Posts Tagged ‘exercise’

A study found that Americans walk an average of 5,117 steps per day, much less than residents of countries with lower obesity rates

Monday, October 11th, 2010

Researchers at the University of Tennessee “used pedometers to gather step data from 1,136 American adults … and compared the results to similar studies in the other countries.” Americans, who report an obesity rate of 34%, averaged 5,117 steps per day. Western Australians (16% obesity rate) averaged 9,695 steps, Japanese (3% obesity rate) averaged 7,168 steps and Swiss (8% obesity rate) averaged 9,650 steps. Please click below for a report from Reuters.






Exercise can initiate lasting improvements in balance, walking ability and fall risk in older women with osteopenia

Wednesday, October 6th, 2010

Exercise can initiate lasting improvements in balance, walking ability and fall risk in older women with osteopenia (mild thinning of bone mass). Researchers at Finland’s Oulu Deaconess Institute have released a followup report 5 years after their original 30 month exercise intervention study of 160 women. The results show that, compared to the non-exercising control group, those who had exercised maintained greater walking ability, had fewer damaging falls and none of their falls resulted hip fractures. Researchers noted that “Regular daily physical exercise should be recommended to elderly women with osteopenia.” Please click below for a report from Reuters Health.




The Critically Ill Benefit from Mild Exercise

Tuesday, October 5th, 2010 by American Senior Fitness Association   View This Issue of Experience!

Researchers have found that critically ill ICU patients recover more quickly and can decrease their use of sedatives by beginning an early program of mild exercise. Following is a report on the study from John Hopkins Medicine:

A report from critical care experts at Johns Hopkins shows that use of sedatives goes down by half so that mild exercise can be introduced to the care of critically ill patients in the intensive care unit (ICU). Curtailing use of the drowsiness-inducing medications not only allows patients to exercise, which is known to reduce muscle weakness linked to long periods of bed rest, but also reduces bouts of delirium and hallucinations and speeds up ICU recovery times by as much as two to three days, the paper concludes.

Mild exercise, the experts say, with sessions varying from 30 minutes to 45 minutes, should be performed by patients under the careful guidance of specially trained physical and occupational therapists and can include any combination of either leg or arm movements while lying flat in bed, sitting up or standing, or even walking slowly in the corridors of the ICU. Indeed, the Johns Hopkins team has since evaluated a number of additional physical rehabilitation therapies, such as cycling in bed using a specially designed peddling device, or stimulating contractions of the leg muscles with overlying electrical pads. Patients can often exercise while still attached to life support equipment, such as a mechanical ventilator that helps them breathe, the group shows.

In its exercise report, published in the journal Archives of Physical Medicine and Rehabilitation online, the Johns Hopkins team closely monitored the progress of 57 patients admitted to The Johns Hopkins Hospital’s medical intensive care unit (MICU) in 2007. Their treatment encompassed 794 days spent in the unit. Members of the MICU team checked the patients’ records daily for several months before and after the physical rehabilitation project began. Each patient was mechanically ventilated for at least four days, with half receiving no more than one exercising session before the enhanced exercise plan started, while half received at least seven physical therapy sessions after the plan’s implementation.

"Our work challenges physicians to rethink how they treat critically ill patients and shows the downstream benefits of early mobilization exercises," says critical care specialist Dale Needham, MD, PhD, who spearheaded the project.

"Our patients keep telling us that they do not want to be confined to their beds, they want to be awake, alert and moving, and engaged participants in their recovery," says Needham, an associate professor at the Johns Hopkins University School of Medicine. "Patients are not afraid of exercising while they are in the ICU, and they are embracing this new approach to their care in the ICU. It actually motivates them to get well and reminds them that they have a life outside the four walls surrounding their hospital beds."

Needham’s latest findings contribute to his team’s other research in the past three years, demonstrating in more than 500 patients how early physical rehabilitation and mild exercise helped ICU patients move about, sit and stand up. He says patients can lose as much as five percent per week of leg muscle mass when confined to bed rest.

In the report, Needham and colleagues found that the use of drowsiness-causing benzodiazepines declined to only 26 percent of patient days spent in the MICU in the four months following introduction of early mobilization practices, compared to 50 percent of patient days in the three months leading up to the project. Daily doses dropped even further. Half of the patients were given more than 47 milligrams of midazolam and 71 milligrams of morphine before early exercising was emphasized. After exercising became more widespread, half needed less than 15 milligrams of midazolam and 24 milligrams of morphine.

Daily episodes of delirium, when a patient may hallucinate, be unable to think straight, or simply be unaware of their surroundings, were sharply curtailed. Before exercising began, ICU patients were spending as little as 21 percent of all patient days without such disturbances, but this grew to 33 percent clear-thinking days afterward. Delirium is known to occur in ICU patients who have been heavily sedated, prolonging their ICU stay and recovery.

Overall time spent in intensive care and in the hospital also dropped after exercising was promoted, by 2.1 days and 3.1 days, respectively. And with patients recovering faster, the Johns Hopkins MICU was able to treat 20 percent more patients even though its capacity, at 16 beds, remained the same.

Critical care expert Eddy Fan, MD, a member of the project team and instructor at Hopkins, says physicians are changing their perspective on prolonged bed rest with heavy sedation, and its long-term consequences to patient health.

Fan says developing appropriate physical therapy regimens involves careful planning and coordination among all members of the critical care team, including physicians, nurses, and respiratory, physical and occupational therapists. He notes that it can take an hour to get a patient ready to perform and finish certain exercises, such as walking short distances, and that patient comfort and safety must be monitored throughout the activity.

Launching this kind of early physical medicine and rehabilitation program requires serious commitment. Fan says the Hopkins initiative involved nearly 150 hospital physicians and staff in meetings about early mobilization of their patients, including 16 educational seminars on sedation alone with MICU nurses, as well as staff presentations by former ICU patients about their problems with muscle weakness since their discharge.

"Things can change quickly in the ICU, but if the patient has the energy to exercise and their vital signs are okay, and the staff are trained and confident in the type of activity to be performed, then it is in the patient’s best interest to get them moving," says Fan.

Needham says long-term clinical studies of these treatment techniques are already under way, in which some critically ill patients are performing early-mobilization exercises and others less so or not at all. The goal of researchers, now that the immediate physical benefits have been shown, is to gauge if early rehabilitation therapy improves patients’ quality of life, such as their ability to stay active and mobile inside and out of the home, and to quantify any hospital cost savings accruing from the effort. Funding support for the report was provided by The Johns Hopkins University and The Johns Hopkins Hospital.


The CDC has tips for “Making Physical Activity a Part of an Older Adult’s Life”

Monday, October 4th, 2010

The CDC’s “Physical Activity for Everyone” includes ideas for “Making Physical Activity a Part of an Older Adult’s Life.” This section of the program discusses how to include exercise in your daily life even if you have physical limitations or chronic conditions. It also includes “case studies” showing how some older adults are meeting the CDC physical activity guidelines. Click below to visit the CDC site.







EACPR statement emphasizes the importance of medical screening for older adults beginning a high intensity exercise regimen

Wednesday, September 29th, 2010

EACPR, a European health organization, has released a “position stand” emphasizing the importance of medical screening for older adults prior to beginning a high intensity exercise regimen. The statement from the European Association of Cardiovascular Prevention and Rehabilitation noted that, although regular aerobic exercise is associated with a reduced risk of coronary events in middle-aged individuals, “moderate and vigorous physical exertion is associated with an increased risk for cardiac events, including sudden cardiac death, in individuals harbouring cardiovascular disease.” Click below for a brief overview from PubMed or here for a PDF copy of the EACPR document.



When traditional training methods aren’t an option, people with disabilities can still obtain the benefits of physical activity

Sunday, September 19th, 2010

When physical disability precludes traditional exercise activities like walking, there are still effective ways to obtain the benefits of regular training. For example, some individuals with disabilities may be able to swim, while others may gain from performing well-designed chair-seated workouts. The National Center on Physical Activity and Disability offers practical ideas on exercise for people with physical limitations. For more information, click on below to visit the NCPAD website.





Here’s yet another good reason to exercise, especially for overweight individuals

Friday, September 10th, 2010

A Brazilian study has shown that, in addition to the obvious energy expenditure that can initiate weight loss, it appears that “exercise restores the sensitivity of neurons involved in the control of satiety (feeling full), which in turn contributes to reduced food intake and consequently weight loss.” Click Here to view the study or below for a brief report from EurekAlert.