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Getting physical activity significantly reduces the risk of arthritis: The specific benefits of different amounts of physical activity are not completely clear It should be commonly known by now that being physically active on a regular basis is beneficial and has a protective effect against many diseases and health conditions. Despite this, it's not completely clear how this protective effect differs based on the exact amount of physical activity an individual gets. In other words, what amount of physical activity is necessary to experience specific effects, and how does this change with greater amounts of activity? The World Health Organization (WHO) currently recommends getting 600 metabolic equivalents (MET) minutes of total activity each week in order to obtain health benefits. A MET is a unit of measurement used to describe the amount of energy exerted when performing physical tasks or activities, and 600 MET minutes in a week is approximately equal to walking (4 METs) for 150 minutes or running (8 METs) for 75 minutes total. Totals for MET-minutes are calculated by multiplying the METS for the activity by the number of minutes it's performed, so five hours of gardening (4 METs) in a week equates to 4 x 300 = 1,200 MET minutes. Though these values are commonly used for physical activity recommendations, it's not completely understood to what degree they reduce the risk for certain health conditions and if greater amounts reduce this risk even more. Therefore, a powerful pair of studies called a systematic review and meta-analysis was conducted. The systematic review gathered all of the highest-quality evidence on the topic available, and the meta-analysis compared the findings of these studies to one another to establish a conclusion. Researchers identify 174 studies for the systematic review and meta-analysis Researchers searched through two databases for studies that examined the connection between physical activity and the risk of any of the following five health conditions: breast cancer, colon cancer, diabetes, heart disease and stroke. In particular, they were interested in the total MET-minutes per week of individuals and how that affected their risk for any of those five conditions. After screening 6,965 studies, researchers identified 174 that fit the necessary criteria and were used for the meta-analysis. Risk for disease is lowered with more physical activity, but only to a certain point Results from the meta-analysis showed that higher levels of total physical activity were associated with a lower risk for all five of the health conditions that were looked into. The health benefits that individuals experienced were found to be the greatest once achieving a certain amount of physical activity, but after that point, the decrease in risk for the conditions studied was minimal. One of the main examples to illustrate this point is the following: individuals who got 600 MET-minutes per week of physical activity had a 2% lower risk of diabetes compared with those who did not get any physical activity. When the amount of physical activity increased from 600 to 3,600 MET minutes/week, this risk was reduced by an additional 19%. After this, however, similar increases in physical activity only led to small reductions in the risk for diabetes. Similar trends were found with the other health conditions examined as well. Individuals should get more physical activity than what is recommended Based on this, researchers said that getting 3,000-4,000 MET-minutes per week appears to be the ideal range for obtaining the most health benefits and the greatest reduction of risk for the five health conditions. More physical activity than this may not necessarily lead to more benefits or a lower risk. The researchers, therefore, suggest that the physical activity levels of individuals should be significantly higher than what is currently recommended (600 MET-minutes/week) in order experience the greatest reduction in risks for breast cancer, colon cancer, diabetes, heart disease and stroke. Since it may take some time before any recommendations are actually changed, individuals can take matters into their own hands and work towards getting more physical activity for their overall health and risk for a disease. -As reported in the August '16 issue of The BMJ
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Recipe Wednesday - Red Beans and Rice: With a quick glance at the ingredients list, you can tell this classic dish is FULL of flavor! Click here for this scrumptious recipe!
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Exercise and physical therapy help patients with knee arthritis: Unclear if additional sessions make therapy any more effective Osteoarthritis (OA) is a common disorder in which cartilage that normally surrounds and protects joints wears away gradually over time. Overweight or obese individuals and those over the age of 65 are also more likely to develop it. There are many treatments available for knee OA, including exercise that may be combined with manual therapy. In this type of therapy, a physical therapist performs manipulations and mobilizations with their hands to reduce pain and improve function. Unfortunately, it's not clear if the use of manual therapy adds any extra benefits to exercise alone. Some patients may also struggle to retain their improvements in the long term. One suggestion is to include "booster sessions," in which patients meet with their physical therapist regularly for weeks or months after their initial sessions to discuss their progress and help them with recommendations to keep improving. Once again, research is lacking on whether these booster sessions are actually beneficial for patients. For this reason, a powerful study called a randomized-controlled trial (RCT) was conducted to compare the effects of manual therapy, booster sessions and exercise therapy for patients with knee OA. Large sample of patients randomly divided into four even groups Individuals with knee OA were recruited to participate in the RCT and screened to determine if they fit the necessary criteria. A total of 300 patients were accepted for the study and randomly assigned to one of the following four groups: 1) exercise with no booster sessions, 2) exercise with booster sessions, 3) manual therapy with exercise (no booster sessions), and 4) manual therapy with exercise and booster sessions. The exercise program, which all four groups performed, consisted of various strengthening, stretching, agility and balance exercises. In some cases, additional exercises were added for the hip and ankle if patients seemed to need them. For manual therapy, different maneuvers were applied with manual force from the therapist to increase the flexibility of the knee and surrounding muscles. This all took place during 12 sessions, with those who didn't receive boosters doing all of them in nine weeks, and those with boosters spreading them out more evenly over 11 months. All patients also followed a home-exercise program twice a week or more that included the same exercises that were performed during the program. Participants were evaluated for pain, function and other measures before treatment, and then nine weeks and one year later. All patients improve, but role of booster sessions and manual therapy not clear After nine weeks, patients in all four treatment groups experienced significant improvements in all the outcomes measured. By one year, some of these effects had reduced, but for the most part, the improvements lasted. Despite this, the addition of booster sessions or manual therapy was not found to result in any greater benefits for patients after one year. Some positive effects were noticed, but they did not remain in the long term. Based on these findings, it appears that exercise is clearly effective for reducing pain and improving the function of patients with knee OA. Although booster sessions and manual therapy may help patients improve even more, it was not found to be the case in this study. Additional research is needed to investigate the role of booster sessions in more detail, but for now, patients with knee OA should feel confident that a physical therapist can effectively treat their condition with various exercises and help them achieve improvements that last in the long term. -As reported in the August '16 issue of Osteoarthritis and Cartilage
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Motivational Monday: -Abraham Lincoln
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Adding movement to stretching is more beneficial: No studies have evaluated the combination of these two types of treatment before Adhesive capsulitis, or frozen shoulder, is a condition that causes stiffness and pain in the shoulder joint. It restricts the function and motion of the shoulder, which makes it difficult to perform many activities normally. Frozen shoulder is most common in adults between the ages of 40-65 and those who have had the condition in the past, and its cause is still not well understood. Treating frozen shoulder is a long and difficult process, and there are several different strategies that may be used. One of them is called joint mobilization, in which a physical therapist moves the shoulder in different directions to increase its flexibility and reduce pain. Another is manual stretching exercises, which are stretches that are also performed by a physical therapist for the same purpose. Although these techniques have been supported by medical literature as to be effective, combining the two of them has not yet been studied. Therefore, a study called a randomized-controlled trial (RCT) was conducted on the topic. RCTs are the most powerful type of individual studies available, and they compare two groups of patients that are randomly assigned to different treatments. Two small groups of patients undergo treatments for six weeks Individuals with frozen shoulder were recruited to participate in the RCT and evaluated to determine if they fit the necessary criteria. Of the 42 patients that were screened, 26 fit the criteria and were then randomly assigned to either the joint mobilization and stretching group or the stretching exercise alone group. Treatment took place during three sessions each week for six weeks, with patients in the combination group receiving both treatments, while the others only received stretching exercises. The joint mobilization exercises were applied by the physical therapist at a lower rate at first, and their intensity increased further into the treatment sessions. This was dependent on the tolerance and pain of each patient. The therapist completed stretching exercises while the patient lay on the bed in 20-minute sessions of 20 seconds of stretching followed by 10 seconds of rest. In addition, patients in both groups followed a home-exercise program twice a day for the duration of treatment. These consisted of 10 repetitions of stretching and strengthening exercises, and patients were told to continue these for at least one year after treatment. All patients were assessed for pain, disability, and flexibility before treatment, immediately afterward, and then one year later. Combining both treatments is more effective than stretching exercises alone Results showed that the patients who received the combination of joint mobilization and stretching exercises experienced better outcomes than those who only had stretching exercises. This was seen in measurements for flexibility, pain, shoulder function and the ability to perform daily activities, and the improvements were present up to one year later. These findings suggest that the addition of joint mobilizations to manual stretching exercises leads to the best possible outcomes for patients with frozen shoulder. All physical therapists are capable of performing both of these techniques, and patients with frozen shoulder are therefore encouraged to seek out their services when deciding what type of doctor to visit for treatment. -As reported in the August '16 issue of Clinical Rehabilitation
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Recipe Wednesday - Rotini With Spicy Red Pepper and Almond Sauce: Are you ready to spice up your meal? Click here for this great recipe!
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Hands-on physical therapy are effective for a shoulder condition: Condition lasts at least one year and consists of three phases Adhesive capsulitis, commonly called frozen shoulder, is a condition that causes pain, stiffness, and loss of motion in the shoulder. It occurs in about 2-5% of the population and is most common in people between the ages of 40-60. Frozen shoulder lasts approximately 12-42 months, and consists of three phases. It starts with a painful phase lasting 2-9 months, which is followed by a stiff phase for 3-12 months in which the shoulder becomes very stiff and difficult to move. The last of these is the healing, or thawing phase, in which patients regain their movement and function over the course of 5-26 months. Physical therapy is commonly used to treat frozen shoulder, and one of the techniques used by physical therapists is called mobilization. This consists of various hands-on movements applied to the shoulder to increase its flexibility and reduce pain. Although mobilizations are frequently used, it's not clear how effective they are and which techniques are best. For this reason, a powerful type of study called a systematic review was conducted. The review collected all available literature on the topic to determine which mobilization technique was most effective for frozen shoulder. A total of 12 studies are accepted for the review Researchers performed a search using two medical databases for any studies that looked into different mobilization techniques to treat frozen shoulder. A total of 12 studies with data on 810 patients fit the necessary criteria and were included in the systematic review. Seven different types of mobilization techniques were evaluated, and the main patient outcomes measured were pain and range of motion, which is a measure of how much they could move their shoulder. The data from all of these studies was evaluated in depth, and their quality was also assessed to determine how reliable their findings were. A combination of a few types of techniques is most effective for frozen shoulder On the whole, mobilization techniques were found to be beneficial for patients with frozen shoulder. A combination of one approach called the Maitland technique with the mobilization of the spine and shoulder stretching appears to be best for reducing pain and improving shoulder flexibility. For this reason, this combination of techniques is recommended for patients with frozen shoulder; however, there was not enough information on many of the other mobilization techniques in the review. Therefore, additional research is needed to investigate these other techniques in more detail so it can be more clearly determined which is the best for treating frozen shoulder. While this process takes place, patients with frozen shoulder should acknowledge that mobilization techniques performed by physical therapists are generally helpful for reducing pain and increasing the flexibility of their shoulder. -As reported in the August '16 issue of the Archives of Physical Medicine and Rehabilitation
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Stressed Out-Try This: Stressed Out-Try This Here is our latest monthly video. http://bit.ly/2iwlwz1
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Recipe Wednesday - Grilled Pork Tenderloin With Asian Sauce: Sounds delicious! Click here for the recipe!
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Motivational Monday: -Brooke Astor
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