Exercise Recommendations and Guidelines

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Exercise Recommendations and Guidelines An exercise routine is vital to your success with the SWL tool. Exercise not only helps with weight loss, but also with weight maintenance for the long-term. A mix of cardio and resistance/strength exercises is essential for success. Cardiovascular exercises help to burn calories, while strength exercises aid in sustaining muscle mass and holding skin tighter. Prior to surgery, you need to identify how you will be able to fit exercise into your lifestyle on a regular basis. Many of us have hectic, fast-paced lifestyles that make it difficult to find time to exercise. Remember to set realistic goals. Start slow and small if necessary, and build on your routine. Dividing exercise into 10 minute bouts can also be effective and helpful for time management. Remember to be cleared by a physician before beginning any new exercise routine. General guidelines from the NIH (National Institute of Health) and the U.S. Department of Health and Human Services (HHS) are as follows: For major health benefits, do at least 150 minutes (2 hours and 30 minutes) of moderateintensity aerobic activity or 75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity each week (or a combination of both). For even more health benefits, do 300 minutes (5 hours) of moderate-intensity aerobic activity or 150 minutes (2 hours and 30 minutes) of vigorous-intensity activity each week (or a combination of both). When doing aerobic activity, do it for at least 10 minutes at a time. Spread the activity throughout the week. Muscle-strengthening activities that are moderate or vigorous intensity should be included 2 or more days a week. These activities should work all of the major muscle groups (legs, hips, back, chest, abdomen, shoulders, and arms). If you feel you are unable to start an individual physical activity routine at this time, please look into the following options that involve a more comprehensive and adaptive fitness package: Physical Therapy (p. 54) HealThy Self Fitness at our Millennium Campus (p. 53) PREP Program at Sportsclub (discuss with Katie)

In-Patient Exercise Guide You are required to be up and moving 2-4 hours after surgery. This early mobility improves recovery. We encourage walking and physical therapy exercises, both in the hospital and for the first 3 weeks post-operative, before release to full activity. You will receive a check sheet in the hospital to record your activity level. Familiarize yourself with the following exercises that you will be performing during that time:

Exercise Resource Guide The following pages will provide you with strength/resistance exercises that can be used both pre and post-operatively. Do not do any exercises that cause pain. Ensure that your medical conditions are under control before beginning exercise (blood sugar levels, blood pressure, etc.). These exercises can be performed with the resistance band that we will provide you. You can also use free weights or alternative weight options (kettlebells, etc.). There will be multiple ways to progress or regress these exercises to make them harder or easier. Please pay special attention to your body and modify the exercises as necessary. Remember to do each exercise on both sides of the body to ensure equal gains. Make sure you warm up with gentle cardio prior to performing these exercises. It is also vital to stretch before and after strength/resistance exercises. As you continue to do these exercises you can progress them or add weight or reps to make them more challenging. Email or speak with our office if you have any questions regarding your exercise routine or plan of care. Prone Iso Abs 1. Place elbows on chair. 2. Contract abdominals/core. 3. Keep hips low & in line with body. 4. Keep a flat back. : To make easier: Place hands on chair. To make harder: Move to the floor with elbows on the floor and stabilized on knees or toes.

Resistance Core Twist 1. Wrap resistance band around stable object at level of stomach. 2. Contract abdominals/core. To make easier: Do not use resistance band. To make harder: Increase resistance band strength or use medicine ball. Single Leg Balance Squat 1. Spread toes on stabilizing foot. 2. Remove one foot from ground as high as comfortable and maintain balance. 3. Lower hips and touch knee with hand. To make easier: Hold single leg balance as able for ~20 seconds. Hold onto chair or object if necessary. To make harder: Touch shin or foot with hand

Dumbbell Row 1. Wrap resistance band around stable object at level of stomach. 2. Pull band toward the body, while keeping elbows close to body. To make easier: Perform while seated. To make harder: Increase resistance or use free weights.

Arm Scaption 1. Stand on resistance band with feet and hold band with arms at side. 2. Keeps arms straight and slowly raise them to the sides of the body until reaching shoulder level. 3. Slowly lower arms back down to side. 4. Slowly raise arms in front of body to shoulder level, while keeping arms straight. 5. Lower to sides. To make easier: Perform while seated

To make harder: Perform in single leg stance. Increase resistance or use free weights. Dumbbell Curl 1. Stand on resistance band with feet and hold band with arms at side. 2. Turn arms so palms are facing up, but in fists. 3. Contract arms and pull fists toward shoulders. 4. Release slowly. To make easier: Perform while seated To make harder: Perform in single leg stance. Increase resistance or use free weights.

Shoulder Press 1. Stand on resistance band with feet and hold band with arms bent at shoulder height. 2. With palms facing up in fists, press arms above head until straight. 3. Slowly release to starting position. To make easier: Perform while seated. To make harder: Increase resistance or use free weights. Push Down 1. Wrap resistance band around stable object at shoulder level. 2. Position arms in front of body in relaxed position, while holding band. 3. Pull down on the band until arms are straight. 4. Slowly release to starting position. To make easier: Perform while seated. To make harder: Increase resistance or use free weights.

Push Ups 1. Start facing chair, with arms straight, hands shoulder width apart on chair and feet on the ground. 2. Bend arms and lower chest to the chair. 3. Push body back up by straightening arms. To make easier: Perform standing using wall.

To make harder: Perform on the ground on knees or toes. Toe-Taps 1. Stand in front of stable stair or box. Lift one foot and tap your toe on the edge of the stair/box. 2. Release food down and repeat with opposite foot. To make easier: Perform while seated or hold onto chair while standing. To make harder: Increase speed of taps or height of stair/box.

Step Ups 1. Stand in front of stair or box. Lift right foot and step up onto top of stair/box with opposite foot following. 2. Step back down onto ground with right foot and left foot following. 3. Alternate starting foot. To make easier: Hold chair or railing while performing. To make harder: Increase height of stair or box. Add knee lift.

Squats 1. Place feet shoulder width apart. 2. Lower hips to 90 degrees, while keeping back straight. 3. Slowly push back up into standing position. To make easier: Lower as low as possible and/or lower onto seat. Hold chair or railing as needed. To make harder: Add weight or perform Squat jumps

Post-Operative Exercise The exercise progression recommended by clinical exercise physiologists post-surgery is as follows: Cardio/Aerobic Exercise Progression Time Post Surgery Frequency Duration 0-2 Weeks Several Times per day As tolerated 2-4 Weeks 5-6 days/week 20-30 min in 10 min increments 4-6 Weeks 5-6 days/week 30-40 minutes 6+ Weeks 5-6 days/week 40-60 minutes Resistance Exercise Progression: *not to begin until cleared for exercise Time Post Surgery 3-7 Weeks 1 set of 20 2-3 days/week 7-11 Weeks 2 sets of 15 2-3 days/week 11+ Weeks 3 sets of 12-15 2-3 days/week Example Upper Body Workout Warm Up: Cardio 5+ minutes Stretches Exercise Sets Reps Prone Iso Abs 2 Hold 20 seconds Dumbbell Row 2 15 Arm Scaption 2 15 Dumbbell Curl 2 15 Shoulder Press 2 15 Cool Down: Cardio 5+ minutes