ADaPT PROTOCOL 

ADaPT Protocpol Video 1

00:00:00:03 - 00:00:26:10
Speaker 1
Hello, everyone. And welcome to the moment you have been waiting for. The ADaPT protocol is here. So this is for you. If you are still experiencing symptoms after three months and you took the active stand test and you had a positive test. If that is you, you are in the right place. The other group, this could be for is if you had this autonomy, a type of things coming into the concussion and know that that is an issue for you.

00:00:27:24 - 00:00:48:08
Speaker 1
So first of all, congratulate on identifying the exercise program most effective for your body. I imagine if you're in this program, you've probably tried a few things already and it hasn't really stuck. And usually these underlying mechanisms that we're going to address in this exercise program is why. So when matched the right person, it is super highly effective.

00:00:48:08 - 00:01:10:00
Speaker 1
And I am so glad that you are here. So again, I obviously am a physical therapist, but I'm not your physical therapist. And we really always want to make sure that you are safe here. So please let your doctor know that you're going to be doing this protocol and make sure that you're healthy and able to do this before making any changes.

00:01:10:09 - 00:01:34:02
Speaker 1
I, of course, don't have your health history or your medications or anything like that. So always, always, always make sure you are safe. So what you're going to learn in this video is why the symptoms are happening. You're going to meet your comprehensive and effective approach to reducing and eliminating intolerance. And then you're going to be introduced to the adaptive protocol for strength and conditioning.

00:01:35:14 - 00:01:57:11
Speaker 1
So why is this happening? We did the active stand test, and you may have noticed you were symptomatic and your heart rate went higher than it ought to of. So basically, upright intolerance is you know, when we have a concussion and this can occur outside of concussion. But since we all have concussions, as we're going to talk about when we have a concussion, we can get the autonomic nervous system is affected.

00:01:57:11 - 00:02:19:14
Speaker 1
And that's the thing that controls your heart rate, your blood pressure, your breathing, all of those things that we don't have to think about. And so what can happen here is the body begins to lose, or it should say the nervous system begins to lose its ability to adapt to upright positions against gravity. So either it's not adapting at all or it's adapting slowly.

00:02:19:14 - 00:02:47:00
Speaker 1
And so this can manifest as symptoms like dizziness, headache, nausea, feeling, lightheaded, all of those things. And oftentimes in concussions, we also have those symptoms from other things. So this is something that tends to be missed for a lot of people. It actually, on average takes people six years to get diagnosed with the type of upright intolerance things that we're going to be giving you your exercise program for.

00:02:47:00 - 00:03:08:22
Speaker 1
So I'm very, very glad you are here. And if you've been through the ringer to get here, I'm very sorry, but I'm glad you are finally in the right place. So let's meet your program. So when we think of, you know, we said exercise program, we're going to do strength and conditioning. But there's a couple other pillars to this program that makes it really comprehensive and effective for you.

00:03:09:08 - 00:03:34:24
Speaker 1
So we've had multiple protocols in the past. There's been one called the Living. There's been one called the chop. They all bring in some sort of these four components that we're going to talk about. But for our purposes, we're going to use something called the ADAPT protocol. So it is a comprehensive approach and it includes things like increasing blood volume, compression, activity modification, and then your strength and conditioning program.

00:03:35:09 - 00:03:52:08
Speaker 1
And we know that people tend to do better with this when they're also, you know, doing some nervous system regulation pacing. They have their sleep nutrition habits that we've already done in this program in there. So there was a reason, there was a method to my madness. There was a reason why we've done those things before. And also talking.

00:03:52:08 - 00:04:12:08
Speaker 1
We usually talk to people about the value of social support because when you have these types of or I'm just going to refer to this as just not anovia moving forward when you have to sell domain sometimes that can lead to some social isolation. So really making sure we get you social again as well. So let's talk about why this is so amazing.

00:04:12:18 - 00:04:41:10
Speaker 1
So for the comprehensive approach where we're going to let's go through actually one of these at a time. So the first thing we're going to do is we're going to increase your blood volume. So what can happen in these types of design and Omega is that we get blood pooling down into our legs. So we're not giving up getting enough blood into the brain, and we're definitely not getting enough when we're in upright positions, sitting, standing and so forth.

00:04:41:18 - 00:05:07:19
Speaker 1
So step one in helping you feel better is increasing blood volume. And we do this two ways. We start by increasing your water intake. So for someone with this adenoma, particularly pots, but all of a sudden omega, we increase your water intake and that can get up to 60 to 100 or I'm sorry, 80 to 100 ounces a day, depending on body size and how hot the climate you live in is and all of that.

00:05:08:04 - 00:05:29:16
Speaker 1
And we also find that if people wake up early, symptomatic or they're feeling symptomatic operatively, if we give them like lots of water, like chuck, like 16 ounces, sometimes that can really help. So now that we've increased fluid, now we need to increase fluid. Actually into the cell. So we use that with salt. So salt will help suck fluid into our cell and give us more blood volume.

00:05:30:04 - 00:05:54:10
Speaker 1
So to add salt and when I say salt, I'm talking about sodium chloride. I'm not talking about regular table salt. So salt can be increased up to ten grams a day, which is a lot. So this is something that you're going to want to speak to your doctor about, particularly if you have any other medical conditions. So the general rule is you can begin increasing salt anywhere from usually recommend 3 to 10 grams.

00:05:54:23 - 00:06:12:10
Speaker 1
And as you're increasing, if you start to feel swollen or kind of puffy, that's usually letting us know, okay, that's our stopping point. We reduce it a little bit and then hang out there. So I definitely want this to be done. What The doctor ended up doing this with the doctor myself eventually, and I was like, Oh my God, how did I not do this sooner?

00:06:12:10 - 00:06:32:05
Speaker 1
It's because all of a sudden I did. I did just the fluid and salt and my lightheadedness was better. My headache was going like it was just so amazing. And then the other thing we can sometimes add here is electrolytes. But again, please talk to your doctor before doing this because it is a lot of salt and sometimes that can be contraindicated for certain health conditions.

00:06:32:05 - 00:06:47:15
Speaker 1
I've also done any of the work I can for you because I know I just want to be able to focus on getting better, doing what you need to do. So I've pulled a few different SALT brands. Here are these top two are just salt tablets. That's what I take. And the bottom one is a little tub of what they call rescue salt.

00:06:47:15 - 00:07:04:15
Speaker 1
So any time you're starting to feel kind of gross from standing or anything like that, you can just take a little pinch and pop it in your mouth. They call it rescue salt. So I've linked each one of these here. You would just click on it and it'll take you right to the company's website. And then I've told you kind of what the price already is.

00:07:04:15 - 00:07:28:10
Speaker 1
And then if this is a printed version, you can just scan it. And that'll be the same for everything within this, within this program so that that work is done for you because it's just those little things, you know? So now that we've got increased blood volume, we need it to go up. We want it to move up towards the heart, up towards the brain, up towards, you know, more of the trunk of the body.

00:07:28:10 - 00:07:52:08
Speaker 1
So we do that with compression. And excuse me, the interesting thing we found is ideally we want to use medical grade compression. So that's how tight the squeeze is. Basically is what we're talking about. So 30 to 40 millimeters per mercury is what's recommended. So that's a pretty tight squeeze. If that feels uncomfortable to you, you can start lower.

00:07:52:08 - 00:08:11:19
Speaker 1
There's several different levels of compression. The other thing that we've learned now from the research is that while compression socks can be helpful, they're actually not what's most effective by themselves. We've learned that really need to have compression that goes from the legs all the way up over the waist to be most effective. So there's a few ways that we can achieve this.

00:08:11:19 - 00:08:33:18
Speaker 1
You can do like workout leggings that have compression in them that go high waist. You could do, I think mostly for women. I think we made from for men they do like high stockings all the way up and then covering the stomach, something like Spanx. They also have abdominal binders, which is what this is. And I remember, gosh, couple of years ago, my pots had been gone for like a year.

00:08:33:18 - 00:08:56:16
Speaker 1
I had one just felt kind of Patsey, popped on the abdominal and Biter did like one exercise and it was gone. So, like, this stuff can be really effective. Obviously, it wasn't like that when I was really, really bad. It took some time, but abdominal compression can feel amazing. So the goal is really, you know, toes up to waist getting that compression in and you can accomplish that.

00:08:56:16 - 00:09:14:23
Speaker 1
Sometimes I like to wear compression socks up to my knees and then they'll wear like a thigh Spanx up to my stomach. Sometimes I'll just wear compressive leggings. So I've pulled a few options for you. I've pulled my favorite compression socks, the ones that are the most comfortable and leave the least marks there for men and women there.

00:09:14:23 - 00:09:40:07
Speaker 1
You can find them here. I've also pulled kind of a mid-thigh up to the AB compression for in Spanx. That would mostly be for the ladies and then for everyone abdominal compressors. You just might need. You can really buy any of them and you're just looking for metal, medical grade, abdominal compression is what you would type in. But I found one for you on Amazon for $20 and then for leggings.

00:09:40:11 - 00:10:01:03
Speaker 1
They don't have necessarily like medical grade leggings, but what you'd just be looking for is pick your favorite workout brand and you want leggings with compression that go high waist. So they have a good old navy, they have them heavy or really any range you want. You're looking for compressive leggings with a high waist that's going to be super, super helpful.

00:10:01:12 - 00:10:22:01
Speaker 1
So now we've got the blood volume increased, we've got it moving up towards back towards the heart and the brain. And then the last piece of this before strength and conditioning is activity modification. And this can really go a long way. So when I say active humidification, these are the things I mean, and this worksheet is going to be in your workbook.

00:10:22:10 - 00:10:42:04
Speaker 1
So the first one I know many of you mentioned to me is like I'm really struggling with heat and that's a really common feature of disordered anemia. So with heat you want to do anything to kind of keep yourself cool because overheating can flare those heart rate symptoms. So this could be anything from you know, I want to I know I want to go to meet up with a friend.

00:10:42:04 - 00:11:02:23
Speaker 1
Let's do in the morning when it's still cool versus midday when it's really hot. Maybe this can be sitting in the shade over sitting in the sun, things like that. You can also have things that help you get cooler. Like they have those neck fans, they have cold metal walls. They even have like ice vests. So I actually pulled a few options for that for you as well.

00:11:03:06 - 00:11:23:15
Speaker 1
You can see this fan and the towels were recommended to me by a colleague who treats this quite a bit. So I know that they're great. And then four vests. No one had a specific recommendation, so I just went and pulled these, too. I pulled a lower priced option and then kind of a mid-priced option for you. I haven't used these before, so I'm just going to note that.

00:11:23:22 - 00:11:40:08
Speaker 1
But if you do use it like it, please let me know so I can let other people know. The only thing I will say for the vests is if you also have vestibular issues sometimes that wait there feels good, sometimes it doesn't feel good. So just note that buy something that you can return if you put it on and it doesn't feel good.

00:11:42:05 - 00:12:03:22
Speaker 1
Okay. Other things will avoid is like prolonged standing. So we're struggling to it. Your nervous system is struggling to adapt to upright positions, right? So that means standing for a long period of time is going to be fairly symptom provoking. If you do have times where you need to stand, obviously you're wearing your compression, you're drinking lots of water, you've got your salt, you've got your electrolytes.

00:12:04:11 - 00:12:23:13
Speaker 1
But if at any point you can take a seat or like I paint, so like I'll use a stool rather than standing there, maybe you're doing your dishes, you can use a stool rather than standing at the sink. Any of those times where you can just start to decrease standing positions. Maybe in the morning you're shaving your face or you're putting on makeup.

00:12:23:13 - 00:12:51:14
Speaker 1
Maybe you do that just sitting and look in the mirror. So anything like that, especially if you're feeling symptomatic with it. The other one combining these is like showers tend to really get people. So there's heat and there's the standing. So for that we can do like a cooler shower or we can do some people like will sit I used to sit or they make actual shower chairs or you can sit down just be slow standing up so that you're feeling okay or take a bath.

00:12:52:20 - 00:13:20:22
Speaker 1
The next one is going to be avoiding static positions. So when you have to sat on a mirror, you generally don't feel well, right? You feel exhausted. Everything feels kind of crappy. Being upright feels crappy. So what a lot of people do is they lay down the which is understandable. And I did that myself. The only problem with that is when we lay down and our nervous system isn't having any opportunity to adapt to upright postures, and it can almost like deconditioning further and make the problem worse.

00:13:21:03 - 00:13:46:03
Speaker 1
So what we want to do is avoid those prolonged laying down situation. And this can be something as simple of like for myself when I was like, okay, I just feel crappy today, I would make sure that every, you know, 30 minutes or so I would change my position. So if I had been laying down, I would sit up if I could, when I was really bad, I would maybe just go from laying down to like leaning back on a couple of high pillows.

00:13:46:11 - 00:14:05:09
Speaker 1
But we just want to make sure that we're changing your position so that your body can get those little opportunities to adapt to that change in posture. Other couple tricks of the trade that I use all the time is if you are stuck in a static position or you're just feeling really crappy, you can pump your ankles. So pump your feet and ankles up and down.

00:14:05:10 - 00:14:25:02
Speaker 1
You can pretend writing letters with your toes. Our calf is nicknamed the Second Heart because it acts as a pump, so it can really help pump that fluid again back up where we need it to be. So pumping your legs. I do this like airplanes, things like that, or squeezing your thighs together can be helpful. And you can also do that in standing.

00:14:25:17 - 00:14:52:24
Speaker 1
And then since we're struggling to adapt to position, when you are changing positions, please do so slowly. So when you're standing up, for example, And then finally, you may have noticed with the desire to know me that you might feel bloated or uncomfortable after meals, or you may not be able to eat as much or be as hungry, Typically we will see some pulling in the abdomen, which can lead to feeling bloated or not feeling good with food.

00:14:52:24 - 00:15:06:23
Speaker 1
So if that's the case, then it is. Eating smaller meals can be really helpful, especially like say, I'm out and I'm like, Oh, it's kind of hot here. Maybe I'm going to eat a smaller meal because I know that when I eat what is going to come to my stomach to help me digest and I really need it other places.

00:15:06:23 - 00:15:39:18
Speaker 1
So eating smaller meals can be helpful as well. And with these three stab strategies, we tend to see positive changes and by that I mean reduction in symptoms within 1 to 2 weeks. So this can happen really quickly. So again, increasing our blood volume with water, salt and electrolytes, adding compression to help push those up and then modifying our activity to help our body, help support our body and help put it in less positions where it's just not able to adapt to at the moment.

00:15:39:18 - 00:16:00:19
Speaker 1
So with that, it brings us to our last piece of the program, which is what we all came for, and that is the strength and conditioning component. So welcome to the Adaptive Protocol. The adaptive protocol was created by the folks at the University of Utah in conjunction with Intermountain Health, and it's being used in this program and shared with permission.

00:16:01:09 - 00:16:28:05
Speaker 1
So thank you to them for that. Yeah. And it's it's one of the I would say it's the newest program and it's one of the ones that I think makes the most sense to be able to move through and be able to do it well. So it consists of two components. It has anaerobic exercise component, and here we gradually increase that position to gravity and they recommend doing the aerobic exercise at least three days a week.

00:16:28:05 - 00:16:45:21
Speaker 1
But if we're dosing right, meaning we have you in the right position at the right heart rate for the right amount of time, you should actually be able to do this 5 to 6 days a week. It's not going to feel like typical exercise. Remember, we're exercising for your nervous system, not for fitness. And then that pairs with two days a week of strength training.

00:16:45:21 - 00:17:13:08
Speaker 1
And strength training, I think is probably the most under utilized thing in this. I normally a recovery because when we get the legs and core especially stronger, it really helps. Remember we go back to that blood volume and pumping up thing. It really, really helps with that. So your strength training follows the same position stages as the aerobic exercise training and here's what it looks like spread out.

00:17:13:08 - 00:17:40:03
Speaker 1
So the ADAPT is a structured five stage exercise program designed to gradually retrain the autonomic nervous system to tolerate, tolerate upright positions and physical activity. And you can see each of these stages, you gradually move upright against gravity. So it starts lying down. So it's supine means then you're kind of sitting but leaned back. It's recumbent, then you're sitting straight up, then you're standing.

00:17:40:03 - 00:18:02:07
Speaker 1
And then in stage five, we start to toll our tone the vagus nerve a little bit by doing some intervals. And then once you pass the stage, you are ready to just maintain the level of exercise you want. And so here maybe you're done and you got where you need to go, or maybe you're really active person or an athlete and you'll train a little bit more and then just maintain what you have there.

00:18:02:07 - 00:18:26:18
Speaker 1
Also notice there is a preconditioning stage, and this is for people who aren't quite ready for the supine stage. And I'll talk you through what that means. I also want to note here that moving through the preconditioning stage and stage two tend to be the slowest. So everyone's going to start preconditioning stage one or stage two. So I just want you to note that these early stages, the nervous system is having to do a lot of adapting.

00:18:26:18 - 00:19:00:21
Speaker 1
So these stages can be a little bit slower, but then as we start to get to seated standing intervals, the pace is going to increase. So stick with it. All right. So what we've learned is why symptoms are happening. You know, the nervous system is not adapting to abrupt positions. You've met a comprehensive and effective program. So we are combining increasing our blood volume compression and activity modification with strength and conditioning to give you a well-rounded approach to recovery.

00:19:01:03 - 00:19:22:20
Speaker 1
And then you've been introduced to the protocol or the adaptive protocol strength and conditioning stages. So what you're going to learn in the next video is, okay, great, how do I actually exercise in each stage? How do I progress? We're also going to choose which stage you're in. We talked about you can be in one of three. We're going to help you understand which stage you're going to be in.

00:19:23:03 - 00:19:31:11
Speaker 1
And by the end of the next video, you'll be ready to get started. So when you are ready, I will see you down in the next video.

How To Progress

00:00:00:05 - 00:00:19:23
Speaker 1
All right. Getting started. So welcome to your next video. Here is where we're going to get you started with the program and have everything you need to know. And then, of course, we will pick your stage here as well. So what you'll learn here is how to exercise and each stage when and how to progress. And then we're going to choose your starting stage together.

00:00:19:23 - 00:00:40:11
Speaker 1
So by the end of this video, you will be ready to get moving. Very exciting. So for each stage, we're going to use either heart rate or we're going to use what's called your rate of perceived exertion. And this is just a 0 to 10 scale of how hard does it feel? Now, I will say almost everyone is going to use heart rate.

00:00:40:19 - 00:01:00:13
Speaker 1
When you have your heart rate monitor used it during your testing. If you can use heart rate, let's use that for anyone whose heart rate is not a reliable marker. This would be for someone on a beta blocker or for anything where their heart rate is not reliable due to some medication. Or maybe you have a pacemaker or something like that for you.

00:01:00:13 - 00:01:18:06
Speaker 1
You're going to used the rate of perceived exertion. Both are effective if you have heart rate. If your heart rate's fine, but you want to use the rate of perceived exertion, you certainly can. But just to make it easy, if you're on a beta blocker or anything that's going to alter your heart rate use rate of perceived exertion.

00:01:18:14 - 00:01:46:17
Speaker 1
If you're not, use your heart rate. So let's talk about the general overview of what an aerobic exercise session is going to look like and how we progress it. So what's going to happen is each day you are ready to start your roping exercise. You're going to have your heart rate monitor on or your R.P. scale, your rate of perceived exertion, and you're going to note your symptoms on a 0 to 10 scale overall, just where they at, don't overthink it.

00:01:47:13 - 00:02:05:00
Speaker 1
Just a quick check. And then what you do is you'll begin to start a warmup. Now we have a five minute warm up here. In the beginning, you might want to start with a one or two two minute warmup. It's really what you can tolerate. Then you'll begin exercising at your target heart rate and I'll give you your target heart rate for each stage.

00:02:05:00 - 00:02:28:08
Speaker 1
It'll be based on your individual heart rate. You'll exercise until you reach the heart rate or rate of perceived exertion. All right. Sorry. You'll exercise at the heart rate or rate of perceived exertion. Excuse me. Until your symptoms increase by more than two points. So say you start your exercise and you're at a three out of ten. Overall, your symptoms are feeling 3 to 10 and you do your warm.

00:02:28:11 - 00:02:49:08
Speaker 1
But then you begin exercising and you start to get to a six that's now above two points. So that's where you would stop, begin your cooldown and then record your workout. Or maybe you start out of five out of ten. So again, you do your warmup and then as you're exercising at your target spot, you begin to do get to an eight.

00:02:49:14 - 00:03:18:24
Speaker 1
She started there five. That's now more than two. So there you would stop and begin your cooldown and then record your workout. When you record your workout, you're going to track your progress here it says Autonomic dysfunction exercise log. This is also from the ADAPT protocol. So thank you to that. And you can see you're going to write the day you'll write your total exercise time in minutes, the type of exercise your heart rate, how your symptoms were at a scale of 0 to 10 before, where they got to when you stopped.

00:03:19:11 - 00:03:35:16
Speaker 1
And then we want to know how long it took you to return to baseline. And that means after you finish exercising, how long does it take you to get back to that initial number? So say you start it on a three out of ten. How long did it take you to get back to feeling out of three out of ten and you'll record that number here?

00:03:35:16 - 00:03:56:13
Speaker 1
It lets us know how well the nervous system is ramping down and recovery and then they have a wellness score here. If you'd like to do that, you certainly can and it would be 0 to 10. Zero is I'm feeling terrible. My life is over, ten is I'm feeling great. So you can keep track of your wellness score there as well.

00:03:56:13 - 00:04:21:00
Speaker 1
So your strength sessions will be at the same stage and heart rate as your aerobics sessions. So in each stage I'm going to give you the types of exercises you could do. We're going to do your heart rate and you'll do your sessions, and then the two days a week you'll do strength training. We have classes that you'll be able to do that will match the exact thing that you're doing in the aerobic exercise.

00:04:21:00 - 00:04:46:05
Speaker 1
So now that you know how that works, how do you progress? Like once you're getting pretty good at it, how do you know when you move on? How do you move on, all of those things. So your notice that I have this page started and I actually had the how to exercise in a session and your autonomic dysfunction log here because you're going to keep those three pieces of paper with you at all times.

00:04:46:05 - 00:05:05:01
Speaker 1
They're going to be with you in every single stage. So they have a little star here so it knows that you'll be using these in every stage to show you what to do. So for this one, when and how do we progress the stages? How it'll work is you will progress your heart rate by five beats per minute or one RPE.

00:05:05:02 - 00:05:25:11
Speaker 1
Once you're able to complete 20 minutes in a session without rest, you have no symptom increase during or after exercise. Does it mean you have to be symptom free? It just means, say, euphoric started at a three out of ten. You're exercising and you're still at a three at a ten and you finish. Then you're still out of three out of ten.

00:05:25:23 - 00:05:48:15
Speaker 1
So that's a no symptom increase. Even though you have three out of ten symptoms. And then finally is you have good heart rate control without manipulating the workload. And this are really, really important and interesting piece here. So what manipulating the workload means is say so any given session, we're going to start with your resting heart rate. So let's say your resting heart rate is 70.

00:05:49:02 - 00:06:09:10
Speaker 1
And then I'm going to say to you, okay, for your first level, you're going to go 15 to 20 beats an exercise in that range or above that your resting heart rate and exercise in that range. So that would be 85 to 90 beats per minute. So say you're cruising along, you get your heart rate up to, you know, 85 beats a minute and then all of a sudden you see it start to go up.

00:06:09:10 - 00:06:33:15
Speaker 1
So you slow down and then you see it's getting too low. So you speed up and then you see it's getting too high, so you slow down. That's considered manipulating the workload. And what's really interesting is when they first started studying this protocol, they didn't have this this bullet point in here. So they got some people that were doing great and then they got some people that came back and they just kind of were moving forward the way they should.

00:06:33:18 - 00:06:50:14
Speaker 1
I gosh, why is this? And they realized it was because they were manipulating the workload. Now they were doing anything wrong necessarily. They were being a good patient. You know, you told me to stay at this rate. I'm staying at this rate. But what we found is it doesn't give the body the ability to adapt because it almost keeps changing where the finish line is.

00:06:50:14 - 00:07:11:12
Speaker 1
Right. So what I want you to do for each session, and I'll remind you in each stage is once you get up to your target heart rate, I want you to turn your phone over if that's where you can see your heart rate or whatever it is, stop looking at your heart rate and just go continue at the same speed, same pace until you get that two out of ten or more and you'll stop there.

00:07:11:21 - 00:07:33:09
Speaker 1
So that's what manipulating the workloads means. So to recap, you'll progress five beats per minute or one RPM. Once you're able to exercise for 20 minutes with no rest, you'll have no once you have no increases in symptoms during or after exercise, and once you have good heart rate control and that means not manipulating the workload. So you get up to the desired heart rate.

00:07:33:24 - 00:07:54:03
Speaker 1
You don't look at it anymore and you just begin or you continue at that same pace until your symptoms go up more than two points, then begin to cool down. So how many progressions are in each stage? There's going to be three. So you'll start at your resting heart rate and I'll say, okay, let's do 15 to 20 beats per minute above that heart rate.

00:07:54:03 - 00:08:16:15
Speaker 1
You'll do that, you'll meet the above progression points and they'll say, Great, increase that five beats per minute. Now do 20 to 25 beats, you'll go for the same procedure. They're right. Great. Let's increase it five more and you'll do what would that be? 30 to 35. And once you have three progressions within each stage, you're ready to transition to the next stage.

00:08:17:12 - 00:08:34:05
Speaker 1
And how we do this is we give you a transition week and during the transition week you'll do one day at your new stage and then you'll do one day at your old stage, one day at your new stage, one day at your old stage, and you'll do that for a week and then continue fully to the new stage.

00:08:34:05 - 00:08:57:23
Speaker 1
It's a really great way to help kind of gradually progress the body rather than all at once. And again, this is going to be in every single stage. And I have a checklist for you. Great. So now that you have a general idea of how this is going to work, let's determine your starting point. So starting stage options are going to be the preconditioning stage.

00:08:58:11 - 00:09:14:23
Speaker 1
Stage one, which is supine or lying down. The sun can also be laying on your side or recumbent, which is basically seated, but leaned back a little bit. Now know what's going to start in stage three, four or five, four and five. You're standing and we know we have an upright or we have an intolerance to being upright.

00:09:14:23 - 00:09:32:18
Speaker 1
So that wouldn't make sense why we're all here. And stage three, even what sitting upright can tend to be a little too much for people to say we have more success. If people start in stage one, two or three. But of course you don't want to do any extra than you need to. So let's get you in the stage that makes the most sense for you.

00:09:33:15 - 00:09:59:01
Speaker 1
So the preconditioning stage, this will be for you if you found that you have pretty significant reactions to exercise. Either you exercise even just a little bit and you feel awful and you just can't do anything. You're like, Why is that? I exercise for like 3 minutes, but then I walk to the store and I'm fine. So usually that's the nervous system is getting a little hyper sensitized to movement.

00:09:59:09 - 00:10:26:09
Speaker 1
It's thinking, Oh my God, we're moving. And it's and it's producing symptoms. So if you are having if you're feeling pretty reactive to any exercise, preconditioning features phase is going to be amazing for you. This is also for you. If you're someone who experiences post exertional malaise. And that basically means after doing any exercise, you feel awful. Like you feel like you have the flu, you feel kind of sick.

00:10:26:22 - 00:10:48:03
Speaker 1
And so to determine if you have post exertional malaise, I've put a questionnaire in here and we're going to go over it together. This is a standardized questionnaire that. So it means it's researched. It's the questions and answers. Do what they say they're doing, basically. So it's about valid, I think was the word I was looking for. My goodness.

00:10:48:15 - 00:11:10:06
Speaker 1
So what you're going to do is you're going to take this short questionnaire to let you know if you're going to be in the preconditioning stage or not. So it has two pieces You can see on the top there is questions, one through five, and then on the bottom there's questions six through ten. You will do each one and then you're going to score it over here.

00:11:10:06 - 00:11:34:17
Speaker 1
So you can see the next two pages of four. Section one. It's a positive score. If I'm at least one of the questions you have severity of moderate to high on both are you have moderate to high on both frequency and severity. So basically, do you have two or two or more for both severity and frequency on the same question?

00:11:35:00 - 00:11:59:23
Speaker 1
So example of question number three, you rated a two and four severity, and the next one you rated a three for frequency. That means the same question has both two or more or both over two for severity and for frequency. And if that's the case, you would check. Yes. And if that's also the case, then that can indicate post exertional malaise.

00:11:59:23 - 00:12:26:04
Speaker 1
And we would start you in the preconditioning phase. If you don't have any questions where both the frequency and severity are over two, then you can move on to the second section. And for the second section is if you answered a yes to questions seven or eight and it lasted more than 14 hours, if any of those was a yes, then again, that can indicate post exertion, malaise and you'll do the preconditioning phase.

00:12:26:13 - 00:12:53:20
Speaker 1
If not, you'll do stages one or two. So if you don't have post exertional malaise and you don't have any significant anxiety or overreactions to exercise, then you can begin in stage one or two. And so to choose for stage one or two, I generally say, How are we doing in each one? Do you already know that you can exercise lying down and you're feeling okay with that?

00:12:53:24 - 00:13:12:15
Speaker 1
If you're like, This is so easy for me, I'm sure of that. Then you can start in stage two. If you're someone who you're like, You know, I really haven't tried. I've just been feeling so awful. I'm not really sure. Start in and start on stage one or if you're someone who's like, I've tried exercise sitting up a little bit and it just really doesn't feel good for me.

00:13:12:17 - 00:13:33:13
Speaker 1
You're also going to be in stage one Now, I will say if you are on the fence, please choose the lower stage. The reason for that being it is going to be much easier to test out of a lower stage quicker than to go to a higher stage, struggle with it, feel kind of crappy and then go back.

00:13:33:24 - 00:14:03:20
Speaker 1
I'm not only will it take probably a little longer, but it's also, I think, mentally harder to to go through that rather than starting at something where we can get some good wins and some good experiences under our belt and then gradually progress. So again, if you are post exertion, malaise, high anxiety or really struggling with exercise and it seems nonsensical, it's not crazy, it's not you, it's just you're going to be best starting in the preconditioning phase because we're going to adapt the nervous system in a different way.

00:14:04:15 - 00:14:23:01
Speaker 1
If you know that setting is going to be too much for you or you've struggled lying down, you will start in the lying down. You can also do the sideline if you know you're okay setting up with exercise. You've done. Some of that might feel like a challenge, but a right spot. You can start in the recumbent, especially if you're like, I know lying down.

00:14:23:01 - 00:14:46:21
Speaker 1
I can do that. It's a breeze. No problem. You'll start in recumbent. So again, my recommendation, if you're on the fence, start at the easier stage and then in your workbook on page 28, you can write here the stage that you will be starting in. And then what you can also do is pick the date that you're going to start the program.

00:14:47:16 - 00:15:13:20
Speaker 1
So this could be tomorrow if you're ready or this could be some time next week, whatever it may be. But choose a conscious start date to begin your program. Now that you have your stage and again, pick your start date. So amazing. You are now ready to start your stage. We've done an overview of kind of what to expect.

00:15:13:20 - 00:15:37:23
Speaker 1
You've selected your stage, but before you go, I have one more gentle reminder for you. This graphic was from Dr. Lawrence. I and I was like, It is so good. I just like had to find a place to share it with you. Just a little reminder for pacing to help keep your energy bank. So remember back to your energy bank and pacing.

00:15:37:23 - 00:15:55:14
Speaker 1
So any time we're doing programs like this, we need to create space and energy to be able to do it. I have a colleague who calls it healing on the side. It's really hard to heal on the side. We have to really kind of make it a priority and make space for in our lives. So this is a really great graphic, just to remind you that, you know, here's your available energy.

00:15:55:23 - 00:16:13:07
Speaker 1
Here's your energy. You going today? We got to leave some spare because we're trying to build up our resilience again, right? So it's going to be challenging if we have our available energy here. We use more than we have in a day and then we have a deficit to make up. And that's going to make progressing through these stages much harder.

00:16:14:04 - 00:16:30:20
Speaker 1
Obviously, I know it's not perfect and I know you're human and you have bad days, especially when you're really low energy. But I do want you to consciously ask yourself, how can I make space for this? Where can I adjusting so that I have the extra energy to start to build this resilience again? That's really going to make a big difference.

00:16:30:24 - 00:16:55:05
Speaker 1
Trust me, I've done it both ways. It is much easier when you make space for it for sure. So with that you have learned how we're going to exercise in each stage when and how to progress. You have your tracker and those two sheets that you'll keep with you for every stage will refer to them frequently. And then you have chosen your starting stage and you're ready to get moving at your starting date.

00:16:55:05 - 00:17:01:13
Speaker 1
So congratulations. I will see you next in your stage below.

Preconditioning Stage

00:00:00:08 - 00:00:31:13
Speaker 1
Okay, Preconditioning, welcome to the preconditioning stage of the adapter protocol. Now, our goal here is to desensitize the nervous system to movement. So I don't particularly care how long someone could go. I don't care what their heart rate is. This whole beauty of the preconditioning phase is let's desensitize your nervous system to movement, because oftentimes, if it's having kind of an overreaction or regarding any post exertional malaise, it's just been a little bit over sensitized.

00:00:32:10 - 00:00:51:05
Speaker 1
So this stage looks a little bit different. So inside your workbook here, you're going to see your preconditioning hand out. And again, at the top, the goal here is we're just working on building total minutes a day that you're moving. That's it. Any kind of movement? We just want to build the amount of total minutes in the day that you're moving.

00:00:51:23 - 00:01:14:22
Speaker 1
And we can do this in many ways. You might start with 2 minutes in the morning and that's it. Or maybe you start with 3 minutes in the morning and 3 minutes in the evening and that's it. Or maybe it's just 7 minutes a day. Maybe it's, you know, four times a day, but you're doing it 5 minutes.

00:01:14:22 - 00:01:36:22
Speaker 1
The goal is we just want to get you moving the little bouts and gradually build your total move total minutes in a day. So we don't need it to be consecutive. We just want to work up to 20 minutes of moving in a day. And typically what I tell people is with that, we're going to start with what you have.

00:01:37:02 - 00:01:54:09
Speaker 1
So if you're someone who you're like, okay, I know I can already do like six or 7 minutes, then let's start there and then we can gradually build. If you're someone who's like, I can't move, I just I just feel awful. We start with something as simple as maybe we start with one minute and then we pump it up each day.

00:01:54:16 - 00:02:24:15
Speaker 1
So the goal of this phase is gradually increasing your minutes to total 20 and you can get there in any route. So any combination that gets you up to that point. Now, some exercises that can you you can use, it'll be supportive in this can be anything laying down can be side lying and for a few of these if you need if lying on your side or on your back is bothersome for you or that increases your anxiety, maybe you can do it.

00:02:24:15 - 00:02:44:06
Speaker 1
Setting up in a way that feels good with something like an under the desk bike. So here's a let's talk about a few options you can use for movement. It's not limited to this, but these are some great options to get you started. One of my favorite is heel slides and wall slides. So heal slides as you're just lying on your back.

00:02:44:10 - 00:03:08:03
Speaker 1
Maybe you've got socks on and you're on wood floor and you're just sliding your feet in and out. Call it heel slides. You can do that same thing lying flat on your back, putting your feet up on the wall and sliding your feet up and down for the cold wall slides. So heel slides or wall slides are great.

00:03:08:15 - 00:03:27:06
Speaker 1
You can do something called bridges, so you're lying on your back looking at strength. We're not looking at perfection. We literally just want you to move. And then another one could be leg lifts. So maybe again, your leg on your back, you have one knee bent with your foot on the floor and you're lifting up the other leg.

00:03:28:14 - 00:03:47:22
Speaker 1
You do a few on that side and then switch over to the other side again. The leg lift can be really low. It could be higher. We don't really care as much as we want it to be. Something that just the movement feels good here. Okay. So the general idea is you can do this as long as you like.

00:03:48:04 - 00:04:02:24
Speaker 1
We just want to keep your symptoms below that increase of two out of ten. That's it. We're going to monitor your heart rate. We're not going to monitor how hard or how easy it feels. We're just going to monitor. Can we start moving? Can we do a little bit? And let's stop when symptoms get over two out of ten?

00:04:03:17 - 00:04:32:05
Speaker 1
Super simple. The goal is to bring calming and desensitizing to the nervous system. The other thing that can be supportive in this stage is some nervous system regulation. Maybe some meditation, or you might be like, You know what? It's me sitting silently that freaks me out. So maybe you add a game to it. Maybe as you're sliding your feet up the wall, you take the number three and you keep adding three all the way up to 100.

00:04:32:17 - 00:05:00:15
Speaker 1
Or maybe you name everything you like. That starts with the letter G or is read anything to kind of distract yourself while you're moving. So that's how the preconditioning stage works. It's pretty short and simple, and the goal here to be able to move on is just, can I get to cumulative 20 minutes in a day? Once I'm able to do that, then you can go on to stage one because we've done some of the desensitizing of the nervous system.

00:05:01:07 - 00:05:24:15
Speaker 1
Okay, So ideas to start is start with what you have, start with what you're able to do and build from there. If doing it all at once feels too much, remember break it up into little chunks throughout the day. I don't care how long one sitting is. We just want 20 minutes total. You can do 5 minutes four times a day if you want, and you're only stopping.

00:05:24:15 - 00:05:56:21
Speaker 1
Parameter is once your symptoms increase more than two out of ten from your baseline. Okay. So reach out to me with questions for this. If you need any help here. This is your pre conditioning stage. And then of course, if you need any more suggestions, let me know. Or the under the bike desk is really great here. I if you don't know what that is, I put it at the end of your workbook and I put a couple of Amazon options that are relatively inexpensive that you can use that as well.

00:05:56:21 - 00:06:20:10
Speaker 1
It's a great piece of equipment to have. We use it in stage one and two as well, but you can pick any of those things or any combination. It doesn't have to be all wheel slides. Maybe you do a few wall slides, then you do a few bridges, maybe later in the day you do a few leg lifts, cumulative 20 minutes stop at a two at a time, gradually increase with what you have until you get to 20 minutes.

00:06:20:15 - 00:06:27:17
Speaker 1
Then you'll move to stage two or stage one. Excuse me, Let me know if you have any questions. I will see you inside the community.

Stage 1 - Supine

00:00:00:01 - 00:00:03:20
Speaker 1
All right. Well, welcome to stage one. In stage one, we start.

00:00:04:14 - 00:00:05:08
Speaker 2
With the least.

00:00:05:08 - 00:00:06:03
Speaker 3
Amount of gravity.

00:00:06:03 - 00:00:11:13
Speaker 2
So that is supine, also known as laying down.

00:00:11:13 - 00:00:12:19
Speaker 1
So the details.

00:00:12:19 - 00:00:15:18
Speaker 3
Inside your workbook on your page here for stage.

00:00:15:18 - 00:00:16:13
Speaker 1
One, supine.

00:00:16:13 - 00:00:20:19
Speaker 3
Here is a few different types of exercises that you can choose from. Really, we're open.

00:00:20:19 - 00:00:22:02
Speaker 1
To anything that is.

00:00:22:02 - 00:00:24:04
Speaker 3
Laying on your back or on your side.

00:00:24:04 - 00:00:24:13
Speaker 1
Here.

00:00:24:24 - 00:00:25:17
Speaker 2
And so a.

00:00:25:17 - 00:00:26:22
Speaker 3
Few great options.

00:00:26:22 - 00:00:27:06
Speaker 2
In this.

00:00:27:06 - 00:00:28:21
Speaker 1
Stage is something like wall.

00:00:28:21 - 00:00:30:17
Speaker 2
Slides. So that is.

00:00:30:17 - 00:00:32:03
Speaker 3
Lying on your back with your.

00:00:32:03 - 00:00:34:22
Speaker 1
Feet facing a wall and then you put your feet up on the.

00:00:34:22 - 00:00:36:22
Speaker 2
Wall and slide up and down.

00:00:37:18 - 00:00:38:11
Speaker 3
Those are wall.

00:00:38:11 - 00:00:40:03
Speaker 2
Slides.

00:00:40:03 - 00:00:41:09
Speaker 1
You can also do heel.

00:00:41:09 - 00:00:42:00
Speaker 2
Slides.

00:00:42:00 - 00:00:43:16
Speaker 3
So you're lying on your back.

00:00:43:18 - 00:00:44:05
Speaker 1
Maybe you've got.

00:00:44:05 - 00:00:44:19
Speaker 2
Some socks.

00:00:44:19 - 00:00:47:04
Speaker 3
On, you're on a wood floor and you're just sliding.

00:00:47:04 - 00:00:50:18
Speaker 2
Across the floor. You can also do something.

00:00:50:18 - 00:00:55:17
Speaker 3
Like marching here. So you're laying on your back with your knees bent and you're just marching your legs.

00:00:55:17 - 00:00:56:10
Speaker 2
Up and down.

00:00:57:09 - 00:01:02:09
Speaker 3
So here's a few exercises to choose from here. The plots reformer is also great here. As long as you're.

00:01:02:09 - 00:01:04:12
Speaker 1
Staying flat and not getting up and down.

00:01:04:12 - 00:01:05:10
Speaker 2
And moving all around.

00:01:06:05 - 00:01:11:14
Speaker 3
So those are a few exercises, aerobic exercise is to choose from. And then for your strength for this.

00:01:11:14 - 00:01:12:09
Speaker 1
Stage, it.

00:01:12:09 - 00:01:14:04
Speaker 2
Is a supine strength class.

00:01:14:12 - 00:01:15:19
Speaker 1
We have it already in.

00:01:15:19 - 00:01:16:17
Speaker 3
The membership for you.

00:01:16:17 - 00:01:17:17
Speaker 1
So all you need to do is.

00:01:17:17 - 00:01:19:21
Speaker 3
Click here or if you have this printed out, you.

00:01:19:21 - 00:01:20:01
Speaker 1
Can.

00:01:20:01 - 00:01:20:22
Speaker 2
Scan this.

00:01:20:22 - 00:01:22:23
Speaker 3
QR code here to take you directly.

00:01:22:23 - 00:01:26:08
Speaker 2
There. And typically.

00:01:26:08 - 00:01:27:20
Speaker 3
What we recommend is remember we.

00:01:27:20 - 00:01:29:04
Speaker 2
Book about about 20 minutes.

00:01:29:04 - 00:01:29:23
Speaker 3
Of strength.

00:01:29:23 - 00:01:30:10
Speaker 1
Training.

00:01:31:04 - 00:01:33:24
Speaker 2
At the same position. So obviously.

00:01:33:24 - 00:01:34:06
Speaker 3
We're going to.

00:01:34:06 - 00:01:35:22
Speaker 1
Be supine for stage one.

00:01:35:22 - 00:01:36:20
Speaker 2
And then we'll talk about the.

00:01:36:20 - 00:01:37:17
Speaker 3
Heart rate here in a.

00:01:37:17 - 00:01:38:03
Speaker 2
Moment.

00:01:39:06 - 00:01:41:07
Speaker 3
You'll notice that your exercise class.

00:01:41:07 - 00:01:41:18
Speaker 1
Can be up.

00:01:41:18 - 00:01:43:01
Speaker 3
To an hour, but you can really.

00:01:43:01 - 00:01:43:15
Speaker 2
Modify that.

00:01:43:15 - 00:01:46:02
Speaker 1
You can choose the exercises you like out of it. Maybe you.

00:01:46:02 - 00:01:47:01
Speaker 3
Do the warm up with.

00:01:47:01 - 00:01:49:07
Speaker 1
Britney in there and then you just do 20 minutes.

00:01:49:07 - 00:01:50:07
Speaker 2
Of the ones you like.

00:01:51:06 - 00:01:52:14
Speaker 3
And then do your cooldown.

00:01:53:08 - 00:01:54:24
Speaker 2
But we have that exercise class.

00:01:54:24 - 00:01:55:19
Speaker 3
In here for.

00:01:55:19 - 00:01:57:15
Speaker 2
You. And then just a note.

00:01:57:15 - 00:01:58:23
Speaker 3
If lying in your back is not.

00:01:58:23 - 00:02:00:12
Speaker 1
Accessible, you can also do things.

00:02:00:12 - 00:02:03:24
Speaker 2
On your side.

00:02:03:24 - 00:02:05:02
Speaker 1
So we need to.

00:02:05:02 - 00:02:06:14
Speaker 3
Get your resting heart rate.

00:02:06:14 - 00:02:09:20
Speaker 1
So that you can begin exercising in the supine stage.

00:02:10:04 - 00:02:11:00
Speaker 2
So to do that.

00:02:12:01 - 00:02:13:19
Speaker 1
You what you will do is.

00:02:13:19 - 00:02:14:05
Speaker 2
You'll.

00:02:14:08 - 00:02:19:07
Speaker 3
When you're I should say, when you're ready to exercise, what you'll do is you'll lay in a quiet place for three to.

00:02:19:07 - 00:02:19:14
Speaker 2
Five.

00:02:19:14 - 00:02:24:13
Speaker 3
Minutes wearing your heart rate monitor at the end of that time, you're going to record your heart rate.

00:02:25:05 - 00:02:25:18
Speaker 2
And that.

00:02:25:18 - 00:02:26:11
Speaker 1
Will be.

00:02:26:12 - 00:02:30:00
Speaker 3
Your resting heart rate. Now, again, if you're going to do.

00:02:30:00 - 00:02:30:10
Speaker 1
R.P.

00:02:30:12 - 00:02:33:02
Speaker 3
Ease the rate of perceived exertion, you're on a beta blocker.

00:02:33:02 - 00:02:33:17
Speaker 1
You won't need to.

00:02:33:17 - 00:02:34:18
Speaker 3
Do your heart rate because it won't.

00:02:34:18 - 00:02:35:04
Speaker 2
Apply.

00:02:35:05 - 00:02:37:00
Speaker 3
But for everyone else who's using heart rate.

00:02:37:16 - 00:02:39:23
Speaker 2
You'll lie down quiet place at.

00:02:39:23 - 00:02:40:08
Speaker 1
The end.

00:02:40:08 - 00:02:40:19
Speaker 3
Of three to.

00:02:40:19 - 00:02:41:14
Speaker 2
5 minutes.

00:02:41:23 - 00:02:45:21
Speaker 3
Take your resting heart rate and write it here.

00:02:46:17 - 00:02:47:19
Speaker 2
Now, one note.

00:02:48:00 - 00:02:49:11
Speaker 1
For some people they may say.

00:02:49:11 - 00:02:50:20
Speaker 3
You know what? My resting heart rate's like.

00:02:50:20 - 00:02:51:23
Speaker 2
71 day and then the.

00:02:51:23 - 00:02:52:23
Speaker 1
Next day it's 80.

00:02:52:23 - 00:02:56:16
Speaker 2
And the next day at 65 and it's just all over the place. So how do I.

00:02:57:02 - 00:03:02:23
Speaker 1
Keep exercising when my resting heart rate changes? Because we use the same one every day. So if you know.

00:03:02:23 - 00:03:03:12
Speaker 3
That yours is.

00:03:03:12 - 00:03:03:22
Speaker 2
Going up.

00:03:03:22 - 00:03:04:23
Speaker 3
Down, and all around.

00:03:04:23 - 00:03:05:09
Speaker 1
You may.

00:03:05:09 - 00:03:08:12
Speaker 3
Want to take your resting heart rate before each exercise.

00:03:08:12 - 00:03:10:05
Speaker 2
Session. And I think you'll.

00:03:10:05 - 00:03:11:16
Speaker 3
Find over time that it's going to start to.

00:03:11:16 - 00:03:13:05
Speaker 2
Level out on its own and.

00:03:13:05 - 00:03:14:22
Speaker 1
Then you can just use that one reading.

00:03:15:10 - 00:03:18:07
Speaker 3
If you know your resting heart rate is relatively stable.

00:03:18:16 - 00:03:20:02
Speaker 2
You can get the number once and.

00:03:20:02 - 00:03:20:15
Speaker 1
Then we use.

00:03:20:15 - 00:03:21:13
Speaker 3
That throughout the rest of.

00:03:21:13 - 00:03:28:14
Speaker 2
The time. I just wanted to mention that because I know that will come up for some folks. So you have.

00:03:28:14 - 00:03:32:19
Speaker 3
Your types of exercises you can choose from. You now have your starting heart rate.

00:03:32:23 - 00:03:34:01
Speaker 2
So what.

00:03:34:01 - 00:03:35:13
Speaker 1
Stages do I need to do.

00:03:35:22 - 00:03:36:00
Speaker 2
To.

00:03:36:01 - 00:03:39:16
Speaker 3
Exercise? So here is your checklist.

00:03:39:16 - 00:03:44:01
Speaker 2
You'll have a checklist in every stage. So stage one supine checklist.

00:03:44:02 - 00:03:46:08
Speaker 3
You're going to write your supine resting heart rate at the.

00:03:46:08 - 00:03:47:18
Speaker 2
Top. So it applies.

00:03:48:03 - 00:03:50:10
Speaker 3
And then you're going to start at level one.

00:03:50:10 - 00:03:50:22
Speaker 2
And you can.

00:03:50:22 - 00:03:51:05
Speaker 1
See.

00:03:51:05 - 00:03:52:02
Speaker 2
Level one is.

00:03:52:02 - 00:03:53:22
Speaker 1
15 to 20 beats.

00:03:53:22 - 00:03:54:13
Speaker 2
Above.

00:03:54:13 - 00:03:56:18
Speaker 3
A resting heart rate, or.

00:03:57:05 - 00:03:57:17
Speaker 2
Two out of.

00:03:57:17 - 00:03:58:08
Speaker 3
Ten are.

00:03:58:08 - 00:04:02:13
Speaker 1
Peace. And the goal is going to be is going to be to build.

00:04:02:13 - 00:04:03:06
Speaker 3
That for 20.

00:04:03:06 - 00:04:05:22
Speaker 2
Minutes. So you're going to say, okay, my level one.

00:04:06:08 - 00:04:07:06
Speaker 3
Say my heart rate's.

00:04:07:06 - 00:04:07:15
Speaker 2
At.

00:04:08:02 - 00:04:09:00
Speaker 1
70 as.

00:04:09:00 - 00:04:09:17
Speaker 2
My resting.

00:04:10:06 - 00:04:10:20
Speaker 1
So that means.

00:04:10:20 - 00:04:11:07
Speaker 2
My level.

00:04:11:07 - 00:04:12:12
Speaker 3
One heart rate rate.

00:04:12:12 - 00:04:14:03
Speaker 1
Is going to be 85 to 90.

00:04:15:08 - 00:04:20:09
Speaker 3
Or let's say your resting heart rate's 80. So then your exercise.

00:04:20:09 - 00:04:22:01
Speaker 1
Rate would be 95.

00:04:22:01 - 00:04:26:01
Speaker 3
To 100. It's going to take your resting heart rate. You're going to add.

00:04:26:01 - 00:04:29:13
Speaker 1
15 to 20 beats per minute, and that's going to be how you.

00:04:29:13 - 00:04:30:13
Speaker 3
Exercise for level.

00:04:30:13 - 00:04:32:23
Speaker 2
One.

00:04:32:23 - 00:04:34:01
Speaker 1
Remember these sheets that.

00:04:34:01 - 00:04:35:03
Speaker 3
I said to you are going to star.

00:04:35:03 - 00:04:35:13
Speaker 1
And use them.

00:04:35:13 - 00:04:36:06
Speaker 2
All the time.

00:04:36:20 - 00:04:45:19
Speaker 3
Here's how are you going to perform your exercise? So when you're ready, you're going to have your heart rate monitor on. You'll record how your symptoms are feeling.

00:04:46:02 - 00:04:46:22
Speaker 2
On a scale of.

00:04:46:22 - 00:04:47:07
Speaker 3
Zero to.

00:04:47:07 - 00:04:47:17
Speaker 2
Ten.

00:04:48:13 - 00:04:50:09
Speaker 1
You'll begin your warmup.

00:04:51:15 - 00:04:52:18
Speaker 2
At one one.

00:04:52:18 - 00:04:54:23
Speaker 1
RPE and anything below.

00:04:54:24 - 00:04:58:03
Speaker 3
Your target heart rate and your resting heart rate is appropriate here for a.

00:04:58:03 - 00:04:58:14
Speaker 2
Warmup.

00:04:58:19 - 00:04:59:19
Speaker 1
But super easy.

00:05:00:04 - 00:05:00:19
Speaker 2
Then you'll begin.

00:05:00:19 - 00:05:04:06
Speaker 3
To X-ray exercise at your target heart rate. So if you were.

00:05:04:06 - 00:05:04:12
Speaker 2
That.

00:05:04:12 - 00:05:05:07
Speaker 1
70.

00:05:05:07 - 00:05:06:07
Speaker 3
Was your resting.

00:05:06:15 - 00:05:07:15
Speaker 1
You would exercise.

00:05:07:15 - 00:05:07:20
Speaker 2
At.

00:05:08:15 - 00:05:09:18
Speaker 1
85 to 90.

00:05:10:03 - 00:05:10:15
Speaker 3
So whatever.

00:05:10:15 - 00:05:14:16
Speaker 1
15 to 20 beats above your heart rate is, and you'll do.

00:05:14:16 - 00:05:17:01
Speaker 3
That until your symptoms increase more than two.

00:05:17:01 - 00:05:18:11
Speaker 2
Points on a ten point scale.

00:05:18:20 - 00:05:19:15
Speaker 3
From where you started.

00:05:20:10 - 00:05:22:05
Speaker 2
When that happens, you'll cool down.

00:05:23:09 - 00:05:29:12
Speaker 3
And then you'll record your workout on your handout over here, over on the right. So you'll record the day.

00:05:30:00 - 00:05:30:16
Speaker 1
How many minutes.

00:05:30:16 - 00:05:31:16
Speaker 2
You did the.

00:05:31:16 - 00:05:32:16
Speaker 3
Type of exercise you.

00:05:32:16 - 00:05:33:12
Speaker 2
Chose.

00:05:34:10 - 00:05:35:16
Speaker 3
The heart rate range.

00:05:36:07 - 00:05:37:02
Speaker 2
So on and so forth.

00:05:37:02 - 00:05:38:19
Speaker 1
So maybe it would be day one.

00:05:39:12 - 00:05:41:07
Speaker 2
Total exercise time.

00:05:41:07 - 00:05:41:13
Speaker 1
Eight.

00:05:41:13 - 00:05:45:19
Speaker 2
Minutes type of exercise, wall slides.

00:05:46:11 - 00:05:53:11
Speaker 1
Heart rate achieved 85 to 96 or 15 to 20 beats above. Maybe before.

00:05:53:11 - 00:05:54:22
Speaker 3
Exercise you were to.

00:05:55:05 - 00:05:58:05
Speaker 2
You stopped because you got to a five and.

00:05:58:05 - 00:05:59:19
Speaker 1
It took you ten.

00:05:59:19 - 00:06:00:22
Speaker 3
Minutes to recover.

00:06:00:22 - 00:06:03:13
Speaker 2
Back to the two. So how long did.

00:06:03:13 - 00:06:06:04
Speaker 3
It take you to cover? And then if you want to do your wellness score, you can.

00:06:06:18 - 00:06:10:07
Speaker 2
Start would be one day of exercise the next day.

00:06:10:07 - 00:06:14:11
Speaker 1
Assuming you feel okay, we're going to do the same thing and you'll continue to do.

00:06:14:11 - 00:06:15:14
Speaker 2
That until.

00:06:15:14 - 00:06:16:16
Speaker 1
You get to the when.

00:06:16:16 - 00:06:17:10
Speaker 3
You can progress.

00:06:17:21 - 00:06:18:13
Speaker 2
Until you can.

00:06:18:13 - 00:06:19:05
Speaker 3
Exercise.

00:06:19:05 - 00:06:19:12
Speaker 2
At.

00:06:19:12 - 00:06:20:00
Speaker 3
That heart.

00:06:20:00 - 00:06:22:05
Speaker 1
Rate for 20 minutes.

00:06:22:05 - 00:06:24:08
Speaker 2
Without rest and without.

00:06:24:08 - 00:06:26:11
Speaker 3
An increase of symptoms during or after.

00:06:27:02 - 00:06:32:03
Speaker 2
Again, without manipulating the heart rate workload. Okay, that makes sense.

00:06:32:20 - 00:06:33:24
Speaker 1
So you'll do.

00:06:35:03 - 00:06:35:11
Speaker 2
You'll do.

00:06:35:11 - 00:06:36:13
Speaker 1
That until you can.

00:06:36:13 - 00:06:40:20
Speaker 2
Get to 20 minutes. I'm not having symptoms. I don't manipulate heart rate.

00:06:40:20 - 00:06:41:00
Speaker 3
Okay.

00:06:41:00 - 00:06:42:04
Speaker 1
Let me increase.

00:06:42:13 - 00:06:43:00
Speaker 2
By five.

00:06:43:00 - 00:06:43:08
Speaker 1
Beats per.

00:06:43:08 - 00:06:46:02
Speaker 3
Minute. So on your checklist here, you.

00:06:46:02 - 00:06:49:07
Speaker 2
Could say, okay, check level one. I can now do 20 minutes at the.

00:06:49:08 - 00:06:50:22
Speaker 1
15 to 20 beats.

00:06:50:22 - 00:06:54:00
Speaker 2
I'm good. Let me go to level two. Level two says.

00:06:54:00 - 00:06:56:02
Speaker 1
15 to 25 beats above.

00:06:56:02 - 00:06:58:02
Speaker 3
My resting heart rate or three.

00:06:58:02 - 00:06:58:17
Speaker 2
Out of ten.

00:06:58:17 - 00:07:02:00
Speaker 3
What's a 3 to 0? I should say three out of ten are peace.

00:07:02:13 - 00:07:03:14
Speaker 2
So I'm going to say, okay, I'm.

00:07:03:14 - 00:07:05:02
Speaker 1
Now 20 to 25 beats.

00:07:05:02 - 00:07:08:00
Speaker 3
Above my resting heart rate. Here's my.

00:07:08:00 - 00:07:09:16
Speaker 2
Exercise session.

00:07:09:16 - 00:07:10:15
Speaker 3
Have my heart rate.

00:07:11:05 - 00:07:14:21
Speaker 2
Get my symptoms at the beginning, do my warmup.

00:07:15:08 - 00:07:17:06
Speaker 3
Exercise at the target heart rate.

00:07:17:06 - 00:07:18:01
Speaker 2
So now I'm.

00:07:18:02 - 00:07:20:00
Speaker 1
20 to 25 beats per minute.

00:07:20:00 - 00:07:23:10
Speaker 2
Above. I'm going to do that till I get to two out of ten.

00:07:23:15 - 00:07:25:15
Speaker 3
Or above two at a ten from where I started.

00:07:27:00 - 00:07:29:02
Speaker 2
When I do that, I'm going to cool down, then I'm.

00:07:29:02 - 00:07:31:23
Speaker 3
Going to record it. I'm going to repeat.

00:07:31:23 - 00:07:33:12
Speaker 2
That until I can do that heart.

00:07:33:12 - 00:07:33:19
Speaker 3
Rate.

00:07:33:24 - 00:07:34:23
Speaker 2
For 20 minutes.

00:07:35:11 - 00:07:36:00
Speaker 3
Straight with.

00:07:36:00 - 00:07:36:15
Speaker 2
No rest.

00:07:37:01 - 00:07:39:18
Speaker 3
With no increase of symptoms during or after.

00:07:40:12 - 00:07:41:00
Speaker 2
And without.

00:07:41:00 - 00:07:41:15
Speaker 1
Manipulating.

00:07:41:15 - 00:07:42:05
Speaker 3
The workload.

00:07:43:17 - 00:07:44:18
Speaker 1
Great. Once you can do.

00:07:44:18 - 00:07:46:08
Speaker 2
That and say, okay, now.

00:07:46:08 - 00:07:47:01
Speaker 3
I can progress.

00:07:47:06 - 00:07:49:23
Speaker 1
Five beats a minute, you'll go back.

00:07:49:23 - 00:07:50:04
Speaker 3
To your.

00:07:50:04 - 00:07:51:12
Speaker 2
Checklist, you'll check off.

00:07:51:12 - 00:07:51:19
Speaker 3
Number.

00:07:51:19 - 00:07:54:00
Speaker 2
Two, you'll say, okay, now.

00:07:54:00 - 00:07:54:20
Speaker 1
I need to be able to.

00:07:54:20 - 00:07:56:03
Speaker 2
Exercise at 20.

00:07:56:03 - 00:07:57:22
Speaker 1
5 to 30 beats per minute.

00:07:57:22 - 00:08:00:09
Speaker 3
Above my resting heart rate or four out.

00:08:00:09 - 00:08:00:21
Speaker 2
Of ten.

00:08:01:03 - 00:08:01:19
Speaker 1
R.p.

00:08:02:21 - 00:08:09:00
Speaker 3
So you're going to go back to your how to perform on your heart rate monitor, get your symptom score.

00:08:09:15 - 00:08:10:07
Speaker 2
Warm up.

00:08:11:04 - 00:08:13:06
Speaker 3
Exercise at that target heart rate with.

00:08:13:06 - 00:08:14:10
Speaker 2
That new added five.

00:08:14:10 - 00:08:14:21
Speaker 1
Beats per.

00:08:14:21 - 00:08:16:23
Speaker 3
Minute until you reach two.

00:08:16:23 - 00:08:17:14
Speaker 2
Out of ten.

00:08:17:21 - 00:08:21:03
Speaker 3
Or more than two out of ten from where you started. You'll begin your.

00:08:21:03 - 00:08:22:04
Speaker 2
Cooldown and.

00:08:22:04 - 00:08:22:20
Speaker 3
You'll record.

00:08:23:15 - 00:08:28:05
Speaker 2
You'll continue to do that until you can do that for 20 minutes with no rest.

00:08:28:18 - 00:08:32:12
Speaker 3
No increased symptoms during or after, no manipulating the.

00:08:32:12 - 00:08:37:02
Speaker 2
Workload. Once that's done, you can also you can check level three.

00:08:37:02 - 00:08:37:16
Speaker 1
Okay, my great.

00:08:37:16 - 00:08:38:19
Speaker 2
So I've done all.

00:08:38:19 - 00:08:39:03
Speaker 1
Three.

00:08:39:03 - 00:08:40:10
Speaker 2
Levels. I've completed.

00:08:40:10 - 00:08:40:12
Speaker 3
The.

00:08:40:12 - 00:08:42:03
Speaker 1
Progressions in this stage.

00:08:42:17 - 00:08:43:06
Speaker 2
So at that.

00:08:43:06 - 00:08:43:22
Speaker 1
Point you'll.

00:08:43:22 - 00:08:45:15
Speaker 3
Be ready to do your transition.

00:08:45:15 - 00:08:46:16
Speaker 1
Week.

00:08:46:16 - 00:08:47:20
Speaker 3
And the transition week works.

00:08:47:20 - 00:08:48:06
Speaker 1
The same.

00:08:48:06 - 00:08:51:01
Speaker 3
In every stage. So you're going to do.

00:08:51:01 - 00:08:52:06
Speaker 1
One day.

00:08:52:06 - 00:08:53:18
Speaker 2
At the new level, one in the.

00:08:53:18 - 00:08:56:09
Speaker 1
New stage, and then you're going to one day.

00:08:56:22 - 00:08:57:11
Speaker 3
On your old.

00:08:57:11 - 00:08:59:17
Speaker 1
Stage, one day at your new stage.

00:09:00:06 - 00:09:02:08
Speaker 2
One day at my old stage when they have.

00:09:02:09 - 00:09:04:07
Speaker 1
A new stage. Once you've done.

00:09:04:07 - 00:09:05:06
Speaker 3
This for a week.

00:09:05:06 - 00:09:07:04
Speaker 2
Successfully, you can then.

00:09:07:04 - 00:09:07:17
Speaker 1
Fully.

00:09:07:17 - 00:09:08:09
Speaker 3
Transition.

00:09:08:09 - 00:09:08:21
Speaker 2
To the next.

00:09:08:21 - 00:09:09:07
Speaker 1
Stage.

00:09:10:20 - 00:09:12:03
Speaker 2
So say.

00:09:12:03 - 00:09:14:22
Speaker 1
Maybe you are working out six days a week, maybe you have.

00:09:14:22 - 00:09:15:24
Speaker 2
One extra.

00:09:16:11 - 00:09:17:12
Speaker 3
Aerobic exercise.

00:09:17:12 - 00:09:22:17
Speaker 1
Here or maybe you're only doing four days a week. So then you would maybe cut off one of these. I put.

00:09:22:17 - 00:09:24:10
Speaker 2
Five. Just as a general.

00:09:25:03 - 00:09:26:01
Speaker 1
You can do the amount of.

00:09:26:01 - 00:09:28:12
Speaker 3
Days you're working for. Again, we're looking for somewhere.

00:09:28:12 - 00:09:30:16
Speaker 1
Between like 5 to 6 days a week being able.

00:09:30:16 - 00:09:31:17
Speaker 2
To do this. If we've got.

00:09:31:17 - 00:09:32:13
Speaker 1
You at the right at the.

00:09:32:13 - 00:09:35:19
Speaker 2
Right to us. Okay. So that's how that works.

00:09:37:18 - 00:09:39:14
Speaker 1
I will be in the group. Let me see if I have.

00:09:39:14 - 00:09:40:02
Speaker 2
Another sign up.

00:09:40:03 - 00:09:41:22
Speaker 1
I will be in the group. If you have any.

00:09:41:22 - 00:09:42:15
Speaker 2
Questions on.

00:09:42:15 - 00:09:43:12
Speaker 3
How this works.

00:09:44:02 - 00:09:46:06
Speaker 1
Please just let me know. It is the same.

00:09:46:06 - 00:09:46:21
Speaker 3
Rhythm.

00:09:46:21 - 00:09:47:01
Speaker 2
In.

00:09:47:01 - 00:09:48:03
Speaker 1
Every stage, so I.

00:09:48:03 - 00:09:49:04
Speaker 3
Think you're really going to get a.

00:09:49:04 - 00:09:49:17
Speaker 2
Hang of it.

00:09:50:07 - 00:09:53:06
Speaker 1
The one thing I do want to note is I think personally.

00:09:53:06 - 00:09:55:23
Speaker 2
Supine is one of the more challenging stages.

00:09:56:10 - 00:09:57:09
Speaker 1
Only because it's.

00:09:57:09 - 00:09:58:16
Speaker 3
Weird to exercise.

00:09:58:16 - 00:10:03:07
Speaker 2
Lying down. So I found 20 minutes of wall slides is kind of a lot.

00:10:03:08 - 00:10:04:22
Speaker 3
Like your quads are going to.

00:10:04:22 - 00:10:06:22
Speaker 2
Get kind of sore. So what I ended up.

00:10:06:22 - 00:10:07:11
Speaker 1
Doing.

00:10:07:18 - 00:10:08:10
Speaker 3
Personally in the.

00:10:08:10 - 00:10:08:22
Speaker 1
Stage.

00:10:09:06 - 00:10:12:07
Speaker 2
Is I did 20 minutes of consistent.

00:10:12:07 - 00:10:12:22
Speaker 3
Exercise.

00:10:12:22 - 00:10:13:17
Speaker 1
But maybe I did like.

00:10:13:17 - 00:10:20:08
Speaker 2
10 minutes of wall slides and then I did like 10 minutes of marching because wall slides was like a lot. So I just want you to know.

00:10:20:08 - 00:10:21:10
Speaker 1
If you need to mix.

00:10:21:10 - 00:10:21:24
Speaker 2
And match.

00:10:21:24 - 00:10:22:24
Speaker 3
Exercises.

00:10:22:24 - 00:10:23:08
Speaker 1
In.

00:10:23:08 - 00:10:25:09
Speaker 2
This, in this.

00:10:25:09 - 00:10:27:04
Speaker 1
Lesson, you can. We just need you.

00:10:27:04 - 00:10:28:08
Speaker 3
Exercising for 20.

00:10:28:08 - 00:10:31:19
Speaker 2
Minutes continuously at the same exertion. Okay.

00:10:32:11 - 00:10:34:15
Speaker 1
So if you have any other questions or anything comes.

00:10:34:15 - 00:10:35:13
Speaker 3
Up as you get started.

00:10:36:05 - 00:10:37:02
Speaker 1
You can find me in the.

00:10:37:02 - 00:10:38:17
Speaker 3
Group and I'll be happy to support.

Stage 2 - Recumbent

00:00:00:08 - 00:00:21:16
Speaker 1
All right. Welcome to stage two. So stage two is recumbent. And what recumbent means is sitting but leaned back a little bit, kind of like this guy you're sitting, but lean back here. So that is recumbent stage two. Now, here the details inside your workbook on page 33, you're going to see if this is the first stage you're with us, you're going to see.

00:00:21:16 - 00:00:44:17
Speaker 1
And every one of these, you're going to have the types of exercise you can choose from and where to take your strength class to start. So for stage two, a few different types of exercises that you may choose from and you can choose one is maybe a recumbent bike or maybe a bike that's sitting straight up. But we just have you lean back a little bit or lean back into a chair or to walk a rowing machine is also okay here.

00:00:44:17 - 00:01:03:12
Speaker 1
As long as the pulling doesn't bother your neck, swimming can be okay here. You can also use the under the desk pedal bike that we mentioned before that I have linked at the very end of your workbook. If you want to see what a couple of these look like and to do this in a recumbent position, you would simply be sitting in a chair.

00:01:03:20 - 00:01:30:07
Speaker 1
You would scoot your bottom forward a little bit and then you lean back so that you're in a recumbent position. Okay, So you can choose any one of these, so you can start or highlight whichever type of exercise you would like to do. I would say choose what's accessible and something you enjoy. And then for straight classes, as in every stage, we perform the strength exercises in the same position that we perform the aerobic exercise.

00:01:30:07 - 00:01:59:03
Speaker 1
Because remember, we're adapting to positions here. So for the strength class you're going to see there's a seated class in the program that you can found find linked where it says here or you can scan it. Now it's a sitting class, but we want you to be recumbent. So what you're going to do at the beginning of the class is you're going to again be sitting in your chair and you're going to scoot forward and then you're going to lean back and have your backrest against the back of the chair that makes it recumbent.

00:01:59:04 - 00:02:20:08
Speaker 1
Okay, So you'll do that for your strength portion. So we need to watch or we need to record your resting heart rate for those of you using heart rate in the stage. So in this stage we're actually going to continue to use your supine heart rate and later stages. You're going to notice that in the standing stage we're going to use your standing heart rate.

00:02:20:15 - 00:02:37:12
Speaker 1
But in this stage, we're still going to use your heart rate. Supine. And that means laying down. So we're going to use your what your heart rate is laying down. To get your resting heart rate. You'll lay flat in a quiet space for 3 to 5 minutes where in your heart rate monitor and at the end you'll record your heart rate.

00:02:37:19 - 00:03:00:11
Speaker 1
That will be your resting heart rate for this stage. So once you have that, you can record it here. Now maybe you're starting at stage two with us. So you didn't hear my spiel in stage one. But if you are someone who you're like, You know what? My resting heart rate is really different every day. Sometimes I take it in at 70, other times it's 80, then it's 55.

00:03:00:11 - 00:03:26:00
Speaker 1
It's all over the place. I don't know how I'm going to use my starting heart or this heart rate throughout the whole stage. And if that's you, what I would say is you'll need to take your resting heart rate before each exercise session and use whatever it is for that day. If you're someone who does not fluctuate much, you can just take it one time and then that will be the heart rate that will be using for this stage.

00:03:26:00 - 00:03:57:20
Speaker 1
So here is your success checklist. You'll use this worksheet to check off your progress as you go. It's the same for every stage, so here is your stage two. You're going to write your resting heart rate at the top. Again, it's taken lying down, so you'll write your resting heart rate at the top and then you'll say, okay, level one, my first stage able to exercise 15 to 20 beats above my resting heart rate or two out of ten r.p For those using your R.P, she'll say, okay, 15 to 20.

00:03:57:20 - 00:04:36:23
Speaker 1
Let's say your resting heart rate was 70. That means your level one exercise is going to be 85 to 90 because you're taking 70 and you're adding 15 to 20 beats a minute. So great. You're going to go to how to perform your exercise. You say, okay, I have my heart rate monitor on. I have my symptoms On a scale of 0 to 10, how I'm doing right now, I'm going to begin my warmup and then going to exercise that my target heart rate, which is that 15 to 20 beats per minute above your resting until my symptoms increase to more than two points on a ten point scale.

00:04:37:11 - 00:04:57:06
Speaker 1
So say your symptoms were at three out of ten. When you start. So once you get to a six, you would stop and you'd begin your cooldown and then you'll record it on your sheet. So it might look like, okay, day one, or maybe this is day 20 for you. Here's the total time I was able to exercise at my heart rate.

00:04:57:06 - 00:05:22:24
Speaker 1
So we're taking this this middle note, our middle spot, the amount of minutes you're at your total heart rate, not including warmup and cooldown. You'll do the type of exercise maybe you did. Maybe you did. The under the desk back here leaned back. The heart rate you achieved or the heart rate that you were in, where your symptoms were begin, where your symptoms were when you stopped.

00:05:22:24 - 00:05:36:17
Speaker 1
And then you're going to take a note later on of like, how long did it take me to return back to where I started? So say you started with your symptoms out of three out of ten. How long does it take you to get back to your symptoms? Out of three. Out of ten. That gives us an idea of how well the nervous system is recovering.

00:05:37:11 - 00:06:00:14
Speaker 1
And then if you'd like, you can include a wellness score. So zero is I am not great tennis. I'm doing fantastic. So you'll continue to do that until you're ready to progress. And remember, we know we're ready to progress when you can complete 20 minutes in one session without rest at your target heart rate. You have no increases or symptoms during or after.

00:06:01:01 - 00:06:19:23
Speaker 1
But this does not mean you need to be symptom free. So say you start at a three out of ten, you exercise for 20 minutes, you're still out of three. Out of ten, you recover. You're still out of three. Out of ten. That's okay. Your symptoms haven't increased during or after exercise. And remember, good heart rate control without manipulating the workload.

00:06:19:23 - 00:06:36:22
Speaker 1
Now, again, if you work with me on stage one, I really want to make sure that we're aware of this. So manipulating the workload means, let's say your target heart rate was 90 and you're at 90, and then you're like, Oh, it's getting a little low. So you go faster and then it gets too high. So you go slower and it gets too low.

00:06:36:24 - 00:06:56:16
Speaker 1
You go faster. That's manipulating the workload. What we want you to do is do your warmup, start exercising, get to your target heart rate, then stop looking at the heart rate and just go and tell your symptoms. Go more than two points out of ten. So that's how that would work. So then say you're like, okay, I can now do this for 20 minutes without rest.

00:06:56:16 - 00:07:17:02
Speaker 1
My symptoms aren't worse and I didn't do any heart rate manipulating. So you're going to say, Great, I'm going to check off level one. So now I'm at level two where able to exercise 20 to 25 beats above my resting heart rate. So let's say your resting heart rate was 70. Now that would be 90 to 95 beats track.

00:07:17:03 - 00:07:42:12
Speaker 1
Okay, I'm at level two. You would go to how to perform your exercise. Can you have your heart rate monitor on? If you're using heart rate, you record where your symptoms are at when you start do your warmup, then you're going to begin exercising at your new level to target heart rate so that 20 to 25 beats above your resting until your symptoms increase to more than two out of ten from where you started.

00:07:42:24 - 00:08:08:15
Speaker 1
Once you hit that, you'll do your cooldown and you'll record on your handout again. You'll do that until you can do that heart rate at level two for 20 minutes in one session without rest, No, no increase of symptoms during or after exercise and good control of your heart rate without manipulating your workload. So once you can do that, you'll say, okay, check and you'll go to level three.

00:08:09:00 - 00:08:35:07
Speaker 1
And level three is the final level where you do that for 20 to 25 beats per minute, you can go back to the same thing. Okay, got my heart rate monitor on if that's what you're using. I set my symptoms for where my symptoms are out for the day, do my warmup exercise at my new target heart rate for that level three until my symptoms go more than two points out of ten from where I started all down record.

00:08:35:07 - 00:08:52:07
Speaker 1
So you can see how this process works. It's the same in every stage. You're going to get the hang of it pretty quick. And then once you have completed that third one and say, Oh, level three is done, I'm ready for my transition week. And remember, we don't go immediately to the next stage. We give our nervous system a little extra love.

00:08:52:21 - 00:09:12:13
Speaker 1
It just helps you be that much more successful. Where you'll do your next day will be at your new stage and the day after that will be at your old stage and you'll do your new stage. Your old stage, The new stage, Your old stage. And then once you're able to do that successfully for a week, you'll transition fully to the next stage, which will be stage three.

00:09:14:02 - 00:09:44:08
Speaker 1
You'll notice I have five boxes here. This is assuming you're doing your exercises. Aerobic exercise is five days a week. If you're doing them six, you would have an extra box if you're doing them for maybe you don't think check these four boxes, but I just generally did five. And then also remember, during this time you're doing two days a week of the strength at these same heart rates with the same parameters of stopping till you get when you get over two out of ten from where you started.

00:09:44:08 - 00:10:10:09
Speaker 1
Okay, easy peasy, right? If you have any questions, please let me know. I am in the group. I'm here with you every step of the way. Go ahead and give this a try. If anything comes up for you again, ask me. I'm really, really excited for you. And please remember to do your other, you know, water compression and all the things you can wear, your compression while you're doing your exercises, that's okay, too.

00:10:10:18 - 00:10:17:12
Speaker 1
And then let me know how you're doing in the group, because I'd love to see and hear your progress. Okay. That's it for today.

Stage 3 - Sitting Up

00:00:00:24 - 00:00:03:09
Speaker 1
All right. Welcome to stage three. So in.

00:00:03:09 - 00:00:05:04
Speaker 2
Stage three, we are fully.

00:00:05:04 - 00:00:06:05
Speaker 1
Sitting up.

00:00:06:05 - 00:00:08:12
Speaker 2
We've gone from recumbent where we're leaned back a.

00:00:08:12 - 00:00:11:01
Speaker 1
Little bit to fully sitting upright against gravity.

00:00:12:08 - 00:00:17:19
Speaker 2
So as in your other stages, here are the details in your workbook on page 36. So for seated.

00:00:17:19 - 00:00:19:09
Speaker 1
Exercise some choices that you.

00:00:19:09 - 00:00:19:22
Speaker 2
Can choose.

00:00:19:22 - 00:00:31:11
Speaker 1
From is an upright bike or a spin bike peloton. Anything you want that is upright. You can also continue to use the pedal bike that you may have used in.

00:00:31:11 - 00:00:31:20
Speaker 2
The other.

00:00:31:20 - 00:00:32:13
Speaker 1
Stages.

00:00:32:18 - 00:00:33:24
Speaker 2
If you're not familiar with that.

00:00:33:24 - 00:00:35:15
Speaker 1
I have it in the end.

00:00:35:15 - 00:00:36:12
Speaker 2
Of your workbook.

00:00:36:22 - 00:00:37:17
Speaker 1
A couple of options.

00:00:37:17 - 00:00:37:23
Speaker 2
For the.

00:00:37:23 - 00:00:40:10
Speaker 1
Under the desk pedal bike and you would just.

00:00:40:10 - 00:00:43:14
Speaker 2
Sit up straight in the chair this time because we are sitting straight up so you can.

00:00:43:14 - 00:00:46:23
Speaker 1
Choose any of these things. For any bikes, please.

00:00:46:23 - 00:00:48:10
Speaker 2
Make sure they are stationary.

00:00:48:18 - 00:00:50:19
Speaker 1
I don't want you riding a bicycle yet.

00:00:51:08 - 00:00:53:10
Speaker 2
So we're talking about stationary bikes, so feel free to.

00:00:53:10 - 00:00:59:03
Speaker 1
Choose one of those. And then your strength class will also be in seated. You can find it here.

00:00:59:03 - 00:01:00:14
Speaker 2
Or if you have this printed out.

00:01:00:14 - 00:01:06:03
Speaker 1
You can use the QR code. Now we need to attain.

00:01:06:03 - 00:01:08:02
Speaker 2
Your resting heart rate for this.

00:01:08:02 - 00:01:08:17
Speaker 1
Stage.

00:01:09:21 - 00:01:10:21
Speaker 2
So what you're going to do.

00:01:10:21 - 00:01:12:24
Speaker 1
Is in a seated position that's a.

00:01:12:24 - 00:01:14:20
Speaker 2
Little bit different than before. So you're in a.

00:01:14:20 - 00:01:16:11
Speaker 1
Seated position this time.

00:01:17:03 - 00:01:17:20
Speaker 2
And you're going to be in.

00:01:17:20 - 00:01:18:08
Speaker 1
A quiet.

00:01:18:08 - 00:01:33:10
Speaker 2
Space for 3 to 5 minutes wearing your heart rate monitor. And at the end of that time, you're going to record your heart rate. That is your seated resting heart rate for stage three. If you're not using heart rate and you're using RPE through beta blockers or something of the sort.

00:01:33:10 - 00:01:37:12
Speaker 1
You can skip this step. And then again, like we mentioned in.

00:01:37:12 - 00:01:38:20
Speaker 2
The other stages, if you're.

00:01:38:20 - 00:01:39:20
Speaker 1
Someone whose.

00:01:40:04 - 00:01:41:13
Speaker 2
Heart rate varies quite.

00:01:41:13 - 00:01:43:20
Speaker 1
A bit day to day, you may want to take it.

00:01:43:20 - 00:01:44:21
Speaker 2
Before each.

00:01:44:21 - 00:01:45:12
Speaker 1
Session.

00:01:45:20 - 00:01:47:22
Speaker 2
Rather than using the same resting heart rate.

00:01:47:22 - 00:01:49:09
Speaker 1
Throughout, you will.

00:01:49:09 - 00:01:52:06
Speaker 2
Find that it starts to evened out as you take it through.

00:01:52:14 - 00:02:00:11
Speaker 1
Each session because it will start to adapt better. But if that's an issue, that's the way you can get around that. And just.

00:02:00:11 - 00:02:04:09
Speaker 2
As before, you have your success or your success checklist here for.

00:02:04:09 - 00:02:06:12
Speaker 1
Stage three seated, so you'll.

00:02:06:12 - 00:02:07:23
Speaker 2
Write your resting heart rate up at the.

00:02:07:23 - 00:02:09:12
Speaker 1
Top. And then you can see.

00:02:09:12 - 00:02:10:14
Speaker 2
Here you're going to start at.

00:02:10:14 - 00:02:14:00
Speaker 1
Level one, same as before 15 to 20 beats.

00:02:14:00 - 00:02:18:01
Speaker 2
Per minute above resting heart rate or to RPE for 20.

00:02:18:01 - 00:02:22:02
Speaker 1
Minutes, you're going to say, okay, let me go to my how to.

00:02:22:02 - 00:02:22:15
Speaker 2
Perform in a.

00:02:22:15 - 00:02:24:21
Speaker 1
Session. You'll have your heart rate.

00:02:24:21 - 00:02:25:12
Speaker 2
Monitor.

00:02:25:12 - 00:02:27:20
Speaker 1
Again. You'll use your symptoms on that.

00:02:28:04 - 00:02:28:20
Speaker 2
0 to 10.

00:02:28:20 - 00:02:29:04
Speaker 1
Scale.

00:02:29:19 - 00:02:32:22
Speaker 2
You'll begin your warmup, you'll exercise.

00:02:32:22 - 00:02:33:13
Speaker 1
And that seated.

00:02:33:13 - 00:02:35:22
Speaker 2
Position at your target heart rate for level.

00:02:35:22 - 00:02:37:21
Speaker 1
One. So 15 to 20 minutes.

00:02:37:21 - 00:02:39:21
Speaker 2
Or beats per minute above your resting heart rate.

00:02:40:11 - 00:02:42:05
Speaker 1
And you'll do that until symptoms.

00:02:42:05 - 00:02:43:04
Speaker 2
Increase more than two.

00:02:43:04 - 00:02:44:01
Speaker 1
Points out of ten.

00:02:44:10 - 00:02:45:08
Speaker 2
From where you started.

00:02:45:22 - 00:02:55:16
Speaker 1
So if you started on a three out of ten, when your symptoms get to a six out of ten, that's when you stop. Start about a five out of ten. When you're symptom get to an eight out of ten.

00:02:55:17 - 00:02:56:04
Speaker 2
That's where you'll.

00:02:56:05 - 00:02:57:15
Speaker 1
Stop and then you'll.

00:02:57:15 - 00:02:58:04
Speaker 2
Complete your.

00:02:58:04 - 00:02:58:17
Speaker 1
Cooldown.

00:02:59:04 - 00:03:00:18
Speaker 2
And record your workout.

00:03:00:18 - 00:03:05:00
Speaker 1
On your hand up. So get the date, the time, total time in.

00:03:05:00 - 00:03:08:19
Speaker 2
Minutes that you were able to exercise at your target heart rate. So not including warmup.

00:03:08:19 - 00:03:13:01
Speaker 1
And cooldown the type of exercise you chose. Maybe it was a peloton.

00:03:13:01 - 00:03:17:01
Speaker 2
Here heart rate. You achieved what your symptoms were before.

00:03:17:01 - 00:03:21:15
Speaker 1
Exercise, what it was when you stopped. And then again, how long does it take you to get back.

00:03:21:15 - 00:03:24:12
Speaker 2
To your baseline? So say you started at three out of ten.

00:03:24:21 - 00:03:26:22
Speaker 1
How long does it take you to get back to three at a time?

00:03:27:16 - 00:03:29:04
Speaker 2
And then you can do your wellness score.

00:03:30:10 - 00:03:36:22
Speaker 1
You will continue that until you meet the progression requirements. So again, it says when to progress.

00:03:37:13 - 00:03:38:03
Speaker 2
When you're able to.

00:03:38:13 - 00:03:38:24
Speaker 1
Do.

00:03:39:18 - 00:03:43:00
Speaker 2
Exercise at that heart rate for 20 minutes.

00:03:43:00 - 00:03:46:16
Speaker 1
With no rest, when you don't have symptoms.

00:03:46:16 - 00:03:48:04
Speaker 2
Increasing during or after it.

00:03:48:16 - 00:03:52:17
Speaker 1
And when you're not manipulating the workload. So once you do that, you can increase.

00:03:52:17 - 00:03:52:22
Speaker 2
It to.

00:03:52:22 - 00:03:57:11
Speaker 1
Five beats per minute. And on your checklist you can see that's level two.

00:03:57:22 - 00:03:59:03
Speaker 2
So now you're exercising.

00:03:59:03 - 00:04:00:24
Speaker 1
At 20 to 25 beats per minute.

00:04:00:24 - 00:04:03:00
Speaker 2
Above your resting heart rate or three out.

00:04:03:00 - 00:04:04:02
Speaker 1
Of ten. If you.

00:04:04:02 - 00:04:07:11
Speaker 2
Are not using heart rate.

00:04:08:07 - 00:04:09:00
Speaker 1
Again, you'll go back.

00:04:09:00 - 00:04:09:10
Speaker 2
Here.

00:04:09:10 - 00:04:12:19
Speaker 1
You'll follow the same protocol for each one.

00:04:13:10 - 00:04:14:11
Speaker 2
You'll record.

00:04:15:00 - 00:04:20:08
Speaker 1
You'll do that until you can do it for 20 minutes in one session with no rest.

00:04:20:08 - 00:04:24:09
Speaker 2
No increase in symptoms during or after, and good heart rate control.

00:04:25:07 - 00:04:29:14
Speaker 1
And you'll go back, you'll check off level two and you'll say, okay, now at level.

00:04:29:14 - 00:04:31:01
Speaker 2
Three, you're going to repeat that.

00:04:31:01 - 00:04:34:22
Speaker 1
Same process for 20 to 25 beats per minute.

00:04:34:22 - 00:04:37:14
Speaker 2
Above your resting heart rate or 4 to 10.

00:04:38:18 - 00:04:39:17
Speaker 1
And then when.

00:04:39:17 - 00:04:40:24
Speaker 2
You're ready to transition.

00:04:40:24 - 00:04:41:24
Speaker 1
We have a little bit of.

00:04:41:24 - 00:04:43:05
Speaker 2
A trend, a different transition.

00:04:43:05 - 00:04:46:23
Speaker 1
In this stage. So stage three is seated, Stage.

00:04:46:23 - 00:04:47:10
Speaker 2
Four.

00:04:47:10 - 00:04:51:08
Speaker 1
Is standing. So we need to test.

00:04:51:08 - 00:04:53:21
Speaker 2
Your readiness for upright exercise.

00:04:53:21 - 00:04:56:08
Speaker 1
Because we know that, you know, big part of a setup is the.

00:04:56:08 - 00:04:56:22
Speaker 2
Nervous system.

00:04:56:22 - 00:04:57:03
Speaker 1
Being.

00:04:57:11 - 00:04:59:17
Speaker 2
Struggling to adapt upright exercise.

00:04:59:17 - 00:05:08:10
Speaker 1
So we do this by using the Buffalo concussion treadmill test. Now, there's two ways that you can do this. One is you can.

00:05:08:10 - 00:05:11:03
Speaker 2
Simply retake or take for the first time.

00:05:11:03 - 00:05:16:06
Speaker 1
The Buffalo concussion treadmill test or March test. And the goal.

00:05:16:06 - 00:05:16:24
Speaker 2
There is.

00:05:16:24 - 00:05:21:17
Speaker 1
That you want to be able to see, okay, if in stage four, I'm going to have my.

00:05:21:17 - 00:05:23:02
Speaker 2
Standing resting heart rate.

00:05:23:02 - 00:05:23:16
Speaker 1
And I'm going to.

00:05:23:16 - 00:05:24:02
Speaker 2
Start like.

00:05:24:02 - 00:05:29:08
Speaker 1
I start all the other stages with 15 to 20 beats per minute above that. So say your.

00:05:29:08 - 00:05:30:17
Speaker 2
Average, your resting heart rate.

00:05:30:21 - 00:05:32:07
Speaker 1
In standing is 70.

00:05:32:22 - 00:05:35:10
Speaker 2
That means your level one for stage four.

00:05:35:10 - 00:05:37:13
Speaker 1
Is going to be 85 to 90.

00:05:37:21 - 00:05:38:06
Speaker 2
Right?

00:05:38:06 - 00:05:40:02
Speaker 1
15 to 20 beats per minute above.

00:05:40:02 - 00:05:40:12
Speaker 2
Harassing.

00:05:40:12 - 00:05:45:10
Speaker 1
Heart rate. And you do the buffalo concussion treadmill test and you realize my heart.

00:05:45:10 - 00:05:46:11
Speaker 2
Rate's 100 when I get.

00:05:46:11 - 00:05:49:14
Speaker 1
On it. That means walking isn't going to be accessible.

00:05:49:14 - 00:05:50:17
Speaker 2
To you because you're already.

00:05:50:17 - 00:05:51:13
Speaker 1
Above.

00:05:51:13 - 00:05:53:02
Speaker 2
Where that level in heart rate.

00:05:53:02 - 00:05:56:16
Speaker 1
Is. So if that's the case, what you're going to do is spend an.

00:05:56:16 - 00:05:57:09
Speaker 2
Extra.

00:05:57:15 - 00:05:58:23
Speaker 1
Level at.

00:05:58:23 - 00:06:00:14
Speaker 2
Stage three where you're then.

00:06:00:15 - 00:06:02:08
Speaker 1
Going to bump up your.

00:06:02:08 - 00:06:03:00
Speaker 2
Heart rate a.

00:06:03:00 - 00:06:04:16
Speaker 1
Little bit higher. So you'll bump.

00:06:04:16 - 00:06:07:04
Speaker 2
It up to 30 to 35 or five.

00:06:07:04 - 00:06:11:03
Speaker 1
Out of ten. And we'll spend some time building some more resilience.

00:06:11:03 - 00:06:11:16
Speaker 2
For you.

00:06:12:04 - 00:06:16:14
Speaker 1
Until you get to the 20 minutes. No increasing symptoms.

00:06:16:22 - 00:06:18:06
Speaker 2
Good heart rate control.

00:06:18:06 - 00:06:24:19
Speaker 1
And then you can try the standing test again. That's kind of the full process. Yeah. As you can see.

00:06:24:24 - 00:06:25:22
Speaker 2
We really just need.

00:06:25:22 - 00:06:26:22
Speaker 1
To know when you.

00:06:26:22 - 00:06:27:23
Speaker 2
Start exercising.

00:06:27:23 - 00:06:28:06
Speaker 1
Can you.

00:06:28:06 - 00:06:33:09
Speaker 2
Exercise and an appropriate heart rate for us to start you at level at level four or at stage four, I should.

00:06:33:09 - 00:06:36:09
Speaker 1
Say. So the other way you can do this is again, you'll.

00:06:36:09 - 00:06:37:14
Speaker 2
Take your resting heart rate and.

00:06:37:14 - 00:06:40:08
Speaker 1
Standing. If you can walk on a treadmill at.

00:06:40:08 - 00:06:40:23
Speaker 2
Three point.

00:06:40:23 - 00:06:41:11
Speaker 1
Two miles.

00:06:41:11 - 00:06:42:03
Speaker 2
Per hour.

00:06:42:15 - 00:06:47:17
Speaker 1
And you can stay and you can do it at about the 15 to 20.

00:06:47:18 - 00:06:49:06
Speaker 2
Beats per hour.

00:06:49:11 - 00:06:50:12
Speaker 1
15 to 20.

00:06:50:12 - 00:06:53:12
Speaker 2
Beats per minute over your resting heart rate. That means you're ready.

00:06:54:12 - 00:07:11:07
Speaker 1
Because remember, that's what we need to get you to to move that. So you can also test it that way. You don't have to go through the four stages of the Buffalo concussion if you want. We would just need to say, okay, if we get you walking on the treadmill, can you be at level one and stage for 15 to 20 beats per.

00:07:11:07 - 00:07:12:18
Speaker 2
Minute above your resting heart rate?

00:07:13:03 - 00:07:13:20
Speaker 1
If you can?

00:07:13:20 - 00:07:18:21
Speaker 2
Great. You're ready to start walking there. If it's already immediately higher than that.

00:07:19:08 - 00:07:20:04
Speaker 1
That means it's not.

00:07:20:04 - 00:07:20:11
Speaker 2
Ready.

00:07:20:11 - 00:07:26:01
Speaker 1
Quite yet, and we'll do that additional week in stage three. Okay. So it's all.

00:07:26:01 - 00:07:27:06
Speaker 2
Written on the chart here.

00:07:27:24 - 00:07:36:15
Speaker 1
If you have any questions on that, please let me know. But congratulations when you get to this. On being ready to exercise in an upright.

00:07:36:15 - 00:07:37:13
Speaker 2
Position or at least.

00:07:37:13 - 00:07:41:22
Speaker 1
Try to see if you are. So if.

00:07:41:22 - 00:07:43:08
Speaker 2
You are just watching this for the.

00:07:43:08 - 00:07:44:07
Speaker 1
First time, go ahead and get.

00:07:44:07 - 00:07:44:22
Speaker 2
Started.

00:07:44:22 - 00:07:45:24
Speaker 1
If this is the last.

00:07:45:24 - 00:07:51:22
Speaker 2
Time around and you're ready to determine your readiness for upright exercise, congratulations. You are welcome.

00:07:51:22 - 00:08:02:10
Speaker 1
To do that. And either way, I will see you when you are ready for the next stage and of course, your questions and always inside the company.

Stage 4 - Standing

00:00:00:13 - 00:00:07:02
Speaker 1
All right, Stage four, we are in standings, so congratulations. If you are in standing.

00:00:07:02 - 00:00:08:10
Speaker 2
I'm very excited you are.

00:00:08:10 - 00:00:09:01
Speaker 1
Here.

00:00:09:11 - 00:00:13:15
Speaker 2
Congratulate since on your nervous system being ready for up right exercise.

00:00:13:15 - 00:00:19:11
Speaker 1
That is amazing. I just want to take a moment to acknowledge you for that accomplishment. I know this hasn't been an.

00:00:19:11 - 00:00:23:04
Speaker 2
Easy journey, so just like for all the other.

00:00:24:05 - 00:00:25:07
Speaker 1
Stages, the.

00:00:25:07 - 00:00:26:15
Speaker 2
Details are in your workbook.

00:00:26:15 - 00:00:27:09
Speaker 1
You can see here on.

00:00:27:09 - 00:00:28:05
Speaker 2
Page 40.

00:00:28:13 - 00:00:48:15
Speaker 1
You have your stage four standing. Your type of aerobic exercise to choose from could be walking, it could continue or it could be the treadmill. I highly recommend any time we're doing these types of things to use something like a stationary piece of equipment, like a treadmill, because it takes out all.

00:00:48:15 - 00:00:50:01
Speaker 2
The other factors.

00:00:50:01 - 00:00:54:21
Speaker 1
It allows us to control the environment, allows us to control the speed. So if you have access to a.

00:00:54:21 - 00:00:56:13
Speaker 2
Treadmill here, that's great. If not.

00:00:56:13 - 00:01:03:12
Speaker 1
Walking also works, if you enjoy the elliptical, you can do that. Sometimes the bouncing up and down might be tough for concussion, but if you.

00:01:03:12 - 00:01:04:11
Speaker 2
Can tolerate that, you.

00:01:04:11 - 00:01:06:01
Speaker 1
Were also welcome to choose that.

00:01:06:22 - 00:01:07:18
Speaker 2
Your strength.

00:01:07:18 - 00:01:11:00
Speaker 1
Class is now in standing. You can access.

00:01:11:00 - 00:01:11:22
Speaker 2
It here or.

00:01:11:22 - 00:01:16:05
Speaker 1
Scan the QR code and a few tips here as if.

00:01:16:05 - 00:01:17:03
Speaker 2
You are struggling.

00:01:17:18 - 00:01:27:12
Speaker 1
With other symptoms like vision, vestibular, neck. Kind of like we talked about. This piece of stationary equipment is going to be a lot better. So again, a treadmill versus walking. This is also.

00:01:27:12 - 00:01:31:17
Speaker 2
Where we're getting you upright. And as we're going to increase your heart rate, we're going to need to increase.

00:01:31:17 - 00:01:33:04
Speaker 1
The speed or maybe the incline.

00:01:33:04 - 00:01:35:16
Speaker 2
At what you're walking. So here's the stage.

00:01:35:16 - 00:01:38:10
Speaker 1
That some people might have. Strength might become an.

00:01:38:10 - 00:01:39:03
Speaker 2
Issue where you.

00:01:39:03 - 00:01:48:13
Speaker 1
Need to be strong enough to walk your body up a slight incline or something like that. So if at any point you hit a little wall, we were feeling like, I'm not strong enough, I want you to focus a.

00:01:48:13 - 00:01:50:07
Speaker 2
Little bit more in on your strength.

00:01:50:07 - 00:01:52:16
Speaker 1
Classes and then come back to this.

00:01:52:16 - 00:01:54:08
Speaker 2
Because it's a really great opportunity.

00:01:54:08 - 00:01:54:11
Speaker 1
To.

00:01:54:11 - 00:01:55:10
Speaker 2
Get stronger.

00:01:56:00 - 00:01:56:13
Speaker 1
But if you find.

00:01:56:13 - 00:01:57:11
Speaker 2
Yourself struggling there.

00:01:57:11 - 00:02:02:14
Speaker 1
That might be why this stage and the seated and then the next one tend to.

00:02:02:14 - 00:02:04:05
Speaker 2
Move through a little bit faster.

00:02:04:14 - 00:02:11:20
Speaker 1
Than the first couple stages and preconditioning. So hopefully you can expect that as well. So we will.

00:02:11:20 - 00:02:13:18
Speaker 2
Take your resting heart rate for the.

00:02:13:18 - 00:02:14:19
Speaker 1
Stage like we have done.

00:02:14:19 - 00:02:15:15
Speaker 2
For the others.

00:02:16:12 - 00:02:17:13
Speaker 1
For this stage.

00:02:17:13 - 00:02:18:15
Speaker 2
Your resting heart rate.

00:02:18:15 - 00:02:33:18
Speaker 1
Is standing and it's unsupported. So what I mean by that is you're not standing leaning against a couch. You're standing all on your own two feet. If you need balance, maybe you put a finger on the desk or something, but I don't want you to be supported.

00:02:33:18 - 00:02:34:20
Speaker 2
Otherwise you're going to be.

00:02:34:20 - 00:02:40:20
Speaker 1
Standing in a quiet place 3 to 5 minutes wearing your heart rate monitor. At the end of that time, you will.

00:02:40:20 - 00:02:44:08
Speaker 2
Record your heart rate and that will be your standing heart rate for the.

00:02:44:08 - 00:02:44:23
Speaker 1
Stage.

00:02:45:01 - 00:02:46:11
Speaker 2
Are your standing resting heart rate.

00:02:46:11 - 00:02:49:04
Speaker 1
For the stage, I should say again, like.

00:02:49:04 - 00:02:53:01
Speaker 2
In the other stages, if you notice, your resting heart rate is really bouncing around a.

00:02:53:01 - 00:02:55:15
Speaker 1
Lot. You might want to take it each time.

00:02:55:15 - 00:02:58:00
Speaker 2
Before you do your workout so you know what your.

00:02:58:23 - 00:02:59:08
Speaker 1
Resting.

00:02:59:08 - 00:03:00:02
Speaker 2
Heart rate is for.

00:03:00:02 - 00:03:00:18
Speaker 1
That day.

00:03:01:11 - 00:03:03:03
Speaker 2
And then of course, over time you're going to.

00:03:03:03 - 00:03:09:15
Speaker 1
Find that's going to start to level out and you won't need to do it everyday anymore. Then you can just go back to the one time. But if you were.

00:03:09:15 - 00:03:12:06
Speaker 2
Not that in your standing heart rate is relatively.

00:03:12:06 - 00:03:17:04
Speaker 1
Stable, you can just use the one time and then use that.

00:03:17:04 - 00:03:17:13
Speaker 2
For each.

00:03:17:13 - 00:03:28:17
Speaker 1
Exercise session. And like with all of your stages, you have your success checklist. So use this checklist to check.

00:03:28:17 - 00:03:29:15
Speaker 2
Your progress off as.

00:03:29:15 - 00:03:32:04
Speaker 1
You go. You'll write your standing resting.

00:03:32:04 - 00:03:33:03
Speaker 2
Heart rate here.

00:03:33:15 - 00:03:34:07
Speaker 1
And then just.

00:03:34:07 - 00:03:35:21
Speaker 2
Like before, we're going to start with level.

00:03:35:21 - 00:03:43:17
Speaker 1
One, move to level two and then to level three. And then we'll transition like we did in stages one and two.

00:03:43:24 - 00:03:44:16
Speaker 2
Where you'll.

00:03:44:16 - 00:03:46:20
Speaker 1
Do one day at your next level.

00:03:46:20 - 00:03:47:22
Speaker 2
Which is intervals.

00:03:47:22 - 00:03:48:21
Speaker 1
And then one day.

00:03:48:21 - 00:03:51:03
Speaker 2
At your previous level, which is level three from.

00:03:51:03 - 00:03:52:17
Speaker 1
Standing, so on and so.

00:03:52:17 - 00:03:53:02
Speaker 2
Forth.

00:03:53:16 - 00:03:56:21
Speaker 1
So to do one, I'm sure you all know this by now, but just to do one.

00:03:56:21 - 00:03:58:05
Speaker 2
One run through so you feel.

00:03:58:05 - 00:04:03:17
Speaker 1
Comfortable, you'll be starting at level one that's 15 to 20 beats per minute above your.

00:04:03:17 - 00:04:04:15
Speaker 2
Resting heart rate.

00:04:05:11 - 00:04:11:00
Speaker 1
Or two at a ten hour piece will say, okay, I've got my.

00:04:11:01 - 00:04:11:22
Speaker 2
Heart rate on.

00:04:11:22 - 00:04:20:21
Speaker 1
I know where my baseline symptoms are. I'm going to start my warmup, I'm going to begin. Let's say you're using the treadmill, then begin walking at my.

00:04:20:21 - 00:04:21:09
Speaker 2
Target heart.

00:04:21:09 - 00:04:27:20
Speaker 1
Rate. So 15 to 20 beats per minute above my resting until my symptoms hit.

00:04:27:20 - 00:04:28:15
Speaker 2
More than two.

00:04:28:15 - 00:04:29:06
Speaker 1
Out of ten.

00:04:29:15 - 00:04:30:20
Speaker 2
From where I started.

00:04:30:20 - 00:04:37:10
Speaker 1
On the ten point scale. So again, if you started at a four, once you had a seven, you would stop because it's more than.

00:04:37:10 - 00:04:38:10
Speaker 2
Three or more than two.

00:04:38:10 - 00:04:41:07
Speaker 1
Points. You'd begin your cooldown and then.

00:04:41:07 - 00:04:42:18
Speaker 2
Again, record your workout.

00:04:42:23 - 00:04:43:08
Speaker 1
So you can.

00:04:43:08 - 00:04:44:20
Speaker 2
See here you record what day.

00:04:44:20 - 00:04:45:09
Speaker 1
You're on.

00:04:45:17 - 00:04:48:02
Speaker 2
The minutes you were able to exercise that your target heart.

00:04:48:02 - 00:04:51:04
Speaker 1
Rate, maybe type of exercise. You were on a treadmill.

00:04:51:20 - 00:04:55:14
Speaker 2
Write your heart rate, hear your symptoms where you started, your symptoms.

00:04:55:14 - 00:04:56:22
Speaker 1
Where you stopped, and then again.

00:04:56:22 - 00:04:59:01
Speaker 2
Recording when your symptoms returned.

00:04:59:01 - 00:05:00:21
Speaker 1
Back to that baseline. So if you.

00:05:00:21 - 00:05:01:22
Speaker 2
Started at a four out of.

00:05:01:22 - 00:05:02:09
Speaker 1
Ten.

00:05:02:18 - 00:05:04:23
Speaker 2
When do your symptoms return to a four out of ten?

00:05:05:11 - 00:05:06:11
Speaker 1
And then again, wellness.

00:05:06:11 - 00:05:07:02
Speaker 2
Score is.

00:05:07:02 - 00:05:12:03
Speaker 1
Optional. Once you can do that for 20 minutes in a session with no rest.

00:05:12:18 - 00:05:16:20
Speaker 2
Your symptoms increase or your symptoms do not increase during or after.

00:05:16:20 - 00:05:18:18
Speaker 1
Exercise and you have good.

00:05:18:18 - 00:05:19:02
Speaker 2
Heart rate.

00:05:19:02 - 00:05:20:07
Speaker 1
Control. You can then.

00:05:20:07 - 00:05:22:20
Speaker 2
Increase your stay or increase your heart rate five.

00:05:22:21 - 00:05:30:03
Speaker 1
Beats per minute in stage two. So on and so forth. What you complete all of that.

00:05:30:03 - 00:05:37:14
Speaker 2
You're ready to begin your transition week. Pretty great, huh? All right.

00:05:37:14 - 00:05:52:15
Speaker 1
So congratulations on being in standing. If you have any questions, please let me know if you need any clarity. Please let me know. I know you've done the other stages, so I didn't feel like I needed to walk you through each one like before. But if you do me that, please.

00:05:52:15 - 00:05:55:13
Speaker 2
Let me know. I'm really, really happy to support you.

00:05:55:13 - 00:06:03:15
Speaker 1
And congratulations and welcome back to standing my friend. And I will see you in the next stage.

00:06:03:15 - 00:06:04:11
Speaker 2
When you are ready.

Stage 5 - Intervals

00:00:00:03 - 00:00:11:13
Speaker 1
Hello, everyone, and welcome to stage five. Stage five is the final stage in the ADAPT protocol till we get to maintenance and it is intervals.

00:00:11:16 - 00:00:16:15
Speaker 2
So details of course are in your workbook. We're still using.

00:00:16:15 - 00:00:17:06
Speaker 1
The same.

00:00:17:06 - 00:00:19:05
Speaker 2
Form of exercise you were using.

00:00:19:05 - 00:00:20:01
Speaker 1
In standing.

00:00:20:01 - 00:00:20:21
Speaker 2
So whether that.

00:00:20:21 - 00:00:21:07
Speaker 1
Was.

00:00:21:07 - 00:00:26:02
Speaker 2
Walking your treadmill or your elliptical versus strength classes, we're going to bump.

00:00:26:04 - 00:00:26:12
Speaker 1
Up a little.

00:00:26:12 - 00:00:27:12
Speaker 2
Bit. So there's one called.

00:00:27:12 - 00:00:29:10
Speaker 1
Pass the Combo in there, and.

00:00:29:10 - 00:00:31:18
Speaker 2
That will be your strength class for this.

00:00:31:18 - 00:00:35:13
Speaker 1
Stage. The other thing I want to mention in this stage is.

00:00:35:13 - 00:00:36:02
Speaker 2
We're going.

00:00:36:02 - 00:00:37:02
Speaker 1
To be doing intervals.

00:00:37:04 - 00:00:42:03
Speaker 2
So intervals means working a little bit harder, then working a little bit.

00:00:42:03 - 00:00:42:15
Speaker 1
Less.

00:00:42:20 - 00:00:44:01
Speaker 2
Working a little bit harder.

00:00:44:10 - 00:00:48:03
Speaker 1
Than working a little bit less. Up until now, what we've been doing.

00:00:48:03 - 00:00:48:23
Speaker 2
Is referred to as.

00:00:48:23 - 00:00:50:16
Speaker 1
Steady state. So that means.

00:00:50:16 - 00:00:51:03
Speaker 2
I'm working.

00:00:51:03 - 00:00:54:21
Speaker 1
At the same speed, same amount of output.

00:00:55:11 - 00:00:58:05
Speaker 2
For 20 minutes straight. That's considered steady.

00:00:58:05 - 00:00:58:17
Speaker 1
State.

00:00:58:17 - 00:01:01:03
Speaker 2
Exercise. Now we're going to intervals, so.

00:01:01:03 - 00:01:01:18
Speaker 1
I'm going to do.

00:01:02:04 - 00:01:03:03
Speaker 2
Some harder stuff.

00:01:03:03 - 00:01:03:16
Speaker 1
I'm going to make it.

00:01:03:16 - 00:01:05:09
Speaker 2
Easier, do it harder.

00:01:05:16 - 00:01:06:16
Speaker 1
I'm going to make it easier.

00:01:06:18 - 00:01:08:05
Speaker 2
That's an interval versus keeping.

00:01:08:05 - 00:01:08:11
Speaker 1
It the.

00:01:08:11 - 00:01:10:07
Speaker 2
Same across the board that is considered.

00:01:10:07 - 00:01:13:24
Speaker 1
Steady state. So in this.

00:01:13:24 - 00:01:16:01
Speaker 2
Stage we're going to start with intervals.

00:01:16:17 - 00:01:17:16
Speaker 1
But we have something.

00:01:17:16 - 00:01:18:17
Speaker 2
Interesting for you here.

00:01:18:17 - 00:01:19:08
Speaker 1
So in this.

00:01:19:08 - 00:01:21:03
Speaker 2
Stage you're going to alternate your interval.

00:01:21:03 - 00:01:21:15
Speaker 1
Days.

00:01:22:04 - 00:01:23:08
Speaker 2
With your steady.

00:01:23:08 - 00:01:26:09
Speaker 1
State days. And so that's basically stage.

00:01:26:09 - 00:01:31:01
Speaker 2
Level three from stage four, and you're going to continue to progress your.

00:01:31:01 - 00:01:33:19
Speaker 1
Steady state by five beats per minute.

00:01:33:19 - 00:01:34:23
Speaker 2
Until you reach.

00:01:35:01 - 00:01:36:13
Speaker 1
65 to 75.

00:01:36:13 - 00:01:37:08
Speaker 2
Percent of your.

00:01:37:08 - 00:01:41:04
Speaker 1
Heart rate, max. So what that means is one day.

00:01:41:05 - 00:01:41:15
Speaker 2
You're going to be.

00:01:41:15 - 00:01:44:03
Speaker 1
Doing you'll take the last.

00:01:44:03 - 00:01:45:22
Speaker 2
Day from stage four. You're going to add.

00:01:45:22 - 00:01:48:14
Speaker 1
Five beats per minute to it.

00:01:48:14 - 00:01:50:16
Speaker 2
And you're going to do your typical progressions there.

00:01:50:16 - 00:01:52:01
Speaker 1
The next day would.

00:01:52:01 - 00:01:53:05
Speaker 2
Be an interval date.

00:01:54:05 - 00:01:56:19
Speaker 1
The next day, another steady state pick up.

00:01:56:19 - 00:02:00:24
Speaker 2
From where you were, increase there and you're going to keep increasing your steady.

00:02:00:24 - 00:02:03:19
Speaker 1
State until you can get to 60 to 70.

00:02:03:19 - 00:02:04:07
Speaker 2
5%.

00:02:04:07 - 00:02:07:15
Speaker 1
Of your heart rate next. So we need to do that calculation.

00:02:09:01 - 00:02:17:00
Speaker 2
And here we go. So we're gonna get your resting heart rate and your heart rate, Max, for the stage. So the resting heart rate is.

00:02:17:00 - 00:02:20:14
Speaker 1
In standing, so you can stand in.

00:02:20:14 - 00:02:21:09
Speaker 2
Unsupported.

00:02:21:09 - 00:02:21:22
Speaker 1
In a quiet.

00:02:21:22 - 00:02:22:19
Speaker 2
Place for three to.

00:02:22:19 - 00:02:23:10
Speaker 1
5 minutes.

00:02:23:10 - 00:02:25:11
Speaker 2
Wearing your heart rate monitor, of course.

00:02:25:21 - 00:02:27:21
Speaker 1
And then at the end of that time, that is.

00:02:27:21 - 00:02:28:03
Speaker 2
Your.

00:02:28:03 - 00:02:31:20
Speaker 1
Resting standing heart rate. And you can write that in this.

00:02:31:20 - 00:02:35:08
Speaker 2
Bluish green box here. We're also.

00:02:35:08 - 00:02:37:15
Speaker 1
Going to calculate 65 to 70.

00:02:37:15 - 00:02:38:23
Speaker 2
5% of your heart rate.

00:02:38:23 - 00:02:39:13
Speaker 1
Max.

00:02:39:13 - 00:02:40:04
Speaker 2
Because we're going.

00:02:40:04 - 00:02:40:16
Speaker 1
To keep.

00:02:40:16 - 00:02:45:04
Speaker 2
Increasing your exercise, your standing exercise from stage four until we.

00:02:45:04 - 00:02:50:10
Speaker 1
Hit these numbers. So it's individual for each one of you. So how you're going to calculate.

00:02:50:10 - 00:02:51:11
Speaker 2
This is you're going to take.

00:02:51:12 - 00:02:52:17
Speaker 1
220.

00:02:53:10 - 00:02:54:08
Speaker 2
And subtract your.

00:02:54:08 - 00:02:57:24
Speaker 1
Age, and then you'll write that number on this line.

00:02:58:18 - 00:03:00:07
Speaker 2
That is your heart rate, Max.

00:03:01:00 - 00:03:05:15
Speaker 1
So again, 220 minus your age, write that.

00:03:05:15 - 00:03:06:02
Speaker 2
Number on.

00:03:06:02 - 00:03:07:08
Speaker 1
This line.

00:03:07:08 - 00:03:10:21
Speaker 2
That is your heart rate, Max. You're going to.

00:03:10:21 - 00:03:11:11
Speaker 1
Take the.

00:03:11:11 - 00:03:11:24
Speaker 2
Number you.

00:03:11:24 - 00:03:13:02
Speaker 1
Just calculated.

00:03:14:00 - 00:03:14:15
Speaker 2
And you're going to.

00:03:14:15 - 00:03:25:09
Speaker 1
Multiply it by .65 and write the number on this line, top line in the second box. Third box, I should say. So again, you'll.

00:03:25:09 - 00:03:27:14
Speaker 2
Take your heart rate, Max, which is the number you.

00:03:27:14 - 00:03:29:23
Speaker 1
Calculated in that middle box.

00:03:29:23 - 00:03:30:08
Speaker 2
You're going to.

00:03:30:08 - 00:03:34:17
Speaker 1
Multiply it by 0.65, and that is.

00:03:34:17 - 00:03:38:10
Speaker 2
65% of your heart rate, Max. You're then going.

00:03:38:10 - 00:03:39:15
Speaker 1
To take that same.

00:03:39:15 - 00:03:40:08
Speaker 2
Number that to.

00:03:40:08 - 00:03:41:01
Speaker 1
20 minus.

00:03:41:01 - 00:03:41:16
Speaker 2
Your age.

00:03:42:24 - 00:03:45:24
Speaker 1
And then you're going to multiply it by 0.75.

00:03:47:11 - 00:03:49:03
Speaker 2
And you're going to write that number down.

00:03:50:01 - 00:03:51:01
Speaker 1
That is 70.

00:03:51:01 - 00:03:52:11
Speaker 2
5% of your heart rate.

00:03:52:11 - 00:03:55:07
Speaker 1
Max. So you now have.

00:03:55:07 - 00:03:56:05
Speaker 2
This range.

00:03:56:08 - 00:03:58:07
Speaker 1
Of 60 to 60 5 to 70.

00:03:58:07 - 00:03:59:16
Speaker 2
5% of your heart rate.

00:03:59:16 - 00:04:00:03
Speaker 1
Max.

00:04:00:23 - 00:04:01:15
Speaker 2
You're going to.

00:04:01:15 - 00:04:02:13
Speaker 1
Continue.

00:04:02:13 - 00:04:03:00
Speaker 2
On your.

00:04:03:00 - 00:04:04:07
Speaker 1
Steady state days.

00:04:04:18 - 00:04:05:23
Speaker 2
Increase in your heart.

00:04:05:23 - 00:04:07:20
Speaker 1
Rate by five beats per minute.

00:04:08:07 - 00:04:09:00
Speaker 2
Every time.

00:04:09:00 - 00:04:09:13
Speaker 1
You meet.

00:04:09:13 - 00:04:11:07
Speaker 2
The progression standards.

00:04:11:18 - 00:04:13:19
Speaker 1
So 20 minutes straight, no rest.

00:04:14:10 - 00:04:20:00
Speaker 2
No worse symptoms before or after good heart rate control. You're going to continue.

00:04:20:00 - 00:04:20:19
Speaker 1
To do that until.

00:04:20:19 - 00:04:22:08
Speaker 2
You start to get into your 60 to.

00:04:22:13 - 00:04:26:04
Speaker 1
65 or 75% range. Now, what I'll.

00:04:26:04 - 00:04:27:11
Speaker 2
Say here is.

00:04:27:18 - 00:04:31:20
Speaker 1
You can stop if you get to 65, you can stop when you get to the 75.

00:04:31:20 - 00:04:34:08
Speaker 2
Percent. The decision here is really.

00:04:34:09 - 00:04:37:20
Speaker 1
How do you want to be able to move in your daily life? Maybe you get to 65.

00:04:37:20 - 00:04:39:20
Speaker 2
Percent and you're like this, This is everything I want to.

00:04:39:20 - 00:04:41:04
Speaker 1
Do. This is fantastic. You could.

00:04:41:04 - 00:04:45:17
Speaker 2
Stop there. Or maybe you're like, No, I still want to be more active than.

00:04:45:17 - 00:04:46:05
Speaker 1
I am at this.

00:04:46:05 - 00:04:47:16
Speaker 2
Stage or be able to do more than I.

00:04:47:16 - 00:04:50:05
Speaker 1
Am at this stage. Maybe you go up to 75.

00:04:50:05 - 00:04:52:04
Speaker 2
Percent of your heart rate, max, for your steady.

00:04:52:04 - 00:04:52:11
Speaker 1
State.

00:04:53:10 - 00:04:55:04
Speaker 2
So whichever one you choose, you're going to.

00:04:55:04 - 00:04:59:17
Speaker 1
Continue your on. Your studies take days to.

00:04:59:17 - 00:05:00:23
Speaker 2
Progress your heart rate.

00:05:01:05 - 00:05:01:18
Speaker 1
As we have.

00:05:01:18 - 00:05:03:08
Speaker 2
Been progressing this entire time.

00:05:03:08 - 00:05:11:04
Speaker 1
Until you get in between these two numbers. Okay. So that's what you'll do on your steady state day.

00:05:12:12 - 00:05:13:00
Speaker 2
On your.

00:05:13:00 - 00:05:16:01
Speaker 1
Interval day. This is what it's going to look like.

00:05:17:04 - 00:05:18:06
Speaker 2
So your interval day is.

00:05:18:07 - 00:05:19:13
Speaker 1
Actually going to be easier.

00:05:19:15 - 00:05:20:05
Speaker 2
Than your steady.

00:05:20:05 - 00:05:20:22
Speaker 1
State Day.

00:05:21:07 - 00:05:22:16
Speaker 2
And intervals really.

00:05:22:16 - 00:05:24:19
Speaker 1
Help us kind of tone.

00:05:24:19 - 00:05:25:05
Speaker 2
The nervous.

00:05:25:05 - 00:05:26:10
Speaker 1
System a little bit more.

00:05:27:07 - 00:05:28:11
Speaker 2
So what you're going to do.

00:05:28:11 - 00:05:29:13
Speaker 1
Is one or two days.

00:05:29:13 - 00:05:30:16
Speaker 2
A week, you're going to do.

00:05:30:16 - 00:05:30:21
Speaker 1
An.

00:05:31:21 - 00:05:34:02
Speaker 2
Interval day, alternated with your steady state.

00:05:34:02 - 00:05:34:09
Speaker 1
Day.

00:05:35:19 - 00:05:48:20
Speaker 2
So you're going to warm up. You will exercise at 30 beats per minute above your resting heart rate, which is where we ended at four stage four, you'll for 5 minutes.

00:05:49:20 - 00:05:50:16
Speaker 1
You'll then.

00:05:50:19 - 00:05:51:19
Speaker 2
Lower your.

00:05:51:19 - 00:05:53:14
Speaker 1
Speed so that you.

00:05:53:14 - 00:05:54:14
Speaker 2
Can recover at.

00:05:54:14 - 00:05:56:16
Speaker 1
10 to 15 beats per minute.

00:05:56:16 - 00:05:57:15
Speaker 2
Above your resting heart.

00:05:57:15 - 00:06:01:15
Speaker 1
Rate for 5 minutes. Once that 5 minutes is.

00:06:01:15 - 00:06:03:09
Speaker 2
Over and you're still if you're.

00:06:03:09 - 00:06:05:09
Speaker 1
Still less than two out of ten.

00:06:05:19 - 00:06:06:11
Speaker 2
Increase.

00:06:07:10 - 00:06:10:14
Speaker 1
Of symptoms, you'll again do.

00:06:10:14 - 00:06:11:04
Speaker 2
30 beats.

00:06:11:04 - 00:06:15:11
Speaker 1
Per minute above resting heart rate, 5 minutes immediately followed by.

00:06:15:11 - 00:06:16:02
Speaker 2
Recover.

00:06:16:20 - 00:06:18:14
Speaker 1
10 to 15 beats per minute.

00:06:18:14 - 00:06:19:23
Speaker 2
Above resting heart rate for five.

00:06:19:23 - 00:06:25:05
Speaker 1
Minutes. That will total 20 minutes. And what you.

00:06:25:05 - 00:06:26:06
Speaker 2
Should see is there should be a.

00:06:26:06 - 00:06:26:16
Speaker 1
20.

00:06:27:03 - 00:06:31:14
Speaker 2
Per minute difference between your work interval. So the one that's a little harder and your recovery.

00:06:31:14 - 00:06:39:19
Speaker 1
Interval, the one that's a little bit easier and then your cooldown. Okay, so what that's going to look like.

00:06:39:19 - 00:06:43:01
Speaker 2
On an interval day, you're going to warm up, you're going to.

00:06:43:01 - 00:06:45:03
Speaker 1
Do the hard one.

00:06:45:14 - 00:06:47:17
Speaker 2
30 beats per minute above your resting heart rate for five.

00:06:47:17 - 00:06:48:04
Speaker 1
Minutes.

00:06:49:09 - 00:06:51:16
Speaker 2
You're going to lower down to the recover.

00:06:52:05 - 00:06:54:09
Speaker 1
You'll only be 10 to 15 beats per minute.

00:06:54:09 - 00:06:56:05
Speaker 2
Above your resting heart rate.

00:06:56:05 - 00:07:00:24
Speaker 1
5 minutes you'll go up 30 beats per.

00:07:00:24 - 00:07:02:08
Speaker 2
Minute above your resting heart rate.

00:07:02:16 - 00:07:05:04
Speaker 1
5 minutes, and then you'll go down.

00:07:06:08 - 00:07:07:04
Speaker 2
To your recovery.

00:07:07:16 - 00:07:08:10
Speaker 1
10 to 15.

00:07:08:10 - 00:07:10:04
Speaker 2
Beats per minute above your resting heart rate.

00:07:11:04 - 00:07:18:01
Speaker 1
That makes 20 minutes. So you'll cool down. You'll stop at any point during that.

00:07:18:06 - 00:07:20:21
Speaker 2
If your symptoms increase more than two.

00:07:20:21 - 00:07:21:13
Speaker 1
Out of ten.

00:07:22:10 - 00:07:23:08
Speaker 2
From your baseline.

00:07:23:08 - 00:07:25:15
Speaker 1
For that day, just like we did.

00:07:25:15 - 00:07:33:05
Speaker 2
Before. So you can see interval is more you're changing your speed a little easier, a little harder, a little easier, a little harder.

00:07:33:05 - 00:07:38:08
Speaker 1
That's an air of all day.

00:07:38:08 - 00:07:39:07
Speaker 2
So here's your.

00:07:39:07 - 00:07:41:14
Speaker 1
Stage five checklist again.

00:07:41:14 - 00:07:42:01
Speaker 2
You're going to get your.

00:07:42:01 - 00:07:42:21
Speaker 1
Standing.

00:07:43:04 - 00:07:43:23
Speaker 2
Heart rate at the.

00:07:43:23 - 00:07:44:08
Speaker 1
Top.

00:07:45:09 - 00:07:47:17
Speaker 2
And you're going to progress your steady.

00:07:47:17 - 00:07:49:15
Speaker 1
State day, the same as all.

00:07:49:15 - 00:07:50:16
Speaker 2
The other stages.

00:07:50:16 - 00:07:51:24
Speaker 1
You've done until.

00:07:51:24 - 00:07:52:10
Speaker 2
You reach.

00:07:52:10 - 00:07:53:23
Speaker 1
60 to 75.

00:07:53:23 - 00:07:54:21
Speaker 2
Percent of your heart rate.

00:07:54:21 - 00:07:56:16
Speaker 1
Max.

00:07:56:16 - 00:07:58:17
Speaker 2
And then you're going to progress your interval.

00:07:58:17 - 00:07:59:05
Speaker 1
Days.

00:07:59:19 - 00:08:05:05
Speaker 2
In a similar way. So you're going to compress to 35 beats per minute over your resting heart rate for five.

00:08:05:05 - 00:08:17:13
Speaker 1
Minutes and then down. So when you're ready to move to the maintenance stage, you should be able to do these two things. You should be able to.

00:08:17:13 - 00:08:18:21
Speaker 2
Complete your study.

00:08:18:23 - 00:08:22:09
Speaker 1
State. So consistent, consistent speed.

00:08:22:09 - 00:08:23:11
Speaker 2
Consistent heart rate.

00:08:25:18 - 00:08:26:06
Speaker 1
That work.

00:08:26:23 - 00:08:27:14
Speaker 2
For 20.

00:08:27:14 - 00:08:28:02
Speaker 1
Minutes.

00:08:29:07 - 00:08:30:12
Speaker 2
Three times in a row.

00:08:30:14 - 00:08:31:11
Speaker 1
Without.

00:08:32:00 - 00:08:32:16
Speaker 2
Increasing.

00:08:32:16 - 00:08:40:09
Speaker 1
Symptoms and good heart rate management. Once you can do that and you can complete.

00:08:40:09 - 00:08:42:12
Speaker 2
Your interval day, just 30.

00:08:42:12 - 00:08:44:00
Speaker 1
Five beats per minute on the.

00:08:44:00 - 00:08:44:20
Speaker 2
Work.

00:08:44:20 - 00:08:46:00
Speaker 1
10 to 15 minutes.

00:08:46:00 - 00:08:46:22
Speaker 2
On the recovery.

00:08:47:18 - 00:08:49:09
Speaker 1
5 minutes each segment.

00:08:49:09 - 00:08:49:22
Speaker 2
For a total.

00:08:49:22 - 00:08:53:07
Speaker 1
Of 20 minutes. Again, like always, without.

00:08:53:07 - 00:08:55:05
Speaker 2
Increase of symptoms during or after.

00:08:56:17 - 00:08:58:16
Speaker 1
And without manipulating.

00:08:58:16 - 00:08:59:07
Speaker 2
The workload.

00:08:59:08 - 00:09:01:24
Speaker 1
Past. Just we want to go up. We want to go down.

00:09:02:18 - 00:09:03:09
Speaker 2
You're ready for the.

00:09:03:09 - 00:09:07:16
Speaker 1
Final stage and that is maintenance. So I'm going to say that again.

00:09:07:16 - 00:09:08:06
Speaker 2
You're going.

00:09:08:06 - 00:09:08:19
Speaker 1
To.

00:09:09:03 - 00:09:10:22
Speaker 2
Progress your steady.

00:09:10:22 - 00:09:13:20
Speaker 1
State days just like we've been doing, just like in.

00:09:13:20 - 00:09:16:15
Speaker 2
Stage four until you're at 60.

00:09:16:15 - 00:09:17:01
Speaker 1
To 70.

00:09:17:01 - 00:09:18:09
Speaker 2
5% of your heart rate.

00:09:18:09 - 00:09:21:12
Speaker 1
Max. And you want to get to an.

00:09:21:12 - 00:09:21:24
Speaker 2
Interval.

00:09:21:24 - 00:09:22:12
Speaker 1
Day.

00:09:22:12 - 00:09:24:21
Speaker 2
Of 35 beats per minute on the work.

00:09:25:12 - 00:09:29:23
Speaker 1
10 to 15 beats per minute on the recovery, 5 minutes each.

00:09:29:23 - 00:09:30:12
Speaker 2
Segment for a.

00:09:30:12 - 00:09:34:17
Speaker 1
Total of 20 minutes. Again, no increase in.

00:09:34:17 - 00:09:37:08
Speaker 2
Symptoms during or after, no manipulation workload.

00:09:38:14 - 00:09:40:11
Speaker 1
Once you're able to do that.

00:09:40:17 - 00:09:41:16
Speaker 2
You're ready for the.

00:09:41:16 - 00:09:48:20
Speaker 1
Final stage. So if you have any questions, please let me know.

00:09:49:13 - 00:09:53:13
Speaker 2
Again, The interval days are actually going to be a little easier than the steady.

00:09:53:13 - 00:09:56:10
Speaker 1
State days you can continue to use.

00:09:56:10 - 00:09:58:16
Speaker 2
You know, your tracker and all the things. And of course.

00:09:58:16 - 00:10:01:06
Speaker 1
I am in the community.

00:10:01:06 - 00:10:01:17
Speaker 2
For any.

00:10:01:17 - 00:10:08:01
Speaker 1
Questions that you may have, so congratulations on making it to the final stage. Stage five.

00:10:08:12 - 00:10:10:11
Speaker 2
When you are ready, I will see you.

00:10:10:11 - 00:10:11:16
Speaker 1
In the last stage of the.

00:10:11:16 - 00:10:12:22
Speaker 2
Protocol, or I should say.

00:10:12:22 - 00:10:16:09
Speaker 1
Last part of the protocol, not even to stage maintenance.

00:10:16:14 - 00:10:17:10
Speaker 2
When you're ready, I will.

00:10:17:10 - 00:10:18:00
Speaker 1
See you there.

Maintenance Stage

00:00:00:01 - 00:00:24:12
Speaker 1
Hello and welcome to Maintenance. So you have done all five stages of the ADAPT protocol and you are now ready for what we call maintenance. Congratulations. You're now in the maintenance phase. I want to acknowledge your hard work for getting here because I know this wasn't easy. So maintenance, just like the other stages that came before us, the details are inside your workbook.

00:00:24:24 - 00:00:45:03
Speaker 1
So here at the maintenance phase, you can really choose any type of aerobic exercise you would like and continue any type of strength that you would like here. We're looking to have you exercise for 150 minutes of aerobic exercise per week, which is about 30 minutes for if you do five days and then continue 2 to 3 days of strength training.

00:00:45:03 - 00:01:06:23
Speaker 1
So here you're just maintaining all the gains you've had. And this is how you'll continue to move, you know, from here on out going forward. Now, if you are at a level where you're like, I'm able to do all the stuff I want to do, aerobics, exercise wise, physically, this is great then great. You make it here. You say, okay, I'm able to do the things I want to do Now.

00:01:06:23 - 00:01:29:01
Speaker 1
I'm you know, I'm not testing for this on an Omega anymore, because if we've gotten to this point in the protocol, your active stand test effect should be negative now, but maybe you're not at the level of exercise that you need to be. If that's the case, you can continue to progress your exercise goals here. So maybe if you're a professional athlete, you you need to get further here.

00:01:29:01 - 00:01:48:09
Speaker 1
Or maybe if you're someone who like, No, I just want to be able to play with my kids or go on a walk and I'm good, then you're good. So the goal is maintain what you've what you've gained here. You want to get at least 150 minutes of aerobic exercise a week, strength training, 2 to 3 times a week.

00:01:48:19 - 00:02:15:03
Speaker 1
If you still want to get to a higher level, you're going to continue to progress. Okay. It's that short, sweet spot that is the maintenance phase. It's just maintaining what you've got and continuing to move forward there. So congratulations. It's that short and sweet. I'm so excited for you to get to the stage. This really is really is quite the journey.

00:02:15:03 - 00:02:40:05
Speaker 1
And I'm very proud of you that you have gotten here. So if you have any questions, please let me know. Otherwise, you are just, you know, a healthy, healthy person exercising aerobically again. So and we shouldn't be having any symptoms here. If you want to do one final active stand test just to say like, hey, it's negative now you can, but otherwise congratulations on completing the ADAPT protocol.

00:02:40:05 - 00:02:48:22
Speaker 1
I'm very, very, very proud of you. Please go. Let me know in the group that you finish so we can all cheer you on. And I hope you continue to get many, many more wins.