http://yfrog.com/5otfhqj Productive night in kitchen: Green Bean/Feta salad, Quinoa Pilaf and Red Cabbage salad.
Archive for June, 2010
An updated review now confirms what has become conventional wisdom: “Normal daily activity seems to be the best way for patients with low-back pain to get better,” said Kristin Thuve Dahm, a researcher at the Norwegian Centre for the Health Services and lead author of the review.
Active patients experience less pain and avoid the side effects of immobility.
The review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
In the review, which directly compared rest in bed and staying active, the authors combined two previous Cochrane reviews, published in 2002 and 2004, that evaluated the two treatments separately. They also searched for additional recent randomized trials, but found none.
The fact that no new study has been published in nearly 10 years “shows that research done in the past already proved the point. Everyone is fairly convinced there’s not much benefit to bed rest,” said Joel Press, M.D., professor in physical medicine and rehabilitation at the Feinberg Northwestern School of Medicine in Chicago.
The researchers looked at two kinds of low back pain: with and without sciatica.
Although the term “sciatica” is often applied to low-back pain in which pain radiates down one or both legs, reviewed studies defined it more strictly: low-back pain accompanied by signs of nerve compression or damage, like numbness, tingling or weakness in the leg.
The comparison between bed rest and normal activity for low-back pain without sciatica used data from three studies that included 481 patients. All three found improvements in pain intensity with both treatments, with no significant differences between them.
One of the studies, however, involved a highly specific group of patients 80 young combat trainees who were hospitalized for their back pain “and thus, it’s applicability to the general population is questionable,” the authors wrote.
When the reviews pooled data from the other two studies, patients who stayed active experienced reductions in pain that were more significant, although the difference was “of limited clinical importance,” they wrote. The difference in pain persisted at follow-up 12 weeks later.
The same two studies found significantly greater improvements in the ability to function in the group that stayed active, four weeks and 12 weeks after treatment.
In comparing treatments for sciatica, the reviewers analyzed data from two studies of 348 patients. No difference existed in pain intensity, directly after treatment or 12 weeks later, between sciatica patients who received advice to stay active and those whose doctors prescribed bed rest. Similarly, there was no difference between groups in patients’ ability to function.
“The available evidence neither supports nor refutes that advice to stay active is better than resting in bed for people with sciatica,” Dahm said. “However, considering that bed rest is associated with potential harmful side effects, we think it is reasonable to advise people with sciatica to stay active.”
In general, Press said, “we’re almost always better moving than not moving. Structures in your back get their nutrition from movement; they have no real vascular system and are supplied with blood by motion, soaking it up like little sponges.”
Negative changes associated with immobility “manifest right away,” he said. Studies done in the 1950s showed that people lose 2 percent to 5 percent of their strength per day of complete bed rest.
The reviewers also compared bed rest and activity with other treatments. Pooled data of three studies including 931 low-back pain patients found little or no difference in pain or ability to function between patients on bed rest and those prescribed exercises.
Similarly, results of a single trial with 186 patients suggested that “exercises add no clinically relevant benefit for patients with acute low-back pain when compared to advice to stay active,” the authors wrote.
They came to the same conclusion about physiotherapy compared to either bed rest or activity for sciatica, from a single study involving 167 patients.
Press emphasized the need for future research to categorize back pain more precisely. “Not all back pain is the same; there are lots of different causes,” and the chances of finding a single treatment to benefit all patients are not good, he said. The goal should be defining subgroups “so we can predict from symptoms, physical examination and imaging studies which patients will respond to which types of treatment.”
http://yfrog.com/jbc8iaj Flight was great! Nice to meet other physicians and arrive in style. Not a bad way to commute.
The human body is filled with complex systems that perform daily tasks and make them seem simple to each and every one of us. We simply overlook the power of the nervous system and take too much for granted. When was the last time you actually stopped to think about a movement you were going to make? Or a sentence you were about to speak? We seem to pay closer attention to our body when it is failing us in one way or another. Whether you are working on strength training, learning to speak a new language, playing a musical instrument, these activities all get better with practice and time. Practice makes perfect. This is something I have to tell myself over and over. One of my current challenges has been trying to master the handstand without support. It is slowly getting there. I am not sure why I am so fascinated with handstands and trying to progress to walking on my hands, but I am loving the challenge so far. There is quite a bit of information that needs to be understood pertaining to the fundamentals of balance and the importance of building a solid foundation for proper balance.
Balance is controlled by 3 highly developed areas of our nervous system: the visual system (eyes), vestibular system (inner ear structures) and the proprioceptive system (system of sensors in the muscles, tendons, ligaments, skin that is responsible for you feeling pressure, vibration and position sense).
Balance is considered an inborn characteristic that starts developing shortly after birth. As the visual system develops and eyesight improves, the muscles in the neck develop as a newborn explores their surroundings and eventually is able to lift their head, which begins the development of the neck curve (cervical spine lordosis). This is then followed by creeping and crawling, which now starts to develop the curve in the lower back (lumbar spine lordosis). This will eventually lead to standing. Standing will lead to falling, over and over again, and all of this information is stored in the brain. All of the information stored is used to initiate our first steps of walking, ultimately leading to running.
The foundation of proper balance begins with our feet, or our hands, depending on your activity. Both are loaded with proprioceptive sensors. These sensors are constantly sending messages to the brain, which then sends these messages back down the spine to the muscles telling them when to contract and relax. Every movement you make is controlled by this system.
In chiropractic, balance is the focus of posture, muscular strength and flexibility. We know it has a huge impact on the health of our nervous system and how well we age can determine if we suffer from degenerative conditions in our later years. Balance and posture should be viewed as important components of fitness and strength from the time we are young. There is no better time to start working on your balance and strength than now. Get outside and start walking, running, swimming, cycling, crossfitting, hiking, whatever interest you may have. Do not be alarmed if you notice increased levels of awareness, strength or just an overall difference in your daily energy. You will start to feel stronger and more coordinated. Most importantly, you will have moved towards preserving the health of your body and improving your balance.
Live your best,
Reference: to your Health, May 2010
A twice weekly hip strengthening regimen performed for six weeks proved surprisingly effective at reducing — and in some cases eliminating — knee pain referred to as patellofemoral pain (PFP) in female runners.
The study by Tracy Dierks, assistant professor in the Department of Physical Therapy at Indiana University-Purdue University Indianapolis, was based on the theory that stronger hips would correct running form errors that contribute to PFP, even though study participants were given no instruction in gait training. The study used a pain scale of 0 to 10, with 3 representing the onset of pain and 7 representing very strong pain — the point at which the runners normally stop running because the pain is too great. The injured runners began the six-week trial registering pain of 7 when they ran on a treadmill and finished the study period registering pain levels of 2 or lower; i.e. no onset of pain.
“I wasn’t expecting such huge reductions, to be honest,” Dierks said. “We’ve had a couple of runners who have been at level 2, but the overwhelming majority have been a 2 or below.”
PFP, one of the most common running injuries, is caused when the thigh bone rubs against the back of the knee cap. Runners with PFP typically do not feel pain when they begin running, but once the pain begins, it gets increasingly worse. Once they stop running, the pain goes away almost immediately. Dierks said studies indicate PFP essentially wears away cartilage and can have the same effect as osteoarthritis. His study participants showed many of the classic signs of PFP, the most prominent being their knees collapsing inward when running or doing a squat exercise move.
The pilot study thus far involved five runners and a control group that comprised another four runners. Hip strength measurements were taken before and after the runners in the control group maintained their normal running schedule for six weeks. Hip strength measurements were taken for all of the runners before and after the next six-week period in which they all performed the hip-strengthening exercises. The exercises, performed twice a week for around 30 to 45 minutes, involved single-leg squats and exercises with a resistance band, all exercises that can be performed at home. This study is part of an ongoing study involving hip exercises and PFP pain, with 11 runners successfully using the intervention. Dierks said he plans to seek funding to test the exercises on a larger group of runners.
Earlier research had focused on the feet as a possible root of PFP, with studies only recently looking more closely at the hips. Dierks said studies have found an association between PFP in women and weak hips, but his study is the first to test a possible treatment. He noted that PFP is considered “multi-factorial,” so his study is examining one of several possible causes of the pain.
Dierks presented the findings of his study, “The effect of hip muscle strengthening on pain when running in females with patellofemoral pain,” on Friday, June 4, at 4:15 p.m. during the gait analysis II session.
Co-investigators are Zachary H. Gergory, Rebecca L. Phipps and Peter A. Altenburger, all of IUPUI.
Source: Indiana University
An Indiana University study found that strengthening inspiratory muscles by performing daily breathing exercises for six weeks significantly reduced the amount of oxygen these same breathing muscles required during exercise, possibly making more oxygen available for other muscles.
Louise Turner, a researcher in the Department of Kinesiology, said just the act of breathing during an endurance activity, such as running, swimming or cycling performed at maximum intensity, can account for 10 to 15 percent of an athlete’s total oxygen consumption. While inspiratory muscle training (IMT) has been shown to improve performance in endurance sports, Turner’s study sought to shed light on how IMT does this.
“This study helps to provide further insight into the potential mechanisms responsible for the improved whole-body endurance performance previously reported following IMT,” she said.
About the study:
- The double blind, placebo-controlled study involved 16 male cyclists ages 18 to 40.
- IMT involves the use of a hand-held device that provides resistance as one inhales through it, requiring greater use of inspiratory muscles. For half of the study participants, the IMT device was set to a level that provided resistance as the subjects took a fast forceful breath in. For six weeks they took 30 breaths at this setting twice a day. The cyclists in the control group did the same exercises with the IMT adjusted to a minimal level.
- After six weeks, when the study participants mimicked the breathing required for low, moderate and maximum intensity activities, the inspiratory muscles required around 1 percent less oxygen during the low intensity exercise and required 3 to 4 percent less during the high intensity exercise.
Muscles need oxygen to produce energy. Turner’s research also is looking at the next component of this equation, whether more oxygen is actually available to other muscles, particularly those in the legs, because less oxygen is being used by the breathing muscles.
IMT has been used as an intervention in pulmonary diseases and conditions, such as asthma, COPD and cystic fibrosis, and also is marketed as a means for improving athletic performance in cyclists, runners and swimmers.
Turner presented her study, “Inspiratory Muscle Training reduces the Oxygen Cost of Breathing during Exercise,” on Thursday, June 03. Co-authors are Timothy D. Mickleborough, Joel M. Stager and Robert F. Chapman from Indiana University; and Sandy Tecklenburg-Lund, Nebraska Wesleyan University.
Source: Indiana University
Tia Albright March 11, 2010
If you think your once-a-day training session counteracts the hours you spend sitting, think again. Leading a sedentary lifestyle—even if you exercise regularly—could do a number on your health, according to an editorial in the British Journal of Sports Medicine.
The Swedish scientists warned that after four hours of sitting, the genes that regulate glucose and fat begin to shut down. This lack of movement has been associated with heart disease, obesity, diabetes, and other health issues.
So why doesn’t exercise help? While working out improves overall fitness, studies have shown that how long you spend sitting may impact your health more than whether or not you hit the gym.
Canadian researchers found that people who sat more had an increased risk of death (independent of whether or not they exercised), while a 2010 Australian study showed that for every hour spent sitting in front of a TV, the risk of death from heart disease increases 18 percent, even for people who exercised.
The take-home advice: Keep up with your daily gym sessions, but make an effort to get up and be active periodically throughout the day to minimize long periods of sitting. Make these tips habit to get more movement in your day:
- Get a pedometer. You may think you’re walking more than you really are. Wear a pedometer to get an idea of how active you are outside of the gym.
- Make your gym time count. Kicking your workout into a higher gear will burn more calories throughout the day and train your most important muscle (your heart) more effectively.
- Give your desk a makeover. If you have a desk job, see if your company can elevate your workstation so that you can stand. Or sit on a stability ball for part of the day (it requires balance to stay seated, so your muscles will be working to keep you steady.
- Set reminders. It’s easy to get lost in your pile of paperwork for hours. Place a Post-It Note on your desk that says “take a walk” or reset your computer’s reminder system to give you daily pop-up messages as a reminder to “stand up” or “take a break.
- Use phone calls to your advantage. While it makes sense to sit while typing, you can stand while talking on the phone. So stand up during conference calls and chats with friends.
Hope the sun returns soon. Back in the pool today. #eugene
Nice to wake up in my own bed again after a long weekend of being on the road. Heading for a swim before the start of another short week.