Nagpur: On occasion of world physiotherapy day 8th September, 2015, CIIMS hospital, Nagpur, had organised a seminar on obesity & osteoporosis along with a free screening camp for body mass index for its house staff. The seminar was conducted by the dynamic & flamboyant staff members of physiotherapy department with special mention to the head of the department Dr. Mrs. Divya Mehta, & her colleagues Dr. Snehal Ramteke, Dr. Sudip Kothari, Dr. Manoj Babhare, Dr. Varsha Nagrkar, Dr. Bushra Siddique, Dr. Shaifali Loya, Dr. Neeraj Gampawar.
The Seminar focused on role of physiotherapy, its various speciality areas where physiotherapists play an important role in providing basic life support, improving quality of living & optimizing functional levels in normal people & those affected by any disease. This was followed by a chief discussion over osteoporosis & obesity.
Dr. Neeraj beautifully elucidated the role of a physiotherapist, where he outlined about the branch of physiotherapy, which started from early 80’s then growing through modern physiotherapy concepts in 1950’s till date. It’s a myth that physiotherapy is all about training and treating sportsperson only, with modernization, physiotherapy has excelled in all fields of medical sciences like neurology where physiotherapist treat patients with stroke, spinal cord injury, parkinsonism, etc.
Cardio-pulmonary conditions pre & post surgery or in order to prevent cardio-pulmonary diseases with the help of fitness programs & so on.
Optimising the abilities in paediatrics in which children are afflicted, conditions such as cerebral palsy, mental retardation, etc.
Geriatrics in elder population helping them to preserve their functional status by training them with their lifestyle modifications, training them for balance activity, to improve or maintain endurance & strength.
Physiotherapy for women health is a boon for women with gynaecological & obstetric conditions along with potential females (obesity & osteoporosis are some of the paramount of this speciality area).
Musculo-skeletal sciences where in day to day life physiotherapy helps in treating mechanical & physiological musculoskeletal problems such as backache, osteoarthritis, fractures, dislocations, & numerous conditions in this field as human race tend to grow busy with extreme unhealthy lifestyles and innumerable ailments.
The seminar then focussed on the topics to impede osteoporosis & obesity. Dr. Shaifali Loya cornered the attention of people over the topic of osteoporosis, as a condition in which the bones become weak & brittle due to tissue loss, as a consequence of deficiency of calcium or vitamin D, or hormonal changes.
She emphasised over the appearance of a normal & an osteoporotic bone, in which the normal bone looks like a filled honeycomb whereas an osteoporotic bone looks like an empty honeycomb, giving another example she explained that a normal bone is like a wet stick which is not easy to break while an osteoporotic bone is like a dry stick which can be broken even with slightest pressure.
The symptoms of an osteoporotic bone begins with pain usually affecting spinal column, followed by fracture or dislocations, stooped posture, resulting in loss of functional activities, etc. & limiting mobility.
Causes of osteoporosis are low levels of calcium, phosphorus, minerals & vitamin D, resulting in less strong & loose structure of bones.
Stating about the risk factor Dr. Shaifali Loya explained that it is usually seen more in females than males cause of disturbances in hormonal levels due to menstrual activity, also with other factors where she asserted that osteoporosis increases with increasing age, low levels of estrogens, with steroid medications, low calcium & vitamin D intake, sedentary lifestyle or inactive lifestyle patterns, excessive soda & alcohol consumption.
The preventive measures for osteoporotic condition was immaculately mentioned which included simple & basic set of exercises with special mention to mobility like brisk walking, swimming, etc. & implementing modification in today’s slow & lazy pattern of working.
Special mention on dietary sources like adding adequate amounts of calcium (milk, soya, tofu, broccoli, almonds, etc.) & vitamin D (best source morning sunlight, milk, cereals, fish, etc.), to avoid smoking & alcohol, excessive consumption of caffeine was given.
Maintaining good posture & performing bouts of exercises during work & at home, & preventing falls in elderly population to avoid breaking of fragile bones, along with pain management was the guidelines given up for the management of osteoporosis.
Obesity was the next & the final topic of the seminar which was magnificently illustrated by Dr. Bushra Siddique, where the general concept and its types were explained. Obesity is a condition in which a person is largely over weight or in simple terms is fat leading to plenty of health complications like heart diseases, stroke, diabetes, high blood pressure, etc.
Obesity is usually seen in two shapes namely the first one is apple shaped obesity & the second is pear shaped obesity. In Apple shape obesity the fat is more around the stomach (the abdominal area) & results in more health complications, in pear shaped obesity the fat is seen more around the waist (the pelvic region) than the stomach & usually is common in females.
Then the various categories of obesity was mentioned in a simplified way satisfying the curiosity of the house staff by letting them know the body mass index formula through which we can calculate how much a person should weigh according to their own height. Special screening for the BMI parameters was done after the seminar was concluded.
Causes of obesity & its complications were framed precisely to make the audience understand the grave importance of the topic more vividly. The causes of obesity comprises of genetic factors, emotional factors (hormonal disturbances), sedentary lifestyle/inactive lifestyle, over eating of junk food (cold drinks, chips, burgers, sandwiches, pizzas, sweets, oily food, etc.), insomnia (inability to sleep resulting in disturbances in hormonal levels which leads to craving for food), pregnancy (along with hormonal factors after delivery the female fails to reduce weight & continue to gain weight).
The complications of obesity listed were neurological disorders like stroke, hypertension, dementia, cardiac conditions like atherosclerosis, cancer, liver diseases, pulmonary disorders like hypoventilation syndrome, obstructive sleep apnoea, breathlessness, easy fatigability, gall bladder diseases, arthritic conditions like rheumatoid arthritis, osteoarthritis, gout, venous disorders like DVT & phlebitis. Other than physiological diseases obesity results in psychological problems like depression, social isolation, and physical inactivity, nowadays commonly faced by obese children known as childhood obesity in which the child is ashamed of the fat look appearance.
Do you need a doctor to overcome obesity? “YES” you need to visit your doctor. You must talk about the things you are facing, giving your doctor a proper detailed history when asked about the above things will help to make your treatment plan more accurate. Your BMI will be calculated & regular routine test would be done (fasting glucose, cholesterol, liver function, thyroid test), & according to the reports your treatment plan is set.
Treatment plan was explained in detail which included the exercises & modification of physical activity which is based on the BMI of every particular individual. Your physiotherapist will provide you with the best treatment sessions for reduction of your obesity.
The importance of exercises where stated clearing the confusions & misbelieve for exercises in relation to obesity such as-
Performing daily work activities doesn’t reduce obesity?
Cause in these daily work activities your heart rate doesn’t reaches to the max level of the heart rate required to burn your fat (70-85% of heart rate is required which is attained by your exercises). So the word exercises and work, or activity are different from each other.
Then some people usually state that we performed exercises for 2-3 months still we didn’t lose weight it was of no use hence we left!
So the reason why you didn’t lose weight or burn your fat is because you require to lose your weight at least half or one kilograms per week for at least six months cause in initial period of first three months its only the body fluid you lose, then from 3-5 months protein breakdown takes place, & from sixth month you start burning your fat for which you need to work for a long time since then.
With all these elucidation about exercise in your treatment plan it focused on dietary changes which was taking healthy fruits and vegetables, lean meat & dairy products, & putting up a stop on yourself from eating unhealthy & junk food.
Behaviour change is also of prime importance, being happy for example motivating yourself by taking up a resolution to be happy for 100 days (HAPPY 100 DAYS), meditation to manage stress, enjoying with friends & family, engage yourself with some hobbies.
Then prescription of medications can be done (proper medications given by your doctor, no self medications), last option if the above listed doesn’t work is usually for obese with BMI of above 40 is weight loss surgery (bariatric surgery), after which you need to perform strict exercises & have strict diet in order to stay fit & gain more out of the money you have invested in the surgery.
The seminar was concluded with encouraging people to do exercise as no one is so heavy that they cannot perform the exercises.
With a vote of thanks to the staff members & all the dignitaries of CIIMS hospital the seminar was highly appreciated by everyone & the screening for obesity parameters was preceded with huge treasure of knowledge seated in everyone’s mind.