By Mirela Holtz, PT, DPT, CLT Rehab / Physical Therapist Cancer Treatment Centers of America Phoenix

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Nigel Warren
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1 By Mirela Holtz, PT, DPT, CLT Rehab / Physical Therapist Cancer Treatment Centers of America Phoenix

2 Week One The focus of this first week is cardiovascular fitness! Your heart and lungs are muscles too. So, let s strengthen them! Try as many of these daily activities as you are able. If you feel uncomfortable with any of them, excluded those and repeat the ones you are able to do a few more times. The key is to keep track of the time and amount of activity you are getting. Using a pedometer is a great way tracking your steps. The more steps, the better. Take a peek at the diagram below to see where you stand: Highly active: 12,500+ steps/day Active: 10,000-12,499 steps/day Somewhat active: 7,500 9,999 steps/day Low activity: 5,000-7,499 steps/day Sedentary: 2,500 or less steps/day Week One Tips 1. Walking is a great way to burn extra calories and boost your metabolism. Some ways to add extra walking into your day include: taking a brisk walk after lunch, parking further way, and walking instead of driving. 2. If you pick activities that you enjoy, you are more likely to stick to daily exercise. 3. Music can make a huge difference in how long you work out. So create a great playlist for the duration of your workout (i.e. 30 minutes) and get moving! 4. It takes 21 days of completing a task daily to make it a habit. Week One Instructions Day of week Day 1: Day 2: Activities to try for each day Walking With a friend Walk to the mailbox Walk longer in the grocery store (example: go to the fruit section, then meat, then back to the fruit section) Park further away Walk to the dog park Get up every 15 minutes at work by going to get water or something off the printer. Gym activities Riding the bike Stair-stepper Walking the track Elliptical Complete a class online at your own pace or find a live class in your community.

3 Day 3: Do some gardening Swim or walk in the pool Go for a light walk down the block Hike with a friend or find a flight of stairs to climb up and down several times Complete an exercise DVD or find a routine on YouTube (look up Total Body Toning Low Impact Cardio workout) Day 4: Push your kids/grandkids down the block in a stroller Mow the lawn Sweep the garage Skim the pool Do some jumping jacks. You can break them up and only do the arm movements and then only do the leg movements. Day 5: Go on a bike ride Play with the grandkids Clean the house Dance to a couple songs you really like Choose to stand instead of sitting while completing activities (example: eating a snack while standing) Day 6: Wash your car Prepare a nice meal in the kitchen and shop for your items that day Go window shopping at the mall Play golf/tennis/basketball Throw the ball around with the kids/grandkids Day 7: March in place Do 1 minute step ups on a platform surface or stair While standing, bring your knees across to the opposite elbow alternating for 1 minute Kick your leg out forward and sideways for 1 minute at a time Complete arm punches at a invisible punching bag ( left/right jabs ).

4 Day 1 Week One Tracking Exercises I did Wins to Celebrate Goals for Tomorrow Day 2 Day 3 Day 4 Day 5 Day 6 Day 7

5 Week Two Week Two Tips 1. Exercise is great for improving your mood while reducing stress, depression and anxiety. 2. Exercise is a great way to improve your sleep habits and helping you to relax. 3. Exercise strengthens and boosts your immune system. 4. Weight bearing exercises stimulate an increase in bone mineral density, thus decreasing your chances of developing osteoporosis. Week Two Instructions Day of week Activities to try for each day Day 1: Stand up from a chair as many times as you can Wall sits (lean your back against the wall and slowly bend your knees do 10 to 15 repetitions) Sit on a stable chair or an exercise ball and lift one leg at a time off the ground Day 2: Chair squats (hold the back of a chair and do mini squats up and down) Place a ball between your knees and squeeze the ball 15 times during every commercial break while watching tv Complete mini lunges every time you need to use the restroom Day 3: Strengthen your calves when brushing your teeth by coming up on your toes 15 times Kick backwards 15 times while waiting for the microwave to beep While in a seated position bring each knee close to your chest 15 times Day 4: Before you fall asleep lift your legs towards the ceiling 15 times per leg Before you get out of bed in the morning lay on your front and kick your legs back 15 times per leg Roll over to your side and lift your leg up towards the ceiling in a sideways position 15 times on each side Day 5: Walk sideways into the kitchen for the day (leading with your right and then your left) On your hands and knees, lift one leg back at a time for 15 times on each leg Stretch your calves by lowering your heel off a stair Day 6: Stretch the back of your leg by lifting one leg onto stool while you are sitting Write out the ABCs with both feet while you are lying in bed Squeeze your bottom cheeks together 15 times while you get ready in the morning Day 7: Kick a ball around with your kids/grandkids Kick your foot out 15 times on each leg while you are seated and eating dinner Move your legs in and out before you get out of bed each morning 15 times

6 Day 1 Week Two Tracking Exercises I did Wins to Celebrate Goals for Tomorrow Day 2 Day 3 Day 4 Day 5 Day 6 Day 7

7 Week Three Our upper body does so much for us from helping us bring in the groceries, to washing our hair and even preparing our meals. This week we are going to focus on exercises to keep our upper body strong. Don t forget to balance these exercises out with the first and second week exercises to prevent from over working certain muscle groups. Week 3 FYI A 2013 study in the Journal of Pain and Symptom Management found that the 64 participants with stage IV colorectal or lung cancer had improvements in mobility, fatigue and sleep quality after they completed exercise four or more days a week for a total of eight weeks of home-based exercises. The upper body exercises the study targeted include: rows, bicep curls, shoulder blade squeezes, and tricep extension, to name a few Cheville AL, Kollasch J, Vandenberg J, et al. A Home-Based Exercise Program to Improve Function, Fatigue, and Sleep Quality in Patients With Stage IV Lung and Colorectal Cancer: A Randomized Controlled Trial. Journal of Pain and Symptom Management. 2013; 45 (5); Week three Tips 1. A great way to keep motivated is to sign up for 1-mile runs or walks and gradually increase the distance (5K walks). 2. Have a buddy system. Enjoy the outdoors with friends or take work out classes together. 3. If you have a lot of aches and pains, pool exercises are a great way to minimize the stress on joints. 4. Drink plenty of water before, during and after a workout to prevent dehydration. Week Three Instructions Day of week Activities to try for each day Day 1: Carry groceries in from the car Do bicep curls with water bottles 15 times on each arm Complete 10 wall pushups Using a yoga strap: hold strap with both hands at shoulder width apart and bring strap overhead. Day 2: Lift a couple of books over your head 15 times Grab a can of beans and move your arms up and down 15 times Make a dinner that involves a lot of chopping Day 3: Complete 15 tricep dips at the countertop (turn away from the countertop and place both hands on the countertop while keeping the elbows bent, now slowly lower yourself down and come back up) Push your grandkids/kids on a swing Day 4: Push a vacuum cleaner back and forth for several minutes Teach your kids/grandkids how to make snow angels while laying down Use a resistance band with both hands and move them closer and further apart 15 times Day 5: Complete 15 arm circles on each side Punch a pillow for 1 minute Push and pull a shopping cart toward and away from your body 10 times in every new aisle while shopping Clap overhead 30 times

8 Day 6: Hold a resistance band right in front of you and pull down 15 times on each side Hold your arms up to shoulder level with elbows bent, hold a water bottle in each hand extend your elbows back squeezing your shoulder blade 15 times While seated, bring one ear to the same side shoulder, hold the stretch for 15 seconds and complete on the other side Day 7: Hold a resistance band right in front of you and pull down 15 times on each side, Hold one water bottle in each hand, bring your arms to shoulder height and bend your elbows. Now bring your arms up and down 15 times Lace your fingers behind your back and squeeze your shoulder blades together 15 times

9 Day 1 Week Three Tracking Exercises I did Wins to Celebrate Goals for Tomorrow Day 2 Day 3 Day 4 Day 5 Day 6 Day 7

10 Week Four You got this! Alright, it s the last week. Let s make sure to go hard and finish well on our last week. The focus this week is core, or mid-section, strengthening. Why is this important? A study entitled The Importance of Trunk Muscle Strength for Balance, Functional Performance, and Fall Prevention in Seniors: A Systematic Review demonstrated that core strengthening exercises through resistance or pilates can be beneficial in improving balance, performance of everyday activities and falls. These exercises require little amounts of space and no equipment Granacher U, Gollhofer A, Hortoba gyi T, et al. The Importance of Trunk Muscle Strength for Balance, Functional Performance, and Fall Prevention in Seniors: A Systematic Review. Sports Med. 2013; 43; Week Four Tips 1. Doing yoga is a great way to improve your balance. 2. Exercise not only changes your body, it changes your mind, your attitude, and your mood. 3. Logging your activity daily helps to keep you on track and motivate you to do more than the previous day. 4. It s important to minimize skin damage if you choose to workout outside. Remember sun block and proper clothing. Week Four Instructions Day of week Activities to try for each day Day 1: Complete 10 bridges: lie flat on your back, bend your knees and bring your pelvis up towards the ceiling. Lift all your groceries one by one from the floor to the countertop Sit on an exercise ball while you watch TV instead of the couch. Day 2: Complete 10 scissors: before you get out of bed, move your legs up and down opposite of one another While sitting in a chair, hold onto the chair with both hands and bring your knees to your chest 15 times Kick your legs back and forward while brushing your teeth Day 3: On your hands and knees, lift the right and then left hip out to the side While lying on your stomach, lift your arms out 15 times While lying on your stomach, lift your legs back towards the ceiling 15 times Day 4: Place a resistance band around each leg, and while lying down, push your thighs apart 15 times While lying on your back in bed, bend up one knee and roll it out to touch the bed 15 times on each leg Lying on your back, place your feet on the wall. Keep your tummy tight and walk your feet up and down the wall 15 times Day 5: Hold a water bottle in each hand and bend sideways to touch the outside of your knee March in place with your tummy tight while you wait for your coffee to get done

11 Day 6: While in bed, bend your knees up and tap your heels with your hands 15 times on each side With a 1-2 pound object in your hands bend forward and stand back up straight 15 times keeping your tummy tight Day 7: Get up on your knees and rock back and forth 15 times while keeping your tummy tight While seated in a chair with good posture, tuck your tummy and count to 5 seconds a total of 15 times

12 Day 1 Week Four Tracking Exercises I did Wins to Celebrate Goals for Tomorrow Day 2 Day 3 Day 4 Day 5 Day 6 Day 7

Full Body. Strengthening Routine

Full Body. Strengthening Routine Full Body Strengthening Routine Full Body Strengthening Routine Strengthening activities are recommended 2 to 4 days a week to help improve strength, reduce body fat, risk of osteoporosis, stress, and