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Better Communication for Better Patient Outcomes

After being involved in a few complex workers compensation claims recently, it has become extremely apparent to me that one of the most important factors in reaching a positive outcome is the style in which we, as stakeholders involved in the claim, communicate with our injured workers. Most of the people I have worked with during a worker’s compensation claim have limited knowledge and understanding of the system and even less education about their injury and how to manage it. Many feel lost and unsupported in the system, which can create feelings of high stress, anxiety and uncertainty about their future. This is where we, as professionals in the industry can have the greatest impact in supporting our injured workers and reduce the risk of them being entrenched in the system.

A study found that up to 50% of biopsychosocial flags and barriers are missed during a consultation and that a physician interrupts a patient 18 seconds into the patient’s description of their problem. Alternatively, these flags can be identified and addressed when using a communication style that educates, positively influences and creates a trusting and open relationship, between the consultant and the injured worker. Studies have found a biopsychosocial communication approach, also known as the patient centred approach, results in greater positive patient outcomes evidenced by improved patient satisfaction, increased adherence to treatment plans and improved patient health, when compared to a biomedical approach.

The patient centred model involves a holistic approach to treatment, from emotional health, symptom resolution, functional status and pain control. To achieve this, both the worker and the consultant need to agree on the nature of the injury and the course of action to overcome it. One study found that in 50% of consultations, the physician and patient did not agree on the main presenting problem, resulting in poor management and outcomes. When conducting an initial assessment with an injured worker, the biopsychosocial communication style looks at not only asking questions about the physical injury, but also discussing the injured worker’s feelings and concerns about their injury, expectations from treatment and their perception about how their problem affects their function. The patient centred approach also encourages patients to be actively involved in the decision making about their treatment plan.

Adopting a patient centred communication approach allows us as stakeholders to really understand the whole impact an injury has had on the worker’s life and understand the worker’s needs, expectations and barriers. From this, we will be able to implement an effective and realistic treatment plan that the injured worker understands fully, regarding what is expected of them and how the treatment will assist them with returning to pre-injury duties and activities of daily living. Having the worker engaged and involved in their rehabilitation is also critical in empowering the worker to take control of their injury and manage it confidently long term. We really do carry a lot of influence in our roles and it is so important for us to continually reflect on how we are communicating with all stakeholders to ensure a positive experience and outcome for our workers.

For more information on how we can assist you with a worker’s compensation injury or claim, contact info@absolutebalance.com.au.

Tayla O’Halloran
(B.Sc. Exercise Physiology)
Accredited Exercise Physiologist (AEP) (ESSAM)

 

References:

Charlton, C., Dearing, K., Berry, J., & Johnson, M. (2008). Nurse practitioners communication styles and their impact on patient outcomes: An integrated literature review. Journal Of The American Academy Of Nurse Practitioners, 20(7), 382-388. doi: 10.1111/j.1745-7599.2008.00336.x

Margalit, A., Glick, S., Benbassat, J., & Cohen, A. (2004). Effect of a biopsychosocial approach on patient satisfaction and patterns of care. Journal Of General Internal Medicine, 19(5), 485-491. doi: 10.1111/j.1525-1497.2004.30059.x

Stewert, M. (1995). Effective physician-patient communication and health outcomes: a review., 1423-1433. 

Exercise physiologist: How we can help you with chronic disease

Exercise is considered a relatively new treatment option for chronic disease prevention and management. Many doctors and patients are unaware of how exercise can help, and what kind of exercise is right for them or their patients. This is where exercise physiologists (AEP’S) come in. We are the experts in exercise prescription. Often AEP’s are confused with physiotherapists and although they are similar, they are not the same thing. Physios address and diagnose acute musculoskeletal injuries and restore initial function; where as AEP’s use evidence based exercise intervention for chronic disease prevention and management. Although different, physios and AEP’s often work together to ensure the best results for patients.

Exercise as a treatment option has only gained traction in the 21th century, however it was widely regarded as one of the best disease prevention options over two thousand years ago. Hippocrates wrote “In a word, all parts of the body which are made for active use, if moderately used and exercise at the labour to which they are habituated become healthy, increase bulk, and bear their age well, but when left without exercise they become diseased, their growth is arrested and they soon become old”.

As AEP’s we use exercise as medicine. Each individual is prescribed a dose of exercise for their particular pathology. The prescription is given similar to any other medication. For example, exercise A, for B times a day, for C amount of time; whether that is for days/weeks/months or years. The dose and type of exercises are chosen for each individual person based on their needs and ability. They are then progressed based on their individual goals and functional need to perform physical tasks. This is designed for long term management, lifestyle and behavioural changes to effectively manage chronic conditions.

Exercise can be used to manage and prevents a number of chronic diseases which include cardiovascular disease, metabolic diseases such as diabetes, neuromuscular diseases such as Parkinson’s; as well as musculoskeletal conditions such as arthritis, osteoporosis and other acute and chronic musculoskeletal disorders.

At Absolute Balance we empower our clients, provide education and encourage positive behaviour changes through the use of evidence based therapies to help out clients achieve their health goals. For more information contact us today info@absolutebalance.com.au.

 

Claire Hills ( B.EXSpSc,Grad.Dip.(Clin.Ex.Phys))
Accredited Exercise Physiologist (AEP) (ESSAM)

 

What is an Accredited Exercise Physiologist? (n.d.). Retrieved March 18, 2019

Moore, G. E. (2004). The role of exercise prescription in chronic disease. British Journal of Sports Medicine, 38(1), 6-7. doi:10.1136/bjsm.2003.010314

Durstine, J. L., Moore, G. E., & Painter, P. L. (2016). ACSMs exercise management for persons with chronic diseases and disabilities. Champaign, IL: Human Kinetics.

Hamstring Injury

Last week I injured my hamstring whilst decelerating from a sprint at soccer training.  Fortunately, it’s not a serious injury, however I will still miss 3 games.  This injury is a wake-up call as two of the main factors were in my control.  In the preceding nights, my sleep quality was poor, causing a state of fatigue, and henceforth an elevated injury risk.  The second factor was my level of conditioning, which was good, but I know it could have been higher, especially for repeated sprints.  So as part of my rehabilitation (and long-term goals) I will focus on maintaining a regular sleep pattern and increasing repeated sprint capacity, in addition to restoring hamstring function.

As with any injury, it is important to understand the mechanism of injury to devise an optimal plan of action.  A key role of the hamstring muscle group is to decelerate the thigh and leg during the late swing phase of sprinting.  During this phase, the hamstrings are working eccentrically.  There is a large body of evidence indicating reduced eccentric hamstring force due to fatigue is associated with an augmented injury risk.  My injury occurred whilst decelerating from a sprint, and during the latter stages of training when hamstring force capacity was reduced due to fatigue.  Therefore, a key part of my rehabilitation will be to increase eccentric hamstring strength and fatiguability (as well as other factors).  I have included the Nordic hamstring lower in my rehabilitation programme to target eccentric strength as it is reported to be an effective intervention for preventing hamstring injury.  The world governing body of soccer/football, FIFA, has included the Nordic hamstring exercise in their injury prevention programme.  Whilst a primary focus will be on restoring hamstring function, I will also increase my lumbo-pelvic stability and maintain aerobic fitness through cycling.  As I return to running, I will progressively increase my repeated sprint capacity to facilitate my return to playing soccer.

Whilst the physical elements are vital for any rehabilitation programme, one of the most important factors for me is my mindset.  I have a strong drive to return to both soccer and running as these are two of my hobbies.  This mindset will facilitate my progress over the next 3 weeks by motivating me to complete my exercises each day.  Additionally, a clear mindset will also lighten the burden of any potential setbacks, which I have experienced with past injuries.

Whilst watching from the sideline is not ideal, I have learnt the importance of having a clear goal and a plan in place to achieve that.  I’m also aware that I need to take responsibility to reduce my future risk of injury and keep me on the playing field.

Please note hamstring injuries can be multi-factorial and those listed above are not an exhaustive list.  If you would like more information on exercise rehabilitation programmes that Absolute Balance can provide, please don’t hesitate to contact us at info@absolutebalance.com.au.

 

Daniel D’Avoine (B.Sc.Ex.Phys)

Senior Exercise Physiologist (AEP, AES) (ESSAM)

 

References:

Al Attar, W.S.A., Soomro, N., Sinclar, P.J., Pappas, E., & Sanders, R.H. (2017). Effect of injury prevention programs that include the Nordic hamstring exercise on hamstring injury rates in soccer players: a systematic review and meta-analysis. Sports Medicine 47(5), 907-916.

doi: 10.1007/s40279-016-0638-2.

Freckleton, G., & Pizzari, T. (2013). Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-anaylsis. British Journal of Sports Medicine, 47(6), 351-358.

doi:10.1136/bjsports-2011-090664

Small, K., McNaughton, L., Greig, M., & Lovell, R. (2010). The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. Journal of Science and Medicine in Sport, 13(1), 120-125.

doi:10.1016/j.jsams.2008.08.005

Smoking and its effect on your health

It has been highlighted by medical professionals that most smokers have heard it is harmful to their bodies, but they continue to smoke. It’s important for clients to know exactly the impacts of the choices they are making to their bodies so they can make an informed decision about their health and seek the correct help.

Every year approximately 6 million people world-wide die prematurely from preventable smoking related diseases, mainly cardiovascular diseases like coronary heart disease and respiratory diseases such as chronic obstructive pulmonary disease. This might be a shocking number to some as the prevalence of smoking has declined over the years.  Smokers are four times as likely than non-smokers to suffer from cardiac related deaths and is the cause of around 20% of all cancer deaths and 80% of all lung cancers. Smoking is a preventable lifestyle choice that leads to premature deaths and illnesses worldwide.

What are cigarettes actually made up of?

You might be surprised to know that cigarettes contain more than 4000 chemicals! A large amount of these chemicals has been identified as cancer causing, a few examples of these toxins include:

  • Nicotine – the addictive agent in tobacco smoke.
  • Formaldehyde – used in preservation of laboratory specimens.
  • Ammonia – used in toilet cleaner.
  • Hydrogen Cyanide – used in rat poison.
  • Acetone – used in nail polish remover.
  • Carbon monoxide – found in car exhaust.
  • Tar – particulate matter in cigarette smoke.
  • Toluene – found in paint thinners.
  • Phenol – used in fertilisers.

Some common health impacts:

  • Smoking reduces fertility in both men and women.
  • Declines in lung function and airway inflammation, which is why many smokers get out of breath quickly.
  • Aggravation of asthma and becoming resistant to inhaled corticosteroids.
  • Increased risk of miscarriage and underdevelopment of foetus.
  • Increased risk of bacterial and viral infections in the respiratory tracts.
  • Increased risk of cancers
  • Increased risk of cardiovascular diseases
  • Increased risk of strokes
  • Increased risk of blindness
  • Increased risk of deafness
  • Increased risk of osteoporosis
  • Increased risk of peripheral vascular disease
  • Increased risk of back pain.

What happens when you stop smoking?

When you take the step to stop smoking it can lead to different reductions in risks of smoking related diseases. 12 months post discontinuing smoking it is shown that the excess risk of having a heart attack due to smoking reduces by 50%! Giving up smoking recovers approximately 2-3 months of healthy life expectancy for every year smoking is stopped, around 4-6 hours every day. It is also shown to reduce breathing difficulties and return your lungs to a normal age-related decline, this will help with completing activities of daily life and being able to efficiently transport oxygen around the body.

For help:

Visit Absolute Balance consultants to discuss your health and fitness or call Quitline on 131 848

Dominique Mitchell

(B.Sc. Exercise, Sports, & Rehab Science; Grad Dip. Exercise Rehabilitation)

 

References:

Godtfredsen, N. and Prescott, E. (2011). Benefits of smoking cessation with focus on cardiovascular and respiratory comorbidities. The Clinical Respiratory Journal, 5(4), pp.187-194.

West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & Health, 32(8), pp.1018-1036.

Quitnow.gov.au. (2019). quitnow – Cigarettes and poison. [online] Available at: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/cigarettes-and-poison [Accessed 14 Feb. 2019].

 

Success Story – Paul Hudston

Paul sustained a knee injury at his workplace when he slipped stepping down from a step and slipped into mud and twisted his right knee. Paul was referred to Absolute Balance for exercise rehabilitation by his employer and insurer 2 weeks post-operative right knee arthroscopy and removal of loose bodies and chondroplasty.  At the initial assessment, Paul presented with slight swelling around the anterior-lateral aspect of his right knee and reported of ‘clicking’ during squatting movements. Paul had slightly restricted range of movement through his right knee specifically in knee flexion approximately 120o in weight bearing postures and approximately 10o in extension. Paul demonstrated loading approximately 40% through his right knee while performing functional movements including squats and step ups, and it was identified Paul had weak gluteal and hamstring musculature. Paul’s restrictions were lifting up 5kg, stand up to 15 minutes, walk up to 200 metres, drive 30 minutes twice day.

 

Job Specific Program

Pauls’ pre-injury duties included construction of scaffolds, working on platforms on average 3 metres in height, working on narrow and in confined spaces, operating cranes, load/unload tools and equipment, carry equipment on even surfaces and climbing up to 10 flights of stairs while carrying tools up to 20kg. The physical critical demands of his job role include lifting from floor to waist up to 25kg, lifting waist to shoulder height up to 20kg and lifting overhead up to 10kg. Majority of Paul’s work tasks are performed in a repetitive forward flexed and outreaches postures combined with push/pull style movements.

 

Paul’s exercise rehabilitation program initially focussed on improving pain-free range of movement through his right knee using a series of stretching and active range of movement exercises. The program progressed to correct muscular recruitment patterns of his right knee particularly his posterior chain and improved proprioception during work-based tasks. The final stage of his program was to increase strength of his supporting knee and hip musculature with the focus on correct biomechanics and safe manual handling technique for his job role to reduce the risk of re-injury. Paul was having concurrent physiotherapy and exercise rehabilitation treatment three times per week. Paul was able to return back on site with some restrictions including lifting up to 15kg and climbing 3 flights of stairs, after 3 months of exercise rehabilitation. Paul completed a few swings with those restrictions and his capacity was upgraded to pre-injury duties after a month.

 

Outcome of Exercise Rehabilitation

Paul is now at 100% functional capacity and has showed significant improvements in range of movement through his right knee with slight restriction at end ranges, he demonstrated improved stability and overall lower limb strength. Paul was able to perform repetitive floor to waist lifts with 25kg load, step ups with 20kg load and farmer’s carry with 20kg load on uneven surfaces. These functional movements matched up with the physical critical demands of his job role. Paul performed pre-injury pain-free as a rigger/scaffolder for a month, as a result he obtained a final medical certificate following a graded exercise rehabilitation program. Along the process, Paul started a strict eating plan along with the exercise program and he was able to lose 15kg in weight. Well done Paul!

 

More some insight on Paul’s exercise rehabilitation program, click on the links below!

Facebook

https://www.facebook.com/watch/?v=329708887674672

LinkedIn
https://www.linkedin.com/feed/update/urn:li:activity:6505660778937487360

 

Daniel Nguyen (B.Sc. Exercise Physiology)

Senior Accredited Exercise Physiologist (AES, AEP) (ESSAM)

 

Time Frames for Rehabilitation following Stem-Cell Injection Therapy

Stem cell injections have been increasingly used in the treatment of tendon and meniscus injuries, with varying degrees of success depending on the initial injury, the type of cells injected and the rehabilitation protocol following treatment. Any surgical intervention comes with an element of downtime, but just how much down time is suitable is a common misconception amongst patients following stem cell injections.

Recommendations for rest following stem-cell injections vary from 4 weeks rest up to 12 weeks rest, however the additional effect of deconditioning can inhibit the rehabilitation of injuries whilst time is set aside allowing the stem cells to take. Research suggests that moderate exercise combined with stem cell therapy provides the optimal outcome for conditions such as meniscus repairs with improved regeneration, reduced inflammation and reduced need for prescription-based medications. Further to this, rehabilitation protocols have been identified as most effective when commencing four weeks post-treatment.

Initial stage rehabilitation incorporating Exercise Physiology for lower limb injuries should incorporate two sessions of hydrotherapy per week using only the patients body weight. The second month of rehabilitation should continue to build incorporating hydrotherapy with additional load, progressing towards body weight only land-based exercise with three sessions completed per week. The final phase of rehabilitation should incorporate four sessions of exercise per week for months three and four with two hydrotherapy sessions completed per week and two land-based sessions completed per week.

Delays in the commencement of such rehabilitation protocols can negatively impact the outcomes of stem-cell surgery. Each patient’s injury and previous experience with exercise is different. Treatment from an Exercise Physiologist incorporating the above protocol can ensure the best possible outcome.

 

Ingrid Hand

BSc – ExHealthSc, GraddipSc – ExRehab, MSc – HumMvt

Exercise Rehabilitation Manager – Accredited Exercise Physiologist (ESSA)

 

Gibbs, N., Diamond, R., O Sekyere, E., & Thomas, WD. (2015). Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case study. Journal of Pain Research, 8, 799-806.

 

Total Knee Replacement and Exercise Rehabilitation

The knee, also known as the tibiofemoral joint, is a highly complex joint that when healthy, has a significant function in gait and weight bearing activities. In a perfect world, the articular cartilage and meniscus that allows smooth mobility and shock absorption throughout the joint would remain undamaged. Unfortunately, damage is extremely common through aging and trauma and this kind of impairment is essentially the definition of osteoarthritis. Given the consistent forces the joint experiences in flexion and extension, it is no wonder that this degenerative disease can result in chronic knee pain – and is the leading cause for 98% of knee replacement surgery in Australia.

There is a lot to consider before going under the knife. Your GP and specialist may try several non-invasive options including pharmacological pain management, walking aids and weight loss/ muscle strengthening through exercise. If these options are deemed inadequate, a total knee replacement (or total knee arthroplasty), may be the best choice. It is a significant yet common procedure where the tibia and femur are cut, diseased bone removed and a prosthetic knee joint is applied – essentially resurfacing the joint. This of course is a very simplified description and the complexity of such surgery should not be underestimated.

In Australia, we have seen significant growth in the popularity of the procedure. According to the Australian Commission on Safety and Quality in Health Care, between 2003 and 2014 the number of knee replacement procedures undertaken per year increased by 88%. They indicate that “the increase is partly due to population ageing but also to the growing use of this intervention for people at earlier ages, as a result of rising levels of obesity, which have increased the need for knee replacements.”

So, let’s assume knee replacement surgery is in your best interest – one can expect to experience impairment to range of motion, muscle flexibility, strength, endurance, balance and muscular recruitment patterns. Whilst all muscles around the knee joint are important, atrophy of the quadriceps is the significant contributor to these listed impairments. Quite positively however, exercise intervention can address all of these implications. A study completed by Mizner, Patterson and Snyder-Mackler (2005), showed that “following 6 weeks of rehabilitation, quadriceps strength improved significantly at each following assessment (2, 3, and 6 months postsurgery).” In addition, functional performance enhanced significantly at each assessment, correlating with that of increased quadricep strength. This study and a wealth of others show that muscle impairment and functional limitations can be reversed following a total knee replacement.

Each individual is unique in their recovery after surgery and this remains true throughout the whole rehab process. Common practise will have you moving very shortly after the procedure and in this stage treatment from a physiotherapist may have the best outcome. Up to 3 months post-surgery however, concurrent or sole treatment with the services of an exercise physiologist would be most suitable. The EP’s at Absolute Balance are experts in knee rehabilitation and use only the most up to date, evidence based research when providing exercise therapies. For the best outcomes in your recover, contact us today!

Ed Daccache

B.Ex.SpSc, Grad.Dip.Ex.Sc (AEP, AES) (ESSAM)
Accredited Exercise Physiologist

 

 

 

References:

Australian Commission on Safety and Quality in Health Care. (2017). The Second Australian Atlas of Health Care Variation (Knee replacement hospitalisations 18 years and over). 243-255. Retrieved from https://safetyandquality.gov.au/atlas-assets/The%20Second%20Australian%20Atlas%20of%20Healthcare%20Variation.pdf

Meir, W., Mizner, R., Marcus, R., Dibble, L., Peters, C., Lastayo, P. (2008) Total Knee Arthroplasty: Muscle Impairment, Functional Limitations, and Recommended Rehabilitation Approaches. Journal of Orthopaedic & Sports Physical Therapy. 38(5), 246-256. Retrieved from https://www.jospt.org/doi/pdf/10.2519/jospt.2008.2715

Mizner, R., Petterson, S., Snyder-Mackler, L. (2005). Quadricep Strength and the Time Course of Functional Recovery After Total Knee Arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 35(7), 424-436. Retrieved from https://www.jospt.org/doi/pdf/10.2519/jospt.2005.35.7.424

 

 

Effects of Altitude Training

Altitude training gyms and chambers are increasingly becoming more popular in our cities. At altitude, the barometric pressure is reduced which decreases the partial pressure of oxygen we inhale. Most altitude training centres will reduce the percentage of oxygen in the air to induce the same effects (hypoxia). How does it feel? I recently did a 10 min intensity sprint on a bike in 14% oxygen. My breathing rate increased to try to get more oxygen into my body, my heart rate increased dramatically and my legs and arms both felt very heavy to produce the same work rate as I did outside the hypoxic chamber.

The benefits of altitude training can be immense, mainly for aerobic performance that relies on our oxygen transport system. However, there is a dose response, meaning you need a defined period of time for the body to adapt to performance-based changes in the hypoxic environment. Some have suggested from 21 hours per week for some benefits and up to 10 days of continuous hypoxic exposure. This is to reach performance goals for endurance sports, increasing the body’s aerobic capacity and ability to produce more work.

What is forgotten in the new age of accessible hypoxic chambers is that intensity is limited when training in this environment, meaning that volume of work completed is lower which may lead to little benefit. The body needs time to adapt to these physiological stressors, which may not be met by intermittent hypoxic training at your local boutique facility. However, studies have shown that training in hypoxia can increase metabolic rate and increase the hormone leptin, which reduces appetite. At the very least this may have meaningful results for weight loss in some people. If you want to discuss ways to improve performance contact an accredited exercise physiologist at Absolute Balance today on 9244 5580 or email info@absolutebalance.com.au.

 

Taylor Downes

Exercise Consultant – B.Sc. Sport & Exercise B.Ed. Human Movement (ESSAM)

 

 

References

Lippl, F. J., Neubauer, S., Schipfer, S., Lichter, N., Tufman, A., Otto, B., & Fischer, R. (2010). Hypobaric hypoxia causes body weight reduction in obese subjects. Obesity, 18(4), 675-81. doi:http://dx.doi.org.libproxy.murdoch.edu.au/10.1038/oby.2009.509

Rodríguez, F. A., Truijens, M. J., Townsend, N. E., Stray-Gundersen, J., Gore, C. J., & Levine, B. D. (2007). Performance of runners and swimmers after four weeks of intermittent hypobaric hypoxic exposure plus sea level training. Journal of Applied Physiology, 103(5), 1523-1535. doi:10.1152/japplphysiol.01320.2006

Exercise Immunity and Me – Case Study

As most of us know, Exercise is a widely recognised intervention for numerous chronic diseases. This article highlights the intricate connections between exercise, stress, anxiety and immune function. We researched this topic further after many of the issues discussed arose for a patient who received exercise rehabilitation at Absolute Balance.

The workers compensation process is one that at times can be drawn out and stressful for those involved. The goal of exercise rehabilitation is to minimise the patient’s time away from meaningful employment. By doing so, we can reduce the impact of injury on both physical and mental health. For this patient, a manifestation of numerous factors outlined below has unfortunately caused a delay in their recovery.

The first thing to note is that the acute healing process involves an inflammatory response, assisting the injury to repair itself. Whereas chronic inflammation is detrimental rather than beneficial, it can result in global inflammation throughout the body which can also cause immunosuppression. High levels of stress and anxiety can result in this chronic inflammation.

This was confirmed by observing the elevated presence of inflammatory cytokines (markers) within the chemistry of those heavily exposed to physical and psychological stressors. Research also shows that the body’s sensitivity to inflammation is heightened by depression and anxiety. (Mases, 2001). As a result, it is easy to see why this may cause delay in recovery of an injury.

As mentioned, immune function can also be lowered by high levels of stress and anxiety. Evidence has found that psychological stressors can cause reactivation latent herpesviruses. For our patient, this manifested as Shingles, a common exacerbation of the latent Chickenpox virus many of us get as children. The flare up of this condition further delayed recovery due to pain and fatigue. Chronic stress and anxiety can also effect wound healing and increase risk of infections such as upper respiratory tract infections (Colds) which our patient also reported. (Glaser & Kiecolt-Glaser, 2005)

In workers compensation we use exercise to treat a specific injury, but we also need to take a holistic approach when it comes to rehabilitation. By also providing exercise to improve mental health and immune function, this should have a flow-on effect toward improving their recovery.  The J-curve theory below gives an indication as to the most appropriate exercise workload for improving immune function. (Niemen et al, 1994)

Self-management and ownership of rehabilitation is another essential factor when it comes to speeding up the recovery process. Our patient’s delay in referral to exercise rehabilitation meant that by the time we began treatment, the pressures of being away from meaningful employment had already became apparent. These high levels of stress hindered their capacity to complete self-managed exercise.

To conclude, high-levels of stress and anxiety are factors that cannot be overlooked when treating any form of injury. As we can see, the physiological repercussions can affect far more than just the injury itself. In addition, some form of psychological intervention may help to assist with the recovery process by addressing any underlying factors associated with elevated levels of stress and anxiety. For more information contact us at Absolute Balance.

Keiran Kowalski (B – Clin.Ex.Phys)
Accredited Exercise Physiologist, (AEP) (ESSAM) (ACSM)

 

References:

Maes, M., Ombelet, W., De Jongh, R., Kenis, G. & Bosmans, E. The inflammatory response following delivery is amplified in women who previously suffered from major depression, suggesting that major depression is accompanied by the sensitization of the inflammatory response system. J. Affect. Disord. 63, 85-92 (2001).

Glaser, R. & Kiecolt-Glaser, J. K. Stress-induced immune dysfunction: Implications for health Nature Reviews: Immunology. 5, 243-251 (2005).

Nieman DC. Exercise, infection, and immunity. International Journal of Sports Medicine 15Suppl3: S131-41. 1994

 

Hypertension

Hypertension, also known as high blood pressure, affects more than one-third of Australians, over the age of 18. It is a key risk factor for heart attack and stroke, which comprises as one of the major causes of death in Australia. Globally, high blood pressure constitutes as an extensive health importance.

What is high blood pressure?

As our blood gets pumped by the heart around the body, the pressure with which it pushes against the walls of the blood vessels changes. When the heart is squeezing blood into the arteries (systolic), the pressure is high. When the heart is relaxed (diastolic), the pressure is lower. Your blood pressure is important because if it is too high, it affects the blood flow to the rest of your organs. In time, when left untreated, this increases your chance of developing further heart disease, kidney failure, eye disease, and other conditions.

How can exercise help?

Exercise, or any form of regular physical activity, can help your heart become stronger. A stronger heart pumps more blood with less effort. When the heart works less to pump the blood, the force on your arteries decreases, thus lowering your blood pressure. Your risk of high blood pressure increases with age, so finding the right exercise for you now can make a world of difference in your cardiovascular health in the future. Becoming more active helps to maintain your blood pressure, but you need to keep exercising on a regular basis to do so. These benefits last only as long as you continue to exercise. If you have high blood pressure, always check with your doctor first, before starting any fitness regimes. Also, if you take any regular medications for blood pressure, always ask your doctor first if exercising will make it work differently or if it will affect the way your body reacts to exercise.

 

If you are looking for ideas or classes that will improve your cardiovascular fitness (or health in general), the friendly exercise physiologists at Absolute Balance our happy to help. Visit our Como Clinic at 1 Preston Street, Como or email info@absolutebalance.com.au.

Norlina Yakin

Exercise Consultant/Personal Trainer

 

https://www.healthdirect.gov.au/high-blood-pressure-hypertension