I am one of those weird people that loves to review research, and figure out how it connects to real life. I also have a profound interest in public health that has emerged from years of working for the school system and seeing youth and families struggle participation in physical activity programs and obesity. The reasons are many...time, access to appropriate activities, motivation, fatigue, stress, safety...the same reasons that many people without disabilities encounter. Although we know from disability studies that people with disabilities experience these things similarly but magnified.
This study recently came my way, and I found it fascinating on a personal as well as professional level. Key points:
1. Currently, there is an emphasis on volume in physical activity recommendations.
2. Less emphasis on strength, primarily because it is more difficult to define strength training (intensity, frequency, loads are all variable).
3. Recent research shows that intensity (how hard you work) is more important than accumulated volume (how many minutes)
5. Efforts need to focus on increasing the intensity of both strength/cardio programs for maximum impact on heath outcomes.
1. "Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort"
2. "Only a marginal reduction in morbidity risk factors and all-cause mortality occurs when they (PA recommendations) are met"
3. "Non-exercise physical activities (NEPA) such as gardening, home/car maintenance, and housework may contribute to improved health and longevity independent of other directed exercise"
Personally, I have been a long time participant in a lot of cardio, mostly running and vinyasa yoga. I introduced strength training and high intensity interval training 3 years ago for a variety of reasons and I have found that strength training has had the most impact on my quality of life: despite being one of the older people at my gym (groan, groan, but it is true), and not lifting the heaviest weights, I am more able to carry heavy items (gait trainers in school), help my husband move a refrigerator into the house (last week actually), and rock climb, than I was before I started strength training. It has also given me a much better sense of well being.
I have noticed the same impact when working with students in a Fit4Work capacity but asking them to carry relatively heavy loads of weight. Why the heavy loads? In order to work in a grocery store or an office, a person might have to carry a case of juice boxes or copier paper (20 pounds?) and carry it across the room. This amount of weight is functional in real life. As my students engage in these activities they do get stronger. Their parents tell us they are more able to carry groceries, and participate in home tasks. I also tell them how strong they are, and that they are getting stronger, and I believe this helps them to feel more confident. How can you not feel strong when you couldn't lift 15 pounds 3 months ago and now you can?
Despite always being a proponent of physical activity and engaging in regular physical activity, I find that implementation and uptake by families is not always as consistent as I would like. The key take homes for me are that we need to consider the need for more intensive strength programs that improve function in life as well as quality of life. We need to consider cardiorespiratory activity as well as more intensive strength activities that are safe for the person to perform. These will be key to improving public health.
Steele J, Fisher J, Skivington M, Dunn C, Arnold J, Tew G, Batterham AM, Nunan D, O'Driscoll JM, Mann S, Beedie C, Jobson S, Smith D, Vigotsky A, Phillips S, Estabrooks P, Winett R. A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health. 2017 Apr 5;17(1):300. doi: 10.1186/s12889-017-4209-8. PubMed PMID: 28381272; PubMed Central PMCID: PMC5382466.