انجام ورزش های زیر به بیمارانی که پوکی استخوان دارند توصیه میگردد:

POSTURAL STABILITY

STRENGTH & BALANCE

Home Exercise Programme

Safety

Ensure that the chair you use is sturdy and stable or use a more sturdy support such as the kitchen worktop or breakfast table if your instructor/therapist recommends this. Wear comfortable clothes and supportive footwear.

Prepare a space and have your exercise band and a glass of water (for afterwards) ready before you start.

While exercising, if you experience chest pain, dizziness or severe shortness of breath, stop immediately and contact your GP (or call an ambulance if you feel very unwell and your symptoms do not go away when you stop exercising).

If you experience pain in your joints or muscles, stop, check your position and try again. If the pain persists, seek advice from your Postural Stability Instructor. However, feeling your muscles working or slight muscle soreness the next day after exercise is normal and shows that the exercises are working.

Breathe normally throughout and enjoy yourself.

Aim to do these exercises twice per week in addition to your exercise class.

If you are using this booklet without attending a supervised exercise session, consult your GP to check it is suitable for you

Warm Up Exercises

Always begin with a warm up to prepare your body for the main exercises.

There are 4 warm up exercises.

Complete them all if you are doing your exercises in one session.

If you decide to spread your exercises over the day do the March warm up exercise before you move on to do your strength, balance or stretch exercises

March

Stand (or sit) tall-
Hold the back (or sides) of the chair-
March with control-
Build to a rhythm that is comfortable for you-
Continue for 1-2 minutes-

Shoulder Circles

 Stand (or sit) tall with your arms at your sides-

 Lift both shoulders up to your ears, draw them back then press them down-

Repeat slowly 5 times-

Ankle Loosener

 Stand side on to (or sit tall at the front of) the chair-

 Pull up tall-

 Hold the back (or sides) of the chair-

 Place the heel of one foot on the floor then lift it and put the toes down on the same spot-

 Repeat 5 times on each leg-

Spine Twists

Stand (or sit) very tall with your feet hip width apart

Fold your arms across your chest

Twist your upper body and head to the right keeping your hips forwards

Repeat on the opposite side

Repeat 5 times

Main Exercises

There are 10 exercises in this section

Complete them all

Aim to do them twice per week on top of your exercise class and walks

If you choose to do the exercises throughout the day, do a little march first to warm yourself up and prepare for exercise

The first 6 exercises are to help improve your balance

Heel Raises

Stand tall holding a sturdy chair, table or the sink

Raise your heels taking your weight over your big toe

Hold for a second

Lower your heels with control

Repeat 10 times

Toe Walk

Stand tall and side on to your support

Raise your heels (weight over big toe as before) then take 10 small steps forwards

Bring your feet together then lower your heels with control

Toe Raises

Stand tall holding your support

Raise your toes taking your weight back into your heels without sticking your bottom out

Hold for a second

Lower your toes with control

Repeat 10 times

Heel Walk

Stand tall and side on to your support

Raise your toes without sticking your bottom out then take 10 small steps forwards

Lower your toes with control

Repeat in the other direction

Side Steps

Stand tall facing your support

Take a sideways step keeping the hips forward and the knees soft

Repeat side to side 10 times, building to a comfortable rhythm

Flamingo Swings

Stand tall and side on to your support

Swing the leg furthest from the chair forwards and back with control

Perform 10 swings

Repeat on the other leg

Main Exercises & Continued

The following 4 exercises are to help improve your bone and muscle strength

Sit to Stand

Sit tall near the front of the chair

Place your feet slightly back

Lean forwards slightly

Stand up (using your hands on the chair if needed)

Step back until your legs touch the chair then slowly lower your bottom back into the chair

Repeat 10 times

Upper Back Strengthener

Hold the band with your palms facing upwards and your wrists straight

Pull your hands apart then draw the band towards your hips and squeeze your shoulder blades together

Hold for a slow count of 5 whilst breathing normally

Release, then repeat 7 more times

Strengthener Thigh Outer

Sit tall near the front of the chair with your feet and knees touching then wrap the band around your legs (keeping the band as flat as possible)

Take your feet and knees back to hip width apart

Push your knees outwards, keeping your feet flat on the floor and hold for a slow count of 5

Release, then repeat 7 more times

Thigh Strengthener

Sit tall at the front of your chair

Place the band under the ball of one foot and grasp it with both hands at knee level

Lift your foot just off the floor then pull your hands to your hips

Now press your heel away from you until your leg is straight and your heel is just off the floor

Hold for a slow count of 5 then return to the starting position

Repeat 6-8 times on each leg

Ending the Session

Finish by marching at a relaxed pace for 1-2 minutes then perform all of the following stretches

Chest Stretch

Sit tall away from the back of the chair

Reach behind with both arms and grasp the chair back

Press your chest upwards and forwards until you feel the stretch across your chest

Hold for 10-20 seconds

Back of Thigh Stretch

Make sure you are right at the front of the chair

Straighten one leg placing the heel on the floor

Place both hands on the other leg then sit really tall

Lean forwards with a straight back until you feel the stretch in the back of your thigh

Hold for 10-20 seconds

Repeat on the other leg

Calf Stretch

Stand behind the chair holding on with both hands

Step back with one leg and press the heel down

Check that both feet face directly forwards

Feel the stretch in your calf

Hold for 10-20 seconds

Repeat on the other leg

Finished

Well done! You have finished your exercises for today

Try to do these home exercises three times per week. Set a day and a time aside for another session now

Balance Progression

Once you are performing the balance exercises with confidence on a regular basis, you should aim to GRADUALLY reduce the amount of hand support you use

This can be done by releasing your little fingers to see if you can still maintain your balance. The next step is to release your ring fingers and when you have mastered this, your middle fingers so that you are now balancing by supporting only with your index fingers. Make sure you master balancing at each stage before progressing to the next

Sit Less

We now know that long periods of sitting, like watching the television all evening, are not good for our health. The more we sit, the more likely we are to get thicker around the waist, develop diabetes, become less mobile and have a low mood

People who get up more regularly and break up long periods of sitting (every 1 – 2 hours at least) are more mobile and healthy

Tips to break up long periods of sitting

Stand up after a few chapters of your book

Remain standing while the kettle boils

Do one of the standing exercises in this booklet

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