Tag Archives: Exercise

Exercise, Health, Medicine, Studies

Infographic: Exercise For ‘Claudication’ (BMJ Study)

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Exercise training is a safe, effective and low-cost intervention for improving walking ability in patients with IC. Additional benefits may include improvements in QoL, muscle strength and cardiorespiratory fitness. Clinical guidelines advocate supervised exercise training as a primary therapy for IC, with walking as the primary modality.

However, evidence is emerging for the role of various other modes of exercise including cycling and progressive resistance training to supplement walking training. In addition, there is emerging evidence for home-based exercise programmes. Revascularisation or drug treatment options should only be considered in patients if exercise training provides insufficient symptomatic relief.

Abstract

Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with the strongest evidence and is recommended in several national and international guidelines. Alternate forms of exercise such as upper- or lower-body cycling may be used, if required by certain patients, although there is less evidence for these types of programmes. The evidence for progressive resistance training is growing and patients can also engage in strength-based training alongside a walking programme. For those unable to attend a supervised class (strongest evidence), home-based or ‘self-facilitated’ exercise programmes are known to improve walking distance when compared to simple advice. All exercise programmes, independent of the mode of delivery, should be progressive and individually prescribed where possible, considering disease severity, comorbidities and initial exercise capacity. All patients should aim to accumulate at least 30 min of aerobic activity, at least three times a week, for at least 3 months, ideally in the form of walking exercise to near-maximal claudication pain.

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Exercise, Health, Studies

Covid-19 Infographic: ‘Exercise Is Medicine’ (BMJ)

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There are over 35,000,000 reported cases of COVID-19 disease and 1 000 000 deaths across more than 200 countries worldwide.1 With cases continuing to rise and a robust vaccine not yet available for safe and widespread delivery, lifestyle adaptations will be needed for the foreseeable future. As we try to contain the spread of the virus, adults are spending more time at home. Recent evidence2 suggests that physical activity levels have decreased by ~30% and sitting time has increased by ~30%. This is a major concern as physical inactivity and sedentary behaviour are risk factors3 for cardiovascular disease, obesity, cancer, diabetes, hypertension, bone and joint disease, depression and premature death.

To date, more than 130 authors from across the world have provided COVID-19-related commentary on these concerns. Many experts4 have emphasised the importance of increasing healthy living behaviours and others5 have indicated that we are now simultaneously fighting not one but two pandemics (ie, COVID-19, physical inactivity). Physical inactivity alone results in over 3 million deaths per year5 and a global burden of US$50 billion.6 Immediate action is required to facilitate physical activity during the COVID-19 pandemic because it is an effective form of medicine3 to promote good health, prevent disease and bolster immune function. Accordingly, widespread messaging to keep adults physically active is of paramount importance.

Several organisations including the WHO, American Heart Association and American College of Sports Medicine have offered initial suggestions and resources for engaging in physical activity during the COVID-19 pandemic. Expanding on these resources, our infographic aims to present a comprehensive illustration for promoting daily physical activity to the lay audience during the COVID-19 pandemic (figure 1). As illustrated, adults are spending more time at home, moving less and sitting more. Physical activity provides numerous health benefits, some of which may even help directly combat the effects of COVID-19. For substantial health benefits, adults should engage in 150–300 min of moderate-to-vigorous intensity physical activity each week and limit the time spent sitting. The recommended levels of physical activity are safely attainable even at home. Using a combination of both formal and informal activities, 150 min can be reached during the week with frequent sessions of physical activity spread throughout the day. Sedentary behaviour can be further reduced by breaking up prolonged sitting with short active breaks. In summary, this infographic offers as an evidence-based tool for public health officials, clinicians, educators and policymakers to communicate the importance of engaging in physical activity during the COVID-19 pandemic.

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Aging, Books, Exercise, Science, Studies

Top New Books On Aging: “Exercised” By Daniel E. Lieberman – “Extending Longevity” (Harvard)

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HARVARD MAGAZINE (SEPT – OCT 2020): From the book EXERCISED: Why Something We Never Evolved to Do Is Healthy and Rewarding by Daniel E. Lieberman, to be published on September 8, 2020 by Pantheon Books:

‘….many of the mechanisms that slow aging and extend life are turned on by physical activity, especially as we get older. Human health and longevity are thus extended both by and for physical activity.’

What Happens When We Exercise?
The graph breaks total energy expenditure (TEE) into two parts: active energy expenditure, and resting metabolism. Resting metabolism remains elevated for hours even after exercise ceases, burning additional calories in a phase known as excess post-exercise oxygen consumption (EPOC).

Exercise is like scrubbing the kitchen floor so well after a spill that the whole floor ends up being cleaner. The modest stresses caused by exercise trigger a reparative response yielding a general benefit.

In order to elucidate the links between exercise and aging, I propose a corollary to the Grandmother Hypothesis, which I call the Active Grandparent Hypothesis. According to this idea, human longevity was not only selected for but was also made possible by having to work hard during old age to help as many children, grandchildren, and other younger relatives as possible survive and thrive. That is, while there may have been selection for genes (as yet unidentified) that help humans live past the age of 50, there was also selection for genes that repair and maintain our bodies when we are physically active.

Daniel E. Lieberman is a paleoanthropologist at Harvard University, where he is the Edwin M Lerner II Professor of Biological Sciences, and Professor in the Department of Human Evolutionary Biology. He is best known for his research on the evolution of the human head and the evolution of the human body.

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News, Podcasts, Science

Top New Science Podcasts: Megatrials For Covid-19 Treatment & Blood Benefits Of Exercise

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science-magazine-podcastsContributing correspondent Kai Kupferschmidt talks with host Sarah Crespi about the success of a fast moving megatrial for coronavirus treatments. The United Kingdom’s Recovery (Randomized Evaluation of COVID-19 Therapy) trial has enrolled more than 12,000 hospitalized coronavirus patients since early March and has released important recommendations that were quickly taken up by doctors and scientists around the world. 

Kupferschmidt discusses why such a large study is necessary and why other large drug trials like the World Health Organization’s Solidarity trial are lagging behind. Also this week, producer Meagan Cantwell talks with Saul Villeda, a professor in the Department of Anatomy at the University of California, San Francisco, about transferring the beneficial effects of exercise on the brain from an active mouse to a sedentary mouse by transferring their blood.

Diet, Exercise, Health, Medicine, Obesity, Studies

Study: “Intensive Diet And Exercise” Reverses Type 2 Diabetes In 61% Of Patients

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From The Lancet Diabetes & Endocrinology (June 2020):

Our findings show that the intensive lifestyle intervention led to significant weight loss at 12 months, and was associated with diabetes remission in over 60% of participants and normoglycaemia in over 30% of participants. The provision of this lifestyle intervention could allow a large proportion of young individuals with early diabetes to achieve improvements in key cardiometabolic outcomes, with potential long-term benefits for health and wellbeing.

The Lancet Diabetes & Endocrinology

Type 2 diabetes is affecting people at an increasingly younger age, particularly in the Middle East and in north Africa. We aimed to assess whether an intensive lifestyle intervention would lead to significant weight loss and improved glycaemia in young individuals with early diabetes.
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Between July 16, 2017, and Sept 30, 2018, we enrolled and randomly assigned 158 participants (n=79 in each group) to the study. 147 participants (70 in the intervention group and 77 in the control group) were included in the final intention-to-treat analysis population. Between baseline and 12 months, the mean bodyweight of participants in the intervention group reduced by 11·98 kg (95% CI 9·72 to 14·23) compared with 3·98 kg (2·78 to 5·18) in the control group (adjusted mean difference −6·08 kg [95% CI −8·37 to −3·79], p<0·0001). In the intervention group, 21% of participants achieved more than 15% weight loss between baseline and 12 months compared with 1% of participants in the control group (p<0·0001). Diabetes remission occurred in 61% of participants in the intervention group compared with 12% of those in the control group (odds ratio [OR] 12·03 [95% CI 5·17 to 28·03], p<0·0001). 33% of participants in the intervention group had normoglycaemia compared with 4% of participants in the control group (OR 12·07 [3·43 to 42·45], p<0·0001).
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Aging, Exercise, Health, Interviews, Podcasts

Podcast Interviews: “Exercise Is Medicine” Author Judy Foreman

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Science Talk logoHealth journalist Judy Foreman talks about her new book Exercise Is Medicine: How Physical Activity Boosts Health and Slows Aging

downloadThis is Scientific American’s Science Talk, posted on April 24th, 2020. I’m Steve Mirsky. And under our current, often locked-down situation, it’s still really important to try to get some exercise. Judy Foreman is the author of the new book Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging. She’s a former nationally syndicated health columnist for the Boston Globe, LA times, Baltimore Sun and other places, and an author for the Oxford University Press.

Judy Foreman is the author of “A Nation in Pain” (2014), “The Global Pain Crisis” (2017), and “Exercise is Medicine,” (2020), all published by Oxford University Press, and was a staff writer at The Boston Globe for 22 years and the health columnist for many of these years. Her column was syndicated in national and international outlets including the Los Angeles Times, Dallas Morning News, Baltimore Sun and others.

She graduated Phi Beta Kappa from Wellesley College and has a Master’s from the Harvard Graduate School of Education. She was a Lecturer on Medicine at Harvard Medical School, a Fellow in Medical Ethics at Harvard Medical School and a Knight Science Journalism Fellow at the Massachusetts Institute of Technology. She spent six months as a guest reporter for The Times of London. She was also a Senior Fellow at the Schuster Institute for Investigative Journalism at Brandeis University. She was also host of a live, weekly call-in radio show on Healthtalk.com.

Judy has won more than 50 journalism awards, including a 1998 George Foster Peabody award for co-writing a video documentary about a young woman dying of breast cancer and the 2015 Science in Society award from the National Association of Science Writers.

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Exercise, Fitness, Profiles

Fitness: 55-Year Old Swimmer Creates New “Land-Based Exercises”

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From a Wall Street Journal article (April 18 2020)

Arlette Godges Master SwimmerA physical therapist based in Santa Barbara, Calif., Ms. Godges is used to seeing injuries that result when swimmers start training on land. “We are great at cardio, but we aren’t used to pounding our joints. Gravity is not forgiving. We need to give our bodies time to adapt.”

With pools closed over concerns about coronavirus transmission, Arlette Godges is adapting to being a fish on land.

The 55-year-old U.S. Masters swimmer was in the pool five days a week training for the UANA Pan American Masters Championships in Medellín, Colombia. The June competition has been postponed. “I was feeling so strong,” she says. “Now I have to challenge myself with other things so I don’t become a slug and lose motivation.”

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Culture, Design, Home Design, Homes, Magazines, Media, Videos

Upcoming Magazines: “Why Home Matters” – (Monocle May 2020)

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Monocle’s home-focused May issue goes beyond the dramatic headlines to look at how to create spaces that are apt to linger in. 

We launch a manifesto for building better, look at the firms eyeing up the domestic market and profile a few elegant residences. Elsewhere, we examine the importance of keeping manufacturing onshore, decode the US political advertising industry and recommend the best media to hunker down with.

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Exercise, Health, Medicine, Studies

Health Study: Physical Therapy Superior To Steroid Injection For Knee Osteoarthritis

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New England Journal of Medicine Articles

Patients with osteoarthritis of the knee who underwent physical therapy had less pain and functional disability at 1 year than patients who received an intraarticular glucocorticoid injection.

Physical Therapy Superior To Glucocorticoid Injection for Knee Osteoarthritis NEJM April 9 2020

Osteoarthritis of the knee is a leading cause of disability.1 Current management is typically limited to the treatment of symptoms until late stages of arthritis lead to knee replacement.2 Intraarticular glucocorticoid injections are commonly used as a primary treatment for osteoarthritis of the knee,3 but there are conflicting reports regarding the extent and duration of the relief of symptoms with this therapy.4-6 Complications from these injections occur infrequently but include joint infection,7 accelerated degradation of articular cartilage,8 and subchondral insufficiency fractures.9

PHYSICAL THERAPY

The physical therapy intervention, which is described in the protocol,26 included instructions and images for exercises, joint mobilizations, and the clinical reasoning underlying the priorities, dosing, and progression of treatment. During a typical clinical session, the physical therapist would implement hands-on, manual techniques immediately before the patient performed reinforcing exercises to help the patient perform the movements with little or no pain. For example, if a patient could not fully extend or flex the knee, or those movements were painful, the physical therapist would use a hands-on, passive mobilizing technique to repeatedly move the knee to reduce stiffness while altering the mechanics of the technique to avoid pain. The patient would then perform repeated active knee movements in the same direction.

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