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Fitness for Breast Cancer Survivors page 3
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Fitness for Breast Cancer Survivors…Continued
3) Improve Endurance And Lean Body Mass
Help clients to adhere to a well balanced diet .Providing weigh training to increase LBM and aerobic exercise to increase metabolism, can assist in achieving weight loss.
Unless there are musculoskeletal limitations, you can use the traditional weight training exercises to the unaffected arm, legs, hips, abdominals and back. Cardiovascular exercise can be performed at 50-75% of heart rate reserve 3-5 days a week for 20-60 minutes.
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A RPE of 11-14 on a 1-20 scale is the best guideline. Walking and cycling are quite beneficial, but most exercises involving the large muscles are appropriate including swimming, cross training, or aerobics. It is best to begin with a 5-10 minute walk to judge your clients tolerance. Some clients who are severely deconditioned or experiencing treatment side effects may require multiple shorter aerobic sessions.
Your goal will be to gradually increase the time period engaged in aerobic exercise and to slowly increase their exercise tolerance. You may find that they have treatment side effects and may not be able to participate on a regular basis while undergoing treatment. It is important to be sensitive to ongoing needs and flexible with your exercise program design.
Frequency and duration should be progressed rather than intensity in the beginning whenever possible. Women who have undergone TRAM flap reconstruction should not perform sit-ups until 6-8 weeks after surgery In addition, high intensity exercise should be avoided during treatment.
4) Reduce Risk For Osteoporosis Related Factors
Encourage your clients to obtain a baseline bone density screening such as a DEXA .Calcium should be taken on a regular basis. There are some drugs that breast cancer survivors can take to maintain bone density, but hormone replacement therapy is contraindicated.
When clients are able, they should participate in weight bearing exercise to the hips and spine.
Although swimming and cycling is excellent vehicles for cardiovascular conditioning, they are non weight bearing activities. Weight training to the back, hips, wrist and forearms should be performed as a preventative measure along with balance training to prevent falls. If your client already has osteoporosis ,sit-ups are contraindicated for fracture risk to the spine.
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When clients are able, they should participate in weight bearing exercise…
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5) Improve Psychological Functioning
Participation in a regular well balanced exercise program that is gentle, slow and progressive can enhance self esteem. As one is physically challenged, sense of self improves as mastery is achieved a body which has once betrayed them. In addition, group exercise can provide companionship, fellowship and support to adhere to an exercise program. Exercise such as yoga can provide flexibility benefits as well as instruction in stress reduction techniques that can prove beneficial.
Working with this population provides numerous benefits. It can be very rewarding, as you see your clients progress. However, adaptability and tolerance are necessary personal assets, as clients my not be able to adhere to a regular program while undergoing treatment. Educate yourself regarding exercise contraindications and consult with rehabilitation professionals who can offer suggestions on range of motion exercises and lymphedema risk reduction.
Research has indicated numerous psychological and physical results after participation in exercise by breast cancer survivors. Bear in mind that more research needs to be conducted to determine what particular type, frequency, duration, intensity ,or rate of progression is most useful .In addition ,the effect of exercise on the development of lymphedema should be addressed in future studies.
About Naomi Aaronson
Naomi Aaronson MA OTR/L CHT is an occupational therapist and fitness instructor who created the Recovercises program for breast cancer survivors at SHARE and Ellen Bodner's Next Step Fitness.
Visit the Author's website at: www.recovercisesforwellness.com
Email: recovercises@aol.com to schedule her ACE/AFAA approved course in your area.
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