Medical Fitness for Duty
notes from a presentation by Dr. Cedric Bryant, American Council on Exercise, Chief Science Officer
Fit for Duty/ Fit for Life:
Firefighters are the ultimate performance athletes. We have to maintain:
1. Cardio strength
2. Muscular strength
3. Thermo control.
Our jobs incorporate a mixture of static and dynamic work.
Fit for Life= 55% of Line of Duty deaths are related to Cardiovascular events.
Of these more than half are related to health, fitness, and wellness.
Significant portion are preventable!
Physical inactivity leads to insulin/glucose receptor dysfunction.
The Metabolic Syndrome ( insulin resistant) the body doesn't respond well to sugar.
Abdominal Adipoosity (Fat Belly)
Do you have this syndrome? Here are the 5 markers:
1. HDL <40 for men <50 for women
2. Triglycerides >150 mg
3. Waist size 40" or more for men and 34.5" for more for women.
4. BP greater than 130/85
5. Blood glucose >100 mg.
If you have 3 out of 5, you need to make some changes!
Consequences of these problems are:
Diabetes-
Prevention is a 3 pronged attack.
1. Physical Activity- Exercise using the FIT Rx. More is better.
Frequency= 5-7 days a week.
Intensity= 40-60% maximal capacity.
Time= 20-60 minutes.
Actvity options include low to moderate aerobics supplemented with weight training, yoga, pilates, etc.
If you are on statins, listen to your body while exercising. Don't push through pain. You can cause muscle tears called Rhabdomyolysis.
Gradually increase caloric expendature. 300-600-800-1200-1500 calories burned per week over a 10-12 week period. Simple gauge= do 150 to 300 minutes of exercise per week.
2. Weight Loss- 5-10% is good. Decreases BP and increases insulin resistance.
3. Diet and Nutrition- adjust macro nutrient mix. Less than 50% low glycemic carbs. 15%-20% protein and 30-35% fats. Increase fiber by utilizing the 5 a day concept. Eat more legumes, whole grains, vegetables and fruits. Limit consumption of highly processed foods.
Hypertension
Exercise for hypertension
20-60 minutes per day
break it up into 2 shorter workouts-am and pm
3-5 or 5-7 days per week.
low intensity aerobic exercise
extend warm up and cool down periods
Avoid high intensity exercises.
Precautions
Be aware of potential medical side effects ie beta blockers and diuretics. They can compromise ability to exercise in heat. Incorporate low to moderate resistance training.
Avoid Valsalva (holding breath)
Avoid start stop activities
Monitor BP before and after exercise.
Major benefits include:
Improved BP control. Reduced rate and severity of complications. Reduced dosage of meds to control BP. Improved CHD risk factor profile.
Keys to success:
Confidentiality
education/ rehab
performance testing to promote gradual consistent improvement
holistic (medical eval, fitness, rehab, behavior)
Long term focus.