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Exercise and Dementia — Does Physical Activity Provide Cognitive Benefits?

/14 April 2021/ All MFN blog/

The World Health Organization recommends regular physical exercise—both aerobic and strength training—for older individuals as a means of reducing cognitive decline.1 However, studies on the effects of exercise on cognitive function in individuals with dementia have produced mixed results. While some research indicates a positive effect, other studies have failed to find clear benefits. Thus, the question remains: Is exercise actually effective at slowing down cognitive decline in individuals with dementia?

Evidence in Favor: Cognitive Benefits in Dementia

Repeated randomized controlled trials have found that various types of exercise programs produce cognitive benefits in dementia over a three- to four-month period. For example, one trial of 40 community-dwelling adults with mild to moderate dementia examined the impact of a four-month home-based exercise intervention consisting of strength and balance training exercises plus daily walking. Those in the exercise group showed improved scores on the Mini-Mental State Examination (MMSE) over baseline as compared with controls. (2) Similarly, a Belgian trial of 25 patients with moderate to severe dementia found that a program of daily physical exercises supported by music produced significant improvements in cognition on both the MMSE and the fluency subtest of the Amsterdam Dementia Screening Test 6 compared with controls. (3) Multiple other trials have produced similar results. (4-7)

A weakness of most randomized controlled trials showing a cognitive benefit of exercise in dementia is that the study populations have been small. One 2016 trial, however, tested a moderate- to high-intensity exercise intervention in a larger sample: 200 community-dwelling patients with mild Alzheimer’s disease (AD). Participants were randomized to either a supervised exercise group (one-hour sessions three times per week for four months) or to a control group. The study found no effect on cognition in the exercise group as a whole; however, in an exploratory analysis, the researchers found a possible beneficial impact on cognition among those who were most consistent in attending exercise sessions and who exercised at the greatest intensity, suggesting a dose-response relationship between exercise and cognition. (8)

Evidence Against: No Cognitive Benefits in Dementia

Although a range of studies suggest that exercise has a benefit for dementia treatment, other studies have found no such benefit. Such was the case, for example, with a 2017 Swedish trial of nearly 200 individuals with dementia in a nursing home setting. Participants were randomized either to a four-month high-intensity exercise intervention or to a seated attention control activity. The exercise intervention had no benefit for either global cognition or executive function over control, relative to baseline measures. This was true regardless of the sex of the participants, their forms of dementia, and their cognitive levels at baseline. (9)

In the case of the Swedish trial, the researchers hypothesized that the lack of benefit could be due to the fact that the exercise intervention focused on strength training rather than aerobic exercise. But a 2018 randomized control trial from British researchers produced no better results with aerobic exercise. In this large, carefully designed trial of almost 500 participants with mild to moderate dementia, participants were assigned to either an exercise group (which included both aerobic exercise and strength training) or to a usual-care group. Not only did exercise fail to produce cognitive benefits, but those in the exercise group actually demonstrated slightly worse cognition at the end of 12 months than did those in the usual care group. (10)

Mixed Results From Meta-Analyses and Systematic Reviews

The mixed results in individual randomized trials mirror the contradictory findings of several recent meta-analyses and systematic reviews.

Specifically, a 2015 systematic review of 17 randomized controlled trials found only very limited benefits of exercise in dementia—namely, researchers concluded that exercise programs may improve ability to do activities of daily living in dementia, but that exercise provides no benefits for cognition, neuropsychiatric symptoms, or depression. (11)

By contrast, however, two other recent meta-analyses reached the opposite conclusion and have affirmed the benefits of exercise—especially aerobic exercise—for cognition in dementia. The first of these meta-analyses, published in 2016, found that exercise has a positive benefit on cognition in both AD and other dementias and that both high-frequency and low-frequency exercise programs are beneficial. (12)

The second meta-analysis with a positive result, published in 2018, included 19 randomized controlled trials involving patients with AD as well as those at high risk of AD. This meta-analysis found that exercise interventions appear to slow cognitive decline in both groups—in those who have AD as well as in those at risk of the disease. (13)

Resolving the Inconsistencies

To make sense of the inconsistencies, a first point of note is that the research on exercise and its impact on cognition in dementia is still in its infancy. “There are a relatively small amount of studies that examine this relationship and there are still many unknowns due to limitations of the current literature,” says Gregory Panza, MS, an exercise physiologist at Connecticut’s Hartford Hospital and lead author of the 2018 meta-analysis referenced previously that found a positive benefit of aerobic exercise on cognition in dementia.

Not only are there a limited number of studies, but many of those that are available have been small and of relatively poor methodological quality. In fact, the authors of the 2015 systematic review that found no cognitive benefits of exercise in dementia explicitly noted that there was considerable unexplained heterogeneity in the analysis, and that the quality of the evidence was “very low.” (11)

With respect to meta-analyses in particular, Panza, a doctoral candidate in the department of kinesiology and the Human Performance Laboratory at the University of Connecticut, notes a major weakness of several analyses that have found a lack of impact of exercise on cognition: Namely, they have included mixed samples of people with multiple types of dementia (AD, vascular dementia, and other types of dementia) and analyzed them all together as one sample, rather than examining each group separately. “This is an issue because there are several physiological differences among the different types, and as a result, exercise may be affecting each type of dementia differently,” Panza says. Additionally, previous meta-analyses usually have failed to examine moderators such as age and gender. It’s important to examine moderators, he says, “because it gives you valuable information on which variables may be influencing the impact that the exercise is having on cognitive function.”

To address these limitations of previous research, Panza and his coauthors adhered to high-quality methodological reporting standards in their own 2018 meta-analysis, suggesting that their group’s finding of a positive cognitive benefit of exercise in dementia may carry more weight than the negative findings of some previous analyses. In their study, Panza and his colleagues also conducted within-group analyses (in which they compared cognitive changes both before and after the intervention for both the exercise and control groups), rather than merely conducting a between-group analysis as had previous meta-analyses. The within-group analysis allowed the group to take into account the cognitive decline that occurs naturally with untreated disease in the control group, and this analysis revealed the novel finding that exercise could improve cognition among controls. Overall, then, the Panza’s meta-analysis offers important support to the hypothesis that exercise can indeed slow cognitive decline in dementia.

Exercise in Midlife Protects Against Dementia

In addition to the evidence about the effect of exercise on cognition in individuals who already have dementia, there’s also a body of research on the effects of mid- to late-life exercise on future risk of cognitive impairment. (14) For instance, in a longitudinal study of women spanning 44 years, high levels of physical fitness were associated with a significantly reduced risk of dementia several decades later as compared with medium levels of physical fitness; in fact, high levels of physical fitness delayed onset of dementia by 9.5 years compared with medium fitness. (15)

Some research suggests that exercise may have especially significant benefits for individuals at highest genetic risk for dementia. A 2014 study, for instance, examined a group of 97 cognitively normal adults and compared how high vs low levels of physical activity correlated with each group’s hippocampal volume over the following 18 months. Researchers found that exercise had no apparent impact on hippocampal volume in those without genetic risk. But in those at genetic risk (that is, carriers of the APOE-E4 allele), low levels of physical activity were associated with a decline in hippocampal volume. This same group of less-active, higher-risk individuals was also more likely to show both cognitive and functional decline over the study period. (16)

According to Stephen Rao, PhD, Ralph and Luci Schey Endowed Chair at the Cleveland Clinic Lou Ruvo Center for Brain Health, a main mechanism by which exercise is thought to affect dementia risk is by affecting inflammation. “What exercise seems to be doing is reducing the amount of inflammation that ultimately is a very important factor in the progression of the disease. The disease is going on for 10 to 15 years prior to its diagnosis. So anything you can do to alter processes like inflammation can make a big dent in the rate of progression of the disease.”

To be clear, not all research shows a protective benefit of exercise against dementia: One 2018 systematic review and meta-analysis found that randomized controlled trials on exercise for dementia prevention are limited, but that the existing evidence does not show any significant effect of exercise in terms of reducing dementia risk. (17)

However, several other meta-analyses have come to the opposite conclusion. A 2011 meta-analysis of 15 prospective studies that included a total of more than 33,000 subjects without dementia concluded that all levels of physical exercise, from low to high, offer a significant and consistent protective effect (-35% or greater) against cognitive decline. (18) Similarly, a 2016 meta-analysis of 10 high-quality prospective observational cohort studies found that those who were more active had a 35% to 40% lower chance of developing AD than did those who were less active. (19)

Implications for Providers

According to Panza, there are still significant gaps in the research on exercise and dementia, and there’s a need for considerably more research using neuroimaging and molecular markers to examine the neuropsychological, electrophysiological, and pathophysiological effects that exercise has on dementia. Still, he recommends exercise—especially aerobic exercise—as a valuable treatment option for those who have dementia or are at risk. “Not only is there evidence that exercise can delay the onset of Alzheimer’s disease but the physical benefits of exercise may also help their patients keep their independence longer.”

Rao likewise acknowledges the unknowns, but he too affirms that exercise appears to be an important means of reducing dementia risk. “Exercise is key. It’s never too late. Providers should really encourage their patients to exercise, within reason, within their level of fitness.”

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This article was featured in Today’s Geriatric Medicine.

Today’s Geriatric Medicine is a bimonthly trade publication offering news and insights for professionals in elder care.

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This article was featured in the May/June 2019 issue of Today’s Geriatric Medicine (Vol. 12 No. 3 P. 6). Written by Jamie Santa Cruz, a health and medical writer in the greater Denver area. Reprinted with permission from Today’s Geriatric Medicine.


References

1. Physical activity and older adults. World Health Organization website. http://www.who.int/dietphysicalactivity/factsheet_olderadults/en. Accessed October 30, 2018.

2. Vreugdenhil A, Cannell J, Davies A, Razay G. A community-based exercise programme to improve functional ability in people with Alzheimer’s disease: a randomized controlled trial. Scand J Caring Sci. 2012;26(1):12-19.

3. Van de Winckel A, Feys H, De Weerdt W, Dom R. Cognitive and behavioural effects of music-based exercises in patients with dementia. Clin Rehabil. 2004;18(3):253-260.

4. Kemoun G, Thibaud M, Roumagne N, et al. Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord. 2010;29(2):109-114.

5. Arcoverde C, Deslandes A, Moraes H, et al. Treadmill training as an augmentation treatment for Alzheimer’s disease: a pilot randomized controlled study. Arq Neuropsiquiatr. 2014;72(3):190-196.

6. Öhman H, Savikko N, Strandberg TE, et al. Effects of exercise on cognition: The Finnish Alzheimer Disease Exercise Trial: a randomized, controlled trial. J Am Geriatr Soc. 2016;64(4):731-738.

7. Cancela JM, Ayán C, Varela S, Seijo M. Effects of a long-term aerobic exercise intervention on institutionalized patients with dementia. J Sci Med Sport. 2016;19(4):293-298.

8. Hoffmann K, Sobol NA, Frederiksen KS, et al. Moderate-to-high intensity physical exercise in patients with Alzheimer’s disease: a randomized controlled trial. J Alzheimers Dis. 2016;50(2):443-453.

9. Toots A, Littbrand H, Boström G, et al. Effects of exercise on cognitive function in older people with dementia: a randomized controlled trial. J Alzheimers Dis. 2017;60(1):323-332.

10. Lamb SE, Sheehan B, Atherton N, et al. Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ. 2018;361:k1675.

11. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015;(4):CD006489.

12. Groot C, Hooghiemstra AM, Raijmakers PG, et al. The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Ageing Res Rev. 2016;25:13-23.

13. Panza GA, Taylor BA, MacDonald HV, et al. Can exercise improve cognitive symptoms of Alzheimer’s disease? J Am Geriatr Soc. 2018;66(3):487-495.

14. Defina LF, Willis BL, Radford NB, et al. The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study. Ann Intern Med. 2013;158(3):162-168.

15. Hörder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: a 44-year longitudinal population study in women. Neurology. 2018;90(15):e1298-e1305.

16. Smith JC, Nielson KA, Woodard JL, et al. Physical activity reduces hippocampal atrophy in elders at genetic risk for Alzheimer’s disease. Front Aging Neurosci. 2014;6:61.

17. de Souto Barreto P, Demougeot L, Vellas B, Rolland Y. Exercise training for preventing dementia, mild cognitive impairment, and clinically meaningful cognitive decline: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2018;73(11):1504-1511.

18. Sofi F, Valecchi D, Bacci D, et al. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med. 2011;269(1):107-117.

19. Santos-Lozano A, Pareja-Galeano H, Sanchis-Gomar F, et al. Physical activity and Alzheimer disease: a protective association. Mayo Clin Proc. 2016;91(8):999-1020.

Young woman having knee pain

Rolling to Fight Arthritis!

/13 April 2021/ All MFN blog/

“By the year 2040, an estimated 78.4 million (25.9% of the projected total adult population) adults aged 18 years and older will have doctor-diagnosed arthritis” (Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA)

The time is now! Let’s talk about how to prevent the onset and symptoms of various forms of arthritis through myofascial release!

What is myofascial release?  

It is a type of physical therapy often used to treat myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder caused by sensitivity and tightness in your myofascial tissues. These tissues surround and support the muscles throughout your body that are affected by arthritis.

What is fascia tissue? 

This holds the muscle together and keeps them in the correct place. The fascia separates the muscles so they can work independently of each other. The fascia provides a lubricated surface so that the muscles can move smoothly against each other. When fascia is constricted, it prevents blood flow and decreases circulation.

What parts of the body can I roll?

  • Head, Face & Neck
  • Shoulders, Chest Arms, Wrists & Hands
  • Upper & Lower Back, Hips, Glutes, Thighs, Knees, Ankles, Feet

What is the Benefit of Rollga Rolling My Face & Neck? 

Rolling for Youth Preservation: First, let’s discuss regaining a rejuvenated look for our skin. When looking at what causes skin aging, it is a slowing down of circulation of blood. As noted by the NIH, this consists of a slowing in the circulation of nutrient-rich blood and detoxifying lymph and increasingly sluggish skin-cell turnover; the skin becomes more “stagnant.”

Rolling the Face. When “rolling” the face, be sure to apply gentle to medium pressure. The two main points of tension are in the superficial fascia and the other is lymph. Lymph is a highly underrated circulatory system within the body that is responsible for detoxifying waste from the skin on a cellular level, in addition to its many, many other functions. When holding tension in the muscles and fascia, lymph cannot move freely and do its job of clearing out waste from the tissue. The result of poor lymph flow can present as dull skin, an accumulation of blackheads and milia, and/or stubborn hyperpigmentation, and more. Superficial fascia is the layer of connective tissue right under the skin on the face. It acts as the support and infrastructure for your skin and is responsible for giving it “lift and tone.” It can also carry a lot of tension and adhesions that restrict circulation of blood and lymph. If you’ve ever used a foam roller on tight legs, think of how much softer one leg feels after rolling when compared to the unrolled leg. Foam rolling is a form of self-administered myofascial release, and that is EXACTLY what we want to do for the face.

Rolling for Neck Tension. The neck is the superhighway of ALL circulation to and from the face. A tight neck acts like a traffic jam between the body to face and back again. This prevents detoxifying lymph from draining as well as it should, and working the neck alone can be major in bringing flow and vitality back to the complexion as well as reducing puffiness in the face. Many people experience a very high level of neck and jaw tension due to everyday stress. Remember that working hard also means you must self-care harder!

Rolling to Fight Arthritis: To reduce the onset of symptoms from various diseases such as arthritis that affect facial and neck muscles, various myofascial release techniques such as Rollga rolling stimulates muscles, improves blood flow and enhances circulation. Because the jaw is a joint that is commonly affected by arthritis, myofascial release eases tension, improves joint mobility and decreases pain while speaking or chewing.

Learn more about Rollga rolling for the face and neck by contacting info@ContiFit.com

Request a manual, attend a workshop, or take an online course to learn about myofascial release with Let’s FACE it Together™ Facial Exercise & Rehabilitation!

Check out the Arthritis Fitness Specialist Online Course from MedFit Classroom.

Reprinted with permission from Christine Conti. Originally printed on rollga.com.

Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is currently writing the MedFit Network Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.

Knee joint anatomy, 3D model

Musculoskeletal System & Healthy Functioning: Parts that Make Up the Whole

/12 April 2021/ All MFN blog/

Orthopedics 101: What makes up our musculoskeletal system? In order for our body to move, the joints, ligaments, and tendons must work together. If a person has a disease, injury, or condition, affecting any one of these parts, nerve signals are interrupted and movement is hindered.

When you think of joints, think of two parts of the skeleton being fit together. The bones are connected by joints. Joints are also called articulations. Here’s the lineup….

  1. Bones are lined with cartilage so they don’t grind against each other; it is the covering at the end of the bone.
  2. Bones are joined to bones by ligaments, so where two bones meet that is a joint; ligaments are important for stability.
  3. Muscles are connected to bones by tendons.

Technically, muscles are not part of the joint, but stronger muscles help protect the joints.

You know that cracking sound we sometimes hear with movement?? When you flex or contract a muscle which takes place at the joint, the ligament stretches with that joint. When you straighten out that joint, the ligament helps to pull the joint back to its normal starting position. This means that ligaments are a major part of movement, but over time, they start to lose their elasticity. This loss of stretch makes the joint make that cracking noise from bone on bone.

Tendons are important for our range of motion with movement. They’re found in smaller joints like fingers and wrists. We use tendons a lot, especially at the wrist. A tendon’s job is to make sure you can bend your wrist, but not too far.

After years of constant use, our joints can develop arthritis. This occurs especially in the knee, hip, and shoulder areas. The knee joint has three parts, the hip has two, and the shoulder has the one that seems to be commonly injured.

Tendons and ligaments do wear out. They do not grow or repair themselves. A baseball pitcher who has repetitively used their arm and shoulder to throw the ball as hard as they can over and over again will, after a number of years, most likely experience damage to the rotator cuff. Then it’s surgery.

Long story short, our body sure does do a lot for us to produce movement. As I type and while you read, movement is occurring even in the eyes. We have to appreciate what we have and if we don’t use it, we lose it before that expiration date comes our way.

Your fitness journey is a lifelong commitment to your health, so exercise wisely, fuel your body right, and MOVE!!!!

Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health, and is a current doctoral candidate in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

 

References

DNA-puzzle

The Evolution of Truly Personalized Medicine: Epigenetics, Food, and Fitness

/9 April 2021/ All MFN blog/

Most would not argue that there is an ongoing transition in how our healthcare is being delivered. This article will examine some of these transitions as a result of breakthroughs in technology, as well as how genetic information, exercise, and diet will play an increasingly greater role.

When medical science was first getting its start, a more holistic philosophy was taken on how to treat illness and maintain health. Hippocrates has often deemed the father of modern medicine, and even today the allopathic physicians (M.D.s) take the Hippocratic Oath – to do no harm to their patients. Hippocrates knew, even in 400 B.C., that the best healer of the body is the body itself. For the most part, the best treatment is to create a strong body and get out of the way. Five guiding principles used in his philosophy for treatment include:

  1. Walking is man’s best medicine.
  2. Know what person the disease has, rather than what disease the person has.
  3. Let food be thy medicine.
  4. Everything in moderation.
  5. To do nothing is also a good remedy.

The second and fifth principles emphasize the power of knowing the individual and getting out of the way! The first and third principles show the power of exercise and food for healthy living. Even the genius, Thomas Edison, realized that a health maintenance organization (HMO) approach was the best method of healthcare both practically and financially. His quote, “The doctor of the future will give no medicine but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease,” is evidence that a holistic, preventative approach is what he advocated. He is also quoted, “…you can’t improve on nature.”

One size does not fit all

Personalized medicine is now at the forefront and it utilizes the genetic and epigenetic data of a person to guide medicines and treatment plans. Cancer drugs have probably harnessed this advantage to the greatest extent, thus far. Former President Jimmy Carter received Keytruda (pembrolizumab) for his brain cancer and it boosted his immune system and beat cancer. While most of America (71%), still doesn’t even know about personalized medicine, those who were familiar with it did not know it would yield better results with fewer side effects. The different directions of personalized medicine are still being realized, but the field of pharmacogenetics is the first to really jump on the bandwagon of highly effective, precision-based treatment.

The reasons some drugs work for some people and not for others, or why side effects occur in some individuals and not others, is due to individual variability in metabolism. Why are some people lactose tolerant, or some can drink alcohol with no problem, and others have severe issues? It is usually because of enzyme differences, which are under the control of our genes. Interestingly, our enzyme genes can often be turned on or off by “inducible sequences” known as promoters or suppressors of operons, respectively. These “switches” can be repressed or induced depending on our environmental stimuli. Thus, we actually have some control over our gene expression, and this field is known as epigenetics.

Knowing what gene variants someone possesses or not will guide the personalized medicine physician on which drug to use or not. By knowing allergic reactions in advance or which medicines may have side effects will help physicians to not make a bad situation worse. Unfortunately, the cost of personalized medicine drugs is much higher than alternative treatments. There is still a lot of exploration to be done on all the various applications of this technology, but the bottom line is that understanding individual variations and enabling the body to do what it is designed to do is a very good thing! Companies like Toolbox Genomics is one of many companies that use your genetic information to then tell you what foods and supplements to eat or avoid, and which exercises may help you the most, and ones that you may not respond to so well. The reason physicians do an intake on family history or run various tests is to collect information that will guide their treatment. A genetic test on certain gene variants is simply taking this a step further.

How do exercise and diet apply to our epigenetics?

Did you know that exercise is highly beneficial to not only help with fighting cancer once it is already present but also to never getting it? Physical exercise or movement, in general, will shift the epigenetics so that genes that suppress tumors are increased, and genes that cause cancer (oncogenes) are decreased. It does this by changing the number of certain reactions called methylations. Things go wrong when there are too much or too few methylation reactions. Exercise has been shown to reduce or even reverse the epigenetic mutations that often result in tumorigenesis or tumor production. Exercise has also been shown to reduce genetic factors associated with aging like telomere length.

The fields of proteomics and metabolomics as well as pharmacogenomics, are all emerging because of the knowledge on how our genetics affects proteins, metabolism, and reactions to drugs, respectively. The field of nutrigenomics is rapidly expanding, and several companies are capitalizing on studying the relationship of how our genes affect how we process and utilize foods, as well as how food can affect our genes. Vitamins A and D, certain fatty acids, especially medium and short-chain, some sterols (derived from cholesterol), and zinc have been shown to directly influence gene transcription. Indirect effects include how diet affects gut bacteria, which in turn influences gene expression. Soon when nutritional recommendations are given, it will likely be “for this individual.”

The future of medicine will be taking our genetic information to a whole new level. Soon “smart” watches, clothes, hats, and other common devices will collect information that can benefit our health in many ways as the way healthcare is delivered continually evolves.

This article was featured in MedFit Professional Magazine

Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

brain

A Simple Exercise to Stimulate Your Cerebellum and Boost Your Movement Accuracy, Balance, and Coordination

/8 April 2021/ All MFN blog/

While every brain structure has the potential to be a valuable training target for a medical fitness professional, the cerebellum should always be a high priority consideration when trying to help clients and patients accomplish their pain and performance goals. The cerebellum, whose name means “little brain,” is located at the back and bottom of the brain, and while it makes up only 10% of the brain’s volume, it houses 80% of the brain’s total neurons

woman-plank-exercise

My 3 Favorite Core Exercises

/6 April 2021/ All MFN blog/

Core Exercises are always in style, right? If I had a $100 for every time I have been asked what is the best core exercise to help me get rid of my belly fat I would be writing this blog from the beach in Punta Cana!

Seriously, core exercises have their place and are important to do. Consider a few of the main reasons why they are important:

  1. They can help stabilize your spine.
  2. They can prevent low back injury or discomfort.
  3. They can help improve sporting activity.
  4. They help improve posture.

As a result of the benefits listed above for doing core exercises, here are my three current (yes, they do change) favorite core exercises:

Bridges

Preparation

Exercise preparation

  1. Begin by lying flat on floor in supine position with knees bent, feet flat, toes pointing straight ahead and arms by sides.
  2. Activate core by drawing navel towards the spine and squeezing the glutes.

Movement

With core activated and glutes squeezed, lift hips off ground to form a straight line between knees and shoulders.

Hold and slowly return back to floor, touching floor momentarily then repeat.

If your client feels their hamstring cramping, check their pelvis for correct alignment. Pelvis should be neutral – asis and psis should be even or horizontal. If there is a misalignment correct it. If you aren’t sure then gently stretch the quads and try the exercise again.

Prone Iso Abs (i.e. Planks)

Preparation

  1. Kneel on the floor on all fours.
  2. Align your hands directly beneath your shoulders.
  3. Align your knees directly beneath your hips.

Movement

  1. Lift and extend one leg to the floor behind you.
  2. Place the ball of your foot on the floor as in a push-up position.
  3. Maintain neutral spinal alignment in this semi-supported position.
  4. If you feel comfortable enough, extend both legs into a full plank position.
  5. Make sure to keep your shoulder blades down and wide on your back during all phases of the exercise.

Mecaback Wedge Crunch

Set Up (standard) 

Feet on the floor, Arms crossed at chest 

Execution 

  1. Maintain a stable pelvis. Tailbone gently pointing down. 
  2. Brace your abdominals and lift straight up. Only lift your torso 2-3 inches from the floor, 
feeling the point at which the abdominals are working hardest, pause.
  3. Slowly lower.
  4. Repeat. 

Maurice D. Williams is the owner of Move Well Fitness in Bethesda, MD, and Assistant Professor of Health & Human Performance at Freed-Hardeman University.  He is a NASM Master Instructor and Master Trainer,  and is also certified with NASM as a Corrective Exercise Specialist, Performance Enhancement Specialist, Senior Fitness Specialist & Weight Loss Specialist, and as a Certified Strength and Conditioning Specialist by NSCA.

Senior-Weight-Training

Fitness: Programming Your Body to Become Strong & Resilient

/2 April 2021/ All MFN blog/

In the early 90s I worked with a colleague who had a track background as a pole vaulter. Doug subsequently became a fitness professional and athletic coach. He had a philosophy about fitness that was characterized by a simple notion: “Weight training is the paycheck and cardio is the bonus”. I have thought about this issue continuously since I met Doug and as I have grown older, I believe he was right.

I am now training as hard – or harder – than I ever have before to ensure I enter my 70s with as little loss of lean muscle mass, and as much strength and power, as I can create. This article will highlight the importance of resistance training, give you some valuable ideas on how you might implement a program, and finally share ideas with you that can protect and preserve your body for the “long haul”.   

The Issue

Resistance training is characterized by working a muscle group to fatigue or failure under a prescribed “load”. This load can be an actual weight or body weight. Any “load-bearing” movement that includes multiple muscle groups is called a compound movement, such as a walking lunge with an overhead press with dumbbells, for example. Because we are sitting for the greatest portion of our days and not stressing our bones we are losing bone mass as well leading to osteopenia (the forerunner of osteoporosis) and then of course osteoporosis – serious bone density decline. The issue of frailty and imbalance is becoming more and more pronounced in our population and will only accelerate if we don’t change our sedentary behaviors.

Identifying the issues related to loss of muscle mass and bone mass is relatively simple and can be done through clinical testing. Women have the highest potential to start this chronic loss because they have different hormonal issues with aging – less testosterone and smaller bones for example – that creates an earlier onset of disease. Fractures and other related problems can happen in an instant if the loss is not addressed in a timely manner and medication can help along with changes in lifestyle and diet. However, the real solution lies in weight-bearing exercise where stresses are applied to the muscles and skeletal structure intentionally and safely. Men are not immune from developing these conditions – they just start later in life due to larger and heavier frames and greater weight.

Beginning a weight training program earlier in life is the best way to prevent the decline and decay of tissues and the easiest form of that training is in the form of weight training – free weights, machines, and other load-bearing exercises, such as bodyweight exercises. I will highlight my program for you as an example of types of exercises that help the most in preserving and protecting our muscles and bones from further loss or damage and injury.

Programming

The idea is to do a multiple set (8-12 repetitions/ 2-3 sets to start) program that targets all the major muscle groups: Back, chest, shoulders, arms, abdominals, and legs (calf, quad, hamstring) while “loading” the muscle and joint appropriately to stimulate fiber growth. Fiber growth occurs over time when a muscle is exposed to a load that forces a larger than normal contraction. One contraction is the shortening of the muscle (positive or concentric) and the other is the opposite force of lengthening the muscle (negative or eccentric). This movement is accomplished across a joint and creates the change we seek in terms of strength and size.

Each movement is done in a rhythmic and controlled manner that gives the muscle an opportunity to move through a “complete range of motion”. This constitutes “one rep” and applies the stimulus necessary for a muscle to be stimulated to grow following the session during what is called the “recovery phase”.  Each time we increase the load, we enable the muscle to grow and become stronger because the stimulus changes the nature of contractions making the movement more difficult but insuring that it becomes stronger in the process. 

We are not really sure about why this works the way it does but the theory is that by “tearing the muscle” microscopically we create a muscle that is stronger, more adaptable, and able to withstand greater loads going forward. This is referred to as “progressive resistance training” because it is designed as a controlled process with its defined purpose of increasing lean mass.

By programming more than one set we set up the muscle to have to deal with “variable loads” and have to adapt to these increased loads thereby making it able to withstand more of life’s rigors. The theory of doing 2-3 sets initially is that regardless of the weight used – light and smaller to heavier and larger – is that ALL muscles react in the same way to each stimulus – they grow in strength – but NOT necessarily in size. You don’t have to fear getting “muscle-bound” by lifting weights. That takes a concentrated and persistent effort, with a significant caloric intake to help repair the body, as all bodybuilders know. Most of us will never be in that category – and I am certainly not! 

Program Design: The Schedule

Designing a program that addresses the needs of the body as it ages is relatively simple and yet very challenging to implement. The reason is that you will experience some muscle soreness initially that you might find uncomfortable, but this is just the body’s way of recovering from the session (you should never experience pain as that is not normal – don’t believe in “the no pain, no gain” theory – that is just wrong!). 48-72 hours of recovery time is generally advised so that you can allow the muscle to heal itself. In between, you can then initiate a cardio program of swimming, cycling, walking or some other form of movement that allows you the opportunity to encourage this process to become more of a habit – and train your heart to support your effort (my favorite organ, other than the brain of course). 

I believe in a 3-5 day opening schedule of activity that encompasses some cardio and some weight training. Each session can be anywhere from 30 minutes to an hour depending upon your willingness to include a warm-up and cool-down phase, which I highly recommend. Cardio activities include an extended activity (continuous movement) over time and include a warm-up, training and then cool-down phase. You can include an abbreviated walk on the treadmill or outside and then engage your weight training program with a brief cool down to finish the session. 

Exercises & Muscle Groups

  1. Chest – (examples) chest press with dumbbells, barbell, wall pushups, modified floor pushups (knees on the floor) or wall pushups at an angle. 
  2. Back – (examples) seated row, pulldown – bar, low back extension, rubber tube chest extension, dumbbell reverse butterfly – standing with weights at chest level and extend backward.
  3. Arms – dumbbell curls, triceps extension with dumbbell, reverse pushup off bench.
  4. Legs – Wall slide, traditional standing squat, standing from seated position, leg press, calf extension (stairs), and standing lunges.
  5. Abdominal – crunches – lying on your back, knees bent – raise shoulders off the floor and repeat. Exhale on shortening and inhale on lengthening.
  6. Shoulders – shoulder press with dumbbells, front and side raise with dumbbells

I do 16 main exercises twice a week: Bench press (barbell), incline upright row (back), shoulder press, incline/decline press (chest), incline-lateral low row (back), seated triceps extension, arm curl, latissimus pull (back), pullover – chair (shoulder/back), seated leg press and calf extension, lateral raise (shoulder), low back extension, seated abdominal crunch with 65 pounds, hanging dips – upper body, and seated cable row.

Each of these exercises is performed in multiple sets with many repetitions and a variety of loads and at varying speeds to not only encourage growth of my muscles but also to help me maintain my speed and quickness as well. Each muscle group consists of type 1 and type 2 muscle fibers. Type 1 fibers are used for longer endurance activities while the type 2 fibers are for quick explosive movements such as sprinting and power activity (jumping out of the way of a car for instance). 

The reason I train my muscles against variable loads – climbing (the ladder) and descending – is to insure I give each fiber a chance to be engaged and give them the opportunity to become stronger. As I said earlier, I do my program twice a week – on Monday and Thursday – to ensure I recover sufficiently and allow the muscles time to repair themselves.

I am also cognizant of the reality that regardless of how hard – or well – I train, the odds are not in my favor for remaining this way due to the aging process. I am, however, “cutting the odds in my favor” by doing what I am to stay fast and strong.  I am convinced that weight training is the key to my future and that my potential for running fast will be able to be maintained through my continued commitment to remaining strong. It is as Doug said more than two decades ago – “weight training is the paycheck and cardio is the bonus” – but I am so glad I ran all these years as well! 

Nick’s Tips

  1. Do find the resolve to begin – and continue – a weight training program. Schedule at least three days a week for a concentrated effort at building and maintaining your lean muscle mass – and joint integrity. Remember, we start losing 2-5% of our lean muscle mass starting in our 20s – and bone mass as well – unless we do the work to prevent and slow the loss.
  2. Take time to build your cardio capacity through a commitment to your heart. I am able to do my weight training in just over an hour due to my overall cardiovascular fitness.
  3. Take your body seriously and examine how you feel about it. Getting mentally strong through accomplishing your goals is one very important way to stay on track and feel good about yourself. 
  4. Getting lean and being able to burn more calories every day requires only two things: Commitment and discipline founded on purposeful activity.
  5. Take your fitness needs very seriously and yet find ways to make them fun. “Every act we take is its own reward” – Earl Nightingale
  6. Finally, when you see how fast your body will change with weight training (within 30 days, you will see results) it will excite and encourage you to do more and finally realize the dream of a healthy, lean, strong, and fit body.

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach and fitness professional with over 25 years of experience. His passion for health and fitness comes from his boyhood in Hawaii, where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.