Cystic Fibrosis at the Playground

Cystic Fibrosis at the Playground

Blog

Cystic Fibrosis at the Playground

Your child has a right to be a kid! Of course, having a child with cystic fibrosis brings on more challenges and worries. It requires being more alert to surroundings, your child, and others. But, your child still deserves to play and you still deserve to watch your child be a child.

Playgrounds are a great way to teach your child to move, build strength, have fun, and explore new surroundings. However, there is an increased infection risk at playgrounds with wet or dry bark, stagnant water and other wiggly body’s running around.

 

 

Having a child with CF means you have to take that extra step in determining if it it’s the right thing to do. Does your child have a cough that he/she’s being treated for? If so, instead of running around and playing, maybe go for a slow walk outside. Has he/she been invited to a birthday party but has a low grade fever? Try to re-schedule for the following weekend, don’t just cancel. It may not be the same as a birthday party, but your child can still have the opportunity to interact and play with another kid (and you get the opportunity to socialize with other parents).

 

 

Some other tips

  • Wash your child’s hands before and after playing in a community environment
  • Teach your child to avoid muddy, dirty waters that can contain bacteria
  • Bring hand sanitizer and wipes to each outing
  • Create a routine in teaching your child to come to you if he/she has played with another child who has coughed/ may be sick. It’s impossible to avoid the germs from other children but use it as an opportunity to teach your child how to take care of him/herself. Your child may have CF, but he/she still has an immune system that knows what to do.
  • Hydrate often! Hydrating needs to consistently occur during play
  • Self-advocate: inform other parents about your child’s CF and ask if you can sanitize their child’s hands too. It’s okay to speak up for your own child’s rights and needs. Teach other’s in the community about CF, that it’s not contagious, and that it requires extra steps to stay healthy.
  • Play with your child and take your child’s lead during play! It might help to decrease some anxiety if you see how your child plays, that he/she is safe, and that playgrounds can be appropriate for your child.

 

 

Your child can do the same things that another child can do. By providing your child with the opportunities to run and build strength and endurance at a younger age through play, you are supporting your child ‘s development to love exercising and to keep moving!

Author: Nicole Ezcurra 

 

For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

 

 

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Complementary Approaches to Clearing Mucus

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Complementary Approaches to Clearing Mucus

The clearance of mucus is very important for individuals fighting pulmonary conditions. In cystic fibrosis (CF) and COPD the clearance of mucus is crucial to clearing bacteria pathogens to reduce the decline in lung function.

To understand how we can attack the clearance of mucus outside of the typical inhaled medication treatments, we need to first understand what we are working with.

What is Mucus?

Mucus is made up of 97% water, 3% solids and is secreted from cells and glands (goblet cells & submucosal glands) (Fahy & Dickey, 2010). In the airways, these cells line the surfaces (epithelia surface) and sweep across the airways picking up and removing waste from air inhalation. In normal conditions, mucus is secreted into the airway tract and traps inhaled particles. When mucus secretion is dysregulated, such as for individual’s with CF and/or COPD, airway mucus secretion increases, which leads to obstruction of the respiratory tract, reduces airflow, and can lead to an increase in inflammatory response within the respiratory tract. The hypersecretion increases ciliary dysfunction and oxidative stress on the respiratory tract. 

 

So, how can you potentially clear more mucus?

 

Step 1: Drink more water.

         The lungs are made up of around 80% water (Lange, & Schuster,1999). The mucus within the respiratory tract is comprised mainly of water. The lungs are estimated to lose 1/4th of the water consumed by the human body through respiration each day. Dehydration increases thickening at the airway surface layer, obstructs ciliary from moving mucus due to dehydrated mucus which leads to inhibition of mucociliary clearance.

Step 2: Strength Training and Cardio   

         Increase mucus build up can lead to an increase in inflammatory markers within the lungs. Increased inflammation causes an increase in oxidative stress and a decline in lung function over time. To combat against this, integrating resistance training and cardiovascular training into your weekly routine can help decrease some mucus build up. Research has shown that resistance training and cardiovascular training reduce oxidative stress markers, improve maximal oxygen consumption, and more importantly, increase mucociliary transit time (Silvaa et al. 2019). To keep it simple, when you move more, or at a greater intensity/frequency, the need for oxygen is going to increase. This increases breathing rate and heart rate, and through the rhythmic vibration, it also loosens up the mucus to be able to move out of your system.    

 

Step 3: Recovery

         After reading this you will want to get started right away, but you need to make sure you don’t push too hard to soon. Remember that exercising can increase inflammatory responses and induce neurological and muscle fatigue. Which is not to worry, it’s expected but you will need time to recover. Recovery between workouts is one of the most important aspects of exercising. People often over train and see less progress. Schedule rest days between hard workouts. On rest days you should focus on hydrating, sleeping, stretching, and your food intake. What you do outside of your workouts is more important than the actual workout itself.

 

Key Takeaways

         Let’s sum it all up so you can get going on clearing more mucus. Drink more water. Most people perform respiratory treatments in the morning when they wake up. Drink a glass of water within 30 minutes of waking up, or before your respiratory treatment, and also throughout the day. Integrate resistance and cardiovascular training into your weekly routine 2-4 days a week. If you are limited on time or days, you can split it up and work out half the time performing resistance training and the other half performing cardiovascular training. Last but not least make sure you integrate rest/recovery days into your exercise plan. Listen to your body. If your body is stiff, beaten down, or you feel like a zombie focus on stretching, drinking water, taking a nap, and getting your calories in for that day. Your body knows best. If you feel better, you will push yourself more and if you can push yourself more you can potentially improve mucociliary clearance.

 

Train Smarter, Not Harder

 

References

Fahy, J. V., & Dickey, B. F. (2010). Airway mucus function and dysfunction. The New England Journal of Medicine, 363(23), 2233–2247. https://doi.org/10.1056/NEJMra0910061

Lange, N. R., & Schuster, D. P. (1999). The measurement of lung water. Critical Care, 3(2), R19–R24. https://doi.org/10.1186/cc342

Silva, B. S. A., Ramos, D., Bertolini, G.N., Freire, A.P.C.F., Leite, M.R. Camillo, C.A., L.A. Gobbo. L. A., & Ramos, E.M.C. (2019). Resistance exercise training improves mucociliary clearance in subjects with COPD: A randomized clinical trial. Pulmonology, 24(6), 340-347.

 

  

For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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One of the ways people measure their success in the gym each week is by counting how many times they showed up to the gym. For example, 5 days in the gym equals 5 workouts. That is assuming you are only working out once a day. When planning out our weekly schedule, it’s common to get specific and plan on which days you will work out, what you are going to do in the gym, and for how long. That works for some. Having everything planned and ready to go before Monday works for some but having a “buffer” is important because life doesn’t always seem to go the way we planned. Events happen that we can’t control and can’t predict. These new responsibilities can take longer than you think and you can’t predict how much time you spend interacting with other people. Some people will chat your ear off, and others may not show up to work, so you now have to do more and be flexible with time you saved for the gym. No matter how much you plan, life happens, and it will at some point, happen to you.

Social, physical, and work constraints come in waves and can last for weeks, requiring you to be pulled out of the gym completely. You could be currently riding one of those waves, where you feel like it is almost impossible to get to the gym.  At some point we all ride that wave.

This is where looking at the bigger picture can help out when it comes to working out. If you feel you don’t have time, start by writing down a particular amount of workouts you want to achieve in 2-3 weeks. For example, 6 workouts in 3 weeks. Then schedule the 1st workout, once you have completed the 1st workout then schedule the 2nd workout and repeat this process each week until you reach your goal of 6 workouts. This approach of programming your training allows you the opportunity to schedule your workouts based on how big of responsibilities you have outside of the gym that week. Establishing a goal number gives you the luxury to fluctuate your workout schedule each week. If you are slammed one week, you can add that workout to the next week. Now, you have to be true to yourself and you can’t procrastinate by stacking all the workouts at the end of your goal period. You should try put a mandatory “one workout a week” goal in your goal setting. This keeps you accountable, while limiting the stress level of trying to cram in workouts at the end of the goal period. This approach isn’t for everyone, but it is another way to look at programming your workouts for the week. In the end, 20 workouts in is 20 workouts. If it takes you 8 weeks and takes someone else 6 weeks, it doesn’t matter. Research shows that exercising consistently over the course of time has higher health benefits than someone who doesn’t exercise at all. The only person you are competing against is yourself. Getting too specific on how you are going to approach exercising can get exhausting and stressful.

Keep it simple and find your wave.

For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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Are You Apart of the Morning Crew or Night Crew?

 

Exercising is important for everyone. Exercising has many benefits from improving cardiovascular health, decreasing stress, to even improving lung function in cystic fibrosis and COPD. However, what is good for us doesn’t mean we will always want to partake in it. In 2018, there were over 253 million people that were 18 years of age or older in the US (Kids Count Data Center, 2019). Out of those 253 million people, 55.3% engaged in physical aerobic activity and 23.2% engaged in aerobic and resistance training. (NCHS, 2018). Based on Center for Disease and Control Prevention Physical Activity Guidelines, physical activity guidelines are set at 150 minutes a week of moderate- intensity aerobic physical activity, 75 minutes a week of vigorous-intensity aerobic physical activity, and/or at least 10-minutes bouts of an equivalent combination of moderate-vigorous intensity aerobic physical activity (NCHS, 2018). Let’s face it, sometimes you will hit these numbers each week, and other times you won’t. In addition, these guidelines do not take into consideration special populations such as pulmonary diseases, so these numbers should be taken with a grain of salt. However, this doesn’t mean we shouldn’t strive to hit these guidelines as the benefits have been well-documented.

 

  So, why don’t we hit exercise goals we set for ourselves even though we know it’s good for us?

 

Generally speaking, there are many variables that could be examined and discussed about this, but we are going to chat about one approach you can take to create some self-awareness on when the best time for you to exercise is. This way, you have more information to help you attack and maintain your fitness and exercise goals.

 

            In research, the goal is to systematically investigate and understand something. Earl Robert Babbie describes it best, “Research is a systematic inquiry to describe, explain, predict and control the observed phenomenon.”  Every day you are doing research without knowing it. When you “get hungry,” you eat something that you perceived to be satisfying, and fulfilling to crave your appetite. You didn’t ask your body what it would like to eat, you told it what you were going to eat based on previous experiences. Then when you eat the food, your body will tell you what it thinks of the food. Upset stomach, headache, muscle and mental fatigue are all end products of a research project you just did. Your body tells you more information than you may realize. Why do you think some people are early risers and others are not? Research isn’t very clear on why this occurs however, but findings have led researchers to believe that it is linked to genetic variants in our DNA. This means you are not lazy or unmotivated to work out in the morning or night, it means that there is a window of time that best fits YOU and you should work off of that.

 

Build your routine around what works best for you and not what is best for someone else.

 

So how do people do it?

          They create a routine. Every person has a routine. There are certain things you consistently do throughout the day/week. You wake up at a certain time, you work at a certain time, you drink your morning coffee at a certain time, the list goes on. You may not realize it, but this is a routine. You’ve adapted your time to create this routine.  Successful people create a routine that not only works with their daily responsibilities but also with their body’s feedback. You have feedback loops in your body that keeps your body in check. For example, some people like to work out in the morning, some like to work out in the afternoon, and others like to work out at night. Some people do not have a choice, or at least think they do not have a choice, but often times it is because people are either “morning people” or “night people.”

 

How to Evaluate Who You Are.

          Sometimes it is hard to figure out the best time to work out. Especially if you have to alternate from morning workouts to night workouts.  What you can do is look at your exercise routine from an objective lens. Compare your morning and night performance results subjectively and objectively. Which workouts do you have more energy during? How much are you lifting in the morning vs. nights? How is your aerobic performance capacity in the morning vs. nights? When you have great workouts, or feel most energized, reflect back on what you did that day at work, or what you ate or drank, was it a high stress day at work or slower paced, and at what time was your workout? All these factors play into your decision on when to workout, whether you realize it or not.  If they didn’t, then every day you work out the intensity, frequency, duration, and mental capacity would be the same and you would be on a linear path to great health performance, but that is not the case. Anyone who has ever worked out or taken a breath of air has great days and bad days. Each day is different but the more you know about what your body is telling you, the better off you are when the bad days roll around.

 

          It can get hard to work out, especially as winter is right around the corner, but you need to listen to your mind and body. If your energy levels are at their highest peak in the morning, then you should think about scheduling your workouts in the morning. If you practically fall out of bed in the morning after you have hit the snooze buttons several times, then workout in the afternoon or night. Don’t stress about not getting a morning lift in, especially when someone posts on social media how they “crushed their workout” this morning. Take a minute to reset and understand why you didn’t go to the gym this morning. It is most likely because you like to sleep in and your best lifts are at night. You are part of the night crew.

            No matter if you crush it in the mornings or you crush it at nights, spend a moment to find out who you are. Now, not everyone has the luxury of working out when they want but try it out and start simple, start with morning workouts or nights and then in a couple of weeks examine how you feel. You are going to have to reflect on your fitness because your life is always changing. You will be surprised what happens when you listen to your mind and body. There is a reason why we don’t stay at a consistent energy level throughout the day.  You may be trying to fit in your workouts during times when you have the least amount of energy. This could be a reason why it is hard to keep a consistent routine.

 

Keep it simple. Find out if you are a morning person or night person and investigate what happens if you exercise at that time compare to another time. Just keep in mind that one acute session at this new time will not give you enough feedback for longevity. Try and stick with this approach for >2 weeks and then revaluate.  

 

 

 

 

References

National Center for Health Statistics. (2018). National Health Interview Survey, Sample Adult Core component. Retrieved from https://public.tableau.com/profile/nhis5946#!/vizhome/FIGURE7_7/Dashboard7_7

 

The Annie E. Casey Foundation. (2019). Kids Count Data Center. Retrieved from https://datacenter.kidscount.org/data/tables/99-total-population-by-child-and-adult-populations#detailed/1/any/false/37,871,870,573,869,36,868,867,133,38/39,40,41/416,417

 

 

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For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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Optimizing Recovery for CF and COPD

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Optimizing Recovery for CF and COPD

          The body is a remarkable system that takes time to recover. When you have chronic illness, such as CF or COPD, the recovery time the body needs will be a little different than for a healthier individual. This is due to decreased oxygen consumption and nutrient intake often seen for patients with CF and COPD. The amount of recovery needed to resupply the brain and muscles with the proper amount of fuel to improve exercise capacity increases for individuals with CF and COPD.

 

          Generally speaking, ACSM’s guidelines for recovery when an individual performs resistance training is 2-3 minutes in between sets (Riebe, Ehrman, Liguori, & Magal, 2018). This is all dependent on the type of training and the goals that an individual has. The general rule of thumb is; the more volume (volume= length x width x height) of work (work= force x distance) you do per set, the more time you’ll need between your sets and the more days you’ll need between your workouts. Within those workouts, exercises also require a certain amount of energy. Recovery is exercise specific and each exercise impacts neurological and muscular recharge differently. Optimizing how you recover between workouts is important if you want to see positive results.

 

 

Exercising has a multiphasic impact on the body and here is why. 

 

 

            When you are exercising there is an increase in neural activity. Your brain is sending your muscle messages to guide your body on how and when to facilitate the right muscle at the right time to create a gross movement pattern. As the intensity or difficulty of the exercise increases, so do the neurological responses to the muscles (Ollivier-Lanvin, Lemay, Tessler, & Burns, 1985). Not only is there an increase in neurological responses to the muscles, but there is an increase in neurological and physiological responses within the heart, lungs and other organ systems.

 

          In order for your body to create the movement you desire, the brain needs to have the ATP (energy) to accomplish that movement. The increase in demand increases the brains need for oxygen and glucose. Oxygen and glucose are two substrates that the brain utilizes to refuel and recharge. Think of these substrates as the fuel you put into your gas tank. Without the adequate amount of oxygen and glucose to fuel the exercise, the brain will decrease its neural responses to the muscles, causing muscle fatigue and muscle cramping to set in.

 

          On top of that, the heart and lungs are working at a higher rate in order to provide your brain with the proper amount of fuel, while also supplying the muscles with sufficient oxygen to facilitate the demands on the muscles and joints. As reps increase, the more oxygen you will need to perform a set. That is why you often hear that 15 reps work muscle endurance. The more repetitions you do, the more oxygen you will need in order to complete the set. 

 

 

 

 

           As you can see, there is a lot going on within the body that is required for you to complete a workout. Depending on the goal of the workout and the intensity at which you work, your body will need adequate time to not only recover between sets, but also between workouts. Research has shown that 24-72 hours after a workout is the time frame at which inflammation is at the highest concentration within the body (Pournot, Bieuzen, Louis, Mounier, Fillard, Barbiche, & Hausswirth, 2011), and is why you may feel tried later in the day after a workout or feel stiff the next day.

 

Have you ever been sore two days after a workout? This is what exercise professionals call “second day soreness.” This time frame is also when the body is at its highest demand for recover.

 

          The human body strives to create a homeostatic balance, this results in the body needing time to rebalance the system after having exhausted its fuel following a workout. When you have a pulmonary condition, it can be hard to facilitate the body’s abilities to reach optimal recovery, as the body is working harder to fight off infections, inflammation, and respiratory distress.

 

 

 

Here are some Tips to optimize your recovery between workouts to set you up for success.

 

 

Follow a harder intensity workout with a lighter intensity workout.

          You only have so much fuel in the tank each week. Harder workouts, or workouts that tax your body, will require more recovery over the course of a week. Try performing a harder workout and then follow it up with a lighter workout, such as stretching, foam rolling, or a light walk or bike ride. Keeping the intensity low and moving the body will help increase blood flow to the muscles that are trying to recover without taxing the brain. For example, have you ever woken up stiff or tight the day after a tough workout? But then you stood up, stretched, walked around and felt better? Standing up and stretching get the body moving and increase blood flow to the muscles at a low intensity. This rhythm of blood flow helps to pull bad waste product away from the muscles, and delivers quality nutrients and oxygen to the muscles for repair. Drinking a glass of water 30 minutes within waking up will also help decrease dehydration and facilitate in increased nutrients to the muscles and brain for recharge.

 

 

 

Simply put, drink water and move around when you feel stiff.

 

 

Active Recovery

 

          It doesn’t matter who you are, if you move often you tend to feel better. Exercise doesn’t always have to be in the gym. It doesn’t always have to be a structured exercise class. Getting outside and playing catch with your son or daughter, kicking the soccer ball around or messing around on the local jungle gym with the family is a form of active recovery. Exercising is too often connected with weight training, cardio blast classes or the new trend of the year class, such as “cold yoga.” Exercising can consist of moving the body in many different directions and different intensities. Spending at least 1-2 days a week of active recovery could be what your body is looking for.

 

 

 

 

 

Don’t Forget to Cool Down

 

          Integrating 5-10 minutes of exercises that down regulate your breathing and bring down your heart rate after your workout is very important for your recovery, especially the days after your workout. As we stated earlier, research has shown that the highest inflammation rate and need for recovery is around 48-72hours after the workout. Ending your workout with stretching, foam rolling, or just lying on a mat with your eyes closed and breathing, gives the body time to catch up and start the recovery process. No matter what, your body will have to start recovery sooner or later. Spending 5-10minutes at the end of your workout stretching and relaxing will kick start this process so you can recover at a more efficient rate.

 

 

 

          Everyone’s recovery will be different, but everyone needs quality recovery. The key is to optimize how you recover. Creating self-awareness on how your body feels in-between sets, in-between workouts, and multiple days after your workouts will put you at an advantage. Recovery comes in all shapes and sizes. Your muscles need to recover just like your heart, lungs, and brain need to recover. If you feel like a zombie after a workout or the next day, your body is letting you know that it needs to recharge. If you are feeling stiff, sore, and/or stressed, your body is telling you it is in the recovery phase of your training. Understanding how your body is recovering between workouts gives you an opportunity to improve your training which will ultimately put you at an advantage to improve your strength, endurance, and potentially your lung function. Performance gains are not developed in the weight room, they are developed during your recovery (sleep, hydration, nutrition). Align your exercise goals with proper recovery and great things will happen.

 

 

 

 

References

 

 

 

Ollivier-Lanvin, K., Lemay, M. A., Tessler, A., & Burns, A. S. (2009). Neuromuscular  transmission failure and muscle fatigue in ankle muscles of the adult rat after spinal cord  injury. Journal of Applied Physiology, 107(4), 1190–1194.

 

 

 

Pournot, H., Bieuzen, F., Louis, J., Mounier, R., Fillard, J. R., Barbiche, E., & Hausswirth, C.   (2011). Correction: Time-Course of changes in inflammatory response after whole-body  cryotherapy multi exposures following Severe Exercise. PLoS ONE, 6(11)

 

 

 

Riebe, D., Ehrman, K. J., Liguori, G., & Magal, M. (2018). ACSMs Guidelines for exercise testing and prescription: American college of sports medicine. Philadelphia (PA): Wolters Kluwer.

 

 

 

 

 

 

For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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