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Wednesday, September 23, 2015
Thomas "Cornflake" LaManna takes on Ayi Bruce as headline bout this Saturday, September 26 in Beach Haven Memorial Park in Beach Haven, NJ
Friday, September 18, 2015
Running injuries increase in the fall, often because of technique, failure to see signs
A few days later, she was diagnosed with a stress fracture in her left hip. While the injury didn’t require surgery, it’s forced Paulson to stop running — or even walking long distances — until it heals, preventing her from taking part in a pair of half-marathons for which she’d been training.
Paulson suspects she sustained the injury while working out with a marathon training group in late June. “The workouts were more intense than I was used to, and I didn’t let my body heal after them,” she says.
She ignored the pain she began feeling — which she attributed to a groin pull — and kept adding miles to her runs. “It becomes addicting,” she explains. “You want to keep going and do more and more. I got into that mode and wasn’t paying attention.”
A tough time of year
Injuries like Paulson’s become increasingly common in the Chicago area come September, as runners increase their distances while training for the Chicago Marathon in October. “People are getting into mileage that they’re unaccustomed to, especially first-time marathoners,” says Josh Blomgren, DO, a sports medicine physician at Midwest Orthopaedics at Rush and an assistant professor of orthopedics and family medicine at Rush University Medical Center. Blomgren has been part of the Chicago Marathon’s medical team since 2007 and also is team physician for the Chicago Fire and a co-team physician for the Chicago White Sox.
“A lot of people approaching these longer distances have some relative weakness or muscular imbalance that gets exploited in those longer runs,” Blomgren explains. “We start to see muscle form and running form break down, which leads to a lot of overuse injuries. They’re relying on secondary muscles to carry the work load and they’re not used to it.”
“Most of the time it’s due to their technique,” adds Julia Bruene, MD, a sports medicine physician at Midwest Orthopaedics at Rush who also has provided medical support at the Chicago Marathon and is a team physician for the White Sox. “If their gait when they run isn’t perfect, they’re more prone to injury.”
Blomgren and Bruene both stress that pain that continues during rest periods between runs is a warning sign, and runners who experience such pain should seek treatment. “If the pain doesn’t get better after a few days and lingers even after rest, that would be when to be concerned,” Blomgren says.
Stress a point
That kind of continuing pain may be a symptom of a stress fracture, a crack in the bone caused by repeated stress, such as long distance running. No wonder that stress fractures are most common in the lower legs and feet.
“Sometimes, we’ll see them in the shins, and people mistakenly think of them as shin splints, which actually is muscle tightness in the shin area that improves once you start running,” Bruene observes.
“The stress fracture typically is going to cause a specific place to hurt, and on examination it will be very tender in that spot,” Blomgren says. The usual treatment for stress fractures is six weeks of rest from running, sometimes with the fractured area immobilized in a brace or cast.
Of course, curtailing training for six weeks at this point means a runner won’t be able to participate in the Chicago Marathon, which can be a major disappointment. While runners may be tempted to continue training, as Paulson did, the doctors warn that they run the risk that the bone will continue to weaken and even actually break.
“It can get to the point that it’s a complete fracture, and even a large compound fracture that won’t heal with rest and will require surgery,” Bruene says. “Someone who goes through that could have avoided surgery if they’ had just stopped and seen a physician.”
Taking a knee
Another affliction is so common to runners that it’s named for them. Runner’s knee is a condition in which the kneecap isn’t properly centered in a groove in the thigh bone in which slides up and down during leg motion. It’s accompanied by knee pain and stiffness around the kneecap during running, going up or down stairs, or sitting for a long time.
Like stress fractures, runner’s knee requires and will heal with rest. Runners should curtail their leg work until they can bend and straighten the knee painlessly and feel no pain when walking or jogging.
Outrunning your food
Some women runners may train so hard it results in a condition known as the female athlete triad, which results from a woman not eating enough food to supply the required by her level of exercise. The condition can occur in conjunction with an eating disorder, but also can be brought on by high levels of exercise alone.
The resulting drop in estrogen production can lead to reduced bone density, which in turn can result in stress fractures. The lessened estrogen levels also result in irregular menstrual cycles or ceased menstruation altogether.
“I have patients who are young college soccer players who think it’s normal,” Bruene says. “In fact, it’s a big red flag that someone’s training too much or not consuming enough calories. That can be the first sign before anybody has bone density issues.”
Assuming eating disorders aren’t an issue, the solution is simply to eat more healthy calories. “Food is fuel. Food is not your enemy,” Bruene says.
Better in the long run
While seeking treatment may mean postponing that 26.2 mile achievement, it also can end up making someone better in the long run, literally. “With these patients, I spend the majority of my time counseling them about why the injury happened and how it happened and strategies to get them running safely so that it doesn’t happen again,” Blomgren says.
“Sometimes we do a gait analysis, and then a physical therapist works with the patient to correct the deficiencies in one area or another, how the foot is hitting the ground, how the knee is reacting, how the foot is reacting,” Bruene adds.
Rachel Paulson has been seeing Blomgren every three weeks to evaluate the progress of her recovery from her injury. She hopes to be able to resume training in time to complete a half marathon at the beginning of spring.
When she does, she’ll take a different approach: “It’ll be slow and steady,” Paulson says.
Follow these topics: Exercise: Capacity, Exercise: High Intensity, Exercise: Marathons, Fitness: Running, Sports Medicine: Injuries
Tai chi benefits documented in new meta-analysis
is linked to improved physical capacity among older adults with certain common long term conditions, indicates a pooled analysis of the available evidence, published online in the British Journal of Sports Medicine.Among people with breast cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD), these improvements were not at the expense of worsening pain or breathlessness, the findings show.
Tai Chi consists of slow, gentle, flowing movements that aim to boost muscle power, balance, and posture. It also includes mindfulness, relaxation, and breath control.
The researchers wanted to find out how effective Tai Chi was in long term conditions that are common among older adults. So they trawled electronic research databases for relevant studies published up to 2014, on the use of Tai Chi in people with cancer, osteoarthritis, heart failure, and COPD.
They wanted to find out if Tai Chi relieved symptoms, and improved physical capacity and quality of life in all four long term conditions.
Out of 1102 articles, 33, involving 24 studies and 1584 participants, were suitable for inclusion; 21 studies were included in the pooled analysis.
The average age of participants ranged from the mid 50s to the early 70s, while the average length of the Tai Chi training programme was 12 weeks, with most sessions lasting an hour. Tai Chi training was usually offered two to three times weekly.
The results showed that Tai Chi was associated with trends, or definite improvement, in physical capacity and muscle strength in most or all four long term conditions.
This included improvements in the six minute walking test; muscle strength, as measured by bending and stretching the knees; the time it takes to get up and move known as the TUG test; and quality of life.
Tai Chi was also associated with an improvement in the symptoms of pain and stiffness in osteoarthritis and in breathlessness in COPD. And it was associated with improved sit to stand times among patients with osteoarthritis.
This is an observational study so no definitive conclusions can be drawn about cause and effect, added to which the only cancer included in the analysis was breast cancer.
But the findings back those of previous research, and provide a reasonable starting point to look at the value of exercise programmes, such as Tai Chi, for people with several co-existing long term conditions, say the researchers.
“Tai Chi can improve some physical performance outcomes in four chronic conditions…but not at the expense of worsening pain or dyspnoea [breathlessness],” they write, adding that it “may provide a suitable exercise stimulus for people with several comorbidities,” and could be used as a complementary therapy in some long term conditions.
Source
See our other posts about tai chi
Follow these topics: Arthritis: Osteoarthritis, Cancer: Breast, COPD, Fitness: Qigong, Fitness: Tai Chi, Fitness: Yoga, Heart Failure
Wednesday, September 16, 2015
Beet juice boosts muscle power in heart patients: WUSTL researchers
Building on a growing body of work that suggests dietary nitrate improves muscle performance in many elite athletes, researchers at Washington University School of Medicine in St. Louis found that drinking concentrated beet juice — also high in nitrates — increases muscle power in patients with heart failure.
“It’s a small study, but we see robust changes in muscle power about two hours after patients drink the beet juice,” said senior author Linda R. Peterson, MD, associate professor of medicine. “A lot of the activities of daily living are power-based — getting out of a chair, lifting groceries, climbing stairs. And they have a major impact on quality of life. We want to help make people more powerful because power is such an important predictor of how well people do, whether they have heart failure, cancer or other conditions. In general, physically more powerful people live longer.”
Based on research in elite athletes, especially cyclists who use beet juice to boost performance, the study’s corresponding author, Andrew R. Coggan, PhD, assistant professor of radiology, suggested trying the same strategy in patients with heart failure.
In the September issue of the journal Circulation:
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Google+Heart Failure, the scientists reported data from nine patients with heart failure. Two hours after the treatment, patients demonstrated a 13 percent increase in power in muscles that extend the knee. The researchers observed the most substantial benefit when the muscles moved at the highest velocities. The increase in muscle performance was significant in quick, power-based actions, but researchers saw no improvements in performance during longer tests that measure muscle fatigue.
Patients in the study served as their own controls, with each receiving the beet juice treatment and an identical beet juice placebo that had only the nitrate content removed. There was a one- to two-week period between trial sessions to be sure any effects of the first treatment did not carry over to the second. Neither the trial participants nor the investigators knew the order in which patients received the treatment and placebo beet juice.
Heart failure can have various triggers, from heart valve problems to viral infections, but the result is the heart’s gradual loss of pumping capacity.
“The heart can’t pump enough in these patients, but that’s just where the problems start,” said Peterson, a cardiologist and director of Cardiac Rehabilitation at Washington University and Barnes-Jewish Hospital. “Heart failure becomes a whole-body problem because of the metabolic changes that happen, increasing the risk of conditions such as insulin resistance and diabetes and generally leading to weaker muscles overall.”
While the trial was not designed to find out whether patients noticed an improved ability to function in daily life, the researchers estimated the size of the benefit by comparing the improvement in muscle power with what is seen from an exercise program.
“I have compared the beet-juice effect to Popeye eating his spinach,” said Coggan, who specializes in exercise physiology. “The magnitude of this improvement is comparable to that seen in heart failure patients who have done two to three months of resistance training.”
The nitrates in beet juice, spinach and other leafy green vegetables such as arugula and celery are processed by the body into nitric oxide, which is known to relax blood vessels and have other beneficial effects on metabolism.
With the growing evidence of a positive effect from dietary nitrates in healthy people, elite athletes and now heart failure patients, the researchers also are interested in studying dietary nitrates in elderly populations.
“One problem in aging is the muscles get weaker, slower and less powerful,” Coggan said. “Beyond a certain age, people lose about 1 percent per year of their muscle function. If we can boost muscle power like we did in this study, that could provide a significant benefit to older individuals.”
This work was supported by The Foundation for Barnes-Jewish Hospital, the Washington University Mentors in Medicine and C-STAR programs, and Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH).
Coggan AR, Leibowitz JL, Spearie CA, Kadkhodayan A, Thomas DP, Ramamurthy S, Mahmood K, Park S, Waller S, Farmer M, Peterson LR. Acute dietary nitrate intake improves muscle contractile function in patients with heart failure: a double-blind, placebo-controlled, randomized trial. Circulation: Heart Failure. September 2015.
Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.
Follow these topics: Nutrition is Medicine, Nutrition: Food: Beets
Clean eating is viewed as a lifestyle versus a diet or fad
Chicago, September 15, 2015 — Clean eating is what is making the perimeter of grocery stores a popular spot, but a new report by The NPD Group, a leading global information company, finds that many consumers feel that clean eating can include some processing and packaged foods. NPD’s How Consumers Define Clean Eating report shows that 61 percent of primary grocery shoppers feel packaged foods are acceptable when eating clean, and 44 percent of shoppers say some processing is also acceptable.
NPD’s study, which surveyed over 5,000 consumers to understand what clean eating means to them and how it impacts consumption and shopping behaviors, shows that there are several key aspects of clean eating that are more prominent than others. Generally, clean eaters emphasize items that are absent in foods or beverages versus what they contain. Of most importance to these consumers are foods that do not contain chemicals, preservatives or additives, and no pesticides, and these consumers appear to be adamant about their choices since 80 percent of clean eaters say this is their lifestyle as opposed to a diet or fad.
People who are core followers of clean eating currently represent only about five percent of primary grocery shoppers, skewing female and younger. While this is a small portion of the population, clean eating may have more staying power than typical diets since consumers view it as a lifestyle. And, some consumers already practice clean eating but may not even know they are following some of the clean eating guidelines. In addition, half of clean eaters have been following this lifestyle for over a year, which suggests that this is a lifestyle that can be sustained and therefore can grow in the coming decades, according to the NPD report.
“Clean eating from a product development standpoint may seem discouraging for CPG manufacturers,” says Darren Seifer, NPD Group food and beverage industry analyst. “But the good news is packaged goods can still fit the bill with these consumers and attract them to the center of the store.”
Source
Follow these topics: Nutrition: Clean Eating
The hot global fitness trends: a new report
Dallas, TX, September 15, 2015. Today, ClubIntel, The American Council on Exercise (ACE), and International Health, Racquet and Sportclub Association (IHRSA) released the inaugural International Fitness Industry Trend Report, “What’s All the Rage?” This study explores the offerings of fitness professionals and gym operators around the world, and quantifies the data to reflect growth in trends over the past two years.
With the collective goal to shed light on what equipment, programs, services and technology the fitness industry is adopting and how these adoption rates are changing over time, ACE, IHRSA and ClubIntel gathered behavioral data from a broad spectrum of industry professionals and business segments across the globe—representing over 11,000 health and fitness businesses. The study explores more than 90 industry trends across three broad categories—programs, services and training protocols; equipment and facilities; and technology—and determines if they are emerging, niche, growing, maturing or declining.
“This is a first-of-its kind report to measure the behavior outcomes across the entire industry, which gives fitness professionals around the world a better understanding of what their peers offer, what’s in demand, and what’s projected for growth,” said ACE President and CEO Scott Goudeseune. “Having access to data of this caliber can help professionals to better understand the opportunities that exist within the industry and assist them in developing a competitive business strategy to grow their businesses.”
“The International Fitness Industry Trend Report provides real-world feedback on what fitness club operators and professionals are actually utilizing in the marketplace,” said IHRSA President and CEO Joe Moore. “The report provides an in-depth analysis of niche, emerging, and mature trends based on comprehensive responses from leading club operators and fitness professionals.”
The key findings from the report include:
Personal training has the highest adoption rate of any program or service in the fitness industry.
Traditional functional fitness equipment and accessories (medicine balls, BOSU, stability balls) and flexibility/mobility equipment (foam rollers, stretch trainers and myofascial release devices) proved to be today’s hottest equipment.
Boot-camp training, small-group training, HIIT group exercise classes and functional resistance training have all achieved a high level of adoption and continue to show above average growth.
Social media is the only well-adopted technology trend. The industry has yet to fully embrace technology as a means to enhance the member/client experience and improve productivity and efficiency. Technology opportunities such as online pricing transparency, online registration and reservations for programs, selling memberships online, virtual training and club mobile applications all have opportunity to gain significantly greater adoption with the industry.
Senior fitness programs are among the top ten most frequently adopted industry trends.
Treadmills and elliptical trainers have experienced resurgence in growth in the past two years.
Notably, a significant majority of the trends across all three categories fell into either the emerging or niche categories. The data in the report is segmented by global region, business model and scope or size of the enterprise.
For a free overview of the study findings, click here to download the executive summary of The 2015 International Fitness Industry Trend Report. The full report will be released at the beginning of October and can be purchased from the ClubIntel store at club-intel.com/store/.
Monday, September 14, 2015
The benefits of four weeks of melatonin treatment on circadian patterns in resistance-trained athletes
The benefits of four weeks of melatonin treatment on circadian patterns in resistance-trained athletes.
Leonardo-Mendonça RC1,2,3, Martinez-Nicolas A4, de Teresa Galván C5,6, Ocaña-Wilhelmi J7, Rusanova I1,2, Guerra-Hernández E3, Escames G1,2, Acuña-Castroviejo D1,2,8.
Author information
1a Instituto de BiotecnologÃa, Centro de Investigación Biomédica, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada , Granada , Spain .
2b Departamento de FisiologÃa, Facultad de Medicina , Universidad de Granada , Granada , Spain .
3c Departamento de Nutrición y BromatologÃa, Facultad de Farmacia , Universidad de Granada , Granada , Spain .
4d Laboratorio de CronobiologÃa, Departamento de FisiologÃa, Facultad de BiologÃa , Universidad de Murcia, IMIB-Arrixaca , Murcia , Spain .
5e Centro Andaluz de Medicina del Deporte , Granada , Spain .
6f Hospital San Juan de Dios, Granada , Spain .
7g Facultad de Ciencias del Deporte , Universidad de Granada , Spain , and.
8h Unidad de Gestión ClÃnica de Laboratorios, Hospital Universitario San Cecilio , Granada , Spain.
Abstract
Exercise can induce circadian phase shifts depending on the duration, intensity and frequency. These modifications are of special meaning in athletes during training and competition. Melatonin, which is produced by the pineal gland in a circadian manner, behaves as an endogenous rhythms synchronizer, and it is used as a supplement to promote resynchronization of altered circadian rhythms. In this study, we tested the effect of melatonin administration on the circadian system in athletes. Two groups of athletes were treated with 100 mg day-1 of melatonin or placebo 30 min before bed for four weeks. Daily rhythm of salivary melatonin was measured before and after melatonin administration. Moreover, circadian variables, including wrist temperature (WT), motor activity and body position rhythmicity, were recorded during seven days before and seven days after melatonin or placebo treatment with the aid of specific sensors placed in the wrist and arm of each athlete. Before treatment, the athletes showed a phase-shift delay of the melatonin circadian rhythm, with an acrophase at 05:00 h. Exercise induced a phase advance of the melatonin rhythm, restoring its acrophase accordingly to the chronotype of the athletes. Melatonin, but not placebo treatment, changed daily waveforms of WT, activity and position. These changes included a one-hour phase advance in the WT rhythm before bedtime, with a longer nocturnal steady state and a smaller reduction when arising at morning than the placebo group. Melatonin, but not placebo, also reduced the nocturnal activity and the activity and position during lunch/nap time. Together, these data reflect the beneficial effect of melatonin to modulate the circadian components of the sleep-wake cycle, improving sleep efficiency.
Source
New Technologies Can Help Short Circuit Chronic Pain
As part of a comprehensive treatment plan, a variety of technologies offer new hope to people living with chronic pain.
Used by physician anesthesiologists who specialize in pain management, these techniques ease pain in various ways – using radio waves, electrical pulses, image-guided injections and special pumps to deliver pain medication. Pain medicine specialists have extensive training and expertise in finding the cause of pain and working in partnership with patients to create a plan for managing pain and improving function.
“Pain is one of the most challenging things to treat because its source can be elusive,” said Richard Rosenquist, M.D., chair of the American Society of Anesthesiologists® (ASA®) Committee on Pain Medicine and chairman of the department of pain management at the Anesthesiology Institute at the Cleveland Clinic. “That’s why it’s vital to see a physician specializing in pain medicine who can help identify the source of the pain and suggest which pain method might work best, including the more recent technical advances.”
Pain Relief Techniques
Here are some of the latest high-tech methods for relieving chronic pain.
• Radio Waves
– Radiofrequency (RF) ablation involves heating a tiny area of nerve tissue, which short circuits pain signals. Using CT imaging as a guide, the pain medicine specialist inserts a needle into the nerve responsible for the pain and zaps it using an electric current created by radio waves. The relief can last for up to a year.
• Blocking the Pain
– Under X-ray guidance, pain medicine physicians can inject numbing medication that blocks or dampens pain, and might even stop chronic pain from developing. The location of the injection depends on the source and type of pain. For example, pain in the arm or face can be relieved by blocking nerves in the neck. Chronic abdominal pain or pain from cancers such as pancreatic cancer can be relieved by an injection into nerves supplying the abdomen. Relief may require a series of injections and may need to be repeated.
• Electric Signals
– Transcutaneous electrical nerve stimulation (TENS) can provide short-term pain relief, especially for various types of muscle pain, by sending low voltage electric signals from a small device to the painful area through pads attached to the skin. The patient will feel little pulses when it’s on. While researchers aren’t sure why it works, they think it may either interrupt the nerve signals to the brain, or stimulate the production of “feel good” endorphins, the body’s natural painkillers.
• Spinal Cord Stimulation
– When other methods fail, a pain medicine specialist might recommend spinal cord stimulation (SCS), which uses a pacemaker-like device that replaces the pain with a more tolerable sensation, typically tingling or a massage-like feeling. The physician implants the device in the lower back, attaching it to tiny wires that are located in the spinal canal. When the patient feels pain, he or she can use a remote control device to send signals to the painful area. This technique can help with back pain as well as neuropathy – nerve damage in the legs that causes numbness and pain. Neuropathy is common in people with diabetes.
• High Frequency Spinal Cord Stimulation
– A recent study published in Anesthesiology, the medical journal of the ASA, showed that a special high frequency form of SCS provided significantly greater long-term relief for both chronic back and leg pain, compared to traditional low frequency SCS. The high frequency SCS also relieved pain without introducing the tingling or other stimulation-induced sensation that some patients find distracting.
• Pumping the Pain Away
– Special pumps can be implanted that allow the patient to push a button and deliver local anesthetics, narcotics and other pain medications to the spinal cord. This can bring relief while avoiding the side effects that often come with taking these drugs by mouth. Patients also get a psychological boost by having direct control over their pain. These spinal drug pumps are most often used by people with cancer pain, but also by patients with other types of pain who had side effects when taking medication.
• On the Horizon: Using Our Cells to Fight Pain
– One of the most promising research areas involves harvesting stem cells from a patient’s bone marrow and injecting them into an area, such as the lower back, that has become painful because tissue has deteriorated. The hope is that the stem cells will build new, healthy tissue and relieve pain for good.
A Patient’s Victory Over Chronic Pain
Chris Power developed a condition called complex regional pain syndrome when he fell on his arm. The pain was unbearable and doctor after doctor told him there really wasn’t much hope. He finally saw a physician anesthesiologist who recommended SCS. It changed Chris’ life. Watch Chris tell his story.
Participating in Your Pain Control
While technology can do wonders for chronic pain, patients can play a big role in managing their pain with some low-tech strategies. If a patient smokes, they should get help to stop. Excess weight puts stress on joints and can lead to hip and knee pain, so patients should try to maintain a healthy weight. Good nutrition is important even if the patient is trim, and exercising can often relieve or prevent pain.
For more information about pain and the importance of a pain medicine specialist, visit our pain management page.
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount.
Thursday, September 10, 2015
Patients prefer relief from lower back pain over improved mobility
A new study out today in the journal Neurology examines the question of quality of life for individuals with a common form of lower back pain called lumbar spinal stenosis. The findings show that, when asked to choose between treatments that reduced pain or would help them stand or walk, patients overwhelmingly chose pain relief.
“There has long been a debate in the medical community over striking the right balance between pain relief and physical function,” said John Markman, M.D., director of the Translational Pain Research Program in the University of Rochester Department of Neurosurgery and lead author of the study. “While physicians have leaned toward the need to increase mobility, this study shows that patients have a clear preference for pain relief.”
Lumbar spinal stenosis is brought about by a narrowing of the spinal canal caused by the degeneration of the vertebrae, discs, joints, and ligaments that comprise the spinal column, resulting in a compression of nerve roots. This narrowing of the spinal canal triggers pain, tingling, and numbness in the lower back, buttocks, and legs which is most commonly experienced when a person is upright or walking.
There is compelling evidence that surgery provides relief and improves mobility, however many patients outlive this benefit or are not candidates for surgical treatment. Epidural steroid injections also may provide short term relief of pain.
Researchers surveyed 269 patients with lumbar stenosis with chronic back pain and difficulty standing and walking. The researchers asked patients about their priorities, specifically, whether they prefer a treatment that reduced their pain or one that would allow them to walk further. The study participants overwhelmingly (79 percent) chose reduced pain over improved mobility – no matter how much the condition impaired their ability to stand and walk.
“Even the patients who could not stand long enough to pick up a letter from their mail box or wash the dishes after dinner chose pain relief,” said Markman.
This research is an example of the new standards for pain relief that are being created based on input from patients. To a great extent, levels of pain relief have been left to pharmaceutical company scientists and government officials to decide, often with little guidance from patients. There is now a growing demand that new generations of pain medications are not only safe, but meet patient’s expectations for pain relief.
The most common study populations for these newer drugs are patients with chronic low back pain. Many experts are arguing that new pain relievers, especially those with greater risks like opioids, should not just relieve pain but also improve patients function such as their ability to walk. This new study calls into question those assumptions.
“This study convincingly demonstrates the need to prioritize pain relief because that is what patients want,” Markman said.
Source
“There has long been a debate in the medical community over striking the right balance between pain relief and physical function,” said John Markman, M.D., director of the Translational Pain Research Program in the University of Rochester Department of Neurosurgery and lead author of the study. “While physicians have leaned toward the need to increase mobility, this study shows that patients have a clear preference for pain relief.”
Lumbar spinal stenosis is brought about by a narrowing of the spinal canal caused by the degeneration of the vertebrae, discs, joints, and ligaments that comprise the spinal column, resulting in a compression of nerve roots. This narrowing of the spinal canal triggers pain, tingling, and numbness in the lower back, buttocks, and legs which is most commonly experienced when a person is upright or walking.
There is compelling evidence that surgery provides relief and improves mobility, however many patients outlive this benefit or are not candidates for surgical treatment. Epidural steroid injections also may provide short term relief of pain.
Researchers surveyed 269 patients with lumbar stenosis with chronic back pain and difficulty standing and walking. The researchers asked patients about their priorities, specifically, whether they prefer a treatment that reduced their pain or one that would allow them to walk further. The study participants overwhelmingly (79 percent) chose reduced pain over improved mobility – no matter how much the condition impaired their ability to stand and walk.
“Even the patients who could not stand long enough to pick up a letter from their mail box or wash the dishes after dinner chose pain relief,” said Markman.
This research is an example of the new standards for pain relief that are being created based on input from patients. To a great extent, levels of pain relief have been left to pharmaceutical company scientists and government officials to decide, often with little guidance from patients. There is now a growing demand that new generations of pain medications are not only safe, but meet patient’s expectations for pain relief.
The most common study populations for these newer drugs are patients with chronic low back pain. Many experts are arguing that new pain relievers, especially those with greater risks like opioids, should not just relieve pain but also improve patients function such as their ability to walk. This new study calls into question those assumptions.
“This study convincingly demonstrates the need to prioritize pain relief because that is what patients want,” Markman said.
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Additional co-authors include Jennifer Gewandter, Maria Frazer, Babak Jahromi, Christine Pittman, Xeuya Cai, and Robert Dworkin with the University of Rochester, John Farrar with the University of Pennsylvania, and Kushang Patel with the University of Washington.Source
Follow these topics: Back Pain
Wednesday, September 9, 2015
People want to exercise at their desks: study
In the study, 27 volunteers at a company in Iowa City were given pedal devices. The devices work like stationary bikes and fit under a desk.
Of the 27 employees, 70% asked to keep the devices after a 16-week trial. Most reported using the device an average of 50 minutes per day, and more than half reported weight loss, improved concentration, and improved productivity.
Many previous attempts at finding exercise devices for the office have failed because the equipment made it hard to workers to focus. For instance, many people report that they’ve lost weight using a treadmill desk, but most say it is hard to work and focus on not falling at the same time.
Previous Carr studies have shown that offering limited amount of exercise equipment for employees to share doesn’t work, either. You can put a high-end treadmill or bike in an office, and it will be mostly ignored.
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Follow these topics: Commercial Fitness Industry, Corporate Wellness, Treadmill Desks, Workplace Issues
Cause of muscle weakness and loss due to aging discovered
Scientists at the University of Iowa have discovered the first example of a protein that causes muscle weakness and loss during aging. The protein, ATF4, is a transcription factor that alters gene expression in skeletal muscle, causing reduction of muscle protein synthesis, strength, and mass. The UI study also identifies two natural compounds, one found in apples and one found in green tomatoes, which reduce ATF4 activity in aged skeletal muscle. The findings, which were published online Sept. 3 in the Journal of Biological Chemistry, could lead to new therapies for age-related muscle weakness and atrophy.
“Many of us know from our own experiences that muscle weakness and atrophy are big problems as we become older,” says Christopher Adams, MD, PhD, UI professor of internal medicine and senior study author. “These problems have a major impact on our quality of life and health.”
Previously, Adams and his team had identified ursolic acid, which is found in apple peel, and tomatidine, which comes from green tomatoes, as small molecules that can prevent acute muscle wasting caused by starvation and inactivity. Those studies set the stage for testing whether ursolic acid and tomatidine might be effective in blocking the largest cause of muscle weakness and atrophy: aging.
In their latest study, Adams’ team found that ursolic acid and tomatidine dramatically reduce age-related muscle weakness and atrophy in mice. Elderly mice with age-related muscle weakness and atrophy were fed diets lacking or containing either 0.27 percent ursolic acid, or 0.05 percent tomatidine for two months. The scientists found that both compounds increased muscle mass by 10 percent, and more importantly, increased muscle quality, or strength, by 30 percent. The sizes of these effects suggest that the compounds largely restored muscle mass and strength to young adult levels.
“Based on these results, ursolic acid and tomatidine appear to have a lot of potential as tools for dealing with muscle weakness and atrophy during aging,” Adams says. “We also thought we might be able to use ursolic acid and tomatidine as tools to find a root cause of muscle weakness and atrophy during aging.”
Adams’ team investigated the molecular effects of ursolic acid and tomatidine in aged skeletal muscle. They found that both compounds turn off a group of genes that are turned on by the transcription factor ATF4. This led them to engineer and study a new strain of mice that lack ATF4 in skeletal muscle. Like old muscles that were treated with ursolic acid and tomatidine, old muscles lacking ATF4 were resistant to the effects of aging.
“By reducing ATF4 activity, ursolic acid and tomatidine allow skeletal muscle to recover from effects of aging,” says Adams, who also is a member of the Fraternal Order of Eagles Diabetes Research Center at the UI and a staff physician with the Iowa City Veterans Affairs Medical Center.
The UI study was done in collaboration with Emmyon, Inc., a UI-based biotechnology company founded by Adams, that is now working to translate ursolic acid and tomatidine into foods, supplements, and pharmaceuticals that can help preserve or recover strength and muscle mass as people grow older.
In addition to Adams, the UI team included Michael Dyle, Steven Bullard, Jason Dierdorff, Daryl Murry, Daniel Fox, Kale Bongers, Vitor Lira, and David Meyerholz, as well as Scott Ebert and John Talley at Emmyon, Inc.
The study was funded by a Small Business Innovation Research (SBIR) grant to Emmyon, Inc. from the National Institute on Aging, as well as grants from the Department of Veterans Affairs and the Fraternal Order of Eagles Diabetes Research Center at the University of Iowa.
Monday, September 7, 2015
Step It Up! The Surgeon General’s Call to Action
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Only half of American adults get enough physical activity to reduce the risk of chronic disease, the leading cause of death in the United States. Walking is an easy way to start and maintain a physically active lifestyle. That is why US Surgeon General VADM Vivek H. Murthy, M.D., M.B.A. aims to increase walking across the nation by calling for access to safe and convenient places to walk and wheelchair roll.
This declaration addresses a number of major health issues facing our country today. Imagine the dramatic impact ACSM members can have if we come together to promote walking and physical activity within our communities. ACSM has been involved with this initiative even before it started, in making the initial suggestion that the Office of the Surgeon General consider a call to action that addresses physical activity.
In anticipation of this historical event, we challenge you to use this call to action as an opportunity for advancing physical activity - specifically walking. Some things you may consider:
LIVE WEBCAST
The U.S. Department of Health and Human Services is hosting a live webcast for the launch of this important Call To Action that will offer strategies for increasing walking and walkable communities for people of all ages and abilities.
If you are unable to participate or if you experience any technical difficulties while trying to sign on to the webcast, a recording of the event will be available on the Office of the Surgeon General’s website after the release: www.surgeongeneral.gov
Please share this invitation with others who may be interested in learning what they can do to promote walking and walkable communities for all.
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Adult coloring is absolutely a growing trend and consumers are really taking to the idea
Whether used for enjoyment, to relieve stress, or as an excuse to get together with friends for a coloring party, Coloring For Adults For Dummies is filled with intricate, detailed, and inspiring patterns & designs and provides hours of stress relief and mental relaxation! Designed for you to color in with markers, colored pencils, or even your kids’ crayons, the pages inside this book are awaiting your imagination and creativity to bring them to life—all while you relax and enjoy staying in the present. Even older children who love to color can enjoy this unique and special coloring book.
- Offers 100 highly-detailed coloring templates
- Helps you channel your anxiety into a satisfying, creative accomplishment
- Promotes finding energy for your stressed soul
- Encourages you to express your inner creativity
Source: Wiley
Follow these topics: Human Behavior: Calm, Human Behavior: Stress
6 tips to getting your kid on a sleep schedule for school
While there’s no magic number when it comes to hours of sleep needed, Dr. Anju Anand, a sleep medicine doctor and respirologist with St. Michael’s Hospital, said school-aged generally children require between eight and 11 hours of uninterrupted sleep. Preschoolers, on the other hand, need even more sleep—between 11 and 13 hours.
“Sleep is important for children’s neurocognitive development,” she said. “Studies suggest a connection between poor sleep and poorer performance in school, increased behavioural problems and reduced concentration.”
Here are six tips to getting your child falling asleep earlier (without having to count sheep).
Start with the wake-up
When adjusting your child’s sleep schedule, Dr. Anand suggests tweaking wake-up time rather than bedtime.
“Children might go to their room with every intention of falling asleep, but if they’re not tired, their body won’t settle down,” she said. “When you set your morning alarm, even if it’s really hard to wake up, you can force yourself to get out of bed.”
Dr. Anand said parents can start working on changing bedtimes once wake-up times are established and children are having an easier time falling asleep.
Be consistent
Make sure children are going to bed and waking up at roughly the same time every day – including weekends. One sleep cycle feeds into the next, so if kids are sleeping in later Sunday morning, they might not be tired that night, said Dr. Anand.
“Teens especially might have more erratic sleep schedules, so when the weekend comes, make sure they go to bed and wake up at around the same time as during the week,” she said.
Regulate light
When you’re trying to bring the clock back, make sure to cut out children’s screen time at least an hour before bed. Bringing electronics like cellphones, tablets and e-readers to bed can suppress melatonin, our darkness signal, which helps our bodies fall asleep.
“Make sure the bedroom is dark and quiet before bedtime,” said Dr. Anand. “In the morning, you want to open the curtains to get that light stimulation, which tells our body to wake up.”
Avoid caffeine
Children should avoid caffeinated beverages and foods like energy drinks, pop and chocolate at least eight hours before bed. They should also avoid drinking any sorts of fluids at least one hour before bed.
Stay active
Dr. Anand said children who are active during the day tend to have better sleep quality.
Parents should also try to convince their teenage children to cut out naps during the day. Dr. Anand said if they do need those afternoon naps, they should be as short as possible – around 20 minutes.
Have a chat
If these tips aren’t’ working, Dr. Anand suggests that parents talk to their children about potential stress or anxiety they might be feeling.
“Sit down and talk to your child to see why they’re having difficulty sleeping, and if there’s something going on at school, or if they’re feeling depressed,” she said. “Mood is a really important part of sleep that often gets ignored.”
Follow these tips and you might help your kids make an “A” in school by ensuring they get enough Zzzzs.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.Source
Follow these topics: Parenting, Pediatric Health: Sleep
Step based physical activity guidelines for preschool-aged children
Vale S1, Trost SG2, Duncan MJ3, Mota J4.
Author information
1Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Department of Sport Science. High School of Education, Polytechnic Institute of Oporto, Portugal. Electronic address: susanavale@hotmail.com.
2School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
3Faculty of Health and Life Sciences, Coventry University, UK.
4Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal.
Abstract
OBJECTIVE:
Public health organizations recommend that preschool-aged children accumulate at least 3h of physical activity (PA) daily. Objective monitoring using pedometers offers an opportunity to measure preschooler’s PA and assess compliance with this recommendation. The purpose of this study was to derive step-based recommendations consistent with the 3h PA recommendation for preschool-aged children.
METHOD:
The study sample comprised 916 preschool-aged children, aged 3 to 6years (mean age=5.0±0.8years). Children were recruited from kindergartens located in Portugal, between 2009 and 2013. Children wore an ActiGraph GT1M accelerometer that measured PA intensity and steps per day simultaneously over a 7-day monitoring period. Receiver operating characteristic (ROC) curve analysis was used to identify the daily step count threshold associated with meeting the daily 3hour PA recommendation.
RESULTS:
A significant correlation was observed between minutes of total PA and steps per day (r=0.76, p<0.001). The optimal step count for ≥3h of total PA was 9099 steps per day (sensitivity (90%) and specificity (66%)) with area under the ROC curve=0.86 (95% CI: 0.84 to 0.88).
CONCLUSION:
Preschool-aged children who accumulate less than 9000 steps per day may be considered Insufficiently Active.
Source
Follow these topics: Exercise: Benefits, Pediatric Health
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