I find it interesting that we all worrying about 'exercise'.  Up until about one 
hundred
years ago no one 'exercised' because they didn't need to, their lives were fully 
active.
Women kneaded and made bread daily, washed heavy  loads of clothes by hand, men tilled 
the
fields or worked down the mines, even children worked in mills, mines, sweat shops. It
wasn't until the rise of the middle classes and the advent of labor-saving devices 
that our
lives became increasingly sedentary and inactive, and we started turning to 
�meaningless�
exercise to take the place of the strenuous activities of yore.

There is definitely much more feeing of accomplishment in digging the garden or baking
bread than there is in doing aerobics, but any exercise is better than none at all.  
The
reason we as a society are becoming obsesssed with exercise in and of itself is 
because of
that loss of an active lifestyle. Speaking as someone with such a lifestyle, I 
persnally
_do_ get a benefit from running and doing aerobics because it increases my strength,  
my
endurance, and makes me feel good. But I wouldn't need to do it if I was in a vocation 
that
gave me those same things (and hence gave meaning to my life).

When it comes to occupational therapy though I would always prefer to make it 
meaningful.
Peddling an exercise bike seems to me to be  really no better than putting pegs in a 
board,
and as OTs we don�t do that do we :-)??

I�m only a student but already I am seeing things on my shadowing that irk me. Why 
can�t
the 76y/o woman with CVA and L hemiperesis  exercise her weak arm and wrist muscles by
stirring a bowl of food, or holding and cutting vegetables instead of using her left 
hand
to put pegs in a board? That sort of exercise is meaningless and other than muscle
strengthening doesn't have much benefit (to my mind, anyway). The patient doesn't see 
the
point of it, and isn't able to appreciate her progress, whereas if the patient is able 
to
progress from stirring cream  say, to making bread, not only does she appreciate what 
she
has accomplished but it has meaning in her daily life.

So, I agree with Ron, as therapists we should be promoting occupations that include
physical activity, and not just prescribing exercise per se.

Sue Hossack




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