Monday, September 30, 2013

Chronic exercise attenuates age-related physiological decline: fresh evidence

        

  Posted on September 29, 2013 by Stone Hearth News

Res Sports Med. 2013;21(4):343-54. doi: 10.1080/15438627.2013.825799.

Does chronic exercise attenuate age-related physiological decline in males?

 Hayes LD, Grace FM, Sculthorpe N, Herbert P, Kilduff LP, Baker JS. Source: a Institute of Clinical Exercise and Health Science, University of the West of Scotland , Hamilton , United Kingdom.

Abstract

Alteration in body composition, physical function, and substrate metabolism occur with advancing age.

 These changes can be attenuated by exercise.

 This study evaluated whether master athletes (MA [n = 20]) would have improved exercise capabilities, anthropometry, and hormone profiles when compared with age-matched sedentary counterparts (S [n = 28]). (adsbygoogle = window.adsbygoogle || []).push({});

 The MA group was predominantly aerobically trained with some resistance exercise incorporated in their routine.

 The VO2max, peak power output, and salivary testosterone was significantly higher (p < 0.05) in the MA group, while diastolic blood pressure, systolic blood pressure, and body fat percentage were lower (p < 0.05).

 Cortisol, fat free mass, (FFM) and total body mass were not significantly different between groups.

Salivary testosterone correlated positively with VO2max (r (2) = .320), suggesting that increased aerobic capacity is linked with higher concentrations of testosterone.

 These results suggest that life-long exercise is associated with favorable body composition and attenuation of the age related decline in testosterone.

Source - See more at: http://www.stonehearthnewsletters.com/chronic-exercise-attenuates-age-related-physiological-decline-fresh-evidence/benefits-exercise/#sthash.I50Umw8j.dpuf

Whole body vibration and stroke: new research

         

 Posted on September 29, 2013 by Stone Hearth News

Arch Phys Med Rehabil. 2013 Sep 22. pii: S0003-9993(13)00924-6. doi: 10.1016/j.apmr.2013.09.009. [Epub ahead of print]

Effects of intensive whole body vibration training on muscle strength and balance in adults with chronic stroke: A randomized controlled pilot study.

Tankisheva E, Bogaerts A, Boonen S, Feys H, Verschueren SM. Source: KU Leuven – University of Leuven, Department of Rehabilitation Science.

 Abstract

OBJECTIVES:

To investigate the effects of a 6-week whole body vibration (WBV) training program in patients with chronic stroke.

DESIGN:

 Randomized controlled pilot trial with 6 weeks follow-up. SETTING: University hospital.

PARTICIPANTS:

Fifteen adults with chronic stroke were randomly assigned to an intervention (n=7) or a control group (n=8).

 INTERVENTIONS:

 Supervised intensive WBV training. The vibration group performed a variety of static and dynamic squat exercises on a vibration platform with vibration amplitudes of 1, 7 and 2, 5 mm and frequencies of 35 and 40 Hz. The vibration lasted 30 to 60 seconds, with 5 to 17 repetitions per exercise 3 times weekly for 6 weeks. The participants of the control group continued their usual activities and were not involved in any additional training program.

 MAIN OUTCOME MEASURES:

 (adsbygoogle = window.adsbygoogle || []).push({}); The primary outcome variable was the isometric and isokinetic muscle strength of quadriceps (isokinetic dynamometer). Additionally, hamstrings muscle strength, static and dynamic postural control (dynamic posturography) and muscle spasticity (Ashworth scale) were assessed.

RESULTS:

Compliance with the vibration intervention was excellent and the participants completed all 18 training sessions. Both vibration frequencies of 35Hz and 40Hz were well-tolerated by the patients and no adverse effects due to the vibration were noted. Overall, the current outcomes show that the effect of intensive whole body vibration intervention resulted in significant between-group differences in favor of the vibration group only in isometric knee extension strength (knee angle 60°) (P=.022) after 6 weeks of intervention and in isokinetic knee extension strength (velocity of 240°/s) after a 6 weeks follow-up period (P=.005), both for the paretic leg. Postural control improved after 6 weeks of vibration in the intervention group when the patients had normal vision and a sway referenced support surface (P<.05). Muscle spasticity was not affected by vibration (P>.05).

CONCLUSION:

These preliminary results suggest that intensive WBV might potentially be a safe and feasible way to increase some aspect of lower limb muscle strength and postural control in adults with chronic stroke. Further studies should focus on evaluating how the training protocol should be administered for best possible outcome and this compared against other interventions.

Source - See more at: http://www.stonehearthnewsletters.com/whole-body-vibration-and-stroke-new-research/vibration-training/#sthash.uTxB0ZP2.dpuf

Thursday, September 26, 2013

New evidence that fruit and vegetable consumption reduces risk of mortality

 


A European study analyzes the relationship between fruit and vegetable consumption and the risk of mortality. As previous research has already suggested, this study concludes that fruit and vegetable consumption reduces all-cause mortality, and especially cardiovascular disease mortality.
The benefits of fruit and vegetable consumption are not a new discovery. However, new research confirms their role in reducing mortality. This reduction is more significant in the case of deaths from cardiovascular disease.
The analysis, recently published in the ‘American Journal of Epidemiology’, was directed by researchers from ten countries, including Spain, as part of the European Prospective Investigation into Cancer and Nutrition (EPIC).
The sample analyzed includes 25,682 deaths (10,438 due to cancer and 5,125 due to cardiovascular disease) among the 451,151 participants studied over more than 13 years.
“This study is the most significant epidemiological study that this association has examined to date,” María José Sánchez Pérez, director of the Andalusian School of Public Health’s (EASP) Granada Cancer Registry and one of the authors of the research, explains to SINC.
According to the results, a combined fruit and vegetable consumption of more than 569 grams per day reduces the risk of mortality by 10% and delays the risk of mortality by 1.12 years compared to a consumption of less than 249 grams per day.
Furthermore, for every 200 gram increase in daily fruit and vegetable consumption, the risk falls by 6%. The proportion of deaths that could be prevented if everyone eating too few fruit and vegetables increased their consumption by 100-200 grams per day – thus reaching the recommended 400-500 grams per day – is 2.9%.
Previous studies already noted that fruit and vegetable consumption, in accordance with the recommended daily allowance, prevents the development of chronic diseases, and reduces the risk of mortality by 10-25%.
“There is now sufficient evidence of the beneficial effect of fruit and vegetable consumption in the prevention of cancer and other chronic diseases,” Sánchez states, “for this reason, one of the most effective preventative measures is promoting their consumption in the population.”
Fruit for the heart
  
A diet rich in fruit and vegetables reduces the risk of cardiovascular disease mortality by 15%. Furthermore, more than 4% of deaths due to cardiovascular disease could be prevented by consuming more than 400 grams of fruit and vegetables a day.
Considering fruit consumption separately, no significant risk reduction was observed, whereas vegetable consumption alone was associated with a lower risk of mortality, which was even more significant for raw vegetables: high consumption reduces the risk of mortality by 16%.
“With regard to cancer mortality, no statistically significant risk reduction was found, although it will be necessary to assess this according to specific types of cancer,” Sánchez adds.
Nevertheless, the expert highlights that given that fruit and vegetable consumption is associated with the risk of certain cancers – colon and rectal, stomach, lung, etc. – it is to be expected that their consumption will also have a positive effect on mortality due to these tumours.
Greater effect in people with bad habits
The mortality risk reduction due to fruit and vegetable consumption was greater in those participants who consumed alcohol (around 30-40% risk reduction), who were obese (20%), and “possibly” also in those who smoked.
The authors add that this positive effect is probably due to their high antioxidant content, which mitigates the oxidative stress caused by alcohol, tobacco and obesity.
“As such, these population groups in particular could benefit from the positive effects of fruit and vegetables in preventing chronic diseases and their associated mortality risk,” Sánchez concludes.
Full bibliographic information
Leenders M, Sluijs I, Ros MM, Boshuizen HC, Siersema PD, Ferrari P, Weikert C, Tjønneland A, Olsen A, Boutron-Ruault MC, Clavel-Chapelon F, Nailler L, Teucher B, Li K, Boeing H, Bergmann MM, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Panico S, Tumino R, Sacerdote C, Peeters PH, van Gils CH, Lund E, Engeset D, Redondo ML, Agudo A, Sánchez MJ, Navarro C, Ardanaz E, Sonestedt E, Ericson U, Nilsson LM, Khaw KT, Wareham NJ, Key TJ, Crowe FL, Romieu I, Gunter MJ, Gallo V, Overvad K, Riboli E, Bueno-de-Mesquita HB. Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition. Am J Epidemiol. 2013;178(4):590-602.
doi: 10.1093/aje/kwt006. Epub 2013 Apr 18.

Source
  
- See more at: http://www.stonehearthnewsletters.com/new-evidence-that-fruit-and-vegetable-consumption-reduces-risk-of-mortality/nutrition-is-medicine/#sthash.GCavOFan.dpuf

Tuesday, September 24, 2013

Group fitness activities for the elderly: an innovative approach to reduce falls and injuries

 


Aging Clin Exp Res. 2013 Sep 21. [Epub ahead of print]
Group fitness activities for the elderly: an innovative approach to reduce falls and injuries.
Bianco A, Patti A, Bellafiore M, Battaglia G, Sahin FN, Paoli A, Cataldo MC, Mammina C, Palma A.
Source: Sport and Exercise Sciences Research Unit, University of Palermo, Via Eleonora Duse 2, 90146, Palermo, Italy, antonino.bianco@unipa.it.
Abstract
AIM:
The aim of this study was to examine the opportunity to adopt, for the elderly, already validated function ability tests to better understand how to prevent falls and injuries and to better plan group fitness activities like ballroom dance classes (e.g., Valzer, Polka, Mazurka).
METHODS:
A cross-sectional study was conducted. The Berg Balance Scale (BBS) and the Barthel Index (BI) were administered and the occurrence of falls during the previous 2 years was evaluated by anamnesis. One hundred and twenty-two elderly subjects living in Palermo city participated to the study. According to the anamnesis, subjects were divided into two groups: experimental group (EG) and control group (CG). The EG consisted of 75 subjects attending classes of ballroom dancing (73.0 ± 5.6 years 26.1 ± 3.9 BMI), while the CG included 47 volunteers (74.3 ± 5.4 years, 26.8 ± 4.4 BMI). A threshold of 70 % for both scales (BBS-70 and BI-70 %) was set, according to the aims of the study. STATISTICA software was adopted to perform an unpaired t test. A P value lower than 0.05 was considered to be statistically relevant.
  
RESULTS:
The BI and BBS of CG were 76.7 ± 33.08 and 30.9 ± 14.9, respectively, while the BI and BBS of EG were 98.1 ± 6.9 and 50.5 ± 54. In EG the BBS-70 % showed 96.0 % of cases compared to 27.6 % of the CG. The BI showed a similar trend to BBS. In EG the BI-70 % showed 98.6 % of cases, while the BI-70 % of CG showed 70.2 % of cases. Moreover, only 36.0 % of EG reported falls previously, while CG reported 53.2 % of falls during the same period of time.
CONCLUSION:
The BBS seems to be a valid and reliable tool able to be adopted also by professionals of the ballroom dancing sector (e.g., Valzer, Polka and Mazurka classes). Instructors may evaluate the functional ability of their attendees through BBS to easily obtain more information and better plan ballroom dance classes. Moreover, we highlight that these conclusions need to be supported by other studies with different cohorts and a larger population scale.
Source
  
- See more at: http://www.stonehearthnewsletters.com/group-fitness-activities-for-the-elderly-an-innovative-approach-to-reduce-falls-and-injuries/elder-care-falls/#sthash.GsQ30sX9.dpuf

Sports medicine specialists on overuse injury prevention in young athletes

          

Posted on September 24, 2013 by Stone Hearth News
               
Newswise — WINSTON-SALEM, N.C. – Sept. 24, 2013 – It stands to reason that young people who play organized sports are going to get injured.

 But while young athletes are susceptible to the ankle sprains, wrist fractures and other acute injuries that are common among competitors of all ages, numerous studies indicate that approximately half of the sports-related injuries among children and adolescents in this country are caused by overuse.

These injuries – pitcher’s elbow, swimmer’s shoulder, runner’s knee, tennis elbow, tendinitis – are the result of repetitive stress on tendons, bones and joints. Because they develop gradually over time, they are not as obvious as bruises or breaks and can be more difficult to diagnose and treat. But they can also be avoided more easily.

 “Overuse injuries in young people are definitely preventable,” said Dr. David Martin, an orthopedic surgeon at Wake Forest Baptist Medical Center. “Athletes, especially kids, want to compete and don’t necessarily recognize when something’s wrong, so we have to be smarter than them.”

Involvement in youth sports has boomed over the last 15 years, to the extent that an estimated 30 million children and adolescents in the United States now participate in organized athletic programs. But the incidence of overuse injuries in young athletes has increased at a much quicker rate across all sports, for reasons that are no mystery to sports medicine experts.

“Participation has increased overall and the sports have become more serious, more competitive at an earlier level, so there are many more year-round athletes than there used to be and many more single-sport athletes,” said Martin, who is director of sports medicine for Wake Forest University athletics and team physician for the Winston-Salem Dash minor-league baseball team. “Kids playing the same sport year-round have no off-season, and this type of early specialization leads to more stresses and more overuse injuries than you normally would see.”

 Playing different sports, on the other hand, is good for young people on multiple levels, said Dr. Daryl Rosenbaum, who specializes in family medicine and sports medicine at Wake Forest Baptist.

“You want to develop overall athleticism, even if you hope to excel in one sport, and playing different sports definitely helps with that,” said Rosenbaum, who has been a team physician for the U.S. Soccer Federation’s under-20 and under-17 men’s and women’s national teams and served as medical director of this year’s Winston-Salem Open tennis tournament. “You also want to avoid an overuse type of injury. It’s tough to go pro or be great in your sport if you injure yourself and fall behind everybody else.

 “On the mental side of things, there’s avoiding burnout,” Rosenbaum added. “If someone’s pushed too hard too soon at one sport, they may get tired of it and then, if they don’t enjoy exercise or sports in the future, that can negatively affect their long-term health.

” That view is echoed by Dr. Michael Freehill, a Wake Forest Baptist orthopedic surgeon who specializes in shoulder injuries and assists as team physician for the Winston-Salem Dash.

(adsbygoogle = window.adsbygoogle || []).push({}); “Playing multiple sports when you’re young, up through high school, is actually beneficial for all your sports,” said Freehill, who pitched in the minor leagues for six seasons before attending medical school, reaching the AAA level with two different organizations and making the 40-man roster of the Anaheim (now Los Angeles) Angels. “You’re utilizing different muscles and performing different motions, resulting in a better athlete overall.

“Additionally, you’re not over-taxing certain areas, such as the elbow or shoulder, as you would by playing the same sport all the time.”

 Proper rest is also a key factor in minimizing the risk of overuse injuries. The body needs time to recover from strenuous activity, especially when it’s a young body with still-growing bones and still-developing muscles and tendons.

 For a positive example of recovery time, Freehill points to major-league pitchers, who generally refrain from throwing for three months once the season ends.

 “How can anybody argue that time off is not needed?” he said. “These are athletes who perform at the highest level, so it makes no sense to think that children who participate in sports can get by with anything less. The same rules apply to volleyball, swimming, tennis, basketball, all sports.”

Rosenbaum recommends that young athletes take at least one day off per week and at least one season off, at least from organized competition in a specific sport, per year. He also emphasizes that both children and adults must realize that “pain is never normal, especially in kids.”

 “There’s no such thing as ‘just sore,’” Rosenbaum said. “It’s never ‘just part of the game.’ Nobody, especially a child, should ever push through pain.”

It’s unlikely that the pursuit of victories, championships, varsity letters, college scholarships and even pro contracts will fade from the youth sports scene anytime soon. But Martin, for one, believes that overuse injuries can be taken out of the picture.

 “The key is education,” he said. “And it can’t be just, ‘Well, the doctor says you can only throw so many pitches.’ It has to be education for the family, the athletes, the coaches and the people who run the game. Little League baseball is one example – they’ve actually changed the game by putting in rules to protect the players’ health – so inroads have been made.

 “We also have to educate players, parents and coaches to recognize the signs of overuse, to catch things before they develop into real injury.”

 Perhaps the most important element, Martin said, is maintaining the proper perspective about sports.

“You have to attach importance to it, but you also have to be sensible,” he said. “What I preach is that we have to get everybody involved to think not only about today’s game, but about the season, about the player’s athletic career, whatever that might be, and about the rest of their life – especially if the player is 10 years old.

 “We’re now doing that with concussions. We need to be doing it with overuse injuries, too, and I think that will come.” -

See more at: http://www.stonehearthnewsletters.com/sports-medicine-specialists-on-overuse-injury-prevention-in-young-athletes/sports-medicine-injuries/#sthash.bDkI68z6.dpuf

Sunday, September 22, 2013

Resistance training for older people a must: J Strength Cond Res

        

  Posted on September 22, 2013 by Stone Hearth News

                J Strength Cond Res. 2013 Sep 14. [Epub ahead of print]

Leg Strength Declines with Advancing Age Despite Habitual Endurance Exercise in Active Older Adults.

 Marcell TJ, Hawkins SA, Wiswell RA.

Source:
1Department of Kinesiology, California State University Stanislaus, Turlock, CA 95382, 2Department of Exercise Science, California Lutheran University, Thousand Oaks, CA 91360, 3Department of Biokinesiology, University of Southern California, Los Angeles, CA 90033.

Abstract

 Age-associated loss of muscle mass (sarcopenia) and strength (dynapenia) is associated with a loss of independence that contributes to falls, fractures, and nursing home admissions, while regular physical activity has been suggested to offset these losses.

The purpose of this study was to evaluate the effect of habitual endurance exercise on muscle mass and strength in active older adults.

A longitudinal analysis of muscle strength (≈ 4.8 yrs apart) was performed on 59 men (age at start of study: 58.6±7.3 yr) and 35 women (56.9±8.2 yr) who used endurance running as their primary mode of exercise. (adsbygoogle = window.adsbygoogle || []).push({}); There were no changes in fat-free mass while body fat increased minimally (1.0-1.5%).

Training volume (km•wk, d•wk) decreased in both the men and women. There was a significant loss of both isometric knee extension (≈5%/yr) and knee flexion (≈3.6%/yr) strength in both the men and women.

However, there was no significant change in either isokinetic concentric or eccentric torque of the knee extensors.

 Our data demonstrated a significant decline in isometric knee extensor and knee flexor strength while there were no changes in LBM in this group of very active older men and women.

Our data support newer exercise guidelines for older Americans suggesting resistance training be an integral component of a fitness program, and that running alone was not sufficient to prevent the loss in muscle strength (dynapenia) with aging.

Source - See more at: http://www.stonehearthnewsletters.com/resistance-training-for-older-people-a-must-j-strength-cond-res/strength-training/#sthash.pYCM5h27.dpuf

Saturday, September 21, 2013

Concussion risk’s two leading factors: Br J Sports Med.

 


Br J Sports Med. 2013 Sep 19. doi: 10.1136/bjsports-2013-092734. [Epub ahead of print]
Risk factors for sports concussion: an evidence-based systematic review.
Abrahams S, Mc Fie S, Patricios J, Posthumus M, September AV.
Source: UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.
Abstract
Concussion is a common sports injury with approximately 1.6-3.8 million sport-related concussions reported in the USA annually.
Identifying risk factors may help in preventing these injuries.
This systematic review aims to identify such risk factors.
Three electronic databases; ScienceDirect, PubMed and SpringerLink, were searched using the keywords ‘RISK FACTORS’ or ‘PREDISPOSITION’ in conjunction with ‘SPORT’ and ‘CONCUSSION’.
  
Based on the inclusion and exclusion criteria, 13 628 identified titles were independently analysed by two of the authors to a final list of 86 articles.
Only articles with a level of evidence of I, II and III were included according to robust study design and data analysis.
The level of certainty for each risk factor was determined.
A high level of certainty for increased risk of a subsequent concussion in athletes sustaining more than one previous concussion was reported in 10 of 13 studies.
Further, a high level of certainty was assigned to match play with all 29 studies reporting an increased concussion risk during matches.
All other risk factors were evaluated as having a low level of certainty.
Although several risk factors were identified from the appraised studies, prospective cohort studies, larger sample sizes, consistent and robust measures of risk should be employed in future research.
Source
  
- See more at: http://www.stonehearthnewsletters.com/concussion-risks-two-leading-factors-br-j-sports-med/concussion/#sthash.000RNqOr.dpuf

Six-minute walking distance correlated with memory in older adults

         

 Posted on September 21, 2013 by Stone Hearth News

                 Dement Geriatr Cogn Dis Extra. 2013 Aug 16;3(1):223-32. doi: 10.1159/000354189.

 Six-minute walking distance correlated with memory and brain volume in older adults with mild cognitive impairment: a voxel-based morphometry study.

 Makizako H, Shimada H, Doi T, Park H, Yoshida D, Suzuki T. Source: Section for Health Promotion, Center for Gerontology and Social Science, Tokyo, Japan ; Section for Japan Society for the Promotion of Science, Tokyo, Japan.

Abstract

BACKGROUND/AIMS:

 High fitness levels play an important role in maintaining memory function and delaying the progression of structural brain changes in older people at risk of developing dementia. However, it is unclear which specific regions of the brain volume are associated with exercise capacity. We investigated whether exercise capacity, determined by a 6-min walking distance (6MWD), is associated with measures of logical and visual memory and where gray matter regions correlate with exercise capacity in older adults with mild cognitive impairment (MCI). (adsbygoogle = window.adsbygoogle || []).push({});

METHODS:

Ninety-one community-dwelling older adults with MCI completed a 6-min walking test, structural magnetic resonance imaging scanning, and memory tests. The Wechsler Memory Scale-Revised Logical Memory and Rey-Osterrieth Complex Figure Tests were used to assess logical and visual memory, respectively.

 RESULTS:

The logical and visual memory tests were positively correlated with the 6MWD (p < 0.01). Poor performance in the 6MWD was correlated with a reduced cerebral gray matter volume in the left middle temporal gyrus, middle occipital gyrus, and hippocampus in older adults with MCI.

CONCLUSIONS:

These results suggest that a better 6MWD performance may be related to better memory function and the maintenance of gray matter volume in older adults with MCI.

 Source - See more at: http://www.stonehearthnewsletters.com/six-minute-walking-distance-correlated-with-memory-in-older-adults/elder-care/#sthash.pwfvmMqo.dpuf

How to make exercise a habit: new science

     

    Posted on September 21, 2013 by Stone Hearth News

                 Int J Behav Med. 2013 Sep 20. [Epub ahead of print]

Predicting Automaticity in Exercise Behaviour: The Role of Perceived Behavioural Control, Affect, Intention, Action Planning, and Behaviour.

 de Bruijn GJ, Gardner B, van Osch L, Sniehotta FF. Source: Faculty of Social and Behavioural Sciences, University of Amsterdam, Kloveniersburgwal 48, 1012 CX, Amsterdam, The Netherlands, g.j.debruijn@uva.nl.

 Abstract

BACKGROUND:

 Habit formation has been proposed as a way to maintain behaviour over time.

 PURPOSE:

Recent evidence suggests that constructs additional to repeated performance may predict physical automaticity, but no research has yet explored possible direct impacts of intention, planning, affect, and perceived behavioural control (PBC) on automaticity.

METHOD:

(adsbygoogle = window.adsbygoogle || []).push({}); In a prospective study over a 2-week period amongst 406 undergraduate students (M age = 21.5 years [SD = 2.59], 27.4 % males), we investigated main and interaction effects of past exercise behaviour, PBC, intention, planning, and affect on exercise automaticity.

RESULTS:

Results showed that – controlling for past behaviour – PBC, affect, and planning were significant and positive predictors of exercise automaticity. Decomposing a significant interaction between PBC and planning when to exercise revealed that planning became less predictive of exercise automaticity at higher levels of PBC.

CONCLUSION:

Findings show that exercise automaticity is predicted by repeated performance and social-cognitive constructs. Further, interactions between social-cognitive predictors may be different for behavioural automaticity than for behavioural frequency.

SOURCE

Monday, September 16, 2013

Foot injuries in runners

       

   Posted on September 15, 2013 by Stone Hearth News

Curr Sports Med Rep. 2011 Sep-Oct;10(5):249-54. doi: 10.1249/JSR.0b013e31822d3ea4.

Foot injuries in runners

Kindred J, Trubey C, Simons SM. Source; South Bend – Notre Dame Sports Medicine Fellowship, Mishawaka, IN 46545, USA.

Abstract

 Injuries of the foot are common among both elite and recreational runners

. Overuse accounts for most of these injuries.

 Plantar fasciitis and tendinopathies of the midfoot and forefoot have a high incidence in running athletes.

These injuries may present with significant pain but often resolve with rest and rehabilitation.

(adsbygoogle = window.adsbygoogle || []).push({}); Bone injuries caused by overuse also have a high prevalence among runners.

 The metatarsals, tarsal navicular, and sesamoids are most at risk for stress damage.

 Most running injuries are self-limited and pose little detriment if diagnosis is delayed.

Navicular and sesamoid stress fractures may impart significant long-term consequences, and thus, a clinical suspicion of either fracture warrants definitive diagnosis and treatment.

 Barefoot running recently has garnered increased attention, but currently, there is a lack of prospective studies regarding its injury reduction.

 Source -

See more at: http://www.stonehearthnewsletters.com/foot-injuries-in-runners/sports-medicine-injuries/#sthash.dBuQxpNL.dpuf

Aquatic exercise may be as effective as dry land training

        

  Posted on September 15, 2013 by Stone Hearth News

                 Physiother Res Int. 2013 Sep 10. doi: 10.1002/pri.1565. [Epub ahead of print]

Aquatic Exercise is as Effective as dry Land Training to Blood Pressure Reduction in Postmenopausal Hypertensive Women.

 Arca EA, Martinelli B, Martin LC, Waisberg CB, Franco RJ. Source; Escola de Fisioterapia, Universidade do Sagrado Coração-USC, Bauru, Brazil.


 Abstract

BACKGROUND AND PURPOSE:

The evidence of the benefits from regular physical activity to hypertensives is based on dry land training studies. Therefore, the aim of this study is to compare the effect of aquatic exercise with dry land training on hypertensive women.

 METHODS:

This is a randomized controlled study with 52 post-menopausal hypertensive women. The patients were randomly allocated in three groups: water aerobic training group (n = 19), dry land aerobic training group (n = 19) and a non-intervention control group (n = 14). The training protocol was performed by 12 weeks. (adsbygoogle = window.adsbygoogle || []).push({});

RESULTS:

There were no differences among the three groups concerning basal blood pressure (BP) and biochemical variables. In water group, there was a statistically significant reduction of systolic BP from 136 ± 16 mm Hg at zero week to 124 ± 18 mm Hg at 11th week and 124 ± 15 mm Hg at 12th week. In dry land training group, there was a statistically significant reduction of systolic BP from 138 ± 15 mm Hg at zero week to 125 ± 10 mm Hg at 7th week, 127 ± 10 mm Hg at 10th week and 126 ± 9 mm Hg at 12th week. The control group presented no change in any of the assessed variables. No changes were carried out in any antihypertensive medications during study.

DISCUSSION:

This is a randomized controlled study that demonstrates the antihypertensive efficacy of aerobic aquatic exercise.

Source -

 See more at: http://www.stonehearthnewsletters.com/aquatic-exercise-may-be-as-effective-as-dry-land-training/fitness-aquatic/#sthash.r6UkTPLW.dpuf

Fibromyalgia: anti-inflammatory and stress responses after acute moderate exercise

 


PLoS One. 2013 Sep 4;8(9):e74524. doi: 10.1371/journal.pone.0074524.
Fibromyalgia: anti-inflammatory and stress responses after acute moderate exercise.
Bote ME, Garcia JJ, Hinchado MD, Ortega E.
Source: Department of Physiology, University of Extremadura, Badajoz, Spain.
Abstract
Fibromyalgia (FM) is characterized in part by an elevated inflammatory status, and “modified exercise” is currently proposed as being a good therapeutic help for these patients.
However, the mechanisms involved in the exercise-induced benefits are still poorly understood.
The objective was to evaluate the effect of a single bout of moderate cycling (45 min at 55% VO2 max) on the inflammatory (serum IL-8; chemotaxis and O2 (-) production by neutrophils; and IL-1β, TNF-α, IL-6, IL-10, and IL-18 release by monocytes) and stress (cortisol; NA; and eHsp72) responses in women diagnosed with FM compared with an aged-matched control group of healthy women (HW).
  
IL-8, NA, and eHsp72 were determined by ELISA.
Cytokines released by monocytes were determined by Bio-Plex® system (LUMINEX).
Cortisol was determined by electrochemoluminiscence, chemotaxis was evaluated in Boyden chambers and O2 (-) production by NBT reduction.
In the FM patients, the exercise induced a decrease in the systemic concentration of IL-8, cortisol, NA, and eHsp72; as well as in the neutrophil’s chemotaxis and O2 (-) production and in the inflammatory cytokine release by monocytes.
This was contrary to the completely expected exercise-induced increase in all those biomarkers in HW.
In conclusion, single sessions of moderate cycling can improve the inflammatory status in FM patients, reaching values close to the situation of aged-matched HW at their basal status.
The neuroendocrine mechanism seems to be an exercise-induced decrease in the stress response of these patients.
Source
  
- See more at: http://www.stonehearthnewsletters.com/fibromyalgia-anti-inflammatory-and-stress-responses-after-acute-moderate-exercise/fibromyalgia/#sthash.ilKyn0xm.dpuf

Thursday, September 12, 2013

Aerobic fitness boosts learning, memory in 9-, 10-year-old children

        

  Posted on September 11, 2013 by Stone Hearth News

                Physical fitness can boost learning and memory in children, particularly when initial learning on a task is more challenging, according to research published September 11 in the open access journal PLOS ONE by Lauren Raine and colleagues from the University of Illinois at Urbana-Champaign.

Forty-eight children aged nine to ten were asked to memorize names and locations on a fictitious map, either only by studying the information or being tested on the material as they studied. Half the children were in the top 30% of their age group on a test measuring aerobic fitness, while the other half scored in the lowest 30 percent.

When asked to recollect the information studied, children who were fitter performed better than those who were not as fit. The difference between the high-fitness and low-fitness groups was also stronger when the initial learning was performed by studying alone than when testing and study were interspersed.

 Previous studies have suggested that combining testing and study improves later recall in children, and is less challenging than studying alone. Based on these results, the authors suggest that fitness levels may influence learning differently when the study method used is more challenging, and that higher levels of aerobic fitness can benefit learning and memory in school-age children.

 They conclude, “Future research should focus on the manner in which these factors impact the neural processes of children during learning.”

  In addition, the study suggests these findings may be important from an educational policy perspective.

As the authors state, “Reducing or eliminating physical education in schools, as is often done in tight financial times, may not be the best way to ensure educational success among our young people.”

 ###

 Citation: Raine LB, Lee HK, Saliba BJ, Chaddock-Heyman L, Hillman CH, et al. (2013) The Influence of Childhood Aerobic Fitness on Learning and Memory. PLoS ONE 8(9): e72666. doi:10.1371/journal.pone.0072666 Financial Disclosure: The authors have no support or funding to report. Competing Interest Statement: The authors have declared that no competing interests exist.

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Migraines linked to obesity


MINNEAPOLIS – People who get occasional migraines are more likely to be obese than people who do not have migraines, according to a study published in the September 11, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Previous studies have shown a link between people with chronic migraine and obesity, but the research has been conflicting on whether that link existed for those with less frequent attacks,” said study author B. Lee Peterlin, DO, of Johns Hopkins University School of Medicine in Baltimore, MD. “As obesity is a risk factor that can potentially be modified and since some medications for migraine can lead to weight gain or loss, this is important information for people with migraine and their doctors.”
For the study, 3,862 people with an average age of 47 filled out surveys with information on height, weight and migraines. A total of 1,044 participants were obese and 188 of the participants had occasional, or episodic, migraine, which is defined as 14 or fewer migraine headaches per month.
Obese people were 81 percent more likely to have episodic migraine (of any frequency) as compared to people of normal weight.
“These results suggest that doctors should promote healthy lifestyle choices for diet and exercise in people with episodic migraine,” Peterlin said. “More research is needed to evaluate whether weight loss programs can be helpful in overweight and obese people with episodic migraine.”
Peterlin said the results also indicate that the link between episodic migraine and obesity is stronger in those under the age of 50, the years when migraine is most prevalent, as compared to people older than 50.
###

The study was supported by a grant from the National Institute of Neurological Disorders and Stroke.
To learn more about migraine, please visit http://www.aan.com/patients.
Source
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BJ PENN AND FRANKIE EDGAR SIGN ON


BJ PENN AND FRANKIE EDGAR SIGN ON

AS COACHES OF The Ultimate Fighter®; SET SIGHTS ON TRILOGY match-up

 

Former UFC champions to coach middleweight (185 lbs.) and light heavyweight (205 lbs.) fighters on the next edition of the series airing on FOX Sports 1

 

Las Vegas, Nevada – Faced with the challenge of outdoing its current historic, adrenaline-charged season of The Ultimate Fighter®, the Ultimate Fighting Championship® (UFC®) today confirmed that the next season of its long-running reality series will feature former champions “The Prodigy” BJ Penn and Frankie “The Answer” Edgar as coaches. The storied foes will coach a cast of middleweight (185 lbs.) and light heavyweight (205 lbs.) fighters in their quest to win the title of Ultimate Fighter and a six-figure contract with the UFC.

 

“BJ Penn is moving down to 145 lbs. to coach The Ultimate Fighter against Frankie Edgar,” said UFC President Dana White. “BJ really hates the fact that he lost to Frankie Edgar. It’s something that’s been burning deep inside of him for three years now. So he’s moving down to 145 lbs. to not only avenge those defeats, but to try and become the first fighter in UFC history to win titles in three different weight classes.”

 

Widely considered one of the greatest fighters in UFC history, Penn (16-9-2 in MMA) is one of only two men to win UFC world titles in two separate divisions. The former welterweight and lightweight champion has defeated a Who’s Who of MMA, including UFC champions Matt Hughes, Matt Serra and Sean Sherk. His reign over the UFC’s 155lbs. division was ended in 2010’s Upset of the Year, when he was outpointed by Frankie Edgar. “The Prodigy” not only returns to the UFC but also The Ultimate Fighter, after coaching season five back in 2007.

 

After defeating Penn in two fights, Edgar (15-4-1) established a reputation for lightweight excellence. “The Answer” defended the lightweight championship in a pair of all-time classic battles with Gray Maynard before losing the title on a controversial decision to Benson Henderson. Edgar then dropped to featherweight, where many believe he will join Penn as a two-division world champion.

 

The series begins filming in mid-October in Las Vegas.

 

Catch all new episodes of this season of The Ultimate Fighter: Team Rousey vs. Team Tate, Wednesday’s at 10 p.m. ET on FOX Sports 1.

Monday, September 9, 2013

Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition

      

    Posted on September 8, 2013 by Stone Hearth News
Clin Interv Aging. 2013;8:1109-17. doi: 10.2147/CIA.S44198. Epub 2013 Aug 27.

Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition.

 Bergamin M, Ermolao A, Tolomio S, Berton L, Sergi G, Zaccaria M.

 Source:

Sports Medicine Division, University of Padova, Padua, Italy.

 Abstract

The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects.

A further aim was to compare this water-based protocol with a land-based protocol and a control group.

For this purpose, 59 subjects were recruited and randomly allocated to three groups: aquatic group (AG), land group (LG), and control group (CG). AG and LG followed a 6-month, twice-weekly, multimodality exercise intervention.

 AG underwent the protocol in hot-spring water (36°C) while LG did it in a land-based environment.

After the intervention, knee-extension strength was maintained in AG and LG. The 8-foot up-and-go test showed a reduction in both exercise groups (AG -19.3%, P < 0.05; LG -12.6%, P < 0.05), with a significantly greater decrease in AG.

The back-scratch test revealed an improvement only in AG (25.8%; P < 0.05), while the sit-and-reach test improved in all groups.

 Finally, AG reduced fat mass by 4% (P < 0.05), and dominant forearm fat decreased by 9.2% (P < 0.05).

 In addition, calf muscle density increased by 1.8% (P < 0.05). In summary, both water- and land-based activities were beneficial in maintaining strength and in improving lower-body flexibility. Aquatic exercise appeared a better activity to improve dynamic balance.

 Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly.

 Source - See more at: http://www.stonehearthnewsletters.com/water-versus-land-based-exercise-in-elderly-subjects-effects-on-physical-performance-and-body-composition/elder-care/#sthash.EMTE2F0O.dpuf

Altered muscle coordination when pedaling with independent cranks

      

    Posted on September 8, 2013 by Stone Hearth News

                Front Physiol. 2013 Aug 28;4:232. doi: 10.3389/fphys.2013.00232. Altered muscle coordination when pedaling with independent cranks Hug F, Boumier F, Dorel S.

 Source:

Laboratory “Motricité, Interactions, Performance” (EA 4334), UFR STAPS, University of Nantes Nantes, France ; NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland Brisbane, QLD, Australia.

 Abstract

Pedaling with independent cranks ensures each leg cycles independently of the other, and thus eliminates the contribution of the contralateral leg during the upstroke phase.

 Consequently the subject is required to actively pull-up the pedal to complete the cycle.

The present study aimed to determine the acute effect of the use of independent cranks on muscle coordination during a submaximal pedaling exercise.

 Ten healthy males were asked to perform submaximal pedaling exercises at 100 Watts with normal fixed cranks (control condition) or independent cranks.

 Both 2-D pedal forces and electromyographic (EMG) SIGNALS of 10 lower limb muscles were recorded.

When the mean EMG activity across the cycle was considered, the use of independent cranks significantly increased the activity level compared to control for Tibialis anterior (TA) (P = 0.0017; +336 ± 302%), Gastrocnemius medialis (GM) (P = 0.0005; +47 ± 25%), Rectus femoris (RF) (P = 0.005; +123 ± 153%), Biceps femoris (BF)-long head (P = 0.0001; +162 ± 97%), Semimembranosus (SM) (P = 0.0001; +304 ± 192%), and Tensor fascia latae (P = 0.0001; +586 ± 262%).

 The analysis of the four pedaling sectors revealed that the increased activity of hip and knee flexors mainly occurred during the top dead center and the upstroke phase.

 In addition, a high inter-individual variability was found in the way the participants adapted to pedaling with independent cranks.

The present results showed that the enforced pull-up action required when using independent cranks was achieved by increasing the activation of hip and knee flexors.

 Further studies are needed to determine whether training with independent cranks has the potential to induce long-term changes in muscle coordination, and, if so, whether these changes are beneficial for cycling performance.

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Trying to get more doctors on board with exercise

 


Jennifer Trilk is fit. She cycles, runs, strength trains and even rides horses. When she’s in her office at USC’s School of Medicine Greenville, she develops teaching materials and writes papers while walking on her custom-built treadmill desk.
A clinical assistant professor in physiology and exercise science, Trilk is a woman in motion and for good reason.
She and her Harvard University School of Medicine colleague, Dr. Edward Phillips, are spearheading a national effort to make lifestyle medicine a formal part of U.S. medical school curricula, hosting an invitational Think Tank in Greenville supported by the Josiah Macy Jr. Foundation. Trilk and Think Tank participants will begin formulating a strategy for transforming U.S. medical education and ultimately world health.
What attracted you to the field of physiology and exercise science?
It was a very circuitous route, but I have always had a passion for exercise and fitness. I was a personal trainer for years. So I decided to go back to school in 2004 and earned a doctorate in exercise science from the University of Georgia. It was important to me to apply exercise physiology to community health, so I then completed a postdoctoral fellowship at the Arnold School of Public Health at USC. My dream was to teach and perform research at a medical school, with a clear focus on using exercise to improve health and wellness in clinical populations.
Tell us about your first teaching job.
I was very fortunate to be hired as a founding member of the biomedical sciences faculty at USC School of Medicine Greenville. Dean Jerry Youkey gave me a dream assignment: incorporate exercise science across our entire curriculum. It’s a groundbreaking approach; we literally link exercise physiology to every disease process so that our students understand the role exercise plays in disease prevention and management. We are the first medical school in the nation to do this as a required curriculum across all four years.
What exactly is exercise physiology?
Exercise physiology is the study of the body’s acute response and chronic adaptations to exercise. My particular interest is to study the effects of exercise on prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome and cancers. 
Why is exercise physiology so important for your students?
Our poor lifestyle choices are literally killing us. By 2020, the World Health Organization predicts that two-thirds of all disease worldwide will be the result of lifestyle choices such as eating unhealthy foods, not exercising, using tobacco and alcohol. If people would make better choices, they could avoid or control diabetes, heart disease, obesity and stroke.
Medical students have the opportunity to be powerful change agents as eventual physicians. First, we have to teach them to “walk the talk,” and that means encouraging them to make positive personal lifestyle choices along with giving them the tools to educate and empower their future patients.
How do you engage students in your cause?
First, I let them know from the opening day of orientation that we are a school that believes in the power of lifestyle medicine. Because of this, USC School of Medicine Greenville teaches lifestyle medicine as a required curriculum of which they will be engaged. Second, our faculty literally get outside of the classroom with the students to show them that we practice what we preach. We have faculty who help me lead a running group with our students and faculty who cycle with students.  I am very thankful for the faculty who take time out of their busy schedules to support our students and myself in this cause. Finally, the medical students who come to our school are now familiar with our lifestyle medicine curriculum and are themselves interested in health, wellness and helping people. 
How do you motivate students who’ve never exercised before?
I make it a social activity. The running and cycling clubs are a great way to de-stress, laugh, talk and get a workout in. And we’re always up for a little friendly competition between the classes with impromptu soccer matches. This year, I also am engaging some of the members and businesses of Greenville to help get the students out into the community. 
What do you love most about teaching?
Our health care system is in the midst of an incredible upheaval and there is a hunger for new ideas and approaches. At the medical school, we are preparing our students to embrace change and their role as change agents. It’s so rewarding to be able to use my passion, exercise physiology, as one of the tools they’ll need to change the course of medicine and public health. 
What do you do when you’re not in the classroom?
Probably trying to get in a good workout or a ride on my horse.
How would you like your students to remember you?
As someone who believed in and lived everything she taught.
Source
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Wednesday, September 4, 2013

ACL injuries may be prevented by different landing strategy



Posted on September 3, 2013 by Stone Hearth News

 CORVALLIS, Ore. —

Women are two to eight times more likely than men to suffer a debilitating tear of the anterior cruciate ligament (ACL) in the knee and a new study suggests that a combination of body type and landing techniques may be to blame.

 In two new studies published online this week in the Journal of Athletic Training, lead author Marc Norcross of Oregon State University documents how women who were asked to undergo a series of jumping exercises landed more often than men in a way associated with elevated risk of ACL injuries.

Both men and women tended to land stiffly, which can lead to ACL injuries, but women were 3.6 times more likely to land in a “knock-kneed” position, which the researchers say may be the critical factor leading to the gender disparity in ACL tears.

 “We found that both men and women seem to be using their quad region the same, so that couldn’t explain why females are more at risk,” Norcross said. “Using motion analysis, we were able to pinpoint that this inability to control the frontal-plane knee loading — basically stress on the knee from landing in a knock-kneed position — as a factor more common in women.



“Future research may isolate why women tend to land this way,” he added, “but it could in part be because of basic biology. Women have wider hips, making it more likely that their knees come together after jumping.”

Norcross, an assistant professor of exercise and sport science in OSU’s College of Public Health and Human Sciences, is a former collegiate athletic trainer dedicating his research to the prevention of ACL tears.

“You see ACL injuries in any sport where you have a lot of jump stops and cuts, so basketball, soccer, lacrosse, and volleyball are high-risk sports,” said Norcross. “We know that people who hurt themselves tend to look stiff when they land and that the combined ‘knee loading’ from multiple directions is likely causing the injury event. But it wasn’t clear initially why women had more injuries than men.”

The researchers used motion analysis software to monitor the landing strategies of 82 physically active men and women. They found that both males and females had an equal likelihood of landing stiffly — likely from tensing the muscles in their quads before landing — putting them at higher risk of ACL tears. Women, however, were more likely to land in a “knee valgus” position, essentially knock-kneed.

Norcross said his next research project will focus on high school athletes, looking at a sustainable way to integrate injury prevention into team warm-up activities through improving landing technique.

 “We are trying to create a prevention strategy that is sustainable and will be widely used by high school coaches,” he said. “A lot of athletes do come back from an ACL injury, but it is a long road. And the real worry is that it leads to early onset arthritis, which then impacts their ability to stay physically active.”

 ### This study was supported by the NATA Research & Education Foundation Doctoral Grant Program. Researchers from University of North Carolina at Chapel Hill and Greensboro contributed to this study.



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Mediterranean diet is good for the mind, according to new research published in the journal Epidemiology

        

  Posted on September 3, 2013 by Stone Hearth News

                 The first systematic review of related research confirms a positive impact on cognitive function, but an inconsistent effect on mild cognitive impairment

 Over recent years many pieces of research have identified a link between adherence to a Mediterranean diet and a lower risk of age-related disease such as dementia.

Until now there has been no systematic review of such research, where a number of studies regarding a Mediterranean diet and cognitive function are reviewed for consistencies, common trends and inconsistencies.

A team of researchers from the University of Exeter Medical School, supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has carried out the first such systematic review and their findings are published in Epidemiology.

The team analysed 12 eligible pieces of research, 11 observational studies and one randomised control trial. In nine out of the 12 studies, a higher adherence to a Mediterranean diet was associated with better cognitive function, lower rates of cognitive decline and a reduced risk of Alzheimer’s disease.

However, results for mild cognitive impairment were inconsistent.

 A Mediterranean diet typically consists of higher levels of olive oil, vegetables, fruit and fish. A higher adherence to the diet means higher daily intakes of fruit and vegetables and fish, and reduced intakes of meat and dairy products.

The study was led by NIHR PenCLAHRC researcher Iliana Lourida. She said: “Mediterranean food is both delicious and nutritious, and our systematic review shows it may help to protect the ageing brain by reducing the risk of dementia. While the link between adherence to a Mediterranean diet and dementia risk is not new, ours is the first study to systematically analyse all existing evidence.”

She added: “Our review also highlights inconsistencies in the literature and the need for further research. In particular research is needed to clarify the association with mild cognitive impairment and vascular dementia. It is also important to note that while observational studies provide suggestive evidence we now need randomized controlled trials to confirm whether or not adherence to a Mediterranean diet protects against dementia.”

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Team First : First Annual Brooklyn Youth Tournament


 


Greetings!
 
On Thursday, September 5, 2013, Team First will have their First Annual Brooklyn Youth Tournament at the Barlcays Center. We invite you and family out to enjoy the games!

As always, thank you for your continued support.
 
 
Sincerely, 
Team First
 
 
Event Info
When: Thursday, September 5, 2013, Games beginning at 10:15am
 
Where: Barclays Center (Enter at the VIP entrance located on Fort Greene & Atlantic Ave. across from Marshall's)
 
Who: YOU! Team First Children, Families, & Supporters
 
What: Great Basketball!  
 
Cost: $5 donation upon entry. All other denominations are greatly appreciated and can also be sent by clicking this link:  DONATE HERE

Enter the $10 raffle to have a chance at winning Nets, St. John's, & Mets tickets!! 

Monday, September 2, 2013

For workers with acute back pain, physical conditioning may have no effect on sickness absence duration

      

    Posted on September 1, 2013 by Stone Hearth News

                 Cochrane Database Syst Rev. 2013 Aug 30;8:CD001822. [Epub ahead of print]
 Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain.
Schaafsma FG, Whelan K, van der Beek AJ, van der Es-Lambeek LC, Ojajärvi A, Verbeek JH. Source: Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute, Van der Boechorststraat 7 – room A524, Postbus 7057, Amsterdam, Netherlands, 1007 MB.

Abstract

 BACKGROUND:

 Physical conditioning as part of a return to work strategy aims to improve work status for workers on sick leave due to back pain. This is the second update of a Cochrane Review (originally titled ‘Work conditioning, work hardening and functional restoration for workers with back and neck pain’) first published in 2003, updated in 2010, and updated again in 2013.

OBJECTIVES:

To assess the effectiveness of physical conditioning as part of a return to work strategy in reducing time lost from work and improving work status for workers with back pain. Further, to assess which aspects of physical conditioning are related to a faster return to work for workers with back pain.

SEARCH METHODS:

 We searched the following databases to March 2012: CENTRAL, MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1982), PsycINFO (from 1967), and PEDro.

SELECTION CRITERIA:

Randomized controlled trials (RCTs) and cluster RCTs that studied workers with work disability related to back pain and who were included in physical conditioning programes.

DATA COLLECTION AND ANALYSIS:

 Two review authors independently extracted data and assessed risk of bias. We used standard methodological procedures expected by The Cochrane Collaboration.

 MAIN RESULTS:

 We included 41 articles reporting on 25 RCTs with 4404 participants. Risk of bias was low in 16 studies.Three studies involved workers with acute back pain, eight studies workers with subacute back pain, and 14 studies workers with chronic back pain.In 14 studies, physical conditioning as part of a return to work strategy was compared to usual care. The physical conditioning mostly consisted of graded activity with work-related exercises aimed at increasing back strength and flexibility, together with a set date for return to work. The programmes were divided into a light version with a maximum of five sessions, or an intense version with more than five sessions up to full time or as inpatient treatment.For acute back pain, there was low quality evidence that both light and intense physical conditioning programmes made little or no difference in sickness absence duration compared with care as usual at three to 12 months follow-up (3 studies with 340 workers).For subacute back pain, the evidence on the effectiveness of intense physical conditioning combined with care as usual compared to usual care alone was conflicting (four studies with 395 workers). However, subgroup analysis showed low quality evidence that if the intervention was executed at the workplace, or included a workplace visit, it may have reduced sickness absence duration at 12 months follow-up (3 studies with 283 workers; SMD -0.42, 95% CI -0.65 to -0.18).For chronic back pain, there was low quality evidence that physical conditioning as part of integrated care management in addition to usual care may have reduced sickness absence days compared to usual care at 12 months follow-up (1 study, 134 workers; SMD -4.42, 95% CI -5.06 to -3.79). What part of the integrated care management was most effective remained unclear. There was moderate quality evidence that intense physical conditioning probably reduced sickness absence duration only slightly compared with usual care at 12 months follow-up (5 studies, 1093 workers; SMD -0.23, 95% CI -0.42 to -0.03).Physical conditioning compared to exercise therapy showed conflicting results for workers with subacute and chronic back pain. Cognitive behavioural therapy was probably not superior to physical conditioning as an alternative or in addition to physical conditioning.

AUTHORS’ CONCLUSIONS:

 The effectiveness of physical conditioning as part of a return to work strategy in reducing sick leave for workers with back pain, compared to usual care or exercise therapy, remains uncertain. For workers with acute back pain, physical conditioning may have no effect on sickness absence duration. There is conflicting evidence regarding the reduction of sickness absence duration with intense physical conditioning versus usual care for workers with subacute back pain. It may be that including workplace visits or execution of the intervention at the workplace is the component that renders a physical conditioning programme effective. For workers with chronic back pain physical conditioning has a small effect on reducing sick leave compared to care as usual after 12 months follow-up. To what extent physical conditioning as part of integrated care management may alter the effect on sick leave for workers with chronic back pain needs further research.

Source - See more at: http://www.stonehearthnewsletters.com/for-workers-with-acute-back-pain-physical-conditioning-may-have-no-effect-on-sickness-absence-duration/back-pain/#sthash.FY1Y3oDy.dpuf