My name is Scott Kimner, MPH, RD, LD! Senior Nutrition Therapy Consultant for the Atlanta and middle Georgia area who has worked with Patient Care America for the last six and a half years. Prior to my tenure at PCA, I was blessed enough to be a renal dietitian with an independent dialysis company in the metro-Atlanta area for nearly six years. I have trained most of my life in martial arts and currently am a 5th Dan Master Black Belt Taekwondo Instructor in Rockdale County, Georgia where I have been an instructor for over 20 years. We all come from various backgrounds with diverse experiences, and I love to use my knowledge of martial arts with dietetics to bring a fun and different dynamic to a health lifestyle!

Let’s Get Physical!

Ok!  Now that we channeled our Olivia Newton-John, lets talk about fitness.  Exercise is an essential part of our health.  Exercising keeps us strong, it can be fun, and it can help us stay healthy for many years.  However, the question comes up often, should dialysis patients be exercising on a routine basis?

The short answer is YES!

Physical activity and exercise has many benefits for people whether they are young and healthy or older with various health issues and risks.

Physical activity can:

  • Improve muscle strength and functionality
  • Improve blood pressure and blood sugar control
  • Reduce body fat
  • Improve mood
  • Reduce other health risks and comorbidities

but wait… THERE’S MORE!

  • Exercising can improve your self-esteem and confidence
  • Keep you engaged with your friends and other people with the same interests
  • And my favorite… It can motivate you to work and improve on yourself when you see
    that positive change of reaching your goals

What can I do to help my patient? What Should I DO…?

Now you might be thinking: “As a dietitian, how can I bring awareness to the importance of physical activity?” “Where can I train my patients?” “Should I train my patients?”  Well, we don’t expect anyone to be a professional athletic trainer or an Olympic Coach when they are promoting physical activity.  Dietitians and nurses can play a key role in helping patients get more exercise and physical activity while staying within professional scope of practice. The most important thing is to help patients focus on doing their best, starting small, and starting simple, or as my dad would say “KISS!”

Keep It Simple, Sir!

Here are some various activities to help get patients started in at the office, dialysis center lobby, house, or treatment floor!

Martial Arts

Martial arts offer an easy and accessible way to increase physical activity with some simple modifications. I’ve taught Taekwondo for 20 years and have worked with many individuals from 5-years-old to 70-years-old.  Below I’ve provided simple instructions patients can follow to get them started working on their upper and lower body conditioning.

  1. Grab a friend or relative and go for a short walk outside or around the home.
    Simple Strength exercises: standing up and sitting down out of a chair several times,
    raising up and down on your toes, stepping up and down off a step.
  2. Use water bottles, canned items, or laundry detergent as free weights.
  3. Choose 3-5 arm exercises 8-12 reps of each and repeat 3 times.
  4. Seated Martial Arts:

Remember, we are starting out slow so be sure to encourage patients to go at a pace they are comfortable with.

Easy to Use Exercise Equipment

If you would like to make a piece of equipment available in your dialysis centers or advise patients on accessible home equipment that is portable, easy on the joints, and can be done anywhere then I recommend the ergometer pedal machine! The pedal machine is small and portable, meaning it can be used while working in an office, watching a favorite show or sports program on the television, or at the dialysis center.

Now don’t be afraid to challenge your patients and have fun with the pedal machine.  Want to combine a couple exercises together?
While patients are pedaling, they can also alternate punches!  Martial arts and a pedal machine – the best of both worlds!

If a pedal machine is not available, resistance bands offer an inexpensive and safe way to make exercises a bit more challenging for your patients.

 

Games to Make Exercise Fun!

Time for a little volleyball!  Don’t worry – I’m not asking patients to start running, jumping, diving, or go to a volleyball court.  For a safe and easy way to play this game they can use their favorite chair, or a chair at the dialysis clinic, and a balloon.  A volleyball or a beachball might be a little difficult to maneuver with which is why I suggest a balloon which requires less speed, strength, and reflexes to maneuver.  If your patient doesn’t have a partner or if you are unable to play this game with the patient, have the patient hit the balloon in the air above their head or in front of them and work on their skills
by themselves.

Do Your Best but Enjoy It!

Throughout our lives we will always have setbacks and new obstacles, patients included. The goal is to help them focus on doing the best they can do. Patients may become discouraged if they try comparing their activity level to others or even to their past performance. It helps to remind them, especially
if they have been sedentary for a long time, that they are starting with a clean slate and it’s going to be a learning process for your patients, so don’t stress!

Remind them not to worry about competing against anyone. By focusing on being better than they were yesterday they can notice even small steps in their progress to a healthier lifestyle. As obstacles come up, I would encourage them to remember the two tenants that I always tell our Taekwondo students:  Perseverance and Indomitable Spirit.  Always keep moving, always have fun, and always be happy with the work that you do.

 

Thank you to our guest blogger, Scott Kimner, MPH, RD, LD, for sharing his expertise and patient experience for this blog post.

 

For more patient and clinician exercise related handouts, please log on to our clinician portal.