How FitBit And FaceTime Use Technology To Make Exercise More Accessible

I have friends who say they love breaking a sweat when they work out. To me breaking a sweat means I’m having another hot flash.

I’ve never been good about sticking to any exercise program; instead I’ve wasted a lot of time and money on gym memberships that I never renewed. In my early twenties I religiously worked out at home with Jane Fonda in our respective leg warmers and headbands. That didn't last long.

When I was 26 I was diagnosed with Multiple Sclerosis and quickly began living my “new normal” that included permanent numbness, loss of balance and heavy bouts of fatigue. I focused on getting through my days as best as I could without feeling deep pangs of guilt that I wasn’t getting any exercise.

I became a mother at 34 and knew it’d take all of my inner strength and physical energy to be the best mother I could be. Once again, exercise took a back seat.

Looking back I regret not being more committed to an exercise regimen. I wish I had the means to hire a personal trainer because that's what I needed; someone who would make me accountable to a weekly workout.

Now that I’m in my fifties I know there’s a strong relationship between exercise and good health. It can improve strength, provide better cardiovascular fitness, help with fatigue and depression, and contribute toward maintaining an overall positive attitude. (Read this article about exercise from The National Multiple Sclerosis Society.)

So when I ran into my former neurologist, Dr. Mary Ann Picone, Medical Director of the Multiple Sclerosis Comprehensive Care Center at Holy Name Hospital when I was attending The Consortium of Multiple Sclerosis Center’s Annual Meeting, I was excited to learn about a new study she’s working on that could help people with MS adhere to an exercise program.

In her study, funded by FCMSC (Foundation for the Consortium of Multiple Sclerosis Centers), she used technology (a Fitbit and FaceTime) for patients who received an individualized workout program and were then monitored using FaceTime.

How simple and brilliant is that?

I asked Dr. Picone to explain her study further for us, because it's my belief that the results have the potential of making a tremendous difference for many in the disability community.

Dr. Mary Ann Picone and Dr. Hunter Vincent presenting their poster at CMSC about utilizing technology to improve patient adherence to exercise programs

CC: What made you decide there was a need to conduct a program to monitor patients at home with an exercise program?

MAP: Everyone knows how important exercise is and how helpful physical therapy can be in improving function. However, it is often difficult for some patients to get to therapy because of lack of transportation and/or lack of insurance coverage.

Another problem is adhering to an exercise program once it is started.

Since technology can be so helpful these days we thought we’d try to utilize it to allow patients access to physical therapy and at-home monitoring that they would not have been able to get otherwise.

Having the ability to FaceTime would allow us to track patients and adjust their exercise regimen as needed, and provide encouragement to maintain the program.

Use of the FitBit was another way to help motivate patients to do more. By using an iPad and having a physical therapist devise an individualized rehabilitation program for each person, then using FaceTime, a Fit Bit and reassessing each person at the end of 12 weeks, we could see if this was feasible, if patients liked it, and most importantly if we saw signs of improvement at the end of 12 weeks.

Jason Kavountzis, Head of the Physical Therapy Department at Holy Name, assessed each patient initially and videoed a program for them on an iPad.

Each person took them home, and Hunter Vincent (then a fourth year medical student at Touro University Medical School who was working with me at the Holy Name MS Center saw the challenges that patients faced. He applied for a Student Research grant from CMSC) also assessed the patient and did FaceTime to monitor them every two weeks throughout the course of the trial.

CC: How did you decide which patients qualified for your study? What types of MS did the patients have? Can patients with progressive MS take part?

MAP: Anyone diagnosed with MS who needed rehabilitation, was having difficulty accessing care, and had Wifi capabilities at home was able to qualify. We were looking for a variety of patients with various levels of disability.

We were able to have 8 patients in the trial ranging from having mild lower extremity weakness but primarily with balance problems to patients using a cane either occasionally or all the time to someone who needed a walker for ambulation.

One person who entered the trial had never been involved in a formal exercise program. Patients with either relapsing or progressive MS could take part. There were 7 women and one man in the study. We wanted to see if this program would work for patients with various levels of ability.

CC: What were the results of your study?

MAP: Each patient in the trial was assessed initially and had baseline testing to evaluate various measures such as fatigue, quality of life scales, time to walk 25 feet and a balance test called Tinetti Balance, and how quickly they could get up from a sitting position.

Several patients had not used an iPad before so they needed to learn how to use it and FaceTime. Everyone learned the technology.

Patients showed improvement in their walking, balance and overall quality of life at the end of the 12 weeks. Having to check in every two weeks was very helpful for support and adjustment of routine if necessary.

It improved everyone's confidence level. Several patients who had been very anxious about using the iPad, Wifi and the FitBit were thrilled about the knowledge they gained.

We presented this study at CMSC in Indianapolis and Hunter won First Prize for Best Platform in Patient and Family Education!

CC: How will these results be used? What is the next step?

MAP: Although there was improvement at the end of the 12 weeks, the next challenge is whether these benefits can be maintained. Twelve weeks may not be long enough to produce long-term change in lifestyle. We think six months is needed.

We would like to do a six-month study, look at FaceTime monitoring every two weeks, and include both a nutritional component to looking at improving a patient's diet and a psychological component that would help with trying to overcome any obstacles to maintaining a healthy diet and exercise program.

The next step is to also compare this to inpatient rehabilitation.

CC: How do you envision the study’s results to be used down the road for more patients in need?

MAP: I would like to see this technology expanded to allow more patients access to an individualized rehabilitation program that they can do at home with remote supervision and occasional inpatient visits for patients who would not otherwise be able to have rehabilitation.

This could even be used globally. I have a patient from Egypt who comes to the center and is using the iPad exercises for at home rehab program!

We want to enable patients to overcome obstacles to care.

CC: Who was involved in your study?

MAP: As stated above, Jason Kavountzis, Head of the Physical Therapy Department at Holy Name Medical Center, Dr. Hunter Vincent who was a fourth year medical student and interested in improving the care of patients with MS (and will be entering Physical Medicine and Rehabilitation Residency), Dr. Fred Foley, Head of Neuropsychology at the MS Center who helped with the statistics and me, Dr. Mary Ann Picone, as the faculty mentor for the study.

CC: Any other thoughts?

MAP: We are grateful to the Foundation of the CMSC for supporting medical student research initiatives.

Our goal is to find ways to improve the lives of patients living with MS and to encourage smart, enthusiastic medical students to become interns, residents and physicians who will continue to improve care in MS.

END NOTE: At the CMSC event in Indianapolis Dr. Hunter Vincent received the award for The Best Platform in Patient and Family Education. He was also designated as the June Halper Medical Student Research Scholar by FCMSC's selection committee. Congratulations Hunter!

How I'm Trying To Practice Mindfulness in 2014: Are You Mindful About What You Eat?

“The best way to capture moments is to pay attention. This is how we cultivate mindfulness. Mindfulness means being awake. It means knowing what you are doing.” ~Jon Kabat-Zinn, Wherever You Go,There You Are: Mindfulness Meditation in Everyday Life

I promised myself that in 2014 I'd try to be more mindful of all that I do by noticing the important and not so important moments that make up my life.

I also want to become more mindful of what I put into my mouth. Mindfulness includes mindful eating, and does not include mindlessly stuffing my face with food whenever I feel hungry. I want to be aware of what I eat, and how I will eat it. Focusing on that will help me feel and look better.

I want to chew every bite more slowly and not rush through my meal. I need to take time to notice the feel and texture of my food, and eat until I feel satisfied and not stuffed. That is mindful eating.

As I try to practice mindfulness, I find it's not as easy as I thought. My mind becomes cluttered with random thoughts that try to distract me from my goal.

The first cup of coffee with social media for breakfast

My days feel like I'm living in the movie Groundhog Day. My mornings always begin the same way: I wake up, grab my laptop, make coffee, check emails and all of social media, answer emails and comments, read others' posts. leave comments, share posts, read articles, begin writing my own articles and, finally, posting them.

Then I make my breakfast.

Being on the Jenny Craig plan continues to make my life easier by knowing exactly what I'm going to eat every day. Truthfully, I've been ~~on a few~~ many diets in my life, and Jenny's cuisine is by far the tastiest and most satisfying.

For me the real test for eating mindfully begins when it's time to supplement my Jenny Craig meals. I choose fresh fruits and vegetables, drink plenty of water and, of course, there's my coffee. I add soy creamer from Trader Joe's to it. It's low in fat, sugar and calories.

I said it before and I'll say it again - thank goodness for Trader Joe's!

I admit, I also have a soy latte from Starbucks at least once a week.

But this week that wasn't a problem because I added in more exercise, and burning up calories helps when it's time to step onto the scale. I practiced being mindful while I exercised, focusing on using different muscle groups as I moved around.

During my Jenny Craig consultation we discussed the difficulties of finding an exercise program I am able to do. After our discussion we agreed on a walking plan to suit my specific needs

I took several walks with my husband, trying to keep up to his fast pace. I'm sure, privately, he's thinks it's his slow pace. But since he's always in my corner, he's never said a word.

Everyone at Jenny Craig is so helpful and supportive

My week of mindful eating ended on a high note as I stepped onto the dreaded scale.

(Drumroll, please.)

I lost another pound and a half! I was thrilled. And ready to tackle another week of mindful eating and mindful living.

Do you practice mindful living?

*I received a free month on the Jenny Craig program and a discount on their food for this review. There was no monetary compensation. All opinions are solely my own. NOTE: Clients following the Jenny Craig program lose, on average, 1 -2 lbs. per week.

During Midlife Exercising Is Even More Crucial For A Healthy Weight Loss

There are many reasons why I enjoy being a woman in my fifties. The freedom to be myself and the ability to chase the rainbow of my passions are the first two reasons that come to mind.

But trying to lose weight? That is not one of them. Why? Because nowadays it’s harder to take the weight off than it used to be.

When I was in my twenties or thirties and needed to lose a few pounds, I’d watch what I ate and burn up calories at the gym. The weight came flying off.

Now? It’s a ~~hard~~ s---l---o---w process.

I have to admit a big part of the reason the weight is coming off slower than I'd like it to is my own fault. I am not getting any exercise. These days it’s harder for me to get the exercise I need, and my job as a writer doesn't make it any easier.

Sitting in front of my laptop for long periods of time is not healthy.

Yes, I know. I have MS. For me that means I can’t run or walk fast or far, and my balance is shaky at best. I also have a frozen shoulder that, even after 8 months, is still very painful and limits my physical activities.

Those are all excuses. Because despite my disability I still have many abilities, and those are the ones I need to focus on and use if I want to keep losing weight and, in turn, feel healthier.

Tools from Jenny Craig to help me get active

Leslie, my Jenny consultant, and I discussed how I could become more active. Walking seems to be the best option, so we decided I need a pedometer and begin a walking program to try and reach those golden 10,000 steps a day.

In the meantime I still have Jenny Craig in my corner. Not only with my weekly consults, but also with their delicious cuisine. This week their newest meal of Pizza Bites was not only delicious, but I also loved that there were three individual pieces. It felt good to know that after I finished one piece there were two more waiting for me!

Jenny Craig has made it easy to stay in control of my diet while learning new ways to become a healthier me.

So I’m ready for another week of Jenny Craig, and although I have a few social engagements, I feel confident that my week will be a healthier one because I'm stepping up my exercise routine and putting what I’ve learned at Jenny to work.

Oh, I almost forgot to tell you. I lost another pound last week!

What healthy changes have you made for yourself lately?

*I received a free month and discounted food on the Jenny Craig program for this review. There was no compensation. All opinions are solely my own. NOTE: Clients following the Jenny Craig program lose, on average, 1 -2 lbs. per week.

Spring Has Sprung: Time To Get Back To Healthy Living

"After thirty, a body has a mind of its own." ~Bette Midler

Spring is here. Looking outside my window, I see snow on the ground, a gray sky, and the leaves of our rhododendrons tightly closed. I can say spring has not yet arrived in the Northeast.

I feel relieved. Why? The colder temperature gives me more time. Warmer weather would mean packing up sweaters and heavy coats. It also means uncovering arms and legs without the benefit of long, woolly, layered outfits. No more turtlenecks to hide any turkey twaddle, and no more long sleeves to cover any jiggle.

In other words, the forty-degree temperature allows me more time to get into shape.

With each passing year, losing weight and getting into shape gets harder and harder. I have a chronic illness that makes playing sports impossible, and menopause has reared its ugly head by redesigning my body to look like a cubist painting by Picasso.

I also curse Isaac Newton for introducing the world to the concept of gravity.

Why, oh why, couldn’t I have been born with the genes of Christie Brinkley? But, alas, even she works out like a good little soldier. Take a look at her Infomercials with Chuck Norris. Seeing those two boomers dressed in clingy workout clothes makes you want to jump off the couch to order a Total Gym.

We all need to maintain a good weight and a healthy lifestyle. Some of us must find an eating program that best suits our needs. What program will help us lose weight and feel better by the summer? My head is spinning with information about new cleanses and detox programs, all claiming to help us regain control over our bodies.

Thirty years ago, the decision was more straightforward. There were only a few popular diet programs to choose from. Weight Watchers, The Scarsdale Diet, The Stillman Diet, The Atkins Diet, or The Ayds Diet were the go-to programs.

"After trying Atkins and doing Nutrisystem a few times, now I'm just focused on maintaining a healthy lifestyle rather than dieting." ~Miranda Lambert

Today consumers have become wiser about diet and exercise. We’ve learned that eating too many carbohydrates and consuming too much fat and sodium may lead to obesity, high blood pressure, or heart disease. We need to stay away from hydrogenated and trans fat oils, and too much sugar may lead to a whole host of diseases.

I’ve cut out white flour and sugar from my diet. I don’t eat red meat and have oily fish at least three times a week. I use olive and grapeseed oils, and I use them sparingly. I eat plenty of fresh fruits and vegetables. Dairy products are limited to low-fat yogurt, soymilk, and soy creamer. Sweets are consumed only on special occasions, and I drink water, coffee, or tea.

So why are these pounds creeping up on me?

The culprit might be I’m not getting enough exercise. Dieting alone is not enough to lose weight. Exercise helps to control our weight by using excess calories that would be stored as fat, as well as boosting our metabolism and lowering insulin levels. As for menopause, the American Council on Exercise states, “The good news is that a regular physical activity program can help manage many of the uncomfortable symptoms of menopause.”

Making better food choices and exercising more often is one of the best gifts we can give ourselves in our Second Chapter. This positive step will sustain us for the rest of our lives.

"I want to get old gracefully. I want to have good posture; I want to be healthy and be an example to my children." ~Sting

I recently had lunch with a new friend I met through my fabulous blogging group. Her website, The Recipe Renovator, illustrates her love of food, taking everyday recipes and turning them into healthy ones. Take a moment to check out Stephanie Weaver’s fascinating website.

She also introduced me to the “Hungry for Change” website, which looks at the relationship between food, health, and emotional well-being. I watched one of their videos and signed up for their “free take action videos and detox recipes and live Q&A” offer. The first video included Dr. Christiane Northrup, a proponent of women’s health and wellness (I’ve read several of her books). It opened my eyes to a new way of looking at eating.

Do you need the benefit of a structured diet program? Has menopause and/or physical issues affected your ability to lose weight and get into better shape? Please share your stories. I’d love to hear what you have to say.

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DISCLAIMER: Comments from An Empowered Spirit are brought to your attention on topics that could benefit you and should be discussed with your doctor or other medical professional. I am not medically trained, and my posts are journalistic and not instead of medical advice. An Empowered Spirit and its author will not be held liable for any damages incurred from using this blog or any data or links provided.

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