Short Bursts of Activity Ease Fibromyalgia

Walking More, Gardening, Taking the Stairs Help Fibromyalgia Patients Feel and Function Better, Study Finds

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

March 29, 2010 -- Exercise may be the last thing you feel like doing if you are among the 10 million Americans living with the chronic pain disorder fibromyalgia. Yet a new study shows that incorporating short bursts of physical activity into the day makes fibromyalgia patients feel and function better. The findings appear in Arthritis Research & Therapy.

"Just trying to accumulate a little more physical activity throughout the normal course of the day, as opposed to engaging in traditional exercise, can improve self-reported measures of functioning and pain among people with fibromyalgia," lead researcher Kevin Fontaine, PhD, an assistant professor of rheumatology at Johns Hopkins University in Baltimore, tells WebMD in an email. "You don't necessarily have to do traditional exercise to reap some benefits, [and] this may motivate people with fibromyalgia who find it difficult to stick with traditional exercise to simply try to get a little more active during the day."

In the 12-week study of 84 people with fibromyalgia, people who incorporated 30 minutes' worth of lifestyle physical activity into their days five to seven days a week took 54% more steps per day than their counterparts who participated in a fibromyalgia education program, which discussed the importance of physical activity in the treatment of this disease, but did not provide any specific recommendations. The lifestyle physical activity group also reported fewer perceived deficits in their physical function and less pain than people in the disease education group, the study showed.

What Is Lifestyle Physical Activity?

Lifestyle physical activity refers to finding ways to accumulate short bursts of physical activity into the day. This can be walking more, gardening, taking the stairs, or really anything that gets you moving more. The current school of thought suggests that such small bursts of exercise throughout the day can be as effective as exercising for 30 consecutive minutes.

"There is probably no single good or best exercise or lifestyle physical activity prescription for people with fibromyalgia because there is such variability in symptoms between people," he says. "For many, walking is helpful, but some may prefer water exercise or cycling."

The bottom line? "The best exercise or lifestyle physical activity is the one that a person can stick with and one that doesn't significantly worsen their symptoms," Fontaine says. "The main thing is for people with fibromyalgia to try to do something physical just about every day."

© 2010 WebMD, LLC. All rights reserved.

America's Fittest Cities, surprise!?

No surprise to see the west coast cities listed here... what shocks me is that Wash. DC is #1. Is the capital really shaping up? Not from what I have seen via the media, that's for sure... jd

Which City Is America's Fittest?

Nation's Capital Is Fittest City in U.S., According to American College of Sports Medicine By Miranda Hitti
WebMD Health News

May 26, 2009 -- Washington, D.C., tops the American College of Sports Medicine's new list of America's fittest cities.

The list is based on personal factors -- including the percentage of residents who smoke, are obese, get regular physical activity, eat at least five servings of fruits and vegetables per day, and have conditions such as diabetes and heart disease -- and on local resources, such as parks, farmers' markets, number of primary health care providers, and crime rates. Data came from sources including the CDC, U.S. Census Bureau, U.S. Department of Agriculture, and the nonprofit Trust for the Public Land.

Here is how the cities ranked:

1. Washington, D.C.
2. Minneapolis-St. Paul
3. Denver
4. Boston
5. San Francisco
6. Seattle
7. Portland
8. San Diego
9. Austin, Texas
10. Virginia Beach, Va.
11. Hartford, Conn.
12. Sacramento, Calif.
13. San Jose, Calif.

View Article Sources

SOURCES:

ACSM American Fitness Index: "Actively Moving America to Better Health."

News release, American College of Sports Medicine.

© 2009 WebMD, LLC. All rights reserved.

Back Pain: Alexander Technique & Exercise rate highest

Randomised controlled trial of Alexander Technique lessons, exercise, and massage for chronic and recurrent back pain

In adults with recurrent or chronic low back pain, all three interventions led to better self reported function and less pain at three months, but only exercise prescribed by general practitioners and training in the Alexander Technique had sustained benefit at one year (MRCT ATEAM trial). Supervised exercise is effective but needs to be tailored to patients' preferences and expectations, says the accompanying editorial.

Strength training relieves chronic neck pain

From the Harvard HEALTHbeat newsletter, April 29, 2008: Most of us are troubled by neck pain at some point in our lives. The most common culprit is overuse or misuse of muscles and ligaments. Today’s computer-dominated workplace can be especially tough on necks, because so many of us sit for long periods with shoulders slumped and heads extended toward monitors. Considerable study has been devoted to the treatment of chronic neck pain. The choices include medications, chiropractic manipulation, electrical nerve stimulation, massage, and various forms of exercise. Results so far have been inconsistent and difficult to compare, and the quality of research has been uneven. Still, there’s mounting evidence that certain exercises designed to strengthen neck muscles can help break longstanding cycles of neck pain. A randomized trial has found that women with work-related neck pain experienced significant and long-lasting relief by regularly practicing five specific neck muscle–strengthening exercises. General fitness workouts, by contrast, reduced the pain only slightly. Results were published in the January 2008 issue of Arthritis Care and Research. The study Danish scientists at the National Research Center for the Working Environment in Copenhagen recruited women engaged in repetitive work, mostly at computer keyboards, at banks, post offices, administrative offices, and an industrial facility. All complained of neck pain lasting more than a month during the previous year. They were eligible for the study if physical examinations showed they had trapezius myalgia — chronic pain and tightness in the muscles that run down the back of the neck and fan out toward the shoulders. Participants were divided randomly into three groups. One group received strength training focused on neck and shoulder muscles. The second group received general fitness training, which consisted of riding an exercise bike without holding onto the handlebars. The third group was given only health counseling. The two exercise groups worked out for 20 minutes three times a week for 10 weeks. The women rated pain intensity in the trapezius muscles immediately before and immediately after each training session and two hours after each workout. The strength training group experienced a 75% decrease in pain, on average, during the intervention as well as during a 10-week follow-up period involving no workouts. General fitness training resulted in only a short-term decrease in pain that was too small to be considered clinically important, although the researchers did suggest that even a little reduction in pain severity could encourage people to give exercise a try. There was no improvement in the health counseling group. This study isn’t the final word on relieving chronic neck pain. The number of participants (48) was small, and most of the women were under age 60. The results may not apply to women who are older or have conditions that limit their ability to strength train. Still, the findings suggest that performing specific muscle-strengthening exercises may be a helpful strategy for many women with chronic neck pain. (The researchers have investigated the effectiveness of each exercise with electromyography, which measures muscle-generated electrical activity. Results will be published in the journal Physical Therapy.) The exercises Strength training in the Danish study consisted of five exercises that involved the use of hand weights to strengthen neck and shoulder muscles. Three times a week (Mondays, Wednesdays, and Fridays), for 20 minutes per session, participants performed three of the five exercises, doing three sets of eight to 12 repetitions (each set lasting 25 to 35 seconds) for each exercise. The exercises changed from session to session but always included dumbbell shrugs. The weight load was gradually increased during the study, roughly doubling in 10 weeks. This was an intensive program and study participants were carefully supervised. So before you embark on a similar regimen, consult a physical therapist or exercise specialist who can help design a program for your needs and make sure that you’re doing the exercises correctly. In the exercises pictured here, the starting weights in parentheses are those used in the study. For each exercise, you should start with a weight that allows a maximum of eight to 12 repetitions. Dumbbell shrug Stand straight with your feet shoulder-width apart and your knees slightly bent. Hold a weight in each hand, and allow your arms to hang down at your sides, with your palms facing your body. Shrug your shoulders upward, contracting the upper trapezius muscle, hold for one count, and lower. Repeat eight to 12 times per set. (Starting weight: 17 to 26 pounds.) One-arm row Stand with your left knee on a flat bench and your right foot on the floor. Hold a weight in your right hand. Bend your torso forward, placing your left hand on the bench for support. Allow the weighted hand to hang down toward the floor. Pull the weight up until your upper arm is parallel with your back, pause, and then lower it. Repeat eight to 12 times per set. Switch to the left side, and repeat. (Starting weight: 13 to 22 pounds.) Upright row Stand straight with your feet shoulder-width apart. Hold the weights down in front of your thighs, with your palms facing your body. Slowly bring the weights straight up, as if you were zipping up a jacket. Slowly lower the weights to their original position. Repeat eight to 12 times per set. (Starting weight: 4 to 11 pounds.) Reverse fly Lie on a bench at a 45-degree angle. Hold a weight in each hand and allow your arms to extend down toward the floor. Keeping your elbows slightly bent, lift the weights up and out to the side to about shoulder level. Slowly lower the weights. Repeat eight to 12 times per set. (Starting weight: 2 to 6 pounds.) Lateral raise Stand straight with your feet shoulder-width apart and your knees slightly bent. Lift your arms up to the sides until they are parallel with the floor. Your elbows should be slightly bent. Slowly lower your arms. Repeat eight to 12 times per set. (Starting weight: 4 to 9 pounds.) For more information on strength training, order our Special Health Report, Strength and Power Training, at www.health.harvard.edu/SPT. Copyright 2008 by Harvard University.

Bigger Brains, Better Genes. Dean Ornish, M.D.

Believe it or not, those are among the benefits of exercising more and eating healthier.
WEB-EXCLUSIVE COMMENTARY
By Dean Ornish, M.D.Special to Newsweek, Updated: 12:47 p.m. PT Sept 12, 2007

“Go pump some neurons! Expand your craniums!”
—Robin Williams, in “Mrs. Doubtfire”

You don’t need to read this column to know that exercise is good for you. You probably already know that regular, moderate exercise is one of the best things you can do for your health and well-being. What you may not know is that new research is showing that exercise beneficially affects your genes, helps reverse the aging process at a cellular level, gives you more energy, makes you smarter, and may even help you grow so many new brain cells (a process called neurogenesis) that your brain actually gets bigger.

Really.

So does improving your nutrition. A diet high in sugar and saturated fat diminishes neurogenesis, whereas other foods increase it, including chocolate (in moderate amounts), tea and blackberries, which contain a substance called epicatechin that improves memory. Small amounts of alcohol increase neurogenesis, whereas larger amounts decrease it. Chronic emotional stress decreases neurogenesis, but stress management techniques increase it. Drugs such as nicotine, opiates and cocaine decrease neurogenesis, whereas a study published in the Journal of Clinical Investigation in 1995 showed that cannabinoids (found in marijuana) increase it, at least in rats. (Uh, what were we just talking about?)

Use It or Lose It
Until about nine years ago it was thought that you were born with a certain number of neurons, and they tended to decrease in number as you got older. The best you could hope to do was to slow the rate at which you lost brain cells.

Fortunately, it’s not true. Researchers at the Salk Institute for Biological Studies and at Columbia University showed that older adults continue to generate new neurons at virtually any age. Earlier this year these researchers found that in addition to growing new neurons, exercise doubled blood flow to the brain. A study published last year by researchers at the University of Illinois reported that just walking for three hours per week for only three months caused so many new neurons to grow that it actually increased the size of people’s brains.

Best of all, the region of the brain that grew the most was the hippocampus, the part most involved with memory and cognition. After only three months, those who exercised had brain volumes typical of people who were three years younger! Also, the new neurons tend to find their way to well-established existing connections and replace ones that are damaged or nonfunctioning. Those who showed the most improvement in fitness also showed the greatest enhancement in memory. The authors concluded, “These results suggest that cardiovascular fitness is associated with the sparing of brain tissue in aging humans. Furthermore, these results suggest a strong biological basis for the role of aerobic fitness in maintaining and enhancing central nervous system health and cognitive functioning in older adults.”

Regular, moderate exercise (along with healthier eating and stress management techniques) also reduces inflammation throughout your body, including in your brain, and reduces the incidence of tiny strokes that can impair your ability to think clearly. Exercise also helps boost your sense of well-being. Levels of beneficial neurotransmitters such as dopamine, serotonin and norepinephrine are higher in those who exercise—the same ones elevated by many antidepressants. These, in turn, may help reduce depression, elevate mood and help you focus better.

Exercise Makes You More Intelligent
Other studies have shown that older adults who exercise regularly have better memory, are better at going from one mental task to another, and can focus and concentrate better than those who are sedentary. In other words, exercise makes older people more intelligent.

Exercise makes younger people smarter too. Kids who exercise have fewer problems with attention-deficit disorder and learn faster. Studies have shown that physical education in schools improves academic performance as well as physical fitness. For example, a study by the California Department of Education of 322,000 seventh-grade students found that the most fit scored in the 66th percentile on their SATs, whereas the least fit scored in the 28th percentile. Studies at the University of Illinois also found that those who were more fit had better standardized test scores.

Exercising Your Genes
Your genes are not your fate. The choices you make each day in your diet and lifestyle have a direct influence on how your genetic predisposition is expressed—for better and for worse. You’re only as old as your genes, but how your genes are expressed may be modified by exercise, diet and lifestyle choices much more than had previously been believed—and more quickly. For example, Finnish scientists reported in a study published in July that increased moderate to vigorous physical activity modified two genes involved in type 2 diabetes and reduced the risk of developing the disease, independent of changes in weight or diet.

Another recent study compared mitochondria in muscle biopsies of older and younger men and women. Your mitochondria are the “energy generators” of your body’s cells. One of the reasons many people feel less energetic as they get older is that their mitochondria work less efficiently with age. The investigators found that in those who were mostly sedentary, mitochondrial function declined markedly with age and was affected by more than 300 genes. Then the investigators put these older men and women through a six-month exercise program that involved strength training for one hour only two days per week using the types of weight machines found in most gyms. Resistance exercise for each session consisted of three sets of 10 repetitions for each of: leg press, chest press, leg extension, leg flexion, shoulder press, lat pull-down, seated row, calf raise, abdominal crunch and back extension, and 10 repetitions for arm flexion and arm extension.

After only six months, the subjects’ strength improved by 50 percent, and they reported feeling much more energetic. Many of the 300 genes that had declined with age began to now act more like those in younger people. In fact, the investigators found that exercise affected age-associated gene expression more than in younger people, meaning that exercise is especially beneficial as people get older.

These high-tech studies illustrate what a powerful difference low-tech interventions such as changes in exercise, nutrition and stress management techniques can play in our lives. People often believe that advances in medicine have to be a new drug, a new laser or a surgical intervention to be powerful—something really high-tech and expensive. They often have a hard time believing that the simple choices that we make in our lives each day—how much we exercise, what we eat and how we respond to stress—may make such a powerful difference in our health, our well-being, and even in our brains. But they often do.

How to remember to exercise in a way that’s sustainable? Do what you enjoy, make it fun and do it regularly. If you grow new neurons, then you won’t forget!

© 2007 Newsweek, Inc. http://www.msnbc.msn.com/id/20746682/site/newsweek/page/0/