A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Discover effective exercises for vestibular rehabilitation with Meri Sehat. Improve balance and reduce dizziness for a healthier you.

Exercises Involved In Vestibular Rehabilitation

Madeeha Syed

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Your Body After Giving Birth

Overview

Post-pregnancy or postpartum is a crucial period. It&rsquo;s also known as the fourth trimester. This is when your body is <a href="https://merisehat.pk/disease/chronic-fatigue-syndrome">recovering from the fatigue</a> of pregnancy.

During pregnancy, the body goes through a lot of changes to accommodate your baby. The body eventually goes back to normal, but this can take a while.&nbsp;

Continue reading to find out more about some common changes that take place in your body, after you give birth. 
&nbsp;

Post-pregnancy or postpartum

During pregnancy, hair growth gets better and the texture of hair gets thicker. This is all thanks to the hormones that are active during that phase. However, post-delivery, this phase settles down and enters into a resting phase for about one to five months. Normal hair growth pattern usually returns six to 15 months after delivery. 
&nbsp;

Shoe surprise is pretty common after pregnancy. It is not just the midsection that gets affected. After a baby is born, your shoe size changes permanently. That is because during pregnancy women gain an average of 25-35 pounds which puts extra pressure on the feet. This pressure flattens out the arch in your feet which is the reason for extra inches in your feet. 
&nbsp;

Belly bulge is common after pregnancy. A lot of women expect that the belly will return to its normal size after birth. The upper portion of the uterus is at the level of your navel. Post-pregnancy belly returns to its normal size in about six to eight weeks. A good diet and exercise are the key to toning down your belly. Workouts focused on the core can show quick results. 
&nbsp;

A common expectation of most women is that the breast size will go up after giving birth and breastfeeding. Once you stop breastfeeding, however, the size goes back to what it was. In fact, in some cases, it goes a cup down. The main reason for the size to increase is that fat tissue in the breast is replaced by functional tissue. Once a woman stops breastfeeding, functional tissue depletes as it is no longer needed. 
&nbsp;

The first six months of the post-partum period are the recovery period. No matter how easy or smooth your pregnancy is, your body has gone through a lot of stress and trauma. It needs time to recuperate. Remember that every mom goes through a different experience and symptoms; hence, the recovery rate also changes.

Most of the symptoms, like sore nipples, backache, pain in the thigh area, etc., continue for more than a week. Other symptoms, like leaky breasts, can linger on for months.

In vaginal delivery, recovery timelines vary depending upon the kind of delivery. The soreness and perennial pain go away in three weeks. However, in the case of vaginal tear or episiotomy (incision made on the vagina to ease the delivery process), recovery can take up to six weeks.

If you have been delivered through c-section, it will take around three to four days in the hospital to recover. In about four to six weeks you can recover completely. 
&nbsp;

For the first 24 hours after birth, ice your perineum region. Sit in warm baths for 20 minutes to ease pain and avoid long periods of standing or sitting.

Ease pain and aches by taking hot showers and massages.

Do your Kegel exercises, to strengthen your pelvic muscles.

Keep up with your doctor appointments. It will help you stay on track. Your doctor can also notify you about your emotional well-being and help you with your new journey.

Ask your doctor regarding your workout plan. They can guide you about how and when can you exercise. It is a good idea to start by walking into your house and then gradually into the neighbourhood. Walking helps in recovery by improving blood circulation and toning muscles. 
&nbsp;

Bottom Line

Your diet after pregnancy shouldn&rsquo;t be very different from what you eat during pregnancy. Avoid processed foods. Focus on eating whole grains, high fibre foods, Omega-3 fatty acid-rich food, nuts, and fish.&nbsp;

<ul>
	<li>Lean Meat: Milk, cheese, and yogurt are all crucial components of a breastfeeding mother&#39;s diet. Your infant receives calcium from breastmilk for the formation of bones. Consume foods high in calcium to replenish the calcium your body has lost. Include three cups of dairy in your diet each day.</li>
	<li>Pulses: These are a good source of protein and fibre. You can cook them with different seasonings to make them tasty and easy to eat. Pulses also prevent fat from accumulating in the body.</li>
	<li>Vegetables:&nbsp;These are low-calorie healthy food. They are rich in antioxidants and aid in losing weight. Spinach and broccoli are good sources of Vitamin A which is healthy for you and your baby.</li>
</ul>

Once the baby is born, you can resume most of the food you avoided during pregnancy. Include nutrient-rich foods like legumes, proteins, fibre, citrus fruits, and vegetables. Don&rsquo;t forget to keep yourself hydrated. You may consult a dietician and your doctor in designing your diet plan.

Namwer Rao

The Power Of Stepping Forward

There&rsquo;s a widely held perception that <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">effective exercises</a> are meant to exhaust you and be physically difficult. When looking to build an exercise regime, most of us are quick to add high-intensity activities like weightlifting and running. Rarely, if ever, does one consider beginning with the simplest and easily accessible activity: walking.&nbsp;

While it may not necessarily outweigh the benefits of a high-intensity strength circuit, walking comes with a host of benefits for both the body and mind. If one is completely new to exercising, or even returning after a long hiatus, walking is a more sustainable place to start. There is no learning curve because it is the one movement that&rsquo;s been inherent to our lives since infancy. It also allows you to start with a gentle pace and build up as your body allows. Whether you start with a moderate pace for ten minutes a day or walk at a faster pace for an hour, you will still be able to reap the many benefits of this activity. 
&nbsp;

Benefits of walking

Walking has been shown to improve blood circulation in the body and lower one&rsquo;s resting heart rate, while lowering blood pressure and cholesterol. A six-year study found that moderately paced walking showed similar reductions in the risk of high blood pressure and cholesterol when compared to vigorous running. A study of post-menopausal woman also showed that walking just one to two miles a day can lower blood pressure by 11 points in 24 weeks. 
&nbsp;

&nbsp;Research shows that walking contributes towards preventing a range of diseases. Improvement in cardiovascular health leads to a decrease in risk of heart disease. In one study, women who walked 30 minutes a day showed a 20 percent decrease in the possibility of having a stroke. Those who walked at a faster, above average pace showed a 40 percent decrease.

In another study, women who walked seven or more hours a week were shown to be 14 percent less likely to get breast cancer as compared to women who walked less than three hours. Even women with other risk factors, such as being on supplemental hormones, were less likely to get the disease.&nbsp;

With its benefits to overall health, regular walking has been shown to reduce risk of early death by upto 39 percent as compared to a sedentary lifestyle. 
&nbsp;

&nbsp;Walking has also been shown to reduce risks of developing Type 2 diabetes, as it helps to balance blood sugar levels. A meta-analysis of 300,000 showed that walking regular decreases the likelihood of Type 2 diabetes by 30 percent. Walking at a brisk pace, of more than 20 minutes to a mile, is even more effective, reducing risk by 41 percent. Meanwhile, a smaller study, of 201 people with Type 2 diabetes showed that every additional 2,600 steps in daily activity was associated with a 0.2 percent decrease in blood sugar level. 
&nbsp;

&nbsp;A joint is the point where two or more bones are joined, such as our knees and elbows. The health of our joints greatly impacts our overall mobility and is essential for living comfortably and pain free. Walking has been shown to improve joint health while reducing chances of osteoarthritis. It lubricates the joints, which protects our bones from friction, and strengthens the muscles that support them. Research has shown that people who walk regularly experienced a 40 percent reduction in knee pain as opposed to those who didn&rsquo;t. 
&nbsp;

&nbsp;Walking has been proven to boost our immune system&rsquo;s ability to protect us against illness. A study tracked 1,000 adults during flu season. Those who walked at a moderate pace for 30 to 45 minutes a day faced 43 percent less sick days and suffered from fewer respiratory infections overall. Even if they did get sick, their symptoms were not as severe or long-lasting when compared to adults with sedentary lifestyles. 
&nbsp;

&nbsp;Like other forms of exercise, walking causes our body to release endorphins. These are neurotransmitters which elevate our mood and alleviate pain. There is ample evidence to support the positive relationship between walking and mental health. One study showed that the more steps people took in a day, the better their mood was. Just 12 minutes of walking resulted in more self-confidence and a better mood in the subjects of another study.

Walking in nature helps us ruminate less over negative experiences, which in turn decreases negative emotions and risk of depression. A study of post-menopausal women showed that walking three times a week for 40 minutes provided relief from symptoms of depression. With all the research to support walking, it&rsquo;s no surprise that psychologists agree a 10-minute walk can be as effective as a 45-minute vigorous workout when it comes to relieving depression. 
&nbsp;

&nbsp;For creative professionals, walking can be a valuable tool in facilitating idea generation. One study compared people trying to think of new ideas while they were walking with those who were sitting. Participants who were walking did better, especially if they were walking outdoors. Research has also shown that walking improves creative output by more than 60 percent. Science shows that engaging in activities that allow our mind to wander creates a mental state that is conducive to coming up with ideas. If we are able to let go of our thoughts while walking, we can go to a place where ideas flow freely to us.

Although simple, walking has incredible and wide-ranging benefits for your body and mental health and should definitely be incorporated as a part of your lifestyle.&nbsp;

Ayesha Binte Rashid

Body Weight Exercises For Strength Training

Body weight exercises mean using your own body weight as resistance to train your muscles. If you’re someone who has never worked out a day in their life, doing bodyweight exercises is the perfect place to start. It’s great for building strength, endurance, balance, coordination and a nice lean muscular body. They are super convenient, can be done anywhere, costs no money and requires no equipment. There are also lower chances of injury that you might get with lifting weights that are too heavy. Another great thing about this mode of exercise is that you can easily mix and match or modify them according to your liking. You don’t have to get perfect at it from the get go and can start any of these bodyweight exercises at the beginner level. Once you perfect your technique, range of motion and your form you can move on to either the normal or tougher variations of these. Some of the easiest and most useful body weight exercises you can do anywhere and anytime are listed below. Most of these can be done in 3 sets with 12 – 15 repetitions.&nbsp;

Planks

&nbsp;This is one of those perfect exercises that challenge multiple muscle groups at once and are super easy to do. They can train muscles in you upper back, shoulders, arms, abs, oblique’s, glutes and quads while helping you work on your stability. They are also great for improving posture and provide your spine that much needed stability by strengthening core muscles, this means no more back pain!&nbsp;The correct way to do a plank is to make sure you are balancing yourself on your toes and elbows, if your are doing arm planks then you are supposed to balance yourself on your palms (start off in a pushup position) while keeping your core tight and your back straight. You can do elbow planks as a beginner or put your knees on the ground to make it easier. If you want to increase difficulty you can do either an active plank which requires you to flex and extend your abdomen or a marching plank where you balance yourself on alternate feet and arms. And no you don’t have to be able to hold a 1 minute plank in your first attempt. You can start off with as little as 20 seconds and build your capacity from there.&nbsp;

Side Planks

This is great for your obliques which usually get ignored amongst all the ab exercises. It also engages your glutes and shoulder muscles and is an overall effective body weight exercise. All the same rules as the plank apply, you can start with a 20 second side plank and you can start at beginner level.&nbsp;The correct way to do this is by putting one elbow on the floor and facing the front of your body entirely to one side while balancing yourself on your feet. You can drop down one knee to make it easier. If you are pro you can do an active side plank by adding a hip dip to make it tougher and challenge more of your muscles.&nbsp;

Mountain Climbers

&nbsp;Another exercise that engages and works multiple parts of the body including your core, abs, obliques, arms, back and shoulders. These can be done in sets of 3 with however many reps you&rsquo;re comfortable with (start with 10/15 and build up to 30). Since this is an active exercise that you can either slow down or speed up, it does give you similar benefit as <a href="https://merisehat.pk/article/why-is-both-cardio-and-strength-training-important-for-a-total-body-workout">doing cardio</a> by getting your <a href="https://merisehat.pk/page/sehat-scan/">heart rate</a> up and making you sweat.&nbsp;

In order to perform mountain climbers you start off in a push up stance, make sure your back is straight and nothing is sticking up, pick your feet and bring your knees to your chest. You can also bring alternate knees to your chest to engage obliques.&nbsp;&nbsp; 
&nbsp;

Squats

&nbsp;The most dreaded yet the most beneficial of exercises perhaps, squats work your lower back, glutes, quadriceps, hamstrings and calves. They also help you burn calories and are great for your joints Although there are a ton of variations of squats but here we are going to discuss the basic squat technique. You start off with your feet a little more than your shoulders’ width apart, you can extend your arms in the front, palms facing the ground and lower down slowly making sure you put all your weight on your heels. Depending upon your flexibility, balance and coordination you can go down as much as possible but note that the deeper your squat the better it works. Now after holding this position for 5 seconds or more, slowly come back up to your original standing stance. You can hold onto something in front of you for example a kitchen counter top in order to make it easier to get back up. Or, to make it tougher, you can stop coming back up entirely to a standing pose before going back into a squat.

Lunges

The first noteworthy thing about lunges is that Jennifer Lopez prescribes them to get a body like hers. The second noteworthy thing is that they work your abs, back, quadriceps, glutes, calves and hamstrings while also helping you lose weight and build up more coordination and balance. These can be forward lunges, reverse lunges, side lunges or one of the countless other variations.&nbsp;Let’s see how to do a basic stationary lunge: you stand in the same wide stance with your feet parallel to each other as you do at the beginning of a squat, hold your arms either in front of you or put them on your hips, lift up one leg and put it in front of you as far as you can go, bend your knee at a 90 degree angle and slowly lower yourself while keeping your upper body straight. As a beginner this is the easiest body weight exercise you can start off with. To make it tougher put one leg up onto something behind you before going into a lunge.&nbsp;

Pushups

The classic pushup works your chest muscles (pectorals etc.), shoulders, arms (triceps, deltoids), glutes, quads and abs. It’s also great for your back and joints. It has quite a few variations too and can be simplified for those who are just starting off.&nbsp;&nbsp; In order to do a pushup you first need to get on all fours and position your arms just a little wider than your shoulders, make sure you keep your elbows lax because this is where the movement will be, keep your back straight and core tight and slowly lower your chest to the ground as far as you can go. Your elbows should end up at a 90 degree bend. Beginners can start with wall pushups as it still engages your core and works your glutes, abs and quads or you can drop down to your knees and perform the rest of the pushup as it is. If you have been working out for a while and consider yourself a pro, you can make it harder by doing a lifted pushup which requires you to keep your feet up on an elevated surface. This helps you put more weight on your hands.&nbsp;&nbsp;

Dr. Safia Mehmood

Why Strength Training Is A Miracle Fitness Routine

Strength training is the healthiest available option for people who want to improve their fitness, regardless of sex or gender. Also known as resistance training or <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training" target="_blank">weight lifting, strength training</a> focuses upon using one&rsquo;s own body weight against them or adding external weights to build muscular endurance. 
&nbsp;

The main idea is to build lean muscle mass by gradually increasing resistance to weight. This is known as progressive overload. Here are some of the main benefits of strength training, applicable to men and women alike:&nbsp;

Miracle Fitness Routine

<ul>
	<li>Decreased Risk For Cardiovascular Disease: Strength training improves heart health. By building musculature, it increases the surface area for blood to be pumped (fat cells do not require blood), which in turn stresses the arteries to perform better and the heart to pump more blood.</li>
	<li>Optimises Fat Burning Efficiency: Strength training boosts resting metabolism by increasing excess post-exercise oxygen consumption (EPOC). Furthermore, muscle mass expends energy to maintain itself, which means that one can burn more calories at rest.</li>
	<li>Increases Bone Strength: Weight training reduces the risk for osteoporosis (bone degradation) because it causes strain on the bone cells. The body responds to this by increasing bone density to handle the strain. This is especially beneficial for women, as women are at an increased risk for osteoporosis later on in life.</li>
	<li>Decreased Risk For Injury: Strength training is not dangerous at all. In fact, it reduces the risk for injury by boosting one&rsquo;s range of mobility. Through various exercises, the body adapts to a greater degree of flexibility and activates more muscles than we use in everyday life.</li>
	<li>Improves Mental Wellbeing: People who strength train are reported to have a better mental health than those who do not. It&rsquo;s not just because exercise produces endorphins; strength training boosts self-esteem due to a greater degree of accomplishment and reward each time the resistance is increased.&nbsp; 
	&nbsp;</li>
</ul>

It&rsquo;s important to mention that the idea that women might &ldquo;bulk up&rdquo; due to weight lifting is not possible because they simply do not have enough testosterone in their bodies. Testosterone is the hormone responsible for bulking up or appearing masculine and the absence of it considerably delays or makes difficult the process of achieving a hefty musculature. In fact, strength training might give women the appearance of being leaner, as muscle occupies less space than fat in the body.&nbsp;&nbsp; 
&nbsp;

Strength training is as beneficial for women as it is for men &mdash; or even more so &mdash; and women can perform much better at it than men all due to the presence of the oestrogen hormone. Estrogen not only influences bone maturation, but also strengthens muscles and their surrounding tissue, such as tendons and ligaments. While women may experience a range of performance as estrogen levels rise and fall throughout their cycle, the fitness routine in itself is better for them. This is because the risk for osteoporosis rises after menopause, when estrogen levels permanently dip.

So, weight lifting is not a masculine activity. In fact, it should be an imperative aspect of one&rsquo;s fitness routine regardless of their sex assigned at birth or the gender that they identify with.

Zuha Malik

Medilink Consultant clinic

Online Consultation

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Best Exercises For Diabetics In Ramadan!

Introduction

Fasting during Ramadan is one of the five pillars of Islam. The holy month is a time of spiritual reflection that is meant to develop a sense of gratitude and discipline, encouraging self-improvement and knitting the community closer.

For all its benefits, though, we know Ramadan can be challenging for diabetic people. However, one trick to managing these blood sugar spikes is regular exercise.

Oh no, don&rsquo;t worry! These are not high-intensity activities. The following exercises can easily be integrated into a daily routine without causing excessive strain or fatigue<a href="#accordion">[1][2]</a>: 
&nbsp;

Understanding Best Exercises For Diabetics In Ramadan

<ul>
	<li>
	<h5>Walking</h5>
	</li>
</ul>

Walking is an excellent low-impact exercise for <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetics </a>as it not only improves blood sugar control but also reduces the risk of heart disease. You can go out for a walk before Suhoor or after Iftar when your body has sufficient energy to fuel the activity.

&nbsp;

<ul>
	<li>
	<h5><a href="https://merisehat.pk/article/yoga-a-life-changing-approach">Yoga</a></h5>
	</li>
</ul>

Yoga is a gentle, cost-effective form of exercise that&rsquo;s more famous for improving body flexibility. But do you know it helps your body manage stress levels, too? It really does! So, if you&rsquo;re struggling to cope mentally and/or physically, then this is for you! Yoga during Ramadan will improve your blood circulation, lower blood pressure, manage insulin levels, and even help you maintain a healthy weight.

&nbsp;

<ul>
	<li>
	<h5>Tai Chi</h5>
	</li>
</ul>

Tai chi is an ancient Chinese practice involving slow movements and deep breathing. It is an effective way for people with type 2 diabetes to manage their blood glucose and A1C levels. Additionally, this form of meditation is known to improve balance and reduce nerve damage, although more research is required in this regard.

&nbsp;

<ul>
	<li>
	<h5>Swimming</h5>
	</li>
</ul>

Swimming during Ramadan helps cool down the body temperature and, consequently, reduces the loss of fluid through sweating. Also, it&rsquo;s a full-body workout, so it will leave you feeling more energetic and focused to go about your daily tasks. Moreover, it doesn&rsquo;t matter if you are at risk of gestational diabetes, young or elderly, or have hypertension or heart conditions; the exercise is ideal for everyone who&rsquo;s tackling diabetes in Ramadan without exhausting their bodies.

NOTE: Make sure to inform the lifeguard about your medical condition before taking a dip.

&nbsp;

<ul>
	<li>
	<h5>Cycling</h5>
	</li>
</ul>

Cycling is yet another exercise that doesn&rsquo;t put excessive pressure on your joints. It can be done indoors or outdoors, whichever is more convenient or suits your condition best. According to recent research, nearly half of the people with type 2 diabetes also have arthritis. Factors like diabetic neuropathy and obesity only make you more susceptible to suffering from joint pain. Cycling helps you keep up with your fitness goals while fasting. 
&nbsp;

<ol>
	<li>Begin slowly, especially if you haven&#39;t been physically active in a while. Do a 5-minute warm-up before exercising. Similarly, finish off with a 5-minute cool-down after exercising.</li>
	<li>Check blood sugar levels before and after exercise to understand how your body responds to it.</li>
	<li>Make sure your blood sugar is less than 250 mg/dl before exercising.</li>
	<li>Wear a medical alert ID band and carry a cell phone in case of emergency.</li>
	<li>Avoid exercising in extremely hot or cold temperatures.</li>
	<li>Always listen to your body. If you feel dizzy or short of breath, stop immediately.</li>
</ol>

NOTE: Always consult with a doctor before starting an exercise program to ensure it&#39;s safe and suitable for your condition<a href="#accordion">[3]</a>. 
&nbsp;

Conclusion

Fasting during Ramadan can make it challenging for diabetic people to maintain a regular exercise routine. Remember, it&rsquo;s okay to modify physical activities to suit your body&rsquo;s needs during this time. Some strategies include adjusting the timing and intensity of exercise, staying hydrated, and monitoring blood glucose levels closely. Consulting with a healthcare professional before starting any exercise program during Ramadan is essential. 
&nbsp;

[1] Grey H. The best 10 exercises if you have diabetes. Healthline.

[2] Migala J, By. 6 great exercises for people with diabetes. EverydayHealth.com.

[3] Team CC. 5 best exercises for people with diabetes. Cleveland Clinic.

Sarah Mhowwala

Functional Exercises For The Elderly

Maintaining functional ability is vital for the elderly population as it allows them to perform daily tasks with ease and independence. Functional exercises focus on improving strength, flexibility and mobility to enhance overall functionality. These exercises mimic real-life movements and engage multiple muscle groups, promoting better coordination and balance. Let&rsquo;s explore the importance of functional <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">exercises </a>for the elderly and see a comprehensive guide to incorporating them into a daily routine. 
&nbsp;

Functional Exercises

Benefits Of Functional Exercises &ndash; Functional exercises offer numerous benefits for the elderly, including improved strength, flexibility, balance and coordination. By engaging in movements that mimic everyday activities, such as walking, bending and reaching, seniors can enhance their ability to perform these tasks safely and efficiently. Functional exercises also help prevent muscle imbalances, reduce the risk of falls and maintain overall functional independence. 
&nbsp;

Consultation With Healthcare Professional &ndash; Before beginning any exercise program, it is crucial for elderly individuals to consult with a healthcare professional, such as a physician or a physical therapist. They can assess the individual&#39;s current physical condition, identify any underlying health concerns and provide appropriate recommendations for functional exercises. 
&nbsp;

Squats &ndash; Squats are functional exercises that strengthen the lower body muscles and improve mobility. Seniors can perform squats by standing with their feet shoulder-width apart, lowering their hips as if sitting back into a chair and then standing up again. This exercise enhances leg and core strength, promoting stability and the ability to rise from a seated position. 
&nbsp;

Lunges &ndash; Lunges are effective functional exercises that target the lower body muscles, including the quadriceps, hamstrings and glutes. Seniors can perform lunges by stepping forward with one leg, lowering the back knee toward the floor and then pushing back up to the starting position. This exercise improves leg strength, balance and mobility for activities such as climbing stairs or getting out of a car. 
&nbsp;

Step-Ups &ndash; Step-ups simulate the movement of climbing stairs, making it an excellent functional exercise for the elderly. Seniors can use a stable step or platform and step up onto it with one foot, then step back down and repeat with the other foot. This exercise strengthens the leg muscles, improves balance and enhances the ability to navigate stairs safely. 
&nbsp;

Standing Leg Curls &ndash; Standing leg curls target the hamstrings, which play a crucial role in walking and maintaining balance. Seniors can perform this exercise by standing behind a chair or using a wall for support, bending one knee and bringing the heel towards the glutes, then slowly lowering it back down. This exercise improves leg strength, stability and walking ability. 
&nbsp;

Wall Push-Ups &ndash; Wall push-ups are modified push-ups that target the chest, shoulders and arms. Seniors can stand facing a wall with their arms extended, placing their palms against the wall at shoulder height. They can then bend their elbows to lower their chest towards the wall and push back up to the starting position. This exercise strengthens the upper body muscles, promoting better pushing and pulling abilities. 
&nbsp;

Standing Marches &ndash; Standing marches simulate the movement of walking and promote coordination and balance. Seniors can march in place by lifting one knee towards the chest while maintaining an upright posture, then alternating with the other knee. This exercise improves hip flexibility, leg strength and overall gait stability. 
&nbsp;

Standing Toe Raises &ndash; Standing toe raises focus on the calf muscles, which are essential for walking and maintaining balance. Seniors can stand with their feet shoulder-width apart, raise up onto their toes as high as possible, then slowly lower back down. This exercise strengthens the calves and promotes better balance and stability while walking. 
&nbsp;

Regular Practice and Progression

Consistency and progression are key when performing functional exercises. Seniors should aim to incorporate these exercises into their daily routine, gradually increasing the number of repetitions or the level of difficulty over time. They can also consider adding resistance bands or light weights to challenge their muscles further.

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

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Wake Up Beauty, It’s Time to Beast

What is the best time to work out? Is it during the day, in the morning, or at night?&nbsp;

The best time to work out varies from person to person. However, many will argue that the best time to exercise is in the morning. When you exercise in the morning, the advantage is that you get up and go before starting your day. Moreover, it doesn&rsquo;t interfere with your daily routine. So, if it works for you, wake up and start exercising. But take the following precautions to maximize the benefits of your workout.&nbsp;

&nbsp;

Understanding Your Workout Regime

Your body temperature is lower upon waking up, so a warm-up before going to the gym will help to advance to the higher intensity portion of the exercise<a href="#accordion">[1]</a>. The earlier you work out in the morning, the longer the duration of your warm-up should be.&nbsp;

&nbsp;

Working out without fuelling up, or hydrating yourself, can cause early <a href="https://merisehat.pk/disease/chronic-fatigue-syndrome" target="_blank">fatigue</a>. If you work out a few minutes after waking up, drink plenty of water. Moreover, eating a 150 to 200-calorie snack before the exercise can give you the required energy for the workout<a href="#accordion">[2]</a>. However, it isn&rsquo;t necessary to eat if you&rsquo;ve had a filling meal at night. Especially, if you plan to exercise for less than ninety minutes.

&nbsp;

Your sleep time is maximized when you exercise right after waking up. According to the National Sleep Foundation, most adults need to sleep between seven to nine hours for good health, cognitive performance, and weight management<a href="#accordion">[3]</a>. If you compromise on sleep to work out in the morning, you will lack energy. Moreover, this can have a negative effect on levels of the hormone that controls hunger, making you eat more and negating the calories burnt. Therefore, waking up a little later and hitting the gym within twenty or thirty minutes after getting out of bed will save you from compromising on sleep.

&nbsp;

A morning routine is always better because you stick to the efforts. However, if you do plan to work out right after waking up, avoid rigorous exercises. Save the intense workout regime for later in the day. Your capability to perform is enhanced when the temperature of your body is warmer. The muscles and connective tissues in your body adapt to activity better when they are less likely to be injured. Since the body temperature is lower in the morning when you wake up, it is best to stick to less rigorous exercises for your morning workout.&nbsp;

<h4>"Daily exercise can help manage and lower stress. Find out your stress level with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> today!"</h4>

Although working out before breakfast is beneficial, the blood sugar in your body must be stabilized prior to exercise. Otherwise, your body will have a hard time powering through.

A light meal with carbs and proteins can help, providing you with the required energy.&nbsp;

&nbsp;

<h5>Ideal Pre-Workout Meal</h5>

The following foods are ideal to have before working out. However, everyone&rsquo;s bodies are different and require different nutrients, so do what is best for you. A general pre-workout meal can include:

<ul>
	<li>Peanut butter and bananas</li>
	<li>Oatmeal and berries</li>
	<li>Apples and Greek yogurt</li>
</ul>

You can eat these an hour before working out. Experimenting with different types of meals is beneficial, and you can stick to what works best in the end.

&nbsp;

<h5>Post-Workout Meal</h5>

After a workout, replenish your body with the following foods:

<ul>
	<li>Whole grain bread, turkey sandwich, and vegetables</li>
	<li>Berries and Greek yogurt</li>
	<li>Protein smoothies and fruits</li>
</ul>

Furthermore, don&rsquo;t forget to hydrate yourself!

&nbsp;

Key Points

<ul>
	<li>When you plan on working out in the morning, make sure you are getting enough sleep. An eight-hour sleep is essential before working out. You can always adjust your workout time gradually to an earlier time.</li>
	<li>Setting your workout gear before going to bed can prevent you from having to rush it in the morning.</li>
	<li>Moreover, make your breakfast in advance and find a workout partner so the two of you can keep each other going.&nbsp;</li>
	<li>Last but not the least, enjoy your workout.</li>
</ul>

&nbsp;

[1] Harding, E.C., Franks, N.P. and Wisden, W., 2020. Sleep and thermoregulation. Current Opinion in Physiology, 15, pp.7-13.

[2] Reports C. The best way to eat before and after exercise. The Washington Post.

[3] Chaput, J.P., Dutil, C. and Sampasa-Kanyinga, H., 2018. Sleeping hours: what is the ideal number and how does age impact this?. Nature and science of sleep, 10, p.421.

[4] Ruegsegger, G.N. and Booth, F.W., 2018. Health benefits of exercise. Cold Spring Harbor perspectives in medicine, 8(7), p.a029694.

[5] Seo, D.Y., Lee, S., Kim, N., Ko, K.S., Rhee, B.D., Park, B.J. and Han, J., 2013. Morning and evening exercise. Integrative medicine research, 2(4), pp.139-144.

Staff Writer

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Low-Impact Exercises For Elderly

Engaging in regular physical activity is crucial for maintaining overall health and well-being, particularly for the elderly. However, the aging process can bring about certain physical limitations and increased vulnerability to injuries. Low-impact exercises offer a safe and effective way for seniors to stay active, improve their strength and flexibility and enhance their quality of life. Here are a couple examples of low-impact exercises specifically tailored for the elderly, ensuring that they can enjoy the benefits of physical activity while minimizing the risk of injury.

&nbsp;

Low-impact Exercises

<a href="https://merisehat.pk/article/the-benefits-of-walking-a-total-body-workout">Walking </a>&ndash; Walking is one of the simplest and most accessible forms of low-impact exercise for the elderly. It promotes cardiovascular health, strengthens muscles and bones and improves balance and coordination. Encourage regular walks outdoors or on a treadmill, starting with shorter distances and gradually increasing as fitness improves. 
&nbsp;

Swimming And Water Aerobics &ndash; Water-based exercises are excellent options for seniors, as they provide resistance without putting excessive strain on the joints. Swimming and water aerobics promote cardiovascular fitness, muscle strength and flexibility while minimizing the risk of impact-related injuries. Look for local community centers or fitness facilities that offer senior-friendly water exercise classes. 
&nbsp;

Cycling &ndash; Cycling, either on a stationary bike or a regular bicycle, is a low-impact exercise that can be adapted to suit the fitness level and comfort of the elderly. It improves cardiovascular health, strengthens leg muscles and enhances joint mobility. Ensure that the bike is properly adjusted to maintain proper posture and minimize strain on the back and knees.

&nbsp;

Tai Chi &ndash; Tai Chi is a gentle and slow-paced martial art that incorporates flowing movements and deep breathing. It promotes balance, flexibility and relaxation, making it an ideal low-impact exercise for the elderly. Tai Chi also offers mental benefits, such as reducing <a href="https://merisehat.pk/disease/stress">stress </a>and improving mindfulness. Look for local classes specifically designed for seniors or follow instructional videos online. 
&nbsp;

Yoga &ndash; Yoga is another low-impact exercise that focuses on flexibility, balance and strength. It offers a wide range of poses and modifications that can be tailored to individual needs and abilities. Regular yoga practice can improve joint mobility, enhance core strength and promote relaxation and mental well-being. Seek out senior-friendly yoga classes or consider practicing with instructional videos at home. 
&nbsp;

Strength Training - Strength training exercises using resistance bands, light weights or bodyweight can help maintain muscle mass and bone density, both of which tend to decline with age. Focus on exercises that target major muscle groups, such as squats, lunges, bicep curls and overhead presses. Start with light resistance and gradually increase as strength improves. 
&nbsp;

Chair Exercises &ndash; Chair exercises are ideal for seniors with limited mobility or those who prefer seated workouts. These exercises can include seated leg lifts, arm curls, seated marching and chair yoga poses. They improve strength, flexibility and circulation while providing stability and support. 
 
Balance And Flexibility Exercises &ndash; Balance and flexibility exercises are essential for reducing the risk of falls and maintaining functional mobility. Simple exercises like heel-to-toe walking, standing on one leg or gentle stretches can be incorporated into daily routines. Yoga and tai chi, mentioned earlier, are also excellent choices for improving balance and flexibility. 
&nbsp;

bottom Line

While low-impact exercises are generally safe for the elderly, it is important to prioritize safety as well. Always consult with a healthcare professional before starting a new exercise program, especially if there are pre-existing health conditions. Start slowly and listen to the body, making adjustments or modifications as necessary. Wear appropriate footwear, maintain hydration and use assistive devices if needed.

How Pakistanis Deal With Post-Workout Sore Muscles

There are many benefits to exercises. A good mix of cardio and <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">strength training</a> aids in better cardiovascular health, strengthens your muscles and bones and helps you sleep better. But what accompanies a bout of intense exercise is Delayed Onset Muscle Soreness (Doms). When, after a workout, your whole body hurts. 
&nbsp;

The fitness community worldwide has responded to this by introducing foam rolling and it can be done either before or after workouts. When done at the beginning of workouts, it&rsquo;s been shown to increase flexibility just as much as stretching. 
&nbsp;

Post-Workout Sore Muscles

Foam rolling is also great for post workout recovery, can alleviate symptoms of Doms and can help prevent myofascial adhesions as your muscles repair themselves. It&rsquo;s easy, affordable, efficient and can be performed anywhere. Foam rolling is done by using foam rollers which are cylindrical blocks of compressed foam that come in all shapes, lengths and densities. 
The desi fitness community, however, prefers their own method to deal with universal ailments &mdash; maalish [massage].

Both of these modalities have the same end goal: to alleviate muscle soreness and to speed up recovery. They both work by exerting pressure on your muscles in long gliding movements. 
&nbsp;

<h5>So How Is A Maalish Different From Foam Rolling?</h5>

The method of maalish we use for sore muscles utilises pressure being put onto the muscle groups that have just been worked. Massage oils or lotions are used in order to ensure smooth movements and reduce friction and some people use essential oils such as lavender oil to get added benefits. 
&nbsp;

It&rsquo;s different from foam rolling in that the pressure can be adjusted according to the needs of the muscles, how they respond and what you need at the moment. It is also better than foam rolling because your maalishi [masseuse] can get into those nooks and crannies where a foam roller can&rsquo;t go. 
&nbsp;

A study published in Frontiers in Physiology in 2018 has found that sports massages were better at reducing soreness and feelings of fatigue than any other modality for example; cryotherapy, compression garments etc. Doms starts 12-24 hours after exercise, peak at 48 hours and the recovery might take up to 10 days. It comes with increased pain, fatigue and inability to produce force. Many studies have shown that if performed right after the workout, a good maalish can help ease the pain of Doms and help speed up the recovery in the days right after the event. 
&nbsp;

A maalish also helps better with injury and pain and doesn&rsquo;t worsen the issue given its adaptable nature as discussed in a 2016 study published in Pain Medicine. Then there&#39;s the element of physical touch that comes with it, the soothing effect it has can have psychological benefits as well. A maalish also helps activate your parasympathetic nervous system that slows down your heart rate and breathing and promotes blood flow to all organs. 
&nbsp;
<quillbot-extension-portal></quillbot-extension-portal>

At the end of the day, whether you use foam rolling or a maalish for post-workout recovery depends on your particular needs and what you can afford. Locally, you can get a good maalishi for as little as Rs500 and reap the countless benefits. Muscle soreness is an ugly and painful aspect of intense physical activity and either way we must get rid of it! 
&nbsp;

Yoga Poses For A Good Night’s Sleep

When you think about it, it is a little hard to believe that how can a body position lead to better sleep? Things are a little more complex than we think. For years yoga has been the key to improved health and mental wellbeing.&nbsp;

&nbsp;

Yoga poses for good sleep

Here are five yoga poses that can help improve sleep and for the nerds out there, how they aid in improving your slumber: 
&nbsp;

<ol>
	<li dir="ltr" style="list-style-type:decimal">
	Child&rsquo;s Pose (Balasana): Child&rsquo;s pose is a gentle pose that calms the nervous system and reduces stress levels. This pose stretches the hips, knees, and back, which can relieve tension and promote relaxation. When you hold the pose for several breaths, you create space between your vertebrae and release pressure on the spinal column. This helps to relieve any physical discomfort that may be keeping you awake. Additionally, child&rsquo;s pose also promotes deep breathing, which further helps to calm the mind and promote relaxation.
	</li>
	<li dir="ltr" style="list-style-type:decimal">
	Legs Up The Wall (Viparita Karani): This is a restorative pose that helps reduce stress levels and improves circulation. When you lie down with your legs up the wall, you reduce the gravitational pull on the veins and heart, allowing blood to flow more easily to the legs and lower body. This helps to reduce swelling, relieve tension and promotes a sense of calm. Additionally, this pose can also help to relieve anxiety, headaches, and menstrual cramps, which can further improve the quality of your sleep.
	</li>
	<li dir="ltr" style="list-style-type:decimal">
	Seated Forward Bend (Paschimottanasana): The seated forward bend is a calming and restorative pose that can help reduce stress and anxiety levels. This pose stretches the hamstrings and lower back, which can help to release tension and promote relaxation. Additionally, the forward bend also helps to slow down the breath and calm the mind, which further helps to promote relaxation and sleep.
	</li>
	<li dir="ltr" style="list-style-type:decimal">
	Corpse Pose (Savasana): Corpse pose is a restorative pose that helps to calm the nervous system, reduce stress, and improve sleep. When you lie down in corpse pose, you let go of any tension and allow yourself to fully relax. The pose helps to slow down the breath, which calms the mind and promotes relaxation. Additionally, this pose is also a great way to help release tension in the body, relieve discomfort, and improve sleep quality.
	</li>
	<li dir="ltr" style="list-style-type:decimal">
	Cat And Cow (Marjaryasana and Bitilasana): Cat and cow is a simple and gentle pose that helps to relieve tension and promote relaxation. This pose involves moving the spine in a gentle and rhythmic manner, which helps to massage the spine and release any tension. Additionally, this pose also helps to improve circulation, relieve stress, and calm the mind, all of which can further improve the quality of your sleep.
	</li>
</ol>

&nbsp;

These yoga poses can be a great way to help improve sleep and relieve stress. By practicing these poses before bedtime, you can help calm the mind, reduce tension, and promote relaxation, all of which can help you get a better night&rsquo;s sleep. It is recommended to practice these poses for about five to 10 minutes a day for best results.

&nbsp;

Umna Salah

Vestibular Rehabilitation Therapy (VRT) is a specialized type of physical therapy that focuses on treating vestibular disorders, which can cause dizziness, vertigo, balance problems, and other symptoms. It involves a variety of exercises and techniques that are designed to help improve the function of the vestibular system and reduce symptoms.

Some patients may not experience any benefits from these exercises. Additionally, it is important to note that exercise may not be appropriate for certain types of vestibular disorders. In this article, we will discuss the different types of exercises involved in VRT. 
&nbsp;

<ol>
	<li>
	<h5>Head Exercises</h5>
	</li>
</ol>

Bending

While seated, bend your head down to glance at the ground, then up to look at the skylight.

With your eyes focused on the ground and the roof, lead your head. Repeat it ten times. Hold off for 30 seconds for clinical signs to rectify and then repeat the entire procedure a further two times. 
&nbsp;

Turning (Side to Side)

<ul>
	<li>While seated, move your head toward the right and left leading your head with the eyes as if viewing a tennis match.</li>
	<li>Move your head quickly enough to produce clinical signs but not so fast that you develop a strain in your neck. (Initially slowly, then rapidly.)</li>
	<li>Repeat ten times, then stop for 30 seconds (or until the symptoms disappear).</li>
	<li>Repeat the entire procedure two more times. 
	&nbsp;</li>
</ul>

As the dizziness resolves:

<ul>
	<li>Close your eyes and carry out the necessary head exercises.</li>
	<li>The next step is to stand while conducting head exercises.</li>
</ul>

The nearer your feet are to each other, the more challenging the exercises become./ 
&nbsp;

Sitting

<ol>
	<li>Shrug your shoulders twenty times.</li>
	<li>Move your shoulders towards the right and left 20 times.</li>
	<li>Then rotate your head, shoulders, and trunk twenty times each:
	<ul>
		<li>Rotate your upper body from the right side to the left side with your eyes wide open, then redo with your eyes closed.</li>
		<li>Rotate your upper body from the left side to the right with your eyes wide open, then redo with your eyes closed.</li>
	</ul>
	</li>
	<li>Bend forward, touch the floor, and sit up. Keep your gaze fixed on the wall. Do this twenty times.</li>
	<li>Bend forward, touch the floor, and then sit up. Move your eyes to the ground and back. Do this twenty times.</li>
	<li>Eye movements (head is still):
	<ol>
		<li>Upward and downward (maintaining focus on finger).</li>
		<li>From one side to the other (maintaining focus on finger).</li>
		<li>Finger to nose tip and out (maintaining focus on finger). 
		&nbsp;</li>
	</ol>
	</li>
</ol>

Standing

Alter Your Position from Sitting to Standing and Back Again

<ul>
	<li>
	Do it twenty times while keeping your eyes open.
	</li>
	<li>Close your eyes and repeat. 
	&nbsp;</li>
</ul>

Standing Still With One Foot Ahead of the Other, One

<ul>
	<li>
	In a corner, stand &quot;heel to toe&quot; (one foot ahead of the other foot, as such that the heel of your one foot starts to touch the toe of your other foot) with your eyes wide open for 30 seconds. The primary objective is to hold for thirty seconds without coming into contact with the wall.
	</li>
	<li>Consider making this more challenging by crossing your arms across your chest. If this is too challenging initially, consider standing &quot;almost heel to toe&quot; (with feet touching at big toes and ankles). Once you&#39;ve managed to master these with your eyes wide open, try them with your eyes shut. 
	&nbsp;</li>
</ul>

Standing On A Cushion

<ul>
	<li>Stand in a nook on a sofa cushion, perhaps several pillows. Make an effort to remain still for thirty seconds without contacting the wall. Experiment with your eyes wide open. When this becomes natural and easy, practice with your eyes shut.</li>
	<li>You can make this more difficult by putting your feet nearer together. It is made more difficult by crossing your arms across your chest. It would be best if you advanced by conducting this in the most challenging position attainable. 
	&nbsp;</li>
</ul>

Standing and Throwing

<ul>
	<li>Toss a tiny rubber ball from one hand to the other above eye level.</li>
	<li>Pass the ball from one hand to the other under one knee. 
	&nbsp;</li>
</ul>

Stand with Heels Together

<ul>
	<li>Maintain your balance while looking straight ahead (attempt only with help).</li>
	<li>
	Stand on One Foot
	</li>
	<li>Conduct with your eyes wide open initially, then with your eyes shut (attempt only with aid).</li>
</ul>

 
Miscellaneous

<ul>
	<li>Perform stooping, stretching, bending, and stair climbing activities (attempt only with aid).</li>
</ul>

 
Walking

Walking in a Straight Line

<ul>
	<li>Walk in a straight line for five minutes in a corridor or adjacent to a wall, one foot ahead of the other, or &quot;heel to toe&quot; (with the heel of one foot touching the toe of the other foot). If this is too difficult initially, practice strolling &quot;almost heel to toe&quot; and gradually move to heel-to-toe touching. 
	&nbsp;</li>
</ul>

Walking Combined with Head-Turning

<ul>
	<li>Practice strolling linearly in a doorway or open area, attempting to turn your head and eyes left and right with each step (i.e., when you step with your left, you take a glance at left, when you step with your right, you look right). Proceed along the hallway for around 20 feet. Repeat the procedure three times. Next, perform the process three times more, but this time glance at the roof or the ground. Relax between reps to allow signs to resolve. 
	&nbsp;</li>
</ul>

Walk Across the Room

<ul>
	<li>Conduct with your eyes wide open initially, then with your eyes shut (attempt only with help).</li>
</ul>

 
Lying Down

<ul>
	<li>While sitting on the side of the mattress, quickly lie down on your left side while swinging your feet onto the bed.</li>
	<li>Lie down for thirty seconds or until your clinical signs subside.</li>
	<li>Repeat three times.</li>
	<li>Now do it again three times to the right. 
	&nbsp;</li>
</ul>

Understanding the Importance of Exercises in Vestibular Rehabilitation

<ol>
	<li>While the head moves, the objective must stay in focus, not hazy, and seem motionless.</li>
	<li>Start exercising with a comparatively tiny head movement (45 degrees on either side).</li>
	<li>The head movement speed should be enhanced as long as the target remains focused.</li>
	<li>Wear your glasses while exercising if you have them.</li>
	<li>These exercises can cause lightheadedness or <a href="https://merisehat.pk/disease/nausea">nausea</a>. Try to overcome these while continuing with the exercises.</li>
	<li>Relax between exercises.</li>
	<li>Exercises necessitate complete focus. Distractions should be avoided.</li>
	<li>It would be best to do standing exercises next to a desk or close to somebody for safety and protection. 
	&nbsp;</li>
</ol>

<ul>
	<li>
	<h5>Gaze Stabilization</h5>
	</li>
</ul>

Maintain your gaze fixed on a single stationary target held in your hand or placed 3-10 feet away on a wall. Move your head from side to side for 30 seconds. Repeat three times. Repeat three times more while moving your head up and down for 30 seconds. Perform three sessions per day. Starting in a sitting position, progress to standing with feet apart, standing with feet together, standing heel to toe, marching in place, or standing on the form. This will be even more difficult if the object you focus on is set against a &quot;busy wallpaper&quot; or a checkerboard background. 
&nbsp;

<ul>
	<li>
	<h5>Smooth Pursuit</h5>
	</li>
</ul>

Keep your eyes fixed on a single target while holding it. Move it side to side for 30 seconds while keeping your head still. Perform the task while sitting. Proceed to the standing position if you can tolerate the exercises. Now, move your head up and down again. Per session, repeat 20 times in each direction. Perform three sessions per day. 
&nbsp;

<ul>
	<li>
	<h5>Head and Eyes Same Direction</h5>
	</li>
</ul>

Keep your eyes fixed on the target by holding a single target (a playing card or a pencil). For 30 seconds, slowly move the target, head, and eyes in the same direction (up and down, side to side). Perform in a sitting position; as you improve, you can progress to standing. Repeat three times per session. This will be more difficult if you have a &quot;background&quot; of busy wallpaper. Do three sessions per day. 
&nbsp;

<ul>
	<li>
	<h5>Head and Eyes Opposite Direction</h5>
	</li>
</ul>

Take your target, keep your eyes on it, and start to move it slowly (up and down, side to side) for 30 seconds while moving your head in the opposite direction of the target. Repeat three times per session. As in the preceding exercise, you may progress from sitting to standing. Do three sessions a day.

<ul>
	<li>Do these exercises at least twice a day until your symptoms have subsided. You do not need to continue these exercises if they do not cause symptoms.</li>
	<li>Begin a home walking program. You should walk five times per week. Begin by going for a 5-minute walk. Increase your walking time by 5 minutes weekly until you can walk for 30 minutes. 
	&nbsp;</li>
</ul>

VRT is a highly effective treatment for vestibular disorders that can help to reduce symptoms and improve the overall quality of life. The exercises involved in VRT are designed to improve the function of the vestibular system, which is responsible for detecting changes in head position and movement.

Eye exercises, head movements, gaze stabilization exercises, balance training, and canalith repositioning maneuvers are all important components of VRT. A trained physical therapist can work with individuals to develop a personalized VRT program that is tailored to their specific needs and symptoms. 
&nbsp;

Key Takeaways

<ul>
	<li>VRT is a specialized type of physical therapy that focuses on treating vestibular disorders, which can cause dizziness, vertigo, balance problems, and other symptoms.</li>
	<li>VRT involves a variety of exercises and techniques that are designed to help improve the function of the vestibular system and reduce symptoms.</li>
	<li>Eye exercises are a critical component of VRT as they help to improve the ability of the eyes to work together and track movement.</li>
	<li>Head movements are another important aspect of VRT. These exercises involve moving the head in different directions, such as side-to-side, up-and-down, or rotating the head.</li>
	<li>VRT is highly effective in reducing symptoms and improving the overall quality of life for individuals with vestibular disorders.</li>
	<li>A trained physical therapist can work with individuals to develop a personalized VRT program that is tailored to their specific needs and symptoms.</li>
</ul>