Category Archives: Exercise

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

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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Podcast Interviews: “Exercise Is Medicine” Author Judy Foreman

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

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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Exercise Podcast: Home Rowing Machine Maker “Hydrow” CEO Bruce Smith

The Entrepreneurs Monocle 24 PodcastAs gyms are closed and many of us are stuck at home, it’s an opportune time for home fitness platforms. We speak to Bruce Smith, founder of Hydrow, while Jason de Savary of London’s Core Collective talks about the gym’s new CCTV platform.

Bruce SmithCEO & Founder

Bruce Smith CEO of HydrowLife-long entrepreneur and rower, Head of the Charles winner, coached the US Lightweight Eight to a Bronze medal at the 2015 World Rowing Championships and former Executive Director of Community Rowing – Boston.

Every aspect of Hydrow is engineered by rowing experts to elevate your experience. From computer-controlled resistance to revolutionary Live Outdoor Reality™ technology, Hydrow delivers an effective and enjoyable workout that brings the river home to you.

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

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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Study: Middle-Aged Knees With Meniscal Tears – No Benefits To Surgery Over Exercise Therapy (BMJ)

Exercise or Surgery - Meniscal Tear in Middle-Aged Knees BMJ

Conclusion: The study was inconclusive with respect to potential differences in progression of individual radiographic features after surgical and non-surgical treatment for degenerative meniscal tear. Further, we found no strong evidence in support of differences in development of incident radiographic knee osteoarthritis or patient-reported outcomes between exercise therapy and arthroscopic partial meniscectomy.

Objective: To evaluate progression of individual radiographic features 5 years following exercise therapy or arthroscopic partial meniscectomy as treatment for degenerative meniscal tear.

Design: Randomized controlled trial including 140 adults, aged 35-60 years, with a magnetic resonance image verified degenerative meniscal tear, and 96% without definite radiographic knee osteoarthritis. Participants were randomized to either 12-weeks of supervised exercise therapy or arthroscopic partial meniscectomy. The primary outcome was between-group difference in progression of tibiofemoral joint space narrowing and marginal osteophytes at 5 years, assessed semi-quantitatively by the OARSI atlas. Secondary outcomes included incidence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis, medial tibiofemoral fixed joint space width (quantitatively assessed), and patient-reported outcome measures. Statistical analyses were performed using a full analysis set. Per protocol and as treated analysis were also performed.

Results: The risk ratios (95% CI) for progression of semi-quantitatively assessed joint space narrowing and medial and lateral osteophytes for the surgery group were 0.89 (0.55-1.44), 1.15 (0.79-1.68) and 0.77 (0.42-1.42), respectively, compared to the exercise therapy group. In secondary outcomes (full-set analysis) no statistically significant between-group differences were found.

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Health & Fitness: “What Is Exercise Physiology?” (Penn Medicine Video)

Exercise physiologists are healthcare professionals that work with patients who are deconditioned or have a variety of different health complications. They work with pulmonary and cardiac patients, as well as competitive athletes with a wide range of fitness issues.

Penn Medicine’s Christopher J. Kusmiesz, MS describes his role as “assessing a patient’s fitness level and providing recommendations and guidance so they can improve and reach their health and fitness goals.”

Exercise physiologists at Penn uses patient test results, recommendations from their cardiologist and the patient’s own goals to create an exercise program that is unique to each patient.

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COVID-19: The Importance Of Home Exercise During Isolation (Mayo Clinic)

As we’re spending more time at home, it’s important to find new ways to remain active and exercise is important. Mayo Clinic physical therapist Sunni Alessandria and her colleagues offer some insight and tips for exercises you can do at home.

Exercise: “Shelter In Place” Home Circuit Workouts For Older Adults (WSJ)

From a Wall Street Journal article (March 21, 2020):

As we age, our balance declines, says Dani Johnson, a physical therapist with the Mayo Clinic’s Healthy Living Program in Rochester, Minn. Implementing balance exercises as simple as standing on one leg as you brush your teeth can help prevent falls. Getting a daily dose of cardio can boost the immune system.

This at-home circuit routine will get your heart rate up while also challenging strength and balance. Perform the circuit three times. Walk up and down steps or march in place for two to three minutes between sets. To up the effort, she suggests adding dumbbells or improvising with cans or tube socks filled with coins or rice.

Chair squats

Stand in front of a chair with your feet shoulder-width apart. Bend your knees, lowering your hips back, keeping weight in your heels and your chest upright. Start by sitting into the chair and standing back up 10 to 12 times. If this is easy, hover above the chair then return to standing.

 

 

Counter push-ups

Image result for incline push up at home gif animationPlace your hands on the edge of a counter, just beyond shoulder-width apart. Lower into a push-up then press back up. Repeat 10 to 12 times. For more of a challenge, walk your feet farther away from the counter.

Chair triceps dips

Sit upright in a chair with your hands on the armrests, elbows bent at 90 degrees. Straighten your arms, lifting your body off the chair. Hold briefly. Then lower yourself down. Use your legs to balance. Repeat 10 to 12 times.

Calf raises

Begin in a standing position. Rise up onto your toes, hold briefly, then lower back down. Repeat 10 to 12 times. Place one or both hands on a table or chair for more support. For an added challenge, perform on one leg at a time.

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Studies: Elderly In 3rd Highest Level Of Exercise Reduce Brain Shrinkage, Aging By 4 Years (AAN)

From a March 5, 2020 American Academy of Neurology release:

American Academy of Neurology (AAN) Logo“These results are exciting, as they suggest that people may potentially prevent brain shrinking and the effects of aging on the brain simply by becoming more active,” said study author Yian Gu, Ph.D., of Columbia University in New York and a member of the American Academy of Neurology.

“Recent studies have shown that as people age, physical activity may reduce the risk of cognitive decline and dementia. Our study used brain scans to measure the brain volumes of a diverse group of people and found that those who engaged in the top third highest level of physical activity had a brain volume the equivalent of four years younger in brain aging than people who were at the bottom third activity level.”

Older people who regularly walk, garden, swim or dance may have bigger brains than their inactive peers, according to a preliminary study to be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, April 25 to May 1, 2020. The effect of exercise was equal to four fewer years of brain aging. The study used magnetic resonance imaging (MRI) scans to measure the brains of people with a range of activity levels, including those who were inactive to those who were very active. The scans showed less active people had smaller brain volume.

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