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Human Osteoporosis

Does Low Bone Mass Mean Osteoporosis?

Nearly 30 years ago when I was in school, I wrote an exercise physiology paper on exercise and osteoporosis.

At that time there wasn’t much research available. But even then, the studies I found on tennis players, astronauts, and bed rest pointed in the direction that weight-bearing exercise could help maintain the bone density you have and even promote bone growth. I was intrigued. I’ve followed the research over the years and even created an osteoporosis exercise program.

In working with my clients, I often hear the question, “What’s the difference between osteoporosis and low bone mass (osteopenia)? And what can I do about it?”

Well to answer these questions, I have to start at the beginning.

Osteoporosis is a disease, which, over time, causes bones to become thinner, more porous and less able to support the body. Bones can become so thin that they break during normal, everyday activity. Osteoporosis is a major health threat. 54 Million are at risk, nearly 80% are women.

Postmenopausal women are particularly at risk because they stop producing estrogen, a major protector of bone mass.

As we age some bone loss is inevitable. Women age 65 or men age 70 should get a bone mineral density test. If you have a family history of osteoporosis or other risk factors, you may need a BMD much earlier.

The test is completely painless, non-invasive and takes only a few minutes. It compares your bone mineral density to that of an average healthy young person. Your results are called your T score. The difference between your score and the average young person’s T-score is called a standard deviation. (SD)

Here is how to interpret your T score:

  • Between +1 and –1: normal bone density.
  • Between -1 and -2.5: low bone density (osteopenia).
  • T-score of -2.5 or lower: osteoporosis.

Until recently it was thought that if you had low bone mass (osteopenia) you were well on your way to getting osteoporosis. But it’s now known even at this stage bone loss can be slowed down, stopped and even reversed. You and your doctor will have a number of options depending upon your particular condition.

Many MDs like to start with a calcium and vitamin D rich diet coupled with weight-bearing exercise. For many of us, that’s all we need. Others will require medication and there are many bone-building medications available.

Remember it’s never too early to start taking care of your bones. The more bone density you have as a young person the less likely to end up with osteoporosis later in life.

EASE IN, BECOME MOBILE, GET STRONG, LIVE LONG!  May is Osteoporosis Prevention Month! It’s Never Too Late To Take Care Of Your Bones!


Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities in the health and fitness industry. Her customer top rated exercise videos for Health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available mirabaiholland.com. Join her NEW Online Workout Club at movingfreewithmirabai.com. Mirabai offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com.

Doctor and patient

Health Coaches Don’t “Diagnose or Treat Disease”: Those Words and Others Don’t Belong in Our Vocabulary

It is nothing new that there’s inevitable overlap between the practice of medicine and providing sound health coaching. Ideally, there should be a seamless continuum between the two endeavors, but that could only exist where there is a continuum of cooperation and respect. Health Coaches need to be careful with how we describe and present our work. While health coaching is a vibrant movement, it is still a junior partner to “traditional medicine” and for self-preservation; we should seek to avoid direct “turf wars” with Physicians.

The most balanced approach requires continuous consideration of the distinctions between these complementary fields. While there will always be principled differences, the practical applications change steadily along with knowledge and technology. The most prudent approach is for Health Coaches to simply concede medicine’s proprietary terms. We need to understand them, and can use them, but anytime we do we must draw distinctions that educate our clients about the difference in objectives and procedures of these complementary endeavors. In that sense, there are no “forbidden words”, but there are plenty of places where lack of clarity in purpose and practice can cause problems. Some of the major terms that should be conceded include:

Patient, practice, diagnosis, cause, disease/pathology, prescribing, medicine, treatment, management, effectiveness, intervention and cure.

Health Coaches should strive to embody in our mission what comes from consideration of those terms. We develop relationships with clients, we are not in the practice of seeking responsibility for treating patients. We are helpful guides in exploring the vast, common sense resources of the field of wellness, not prescribing proprietary agents or using medical modalities to treat disease. We act as individual guides on a quest that prioritizes personalized discovery and anecdotal utility, not practitioners who prescribe antidotes approved by impersonal population-based investigations.

Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization.

We look for associated (natural) influences that can combine to re-establish balance, not for a cause or diagnosis that be controlled by the use of a foreign/artificial agent. Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization. Medicine predominantly lays claim to systems that don’t display those features.

“The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.”

Each term, of course, could be expanded upon greatly as time permits. Back in 1903, Thomas Edison said that “The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” Edison was simply wrong. Health Coaches should focus on care of the human frame and diet which are the wellsprings of function and flourishing. That’s a big task that requires ever-increasing knowledge and wisdom.

Unfortunately, the human “machine” is inevitably subject to decay of various sorts and severities. Medicine will always have a very important place in providing resources for comfort where nature has been pushed to failure – which is not an uncommon occurrence. The line between those positions shifts over time, but until utopia breaks out, reality will maintain a vast market for both types of emphasis. For now, it is up to the junior partner to hold up their banner while keeping the peace.

Originally printed on the FDN blog. Reprinted with permission.


Reed Davis is a Nutritional Therapist and has been the Health Director and Case Manager at a wellness clinic San Diego for over 15 years. Reed is the Founder of the Functional Diagnostic Nutrition® Certification Course, offering functional lab training, data-driven protocols, tools and leadership you need so professionals confidently solve your client’s health issues and grow your career.

brain-neurons

Parkinson’s Disease and Exercise

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease.  Unfortunately, the incidence of Parkinson’s disease has not declined, and its impact is seen in all races.  This is due in part to the fact that the population of the world is greater than ever before and increasing. In addition, people are living longer than in previous generations, and the baby boomer generation, one of the largest generations in history, has reached old age.

Risk factors for Parkinson’s disease include:

Age: Risk of Parkinson’s disease increases with age.  The average age of onset for this disease is 55 years and the rate of incidence increases steadily until the age of 90.

Gender: Men have a higher risk for Parkinson’s disease than women.

Family history: Individuals with a family history of Parkinson’s disease are at a higher risk for Parkinson’s disease. Moreover, it is said that those with affected first-degree relatives double their risk of Parkinson’s disease.

Agricultural work: Individuals exposed to pesticides and herbicides have a greater risk of developing Parkinson’s disease symptoms. Drinking well-water and living in rural areas have also been associated with an increased incidence of Parkinson’s disease.

Head Trauma: Head trauma can be a risk factor for Parkinson’s disease as is seen in the case of boxers. One study showed that trauma to the upper cervical region, head, and neck was a risk factor for Parkinson’s disease. However, in some cases it took years for these symptoms to appear.

The exact cause of Parkinson’s disease is unknown.  Regarding the molecular events that lead to the development of this disease, there is still some uncertainty in terms of what causes the neurodegeneration seen in Parkinson’s disease. The current hypothesis is that Parkinson’s disease may result from the interaction between environmental factors and genetic susceptibility.

The primary symptoms for PD are deficiencies in motor performance due to the loss of the dopamine pathways in the brain. Decreased dopamine production in the substantia nigra in the brain causes the 4 primary motor symptoms:

  • Bradykinesia: described as slowness in the execution of movements while performing daily activities.
  • Rigidity or Stiffness: caused by an involuntary increase in tone of the limbs and axial musculature.
  • Resting Tremor: Found primarily in the arms and hands and can be socially bothersome. Resting tremors are less disabling since they often vanish with the initiation of activity (especially in the early stages of Parkinson’s disease).
  • Postural Instability: manifested in a slow speed of walking, shortened stride length, narrowing of base of support, and leaning towards one side.

Exercise should be targeted for the primary motor symptoms with exercise and occupational therapy to improve quality of life. Recommended program components include:

  • Posture, gait, mobility
  • Fall risk reduction
  • Cardiorespiratory health
  • Strength and function
  • Depression and Anxiety
  • Joint health

Exercise prescription for clients with PD includes: (ACSM)

  • An individualized program
  • Cardiorespiratory: use guidelines for healthy adults
  • Muscular Fitness: use guidelines for healthy adults
  • Flexibility: slow, static exercises for all major and minor joints in the body including the upper torso, spine, and neck.
  • Neuromotor Exercises: help with balance, gait, and postural instability. Clinicians use a gait belt or parallel bars to ensure safety depending on the severity of the symptoms.  Include functional exercises to improve ADLs and quality of life.

PD exercise therapy includes intervention with many kinds of exercise modes. Both personal training and group fitness have been successful in helping to manage the disease and reduce the symptoms. There is not strong evidence at this point to show that exercise prevents PD, but it is believed that exercise may play a role.  Exercise is however the mainstay for symptom management and slowing disease development.

 


June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.

References and Resources:

pregnancy-fitness

High Altitude Sports During Pregnancy: Are the Risks Worth the Thrill?

Research in the field of prenatal fitness has conclusively shown that exercise during pregnancy provides health benefits to mother and fetus, and the American College of Obstetricians and Gynecologists encourages pregnant women without complications to continue or start a fitness routine during pregnancy. Although prenatal exercise is considered safe for most pregnant women, some activities are more controversial because of potential injury risks or because of the environment where they take place.

Many women enjoy downhill skiing, cross country skiing, and snowboarding, and have questions about whether it’s safe for them to continue these sports during pregnancy. The safety of these sports, as well as the effect higher altitudes, may have on pregnant women and their fetuses, are important factors to consider before taking part in high altitude snow sport activities.

Several studies have examined pregnancy outcomes and complications comparisons between pregnant women who were exposed to high altitudes versus pregnant women who did not travel to high altitudes. One study (1) that examined the association between high altitude exposure and self-reported pregnancy complications found that there is a low rate of complications for pregnant women who participated in activities and travel in high altitude areas.

Another study (2) suggested that pregnant women who traveled to high altitudes (determined as above 2440 meters, or 8,000 feet) did not have a higher risk of pregnancy complications when compared to women who did not have high altitude exposure. These women were more likely to have preterm labor than those not exposed to high altitude, but the percentage of preterm labor in the study were below the US population rate of preterm births. There was a statistical increase in newborn oxygen need at birth, but no complicating issues were associated with this.

Although these study results are reassuring, more rigorous research is needed to provide further information regarding the safety of high-altitude exposure and exercise during pregnancy.

There are key factors that may influence the degree of hypoxia-related pregnancy complications for the fetus and mother.

  • Duration of exposure
  • Intensity of activity
  • Degree of altitude
  • Difference between altitude at home and sport

These factors should be taken into consideration by a pregnant woman who is planning to travel to (and exercise in) high altitude. If she lives in a low altitude area, it’s a good idea to build in several days of progressive altitude increase to allow time for her to adjust. If possible, she should vary the duration of her exposure by sleeping at lower elevations. She should be aware of signs of hypoxia (see list below) and move to a lower altitude if she experiences increased symptoms.

Complications from exercise at higher elevations may be compounded by increased dehydration as a result of dry and cold air. Maintaining adequate fluid intake and allowing for rest breaks to hydrate can avoid this issue.

The key to avoiding altitude-related issues is being aware of how altitude is affecting the body and pregnancy and knowing the signs and symptoms of hypoxia.  As long as a pregnant woman continues to feel well and isn’t experiencing any issues while exercising at higher altitudes, she can feel confident that her pregnancy won’t be negatively affected.

*Signs of Hypoxia

  • Feeling dizzy and lightheaded
  • Persistent cough
  • Headache
  • Vision changes
  • Extreme fatigue
  • Nausea
  • Confusion and mental status change

It’s important also to consider the risks of some types of snow sports. Downhill skiing and snowboarding require good balance, and as pregnancy progresses, the changes in a woman’s center of gravity can affect her balance and make her more prone to falls. Also, the risk of collisions with other skiers and snowboarders is a concern, especially when slopes are crowded. Careful consideration of a woman’s skill level and difficulty of the ski slope should be weighed, and modifications such as switching to easier slopes and terrain can reduce risk.


Catherine Cram started her company, Prenatal and Postpartum Fitness Consulting, in order to provide current, evidence- based guidelines maternal fitness guidelines to health and fitness professionals. She was a contributing author for the textbook, Women’s Health in Physical Therapy and co-authored the revision of Exercising Through Your Pregnancy with Dr. James Clapp.  Her company offers the certification course, “Prenatal and Postpartum Exercise Design” which provides continuing education credits for over 30 health and fitness organizations, including ACSM, ACE, ICEA, and Lamaze.

 

References

Wilderness Environ Med, 2016 Jun;27(2):227-35. doi: 10.1016/j.wem.2016.02.010. Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies. Keyes LE1Hackett PH2Luks AM3.

Eric Chessen 1

Is Fitness for ASD for Me…Let’s See…

Is that hip tracking properly?

 Is he planning on flopping down to the mat after this next hurdle?

 Does Adam know what exercise is after these forward hurdle steps?

These are the series of questions that reverberate in my head as Adam completes the set of low hurdle steps as part of his warm-up. They’re the same questions that need to be mentally noted and checked off throughout a session with an individual on the autism spectrum.

Picture courtesy of Eric Chessen.

Fitness for special needs populations, particularly the autism and neurodiverse demographics, is gaining both awareness and more professionals are entering the sphere of practice. Some still overlap the autism spectrum disorder (ASD) population with other neurobiological disorders such as Downs Syndrome. They are different. And they need to be approached accordingly.

The most current statistics from the Centers for Disease Control (CDC) show an autism diagnosis occurring at 1 in 59 children. The statistics for teens and adults with autism are more difficult to find, though many individuals have been diagnosed retroactively as the criteria for diagnosis has changed/broadened with the DSM V (Diagnostic and Statistical Manual of Mental Illness Vol 5). Some of the most common, if not readily discussed, areas of deficit for those with ASD are gross motor deficits and low muscle tone (a catch-all phrase).

By way of intrepid professionals and dedicated parents/caregivers, the field of fitness for individuals with autism has grown in the last few years. As is the case across the fitness/wellness arena, programs and practices vary with no official standard or code of practice for those providing exercise programs to individuals with ASD.

Given the number of children, teens, and adults affected by autism and the evident need for professional fitness services, this is a burgeoning specialty area. While sport-specific, even vocation-specific training has existed in the fitness profession for decades, fitness programming for the ASD population is new and requires some important considerations.

Working with the autism population in a fitness capacity requires being a specialist turned generalist turned specialist. Allow me to expand on that.  A fitness professional working with the ASD population, ideally, has a conceptual background and practical skill set to assess movement skills and provide appropriate progressions and regressions for various exercises.

The adaptive/behavior challenges inherent to autism require more than a great fitness program “on paper”/in theory. Not only are the previously noted movement and strength deficits significant considerations, but behavior issues (off-task, maladaptive) must be addressed. The “Greatest Program Ever” is no match for a 17-year old who refuses to budge from lying face down on a yoga mat in the corner of the room.

So here we move from specialist to generalist; gaining an awareness and working knowledge of how different challenging behaviors present in the autism population, how to effectively manage those behaviors within scope of practice, and then how those behaviors may present with specific individuals. Some of our athletes (term used universally) with ASD may be off-task, wandering around the room for ninety-four percent of the session, while others are cooperative to a remarkable degree.  Understanding motivation and reinforcement both generally and with specific application to each individual is a necessity here.

Cognitive deficits are another hallmark of autism that requires both global and specific understanding and working knowledge. Our athletes with autism tend to be literal thinkers, having a great amount of difficulty with abstract concepts or directions that include analogies. “Run as fast as a Cheetah” won’t have the same connotation for an individual with ASD as it does for the neurotypical population. With respect to cognitive functioning we have one priority; ensure that our athletes are able to follow our directions to the best of current ability.

Fitness and Medical Fitness professionals considering working with the ASD population may find that the instructions, cues, and even the exercises they rely on with most clientele don’t quite work for individuals with autism. While the general best practices approach to strength, stability, and motor planning still apply (strengthen the large muscle groups first, build a healthy movement pattern before adding load), the path towards success may wind a bit.

In our Autism Fitness™ Certification Level I, we have a consistent cornucopia of professionals with backgrounds in fitness, occupational and physical therapy, behavior therapy, pediatrics, recreational therapy, and education (not to mention parents of individuals with ASD).  Each attendee brings in their own knowledge and experience with autism from their professional vantage point. The keys to success are taking the best practices from each area of ability (physical, adaptive, and cognitive), and having strategies that have wide-ranging application. Again, specialist-generalist-specialist.

Odds are that if you’re reading this or have been researching fitness programming for autism, a parent or school has approached you about running a 1-to-1 or group program. You may be starting next month, or next week, or in two hours. So I’ll spend the last of this article providing some practical, go-to strategies within each of the physical, adaptive, and cognitive (PAC Profile™) framework.

Physical

Focus on basic, essential movement patterns (pushing, pulling, crawling, squatting, carrying, and locomotion)

Have appropriate progressions and especially regressions for each exercise

Don’t add variety where it is not needed. Keep programming as simple as possible.

Adaptive

Let the athlete know what they’ll be doing and what’s coming after that. Anxiety levels tend to be high among those with ASD. Providing a “what’s happening next” can deescalate.

Provide opportunities for choice; “Do you want to do push throws or overhead throws first?”

This establishes that the athlete will be doing one of those two throws AND they get to choose which one

Use contingencies; “First hurdle steps, then you can take a break for a minute.” This creates a natural timeline and enables the athlete to know the specific beginning and end of the sequence and what the expectation is.

Cognitive

Label the exercise and demonstrate. Avoid extraneous language.

Teach exercises one at a time. Use a lot of repetition.

Fitness is a life skill, one that is tremendously needed by the autism population of all ages and ability levels. For professionals who choose to offer fitness services to those with ASD, it is imperative that best practices, all around, be used. When we know what we are looking at, what outcomes are realistic, and what strategies to employ, we can meet our athletes where they are at and enhance quality of life.


Eric Chessen, M.S., is the Founder of Autism Fitness. An exercise physiologist with an extensive background in Applied Behavior Analysis (ABA), Eric has spent nearly two decades developing and implementing fitness and adapted PE programs for individuals of all ages and ability levels. Eric is the creator and Lead Instructor for the Autism Fitness Certification and has presented at TEDx on the subject of fitness for those with ASD. He is also the Co-Founder of strength equipment company Stronger than U. He is New York native and very new resident to Charlotte, NC.

gym training, young man and his father

Exercise for Atrial Fibrillation

Here are some things to look for when working with a client with Atrial Fibrillation (A-fib).

FIRST…

What types of medications are they on? Calcium Channel Blockers, blood thinners (Coumadin)? These may have an effect on the intensity and type of exercise performed. You know that people who have A-fib are at increased risk for strokes, and may have hypertension and get dizzy more often. The medications – while they may help with some factors – may preclude a well-designed exercise program just because they may not tolerate some types of exercise.

What are the exercise goals? Are they wanting to tone up? Lose some weight? Get stronger? Train for a tennis match or 5K? This would help in structuring the program. The type / intensity / duration are all dependent on what the client wants. If they are just coming off surgery or a new prescription – this is important to build the foundation (which you know).

SECOND…

Does the doctor have any contraindications for exercise? Usually, it’s not to “overdo”, which means building up a program. I read a good article by Dr. Bill Sekula on a program for A-fib. It’s essentially a “step down, time up” program, where patients go from a few minutes of exercise a few times per day – to building up to an hour of exercise one time per day.  However, I am going to recommend more of an ITP (interval training program) that concentrates on moderate strength programs (using the 40-50% rule similar to cancer patients), so they don’t use the Valsalva maneuver while lifting, but still use a progressive resistance approach. 

THIRD…

Monitoring with a HR monitor, and having good hydration status are both important. Of course, you probably have them using the smart water bottle. Because of the heart dynamics and possible Coumadin Rx, the hydration is important. I assume you do a HR variability test with your client. This may be a very important test to do, as over time it may be instrumental in reducing A-fib occurrences.

I like the article by Dr. John Mandrola on the amount of exercise. He states that A-fib is completely controllable through specific lifestyle changes. He states that low inflammation exercise (high intensity endurance / triathlon, etc.) training needs to be modified, as do other lifestyle issues. I really like the discussion on inflammation, which may be one of the biggest issues in cardiac care of late. He talks about the “J curve” of exercise and that the more intense actually increases the odds ratio (OR) for sudden cardiac events and other abnormalities related to A-fib. 

I think he is on to something, and you should look into some other lifestyle aspects such as meditation and heartbeat regulation through mindful breathing and relaxation. I know that excess stress, lack of sleep and poor diet have effects on the electrical system, including SA node and conductivity. Regular relaxation may do a LOT to improve the normal sinus rhythm and reduce resting HR to a more manageable level. 

Dr. Mandrola also recommends regular monitoring of BP, keeping the use of warm exercise clothing due to peripheral circulation issues, and not overheating. 

I like the issue of ITP and progression.  I also am more of a fan of modified strength training for most clinical conditions.  I think it would work for AF because if you think of the strength of contraction during exercise (even moderate) – it will have a strong steady beat during exercise (in most cases).  


Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

 

References

  1. https://www.everydayhealth.com/hs/atrial-fibrillation-and-stroke/afib-exercise-safety-tips/
  2. https://drbillsukala.com/tips-for-safe-exercise-with-atrial-fibrillation-af-or-a-fib/
  3. http://www.drjohnm.org/2014/05/exercise-over-indulgence-and-atrial-fibrillation-seeing-the-obvious/

 

group-of-people-balance-exercise

Movement and Cognition

How our ability to maintain balance, walk, and move is directly reflective of our higher human functions (A brief overview and case study)

Balance and cognition are inextricably linked. Quantification of improvement in key performance indicators of cognition is directly related to precisely measured improvements in balance and postural stability. A thorough understanding of this relationship is paramount to the understanding of conditions related to cognitive impairment, leaning and behavioral struggles, brain injury, and so much more.

At the time of presentation to APEX Brain Centers, Roger was a 70-year-old male struggling with severe balance problems, clumsiness, fatigue, and a general disinterest in life. He used to enjoy life as a family man, successful entrepreneur and golfer. Just over 10 years prior he had undergone radiation therapy for cancer that damaged his 8th cranial nerve (the balance and hearing nerve). He had also undergone prism therapies and surgery for eye position abnormalities, which have caused further insult to his ability to maintain good balance and to learn effectively. Although not listed as a primary complaint, he also suffered from significant cognitive decline in several areas as evidenced by very low to low average scores on standardized cognitive testing.

Roger sought care at APEX Brain Centers in Asheville, NC in May of 2015 and underwent an intensive course of brain/body rehabilitation. He was admitted into an individualized program directed by extensive diagnostic testing and led by clinicians highly experienced in functional neurology. What follows is a sampling of some of the leading-edge clinical interventions and significant functional gains Roger experienced during his program.

Intervention for balance and cognitive decline

Roger underwent comprehensive brain/body rehabilitation at a frequency of 3 times per day over the course of 15 days (with 2 days off between each for much needed rest and recovery). His brain function was carefully monitored throughout the training process with measurement of EEG, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount therapy to be effective, but not too much so as to be counter-productive. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic and nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, breathing exercises, and home care recommendations.

Outcomes after Brain Training

Subsequent to his rehabilitative program, Roger reported subjective improvements in the vast majority of his pre-intensive complaints. More profound than that, his wife was quoted as saying, “it’s like I have my old husband back.” She noted that he used to be the life of the party and had been slowly deteriorating over time to the point of sitting in his chair all day and sleeping more and more often. He was finally plugging back into life, putting an end to his isolation and apathy. As is demonstrated by his balance testing, he is also experiencing a renewed ability to maintain balance, allowing him to be safer and more efficient in navigating his physical environment and getting back on the golf course.

Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:

  • Cognitive Testing: Increase in his Neurocognition Index of 48%. This is a standardized overall score of cognitive performance. Increases in various aspects of memory, attention, processing speed and more as great as 21%.
  • Interactive Metronome: 56% improvement in task average with motor timing, and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. responding prematurely to a pre-set reference tone).
  • Computerized Assessment of Postural Stability (CAPS): 20.5% improvement in balance on an unstable surface with eyes closed – bringing him from severe to mild reduction in balance compared to his peers. Elimination of a posterior center of pressure (CoP); significantly reducing his risk of falling backwards.
  • Video Oculography (VOG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.

Better Movement Equals Better Cognition

With an alarming increase in the number of baby boomers and seniors experiencing balance issues and cognitive decline (that are in fact related and measurable), it is important to recognize the symptoms of these potentially debilitating disorders and, more importantly, that something can be done about them. Early intervention is key, as the longer one waits and the more function is lost, the more difficult it is to recover and have full engagement with life. These same concepts apply to all areas of cognitive and mental health.

Learn more on this topic… join Dr. Trayford for his MedFit webinar, Movement and Cognition.


Dr. Michael S. Trayford is a Board Certified in Chiropractic Neurology and Neurofeedback; and is the Founder and Director of Clinical Operations at APEX Brain Centers in Asheville, NC. His primary areas of focus in clinical practice, associated research, and teaching are learning and behavioral disorders of adulthood (with a focus on addictive and compulsive behaviors), brain injury, and cognitive impairment.

sun-behind-the-storm

Interesting Times for Interested People

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas New Wellness Areas
S-ocial Social – all interactions with people outside of ourselves
P-hysical Physical – our physiological status
I-ntellectual Intellectual – includes cognitive and emotional health
C-ognitive Career – includes educational and skill acquisition and financial health
E-motional Environmental (could include emotional) – clean, organized?
S-piritual Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.


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.

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Times Change, So Must You To Some Degree

By the time this article is released, things will have changed in society, for better or for worse. I seriously doubt anyone predicted what is going on in society worldwide. I have been on planet Earth over a half a century and have never seen anything like this! The COVID-19 restrictions on gatherings, the emotions, and literally the panic that people are experiencing is unprecedented. While everyone has their opinion on the seriousness of the issue to them or to their health, the impact on their current lifestyle is undeniable.

For Better or For Worse – Your Perspective

The old analogy “Is your glass half empty or half full?” is good for this issue. Interestingly, people will vary in their opinions on this, depending on the issue and circumstances surrounding the issue. Sure, some people will see the bright side of life in most circumstances, and others seem to be the Darth Vader of life, and go to dark side. Given enough time and bad or good circumstances, or given the proper intervention, most people can shift perspectives.

The Human Side and Technology

I am currently a teacher in colleges and universities. My various schools have shifted their level of isolation from one to three times! It started off as a delayed move to the online environment, then to lab classes (which I teach) meeting but not lectures, to then all classes are online. Things shifted because circumstances did. I enjoy teaching face to face or “on ground” as it is labelled. This is the human side of me. I like seeing faces, making people laugh, making people think and answer my questions. I like finding out about them and then letting them know something about me. Could this be done in an “online” environment? Yes and no.

By using the conference applications, I can see my student’s faces and they can see mine. They hear my voice and I can have them ask questions and so forth. But their presence, their energy is not in front me, and their separate environment creates a gap that can’t be erased. As fitness professionals, be it with groups or individuals, I know you understand what I speak of. The ability to “tap into” another’s psyche and see them interact to you and you to them is golden, it’s magical, it’s what our humanity is all about!

I have learned new skills, worked with colleagues during this time of desperation on a common solution, and had time with my family I would not have had. Interestingly, I have enjoyed what this horrific event has presented in my life. I am a Hurricane Katrina evacuee. I lived in New Orleans during it and it flipped my life 180 degrees, to say the least. I now live in Southern California, got married and started a family and many, many other things presented themselves because of this event.

We need to be able to learn from these “life-changing events”, grow and see the benefits of them. We need to learn new skillsets to be able to adapt and remember to embrace humanity in the midst of the trauma. People need us and we need people. Be a trainer who engages people with technology and with humanity.


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.