Study Design: A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain–related disability [FFbH-R]).
Objective: Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy.
Summary of Background Data: Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise.
Methods: Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being.
Results: For the Hannover Functional Ability Questionnaire for measuring back pain–related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception.
Conclusion: The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.
Source: http://www.medscape.com/viewarticle/742533
David P. Chen, D.C.
Chiropractor
20708
Laurel Regional Chiropractic
Monday, June 20, 2011
Monday, June 13, 2011
High heels and the risk of arthritis
Women who wear high heels or badly-fitting trainers could be putting themselves at risk of arthritis, experts have warned.
The Society of Chiropodists and Podiatrists said the UK could be facing an "arthritis crisis" due to increasing levels of obesity, people living longer and poor footwear.
The most common form of the condition, osteoarthritis, causes pain and stiffness in the joints and affects at least eight million people in the UK.
High heels affect body posture, placing more pressure on foot, ankle and knee joints. This can cause stress to the cartilage and lead to the onset of osteoarthritis.
The condition is more common and severe in women, and can badly affect the feet. A quarter of women wear high heels every day or "frequently", a poll of 2,000 people for the Society of Chiropodists and Podiatrists found.
The poll also found that 77% of both men and women do not wear shoes designed specifically for the sport they are doing, which can cause injury and stress on the joints, increasing the risk of the debilitating condition.
Although you are more likely to develop arthritis as you get older, it can occur at any age and the good news is that there are simple things you can do to help prevent and treat arthritis. Choosing the right footwear will help minimize the stress placed on the feet and joints during everyday activity and helps reduce the risk of injury and joint damage.
For daily wear, the recommendation is to opt for a round-toed shoe with a heel height of no more than 2-3cm (one inch) and with a shock-absorbent sole to help minimize shock to the joints. When doing exercise, wearing trainers that are fitted and designed specifically for that form of exercise will both improve performance and protect from injury.
The survey found 36% of people do not know much about arthritis and 22% think it is an inevitable part of getting older. While 65% have suffered stiffness or pain in their lower body and feet, only half have sought help for their symptoms.
Experts say people should be on their guard because arthritis is on the rise, with 60% of cases in feet.
Source: http://www.telegraph.co.uk/health/women_shealth/8565796/High-heels-could-cause-UK-arthritis-crisis.html
David P. Chen, D.C.
Chiropractor
Laurel, MD 20708
The Society of Chiropodists and Podiatrists said the UK could be facing an "arthritis crisis" due to increasing levels of obesity, people living longer and poor footwear.
The most common form of the condition, osteoarthritis, causes pain and stiffness in the joints and affects at least eight million people in the UK.
High heels affect body posture, placing more pressure on foot, ankle and knee joints. This can cause stress to the cartilage and lead to the onset of osteoarthritis.
The condition is more common and severe in women, and can badly affect the feet. A quarter of women wear high heels every day or "frequently", a poll of 2,000 people for the Society of Chiropodists and Podiatrists found.
The poll also found that 77% of both men and women do not wear shoes designed specifically for the sport they are doing, which can cause injury and stress on the joints, increasing the risk of the debilitating condition.
Although you are more likely to develop arthritis as you get older, it can occur at any age and the good news is that there are simple things you can do to help prevent and treat arthritis. Choosing the right footwear will help minimize the stress placed on the feet and joints during everyday activity and helps reduce the risk of injury and joint damage.
For daily wear, the recommendation is to opt for a round-toed shoe with a heel height of no more than 2-3cm (one inch) and with a shock-absorbent sole to help minimize shock to the joints. When doing exercise, wearing trainers that are fitted and designed specifically for that form of exercise will both improve performance and protect from injury.
The survey found 36% of people do not know much about arthritis and 22% think it is an inevitable part of getting older. While 65% have suffered stiffness or pain in their lower body and feet, only half have sought help for their symptoms.
Experts say people should be on their guard because arthritis is on the rise, with 60% of cases in feet.
Source: http://www.telegraph.co.uk/health/women_shealth/8565796/High-heels-could-cause-UK-arthritis-crisis.html
David P. Chen, D.C.
Chiropractor
Laurel, MD 20708
Monday, June 6, 2011
Women With Carpal Tunnel Syndrome Show Restricted Cervical Range of Motion
STUDY DESIGN: A case control, blinded study.
OBJECTIVES: To compare the amount of cervical range of motion in women with minimal, mild/moderate, and severe carpal tunnel syndrome (CTS) to that of healthy control participants. We also assessed the relationships between cervical range of motion and clinical variables related to the intensity and temporal profile of pain within each CTS group.
BACKGROUND: It is plausible that the cervical spine may be involved in individuals with CTS. No study has investigated the relationship between cervical range of motion and symptoms associated with CTS severity.
METHODS: Cervical range of motion was assessed in 71 women with CTS (18 with minimal, 18 with mild/moderate, and 35 with severe signs and symptoms) and in 20 similar, healthy women. Those with CTS were aged 35 to 59 years (mean ± SD, 45 ± 8 years) and those in the healthy group were aged 31 to 60 years (45 ± 8 years). An experienced therapist, blinded to the participants’ conditions, used a cervical range-of-motion (CROM) device to assess cervical range of motion. Mixed-model analyses of variance (ANOVAs) were conducted to evaluate the differences in cervical range of motion among the 3 groups of patients with CTS and healthy controls. A corrected P value of less than .025 was used as threshold for significance (Bonferroni correction).
RESULTS: The mixed-model ANOVAs revealed that the individuals with CTS exhibited restricted cervical range of motion compared to healthy controls (P<.001), with no significant differences among the groups with minimal, mild/moderate, or severe CTS (P>.356). A significant negative correlation between pain intensity and cervical spine lateral flexion away from the affected side was identified: the greater the mean pain intensity, the lesser the cervical lateral flexion away from the affected side.
CONCLUSIONS: Women with minimal, mild/moderate, or severe CTS exhibited less cervical range of motion compared to women of a similar age, suggesting that restricted cervical range of motion may be a common feature in individuals with CTS, independent of severity subgroups, as defined by electrodiagnosis. Future research should investigate cervical range of motion as a possible consequence or causative factor of CTS and related symptoms.
Source: http://www.jospt.org/issues/articleID.2575,type.2/article_detail.asp
David P. Chen, D.C.
Chiropractor
Laurel, MD 20708
OBJECTIVES: To compare the amount of cervical range of motion in women with minimal, mild/moderate, and severe carpal tunnel syndrome (CTS) to that of healthy control participants. We also assessed the relationships between cervical range of motion and clinical variables related to the intensity and temporal profile of pain within each CTS group.
BACKGROUND: It is plausible that the cervical spine may be involved in individuals with CTS. No study has investigated the relationship between cervical range of motion and symptoms associated with CTS severity.
METHODS: Cervical range of motion was assessed in 71 women with CTS (18 with minimal, 18 with mild/moderate, and 35 with severe signs and symptoms) and in 20 similar, healthy women. Those with CTS were aged 35 to 59 years (mean ± SD, 45 ± 8 years) and those in the healthy group were aged 31 to 60 years (45 ± 8 years). An experienced therapist, blinded to the participants’ conditions, used a cervical range-of-motion (CROM) device to assess cervical range of motion. Mixed-model analyses of variance (ANOVAs) were conducted to evaluate the differences in cervical range of motion among the 3 groups of patients with CTS and healthy controls. A corrected P value of less than .025 was used as threshold for significance (Bonferroni correction).
RESULTS: The mixed-model ANOVAs revealed that the individuals with CTS exhibited restricted cervical range of motion compared to healthy controls (P<.001), with no significant differences among the groups with minimal, mild/moderate, or severe CTS (P>.356). A significant negative correlation between pain intensity and cervical spine lateral flexion away from the affected side was identified: the greater the mean pain intensity, the lesser the cervical lateral flexion away from the affected side.
CONCLUSIONS: Women with minimal, mild/moderate, or severe CTS exhibited less cervical range of motion compared to women of a similar age, suggesting that restricted cervical range of motion may be a common feature in individuals with CTS, independent of severity subgroups, as defined by electrodiagnosis. Future research should investigate cervical range of motion as a possible consequence or causative factor of CTS and related symptoms.
Source: http://www.jospt.org/issues/articleID.2575,type.2/article_detail.asp
David P. Chen, D.C.
Chiropractor
Laurel, MD 20708
Thursday, June 2, 2011
Arthritis, Foot Pain and Shoe Wear
Both arthritis and foot pain are major public health problems. Approximately 24% of adults have foot ailments, and the prevalence increases with age. Foot pain, particularly related to shoes, footwear and rheumatic disorders, may be an important modifiable factor.
Despite the major focus of structure and alignment in arthritis, remarkably little work has focused on the foot and nonsurgical foot interventions that might affect lower extremity joint alignment, structure and pain in rheumatic diseases. Emerging research suggests that there may be a significant role for foot orthotics and footwear in the treatment of rheumatoid arthritis and osteoarthritis of the hip, knee and foot. This review highlights the current understanding on the topic of foot orthotics and footwear in adults with rheumatic diseases.
Biomechanical evidence indicates that foot orthotics and specialized footwear may change muscle activation and gait patterns to reduce joint loading. Emerging evidence suggests that orthotics, specific shoe types and footwear interventions may provide an effective nonsurgical intervention in rheumatic diseases. As there are a limited number of studies that underpin the foot's role in arthritis cause and progression, clinical trials and prospective studies are of utmost importance to unravel the links between foot pain, foot conditions and interventions that lessen the impact of rheumatic diseases.
Source: http://www.medscape.com/viewarticle/736930
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Despite the major focus of structure and alignment in arthritis, remarkably little work has focused on the foot and nonsurgical foot interventions that might affect lower extremity joint alignment, structure and pain in rheumatic diseases. Emerging research suggests that there may be a significant role for foot orthotics and footwear in the treatment of rheumatoid arthritis and osteoarthritis of the hip, knee and foot. This review highlights the current understanding on the topic of foot orthotics and footwear in adults with rheumatic diseases.
Biomechanical evidence indicates that foot orthotics and specialized footwear may change muscle activation and gait patterns to reduce joint loading. Emerging evidence suggests that orthotics, specific shoe types and footwear interventions may provide an effective nonsurgical intervention in rheumatic diseases. As there are a limited number of studies that underpin the foot's role in arthritis cause and progression, clinical trials and prospective studies are of utmost importance to unravel the links between foot pain, foot conditions and interventions that lessen the impact of rheumatic diseases.
Source: http://www.medscape.com/viewarticle/736930
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Wednesday, June 1, 2011
Study Suggests Back Disease May Run in Families
In an analysis of a database of more than 2 million people, first-degree and third-degree relatives of people with lumbar disc disease had a significantly increased relative risk of developing the back condition themselves compared with expected rates for the general population. "The results of this study support a heritable predisposition to lumbar disc disease," lead author Alpesh A. Patel, MD, and colleagues from the departments of Orthopaedics and Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, report in the February 2 issue of the Journal of Bone and Joint Surgery.
Low back pain is common and costly — its estimated lifetime risk in the United States is 84%, with an annual cost that exceeds $100 billion — yet its etiology remains incompletely understood. Several earlier studies have hinted at a familial predisposition.
To test the hypothesis that lumbar disc disease may be inherited, the authors analyzed data from both the Utah Population Database, which permits the tracking of medical information on the founding pioneers of Utah and their descendents, and the University of Utah Health Sciences Center data warehouse, which has diagnosis and procedure data on all patients treated at the University Hospital. Together, the databases contain information on more than 2.4 million patients. Only patients and control participants with at least 3 generations of genealogical data were included in the study.
Of those individuals, 1254 people had at least 1 diagnosis of lumbar disc disease or lumbar disc herniation, along with the requisite genealogical data. The authors tested for heritability in 2 ways: by estimating the relative risk for lumbar disease in relatives and by determining a genealogical index of familiality (GIF). They compared their findings in affected families with the expected results for the general population of Utah.
First-degree relatives of people with lumbar disc disease had a relative risk of 4.15 of having the disease themselves (95% confidence interval [CI], 2.82 - 6.10; P < .001). In third-degree relatives, the relative risk was 1.46 (95% CI, 1.06 - 2.01; P = .027). Relative risk was slightly elevated in second-degree relatives, at 1.15, but this was not significant (95% CI, .71 - 1.87; P = .60), perhaps because of limitations in the data.
The GIF tests the hypothesis that there is no excess familial clustering, or relatedness, of the phenotype of interest by measuring excess relationships between pairs of patients compared with pairs of control participants. "It is not the absolute value of the GIF statistic that reveals excess relatedness of disease, but the relative value of the case-GIF to the control-GIF," the authors explain. In this analysis, the case overall GIF was 3.05 compared with a mean control GIF of 2.51 (P < .001 for overall GIF), suggesting "a significant excess of relationships among patients compared with controls."
Now that a genetic predisposition to lumbar disc disease has been identified, the identification of the specific genetic products responsible for lumbar disc disease may help in the development of potential biologic interventions to prevent and/or treat lumbar disc disease in the population at large.
Source: http://www.medscape.com/viewarticle/736881
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Low back pain is common and costly — its estimated lifetime risk in the United States is 84%, with an annual cost that exceeds $100 billion — yet its etiology remains incompletely understood. Several earlier studies have hinted at a familial predisposition.
To test the hypothesis that lumbar disc disease may be inherited, the authors analyzed data from both the Utah Population Database, which permits the tracking of medical information on the founding pioneers of Utah and their descendents, and the University of Utah Health Sciences Center data warehouse, which has diagnosis and procedure data on all patients treated at the University Hospital. Together, the databases contain information on more than 2.4 million patients. Only patients and control participants with at least 3 generations of genealogical data were included in the study.
Of those individuals, 1254 people had at least 1 diagnosis of lumbar disc disease or lumbar disc herniation, along with the requisite genealogical data. The authors tested for heritability in 2 ways: by estimating the relative risk for lumbar disease in relatives and by determining a genealogical index of familiality (GIF). They compared their findings in affected families with the expected results for the general population of Utah.
First-degree relatives of people with lumbar disc disease had a relative risk of 4.15 of having the disease themselves (95% confidence interval [CI], 2.82 - 6.10; P < .001). In third-degree relatives, the relative risk was 1.46 (95% CI, 1.06 - 2.01; P = .027). Relative risk was slightly elevated in second-degree relatives, at 1.15, but this was not significant (95% CI, .71 - 1.87; P = .60), perhaps because of limitations in the data.
The GIF tests the hypothesis that there is no excess familial clustering, or relatedness, of the phenotype of interest by measuring excess relationships between pairs of patients compared with pairs of control participants. "It is not the absolute value of the GIF statistic that reveals excess relatedness of disease, but the relative value of the case-GIF to the control-GIF," the authors explain. In this analysis, the case overall GIF was 3.05 compared with a mean control GIF of 2.51 (P < .001 for overall GIF), suggesting "a significant excess of relationships among patients compared with controls."
Now that a genetic predisposition to lumbar disc disease has been identified, the identification of the specific genetic products responsible for lumbar disc disease may help in the development of potential biologic interventions to prevent and/or treat lumbar disc disease in the population at large.
Source: http://www.medscape.com/viewarticle/736881
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Tuesday, May 24, 2011
Exercising With Arthritis
An estimated 40 million people have some form of arthritis. The two most common forms are osteoarthritis, a degenerative joint disease characterized by a progressive loss of cartilage, and rheumatoid arthritis, a chronic condition causing the lining of the joints to become inflamed. Both conditions can make exercise a difficult and painful proposition. However, a well-designed physical activity program can decrease joint swelling and pain and improve overall function. Furthermore, regular exercise can help you maintain a healthy weight (which reduces pressure on your joints) and improve cartilage and bone tissue health. The key is to keep yourself active in a variety of ways, and you will be on your way to greater mobility and better health.
Getting Started:
Talk with your health care provider before starting an exercise program and ask for specific recommendations.
Select low-impact and non-impact activities such as walking, swimming, water exercise and cycling.
An extended warm-up and a gradual cool-down may help reduce the likelihood of aggravating joint pain.
Spread your activity throughout the day (e.g., three 10-minute sessions). Set time goals rather than distance goals.
Start slowly and gradually progress the intensity and duration of your workouts. Take frequent breaks during activity if needed.
Select shoes and insoles for maximum shock absorption. Be prepared to adjust your workouts according to fluctuations in your symptoms.
Exercise Cautions:
Avoid overstretching.
Some discomfort after your workouts is to be expected, but you should not be in pain.
Avoid vigorous, highly repetitive activities, particularly if your joints are unstable.
Your exercise program should be modified to maximize the benefits while minimizing the risk of aggravating your health condition. Contact us at Laurel Regional Chiropractic, we will help you to establish realistic goals and design a safe and effective program that addresses your specific needs.
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Getting Started:
Talk with your health care provider before starting an exercise program and ask for specific recommendations.
Select low-impact and non-impact activities such as walking, swimming, water exercise and cycling.
An extended warm-up and a gradual cool-down may help reduce the likelihood of aggravating joint pain.
Spread your activity throughout the day (e.g., three 10-minute sessions). Set time goals rather than distance goals.
Start slowly and gradually progress the intensity and duration of your workouts. Take frequent breaks during activity if needed.
Select shoes and insoles for maximum shock absorption. Be prepared to adjust your workouts according to fluctuations in your symptoms.
Exercise Cautions:
Avoid overstretching.
Some discomfort after your workouts is to be expected, but you should not be in pain.
Avoid vigorous, highly repetitive activities, particularly if your joints are unstable.
Your exercise program should be modified to maximize the benefits while minimizing the risk of aggravating your health condition. Contact us at Laurel Regional Chiropractic, we will help you to establish realistic goals and design a safe and effective program that addresses your specific needs.
David P. Chen, D.C.
Chiropractor in Laurel, MD
20708
Monday, May 16, 2011
High-intensity Training versus Traditional Exercise Interventions for Promoting Health
This study shows that if you want to lose weight or lower your cholesterol, then you have to stick to a long-term exercise or strength training program. But if your goal is just cardio-respiratory fitness and glucose tolerance, then short-term intense interval training can help you to achieve that goal.
Purpose: The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training.
Methods: Thirty-six untrained men were divided into groups that completed 12 wk of intense interval running (INT; total training time 40 min·wk−1), prolonged running (~150 min·wk−1), and strength training (~150 min·wk−1) or continued their habitual lifestyle without participation in physical training.
Results: The improvement in cardio-respiratory fitness was superior in the INT (14% ± 2% increase in VO2max) compared with the other two exercise interventions (7% ± 2% and 3% ± 2% increases). The blood glucose concentration 2 h after oral ingestion of 75 g of glucose was lowered to a similar extent after training in the INT (from 6.1 ± 0.6 to 5.1 ± 0.4 mM, P < 0.05) and the prolonged running group (from 5.6 ± 1.5 to 4.9 ± 1.1 mM, P < 0.05). In contrast, INT was less efficient than prolonged running for lowering the subjects' resting HR, fat percentage, and reducing the ratio between total and HDL plasma cholesterol. Furthermore, total bone mass and lean body mass remained unchanged in the INT group, whereas both these parameters were increased by the strength-training intervention.
Conclusions: INT for 12 wk is an effective training stimulus for improvement of cardio-respiratory fitness and glucose tolerance, but in relation to the treatment of hyperlipidemia and obesity, it is less effective than prolonged training. Furthermore and in contrast to strength training, 12 wk of INT had no impact on muscle mass or indices of skeletal health.
Source: http://www.medscape.com/viewarticle/729632
David P. Chen, D.C.
Chiropractor in Laurel, Maryland 20708
Purpose: The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training.
Methods: Thirty-six untrained men were divided into groups that completed 12 wk of intense interval running (INT; total training time 40 min·wk−1), prolonged running (~150 min·wk−1), and strength training (~150 min·wk−1) or continued their habitual lifestyle without participation in physical training.
Results: The improvement in cardio-respiratory fitness was superior in the INT (14% ± 2% increase in VO2max) compared with the other two exercise interventions (7% ± 2% and 3% ± 2% increases). The blood glucose concentration 2 h after oral ingestion of 75 g of glucose was lowered to a similar extent after training in the INT (from 6.1 ± 0.6 to 5.1 ± 0.4 mM, P < 0.05) and the prolonged running group (from 5.6 ± 1.5 to 4.9 ± 1.1 mM, P < 0.05). In contrast, INT was less efficient than prolonged running for lowering the subjects' resting HR, fat percentage, and reducing the ratio between total and HDL plasma cholesterol. Furthermore, total bone mass and lean body mass remained unchanged in the INT group, whereas both these parameters were increased by the strength-training intervention.
Conclusions: INT for 12 wk is an effective training stimulus for improvement of cardio-respiratory fitness and glucose tolerance, but in relation to the treatment of hyperlipidemia and obesity, it is less effective than prolonged training. Furthermore and in contrast to strength training, 12 wk of INT had no impact on muscle mass or indices of skeletal health.
Source: http://www.medscape.com/viewarticle/729632
David P. Chen, D.C.
Chiropractor in Laurel, Maryland 20708
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