THE IMPACT OF LACK OF PHYSICAL ACTIVITY IN AIR TRAFFIC ...€¦ · implantatio stenti 2x(2012.) -...

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THE IMPACT OF LACK OF PHYSICAL ACTIVITY IN AIR TRAFFIC CONTROLLERS Prim. Vlasta Brozicevic M.D., spec. in physical medicine

and rehabilitation, rheumatology

Head of dpt. Terme Selce, Croatia

Moscow, October 31, 2019


5 years experience in providing health & wellbeing program for air traffic controllers

30 TM


3

• Croatia

• Crikvenica

riviera

• Selce

• Arrival

• Airports

distances

• Climate

• The average air

temperature in

summer is 25°C,

while the average

sea temperature is

23°C.

• Tradition

• 130 years of

health tourism

• Health from

sea • Clinic only 100

meters from

the sea. Krk 23 km

Pula 144 km

Trieste 146 km

Ljubljana 175 km

Zagreb 180 km


Content

• THE PROBLEM

• THE SOLUTION

• OUR METHOD


• 1

„Aviation is considered to be

an ultra safe industry.

However, even in these ultra

safe industries things happen

that surprise us and make us

think; how did that happen or,

where did that come from? „


CONTROLLERS - Think Quick & Act Quick

Cognitive Processes

Fatigue LMS stress


high-stake risks on a day-to-day basis 6-8 hours sitting Overweight Back or neck pain Osteoarthritis/Arthritis Increased risks of injury And other....

There is a PROBLEM

Why?


BIOMECHANICS – COMPRESSION

Pre

ssu

re o

n d

isc

5 kg

15 kg

20 kg

BIOMECHANICS – COMPRESSION


CAUTION !

Locomotor system disorders: 97 %

44 %: hip, knee, ankle

– 2nd reason of sick leaves


WARNING !!!

10

osteoporosis muscle degeneration or weakness

atrophy poor grip strength increase overuse

wrong activity may

cause injuries and re-injury

Sedentary job connected to 25+ chronic diseases & Influence on most common injuries: lower leg/ankle/foot


55 Diagnoses Anaemia sideropenica – Adipositas - Chondropathio patellae dex. - Contractura coxae bil. praec lat. dex. - Coxarthrosis bil. - Diathesis urica - Displasio coxae cong. bil. praec lat. dex. - Giht - Graviditas hbd XIII - H.D i.v C5/C6 – HLP - Hypertensio arterialis - Instabilitas genus sin. – Migrena - Molimina statica - Myofibrositis m.trapezii lat.dex – Obesitas - Osteochondrosis C4/C5, Uncarthrosis - Osteochondrosis i.v C4-C7, Uncarthrosis - Osteopenia - Protrusio disci i.v. L3/L4 foraminalis l.sin. - Protrusio disci i.v. L4/L5 dorsomedialis - Rhizarthrosis bil - Scoliosis thoracolumbalis - Sindrom prenaprezanja lijevog lakatnog zgloba - Spica calcanei bil. gr.laevis - Spica calcanei bill - St post op. coxae dex , reop. - St.p. IM St.p.PCI RCA et implant. stenti et PCI LXC Obesitas,HLP. - St.p.infarctum myocardii - St.post contusionem antebrachii bil. 7/2017. - St.post fracturam spiralis ossis MTC III et IV manus dex. cum disloc. - St.post rupturam ACL genus sin 2012. - St.post rupturam et haemathoma caput mediale m.gastrocnemii lat.sin. - St.post rupturam partialis. m.rectus femoris/2013. - St.post STEMI , PCI et implantatio stenti 2x(2012.) - St.post VLC et contusio art. TC lat.sin. 2003. - St.post Whyplash injury - Struma nodosa gl.thyreoideae, Euthyreosis - Sy cervicale - Sy cervicale in remiss - Sy cervicale et lumbale - Sy cervicale in remiss - Sy cervicocephale et cervicobrachiale sin. - Sy lumbale - Sy lumbosacrale chr. - Sy lumbosacrale lat.sin. - Sy lumbosacrale recidivans - Sy lumbosacrale, Molimina statica - Sy lumbosacrale, Sindrom traktusa iliotibialisa, Distorsio art.TC lat.dex. Recidivans - Sy tractus illiotibialis lat.sin. i.o. - Tendinis calcarea reg.caput longum m. bicepitis lat. dex. - Tendinitis m.supraspinati calcarea lat. sin. - Tendinosis Achilis lat.sin. gr.laevis - Tendinosis Achillis bil. praec. lat.dex.

103 Recommendations 1-2 times a year shorter reeducational program with a view to further improving the locomotor and psychophysical condition - 5 daily meals - More blood pressure control! - Further treatment of endocrinologist - Dietary Measures - Good regulation of lipid values - Exercising exercises for Achilles tendon - Exercising exercises for the left elbow - Ergonomic positions - Individual kinesitherapy twice a year for 8 days - Avoid walking on stairs with load carrying - Avoid rotating and shaky movements in the hull - Avoid all rotational movements in the knee joint - Avoid squatting - Avoid kneading - Avoid sudden and chaotic movements in the shoulder's wrists - Avoid lifting and carrying heavy loads - Avoid working with your arms raised over your shoulder level - Avoid working with squeezed fists against resistance (scissors, clutches) - Avoid rotations and shaking movements in the lumbar segment of the spine - Avoid jumps and dozens - Avoid static spinal loads - Avoid shaking movements in the spine of the spine - Avoid higher statodynamic loads of spine and hips - Avoid flailing - Avoid higher right hand loads - Izometric exercises for cervical musculature - Izometric exercises for strengthening the thigh muscles - Isometric exercises for shoulder muscle muscles - Strengthening the abdominal and back muscles - Strengthening the neck-shoulder muscles - Control of laboratory findings: Cholesterol, HDL and LDL cholesterol, triglycerides, urates, iron, TSH, T3, T4, lipidogram, glucose, U.S., iron serum finding, UIBC, TIBC, ferritin - Orthopedic control for the decision on the surgical procedure - Traumatologist control - Control of gastroenterologists - Correction of static orthopedic cartridges - Kotnrola Doppler TCD CD for 12 months - Continue the same physiotherapy session for a week - Continue walking, cycling - Do not smoke - Abundant hydration - Limitation of fat of animal origin, purine - Strengthen the abdominal and back muscles – Orbitrek – Walking - Plan densitometry – Swimming - Swimming style - Improve overall muscle status ie increase muscle mass - Improve strength and trophies as well as the suppleness of overall musculature - Improve the status of the lower kinetic chain with exercises to strengthen the subclinical musculature - Repeat densitometry - Post-graduate BMI Optimization - Increase total muscle mass - Occasional blood pressure control - Stop smoking - Observe ergonomic rules including regular ergonomic breaks - Take ESWT therapy 3-5 times - Carry out a dosed therapeutic program - Perform stretching exercises of all muscle groups - Perform exercises to strengthen the thigh muscles for the active knee stabilization and prevention of premature knee arthrosis - Perform exercises for the cervical segment of the spine - Right hook erosion - Consider the therapy of statin (Roswera 10 mg) according to neurological guidance for plaque in carotids and elevated cholesterol values - Consider the introduction of medicamnotherapy for hyperuricemia (uricosis) since urates are increased for a longer period of time - Regular blood pressure control - Regular physical activity - Regular shorter ergonomic breaks - Regular target exercises improve the elasticity of the back loops and the overall musculature - Weight reduction of 19 kg - Weight reduction of 10 kg - Weight reduction of 11 kg - Weight reduction of 15 kg - Weight reduction of 20 kg - Weight reduction of 6 kg - RTG C and LS segment of the spine - RTG of the right shoulder - RTG LS segment of the spine - Reduce lipid intake, control for 2-3 years - Static exercises for strengthening the thigh muscles stretching - Gout therapy - Do a Balance Test on the Biodex 3 system or frequent right ankle distortion - Perform Izokinetic Testing of Negative Muscle on the Biodex 3 System to Inspect the Agonist and Anatagonist Relationships - Do orthopedic control for the decision to reconstruct the front crossover - Make hepatitis markers - Make the MR C segment of the spine - Perform the RTG C segment in AP and LL projections - Do the RTG LS segment of the spine - Uric Diet - Take Fe (Ferohil) with Vitamin C 500 mg - Balance exercises and proprioceptions - Stretching exercises - Exercises to stretch the back of the loci and to strengthen the thigh muscles - Exercises on specific trainers with expert supervision - Exercises for open and closed eyes, capturing and adding balls with deliberate distortion of the equilibrium position - Exercises in the auditorium - Exercises in the gym - Exercises for Strengthening Negative Muscle With an Emphasis on Flexible Muscovirus Both Nipples - Exercising on harder substrates – Cycling - Room bike ride - Static Protection (Roswera 10mg)


12

INCREASE OF HEALTH PROBLEMS

FORCAST OF RISKS Expect increase of back pain, dizziness, neck pain, headaches - which can lead to a reduction of concentration, work absenteeism


13

‘Human at the Centre of the System’

Key problems No. of Therapies

Average age

24 - 44

Everyday activity

17

Weekly activity 106

No activity

28

67% 17% 80% 21%

Gender 23 F – 77 M

2000 years ago

Hippocrates

highlighted the importance of

active living !


to Prevent osteodegenerative disease, backpain, work absenteeism

to Improve health, wellbeing, work performance

SOLUTIONS needed!

14

Regular isokinetic other testing

Diagnostics &

Lab tests, BCT

Physical therapy individualized programs

Education

Education – Prevention – Healing – Reconditioning

IN COLLABORATION


Monitoring

By calculating the values of the relative strength of the left and right quadriceps, the strength ratio of the hamstrings.

Goal setting

Tests show disparity in sitting muscle groups, which accelerates premature changes and knee problems – that enabled goal setting for individualized TH programs.

15

OUR METHOD Isokinetic testing, DG, individual 7 days programs

Status

Initial questionnaire analysis,

specialists’ exam, lab tests,

isokinetic spine and knee tests,

isochronous knee testing at 60

°/s

Follow up

Based on the questionnaire after the program and recommendations by specialists.

Regular isokinetic measurements are recommended.

Assessment

Through individual consultations with specialists, psychologist, nutritionist.

Evaluation

Of an individual TH & exercise protocol created, to determine the progress and effectiveness of the TH and exercise.


Clinical exams & US/CD

US:

Achilles tendon

Shoulders

Knee and ankle

Thyroid gland.....

CD: Vertebral arteries

Clinical exams by specialists: physiatrists / rheumatologist, internist - cardiologist, neurologist, radiology diagnostics specialist, ECG, Bicycle ergometry, Finger Dynamometry

16

OUR METHOD

Tests and measures

Biodex B3 System Isokinetic Test

Biodex B3 Balans test system

Body composition analysis

FMS test

Laboratory findings

Spine Resistance Measures - Back Spine

Lower limb volume measures

Flexibility of the lumbar part of the body and the pelvic band

Spine / Low back


17

OUR METHOD – therapy procedures


18

OUR METHOD – wellbeing program


19

OUR METHOD – kinesitherapy

PNF PIR kinesitherapy 15 'Kinesiotherapy 60 ' Kinesitherapy 30 'Kinesitherapy 20 ' Kinesitherapy 15 'Kinesitherapy 10 ' Chinese Therapy - Corrective 30 'FSS system - monitored kinesitherapy


Theoretical Framework tested /verified

THROUGH DRVB

METHOD:

fast & safe

innovative

individualized

protocols and

scoring system

INDIVIDUALIZED

APPROACH

GOALS

PROTOCOLS MONITORING

ASSESSMENT

EVALUATION medical

wellbeing

counselling education

anti-stress

prevention


21

109

+ EXPERIENTIAL


22

+ EXPERIENTIAL


Work – Life BENEFITS in MINDsetBODY Reconditioning

• No fatigue

• Less emotional stress

• Less anxiety

• Less panic

• Boosted confidence

• Better team work

• Increased capacity

• Mentally and physically fit

• Motivated through workshop:

MindsetBody & ergonomics

• Motivated through workshop: nutrition

• Increased performance

• Less absenteeism 23

In combination of TS departments: Physical medicine and rehabilitaton, Internal medicine & cardiology, Wellbeing counselling, BIODEX Isokinetic centre

TEAM + 30 experts more

Prim. MSc. Ivan Brozicevic MD, spec. internist-cardiologist

GM

MSc. Iva Brozicevic Dragicevic, prof., clinical and sports psychologist

Project leader

Domagoj Tomljanovic Kineziologist

Amira Salibasic Therapy Co-ordinator

Smiljana Supak, MD, spec. physical medicine and

rehabilitation Project assistant

OUR STRENGHTS

Verified 44.000 patients from 86 countries

120 Olympic sports champions

150 air traffic controllers

Safe & Fast 35 highly skilled experts

Results proved In 7 days program results show high level of

improvement of health and overall wellbeing

Method based 30 years’ tradition

Innovative solutions Newest technology

THE

BRAND

Prim. Vlasta Brozicevic, MD.,spec.

THANK YOU! & Welcome

THE IMPACT OF LACK OF PHYSICAL ACTIVITY IN AIR TRAFFIC ...€¦ · implantatio stenti 2x(2012.) -...

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