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Advice Pool - Referring Your Clientele for Aquatic Exercise Programs
Aquatic exercise can be very beneficial for a variety of patients: seniors, athletes needing injury rehabilitation, and pregnant women are just a few of the groups that aquatic exercise can benefit. Few practitioners know what to look for when they refer their patients to an aquatic exercise program, though. Most usually t According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product ell their patients to “join a water aerobics class” and leave it at that, without really knowing what the patient may be getting into. Below are some of the things health practitioners should consider when referring their patients for aquatic exercise. Referring Patients for Aquatic Exercise ? Observe classes in your a ; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug. Examples of combination products may in rea. ? Know the pool temperature. (86? or higher for arthritics, 79-82? for lap swimming) ? Know the special needs accessibility of the pool and locker rooms ? Check on third party payer reimbursement. ? Think of your patient. Would you send a 70-year-old to a class at a mirror-clad health club, or to a lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together. YMCA? Does a 20-year-old athlete need to be in an Arthritis Foundation level class? Safety Issues ? Is a lifeguard present? ? How comfortable is the patient in the water? ? Is there food available in the area for diabetics if necessary? ? Is there a first aid kit? ? Is there a backboard? ? Is t here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe here a phone? ? Is there a defibrillator on the premises? ? Are the instructor and lifeguard aware of your patient’s particular problem? Aquatic Exercise Design ? Water affects each body type/design/fat distribution differently. For example, males will have a harder time in deeper water than will female d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations. Combination pro s due to wider shoulders and narrower hips. Pear-shaped patients will have a harder time keeping their legs from floating, due to their fat distribution, so they will need to exercise more abdominal control. ? The same exercise will work different muscles, depending on the depth of the water. ? Changing the speed o ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc f the exercise changes the amount of friction, which changes the resistance. ? Currents change proprioception, stability, and level of control. ? Water at neck level supports 90% of the body’s weight; water at mid-torso level supports 75% of the body’s weight, and water at waist level supports 50% of the body’s weig easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi ht. How deep the patient should be depends on their individual needs. ? In most aquatic exercises, there is frequent use of the abdominals to maintain position, without doing sit-ups/crunches. ? Emphasize posture and body position to get the most benefit from aquatic exercise. ? Start easy to avoid discouragem nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically ent. Intensity of Aquatic Exercise ? Intensity should not be based on heart rate. Heart rates are only valid of they correlate to oxygen consumption. Heart rates will be lower in the water because water dissipates heat more effectively than air, so the heart doesn’t beat as fast to cool the body; decreased gra and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ vitational pull eases venous return; and hydrostatic effects shift blood volume from the extremities to the thorax. In the water, heart rates on average are decreased 13% or 17 bpm from those on land. ? Intensity must also take into account the effects of medications or specific disease conditions. ? To increase th ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi e heart rate, use shorter levers and less elevation of movements. ? Using the arms overhead increases the heart rate, but not the stroke volume, so the cardiac output may not be enough to achieve cardiovascular fitness. ? You cannot use sweat to correlate to exercise intensity. You may sweat in the water without kn ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it. Following aspects would a owing it. ? New exercisers must be taught the difference between “bad pain” and “good pain” (from exercising). Aquatic Exercise and Pregnancy ? Benefits of aquatic exercise during pregnancy: ? decreased impact. ? decreased gravitational pull. ? cooling effect of water prevents overheating. dd to the challenges in developing combination products: Which markets to tap where the combination products can do fairly well? Which combination prod >
? heart rate doesn’t increase as much as with land exercise. ? hydrostatic pressure pushes excess fluid into the bloodstream, decreasing edema. ? less of a heavy, clumsy feeling in the water. ? feel like they can move with more grace. ? Safer. ? Emphasize simply maintaining their current fitness le cts are meaningful and rational? Which therapeutic categories to select? Which Combinations can address unmet needs of the patients? Do combin vel instead of trying to improve it. ? Pregnancy may be the first time she considers fitness, so she may need more feedback from the instructor. ? Special needs for pregnant patients in aquatic exercise: ? longer warm-up and cool-down ? gradual intensity changes and longer transition times ? simple ch tions increase the patient compliance? What would be the developing cost? How to tackle the risks encountered during combination product developmen oreography ? caution against overstretching ? good chance to educate on proper nutrition and hydration ? Pregnant women can safely perform supine abdominal exercises in the water because there is no pressure on the vena cava like there would be on land. (Must check for diastasis recti, though.) ? Intensity t? As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel should reflect how they feel today, not how they “usually” exercise. ? If a pregnant woman is in a mixed class, do not single her out. Talk to her about special precautions either before or after class. Strength Training in the Water ? Of all the body systems, the neuromusculoskeletal system can demonstrate t ping new procedures for reviewing their safety, efficacy and quality. Professional from academic institutions, pharmaceutical industries, health care indust he most visibly dramatic difference between a completely sedentary person and a person who conscientiously trains. ? A 1990 study of 86-96 year olds in long term care facilities with only 8 weeks of aquatic strength training to their knee extensors there was an average strength increase of 180%. Some subjects in the stu y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products dy were even able to eliminate their use of canes when walking. ? Aquatic strength training does not increase the number of muscle fibers, but does increase their size, the number of fibers activated, the number of capillaries going to the muscle fibers, and the mitochondrial efficiency in the muscles. For More Informat . As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de ion: ? Arthritis Foundation--www.arthritis.org ? American Red Cross--www.redcross.org ? YMCA--www.ymca.net ? Aquatic Exercise Association—(813) 486-8600 or www.aeawave.com ? American Alliance for Health, Physical Education, Recreation, and Dance—(703) 476-3400 or www.aahperd.org ? United States M elopment. They need to be wiser in analyzing the market trends and the regulatory requirements. Companies that provide selfless information through particip asters Swimming—(804) 355-6588 or www.usms.org ? United States Swimming—(719) 578-4578 or www.usswim.org ? USA Triathlon--www.usatriathlon.org ? National Sports Center for the Disabled--www.nscd.org ? Wheelchair Sports USA--www.wsusa.org ? Special Olympics—(202) 628-3630 or www.specialolympics.org tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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