Energy and Fatigue Archive

Physical therapy may be an effective alternative to surgery in relieving joint and back pain.

 Image: © Hemera Technologies/Thinkstock

Exercising may be the last thing you want to do when you have a sore knee or aching back, but it might be the first thing you should do. Physical therapy has long been recommended following surgery. But for some, trying physical therapy before opting for surgery may be the better choice.

"You may be able to spare yourself the expense, pain, and recovery time of surgery," says physical therapist Karen Weber, clinical supervisor at Harvard-affiliated Spaulding Rehabilitation Outpatient Centers in Braintree and Quincy, Mass.

Research we're watching

While obesity presents a number of health risks for older adults, weight loss is often accompanied by a reduction in muscle tissue and loss of strength. A team led by researchers at Baylor College of Medicine set out to determine whether more exercise or specific types of exercise would help preserve muscle during weight loss.

The researchers randomly assigned 103 obese women and 57 obese men over age 65 to one of four groups. Three groups participated in a reduced-calorie diet plus one of three exercise programs — aerobic training, resistance training, or combined aerobic and resistance training — while the fourth, a control group, only received information on healthful eating.

Are you exercising enough to prevent heart disease?

It can help you lose weight; decrease your blood pressure, cholesterol, and blood sugar; and reduce your stress. But wait, there's more: it also lowers your odds of a heart attack or other cardiovascular event and may even extend your life.

This wonder drug isn't a drug at all, of course — it's exercise. Yet only about half of all American adults do enough physical activity to benefit their health. And exercise is especially vital for people who are at risk for heart disease or already have it.

Research we're watching

About 8.5 million Americans have peripheral artery disease, or PAD, in which fatty plaque clogs arteries outside of the heart, most commonly in the legs. The hallmark symptom is calf or thigh pain while walking that goes away when you rest.

The safest, most effective treatment for PAD is supervised exercise training, in which you're monitored while walking on a treadmill. Few people participate, however, partly because of the expense of the regimen. It involves up to 36 sessions of 30 to 60 minutes each over a period of three months.

Studies have linked long periods of sitting with an increase in heart disease and early death.

 Image: © monkeybusinessimages/Thinkstock

Odds are you are sitting while you read this. In fact, more than half of an average person's waking hours are spent sitting, according to a study in the Jan. 19, 2015, Annals of Internal Medicine.

All that sitting can cause great damage to your health. "The health risks tied to sitting may not be completely related to the act of sitting itself, but rather that sitting keeps you from doing healthier activity," says Dr. I-Min Lee of Harvard's T.H. Chan School of Public Health.

A small study supports the idea that exercising improves body image, whether or not the activity leads to any visible change in appearance. This suggests that additional research examining different types of exercise, and the long-term psychological effects of physical activity would be valuable.

News briefs

 Image: © Horsche/Thinkstock

A review of research published online April 24, 2017, by the British Journal of Sports Medicine suggests that physical exercise may help improve thinking skills in adults ages 50 or older, regardless of their mental performance when they started exercising. Researchers combed through 39 randomized controlled trials that looked at this age group. Most of the studies involved people who did aerobic exercise (the kind that gets your heart and lungs pumping, like brisk walking), resistance training (the kind that works your muscles and bones, like weight lifting), or a combination of aerobics and resistance training. A handful of the studies involved people who did yoga or tai chi. In all of the studies, participants took tests that measured various aspects of thinking skills — such as attention, working memory, and the ability to plan, organize, and manage time. All exercise types but yoga appeared to have benefits for the brain. The authors say the exercise regimen with the biggest brain boost was a combination of both aerobic and resistance-type training, of at least moderate intensity, for at least 45 minutes per session on as many days of the week as possible. The takeaway? Start exercising, and incorporate resistance training into your weekly routine.

When it comes to heart health, there's a lot to love about racket sports.

If you haven't lobbed a tennis ball over a net since high school, you might want to pick up a racket again. A recent study suggests that people who play racket sports regularly may slash their odds of dying from a heart attack or stroke.

Tennis, which ranks among the world's most popular sports, provides an excellent full-body workout, plus a few other less obvious benefits. And lower-impact racket sports, such as badminton or table tennis, may be good choices for people who have certain health conditions or who are older (see "Ping-Pong, perhaps?").

On call

Q. I have heard that exercising on an empty stomach burns more fat and at a faster rate. Is this true?

A. When the body is in a fasting state, several backup mechanisms ensure your muscles and brain get the necessary sugar for fuel. During exercise, after your body's sugar stores are exhausted, the body then taps into stored fat and turns that into sugar or turns protein from muscle into sugar. This has led to the hypothesis that exercising when the body is already "sugar starved" will lead to more rapid fat burning.

In the journals

A study published online March 14, 2017, by The Journal of the American Medical Association suggests that when it comes to speed of recovery after a total knee replacement, a home-based rehabilitation program is as good as rehab that starts with a stay in the hospital.

Researchers randomly assigned people with osteoarthritis undergoing total knee replacement into two groups for 10 weeks of therapy. Those in one group received 10 days of hospital inpatient rehabilitation followed by a clinician-monitored program that they attended two to three times a week for eight weeks. Those in the other group skipped the hospital rehab and went straight into the clinician-monitored program but then progressed to at-home exercises.