Circulatory Exercises

Circulatory exercises

Circulation, or the flow of blood throughout our bodies, is important for good health. Normal circulation promotes all of our biological systems by delivering oxygen throughout the body and helping to eliminate waste. When circulation is inadequate, or the blood does not flow vigorously, symptoms can include tired or heavy legs, cold fingers and toes as well as low energy and even dull skin. An easy way to boost circulation is with exercise. 

Circulation, a primary function of the circulatory system, delivers oxygen and nutrients via blood to each cell while also washing away toxins. The exercise makes the circulatory system stronger, more flexible, and more expansive all at the same time.

The circulatory system is metabolically active, supports optimal immune function, and serves as an important waste-removal system.

1. Heart

This muscular pump contracts and relaxes some 80 times a minute on average (depending on a person’s genetic profile and fitness level), moving enriched blood through arteries to organs, tissues, and bones. The oxygen and nutrients it delivers fuels every cell in the body. Regular exercise helps strengthen and enlarge the heart. With circulatory exercise the heart becomes stronger and resting heart rate decreases.

2. Lungs

During inspiration, lungs fill with oxygen. Then, in a process known as gas exchange, oxygen crosses over from the lung tissue to the bloodstream via a web of capillaries. Exercise has been shown to improve the efficiency of gas exchange. This newly oxygenated blood then flows into the left side of the heart.

3. Liver

Liver detoxifies body, filtering waste via blood and bile. Exercising regularly improves blood flow by strengthening the heart and blood vessels, bolstering this filtration system. In turn, overall energy and well-being are improved if the body’s natural detox method is functioning well.

4. Stomach and Intestines

Blood absorbs nutrients from digested food via capillaries in the gastrointestinal system; and blood vessels then distribute these nutrients throughout the body. Exercise not only increases the formation of “collateral” blood vessels, which improves nutrient delivery.

5. Waste System

Exercise boosts overall circulation, which moves waste out of the body through the capillaries. 

Examples of circulatory exercises:

1.Flex and extend toes (3 times slowly, 3 times fast, 3 times slowly)

2.Dorsiflexion & plantar flexion (3 times slowly, 3 times fast, 3 times slowly)

3.Circular movement of the foot (inward & outward) 

4.Static contraction of the quadriceps 

5.Contraction of the glutei 

Renal disease

Functions of the kidney:

1.Remove waste products & excess water from the body (filtration).

2.Secrete important hormones (e.g. renin: affect blood pressure).

3.Regulate the volume & chemical composition of the blood.

4.Reabsorption.

Stages of medical management of kidney dysfunction:

1.Chronic kidney disease

2.Renal dialysis

3.Renal transplantation

I.Chronic kidney disease 

         Goals of exercise:

• Control blood pressure
• Reduce the risk of diabetes
• Improve muscle strength and physical function 
• Reduce anxiety and depression

       Exercises for chronic kidney disease patients:

• Warming up 5-10 minutes
• Aerobic exercises (e.g. walking, jogging, cycling)
• Strengthening exercises (for large groups of muscles)
• Stretching exercises
• Cooling down 5-10 minutes
• Exercise program should begin slowly, progress gradually and suitable for the patient's fitness.

II.Renal dialysis

*It is more convenient for patients to exercise on non-dialysis days. A patient may become hypotensive after hemodialysis and should avoid exercising directly afterward.

Dialysis

Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when kidneys can no longer take care of the body's needs.

What does dialysis do?

When kidneys fail, dialysis keeps the body in balance by:

• removing waste, salt and extra water to prevent them from building up in the body
• keeping a safe level of certain chemicals in blood, such as potassium, sodium and bicarbonate
• helping to control blood pressure

There are 2 main types of dialysis

1.hemodialysis involves diverting blood into an external machine, where it's filtered before being returned to the body 

2.peritoneal dialysis involves pumping dialysis fluid into the space inside the abdomen to draw out waste products from the blood passing through vessels lining the inside of the abdomen

1) Haemodialysis

• In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from blood. 
• Sometimes, an access is made by joining an artery to a vein under skin to make a bigger blood vessel called a fistula.
• Two thin needles will be inserted into AV fistula or graft and taped into place. One needle will slowly remove blood and transfer it to a machine called a dialyser or dialysis machine.
• Most people need 3 sessions of hemodialysis a week, with each session lasting around 4 hours. 
• The dialysis machine is made up of a series of membranes that act as filters and a special liquid called dialysate. The membranes filter waste products from blood, which are passed into the dialysate fluid. 
• The used dialysate fluid is pumped out of the dialyser, and the filtered blood is passed back into the body through the second needle.
• This is caused by the rapid changes in blood fluid levels that occur during the treatment.

2) Peritoneal dialysis

In this type of dialysis, blood is cleaned inside the body. The doctor will do surgery to place a plastic tube called a catheter into abdomen (belly) to make an access. During the treatment, the abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line peritoneal cavity. Extra fluid and waste products are drawn out of blood and into the dialysate. There are two major kinds of peritoneal dialysis.

Both treatments can be done at home. There are 2 main types of peritoneal dialysis:

• continuous ambulatory peritoneal dialysis (CAPD) – where blood is filtered several times during the day
• automated peritoneal dialysis (APD) – where a machine helps filter blood during the night

Exercises for patients on dialysis:

1.Warming up 5-10 minutes

2.Aerobic exercises (e.g. walking, jogging, cycling)

3.Strengthening exercises (for large groups of muscles)

4.Stretching exercises

5.Cooling down 5-10 minutes

6.Exercise program should begin slowly, progress gradually and suitable for the patient's fitness.

7.If the patient is bed ridden the following should be applied:

• Strengthening exercises (static abdominal exercises).
• Circulatory exercises.
• Breathing exercises.
• Proper bed positioning and mobility training to avoid pressure ulcers.

III.Renal transplantation

Pre-operative treatment:

1.Aerobic exercises (e.g. walking).

2.Strengthening exercises for quadriceps, hip flexors and extensors, back and abdominal muscles.

3.Circulatory exercises.

4.Breathing exercises.

Post-operative treatment: 

1.Aerobic exercises (e.g. walking).

2.Strengthening exercises (static abdominal exercises).

3.Circulatory exercises.

4.Breathing exercises.

5.Techniques to improve cough.

6.Airway clearance techniques and devices.

7.Proper bed positioning and mobility training to avoid pressure ulcers.

• Precautions for patients with renal transplantation:

a.Avoid left, push or pull heavy objects.

b.Stop exercising if the patient had any of the following:

*Chest pain

*Dizziness 

*Swelling 

*Rapid or irregular heart rate

*Fatigue 

*shortness of breath

Liver diseases

The liver is essential for digesting food and ridding body of toxic substances. Liver disease can be inherited (genetic) or caused by a variety of factors that damage the liver, such as viruses and alcohol use. Obesity is also associated with liver damage. Over time, damage to the liver results in scarring (cirrhosis), which can lead to liver failure, a life-threatening condition.

Symptoms

Most types of liver disease don't cause any symptoms in the early stages. Once start to get symptoms of liver disease, liver is already damaged and scarred. This is known as cirrhosis.

Signs and symptoms of liver disease include:

• Skin and eyes that appear yellowish (jaundice)
• Abdominal pain and swelling
• Swelling in the legs and ankles
• Itchy skin
• Chronic fatigue
• Nausea or vomiting
• Loss of appetite
• Tendency to bruise easily

Causes

Liver disease has many causes.

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Primary biliary cirrhosis
• Liver cancer
• Bile duct obstruction
• Chronic alcohol abuse
• Fat accumulating in the liver (nonalcoholic fatty liver disease)

Exercises for patients with liver disease

1.Aerobic exercises (e.g. walking, jogging, cycling)

2.Strengthening exercises (for large groups of muscles)

3.If the patient is bed ridden the following should be applied:

• Strengthening exercises (static abdominal exercises).
• Circulatory exercises.
• Breathing exercises.
• Proper bed positioning and mobility training to avoid pressure ulcers.

Pre-operative treatment for patient on liver transplantation: 

1.Aerobic exercises (e.g. walking).

2.Strengthening exercises (for large groups of muscles)

3.Circulatory exercises.

4.Breathing exercises.

Post-operative treatment for patient on liver transplantation: 

1.Aerobic exercises (e.g. walking).

2.Strengthening exercises (static abdominal exercises).

3.Circulatory exercises.

4.Breathing exercises.

5.Techniques to improve cough.

6.Airway clearance techniques and devices.

7.Proper bed positioning and mobility training to avoid pressure ulcers.