|  | Feature: Healthy Living Move for Health | No.49 January 2007 |
|  |  | print / save view |

Overcoming Barriers to Physical Activity C.A. Ajibola & S.C. Akpan |
Abstract The most important parameter involved in healthy living is a physically active life. Unfortunately, over the years, technological advancements have made our lives increasingly sedentary. As such, the benefits accrued to physical activity and fitness are being denied. Being interwoven and interrelated with other dimensions of health, it indicates that the inability to be physically active in the real sense, can lead to physical health problems. Besides this, missing the opportunities which expose a person to being active can produce such problems as social, emotional, psychological, intellectual, spiritual or environmental problems. A person’s inability to be occupationally active (in school or working life) can produce physical illness, and hence, other illnesses. Healthy living includes being physically active and alert to protect ourselves from environmental hazards and the ability to minimize the negative impact of our behaviour on the environment. This paper tackles the barriers to physical activity. Suggestions are made on how to overcome the obstacles to a physically active lifestyle. Introduction The term wellness connotes the attainment of healthy living. In the broad sense, healthy living encompasses the ability to carry out assessment of personal health, the provision of information, behaviour change and individual or group counseling that ultimately leads to the adoption of a healthy lifestyle. As a continuum, a healthy lifestyle is characterised by low-risk, healthy behaviours, which over time, culminate to a sense of well-being. Thus, healthy living suggests a person’s ability to adopt a healthy lifestyle, which unlocks his or her full potential to interact well within a variety of life arenas. The fact remains that many wellness activities are engaged in risk reduction that results in health promotion; health maintenance; and prevention of illness/diseases (Oja & Borms, 2004). Wellness professionals believe that the key to unlocking the full potential of health, and experiencing healthy living, lies in health promotion. This is focused primarily on risk reduction, through quality health education, but not in treating chronic illnesses/diseases (Edwards & Bouchier, 1991; Egwu, 1996; Hardman & Stensel, 2003; Oja & Borms, 2004). Healthy living embraces wellness in all dimensions of health. According to the Geneva based World Health Organization (WHO), ‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Egwu, 1996). Health, being multifaceted, extends beyond these three dimensions. It encompasses the physical, mental, social, intellectual, spiritual and environmental dimensions. These sum up to bring a total person. Thus, being healthy involves physical health, emotional health, social health, intellectual health, spiritual health, occupational health and environmental health. These dimensions of health are interwoven, where one aspect of wellness amounts to wellness of the other six dimensions. Based on these multi-dimensions and interrelationships, healthy living can better be described as the ability to utilise well the intrinsic and extrinsic resources within each dimension of life to participate fully in life activities which contribute to growth and development in each stage of the lifestyle of a person; from birth, infancy, to aging. Staying Physically Fit Physical fitness gives the ability to carry out our daily tasks with vigour and alertness, without undue fatigue and with ample energy to enjoy leisure time pursuits and to meet unforeseen circumstances. You need not become a full-time athlete to enjoy the health benefits of fitness. Incorporating regular, moderate physical activity into your lifestyle can benefit your health and your overall quality of life in other dimensions. The Benefits of Physical Activity on Health The greater the demand made on the body, the more fit it becomes. Over time, immediate, short-term adjustments translate into long-term changes and improvements. The rationale behind this is that when breathing and heart rate increase during exercise, the heart gradually develops the ability to pump more blood with each beat. Then, during the next bout of physical activity, it does not have to beat as fast to meet the body’s demand for oxygen. This oxygen is needed for normal functioning of body cells. Immediate Effects of exercise Increased level of neurotransmitters leading to increased alertness; constant or slight increase of blood flow to the brain. Increased heart rate and stroke volume ie. the amount of blood pumped per beat. Increased pulmonary ventilation ie. amount of air breathed into the body per minute. Increased energy production in muscles. Increased blood flow to the skin and increase sweating to help maintain a healthy temperature. Increased systolic pressure, increased blood flow and oxygen transport to working skeletal muscles and the heart; hence increased oxygen consumption. Long-term Effects of exercise Improved self-image, cognitive functioning, endurance and ability to manage stress. Decreased depression, anxiety, reduced risk of stroke. Increased heart size, resting volume, lower resting heart rate. Risk of heart disease significantly decreased. Improved ability to extract oxygen from the air during activity. Reduced risk of cold and upper respiratory infections. Increased sweat rate; earlier outset of sweating helps to cool down the body. Increased energy expenditures helps to decrease body fat. Reduced risk of cancer, through proper circulation and facilitation of metabolism. Muscle cell changes, which allow for greater energy production and power output. Thus, insulin sensitivity remains constant or improves helping to prevent type 2 diabates. Muscle mass also increases. Increased bone density and bearing strength of bones, ligaments and tendons. Reduced risk of low back pains, injuries and osteoporosis. Improved range of motion at joints. Increased blood volume and capillary density, increased levels of high density lipoprotein (HDL) and lower levels of tricyclicerides, lower resting blood pressure and reduced platelets stickness. (Edwards and Bouchier, 1991; Rockhill, Willet, Hunter, Manson, Hankinson and Colditz, 1991; Hardman & Stensel, 2003; Vouri, 2004; Otinwa, 2005). Lifestyle Physical Activity for Healthy Living. To develop fitness, a person must perform efficient amounts of physical activity to stress the body. Over time, this produces long-term physiological changes. A moderate amount of physical activity on most, preferably all, days of the week rules out a sedentary lifestyle. A goal focused on expending 150 calories per day or about 1,000 calories per week in physical activity is okay, because energy expenditure is a function of both intensity and duration of physical activity. The same amount of energy expended in shorter sessions of strenuous activity can be obtained in longer sessions of moderate intensity physical activity (Insel & Roth, 2002). Thus, 15 minutes of running is equivalent to 30 minutes of brisk walking, ie. both activities use about 150 calories of energy. Other moderate activities include playing ball for 45 minutes, gardening for 30-45 minutes, wheeling one self in a wheel chair for 30-45 minutes, bicycling 5 miles in 30 mins, jumping rope for 15 minutes and stair walking for 15 minutes. In addition to moderate-intensity physical activity, resistance exercise ie. exercise against an opposing force such as weight, is also recommended at least twice a week to build and maintain strength. With these increases in lifestyle activity, people can expect to improve their health significantly. Assessment of your Activity Index You can assess your activity index by multiplying the frequency and intensity of your physical activity by the duration. Frequency x Duration x Intensity = Activity Index. 1. Frequency: How often do you exercise?
Exercise | Your frequency score
Less than 1 time a week | 0
1 time a week | 1
2 times a week | 2
3 times a week | 3
4 times a week | 4
5 times a week | 5
2. Duration: How long do you exercise?
Duration | Your Duration Score
Less than 5 minutes | 0
5 – 14 minutes | 1
15 – 29 minutes | 2
30 – 44 minutes | 3
45 – 59 minutes | 4
60 minutes or more | 5
3. Intensity: How hard do you exercise?
Intensity | Your Intensity score
No change in pulse resting level | 0
Little change in pulse from resting level | 1
Slight increase in pulse and breathing | 2
Moderate increase in pulse and breathing | 3
Intermittent heavy breathing and sweating | 4
Sustained heavy breathing and sweating | 5
Multiply to determine your total score. To assess your activity index, refer to the table below.
Activity Index | Estimated Level of Physical Activity
Less than 15 | Sedentary life
15 – 24 | Low active life
25 – 40 | Moderate active life
41 – 60 | Active life
Over 60 | High active lifestyle
Source: Kusinitz, I. & Fine, M. (1995). If your activity level is in one of the lower categories, review the components of your score (be it frequency, duration or intensity, or all) and see how you can raise your score. Then you can add more physical activity to your current exercise program or devise a new one. Exercise Program Design to Develop Physical Fitness How much physical activity is enough? Most experts agree that some physical activity is better than none. They believe that more activity, as long as it does not result in injury, is better than less. The physical activity pyramid below is a guide to meeting goals. If your activity index score reveals a sedentary lifestyle, as at the peak of the pyramid, do those things infrequently and gradually increase your activity to moderate-intensity. If your score shows you to already be moderately active, begin a formal exercise program that includes cadio-respiratory endurance, flexibility training and strengthen training to help you develop all of the health related component of fitness. Overcoming Barriers to Physical Activity There are numerous reasons given by people to explain why they do not participate in much physical activity. The reasons falls into seven categories: Lack of time, social influence, lack of energy, lack of power, fear of injury, lack of skill and lack of resources. Table II. Personal Assessment of Your Barriers to Physical Activity. Please read each statement and indicate how likely you are to admit each of the statements.
| Items | Very likely | Somewhat likely | Somewhat unlikely | Very unlikely
1 | My day is so busy now. I just don't think I can make the time to include physical activity in my regular schedule. | 3 | 2 | 1 | 0
2 | None of my family members or friends like to do anything active, so I don't have a chance to exercise . | 3 | 2 | 1 | 0
3 | I'm just too tired after work to get any exercise. | 3 | 2 | 1 | 0
4 | I've been thinking about getting more exercise, but I just can't seem to get started. | 3 | 2 | 1 | 0
5 | I' m getting older so exercise can be risky. | 3 | 2 | 1 | 0
6 | I don't get enough exercise because I have never learned the skills for any sport. | 3 | 2 | 1 | 0
7 | I don't have access to jogging trails, swimming pools, bike paths, etc. | 3 | 2 | 1 | 0
8 | Physical activity takes too much time away from other commitments-like work, family, etc. | 3 | 2 | 1 | 0
9 | I'm embarrassed about how I will look when I exercise with others. | 3 | 2 | 1 | 0
10 | I don't get enough sleep as it is. I just couldn't get up early or stay up late to get some exercise | 3 | 2 | 1 | 0
11 | It's easier for me to find excuses not to exercise than to go out and do something | 3 | 2 | 1 | 0
12 | I know of too many people who have hurt themselves by overdoing it with exercise | 3 | 2 | 1 | 0
13 | I really can't see learning a new sport at my age | 3 | 2 | 1 | 0
14 | It's just too expensive. You have to take a class or join a club or buy the right equipment. | 3 | 2 | 1 | 0
15 | My free times during the day are too short to include exercise. | 3 | 2 | 1 | 0
16 | My usual social activities with family or friends do not include physical activity | 3 | 2 | 1 | 0
17 | I'm too tired during the week and I need the weekend to catch up on my rest. | 3 | 2 | 1 | 0
18 | I want to get more exercise, but I just can't seem to make myself stick to anything. | 3 | 2 | 1 | 0
19 | I'm afraid I might injure myself or have a heart attack. | 3 | 2 | 1 | 0
20 | I'm not good enough at any physical activity to make if fun. | 3 | 2 | 1 | 0
21 | If we had exercise facilities and showers at work, then I would be more likely to exercise. | 3 | 2 | 1 | 0
Source: Insel and Roth (2002) Scoring
Items | Variable
1,8,5 | Lack of time
2,9,16 | Social influence
3,10,17 | Lack of energy
4,11,18 | Lack of willpower
5,12,19 | Fear of injury
6,13,20 | Lack of skill
7,14,21 | Lack of resources
The sum of scores of the three items in each variable reveals the level to which you will be active. A score of 5 or above in any category reveals that it is an important barrier. Try the suggestions given here. Suggestion for Overcoming Barriers to Physical Activity. Lack of time Identify available time slots. Monitor your daily activities for 1 week. Identify at least three 30 minutes time slots you could use for physical activity. Add physical activity to your daily routine. For example, walk or ride your bike to work or shopping, organise social activities around physical activity, walk the dog, exercise while you watch TV, park farther from your destination, and so on. Make time for physical activities. For example, walk, jog or swim during your lunch hour, or take fitness breaks instead of coffee breaks. - Select activities requiring minimal time, such as walking, jogging, stair climbing. Social influence Explain your interest in physical activity to friends and family. Ask them to support your efforts. Invite friends and family members to exercise with you. Plan social activities involving exercise. Develop new friendship with physically active people. Join an exercise group. Lack of energy Schedule physical activity for times in the day or week when you feel energetic. Convince yourself that if you get a chance, exercise will increase your energy level; then, try it. Lack of willpower Plan ahead. Make physical activity a regular part of your daily or weekly schedule and write it on your calendar. Invite a friend to exercise with you on a regular basis and write it in both of your calendars. Join an exercise group or class. Fear of injury Learn how to warm up and cool down to prevent injury. Learn how to exercise appropriately considering your age, fitness level, skill level and health status. Choose activities involving minimal risk. Lack of skill Select activities requiring no new skills, such as walking, climbing stairs or jogging Exercise with friends who are at the same skill level as you are. Find a friend who is willing to teach you some new skills. Take a class to develop new skills. Lack of Resources Select activities that require minimal facilities or equipment, such as walking, jogging, jumping rope or calisthenics. Identify inexpensive, convenient resources available in your community (community education program, park and recreation programs, worksite programs etc.) Other additional barriers can also be overcome. Weather conditions Develop a set of regular activities that are always available regardless of weather (indoor cycling, aerobic dance, indoor swimming, calisthenics, stair climbing, rope skipping, mall walking, dancing, gymnasium, games etc.) Look at outdoor activities that depend on weather condition (cross-country skiing, outdoor swimming, outdoor tennis, etc), as “bonuses" ie. extra activities possible when weather and circumstances permit. Travel Put a jump rope in your suit case. Walk the halls and climb the stairs in hotels. Stay in places with swimming pools or exercise facilities. Visit the local shopping mall and walk for half an hour or more. Bring a small tape recorder and your favorite aerobic exercise tape. Family Obligations Trade babysitting time with a friend, neighbor or family member who also has small children. Exercise with the kids. Go for a walk together. Play tag or other running games, get an aerobic dance or exercise tape for kids and exercise together. You can spend time together and still get your exercise. Hire a babysitter and look at the cost as a worthwhile investment in your physical and mental health. Jump rope, do calisthenics, ride a stationary bicycle or use other home gymnasium equipment while the kids watch TV or when they are sleeping. Try to exercise when the kids are not around (ie during school hours or their nap time). Retirement years Look on your retirement as an opportunity to become more active instead of less. Spend more time gardening, walking the dog and playing with your grandchildren. Children with short legs and grandparents with slower gaits are often great walking partners. Learn a new skill you've always been interested in, such as ballroom dancing, square dancing or swimming. Now that you have the time, make regular physical activity a part of every day. Go for a walk every morning or every evening before dinner. Treat yourself to an exercycle and ride every day. Conclusion The benefits of physical activity are both immediate and far-reaching. Being physically fit makes it easier to do everyday tasks. Over the long term, physically fit persons are less likely to develop chronic illness. Over the years, they develop cardio-respiratory endurance. You can become involved in your own wellness. A sedentary lifestyle is a barrier to healthy living. To assume healthy living, use the personal assessment tool and evaluate your activity index. It will help you to evaluate your lifestyle. You can overcome the barriers through behaviour change. References Edwards, C.R.N. & Bouchier, I.A.D. (1991). Davidson’s Pinciples and practice of medicine. Hong Kong: ELBS with Churchhill Livingstone. Egwu, I. N.(1996). Primary Health Care in Nigeria. Theory, Practice and Perspective. Lagos: Elmore Printing and Publishing Company. Hardman, A.,E. &Stensel, D.J. (2005). Physical Activity and Health: The Evidence explained. London: Routledge. Insel, P.M. & Roth, W. T.(2002). Core concepts in health: (Brief 9th ed.). United States of America: McGraw-Hill Companies. Insel, P.M. & Roth, W.T.(2002). Wellness Worksheets to accompany core concepts in health (Brief 9th ed) USA: McGraw -Hill Companies. Kusinitz, I. & M. Fine (1995). Your guide to getting fit (3rd ad). Maintain View, Calif: Mayfield. Ntui, E.P. (2005). Scientific basis for sports training. Calabar: University of Calabar Press. Oja, P. & Borms, J. (2004). Health Enhancing Physical Activity: An introduction. Perspectives, The Multidisciplinary series of Physical Education and Sport Science Vol 6, 21-27. Oxford: Mayers and Meyers Sport (UK) Ltd. Otinwa, Grace (2005). Walking for fitness (2nd ed). Lagos Activity Communications. Oworu, O.O. (2002). Socio-cultural determinants of female low participation in sports in Ogun State: In V. C. Igbanugo (Ed). The Official Magazine of the International Council for Health, Physical Education, Recreation, Sports and Dance/ (P44-46). Lagos: Stirling Hoden Publishers Nigeria. Payne, W.A. & Hahn, D.B. (1998). Understanding your health (5th ed). Boston Burr Ridge: MCD/ McGraw- Hill. Vuori, I. (2004). Physical inactivity as a disease risk and health benefit of increased physical activity. In Pekka Oja and Jan Borns (Eds) Perspetives, The Multidisciplinary Series of Physical Education and Sport Science. 6 (24-95) Oxford: Mayer at Meyer Sport (UK) Ltd. Rockhill, B., Willet, W.C., Hunter, D.J., Manson, J.E., Hankinson, S.E. & Colditz, G.A. (1999). A prospective study of recreational physical activity and breast cancer risk. Archives of Internai Medicine: 159: 2290-2296. Contact Dr. Clement Abiodun AJIBOLA Ph.D & AKPAN, S. C. (Mrs.) Physical And Health Education Unit Department Of Vocational And Special Education Faculty Of Education, University Of Calabar Calabar, Nigeria perrycaa@yahoo.com http://www.icsspe.org/portal/index.php?w=1&z=5 Overcoming Barriers to Physical Activity C.A. Ajibola & S.C. Akpan