Professional Rehab Associates, Inc.
Newsletter
Summer Edition
V O LUME 1 I SSUE 3
J UNE 2013
The Use of Fitness Physicals & Exercise
to Achieve Wellness
Maintaining health function throughout your life can be extremely important for several
reasons. Typically, healthier adults and children are more able to pursue higher level leisure and sport
activity, allowing for better quality of life. Those who are more healthy also have better performance
in school and at work, with better attendance, mood, and performance ability. In today’s economic times it is important to consider
the cost of health, as those who are more healthy tend to require less
out of pocket health care expenditure. Pursuing health and a state of
wellness can be crucial in keeping performance at maximum ability
and attempting to ensure minimal health care expenditures. PRA
can offer specific approaches to assist you and your family in first
attaining, and then secondarily keeping optimal health. PRA can
also offer screening and primary detection of movement dysfunction and vital signs which can often be the first signs of disease and
pathology. This can help prevent a minor pain from becoming a
serious injury, allowing you to direct your health status to a more
positive direction more rapidly rather than feeling that your health is
out of your control and having to endure a more prolonged recovery.
Movement quality, postural control, cardiovascular fitness, and maintenance of healthy
muscle to fat ratios are elementary to optimal wellness. Studies conducted by the American College
of Sports Medicine reveal that optimal exercise performance can reduce the risk of coronary heart
disease and stroke, reduce blood pressure, improve cholesterol
levels, lower the risk for onset of non-insulin dependent diabetes
mellitus, reduce the risk for colon and breast cancer, improve
bone mineral density, reduce the risk of falling, and improve
mood disorders of depression and anxiety. Findings also indicate
that those with optimal cardio-respiratory fitness possess a 60
percent reduction in mortality rate than those with low levels of
fitness. The benefits of exercise can last for hours and even days
and regular exercise can have prolonged benefits to the body’s
metabolic system, which is of more benefit versus a “weekend
warrior” mentality. The metabolic effect can be present even in
the absence of weight reduction; however, with more prolonged
exercise exposure weight loss can be achieved which can significantly improve movement performance, reduce the stress upon
connective and supportive tissue structures, and can significantly improve risks of diabetes, stroke,
and heart disease. Utilizing exercise and healthy lifestyle habits can seriously pay off as annual health
care costs are estimated to be 20 to 30 percent higher in those who have a high waist circumference.
Keeping up with age appropriate exercise performance can ensure optimal performance,
lower disease risk and can allow parents to pass healthy behaviors onto their children. It can allow
children, adolescents, and teenagers the ability to play the sports they love with less risk of injury. In
adulthood the average adult gains one pound per year of body mass on average, while losing one-half
pound of muscle mass per year. So what can be done to not be just average? What can be done to
lower your risk of injury and lower your risk of chronic and costly disease?
Achieving wellness starts with assessment and detection. PRA utilizes a standardized approach to data collection assessing a wide variety of physical performance parameters for the arms,
trunk, and legs as well as comparing resting measures to exercise induced vital signs to arrive at a
measured level of function and relative risk that is unique to you. Your data is then compared to national age and gender averages to see how strong, lean, fit, and healthy you are. The better you score,
the lower your risk for injury and chronic disease. The movements specific for your job and your
sport can also be assessed to determine if there are any weaknesses or limitations that may pose risk
for injury. These limitations can be addressed by PRA to keep you fit to work with less risk for time
out of work, or can keep you in the games you love to play.
(Continued on Page 2)
SPECIAL POINTS
OF INTEREST:
 Fitness Physicals by PTs
 Defining Terms Used in
Weight Loss Strategies
 Side Dish Recipe for
Cookouts
V O LUME 1 I SSUE 3
P AGE 2
With sports specific programs we utilize an approach adapted from the Duke University School of Medicine Doctor of Physical
Therapy Division that incorporates a Targeted Enhanced Athletic Movement (TEAM). Using TEAM our staff will analyze movement patterns to identify faulty patterns to movements such as landing from jumps, cutting to change direction, and/or trunk and arm
angles during throwing and swinging to then correct the movements. We utilize specific exercise approaches unique to each athlete
and sport to improve the movement by refining joint angles and improving overall strength
with exercise that goes far beyond what is performed in physical education classes or given as
blanket exercises to all athletes in practices despite differences in position and differences in
anatomical make up.
Your assessment will be performed by a physical therapist. Physical therapists are
uniquely trained in primary care practice, movement science and motion analysis, and possess
the ability to intervene upon health and injury risk without the use of invasive procedures or
the use of medication. Physical therapists provide care that works as a collaboration of care
with your physician(s) to address your personal health goals. The physical therapists at Professional Rehab Associates possess over 40 years of combined experience, possess advanced
training and certification in orthopedic care, and utilize evidence supported by the research community to approach care to combine
your health and sport habits with best practice to promote your success. Put simply, we want to be on your team to achieve the best
health for you and your family.
From your initial measurements we can make preventative recommendations for exercise to rectify any movement impairments and can initiate a focused exercise program that is matched to your interests and ability levels. A repeat assessment can then
be performed at a suitable duration from your initiation of exercise to compare you again to the national averages, but also to yourself to see your progress. Your program can be adjusted, recommendations can be updated, and the process can continue toward
your goals and toward you achieving better work and sport performance, along with experiencing an overall healthier life.
Wellness Topics 1: BMI, BMR, and Weight Loss
All too often acronyms and terms such as BMI, BMR, metabolism, and caloric intake are used to give guidance for weight
loss. Yet, a large portion of our population does not have full understanding so as to accurately apply them. In this quarterly newsletter we are going to break down these terms in order to assist you in your weight loss goals.
Let us first start with your body mass index, frequently referred to as BMI. Your BMI is a ratio of weight to height, that
does not necessarily take into account body composition. It is an easy and inexpensive method of screening for weight that then
categorizes individuals for relative health risk. The calculation of BMI in isolation of other measures is not an accurate diagnostic
tool, meaning if you calculate that you have a high BMI you would benefit from the guidance of a healthcare provider to determine
if excess weight is posing a health risk. In some individuals a high BMI ratio is due to carrying a high amount of muscle and their
score of greater than or equal to 30.0 BMI is not truly a measure of obesity. The manual formula, seen below in figure 1, is one simple way to calculate your BMI. Another way to calculate your BMI is to use a computer based calculator such as the one on the
CDC website: http://www.cdc.gov/healthyweight/assessing/bmi/. The next step after you have calculated your BMI is to compare
your number to the provided scale (see figure 2) for an overall assessment of your current weight category.
Figure 1:
Figure 2:
BMI
Weight Status
Below 18.5
Underweight
18.5-24.9
Normal
25.0-29.9
Overweight
30.0 and above
Obese
The next term we will discuss is Basal Metabolic Rate (BMR) also referred to as Resting Metabolic Rate or Resting Energy Expenditure. BMR is an estimate of how many calories your body will burn at rest in order to maintain normal body functions.
The basal metabolic rate is a calculation based upon your gender, height, weight, age, and activity level. Once you have estimated
your BMR, an activity factor is applied. It is important to note that these calculations are only an estimate. To calculate your BMR
you can use the equation seen in figure 3, which is based upon your gender, or use the online calculator on the WebMD website:
http://www.webmd.com/diet/healthtool-metabolism-calculator.
Once you have your calculated BMR you need to take that number and multiply it by an activity level value (see figure 4
for activity levels). After multiplying your activity level by your BMR you have the total number of calories you need to eat in order
to MAINTAIN your weight. This measure can be used as a baseline to determine approximate caloric needs, and help you understand how you may lose weight. It is important to remember that women should never eat less than 1200 calories per day and men
1800. More than 2 pounds lost in a week is not considered healthy and is most likely not maintainable/sustainable. Let us illustrate
an example. It takes 3500 calories to equal approximately one pound of weight; thus in order to lose one pound of weight in one
week you need to make a calorie deficit of 500 calories per day. You can make a deficit through exercise, as well as watching your
caloric intake.
(Continued on Page 3)
P RO FE SS ION A L R E HAB A SSO CIAT E S , I NC . N E WS LE T T E R
P AGE 3
First we will do some math only looking at making a dietary change. If your BMR is 1515 calories and your activity level is 1-3
times per week your total is 2083 calories per day in order to maintain your current weight. If you wanted to design a diet program
to lose one pound per week you would have to subtract 500 calories from 2083 (your daily caloric intake) putting your total at 1583
calories per day. Remember you can use exercise to make an alteration to caloric needs as well, so now let’s say you want to cut 250
calories per day by dieting and another 250 by exercise. This would make your calorie intake 1833 which may seem like a much
more reasonable number to achieve. Another way of looking at the example would also be to achieve weight reduction via exercise
only. If your daily caloric needs in order to maintain your current weight is 2083 calories per day, and you want to lose 1 pound per
week, it is possible to exercise to burn 500 calories per day to achieve weight reduction. Want an even more potent approach to
weight loss? Combine your 500 calorie per day loss from exercise (moderate intensity exercise for one hour) and the 500 calorie per
day subtraction from less caloric consumption and you would result in a 1,000 calorie per day net loss which would result in double
the weight loss, two pounds per week. It is important to remember this is an estimated calculation and that losing weight needs to be
a lifestyle change not a 1, 2, or 3 month fad. Also, in our examples we used concrete numbers for the math. In your daily life you
would just need to average the dietary caloric intake reduction and meet an average caloric expenditure to achieve weight loss. Lastly, keep in mind that everyone’s weight will fluctuate and it is important to not worry over every individual pound lost or gained but
to look more at overall trends. Try to use reinforcement strategies to stay the course to your long-term goals, ensuring a true lifestyle
change to avoid the dreaded “Yo-yo” effect. Muscle mass, which is denser than fat, may be gained with exercise and may cause an
alteration in body mass. We will discuss body composition and your health in the next newsletter.
Figure 3:
Figure 4:
Men
10 x weight (kg) + 6.25 x height (cm) - 5 x age (y) + 5
Women
10 x weight (kg) + 6.25 x height (cm) - 5 x age (y) - 161
Activity Factor
1.2
1.375
1.55
1.725
Category
Definition
Little or no exercise and
desk job
Light exercise or sports
Lightly Active
1-3 days a week
Moderately
Moderate exercise or
Active
sports 3-5 days a week
Hard exercise or sports
Very Active
6-7 days a week
1.9
Sedentary
Extremely
Active
Hard daily exercise or
sports and physical job
Do you have more questions regarding your overall health and fitness level after reading this article? You can make an appointment
with a physical therapist at PRA for a wellness/fitness physical examination. We have the tools to perform a more accurate measurement for body fat composition, as well as the knowledge and ability to determine areas of functional impairment with in depth tests
and measures to better assist you in making decisions about and then performing the necessary steps to achieve true lifestyle change.
Roasted Sweet Potato Salad Recipe
Ingredients:
4 medium sized sweet potatoes, peeled & cut into 1’’ cubes
Dressing Ingredients:
2 tbsp apple cider vinegar
1 tbsp olive oil
1 tsp salt
2 tbsp brown sugar
Zest of 1 orange
1 tsp black pepper
2 cups fresh pineapple chunks
2 tsp deli style brown mustard
1/4 cup vegetable oil
1 red bell pepper diced
1 yellow bell pepper diced
1/2 cup shallots diced
1 jalapeno seeded and finely chopped
1/2 cup scallions thinly sliced
1/2 cup fresh cilantro chopped
1/2 cup flat leaf parsley chopped
Salt and pepper to taste
Directions: In a roasting pan, combine sweet potatoes and olive oil, salt, and pepper. Stir around coating potatoes in oil. Roast for
25-30 minutes at 425° F, until tender and golden brown. In a large bowl, add potatoes and mix with rest of non-dressing ingredients.
Let cool while you prepare the dressing. To prepare dressing, whisk together the apple cider, vinegar, brown sugar, orange zest,
mustard, and vegetable oil. Pour dressing over cooled potato salad. Toss. Chill in refrigerator until ready to serve. Toss again prior
to serving.
What’s New at PRA?
Professional Rehab Associates
2875 Barn Road, Suite 100
Christiansburg, VA 24073
Phone: 540-639-5786
Fax: 540-633-0787
E-mail: [email protected]
Therapy and Wellness for
All Ages!
Serving the NRV since 1987
Nolan Stewart, PT, DPT, OCS, Brittany
Stewart, PT, DPT, Ashley Goodridge, PT, DPT and
our former Duke University DPT student intern Briana
Gregory recently presented a lecture on common injuries, prevention of injuries, and performance enhancement for youth baseball and softball at the Radford
Recreational Center in April. PRA is a participating
Sports Medicine Practice within the STOP Sports Injuries campaign of the American Orthopedic Society for
Sports Medicine. In the future we plan to give more
presentations in concert with the recreational department to provide education to coaches, parents, and
players in all sports. Be sure to spread the word and keep an ear/eye out for our next lecture, which
could benefit your children or grandchildren.
If you have been into our clinic recently, you may have noticed some new faces. Anna
Critz, SPT is a rising second year DPT student at Radford University who is interning with us.
Molly Slusser recently graduated from Radford University and is completing her undergraduate
internship. PRA has long prided itself as a leading teaching facility in the area and we look forward to continuing our advancement of the rehab professions.
We’re on the web!
professionalrehabassociates.com
We gladly welcome any feedback you may have regarding the
newsletter. Please send us any questions, comments, or suggestions via email, with the subject heading ‘Letters to the Editor’.
Our email address is [email protected].
Or send them via mail to 2875 Barn Road, Suite 100, Christiansburg, VA 24073. Your question or suggested topic of
interest may be featured in our next issue.