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Clarian health health promotion inservice november 8, 2010
1. Health Promotion for Physical Therapists: Concepts and Practical Applications Julie Gahimer PT, HSD Associate Professor Krannert School of Physical Therapy University of Indianapolis November 8, 2010
26. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14%
27. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19%
28. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19% ≥20
29. Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Source: Behavioral Risk Factor Surveillance System, CDC
30. Obesity* Trends Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: Behavioral Risk Factor Surveillance System, CDC
40. Source: Behavioral Risk Factor Surveillance System,CDC 2006 Nationwide Data shows Tobacco Use: 20% yes; 80% no
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42. Native Hawaiian/ Pacific Islander Am. Indian/ Alaska Native I = 95% confidence interval. *Data are statistically unreliable and are suppressed. NOTE: Data are for adults aged 18-84 years and are age-adjusted to the 2000 standard population. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. For data prior to 1999, respondents reported one or more races and identified one race as best representing their race. For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Health Interview Survey (NHIS), NCHS, CDC. White Black Asian Hispanic * Total Age-adjusted rate per 1,000 population 1997-99 2000-02 2003-05 2010 Target: 3.8 * 5 10 15 0 20 Obj. 5-2 New Cases of Diabetes, Among Adults Decrease desired
43. Percentage of Adults Who Reported Eating fewer Than Five Servings of Fruits and Vegetables a Day, by Sex, 2002 The State of Our Nation: Trends in Health Behaviors Dietary Factors Associated 4 of the 10 leading causes of death: - CHD - Cancer - Stroke - DM II Source: CDC, At A Glance: Phys. Activity & Good Nutrition
85. The Big Picture Adapted from Health Promotion and Wellness: Expanding Your Practice Paradigm American Physical Therapy Association (APTA) Bezner, Black, Ingman Pre-pathogenic Period Period of Pathogenesis Primary Prevention Secondary Prevention Health Promotion Health Protection Preventative Health Services Tertiary Prevention Early dx & prompt treatment Prior to symptoms Disability Limitation Rehabilitation
86. Health Promotion Natural Extension of PT’s Role Primary Care Practitioner Examination Evaluation Diagnosis Prognosis (Including Plan Of Care) Intervention Outcomes Examples: Booth at Walmart; Lifelong PT, Annual Exams
90. An estimated 54 million persons in the United States, or nearly 20% of the population currently live with disabilities (McNeil 1997)
91. Interaction of Concepts International Classification of Function (ICF, 2001) Health Condition ( disorder/disease ) Environmental Factors Personal Factors Body function&structure (Impairment ) Activities (Limitation) Participation (Restriction)
97. ACSM Guide to Exercise Testing Durstine and Moore 2009 Methods Measures Aerobic- Cycle and wheelchair ergometer, traditional or wheelchair treadmill, combo arm and leg ergometer, seated stepper, arm ergometer BP, HR, RPE Endurance 6 or12 min walk, arm/leg ergometer Distance walked, time of exercise at 60% peak power Strength Mmt with or without hand held dynomometer Force generated on dynomometer
98. ACSM Guide to Exercise Testing Durstine and Moore 2009 Flexibility Hand held goniometer ROM in shoulder, elbow, wrist, knee, ankle and other joints of affected limbs Neuromuscular Gait analysis, Berg balance, functional reach, POMA Gait speed, symmetry of movement Functional Duke Mobility, FIM, Individualized criterion referenced tests
99. ACSM Guide to Exercise Programming Durstine and Moore 2009 Modes Intensity/freq/duration Aerobic Upper and lower body ergometer cycle ergometer, treadmill, wheelchair ergometer, wheelchair treadmill, arm ergometer, swimming seated stepper, seated aerobics, free wheeling RPE 13-20 50-80% peak HR 3-5 days/week 20-60 min session (or multiple 10 min sessions) Strength Isometric exercise, weight machine Free weights/dumbells, wrist weights, rickshaw, lat pull-downs, rowing 3 sets of 8-12 reps 2-4 days/week
100. ACSM Guide to Exercise Programming Durstine and Moore 2009 Modes Intensity/freq/duration Flexibility stretching 2 days a week (before or after aerobic or strength activities) Neuromuscular Coordination and balance activities 2 days/week (consider performing on same day as strength activities)
105. Evidence-Based Community Programs and Outcomes for SCI Ditor (2003) 9 month exercise intervention Less pain, stress, increase in quality of life Manns(1999) Relationship between fitness, physical activity, subjective quality of life, and handicap Persons who were more fit, were generally less handicapped
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Hinweis der Redaktion
Over the last century, public health concerns have shifted Early 1900’s controlling infectious disease such as tuberculosis, pneumonia and influenza, diarrhea, enteritis, nephritis, premature births, sanitation, immunization that were threats to mortality mid 1900’s discovery of penicillin, antibiotics, improvements in prenatal care, many of these causes of disease diminished or disappeared (still some concerns HIV, etc) Increased life expectancy by 30 years from beginning of 20th century
Mortality rates today are much more common to that of “diseases of behavior or lifestyle” and those that occur as a result of living into older years -heart disease (became #1 in 1921) -Cancer (top 10 early, worked its way up #2 in 1933) - Stroke, intracranial vascular lesion (worked way up #3 1938) COPD entered top 10 in 1974, now #4 Accidents, MVA (entered top 10 in 1926, worked way up) Diabetes (entered top 10 in 1932)
Over the last century, public health concerns have shifted Early 1900’s controlling infectious disease such as tuberculosis, pneumonia and influenza, diarrhea, enteritis, nephritis, premature births, sanitation, immunization that were threats to mortality mid 1900’s discovery of penicillin, antibiotics, improvements in prenatal care, many of these causes of disease diminished or disappeared (still some concerns HIV, etc) Increased life expectancy by 30 years from beginning of 20th century
Over the last century, public health concerns have shifted Early 1900’s controlling infectious disease such as tuberculosis, pneumonia and influenza, diarrhea, enteritis, nephritis, premature births, sanitation, immunization that were threats to mortality mid 1900’s discovery of penicillin, antibiotics, improvements in prenatal care, many of these causes of disease diminished or disappeared (still some concerns HIV, etc) Increased life expectancy by 30 years from beginning of 20th century
Healthy People followed by release of first set of health goals and objectives for the nation Have been several generations of these, most current is Healthy People 2010 (objectives set for each decade)
Leading Health Indicators reflect the major public health concerns in the U.S. And were chosen based on their ability to - motivate action - availability of data to measure progress - their relevance as broad public health issues
Recent correspondence with Janet Bezner, Vice President of APTA and health promotion specialist Stated that the APTA has played an active role since HP 2000 was created in 1990 Continues to be a part of the coalition of individuals and groups associated with HP2010 Recently met individually with the surgeon general to discuss APTA and physical therapist ’ s role in promoting fitness and wellness Representatives were at the press conference when the new dietary guidelines were announced - we were the only providers there relative to exercise. These efforts are currently coordinated by the Department of Practice - the director is Ken Harwood, PT, PhD
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