Health Tip: On the Links this Winter?

January 5, 2006 08:41:22 PM PST

To avoid golfer's elbow, squeeze a tennis ball for five minutes to strengthen forearm muscles. Wrist curls and reverse wrist curls can also help reduce your risk.

Simple rowing exercises can reduce your chances of developing back pain. These should be done at least three times weekly.

Above all, be sure to do some light stretching just before you tee off.

 

Low Impact Aerobic Exercise Reduces Fatigue In Auto-immune Conditions Says Multi-study Review

Low impact aerobic exercise, such as walking and cycling, can effectively reduce fatigue in adults with chronic auto-immune conditions, according to a research review in the latest issue of the UK-based Journal of Advanced Nursing.

A team led by nurse researcher Dr Jane Neill from Flinders University in Adelaide, examined 162 research studies published between 1987 and 2006, analysing 36 in detail.

They discovered that there was reasonable evidence that people with conditions like multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus could benefit from exercise that gradually increased in intensity, duration and frequency.

"Fatigue is a major symptom in all three conditions and can cause a range of physical, psychological and social problems" says Dr Neill.

"Our review showed that aerobic exercise can significantly reduce fatigue and that some behavioural, nutritional and physiological interventions are also very effective."

Studies reviewed by the team tested 38 interventions on more than 1,700 patients. 24 resulted in statistically reduced fatigue or increased vitality levels.

The effective aerobic exercise programmes lasted an average of 12 weeks, with participants exercising for 30 to 60 minutes, three times a week.

Group interventions involved supervised exercise classes, including warm up, low impact aerobic activity and strengthening or stretching exercises before cool down. Home-based programmes made use of exercise bicycles, walking, cycling, jogging or swimming.

"There is good evidence that people experiencing fatigue from chronic auto-immune conditions can benefit from a range of non-medicinal interventions" concludes Dr Neill.

"Other effective strategies, apart from aerobic exercise, include health education and cognitive behavioural therapy.

"Cooling techniques and nutritional supplements such as acetyl-L-carnitine and fish oil showed a number of benefits, but need to be looked at in more detail."

The authors suggest electro-magnetic field devices also warrant further investigation, due to promising results.

But they add that low-cost, low technology interventions that promote self-management of fatigue are probably more appropriate and feasible than those requiring specialised equipment or professional expertise.

They stress that any exercise programmes must be suitable for each individual and take account of issues that affect how people manage their conditions, like reduced mobility, pain, nausea and stress.

"Healthcare professionals should ask people about their fatigue and assess each person's symptoms" adds Dr Neill. "People with fatigue should be encouraged to design their own exercise routines based on awareness of their individual fatigue patterns and daily priorities, while group activities must take account of the changing nature of fatigue over time."

Previous research suggests that 70 per cent of people with multiple sclerosis suffer daily fatigue, 57 per cent of people with rheumatoid arthritis experience fatigue and 81 per cent of those with system lupus erythematosus find fatigue moderately to severely disabling.

"Any measures that can reduce people's fatigue and improve their quality of life are to be welcomed. Our review shows that some interventions have great potential, particularly in the short term, but that more research is needed to measure their long-term effectiveness" says Dr Neill.

Journal of Advanced Nursing, which is celebrating its 30th anniversary in 2006, is read by experienced nurses, midwives, health visitors and advanced nursing students in over 80 countries. It informs, educates, explores, debates and challenges the foundations of nursing health care knowledge and practice worldwide. Edited by Professor Alison Tierney, it is published 24 times a year by Blackwell Publishing Ltd, part of the international Blackwell Publishing group.

http://www.journalofadvancednursing.com

Walk slowly for weight loss if you are obese

Leisurely walking for distance combined with low-impact cardiovascular activity appears to be the best formula for obese people seeking to get into shape and stay healthy, according to a University of Colorado at Boulder study.

Ray Browning, a doctoral student in CU-Boulder's integrative physiology department and lead author on the new study, said the results show that people who walk a mile at a leisurely pace burn more calories than if they walk a mile at their normal pace. In addition, those who walk at 2 miles per hour rather than 3 miles per hour reduce the loads on their knee joints by up to 25 percent.

"The message is that by walking more slowly, obese individuals can burn more calories per mile and may reduce the risk of arthritis or joint injury," he said.

Browning and his CU colleagues also found the number of calories burned per pound of body weight is similar for obese adults as normal sized adults walking at the same speed. Because obese people generally have heavier legs, wider stances and swing their legs in a wider arc, the researchers expected the cost of walking for obese people to be significantly higher.

"This was a surprise," said Browning. "The subjects probably are unwittingly altering their posture and walking with straighter legs, conserving calories in the process."

A paper by Browning, CU-Boulder integrative physiology Associate Professor Rodger Kram and undergraduates Emily Baker and Jessica Herron was presented at the June 2005 meeting of the American College of Sports Medicine meeting in Nashville and published recently in the journal, "Obesity Research."

The CU-Boulder researchers based their expectations that obese adults would have a greater energy cost when walking on previous studies by Kram's lab team. In one study, energy expenditure increased by about 25 percent when normal-weight people walked with a deliberately wider stance, said Browning.

Other CU studies conducted in CU's Locomotion Laboratory have shown that normal weight people wearing "winged" shoes designed to force them to increase their lateral leg swing increased the metabolic cost of walking by 30 percent, Browning said.

"As people become gradually obese, they also seem to become particularly graceful," said Kram. "There appears to be some sort of a physiological drive for them to minimize the amount of energy they expend."

The researchers tested 20 men and 20 women on treadmills and sidewalks, half of whom were of normal weight and half classified as class 2 obese, meaning they have a body mass index, or BMI, of 30 to 40. A 5-foot 4-inch tall woman with a BMI of 30 weighs about 175 pounds, while a 6-foot man with a BMI of 30 weighs about 225 pounds.

The researchers measured each subject's body composition using an instrument known as a DEXA scanner to measure fat mass, lean tissue mass and bone mineral content of the total body. They also measured the oxygen consumption and carbon dioxide production of the test subjects to determine the energy and calories expended while walking.

As part of the ongoing research, the research team is using a unique treadmill that can independently measure loads placed on the left and right feet while walking, Browning said. The treadmill helps them measure how the biomechanical forces increase with body weight and walking speed.

The results show that brisk walking dramatically increases the knee joint forces, which can lead to a variety of problems including joint injuries and arthritis, the researchers said.

"This study also pointed up the phenomenal accomplishments of obese people," said Kram. "Our test subjects lead productive lives, and if you weigh 300 pounds, many everyday activities are athletic endeavors."

Walking doesn't require special clothing, stressed Browning. "It's doing some simple things, like using the stairs rather the elevator, parking your car further from your destination, or getting off the bus one stop early and walking. Rather than trying to walk fast, obese individuals can gain both caloric and biomechanical benefits from walking at a more leisurely pace."

Because walking slowly may not significantly improve an obese person's level of cardiovascular fitness, performing other vigorous lower-impact activities like swimming, cycling, step routines and elliptical training workouts also are recommended, said Browning.

Much of the research was carried out at the General Clinical Research Center housed within CU-Boulder's Wardenburg Health Center, which receives more than $1 million in funding annually from the National Institutes of Health.

Contact: Ray Browning
browning@colorado.edu
303-492-0926

Rodger Kram
Rodger.kram@colorado.edu
303-492-7984

Jim Scott
303-492-3114

University of Colorado
http://www.colorado.edu

A unique video for people with type 2 diabetes and pre diabetes

Joslin Diabetes Center in Boston, the world leader in diabetes research and care, announced today that it has released Keep Moving!...Keep Healthy with Diabetes, the first video designed by Joslin Diabetes Center specifically for people with diabetes or pre-diabetes. Created by the Exercise Physiology Department at Joslin, the video offers low-impact exercises designed for people who have physical limitations or are new to exercise programs. These exercise routines have been used by Joslin patients as part of Joslin's clinical practice, and can be an ideal tool for those looking for low-impact exercises to help get the physical activity they need.

The Keep Moving!...Keep Healthy with Diabetes video costs $24.95, and is available by calling Joslin at 800-344-4501 or by visiting Joslin's online store at http://www.store.joslin.org.

Exercise is an important way to delay or prevent the onset of type 2 diabetes as well as to improve the health of people with diabetes. A recent Joslin Diabetes Center study showed that obese adults who lost just seven percent of their weight - or 16 pounds in a 220-pound, 5'5" tall woman - and did moderate-intensity physical exercise for six months such as the exercises on the Keep Moving! video, improved their major blood vessel function by approximately 80 percent, regardless of whether or not they had type 2 diabetes.

"Physical limitations often prevent many people who want to improve their fitness from doing so, but these limitations do not need to stop them from exercising. In fact for people with physical limitations, having a regular exercise routine is very important since they otherwise tend to lead sedentary lives," said Cathy Mullooly, M.S., R.C.E.P., C.D.E., Clinical Exercise Physiology Specialist at Joslin. "This is a unique resource, especially for those with type 2 diabetes. It is also beneficial for those struggling with their weight and who either should not or cannot embark on a high-impact exercise routine. This video is a great resource for people who assume that fitness is unattainable."

The video shows two simultaneous exercisers, one seated and one standing, performing similar aerobic activities. Seated exercises are appropriate for individuals with a limited capacity for exercise as well as for people with physical limitations (hip or knee problems, balance difficulties, etc.). The standing version involves a higher level of aerobic activity, but is still relatively "low impact."

Each workout segment is set to music and led by Joslin Clinical Exercise Physiologist Catherine Jarema, M.S., R.C.E.P., C.D.E. Richard A. Jackson, M.D., a senior physician at Joslin Diabetes Center and head of its federally funded "On the Road" program, also provides useful information regarding the correct methods for performing exercises. The entire video runs 45 minutes.

The production of the video was supported by funding from the Cooperative State Research, Education and Extension Service, a division of the United States Department of Agriculture. "On the Road" is a program established by Joslin Diabetes Center to reach out to underserved populations at risk for diabetes.

About Joslin Diabetes Center

Joslin Diabetes Center, dedicated to conquering diabetes in all of its forms, is the global leader in diabetes research, care and education. Joslin Research is a team of over 300 people at the forefront of discovery aimed at preventing and curing diabetes. Joslin Clinic, affiliated with Beth Israel Deaconess Medical Center in Boston, the nationwide network of Joslin Affiliated Programs, and the hundreds of Joslin educational programs offered each year for clinicians, researchers and patients, enable Joslin to develop, implement and share innovations that immeasurably improve the lives of people with diabetes. As a nonprofit, Joslin benefits from the generosity of donors in advancing its mission. For more information on Joslin, call 1-800-JOSLIN-1 or visit http://www.joslin.org.

Note for Media: A color image of the exercise video cover can be downloaded at the following link:
http://www.joslin.org/images/exerciseblueborder.jpg

Additional Contact:Jenny Eriksen
Joslin Communications
Jenny.eriksen@joslin.harvard.edu
617-732-2415

Contact: Marge Dwyer
marjorie.dwyer@joslin.harvard.edu
617-732-2415
Joslin Diabetes Center

Myth That Exercise and Arthritis Don't Mix Still Lingers

Most patients still believe something other than exercise is the most effective non-drug treatment for osteoarthritis, according to a new poll by Spine-health.

The Spine-health.com poll of 897 back pain patients shows that 53% of patients chose options besides exercise as the best course of action for treating osteoarthritis pain and inflammation. Eighteen percent chose "heat/ice", 12% chose "rest", 12% chose "manipulation (e.g., chiropractic/osteopathic adjustments)", 9% chose "acupuncture" and 2% chose "support devices (e.g., a brace)".

"For years, people with arthritis thought the right answer was to avoid activity, physical therapy and exercise, for fear that their pain would get worse. Well, avoiding activity and exercise is actually the wrong answer," says Vert Mooney, M.D., an orthopedic spine surgeon in San Diego, and author of a new article published on Spine-health.com about spinal osteoarthritis treatment options. "The common thread among most osteoarthritis patients successfully managing their condition, including reducing pain and improving movement, is regular exercise. While the poll results show that more and more people understand the role of exercise in helping improve osteoarthritis symptoms, there is work to do in adequately busting the myth that arthritis and exercise don't mix."

Of the several varieties of arthritis, the most common, disabling and often the most painful is osteo- (meaning bone) arthritis, mostly affecting knees, hips, hands, feet and the spine. Osteoarthritis, also known as degenerative joint disease, affects up to 30 million Americans, mostly women and usually those over 45 or 50 years of age. Normally, joints have remarkably little friction and move easily, but with degeneration of the joint, the cartilage becomes rough and likely worn out - causing the joint halves to rub against each other, creating pain and limiting motion.

For those with osteoarthritis, exercise should focus on strengthening the muscles around the joints (removing some stress from the joints), improving joint mobility and reducing joint stiffness and pain. The recommended categories of exercise usually include strengthening (done on resistance or weight machines or with exercise bands), low impact aerobics, and range of motion exercises. Popular activities for arthritis sufferers include gentle exercises such as swimming and other water therapy, walking, stationary cycling, yoga, even golf. "The key is making the patient's muscles work harder (not necessarily faster or longer) than they usually do with normal daily activity. However, exercise needs to be done correctly to avoid causing further joint pain and should be guided by an appropriately trained physical therapist or other professional," adds Dr. Mooney.

Further information on osteoarthritis and treatment options, including exercise, medication, and surgery, can be viewed at http://www.spine-health.com.

About Spine-health.com

Spine-health.comprovides in-depth information and resources for patients with back pain, neck pain, and a full range of spinal disorders. Written and peer-reviewed by spine specialists, the site includes thousands of pages of original articles, animations, clinical trials, and spine physician web pages.

 

Health Tip: Making Changes To Your Family's Diet?

January 5, 2006 08:41:22 PM PST

Here are some suggestions:

• Decide on two or three specific, small changes in eating or physical activity at a time. Don't overdo it all at once.
• Write down your family's weekly goals and keep track of them.
• Keep a daily food and activity log.
• Don't expect perfection.
• Reward your family for positive change.