।। Zahid Bin Sultan ।।
Social distancing policy during the COVID-19 pandemic is being encouraged or enforced by governments worldwide restricting people’s daily activities. For that reason people are spending most of time at home. People are getting less opportunity to participate in physical activities and leisure sports activities like going to gym or walking in the park. According to WHO (World Health Organization) insufficient physical activity is one of the leading risk factors for death worldwide and also a key risk factor for non-communicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes. Physical inactivity and sedentary lifestyle also cause worsening of the condition of people who are already suffering from chronic diseases like diabetes, hypertension, arthritis and also bad effect on mental health.
What is physical activity?
According to WHO, physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity may include:
• Activities undertaken while working
• Active recreational activities
• Sports participation
• Cycling
• Walking
• Travelling
• Dancing
• Gardening
• House cleaning
• Stretching, strengthening and balance exercises
What are the benefits of physical activity?
There are many benefits of physical activity. These include:
• It helps to maintaining the immune system strength and make less susceptible to infections.
• Also helps to bring the stress hormone (cortisol) levels in balance. Stress and distress (such as during a pandemic) creates an imbalance in cortisol levels and this negatively influences immune function and inflammation.
• It helps to control high blood pressure and body weight.
• Improves vascular function, increases oxidative capacity, increase the blood glucose sensitivity.
• Reduce the risk of heart disease, diabetes, stroke and certain cancers.
• Improves bone density and muscle strength.
• Maintain body balance, flexibility and maximize general fitness.
• Delays the onset of dementia and slow down the process of cognitive decline.
• Physical activity is a great stress management tool through reducing anxiety and depression. It improves overall feeling of well-being.
• In children physical activity support for healthy growth and help in the development of fundamental movement skills.
How much of physical activity is recommended?
WHO recommends:
Children and adolescents aged 5-17 years
• Should do at least 60 minutes of moderate to vigorous intensity physical activity daily and also include activities that strengthen muscle and bone, at least 3 times per week.
Adults aged 18–64 years
• Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous intensity physical activity throughout the week, or an equivalent combination of moderate and vigorous intensity activity.
Adults aged 65 years and above
• Should do at least 150 minutes of moderate intensity physical activity throughout the week, or at least 75 minutes of vigorous intensity physical activity throughout the week, or an equivalent combination of moderate and vigorous intensity activity.
The intensity of different forms of physical activity varies between people. Many people are used to doing only aerobic activity like walking or jogging. Research suggest that combination of aerobic (walking, cycling, swimming) and muscle strengthening (resistance training) exercise, have a greater benefit than aerobic or strengthening exercise alone. So, I suggest some combine exercise for healthy individuals like 30 minutes of brisk walking or cycling and then 20 minutes strengthening exercises as for example: lunges, butt bridge, body weight squat, light weight dumbbell curl and front dumbbell raise, etc. Intensity of strengthening exercise should be 8-10 repetition and 2-3 set of each exercises.
How to stay safe while exercising during Covid-19?
• If you have fever, cough or difficulty of breathing or any symptoms of Covid-19, stop doing exercises, contact with your health care provider regarding your symptoms because Covid-19 patient required specific exercise protocol according to WHO guideline. In that case, respiratory physiotherapist helps you to make an effective respiratory exercise plan.
• Maintain social distancing when exercising outdoors and practice good hand hygiene before and after doing exercises.
• If you are not used to physical activity, start slowly with low intensity activities such as walking or low impact exercises for shorter periods of time and gradually increase the intensity of activity over time.
• Choose the right activity and right intensity to reduce the risk of injury.
• If you feel any chest pain or discomfort during any kind of physical activity, stop activity immediately and talk to your doctor. Patient with heart disease should measure their Target Heart Rate (THR) before doing any physical activity.
How to determine your target heart rate zone?
Here I have given the simple way of measuring Target Heart Rate, or you can use online calculator to determine Target Heart Rate or, you can send me email if you do not understand the Target Heart Rate. If you are planning for moderate intensity exercises then you have to determine 50% to 70% of Maximum Heart Rate.
• Subtract your age from 220 to get your maximum heart rate.
• Calculate your resting heart rate by counting how many times your heart beats per minute when you are at rest, such as in the morning. It is usually somewhere between 60 and 100 beats per minute for the average adult.
• Calculate your heart rate reserve (HRR) by subtracting your resting heart rate from your maximum heart rate.
• Moderate exercise intensity: 50% to about 70% of your maximum heart rate. So,
o Multiply your HRR by 0.5 (50%). Add your resting heart rate to this number.
o Multiply your HRR by 0.7 (70%). Add your resting heart rate to this number.
• These two numbers are your average target heart rate zone for moderate exercise intensity. Your heart rate during moderate exercise should generally be between these two numbers.
Being physically active is a challenge for us during the Covid-19 pandemic situation. It is very hard for us to make a plan for physical activity and minimize our inactivity in that situation. We need to be persevering to be physically active and utilize our time in a way that requires energy expenditure. Thus we can maintain our good health and prevent some diseases during the Covid-19 pandemic.
The writer is clinical physiotherapist, BRB Hospital Ltd. Email:ranacrpphysio@gmail.com
