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Get Moving!

The Importance of Physical Activity

July 7, 2015

Gretchen Snethen, Ph.D., CTRS

The contents of this webinar were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number #90RT5021-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

• Life Expectancy: 13-30 years less than the general population

• High incidence of physical health conditions unrelated to Dx

• Metabolic Syndrome: Group of risk factors increasing one’s risk of heart disease, diabetes, and related conditions. Must have 3 of 5 risk factors• Risk factors:

– Large waistline (abdominal fat)

– High triglyceride levels

– Low HDL cholesterol

– High blood pressure

– High fasting blood sugar

• Incidence 2-3 x greater than general population

Before we get started…

Today’s Agenda

• Defining types of physical activity

• Understanding the physical activity guidelines

• Benefits of physical activity

• Assessing physical activity and physical activity motivation

• Setting and supporting physical activity goals

• Questions

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Activity Levels

• Four levels of activity

– Sedentary

– Light

– Moderate

– VigorousLIGHT

MODERATE

VIGOROUS

What’s the deal with METs?!

• Metabolic Equivalency• Energy expenditure/hour

– Sitting for 1 hour = 1 MET– Sleeping for 1 hour = .9 MET– Standing for 1 hour = 1.3 MET

• MET for average adults calculated in the Compendium of Physical Activity

• https://sites.google.com/site/compendiumofphysicalactivities/

Defining Sedentary Activity

• Little-no energy expenditure (1-1.5 MET)

• Seated or reclined position

– Screen time activities

– Reading

Sedentary Behavior… so what?

• Decreased health related quality of life

• Increased risk of chronic diseases– Cancer, diabetes, cardiovascular disease, gallstone disease,

hypertension

• Increased risk of overweight and obesity

• Chronic disease contributes to early mortality

• Cardiovascular disease #1 cause of decreased life expectancy– Being overweight or obese increases chance of cardiovascular

problems

– Low cardiorespiratory fitness -> cardiovascular disease

Amount of Sedentary Behavior

• Overwhelming percentage of adults with psychiatric disabilities experience high rates of sedentary behavior– 22 hours/day!

• Less likely to meet the physical activity guidelines• Some report zero leisure time physical activity• Women and older individuals are

especially at risk for negative effects of sedentary behavior

Light Activity

• Require minimal energy expenditure (1.6-2.9 MET)

• Purposefully acquired (walking for fun)

• Incidentally acquired (walking for transportation)

• Examples– Washing dishes, shopping, putting away groceries,

billiards

• Often does not raise your heart rate noticeably or increase respiration

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Light Activity…. So What?!

Mental Benefits of Walking

• Reduced symptoms of depression (McCaffrey et al., 2011; Ng et al., 2007)

• Reduced anxiety (Ng et al., 2007)

• Reduced stress (Ng et al., 2007)

• Increased positive emotions (McCaffrey et al., 2011)

Physical Benefits of Walking (Hart, 2009)

• Decreases weight

• Decreases BMI

• Decreases risk of diabetes

• Reduced occurrence of heart disease

• Strengthen bones

Moderate-Vigorous Activity

• Activities that expend the most amount of energy (<3.0 MET)

• Moderate: ability to talk, but not sing while participating– Examples: Walking up/down steps, walking

moderate/brisk pace, Table Tennis, Sweeping

• Vigorous: ability to say only a few words before taking a breath– Jogging, Running, Playing basketball, Jumping Rope

Physical Health Benefits Physical Health Benefits

• Increased health related fitness and physical health

• Decreased weight and waist circumference

• Decreased risk of chronic disease and early mortality

• Reduced risk of diabetes

• Sleeping better

What it looks like

• Reduced weight• Decreased waist size- wearing

smaller pants• Increased endurance• Ability to be physically active for

longer• Feeling more awake• Improved ability to breathe after

being active• Decreased chest pain

Mental Health Benefits

• Decreased symptoms of depression• Increased motivation• Improved mood• Grow your brain!

– Improve concentration skills– Improve memory

• Reduced stress• Increased self-esteem• Increased self-confidence• Sense of independence• Satisfaction with life • Decreased boredom

• Processes information better

• Remembers appointments

• Eager to engage in activities

• Confident in ability to learn new things

• Improved affect– More enjoyable to be around

– More even tempered

– Complain less

Mental Health Benefits What it looks like

Types of Physical Activity

• Adults should complete two types of physical activity each week to improve health

– Aerobic Activity

– Muscle-strengthening activity

Physical Activity RecommendationsOption 1

2 hours and 30 minutes of moderate-intensity aerobic activity per week (Ex. walking fast, water aerobics, biking with few hills, pushing stroller)

AND2 or more days of muscle-strengthening activities per week (all muscle groups: legs, hips, back, abdomen, chest, shoulders, and arms)

Option 2

1 hour and 15 minutes of vigorous-intensity aerobic activity per week (Ex. jogging, running, swimming laps, biking fast or on hills, playing basketball)

AND2 or more days of muscle-strengthening activities per week (all muscle groups: legs, hips, back, abdomen, chest, shoulders, and arms)

Option 3

Combination of moderate- and vigorous-intensity aerobic activity per week (Ex. 90 minutes of moderate-intensity plus 30 minutes of vigorous-intensity aerobic activity)

AND2 or more days of muscle-strengthening activities per week (all muscle groups: legs, hips, back, abdomen, chest, shoulders, and arms)

Types of Activities

throughout the week

Here are some recommendations on how to integrate activity throughout the week and meet the physical activity guidelines.

Assessing & Monitoring Physical

Activity

• Provides comprehensive understanding of baseline activities

• Allows individuals to track and monitor their own progress

Types of Assessment

• Self-report– Physical activity diary

– Assessment scales (International Physical Activity Questionnaire)

• Digital monitoring– Accelerometers

• Phone, FitBits

– Pedometers

Setting Goals: Big Picture

• First understand what individuals want to accomplish

• What personal benefits do they want to achieve?

• What benefits do they want to attain specific to physical and mental health?

• Create clear picture of how to set goals to promote increased physical activity

• Experiencing desired outcomes leads to sustained participation

• Set goals that will lead to specific individual benefits

Setting Goals: Identifying Activities

• Personally meaningful activities motivate participation

• Identify interesting, enjoyable, and meaningful activities

• What activities have they participated in previously?

• What activities do friends or family members enjoy?

• Make suggestions based on yours or others’ experiences

• Look through magazines for mainstream and alternative activities

Exercise Doesn’t have to be a four letter

word!• Interest-based activities• Identify leisure interests (LTPA)• Offer a variety of options• EXAMPLES

• Exergames (Wii)• Dance• Walking• Gardening• Dance• Sports• Running• Others?

Action Plan: Getting Started

What Expected Benefits Where? Cost to participate

Other Factors How often

Jog in a 5K

- Lose weight- Increase energy- Get fresh air- Spend time with

cousin who is a runner

- Less time bored at home

- Improve joints- Feelings of

accomplishment

- Delaware river trail

- YMCA Treadmill

- Track at park- Recovery 5K

- $10 registration

- YMCA Monthlycost

- Running shoes/clothing costs

- Get runningclothes & shoes

- Schedule weekly runs

- Create a calendar to track runs

- Invite cousin to run with me

- 1 5k in 3 months

- Training: 3 runs/week

- Training: walk every day

Self-Monitoring

• Important for individuals to Self-Monitor Physical Activity• The individual is the only one who can track daily physical

activity• Increases ownership of goals and responsiveness to

progress • Sense of independence and control• Increase self-efficacy

– Most consistent factor related to increased participation– Maintain participation over extended period of time– More likely to achieve goals through sustained participation

Reviewing and Discussing Progress

• Compare goals to actual progress• Work with individuals to assess whether or not present goals

need to be adjusted• Discuss barriers and adjust action plans if necessary• Identify additional supports that may be needed• Review time spent participating in different types of physical

activity • Discuss developing additional goals in order to reach

recommended levels of physical activity

1. Physical activity is important for both mental and physical health

2. Individuals with psychiatric disabilities engage in reduced amounts of physical activity and

high amounts of sedentary behavior

3. Develop strategies to assess physical activity levels and participation with consumers

4. Identify personally meaningful outcomes and goals

5. Identify personally meaningful activities

6. Set goals and action plan

7. Monitor and support progress

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Summary

Additional Resources

• Recommendations for physical activity – http://tucollaborative.org/wp-content/uploads/2015/06/PA-Document-Final.pdf

• Supporting physical activity: A guide for Peer Specialists– http://tucollaborative.org/wp-content/uploads/2015/06/Supporting-Physical-Activity-

A-guide-for-peer-support-specialists.pdf• Exercise Fact Sheets

– http://tucollaborative.org/wp-content/uploads/2015/06/Exercise-Provider-factsheet-FINAL.pdf

– http://tucollaborative.org/wp-content/uploads/2015/06/Exercise-Consumer-factsheet-Final.pdf

• Walking Fact Sheets– http://tucollaborative.org/wp-content/uploads/2015/06/Walking-Consumer-

factsheet.pdf– http://tucollaborative.org/wp-content/uploads/2015/06/Walking-Provider-

factsheet.pdf

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Contact Us For More Information

Gretchen Snethen, PhD, CTRS

215-204-1699

gsnethen@temple.edu

Or for additional technical assistance, check out the

Temple University Collaborative Consultation Services

http://tucollaborative.org/tucollaborative-consultation-services/

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