Is Exercise a Panacea?

We talk about exercise a lot on this blog. Just in case you think we’re obsessed with it for no good reason, we have assembled a short list of things you might be surprised are positively impacted by exercise. We use “n” in this context to refer to the number of subjects in a study or the number of studies reviewed in a systematic review; the higher the “n”, generally, the more robust the study and the more attention we give to the results. Where possible, we have sought out high-“n” studies and large systematic reviews so that we can be more confident in generalizing and applying these results.

1. ADHD (Ng)

   1. n = 30 studies

   2. Result: “Physical activity, in particular moderate-to-intense aerobic exercise, is a beneficial and well-tolerated intervention for children and adolescents with ADHD.”

2. All-cause mortality in older women (Kamada)

   1. n = 28,879 women

   2. Result: “Time in strength training showed a J-shaped association with all-cause mortality in older women. A moderate amount of time in strength training seemed beneficial for longevity, independent of aerobic activity.”

3. All-cause mortality in adults (Oja)

   1. n = 80,306 adults >30 y/o

   2. Result: Strength exercise, aerobic exercise, and a combination of the two were all associated with decreased all-cause mortality

4. Alzheimer’s (Morris)

   1. n = 76 older individuals with Alzheimer’s

   2. Result: “Aerobic exercise in early [Alzheimer’s Disease] is associated with benefits in functional ability. Exercise-related gains in cardiorespiratory fitness were associated with improved memory performance.”

5. Cancer functional outcomes (Stout)

   1. n = 53 studies

   2. Result: “Exercise promotes significant improvements in clinical, functional, and in some populations, survival outcomes and can be recommended regardless of the type of cancer.”

6. Cognitive capacity in young adults (Opel)

   1. n = 1,206 healthy young adults

   2. Result: Improved walking endurance was associated with improved cognitive function (note that this was not a causative relationship, just identifying a positive correlation between endurance and cognitive function)

7. Cognitive capacity in older adults (Northey)

   1. n = 36 studies

   2. Result: “Physical exercise improved cognitive function in the over 50’s, regardless of the cognitive status of participants.”

8. Knee osteoarthritis (Fransen)

   1. n = 54 studies

   2. Result: “Among people with knee osteoarthritis, land-based therapeutic exercise provides short-term benefit that is sustained for at least 2-6 months after cessation of formal treatment.” Benefits included decreased pain, increased function, and quality of life.

9. Sleep (Kovacevic)

   1. n = 13 studies

   2. Result: “Chronic resistance exercise improves all aspects of sleep, with the greatest benefit for sleep quality.”

So there you have it: A quick review of a handful of the benefits of exercise. And this really is just a handful - the effects of exercise are diverse and significant. One common theme among these studies is that exercise needs to be sufficiently challenging to make changes. If you are unsure of how hard you should be exercising, what mode of exercise might be best for you, or how to start/modify an exercise routine that fits you best, we are here to help! Take a look at our programs page to see what we have on offer right now, and check back regularly for new offerings. If you would like an individual consultation to discuss exercise goals and recommendations, our therapists would be glad to help. Contact us today!

1. Fransen, M., & Mcconnell, S. (2008). Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.cd004376.pub2

2. Kamada, M., Shiroma, E. J., Buring, J. E., Miyachi, M., & Lee, I. M. (2017). Strength Training and All‐Cause, Cardiovascular Disease, and Cancer Mortality in Older Women: A Cohort Study. Journal of the American Heart Association, 6(11). doi: 10.1161/jaha.117.007677

3. Kovacevic, A., Mavros, Y., Heisz, J. J., & Singh, M. A. F. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep Medicine Reviews, 39, 52–68. doi: 10.1016/j.smrv.2017.07.002

4. Morris, J. K., Vidoni, E. D., Johnson, D. K., Van Sciver, A., Mahnken, J. D., Honea, R. A., Wilkins, H. M., Brooks, W. <., Billinger, S. A., Swerdlow, R. H., Burns, J. M. Aerobic Exercise for Alzheimer's Disease: A Randomized Controlled Pilot Trial. Plos One, 12. doi:10.1371/journal.pone.0170547.

5. Ng, Q. X., Ho, C. Y. X., Chan, H. W., Yong, B. Z. J., & Yeo, W.-S. (2017). Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: A systematic review. Complementary Therapies in Medicine, 34, 123–128. doi: 10.1016/j.ctim.2017.08.018

6. Northey, J. M., Cherbuin, N., Pumpa, K. L., Smee, D. J., Rattray, B. (2017) Exercise Interventions for Cognitive Function in Adults Older than 50: a Systematic Review with Meta-Analysis. British Journal of Sports Medicine, 52, 154–160. doi:10.1136/bjsports-2016-096587.

7. Oja, P., Kelly, P., Pedisic, Z., Titze, S., Bauman, A., Foster, C., … Stamatakis, E. (2016). Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80 306 British adults. British Journal of Sports Medicine, 51(10), 812–817. doi: 10.1136/bjsports-2016-096822

8. Opel, N., Martin, S., Meinert, S., Redlich, R., Enneking, V., Richter, M., Golterman, J., Johnen, A., Dannlowski, U., Repple, J. (2019). White Matter Microstructure Mediates the Association between Physical Fitness and Cognition in Healthy, Young Adults. Scientific Reports, 9. doi:10.1038/s41598-019-49301-y.

9. Stout, N. L., Baima, J., Swisher, A. K., Winters-Stone, K. M., & Welsh, J. (2017). A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017). Pm&r, 9. doi: 10.1016/j.pmrj.2017.07.074

What is in an Home Exercise Program?

While many patients would love to have a physical therapist that could be with them 24/7 like Russell Wilson, for most, it is not a realistic aspiration. How do we achieve success instead? By implementing a cohesive home exercise program (HEP) for each patient. That being said, not all HEPs are created equal and we would like to provide some tips on what to look for with your own programs including what to expect from those here at Colorado Sports Physical Therapy.

1.       Programs should be created to fit YOUR individual needs. Many injuries come from imbalances in strength and mobility so your plan should look to address those needs. For some of us, that means more strength exercises and for others, it may mean mobility, flexibility, and range of motion activities.

2.       HEPs should have variations in intensity and should grow with you through your treatments. I like to tell my patients that by the time they are done with me, they should have 20-30 exercises that they can choose from ranging from easy to very challenging and that fall into different categories such as pushes, pulls, lateral movements, or rotational movements, to name a few. That way, you AND your body do not get bored, and you can vary your workouts depending on how you are feeling.

3.       A good portion of your activities should be able to be performed in the comfort of your own home. Sure, getting on a lifting program can be helpful (and the PTs at CSPT can also help with this), but in order to increase your chances of sticking with the program, it’s best to have activities that require minimal equipment and space. This way, you have NO EXCUSES!

4.       Your program should be something that you feel comfortable with. This means you have spent ample time learning the techniques and how to modify them. Remember our blog about pain? Exercises should not be triggering your pain, so make sure that you know the proper modifications in order to continue your progress on a day-to-day basis.

5.       Lastly, remember that the definition of insanity is to do the same thing over and over and expect different results. That means, if things are not working, CHANGE IT! Your HEP is meant to supplement your physical therapy sessions to help you get better faster so if you don’t see a change or you feel worse, talk to your PT about it. Chances are they have a whole host of other exercises in their repertoire that may work better for you!

With all this being said, the MOST important thing about a good home exercise program is your willingness to perform. Keeping to your homework will only help you get better faster, which is everyone’s goal. Want to get your very own HEP in place today? Reach out and schedule your initial evaluation today with our experienced team!

Physical Therapy for the Active Pregnant and Postpartum Mom

               For those of us who have had the experience of pregnancy and postpartum life, you know that not only does your life turn upside down, but your body changes immensely. Most of the time, we chalk it up to the normal aches and pains of growing and birthing a human, but in reality, you don’t always have to just suck it up and deal with it.  As someone who has dealt with managing these pains with and without a physical therapist, I know that physical therapy can help you immensely, both during and after your pregnancy.   

              I went into my first pregnancy feeling great. I was lifting, spinning, and doing general workouts until I was about 34 weeks pregnant, but I still suffered from sacroiliac pain and sciatic nerve pain that had me laying on the floor in tears and scooting around my office relying on my peers to help me with treating my patients. I had an unplanned C-section for this pregnancy and the recovery was brutal, especially living in a walkup apartment and on a subway stop with 4 flights of stairs instead of an elevator. After 6 months, I finally worked out the kinks in my body and was almost pain-free, but I definitely did not get back into fighting shape.

              Fast forward two years and, when I became pregnant with my second daughter, I knew that I needed more help. Thankfully, I had phenomenal resources around me and I would be remiss if I did not give a shout out to Dr. Natalia Farnsworth, PT. Not only did she work through pain that would cause my leg to give out every time I turned right on my skis (obviously, not ideal), but after my pregnancy she got me going within a week after my second unplanned C-section.

              To be clear, I was not getting into my pre-pregnancy jeans within that first week, but compared to round one, I was able to walk better, feel stronger, and negotiate those subway stairs more confidently in a fraction of the time. I went from being barely able to engage my core to do a pelvic tilt to swinging a 25 lb kettlebell by week 8 post-pregnancy.  My 3 year old diastasis recti was gone, my hip pain was gone, and I was well on my way to becoming the strongest and fittest I have felt since I was competing in gymnastics at college.

              Personal experience aside, as a clinician, I have also seen the benefit of physical therapy for my pregnant and postpartum patients. In the medical field, we know that exercise during pregnancy can help to decrease the risk of gestational diabetes, so our ability to help you manage your orthopedic pain during that time can help keep you active. For those who are trying to return to an active lifestyle post-pregnancy, it is helpful to have someone who can give you tips to get your strength and flexibility back.

              You may be asking yourself, why doesn’t everyone get physical therapy for these aches and pains? Why doesn’t my doctor recommend PT? The simple answer is that we, as a profession, have come a long way from the days of just using hot packs, ultrasounds, and stim as the basis of our treatments. Now, we use combinations of exercises, manual techniques, and a lot of patient education as the foundation for our plans of care.  As practitioners, we are working to educate not only our patients, but other medical providers of the benefits of physical therapy during pregnancy and post-pregnancy.  As we continue to watch the physical therapy practice develop, we believe that this type of care is quickly becoming the norm.