WHOM TO BLAME FOR KIDNEY STONES ?

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Kidney Stones  which are no longer a rare disease  affects about 12% of the world population. Among all the predisposing factors lack of physical activity constitutes 42.79%. In India STONE BELT,occupies Maharashtra,Gujarat,Punjab,Haryana,Delhi and Rajasthan. How inactivity linked to kidney stones? Limited activity or lack of activity cause bones to release more calcium i.e. increased bone resorption. About 80% of stones are calcium based, predominantly either calcium oxalate (70%) or calcium phosphate (10%). Those with BMI ≥ 30 kg / m2 have 30% higher risk among men, but there is nearly a two-fold higher risk among women compared to those with a BMI of 21 – 23 kg / m2.  BUT  PHYSICAL  THERAPY  CAN  HELP!!!! Source- Sorenson et al 2014  J ournal of the American Society of Nephrology ,  25 (2), 362-369 . 30 minute walk 3-times per week. Women could get the maximum benefit by performing 10 metabol...
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THE PREGNANT PELVIS - GUIDELINES FOR SAFE EXERCISE DURING PREGNANCY 1.0

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There are usually many questions that come to mind when planning how to exercise during pregnancy. 
Many women in the childbearing year wish to commence or continue with their exercise programs during and post pregnancy to maintain their health and quality of life. The traditional medical advice has been for exercising women to reduce their habitual levels of exertion in pregnancy and for non-exercising women to refrain from initiating strenuous exercise programs. This advice was primarily based on concerns that exercise could affect early and late pregnancy outcomes.




Pre-Exercise Screening and Referral
Before Preceding for any PHYSICAL ACTIVITY DURING PREGNANCY , Registered Exercise Professionals should complete a suitable pre-exercise health screening questionnaire by the pregnant mother such as The Physical Activity Readiness Medical Examination for Pregnancy i.e. PARmed-X for Pregnancy  developed by the Canadian Society for Exercise Physiology also provides a useful guide for screening and referral. 

Pre-Natal Guidelines
Past exercise history
Pregnant women who were previously exercising may continue but should be advised to modify their exercise in accordance with general physiological changes associated with pregnancy and their individual situation. Clients who were previously inactive need to start at a low level and progress gradually.

Warning signs
It is recommended that Registered Exercise Professionals stop the exercise and refer to their health care professional for medical advice if their client experiences any of the following:
  • Excessive shortness of breath
  • Dizziness or feeling faint
  • Fainting
  • Headaches
  • Chest pain or palpitations
  • Blurred vision
  • New or persistent nausea or vomiting
  • Calf pain or swelling, or unusual muscle weakness
  • Any kind of pain or numbness
  • Excess fatigue after exercise
  • Vaginal bleeding
  • Abdominal cramps or pain
  • Intense or new back pain
  • Contractions
  • Leaking of amniotic fluid
  • Reduced movements of baby. 
Intensity
The most recent evidence has indicated that both aerobic and resistance training at moderate intensity are considered safe and have no adverse outcomes throughout pregnancy. Monitoring exercise intensity in pregnant women is best achieved using a rating of perceived exertion (RPE) scale such as the Borg scale rather than heart rate.In order to prevent raised maternal core temperature and unwanted musculoskeletal stress, the recommendations for pregnant women performing exercise is a score of 12-14, on a 6-20 scale.

Duration & Frequency
It is recommended that session duration is limited to avoid hypoglycaemia and overheating. However, intensity and duration must be considered together, i.e. low intensity can be performed for longer than moderate intensity exercise. 


It is advisable to include the following activities: s advisable to ctivities:


s advisable  IT IS ADVISABLE TO DO FOLLOWING ACTIVITIESinclude owing ctivities:
  • Gradual warm ups and cool downs for pre-natal circulation and avoidance of blood pooling.
  • General strengthening plus particular focus on pregnancy specific muscles such as pelvic floor core and postural muscle strengthening. 
  • Modifications for supine and stationary standing such as four point kneeling, sitting on a fitball and side lying.
  • Flexibility training limited to a comfortable range of movement.
  • Relaxation.
  • Labour preparation.
  • Appropriate low impact exercise styles.
  • Modified exercise programs when risk of overheating is raised.
  • In the presence of a pregnancy related musculoskeletal condition include exercises that either do not exacerbate or assist the condition.
It is advisablITIT IS ADVISABLE TO AVOID FOLLOWING ACTIVITIESd the ollowing activities: 
  • High impact, jerky or ballistic movements.
  • Exercise intensities or duration that make the client feel hot, exhausted or excessively sweat.
  • Sudden changes of, intensity and position.
  • Any exercise that involves breath holding or Valsalva manoeuvre.
  • Any exercise that places significant load on the abdominals or pelvic floor including abdominal curls, sit ups, planks and hovers.
  • Stretching beyond comfortable range of movement to avoid overstretching due to increased joint and ligament flexibility.
  • Weight bearing activities beyond comfortable range of movement.
  • Exercises involving lying supine from 16 weeks onwards.
  • Exercises in stationary standing (especially upper body strengthening) that will increase the risk of fainting.
  • Contact activities (to minimise risk of falls and blows to the abdomen). 




 Reasons to stop physical activity and consult a
healthcare pREASONS REASONS TO STOP PHYSICAL  ACTIVITYrovider
► Persistent excessive shortness of breath that does not resolve
on rest.
► Severe chest pain.
► Regular and painful uterine contractions.
► Vaginal bleeding.
► Persistent loss of fluid from the vagina indicating rupture of
the membranes.
► Persistent dizziness or faintness that does not resolve on rest.

What physical activity is recommended during
 pregnancy? 

Recommendation 1
Pregnant women should accumulate at least 150min of moderate-intensity physical activity each week to achieve clinically meaningful reductions in pregnancy complications. 
Recommendation 2 
Physical activity should be accumulated over a minimum of 3days per week; however, being active every day is encouraged. 
Recommendation 3
Pregnant women should incorporate a variety of aerobic exercise and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial. 
Recommendation 4 
PFMT (eg, Kegel exercises) may be performed on a daily basis to reduce the odds of urinary incontinence.
Recommendation 5 
Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position. 






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