Vestibular disorders are a common presentation for our Vestibular Physiotherapist Peter Vitale and Balance Retraining Specialist Craig Harrison. In this 3 part series blog you will learn the following:
The names of common Vestibular conditions and symptoms
How we define Vestibular disorders and the effectiveness of Physiotherapy and Exercise Physiology interventions for management
The practical techniques that clinicians use to assist with treatment.
Vestibular disorders occur when parts of the inner ear and brain, that process the sensory information such as balance and eye movements, are damaged by a disease or an injury. It can occur for unknown reasons, but can also result or be worsened by genetic and environmental conditions. They can affect both children and adults. In addition to damage of motor development and balance, vestibular deficits may cause poor gaze stability that suppresses children from learning to read. Children are not screened for these disorders, which results in a failure to receive early medical attention and treatment.
Some of the most common symptoms of a vestibular disorder are:
Vertigo (sensation of the room spinning)
Unsteadiness during gait (disequilibrium)
All these symptoms can lead to a reduced ability to perform daily functional tasks, reduced confidence and social isolation.
At Essendon Physio Group, we will be able to conduct an appropriate and thorough assessment and outline a detailed management plan. This can involve formal physiotherapy rehabilitation, cross- referral to the exercise physiologists at Exercise for Rehabilitation and Health for vestibular balance retraining and a home exercise program, or a referral to another health professional such as an ENT specialist or neurologist.
Vestibular conditions that we can assist with include:
Life! Programs at Exercise for Rehabilitation & Health
Our programs are continuing to gain in popularity, and as such, all of our evening and weekend programs beginning in February are now fully booked. To ensure that you can secure a place in our March/April programs simply call or email us to be placed on our waitlist.
The importance of workplace safety - Nicole French (AEP)
I was delighted to meet an inspirational man by the name of Kahi Puru last month during a workplace visit. Kahi, a Paralympian and WorkCover NSW ambassador, was crushed in a forklift accident at work at age 29. His left leg was amputated at the hip and doctors feared that he would not survive the accident. But, believing in the power of positive thought, Kahi defied the odds and went on to become a world-class athlete. There wasn't a dry eye in the house as he told his story and spoke of his passion for workplace health and safety. Making the day even more special, Kahi shared with the group, that just earlier that morning he was told that his beautiful daughter had given birth to a little baby girl and he was now a proud grandfather.
Jill Hennessy | Minister for Health and Minister for Ambulance Services | Member for Altona District - Nicole French (AEP)
I was delighted to have had the opportunity to meet Ms. Hennessy at an opening of a new Medical Centre at the Laverton Hub earlier this month. It was a thrill to meet such an inspiring and community orientated politician who took the time to meet and speak with all of the invited guests. I look forward to working with Ms. Hennessy to improve accessibility to Exercise Physiology and Physiotherapy services in her region. Ms. Hennessy is pictured below (centre).
Measuring our progress and planning ahead - as seen in Membership Matters, June 2015 edition (Diabetes Australia Victoria) author Nicole French
Wow, who can believe that it is June already? What a great opportunity to stop and reflect on the first half of the year and to start setting some physical activity goals for the next six months.
A big part of setting future goals is to take a moment, look in our own rear view mirror and reflect on our progress to date. In this month’s blog, we are going focus on some user friendly ways to measure your progress towards your goals and revisit the idea of SMART goal setting to help you keep on track. Let’s start off with measuring your progress.
Measuring Progress – Where to Begin
There are some great ways to measure progress towards goals, some will be using a measuring tool like a stop watch or tape measure and others will be thinking about the exertion or how you feel whilst you are exercising. Below are some suggestions for how you can measure fitness, muscular strength and endurance, balance and weight loss:
Counting the number of laps you can swim without having to take a break.
Taking note of the amount of rest breaks you used to take during exercise and compare them to what you need now - maybe you don't need a rest break at all.
Monitor the time it takes you to complete your usual walk - can you reach your destination in a quicker time or is it about the same.
Measuring your heart rate whilst you are exercising by using a heart rate monitor or taking it manually at your neck or wrist. If your heart isn't beating as quickly as it once did and you are not breathing as hard, this is a good indication that your fitness has improved.
Thinking about how many hills, steps and higher intensity bouts of walking or jogging you might now be integrating into your cardiovascular training routine that you weren't before.
For muscular strength and endurance, try:
Counting the number of times you can sit and stand from a chair in 30 seconds.
Monitoring the resistance of the weights you are using.
Noting the number of repetitions and sets of exercises that you can do now compared to before.
Taking note of the colour of the Theraband you are using (this will indicate the resistance/strength of the band). Did you change the band recently because the exercise started to feel too easy?
For balance, try:
Timing how long you can stand with your feet together, then try this again standing on a pillow or piece of foam.
Counting the number of times you can tap each foot on a step in 15 seconds.
Timing how long you can stand on one leg.
For weight loss, try:
Thinking about how your clothes fit you now. Are your jeans looser than before and are your shirt buttons easier to do up?
Measuring you waist with a measuring tape. Having a number value can be great because you can write it down and objectively track change. To improve accuracy of the measure, take note of a landmark (e.g. belly button) so that you can measure in the same place each time.
Using a set of scales. Having a value that you are familiar with (kg's or lbs') may assist you to keep on track. Do be mindful that you will experience daily fluctuations with weight and that most scales are not able to take into consideration levels of hydration or differentiate between muscle and fat. Also try to use the same scales each time for consistency of the measure.
It is also important to think about what other benefits your exercise is providing you with. These may not have been a part of your initial goal setting, but may help you set future goals. Ask yourself:
Has my quality of sleep improved?
Do I have more energy throughout the day?
Am I feeling more positive?
SMART Goal Setting – How and Why
Once you have looked at measuring your progress, you will be ready to look at setting some goals. The best way to set a goal is to look at the principle of SMART goal setting. We initially looked at this concept in the November 2014 blog. SMART goals are goals that are:
Specific This is the who, what, when, where, and how of your goal.
Measurable How will you measure you goal? If there is not a clear measure in place, how will you know if you've reached it?
Achievable If you really want to set yourself up for success, the goals should be something you can practically attain.
Realistic Something that you are willing and able to work towards. This doesn't mean you can't set the bar high.
Timely Your goal(s) should have a specific time-line; a date by which you want to achieve them. This will motivate you to get started.
This may be a simple concept, but simple doesn’t always mean easy. To practice your goal setting skills, why not try to workshop how you could improve the following Non SMART goal – ‘I want to get healthy’. After you have tried this, start planning your own. Another little tip, share your goals with others to increase your accountability.
Being able to measure your success and set SMART goals is a great way of setting yourself up to improve your health and wellbeing and the best part is, you are in the driver’s seat. It is important to remember that any progress towards your goals is something positive, you may not achieve all that you want the first time around, but like any good marathon (or tortoise and hare race) it is those that plan, pace and focus that will achieve their goal in the end. And if you feel like sometimes you are taking two steps forward and then one step back, keep in mind that you are still one step in front.
The burning Question - How hard should I be aiming to exercise to achieve the greatest health benefits - as seen in Membership Matters, March 2015 edition (Diabetes Australia Victoria) author Nicole French
As an Accredited Exercise Physiologist, I am often asked how hard exercise needs to be in order to be effective. This month’s blog aims to explore the topic of exercise intensity, more specifically how different intensities can influence health outcomes and whether you should focus more on exercise effort or how long the exercise lasts for.
Let’s first have a quick look at the different intensities of exercise:
Activities that usually involved sitting or lying and that have little additional movement and a low energy requirement
e.g. sitting on the couch or at a desk
An aerobic activity that does not cause a noticeable change in breathing rate
An intensity that can be sustained for at least 60 minutes
e.g. gentle walking in a shopping centre, dusting, washing
Still breathing comfortably
An aerobic activity that is able to be conducted whilst maintaining a conversation uninterrupted
An intensity that may last between 30 and 60 minutes
e.g. brisk walking, recreational swimming
Aware of breathing harder
May be feeling warm
An aerobic activity in which a conversation generally cannot be maintained uninterrupted
An intensity that may last up to about 30 minutes
e.g lap swimming, jogging
An intensity that generally cannot be sustained for longer than about 10 minutes
Should I aim to exercise harder or longer?
Both moderate and vigorous intensity exercise can be used to meet the minimum exercise recommendations for people living with diabetes. However, participating in vigorous intensity exercise may save you time, since the harder the exercise the less time you need to do it for.
How much more time efficient can vigorous exercise be?
Current exercise recommendations for people living with type 2 diabetes indicates that you should accumulate a minimum of:
210 minutes of moderate intensity exercise per week (30 minutes 7 days a week), or
125 minutes of vigorous intensity exercise per week (25 minutes 5 days a week)
Therefore, you could save 85 minutes a week if you were able to build your fitness up to a point where you could exercise vigorously.
If I exercise more, will I enjoy greater benefits from my exercise?
The simple answer is yes. If your exercise routine fulfills the minimum amount of exercise you should see some improvements in your blood glucose control, however if you were to exercise more than this, you can expect even greater health benefits.
The latest research indicates that how hard we exercise (intensity) can be more important in improving blood glucose control than how long we exercise (duration).
Tips to increase exercise intensity:
Include walking for higher intensity bouts, for example 4 minutes of slow walking and then 2 minutes of brisk walking
Stair or hill climbing
Water exercise -
Use resistive devices such as kickboards, noodles and flippers
Swim one fast lap for every few slow laps
Use heavier weights
Increase the number of repetitions or sets you do
Theraband work -
Make the band shorter to increase the intensity
During exercises, hold the stretch for longer
Incorporate short bouts of fast running or sprinting
Short bouts of ‘sprints’
Try a BPM class for a high intensity workout
If at this point you are thinking ‘but I can’t exercise vigorously’, please don’t be dismayed. We know that there are terrific benefits in moderate intensity exercise for blood glucose control, blood pressure, cholesterol, body fat and many more. You should always work at an intensity that provides a challenge for you but that is also safe given your personal medical history and any movement limitations you may have. Ask yourself the simple question ‘is this a challenge’ when you are exercising, if the answer is yes then you are doing a great job, if it is no try working a little bit harder.
When is vigorous exercise not recommended?
Vigorous intensity exercise is generally well tolerated, even in older adults; however there are circumstances when this intensity would not be recommended. If your blood pressure or blood glucose levels are not well controlled, if you have complications with your eyes or if you have unstable heart disease then we would not recommend vigorous exercise. It is also advisable to seek the guidance of a suitable health professional before commencing vigorous intensity physical activity to ensure that you are safe to do so.
Higher intensity exercise can offer greater health benefits when compared to light-moderate intensity exercise. It is more important than duration to improve blood glucose control and it can also be more time efficient. Many individuals report that the challenge that accompanies higher intensity exercise increases their motivation to adhere to a regular program which is important in sustaining health benefits in the long term.
It is advisable that prior to starting a vigorous or high intensity exercise program that you seek the advice of a medical professional and consider any pre-existing health conditions you may have to ensure the safety and appropriateness of this type of exercise. It is also recommended that you follow an individually prescribed program by a qualified health professional such as an Accredited Exercise Physiologists
We are back from our Christmas break and look forward to another wonderful year of helping you achieve your goals. Exercise Physiology appointments for January are almost exhausted, so if you're keen to get started on a new program or pick up where you left off last year ensure you make your appointment today.
It's that time of year again, hard to believe another year has flown by! The team at Exercise for Rehabilitation & Health would like to take this opportunity to thank our wonderful clients and colleagues for another fantastic year and wish each and every one of you a Happy and Blessed Christmas and New Year.
Our clinic will be closed during the Christmas & New Year period from Tuesday 23 December to Monday 5 January, 2015.
If you require any of our services before Christmas & in January, please book your appointment early to guarantee your preferred date and time.