Interrogating the Age-Old Wisdom of Exercise.

Dec 2012

Cheng S.

Source

Framingham Heart Study, Framingham, MA; Brigham and Women's Hospital, Boston, MA.

Abstract

We have long known that exercise is good for us. Hippocrates declared over 25 centuries ago that "if we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." There is now a wealth of evidence indicating that the benefits of physical activity extend across multiple organ systems and span the age spectrum.(1,2) Perhaps most compelling are data highlighting the potential of exerciseto prevent and attenuate chronic conditions related to insulin resistance and atherosclerosis.(3,4) Despite nationwide recommendations encouraging regular exercise for all adults, fewer than 1 in 3 Americans engage in routine physical activity.(5) Low adherence rates could relate in part to the fact that we still do not really understand how exercise works. For this reason, recommendations remain non-specific with respect to how frequent, how intense, how long, what type, and for whom exercise should be prescribed.(4).

PubMed

The Benefit of Aquatic Exercise for Lymphedema

BY JOACHIM ZUTHER, ON JANUARY 20TH, 2011

Today I would like to share with you an article on aquatic exercises written by Mary Essert, B.A., ATRIC for this blog.

Mary specializes in creation and delivery of water fitness and post rehab aquatic programs for individuals with disabilities and conditions such as Arthritis, Fibromyalgia, Breast Cancer, Lymphedema, post Polio Syndrome and chronic pain issues. More information on Mary Essert is available at the bottom of the article.
I would also like to inform you that all the exercises for the upper and lower extremities I covered in the last blog entry (Decongestive and Breathing Exercises for Lymphedema) may be performed in the water as well.

Here is Mary’s article:

Following Joe Zuther’s recent article on Resistive Exercises, this article would be a natural sequence and serve as an introduction to another non-invasive tool to use in management of Lymphedema symptoms.

In addition to a number of other benefits, aquatic exercises have a strengthening effect on the musculature.

Remainder of article:

Lymphedema Blog

**This is an excellent source of solid lymphedema information and I highly recommend it to anyone with an interest in this condition. Pat O'Connor**

Evidence based exercise - Clinical benefits of high intensity interval training.

Dec 2012

Shiraev T, Barclay G.

Abstract

Obesity rates in Australia are among the highest in the world, with one in 4 adults being obese. Obesity increases the risk of coronary heart disease, type 2 diabetes mellitus (T2DM) and stroke, three of the top five causes of burden of disease and injury in Australia.2 Dietary modification is the mainstay of any weight loss program and has been shown to improve cardiovascular and metabolic risk factors including blood pressure, lipids, serum glucose, glycated haemoglobin (HbA1c) and insulin levels as well as reducing risk of acute coronary syndromes, stroke and all cause mortality. Exercise has been shown to be an important additional strategy to a weight loss program. However, in Australia, nearly 40% of males and 60% of females carry out insufficient daily physical activity.

BACKGROUND:

Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobicexercise, as per Australian Heart Foundation clinical guidelines.

OBJECTIVE:

This article describes the benefits of exercise for patients with cardiovascular and metabolic disease and details the numerous benefits of high intensity interval training (HIIT) in particular.

DISCUSSION:

Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.

PubMed

The role and efficacy of exercise in persons with cancer.

Nov 2012

Eickmeyer SM, Gamble GL, Shahpar S, Do KD.

Source

Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin and Clement J. Zablocki VA Medical Center, Milwaukee, WI(⁎). Electronic address: seickmeyer@mcw.edu.

Abstract

Improvements in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors with impairments in physical function, cancer-related symptoms, and reduced quality of life. Exercise and physical activity have therapeutic value at multiple points along the cancer disease continuum, spanning disease prevention, treatment, survivorship, prognostic outcomes, and end-of-life issues. Molecular mechanisms for the influence of exercise in persons with cancer include altering tumor initiation pathways and affecting hormonal, inflammatory, immune, and insulin pathways. Physical activity has been found to play a role in the prevention of certain malignancies, including breast, colon, and other cancers. An increasing amount of evidence indicates that physical activity may affect prognostic outcomes in certain cancer diagnoses, especially breast cancer. Structured exercise and physical activity interventions can be helpful in addressing specific survivorship issues, including overall quality of life, cardio respiratory impairment, cancer-related fatigue, and lymphedema. Exercise also may be helpful during the palliative care phase to alleviate symptoms and increase physical well-being. This article will familiarize physiatrists with the current state of evidence regarding the role and efficacy of exercise in persons with cancer.

PubMed

**I have included this as so many of us (including myself) are either cancer patients or cancer survivors.**

Aerobic Exercises for Lymphedema

Aerobic Exercises for Lymphedema

BY JOACHIM ZUTHER, ON DECEMBER 17TH, 2010

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This is the first part in a three-part series covering exercises for patients affected by lymphedema. Part two will cover resistive exercises; part three will discuss decongestive and breathing exercises – so stay tuned.

Lymphedema patients can and should be active, and those who never exercised before should consider starting that daily walk, wim or spending twenty minutes on a stationary bicycle. The right type of physical activity helps to reduce the swelling by improving the flow of lymph, and presents a vital tool for patients to stay in shape and continue with normal activities of daily living.

So what is the right type of exercise for lymphedema?

Many patients ask if they can continue their pre-lymphedema activities, or if the should adjust, or replace them. The answer to that question really depends on the kind of activity. Tennis or golf for example does not rank very high on the list of beneficial activities for individuals with upper extremity lymphedema. For patients with lymphedema of the leg, kick-boxing and step-aerobics are activities that bear a great risk of injury and therefore should be avoided.

But the reality is that for some individuals exercise plays such a vital role in their daily routine, and is so engrained in their personality, that giving up these so called “high-risk activities” would have a serious impact on their well-being.

Complete Article:  Lymphedema Blog

Editor's Note:  I have spoken of this blog in many of my own sites and if you have not yet "toured" it, you are missing out on some top quality information for your lymphedema.  

Tips for Getting Exercise Into Your Life

Tips for Getting Exercise Into Your Life

1. Get off a stop or 2 earlier during your bus or subway commute; walk the rest of the way. 

2. Purposefully park you car a little further from the mall or store. It may not seem like much, but over weeks and months, these minutes of exercise add up. 

3. Use the stairs instead of elevators and escalators whenever possible. 

4. Consider buying a piece of cardiovascular equipment for your home (e.g. treadmill, bike, elliptical machine). Home models can be more reasonable than you think and you can't beat the convenience. 

5. When you get busy, try to combine your cardiovascular exercise with something that you do already. Hop on that piece of home equipment while watching TV, reading the newspaper or returning phone calls. 

6. Make it fun! Try a new sport like tennis or rollerblading. The more that you enjoy exercise the more likely you are to stick to it. 

7. Make it social. Walk with a friend, your spouse, or your family in the morning or evening. 

8. Keep an exercise log. It will help to make you more accountable. 9. Take a walk for 20 minutes of your lunch hour. 10. Hire a personal trainer for a session or 2 to help you with your weight training and flexibility training.

Then you'll have the confidence to branch out on your own.

Time for an Average 150 lb Adult to Burn 150 Calories:

Intensity Activity METs* Duration in minutes Moderate Volleyball, noncompetitive 3.0 43 Moderate Walking, moderate pace (3 mph, 20 min/mile) 3.5 37 Moderate Walking, brisk pace (4 mph, 15 min/mile) 4.0 32 Moderate Table tennis 4.0 32 Moderate Raking leaves 4.5 32 Moderate Social dancing 4.5 29 Moderate Lawn mowing (powered push mower) 4.5 29 Hard Jogging (5 mph, 12 min/mile) 7.0 18 Hard Field hockey 8.0 16 Very hard Running (6 mph, 10 min/mile) 10.0 13

* MET indicates metabolic equivalent. One MET is the amount of energy used when sitting quietly. Source: Physical Activity and Health: A report of the Surgeon General (1) 

Harvard EDU - page no longer available

Nurse-assisted education and exercise decrease the prevalence and morbidity of lymphedema following breast cancer surgery.

JulSep 2012

Sisman H, Sahin B, Duman BB, Tanriverdi G.

Source

Department of Nursing, Cukurova University Medical Faculty, Balcali, Adana, Turkey.

Abstract

PURPOSE:

To evaluate an educational and exercise program for the prevention and progression of post-mastectomy lymphedema of the arm and shoulder.

METHODS:

Fifty-five patients who had undergone mastectomy and axillary lymph node dissection between June 2009 and January 2010 were included in this study. The patients were informed by a trainer nurse about the precautions they should take to prevent the development of lymphedema. The patients were also trained for the appropriate exercises and were given written educational material prepared by the investigators.

RESULTS:

Among the participants, 96.4% underwent modified radical mastectomy (MRM) and 3.6% breast-conserving (BCS) surgery. The mean postoperative follow-up period was 9.87 ± 17.55 months. The degree of lymphedema was found lower, even within 6 months, in the patients that exercised as compared to the patients that did no .

CONCLUSIONS:

The results indicate that the risk of development and progression of mastectomy-related lymphedema was reduced with education and exercise provided by trained nurses at an early stage.

PubMed