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How Good Are Patients at Following Doctors’ Orders, Really?

How Good Are Patients at Following Doctors’ Orders, Really?

The simple answer to the question posed in this article’s title is “Terrible.” Need a simple example? An estimated $300 billion is wasted every year in the US because patients don’t follow the treatment regimens that have been prescribed for them. Between 20% and 30% of first-time prescriptions are never filled, and over 50% of patients admit to not remembering or not adhering to their doctors’ instructions for how to take the prescriptions they did have filled.

So what causes non-compliance with doctors’ medical advice?

Obviously, part of the problem is poor communication on the part of both doctors and patients. It’s not unusual for healthcare providers to provide only a brief explanation of the treatments they prescribe. And for their part, many patients don’t really understand their doctors’ instructions and are uncomfortable asking questions.

Another part of the problem is inherent in the language used to describe the “old-school” relationship that once existed between doctors and their patients. “Following orders” is a military term, but most patients in this day and age are not in the military, and they don’t believe that their doctors have the right to give them orders. More often, patients regard a doctor’s advice as an expert’s suggestion, which they follow for as long as they’re experiencing symptoms that concern them. This can be especially true (and dangerous) when a patient has a chronic health condition that must be actively managed and that may require meaningful lifestyle changes related to diet or exercise.

Improved communication leads to improved compliance.

The more clearly doctors communicate the reasons for adhering to a treatment regimen, the more likely patients are to actually follow their advice. Doctors should take note of patients who seem depressed, for example, because statistically they will be the most likely to ignore or forget treatment advice.

But there are also things patients can and should be doing to improve their own healthcare outcomes. If you don’t understand your condition, don’t believe your treatment is working or are experiencing side effects, always tell your doctor. It’s never a good idea to simply discontinue treatment without having that conversation. Remember—you are ultimately responsible for your own healthcare. Whether you’d like a second (or third) opinion about your diagnosis or are interested in alternative treatment options, it’s important for you to communicate candidly!

As chiropractic physicians, we understand just how important good communication is in building a productive relationship with our patients. We want to be your partners in good health, and that means listening carefully and answering questions as directly and completely as possible!

Adding Variety to Your Resistance Band Workouts

Adding Variety to Your Resistance Band Workouts

In the TV show Star Trek: The Next Generation, “resistance was futile” against the Borg arch villains. But when it comes to exercise and staying in good shape, resistance is NOT futile, and can be one of the best ways to have a great workout—anytime and anywhere.

Resistance bands are the “great democratizer” of the exercise world. Sure, you could join an expensive gym and have access to their shiny exercise machines and racks of free weights. Or you can buy a set of resistance bands for about the same cost as one single month’s membership at the gym and effectively perform all of the same exercises (and more) any time you want and wherever you want to do them. With resistance bands, you can easily exercise at home without having to convert a whole room into a mini-gym to hold all the equipment.  And the bands are lightweight, so you can toss them in your luggage and take them with you when you travel. This makes it easy to exercise in your hotel room!

Ease of use is not the only advantage of resistance bands over weights and machines.

With resistance bands, you can perform pretty much all of the same exercises you can perform using free weights or specialized exercise machines at the gym. For example, by simply standing on one end of the resistance band and pulling upwards, you can do biceps curls. By securing the band at the top of a door jam, you can pull downwards to do pulldowns or triceps pushdowns. You can wrap the band around a vertical pole and perform the same motions as bench presses or butterfly presses to work on your chest. The possibilities are endless and limited only by your own imagination. You can even use your resistance bands in conjunction with other pieces of exercise equipment you have, such as stability balls, Bosu balls, steps, or wall mounts.

Another advantage of resistance bands over free weights or exercise machines is that you get to decide where the resistance comes from, and keep it constant during the full range of motion. With free weights, resistance is determined by gravity, so for example when you are performing biceps curls the resistance is stronger during the upswing of the curl (when you are working against gravity) than during the downswing of the curl (when you are being assisted by gravity). With bands, the resistance is constant, forcing you to use more muscle groups, and improving your coordination and balance at the same time you build strength.

The main benefit of bands, however, is the variety that can be built into a workout.

We could list dozens of ways to use your resistance bands in this article, but our advice is to just use your imagination to think up your own new ways to exercise using them. One quick Google search will give you dozens of “starter” ideas, but then (if you’re like most people) you’ll discover the fun of inventing your own workout routines and start inventing new exercises of your own to add variety to your workout.

And variety is essential for several reasons. First, it keeps you from getting bored with the same old routine and makes it more likely that you’ll develop an exercise habit that sticks. With resistance bands and a little creativity, you can have a different workout almost every day, and never fall into the rut that many people experience with their exercise routines at the gym. All it takes is a little creativity. Just for starters, you can change the anchor point of the bands and create resistance from wherever you want it—the side, overhead, below, wherever. If you play sports, you can also use the bands to mimic movements you want to strengthen, such as your golf swing or tennis serve. No machine in a gym allows you to do that through the full range of motion.

Resistance bands—especially the type with detachable handles that can be “mixed and matched” to produce different levels of resistance—are great for all fitness levels. You can benefit from them as a beginner, but if you use a little creativity you can benefit even more from them as an advanced exerciser. So go boldly forth and invent new exercises, because no matter what the Borg said in Star Trek, resistance is NOT futile.

Spinal Health in the News:  The McKenzie Method

Spinal Health in the News: The McKenzie Method

The McKenzie Method is a technique for treating spinal problems and related pain that is well-regarded in Australia, New Zealand, and Europe, but so far is not as well-known here in America. The McKenzie Method was created in the 1960s by New Zealand physical therapist Robin McKenzie. The concept behind his method is called Mechanical Diagnosis and Treatment, or MDT. It is a complete system that encompasses the full range of assessment or evaluation, diagnosis, and treatment of disorders of the spine and extremities.

A central tenet of the McKenzie Method is that self-healing and self-treatment are important in alleviating the patient’s pain and facilitating rehabilitation. Diagnosis is an interactive process during which the patient works with a certified McKenzie physical therapist to assess pain and range of motion by working through a series of safe movements that enable the therapist to determine exercises that can most quickly heal any abnormalities. Also, no “passive” modalities—such as heat, cold, ultrasound, medications, or needles—are used during the treatment itself.

What is McKenzie Method treatment like?

The therapist works with the patient to determine whether his or her condition should be categorized into one of three syndromes – postural (related to end-range stress in normal musculoskeletal structures), dysfunction (related to end-range stress due to musculoskeletal structures shortened by scarring or fibrosis), or derangement (related to anatomical disruption or abnormality). Each of these syndromes is then addressed uniquely, using proprietary mechanical procedures involving movement, extension exercises, and static positions.

McKenzie physical therapists work with patients, emphasizing education to help them understand why each exercise or position is being used, and how it helps the healing process. The goal is to develop a pattern of active patient involvement in which patients learn the movements and then practice them at home, not just while in the therapist’s office. Many studies have indicated that this approach has many advantages—it decreases pain rapidly, and restores motor function, range of motion, and independence, all while minimizing the actual number of visits to the clinic. One 2012 study found that when used to treat lumbar disorders, the McKenzie Method “was associated with a better recovery prognosis in terms of pain, short- and long-terms disability, and reduced likelihood of undergoing surgery in the following year.”

Other studies have suggested that the McKenzie Method is more effective for treating acute low back pain than for chronic low back pain, and in general is more effective when dealing with acute pain than long-term chronic pain. The primary benefit of the McKenzie Method as opposed to traditional chiropractic manipulation is that the sense of patient involvement seems to facilitate faster and more complete healing in some patients. However, it’s important to keep in mind that chiropractic physicians are typically trained to apply a wider variety of techniques depending on the patient’s condition, and that most chiropractors also emphasize the importance of lifestyle changes (often related to exercise, nutrition, sleep and stress management) in their broader treatment plans. Because of their expertise in treating a range of musculoskeletal conditions, they are often consulted in cases involving auto-, work- and sports-related injuries.

If you are interested in finding out more about the McKenzie Method, please contact our office. We’ll be happy to explain its uses as well as how it compares with other approaches to manual therapy, including spinal manipulation and mobilization.

Is There Really a “Gender Gap” in Children’s Fitness?

Is There Really a “Gender Gap” in Children’s Fitness?

It’s no secret that public health officials and the medical community are concerned about the physical fitness of American boys and girls in general. But recent data from a variety of sources suggest that girls may be significantly less likely than boys to get the exercise they need. And worse still, this physical activity “gender gap” between boys and girls appears to get larger as children get older.

According to an analysis of the combined 2012 National Health and Nutrition Examination Survey (NHANES) and NHANES National Youth Fitness Survey (NNYFS), only one-quarter (24.8%) of youth between 12 and 15 years of age get 60 minutes of moderate-to-vigorous physical activity every day. Obviously, this statistic is NOT good news. However, a closer look at other data* reveals that:

  • The percentage of boys who get at least 1 hour of moderate-to-vigorous exercise remains relatively constant between the ages of 11 and 15 (30% of 11 year-olds, 34% of 13 year-olds and 33% of 15 year-olds).
  • The percentage of girls who get at least 1 hour of moderate-to-vigorous exercise is lower than it is for boys to begin with and drops substantially between the ages of 11 and 15 (24% of 11 year-olds, 19% of 13 year-olds and 17% of 15 year-olds).

This means that by the time a boy and a girl are 15 years old, the girl is only half as likely as the boy to get the recommended exercise.

Why the Gap?

Since we’re talking about levels of physical activity generally rather than participation rates in organized sports, the gap seems to be a cultural one rather than one of access. Traditionally, we have thought of certain sports as being more appropriate for either boys or girls. For example, boys have been expected to enjoy rougher sports like football or hockey, while girls have been expected to be drawn to athletics involving less exertion and contact. These kinds of stereotypes no longer hold, and there are clearly more options today for members of each sex to participate in sports that they really like. At the same time, some patterns do exist.

 

How Girls are Physically Active

As a very general rule, girls continue to be more likely than boys to participate in activities like dance, gymnastics, cheerleading or aerobics. That said, sports like soccer, basketball, softball, volleyball, swimming and skiing all offer opportunities to develop physical skills in the same sort of environment that boys find familiar.

How Boys are Physically Active

Boys are still more likely than girls to engage in more intense physical activities and contact sports. While the popularity of traditional American team sports like baseball, football, soccer and basketball has ebbed and flowed over time, other less mainstream sports like martial arts, hockey and lacrosse have become more common.

The Real Priority in Children’s Fitness

The most important thing for parents and school leaders to address is the overall need for both boys and girls to remain active as children and young adults. This means creating engaging, accessible opportunities for both genders. But it also means actively encouraging girls to participate and shifting the cultural norm toward being more physically active.

Importance of Physical Activity for Growing Children

There are a number of reasons that physical activity is important for children of both genders and all ages:

  • Physical activity reduces the likelihood of obesity, a growing problem in school-aged children.
  • Physical activity contributes to bone growth and strength.
  • Physical activity starts children on the path to good cardiovascular health.
  • Children who participate in regular physical activity are less likely to develop Type 2 diabetes.
  • Physical activity Increases confidence and self-esteem.
  • Physical activity boosts cognitive development.
  • Physical activity Improves social skills.

Despite the differences in the types of physical activities girls and boys tend to prefer, children of both sexes need regular physical activity to stay strong and healthy. The habits they develop early on will help them establish healthy lifestyle patterns as they grow into young adults!

 

 

*Source: Health Behaviour in School-Aged Children Survey. Currie C et al. eds, Social determinants of health and well-being among young people, in Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. 2012, WHO Regional Office for Europe (Health Policy for Children and Adolescents No. 6): Copenhagen [20].

Beating the Odds: How Some People Stick with Diet and Exercise Plans

Beating the Odds: How Some People Stick with Diet and Exercise Plans

How long did your last diet or exercise plan last? If you’re like many people, your answer is “not that long.” In fact, one UK survey found that the average length of time a person stays on a nutrition plan is 19 days. A slightly more positive poll found that women tended to quit their diets after five weeks and two days. If these statistics sound distressingly familiar, it might be time to reassess how you approach your own diet plan.

How Do People Stick with Their Diet and Exercise Plans?

If you want to make sure your diet and exercise plan doesn’t become just another statistic, a change in attitude can make all the difference. In order to create a diet plan you can stick with, it’s important to be honest with yourself about what types of changes will fit into your lifestyle. Diet plans with long lists of “bad” foods might help you cut back on calories in the short term, but do you really plan to go the rest of your life without cake? People who stick with their diet plans take a more moderate approach, making small changes that they can live with in the long term.

Exercise plans can be just as difficult to carry out. People who stick with their exercise plans view physical activity as a regular part of life, not something they do only when they have the time, energy, and motivation. Of course, sticking with physical activity is much easier when it’s enjoyable. Rather than slogging it out on the treadmill, try yoga, martial arts, or another exercise program that stimulates your mind as well as your body. And variety helps too!

You Don’t Have to Go It Alone

Whether you’re building a diet plan or an exercise program (or are making changes in both areas), the people around you can make a huge difference in your level of success. If your spouse, children, or friends tend to turn to food in celebration or out of boredom, it’s easy to forget about your diet goals. Getting enough exercise is a lot more difficult if the people around you would rather watch TV than go on a walk.

Fortunately, when it comes to sticking with your diet and exercise plan, the people around you can also be a huge help. Making dietary changes as a family can help everyone involved lose weight and improve their health, while exercising with a friend can make the time go by much more quickly and pleasantly.

Having the support of a chiropractor who really understands the power (and challenges) of making healthy lifestyle changes (think nutrition, exercise, sleep and stress management, for example) is another way to help you meet your goals. Your chiropractor can work with you to make targeted, realistic adjustments that you’ll be able to stick with in the long term. Sticking with a diet and exercise program isn’t always easy, but you might be surprised by just how easy it is to make the changes you’re looking for with the right type of advice and support!