQMwAw

http://www.google.com/imgres?imgurl=http://0.tqn.com/d/gocalifornia/1/0/W/q/P8291789-a.jpg&imgrefurl=http://gocalifornia.about.com/od/topcalifornia/ig/Best-Destination/Active.htm&usg=__ym4AYk9YZYt2CmJaahV9G_usokM=&h=500&w=500&sz=94&hl=en&start=19&zoom=1&tbnid=LGQTafj5KfjvDM:&tbnh=130&tbnw=130&ei=RVkCUsXyO8-kyAGq3ICgBQ&prev=/search%3Fq%3Dactive%2Bbeach%2Bvacations%26safe%3Dactive%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1&sa=X&ved=0CFAQrQMwEg

http://www.google.com/url?url=http://thenewdaily.com.au/life/2013/12/11/paradise-lost-gentrifying-destinations-death-nigel-bowen/&rct=j&frm=1&q=&esrc=s&sa=U&ei=4droU5n-KuGc8QH764GICg&ved=0CDYQ9QEwEA&usg=AFQjCNGiyWvJZNx8a3LJhT2XjsvbN0fueQ

28

Reminder…..

60-90%

Of all physician’s visits related to

STRESS

But…Are We All

Desensitized to the Word????











9) Weight Gain




13) Poorer Sleep


https://www.google.com/url?q=http://www.bostonmagazine.com/2012/12/health-and-fitness-exercise-workout-habits-2013/&sa=U&ei=hgttU-yNNuHQ8AHwxoGoBA&ved=0CFQQ9QEwEw&usg=AFQjCNGw9lJfcOEphN5b_3QMcXoVGvNWdA

https://www.google.com/url?q=http://blog.entrepreneurthearts.com/2012/04/11/exhaustion-paying-it-forward-and-patience/&sa=U&ei=fwhtU_q3JOGu8AG4s4DABw&ved=0CDoQ9QEwBg&usg=AFQjCNFCal0Q6zuqMV5XopFDRCrpjoUFRQ


29

Sobering

There is Research

There are

Options

There Are Choices

Opportunities

Self-Care

Self-Inquiry

Self-Awareness

Lifestyle Behavior Change

http://www.google.com/imgres?imgurl=http://www.colourbox.com/preview/1747134-437534-human-figures-holding-hands-in-a-circle.jpg&imgrefurl=http://www.colourbox.com/image/human-figures-holding-hands-in-a-circle-image-1747134&usg=__xAWfx0AYM3G3SS7yoACXtr0sBF0=&h=406&w=480&sz=89&hl=en&start=6&zoom=1&tbnid=ahhgjg-26FzsfM:&tbnh=109&tbnw=129&ei=KeJ2UJENpaLZBYfSgJgG&prev=/search%3Fq%3Dcircles%2Bof%2Bpeople%2Bfigures%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1

http://www.google.com/imgres?imgurl=http://cloud.graphicleftovers.com/11014/661531/one-out-of-ten-people.jpg&imgrefurl=http://graphicleftovers.com/graphic/one-out-of-ten-people/&usg=__bIub1CfKbOUoizP9S0R0iLrWpuw=&h=500&w=500&sz=93&hl=en&start=4&zoom=1&tbnid=1hBP7SrnNceH3M:&tbnh=130&tbnw=130&ei=1OJ2UNKwJOOy2wXaq4GABw&prev=/search%3Fq%3Dten%2Bpeople%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1

http://www.google.com/imgres?imgurl=http://bp2.blogger.com/_iJP_wg6Tnag/R6nzUePSscI/AAAAAAAAA4g/3lwnCx5T4NQ/s400/manicule.png&imgrefurl=http://mleddy.blogspot.com/2008/02/manicule.html&usg=__R6hYdpWsBaqcRQHliKYa9B5thLE=&h=179&w=322&sz=15&hl=en&start=3&zoom=1&tbnid=A4XLIrrgK_tYvM:&tbnh=66&tbnw=118&ei=COR2UPZX5oLbBcSUgLAG&prev=/search%3Fq%3Dpointing%2Bfinger%2Bicon%26hl%3Den%26gbv%3D2%26tbm%3Disch&itbs=1








30

Awareness

Choice

Action

Practice

Value

Beliefs

If you do not make any changes in your life

what does your health and well-being

look like in 3-5 years?

Thank You

http://www.google.com/url?url=http://www.tweeddailynews.com.au/things-to-do/pottsville-beach-drumming-circle/60637/&rct=j&frm=1&q=&esrc=s&sa=U&ei=B0biU5HnMJeeyATkhoGACg&ved=0CCIQ9QEwBg&usg=AFQjCNGKGSmorRNHxcu2qTVSJUYGe9rc9A

http://www.google.com/url?url=http://www.npr.org/blogs/health/2012/10/12/162782583/classroom-yoga-helps-improve-behavior-of-kids-with-autism&rct=j&frm=1&q=&esrc=s&sa=U&ei=EEniU7qHLoyLyAS984DICA&ved=0CBgQ9QEwAQ&usg=AFQjCNHPvwDWhURiRtpfiXmokuFk_mr3fg


Fall Prevention and Reduction of Fear of Falling

Documents

Transcript of Fall Prevention and Reduction of Fear of Falling