Category Archives: FITNESS

Brisk walking is good for health. Use the right shoes and follow certain do’s and don’ts.

What is the behavioural approach used in ADHD? (ADHD Part -IV)

What is the behavioural approach used for treating ADHD?

The behavioural approach, for instance, is to increase the attention span of the child. In mild to moderate only behavioural management is needed.  It could be in the form of a game, depending on the age of the child. Depending upon the developmental level of the child we give them tasks to improve their attention skill:

Games and Activities

What is the behavioural approach used in ADHD?We prescribe certain games and activities where the child can sit and persist with the task. That will improve the child’s attention span.

At School

What is the behavioural approach used in ADHD?For the classroom instruction, we sometimes give a letter to the teacher suggesting where he should be seated.  The teacher should have proximity to the child. Seat given to the child should not be near the window side, door side or outskirts. The child should be given aisle seat so that he can have eye contact with the teacher. These will help him focus on activities in the classroom. The teacher should be monitoring the child so that his attention doesn’t wander. They should examine the notebooks frequently so that the books are complete. The child should be called his or her name. If he is called by his name, his attention span will persist.

Appreciation and Rewards

What is the behavioural approach used in ADHD?The parents and teachers are instructed to reward the child whenever he behaves well. Usually, his hyperactivity or impulsive behaviour is judged as indiscipline in the school. He is scolded and not much of positive comments are obtained by the child. Parents and teachers are asked to look out for even the smallest good behaviour. He must be praised and rewarded with gifts. He must be given small responsibilities in the class like carrying the books to the staff room so that he feels that he is worthy. In this way, his behaviour is likely to improve.

At home

Medication for ADHD (Attention Deficit Hyperactivity Disorder)Parents are asked to give clear instruction to the boy to keep his shoes, bags and toys in its proper place.  Thus his life will become more structured. Whenever he complies with the parents’ expectation of the kind of behaviour they expect from him he can be rewarded.

Nurturing their Abilities

What is the behavioural approach used in ADHD?When we assess the child we assess their potential. Some of them are good at sports. So encouraging them in sports is part of the behavioural therapy. Some may be good in arts or electronics, so channelizing their ability will help them.

‘Time Out’ Method

What is the behavioural approach used in ADHD?Parents are trained to deal with impulsive behaviour. Sometimes they have to set limits when the child is exceeding certain limits. In very severe situations parents may be asked to keep the child in a room so that anger comes down. It is not a punishment but a principle of ‘time out’.  This principle has to be applied only sometimes.

Medication for ADHD (Attention Deficit Hyperactivity Disorder) childDr. Varghese Punnoose specilaised in Child Psychiatry. He is an MBBS and MD in Psychiatry from Government Medical College. He is currently  Professor and Head of Department at Government Medical College, Kottayam, Kerala.

He authored a book ‘Manorogangal’, in malayalam, about Pshycatric disorders. There is one chapter on ADHD also. 

Is Medication for ADHD (Attention Deficit Hyperactivity Disorder) child necessary? (ADHD Part -I)

What is ADHD (Attention Deficit Hyperactivity Disorder)? (ADHD Part -II)

How ADHD is diagnosed?(ADHD Part -III)

What is ADHD (Attention Deficit Hyperactivity Disorder)? (ADHD Part -II)

What is ADHD (Attention Deficit Hyperactivity Disorder)?

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder. Some say that there is no such disorder, which is incorrect. It is a worldwide accepted condition. It is a brain development disorder occurring in about 5 to 7 percent children.

It is a brain development disorder occurring in about 5 % to 7% children.

In certain brain development disorders, the physical features are visible. In Cerebral Palsy and Down Syndrome, for instance, the physical features are evident and hence these are accepted as real disorders. But, when you look at a child with ADHD they may not have any visible physical anomaly. And therefore it is not recognized as a medical condition. The behavioural manifestation of ADHD could be passed on as a naughty behaviour of a normal childhood, or even smartness. In these children there are no physical abnormalities, they have behavioural problems.

What are the mental functions that are affected in ADHD?

Attention deficit

What is ADHD (Attention Deficit Hyperactivity Disorder)?

 

The ability to focus attention is the function of the brain. As far as a school child is concerned he should have approximately 30-40 minutes of attention span.  There should be a coordination of eyes, hands and mind. Brain should be able to focus these functions.  That varies from person to person, but with children with ADHD, attention holding function is very grossly impaired.

What happens is that the child will not be able to persist with the task. In the classroom, he will not be able to pay attention for a long time, and this will affect his academic performance.

Hyperactivity

What is ADHD (Attention Deficit Hyperactivity Disorder)?

Generally, a five or six-year child is able to sit quietly and keep calm when they are engaged with some serious activities. But children with ADHD will not be able to control their action. They will be very fidgety, restless, squirming on the seat and moving around.   In addition to the distractibility, if the student is restless he can disrupt the whole class. The energy might be considered as the smartness of the child; however, it is an illness. It is “Disruptive” overactivity. Normally school going children are active and exuberant. That is not hyperactivity. Disruptive overactivity is called hyperactivity.

In addition to the distractibility, if the student is restless he can disrupt the whole class. The energy might be considered as the smartness of the child; however, it is an illness. It is “Disruptive” overactivity. Normally school going children are active and exuberant. That is not hyperactivity. Disruptive overactivity is called hyperactivity.

Impulsivity

What is ADHD (Attention Deficit Hyperactivity Disorder)?Impulsivity means they are unable to hold their responses. Whenever they are angry they may use bad words. They may be talkative in class and they may find it difficult to wait for their turn in group activities. They may blurt out answers even before questions are finished.  They are unable to hold their emotions. Impulsivity can land them in trouble.

When attention deficit, hyperactivity and impulsivity combine that produces this syndrome called ADHD.

What can be the reason for ADHD?

The exact reason cannot be pointed out. The genetic factor could be a reason for ADHD. Many parents say that the father also was hyperactive in his childhood, but in those days, no one realized that it was ADHD. Nobody is sure why it happens in some children.

Nobody is sure why it happens in some children. Basically, there could be some genetic influences.

Basically, there could be some genetic influences. It could be some infection or toxins that the mother carried when she was pregnant. Many a time we are unable to pinpoint that this is the cause, but these are the possibility. Scientific research has shown that the circuits in the brain that control the motor activity – brain circuits which control the impulsive reactions – these circuits are dysfunctional.

Medication for ADHD (Attention Deficit Hyperactivity Disorder) childDr. Varghese Punnoose specilaised in Child Psychiatry. He is an MBBS and MD in Psychiatry from Government Medical College. He is currently  Professor and Head of Department at Government Medical College, Kottayam, Kerala.

He authored a book ‘Manorogangal’, in malayalam, about Pshycatric disorders. There is one chapter on ADHD also. 

READ MORE…

Is Medication for ADHD (Attention Deficit Hyperactivity Disorder) child necessary? (ADHD Part -I)

How ADHD is diagnosed?(ADHD Part -III)

What is the behavioural approach used in ADHD? (ADHD Part -IV)

3 New year resolutions for people with arthritis

Every year we take new year resolution to give up a bad habit or to begin a good  one. This years theme for World Arthritis Day on October 12th was “It is in your hand, take action” to live life to the fullest. Most of the people with arthritis, whom I know, put in lots of efforts so that they can keep in pace with the demands of the world and live life like normal human being. The excruciating pain, fatigue and disability are some of the hindrance for a arthritis patient. Some succumb to the condition, while other turn all the obstacles into opportunity. If those suffering from arthritis take some new year resolutions to improve their lifestyle then they too can live their life to the fullest.

Arthritis is becoming quite common in Delhi, especially after the yearly outbreaks of Chikungunya virus.  People experience joint pain and difficulty to walk even a few months after they had Chikkungunya. Now a days, if you stagger, people inquire if you were suffering from Chikkungunya.

There is lot of commonality between Chikkungunya and Arthritis pain, and in some cases Arthritis pain and deformation are triggered after a Chikungunya attack.  People of any age can get arthritis, but if you take some precautions you can avoid worsening of the  condition. If you chart out a healthy lifestyle pattern for yourself, some of the damages get repaired and you can enjoy a normal lifestyle.

Most of the arthritis patients I meet have come up with their own creative methods to mitigate the pain. Some rely on allopathic medicines, others on Ayurveda and some on herbal remedies. They now know which food causes pain and which one relieves pain.

On this New Year, those suffering from arthritis should take the New year resolutions to live life to the fullest. Here are a few, new year resolutions, ideas based on the experience of those arthritis patients who have overcome all odds by following a healthy lifestyle:

Eat the right Food

Preferably follow a vegetarian diet, which is easier to digest. Some fishes are good, but egg and meat are better not to be consumed regularly. Have lots of water especially on an empty stomach.

And sometimes it is good to fast. Most religions have fasting period in the religious calendar. If you follow the fasting with discipline that will help relieve the pain. If you have never fasted in your life, then consult a doctor before fasting. Arthritis is an auto-immune disease where the body cells are attacking one another. Experts say that  during fasting period the body cells get time to relax and repair.

Walking and Exercise

Of all the medicines, walking is the best prescription for arthritis. Some say that they walk instead of driving or riding a scooter. But that is not enough. Every day you must walk atleast 20 minutes, as part of fitness regime. Consult your doctor to find out how much time is recommended for your walking and exercise. Also find out if you are permitted to Jog. Walking is the best medicine for arthritis. If you walk atleast 5 days a week, you can maintain a healthy lifestyle. When you feel pain, doing exercise will mitigate the pain.

Meditation and Spirituality

Mental and spiritual well being is a crucial aspect of arthritis. The condition aggravates when one is mentally disturbed. Hence you should spend atleast an hour every day for Meditation. You must find the inner peace and the soul connect. Many patients with RA positive,and some even chronically bed ridden, claim to have been miraculously cured because of their belief in God. Some doctors recommend meditation  for an hour daily. Being at peace with oneself and avoiding stress helps in coping with arthritis.

 

 

At 83, she is preparing for her next veterans athletics meet

When professional sportsmen hang their boot at 40, Daisy Victor began participating in athletic events when she was just few days shy of her 50th birthday.  “I am only 83 years old” says Daisy who runs and exercises everyday in the ground near her house in Madhavaram, Chennai, and she also hits the gym twice a week.  She also practices long jump at the Nehru stadium every week.  In National and International Veterans athletics Meets so far she has won 377 medals from 104 meets. She won 46 golds from 22 internationals meets and 96 golds from 33 national events.

Daisy, a former employee of BSNL in Chennai, and a mother of 6 children took up athletics seriously in 1981 when she participated in the World Veterans Athletics Meet in ChristChurch, Newzeland. Her biggest moment was when on her return from the event, she was introduced to Prime Minister Indira Gandhi by the Flying Sikh Milkha Singh.

veterans athletics

Daisy’s indomitable spirit has inspired the youngsters, including her 13 grandchildren who are proud of their grandmother’s achievements.  During summer vacations, boys and girls come to her to get coached for athletics. Schools and Colleges invite her  to inspire the youth to make sports and exercise a part of their lifestyle.

Secret of her Success

“All my achievements is because of the Grace of God. He gave me the strength and talent to run.” says Daisy who wakes up at 5 in the morning and begins the day with prayer along with her husband Victor Sundararaj.

veterans athletics

“Though women are physically active through out the day with household activities, they need to do exercise everyday for their necks, hands, legs, etc” says Daisy who began running and winning as a school girl in Bellary. It was her father, who was a sportsman, encouraged her to participate in athletic events.

When asked what the elderly must do to be physically fit she said “They must do physical exercise and walk atleast 15 minutes everyday. The should not be walking leisurely but brisk walk”. Read this post to know more about the advantages of brisk walking.

She says people should follow a strict diet and a strict routine to remain healthy and fit. She takes very little rice, consumes a lot of vegetables and avoids snacks and tea as much a possible.

Her running and exercise has kept her away from certain hereditary lifestyle diseases. Says her son Stephen, “When she was 75, she argued with a doctor who said she was diabetic. She said since she is physically fit she should not be diabetic. But the doctor told her in her family diabetic begins at 35 years of age, so she should consider herself lucky as she could keep the disease away for 40 years.”

When most people struggle to walk a few miles at this age, Daisy travels everyday by bus and she talks to people, inspiring them with her own testimony of determination and complete faith in God.

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Walking Habit of Four Generation

Until a decade back,when transportation was costly and very few owned a vehicle, we used to walk a lot in India. As the years go bye the daily walking hours keep decreasing. My family was enthusiastic of walking. I thought why not make a comparative study of the walking habit of four generation – grandfather, father, myself and now kids spend walking. Read this post to find more about how walking boost memory.

Grandfather: An accountant by profession, before the independence of India, he used to walk hundreds of miles to meet his clients. He walked day and night, barefoot, and come back home sometimes in the wee hours of morning.
Diet: Rice was his staple food – breakfast of rice flour dishes; rice and curry for lunch and dinner. Every morning, at 4 AM, before starting his work, he had egg-milk (piping hot milk poured into a steel tumbler containing raw whipped egg). As a small child one day I insisted on having the same concoction and the same quantity as grandpa was drinking. Guess what happened – I couldn’t drink even one sip and that disgusting smell  of the raw egg persists in my memory!. Grandma says that this ‘Magic Egg’ concoction was the secret of his good health.
Health status: Grandpa was a thorough professional of those days with a high social status. He was active in many social circles until one day when he died of heart attack at the age of 75.
Father:  A post-independent product, the maximum my father walked was from his home to school, an aggregate of 10 kms per day. By the time he grew up there were buses and cycles. When he started working he brought a cycle and now he has a car.
Diet:  A strict non-vegetarian, he has only home made food. Ask him to control his weight or to change his food habit according to age – my kids don’t have to be coaxed so much to eat vegetables.
Health status: Now a days he is a cardiac patient and so he is supposedly on a cholesterol-control diet.
Myself: On a average I used to walk for 6 kms/days during my college days – home to bus stand / bus stop to college. Sometimes we friends used to walk for 3 kms, from the college to a Bus Junction. Now I have my private vehicle; the public transportation  also reaches upto my door steps. If I think of walking from the metro station to home, there are many hurdles – pollution, heavy traffic,….

Diet: Though I insist on having home made food; everyday I have a grab of the Junk food due to uncontrollable factors – office party, going out with family, overtime in office. Blame it on the lifestyle! The lifestyle promotes the Junk food culture!
Health status:Would have been an easy target for Obesity, diabetes, arthritis, spondylitis,….. had it not been for my regular walks, restricted diet and exercise.

Kids: They run, jump, jog, swing, leap, and yes walk also! Not the kind of walk that will enhance good health. They walk in schools, in malls, on the market lanes; they never walk fast consistently for 10 minutes. The residence are so small and packed with furniture that children don’t get a chance to walk inside home. Some also have skateboards to move around in the house.
Diet: Its hard to draw a clear distinction on the kind of diet to follow for kids – nutritional diet/freshly cooked food diet/Junk food. Mothers have to decide very early in life about the kids diet.  No matter how strict a mother is about home-made food and nutritional diet, a child on a average has atleast 100g of processed chips daily. In addition jam, sauce, biscuits, cakes,…….are all processed food.
Health status: Obesity is common, some kids are on weight reduction diet.We walk when the circumstances demand! There is no compelling factor, today, to wake up early in the morning for walk; until one becomes a victim of lifestyle diseases.Walking half an hour a day can keep lifestyle diseases away!

Walking shoes are essential

When we are yet to get used to the habit of walking for health, experts say that we should wear shoes for walking. Shoes is an alien concept, in India were we don’t have the tradition of covering the feet completely. Our forefathers used to walk barefoot hundreds of mile for a livelihood ; I used to walk to college in stilettos. So one fine day when someone says that walking shoes are essential for walking, sound irrational! Read this post to know about the fitness regime of the elderly.
I always ignored the advice to wear shoes for walking. Once I brought a canvas shoes, within a few days gave it in charity. There is nothing more comfortable than the lightweight, rubber slippers in which the foot can move freely.
I stuck to my theory for over a decade, until I saw many elderly women wear sports shoes for walk. Whether in sarees or salwar/kameez most of the walkers now walk in sport shoes. Though not fully convinced that there will be any visible change, I decided to go with the trend – I brought an athletic shoe for walking.
The Result!
My viewpoint has changed completely! My life has change for ever! There are atleast five benefits of walking in shoes.  Some of the advantages of walking in shoes are as follows:
  • Increase in Speed

I used to cover 10 laps in an hour; wearing shoes I can cover 15 lapse. Which means 50% increase in performance.

  • Less pressure on feet

While walking in a slipper the toes have the additional job of holding the straps in place. This decreases the speed of walking.

  • Shoes are walking aides

Walking shoes are generally designed to be flexible to the ball of the foot;  when you walk the weight of the body rolls from the heel, to the ball of foot and finally to the toes. A good walking shoe will help reduce the pressure borne by the foot.

  • Improves body posture

A good shoe helps create natural body posture. Buy shoes that are flexible in the toe so that you can bend and twist the toe part while walking.

  • Protects the feet

In the slippers the feet is covered with dust and they are prone to get injured. A shoe protects the feet from external damage.

Tips for buying a good pair of athletic shoe
Before buying the athletic shoe I surveyed the market by reading articles online, talking to friends and visiting athletic shoe showrooms. Some of the findings are as follows:
  • Running shoe is better than walking shoe for walking
  • The shoe should be lightweight and flexible.
  • There should be enough cushioning under the ball of the foot.
  • Ensure that the toes can move freely inside the shoe
  • Buy a shoe of good quality; use your instinct rather than the salesman’s opinion. Take a trial, of both the shoe, before buying.

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To lose weight, make friends with lean people

A scientific study says that if you want to lose weight make friendship with lean people. The attitude of my friends towards walking proves the finding to be true. Read this post to know about the walking habits of four generations of a family.

I have a couple of lean, perfectly in-shape, friends who have a predominantly fatty food diet. The difference between the lean, heavy-eaters and the obese is that the former does all the physical work without applying any brain, while the latter tries to find short cut for all activities. Since the zebra crossing is faraway, I would risk the busy traffic to cross the road. But my lean friends follows the rule and goes all the way to the zebra crossing to cross the road. When I take the escalator to go to the metro train platform, my lean friend prefers to take the stairways. Such lean people burn so much of calories during their daily routine, that they do not need any form of physical exercise

During friendly chats, when I tell my friends about the refreshing morning walks, they complain that I was too mean to not call them for company. So one of them decided to come for the walk at 7:00 in the morning. However I was awaken by a mobile message at 3:00 AM; which read ‘I won’t come for walk, as I slept very late yesterday‘.

Another friend decided that her children also require some exercise, so she accompanied me on morning walks with two teenage son and a little daughter. While we walked, the kids played badminton in the park. As the children were playing, our concentration was on the security of the kids; so we walked less and watched the kids more. In order to cajole the children to come everyday for walks, we used to have a small party of cookies and hot coffee after the walk and game section.
Walking with friends strengthens friendship but fails to achieve the ultimate aim of achieving physical fitness. So on weekday I walk alone and on on the longer weekend walks friends are also invited.
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Brisk walking is good for health

The first golden rule to maintain a healthy lifestyle – Brisk walk everyday. I have read many articles about the benefits of brisk walking, but I still don’t know how fast I should walk. Since articles were of no use I decided to follow the footsteps of the fittest person in the park. I discovered that, if the articles were confusing, the ingenious walking techniques of the walkers were even more confusing. Read this post to know about the walking habits of four generations of a family.

I located the leanest walker, since I wanted to be that thin, and observed how she walks. There was nothing artistic about her style. She kept on walking, non stop, around the park for hours, with an earphone fixed in her ears. There were youngsters who ran at full speed –  I decided not to follow them. Then came a healthy girl in the opposite direction, she was taking long, hefty strides and swinging her hands to and fro, violently, as if she was going to beat someone. There were some who did combo-exercises. They stretched hand and legs; and swung them round and round while walking. Others just jogged.

While most walked alone, some were in groups. They walk to rejuvenate, so that they can start their day on a fresh note. While they walk, they occupy the whole space, disturbing the pace of the serious walkers. There was also a group of elderly aunts, who wore sports shoe with their traditional dress, walking religiously in the morning and evening. These beautiful women in their seventies are so fit and healthy that any youngster would want to make them their fitness icon. (I know them personally, the secret of their fitness, and beauty, is also because of their harmonious family life.)

After observing the walkers in the parks, and discussing with regular walkers, I concluded that how you walk or how fast you walk is not important. What is more important is to walk regularly without fail.

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The fitness freak elderly

 

Going to park in the morning is the most refreshing way to start a day. Parks are so common that every place in Delhi is within walking distance of one or two parks. There are parks in my colony, however I like to go the District Park which is situated in acres of land and the whole place is buzzing, in the morning, with fitness activities. Read this to know about an 83 year old international woman athlete.

Most of the early morning park goers are the elderly who can give tough competition to youngster with their innovative fitness techniques. In the ‘laughing clubs’ who stand in a circle and laugh their lungs out on some artificially created jokes. Some of them sit on the bench and sing spiritual songs or poems. Sometimes they decide the future of the government by just sitting on the bench – without jumping on their feet or running to the well of the house. Their spirits defy their age and they come up with new projects for the development of the colony.
As they have lot of time and they are keen to stay fit, they opt for traditional fitness lifestyle. So they use dantoon (neem twig) to brush teeth and have green herbal juice consisting of bitter herbs like alovera, gooseberry, bitter gourd, china grass,……etc.(tips: any herb or vegetable that in green and bitter can be included). The fitness-freak-elderly enthusiasm led to three make-shift herbal juice shops being erected inside the park, that make sweet money in return of serving the fitness-freaks bitter juice.
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