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What's best for your Body?

Set your unique activity plan.  Track it over time.   


 

Understanding the RPA

For good health, it is generally recommended that you perform a balanced amount of certain types of physical activity each week.  These health related activities include tasks for flexibility, joint stability, balance, strength, endurance, or coordination. We have grouped these different health related aspects of fitness into 3 categories - Mobilize, Stabilize, and Energize. 

 

RPA - the Holistic activity App

When you sign up for the RPA app, it will automatically encourage you to complete a recommended amount of the 3 types of fitness.  You can just sign up and use RPA as an holistic activity tracker that encourages a balanced approach to fitness.

 

RPA is Individualized

At HealthOut, we think that different people should do different types of health related activities, to accommodate for their unique body types, health histories, and life goals. You can use RPA to create a unique activity plan for yourself or for your patient if you are a health care provider.  For instance, if your patient has poor posture and flexibility, you might choose to increase their weekly flexibility work by prescribing up to %300 of the usual RPA in the mobilize category.   

 

RPA Encourages Lifestyle Change

Your RPA includes all types of physical activity, even lifestyle activity such as walking, doing housework, or leisure play time. Our mission at HealthOut is to promote healthier lifestyles - you don't have to be a customer of HealthOut to use the RPA method and apps.

Finding your Balance

Once you start using the RPA, you may notice that its hard to find balance between your 3 types of fitness activities.  If you are used to doing indoor cycling for your activity, you will notice that your mobilize category is still low.  If you are used to doing yoga, you may notice that your energize category is low. Learn through trial and error or read here for some helpful tips on how to find your balance.

 

Mobilize

Improving your mobilize requires you to do activities that challenge your range of motion or flexibility.  The only true activity that will award you 1:1 for your efforts would be stretching.  For instance, if your therapist prescribed certain stretching exercises to improve your knee pain. Other activities that contribute to your Mobilize category include:

  • Yoga
  • Some types of Pilates
  • Physical therapies, massage therapies, other hands on muscle release therapies.
  • Workout moves that use full range of motion, for example a squat, a single leg deadlift, or lifting the arms over the head.  If you do these things in your workouts, you can count them toward your mobility RPA.

 

Stabilize

If you want to increase your stabilize component, you need to perform exercises that challenge you to have better posture, balance, coordination, or strength endurance. Pilates is probably the most well known in this category.  Here are some other alternatives:

  • aerobics classes
  • yoga
  • "core stability" workouts
  • most fitness exercises administered at the physical therapy clinic
  • strength workouts in which you are performing full body activities with light weights and proper technique or posture.

 

Energize

Energize workouts are higher intensity, meaning the main focus is to perform more work in shorter periods of time.  This includes workouts people would have called "Cardio" as well as "Strength".  The higher the intensity of the activity, the more energy credits you get per unit of time.  Examples of activities include:

  • Interval training, or "HIIT" training.
  • Strength training.
  • Circuits or other workouts with mixed exercise selections.
  • Running, hiking, biking, swimming and other sports.

 

 

 

Mobilize

 

 
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Flexibility. Posture. Relaxation. Recovery.

Mobilize


Indications and Clinical Use

  • Poor posture/ asymmetrical posture.
  • Conditions related to poor thoracic, hip, and ankle flexibility:
    • Chronic Neck and Back pain.
    • Impingement syndrome of the shoulder, knee, ankle, or hip. 
    • Plantar Fasciitis/ other foot and ankle pain.
    • Tennis/ Golfer’s elbow
    • Difficulty performing activities of daily living
      • Squatting down or bending to pick things up while keeping a straight back.
      • Reaching arms over head while keeping a straight/ relaxed spine.
      • Twisting for sports such as golf or tennis.
  • Individuals that recover poorly from exercise.

Contraindications

  • Any medical condition that can be aggravated or made worse by physical activity, including but not limited to
    • Heart, Lung, or Metabolic Disease
    • Acute injury
    • Active arthritis

Precautions

  • Not recommended for patients who have hypermobility or joint instability.  
  • Pregnant patients – stabilize sessions may be more appropriate, given their increases in joint laxity.
  • Patients in the sub acute and chronic stages of healing should alert healthout staff so that they can effectively modify activities as needed. 

Adverse Reactions

  • Joint inflammation, ligament and other soft tissue injuries can result from overstretching.  Slowly progress in duration and intensity.
  • Failure to isolate the proper joint when stretching (for instance the hip) often exacerbates and already existing problem (for instance lower back pain).
  • As with any exercise program, some positions may prove uncomfortable for patients (for instance the wrists may be uncomfortable in front support) – patients should be encouraged to ask instructors for modifications rather than take a ‘no pain no gain’ approach.
 
 
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% Contribution of Mobilize Appointment Toward Weekly Recommended Physical Activity

% Contribution of Mobilize Appointment Toward Weekly Recommended Physical Activity

 
 

Sample Heart Rate Summary (Polar)

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Dosage

 

  • 1-3 appointments per week, or 60-180 minutes per week.
  • Maintenance of flexibility and posture
    • 1-2 per week (60-120 min/ week)
  • Improvement of flexibility and posture
    • 2-3 per week (120-180 min/ week)
    • To get up to higher doses, never add more than 60 minutes of additional mobilize sessions per 2-week period.  Thus, a beginner would take 5 weeks to work up to 180 minutes per week. 
  • Re-evaluate at 3-6 months.

Actions

 

  • Stretching/ Mobility exercises emphasizing the following
    • Thoracic extension and rotation
    • Hip mobility – all planes
    • Ankle Extension
    • Shoulder flexion and abduction (pectoral and latissimus release)
  • Typical activities:
    • Isolated stretches (see above)
    • Split Squat, Single Leg Deadlift, Squat, Thoracic Extensions over foam roll, Shoulder Flexion with no/ low resistance, rotations with functional trainer.
    • Low intensity cardiorespiratory activities (ex: bike, treadmill, resistance activities)

Notes

 

  • This is the recommended starting point for most patients, unless they are experienced trainees and/ or already have adequate or excessive flexibility or joint instability.   
  • Typical Timeline:
    • 30 minutes - dynamic or active flexibility activities combined with light to moderate cardio respiratory activities. 
    • 30 minutes – isometric flexibility and posture work.  Isolated stretches. 
    • In order to make tissues more pliable and responsive to stretching, these workouts start with a more generalized warm up and then slowly progress toward more targeted and deeper stretching activities. 
 

Stabilize

 
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Balance. Coordination. Strength.

Stabilize


 

Indications and Clinical Use

  • Individuals that would benefit from the health benefits of Neuromotor and Strength activities.
  • Conditions related to instability and poor coordination:
    • Neck and lower back pain
    • Anterior knee pain.
    • Recurrent shoulder dislocations and rotator cuff injuries.
    • Chronic hamstring strains/ other muscle strains
    • Pelvic and groin pain.
    • Chronic ankle sprains
    • Most chronic, overuse injuries of the shoulder, spine and knee.
  • Prevention of osteoporosis and fall injuries.  

Contraindications

  • Any medical condition that can be aggravated or made worse by physical activity, including but not limited to:
    • Heart, Lung, or Metabolic Disease
    • Acute injury
    • Active arthritis

Precautions

  • Less experienced individuals should consider participating in mobilize sessions first. 
  • Patients in the sub acute and chronic stages of healing will likely need to modify certain activities. 

Adverse Reactions

  • These workouts have a high skill requirement - patients may get annoyed because they feel uncoordinated or have trouble performing the exercises correctly at first.  Instruct beginners to ask for the simplest progressions of the various exercises.
  • Patients with histories of chronic or recurrent pain may experience aggravation or worsening of symptoms at first.  A trial and error period is often necessary for patient’s and staff to learn what individualized modifications are necessary for each patient.
  • Rotator cuff and shoulder stability exercises can cause a stiff or irritated feeling for beginners – assure patient and encourage light resistance with gradual progressions in volume. 
  • As with any exercise program, some positions may prove uncomfortable for patients (for instance the wrists may be uncomfortable in front support) – patients should be encouraged to ask instructors for modifications rather than take a ‘no pain no gain’ approach.

Dosage

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% Contribution of Stabilize Appointment Toward Weekly Recommended Physical Activity

% Contribution of Stabilize Appointment Toward Weekly Recommended Physical Activity

 
 

Sample Heart Rate Summary (Polar)

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  • 1-3 appointments per week, or 60-180 minutes per week.
  • Maintenance of Stability
    • 1-2 per week (60-120 min/ week)
  • Improvement of Stability
    • 2-3 per week (120-180 min/ week)
    • To get up to higher doses, never add more than 60 minutes of additional mobilize sessions per 2-week period.  Thus, a beginner would take 5 weeks to work up to 180 minutes per week.
  • Re-evaluate at 2-4 months

Actions

 

  • Exercises that bias the small, stabilizing muscles around the:
    • Lower back and pelvis
    • Knee
    • Scapula and Shoulder Joint
    • Foot and ankle
  • Typical activities:
    • Muscle isolation
    • Hip rotators, abductors and adductors
    • VMO and Hamstrings (knee)
    • Lower Trapezius, Serratus Anterior and Rotator Cuff (Shoulder)
    • Spinal stabilizers such as multifidus and deep neck flexors
    • Peroneals, Tib Anterior and Posterior (Ankle)
    • Oblique abdominals and Transverse Ab
    • Low resistance, full body activities that emphasize endurance and proper technique. 
    • Reverse lunge with medicine balls or functional trainers, thoracic rotations with functional trainers, pushing, pulling, squatting, lifting movements
    • Moderate intensity cardiorespiratory activities (ex: bike, treadmill, resistance activities)

Notes

 

  • This is the recommended “step 2” for most patients, as these appointments require more skill and coordination than the Mobilize sessions.  
  • Typical Timeline
    • 20 minutes – Dynamic Warm up with equal parts flexibility, Neuromotor, and Cardiorespiratory activity.
    • 20-30 minutes – Moderate intensity strength endurance and cardiorespiratory activity.
    • 10-20 minutes – Cool down with targeted muscle isolations for local stabilizers.  
 

Energize

 
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Strength. Endurance. Metabolism. Sport.

Energize


Indications and Clinical Use

  • Experienced and skilled trainees that would benefit from higher intensity and sport specific activities. 
  • Trainees with time constraints for physical activity.
  • Prevention of diabetes and metabolic syndrome. 
  • Weight Management
  • Sports Injury prevention
  • Healthy alternative for patients that enjoy high intensity workouts.

Contraindications

  • Sedentary individuals
  • Any ongoing injuries, including recently healed, sub acute or chronic stages of healing. 
  • Any medical condition that can be aggravated or made worse by intense physical activity, including but not limited to:
    • Heart, Lung, or Metabolic Disease
    • Acute injury
    • Active arthritis  

Precautions

  • These appointments involve complex, high intensity activities, both of which have reported higher rates of injury and adverse events.   Ensure the benefits of intense physical activity are carefully weighed against the cons, especially in populations who are higher risk:
    • Sedentary lifestyle
    • Smoking
    • Adolescent
    • >50 years of age
    • Metabolic Syndrome
    • History of/ recurrent injuries.

Adverse Reactions

  • Musculoskeletal injuries are more likely when performing higher intensity physical activity; for instance, ligament injury, stress fractures, muscle tears or strains, or exertional rhabdomyolysis. 
  • Adverse cardiovascular events are higher with intense activity, particularly in older age groups and other higher risk populations. 
  • Diabetics may find it more challenging to control their blood sugar during and after intense exertion.
  • Frustration – these sessions often involve complicated movements that novices may find challenging and frustrating. 
  • Patients with histories of chronic or recurrent pain may experience relapse or worsening of their already existing condition.
  • As with any exercise program, some positions may prove uncomfortable for patients (for instance the wrists may be uncomfortable in front support) – patients should be encouraged to ask instructors for modifications rather than take a ‘no pain no gain’ approach.
 
 
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% Contribution of Energize Appointment Toward Weekly Recommended Physical Activity

% Contribution of Energize Appointment Toward Weekly Recommended Physical Activity

 
 

Sample Heart Rate Summary (polar)

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Dosage

 

  • 1-2 appointments per week, or 60-120 minutes per week.
  • Never add more than 60 minutes of additional energize sessions per 1-month period.  Thus, a beginner would take 5 weeks to work up to 120 minutes per week.
  • These workouts are periodized throughout the year.  Re-evaluate as you see fit.  (HealthOut re-evaluates fitnessevery 3-6 months). 

 

Actions

 

  • Strength activities
    • Increase lean mass, promote bone density and promote a higher resting metabolism.
  • High intensity interval training
    • Fast improvements in aerobic fitness. Provides health benefits at 2-3 times the rate of mild to moderate physical activity.
  • Typical activities
    • Resisted and combined activities such as squats, step ups, lunges with upper body resistance, pulling and squatting at the same time, twisting and lunging at the same time, etc. 
    • Advanced stability exercises – prone walk outs, torsional supine and standing core stability exercises, higher speed twisting movements, single leg balancing and agility drills.
    • Intense anaerobic and aerobic intervals utilizing a variety of different movements, including running, biking, jumping, strength activities, and agility drills.

Notes

 

  • This is our most complicated and intense session.  It is designed primarily for advanced trainees who need variety in their training and they desire fitness and injury prevention for sports.  Please do not refer new clients for these appointments.  
  • Typical Timeline:
    • 20 minutes – Dynamic Warm up with equal parts flexibility, Neuromotor, and Cardiorespiratory activity.
    • 30 minutes – High intensity strength and power training combined with high intensity aerobic and anaerobic intervals.
    • 10 minutes – Cool down