Monday, June 18, 2018

The Power of Movement

Image result for exerciseMovement...we've all heard about it's benefits. There's the current craze about the detriments of a sedentary lifestyle. In fact, a term has even been coined to describe this problem - "Sitting Disease".
I don't think there is any doubt or debate about this topic. With that idea established, however, we can probably all attest to the fact that knowing something and doing something are oftentimes mutually exclusive! I know that for me, I am good about doing minimal exercise daily. By that I mean, I have no problem taking my 20-30 minute brisk walk every day but I struggle much more with adding on to that minimal amount of exercise. In reality, strength training is equally important, especially as we age. If we don't consistently tone those muscles and work to strengthen them as we age, we gradually lose more muscle mass and have the tendency to become flabby and saggy! I don't know about you but that is something I never want to be and am determined never to allow in my own body! And of course, that takes consistency.

So it comes as no surprise to you that an active lifestyle is more beneficial, right? We could take it a step further replace the word "movement" with "exercise" and agree that the act of intentional movement by way of actual exercise is even better. Clearly there is a difference between being up and moving in your daily life and engaging in an exercise routine.

Now, you may get the idea that this post is all about the benefits of exercise in regard to weight loss or general toning and strengthening and though I have mentioned those aspects and believe they are vitally important to a healthy lifestyle, that's not why I am writing this post. On the contrary, I want to provide another reason to get exercising.

For the remainder of this article, I want to speak specifically to those suffering from Rheumatoid Arthritis (RA). Along with a number of diet and lifestyle changes, people who struggle with consistent joint pain, can benefit significantly from consistent exercise.
In a study of 220 patients with RA, subjects were divided into a class exercise group, a home exercise group and a control group. Subjects were measured at base line and subsequently at six and 12-week marks. Results displayed that in the class exercise group, grip strength, walk time and fatigue greatly improved. Further, overall symptoms of pain and depression were all positively affected in the class exercise group. Though some improvements were made in the home exercise group, they were not as significant in the class exercise group, despite the similarity of exercises completed, possibly due to the differing levels of intensity. Researchers concluded that exercise was a positive influence on RA symptoms.

A literature review looked at the benefits of exercise for RA patients and also found a positive level of effect. Authors deduced that exercise in general showed a clear and proven method of treatment that provided an improvement in overall function for RA patients. An additional meta-analysis and literature review of studies looked at the effect of cardiorespiratory aerobic exercise for RA patients in regard to quality of life, function and clinical and radiologic outcomes. Collective results showed that cardiorespiratory aerobic exercise proved to be a safe method of treatment, providing improvement in some of the most important outcome measures for RA.

Another meta-analysis examined the efficacy of resistance exercises in RA patients. Following the study of a total of 10 randomized, controlled trials with 547 patients, authors concluded that not only was resistance exercise in RA patients safe, but it also showed improvement in most outcomes and was statistically significant as well as possibly clinically significant for the outcome of RA disability measures. Further, subgroup analysis also revealed a trend towards increased efficacy in programs with high-intensity resistance exercise.

So, not only does exercise provide positive benefit for the general population, but it significantly improves the symptoms of a disease typically treated with pharmaceutical options. Whether you have RA or not, the power of movement is essential for an optimal lifestyle.

Monday, June 4, 2018

Hand Grip Strength as a Predictor of Health

I was recently asked if hand grip strength is a predictor of overall health outcome and decided this would be a great topic to address here.

Image result for hand gripThis concept makes sense from the standpoint of looking at muscle mass and body strength - we know that physical fitness does has something to do with health. However, muscle strength alone is not sufficient for a picture of optimal health. So, what does the research say?

A study of 4,654 participants in the UK was performed to determine the association between hand grip strength and cardiac structure and function for an adult population in the United Kingdom. Results showed that hand grip strength was related to cardiovascular magnetic resonance based measures of cardiac structure and function which in turn have shown to be predictive of less cardiac hypertrophy (an abnormal enlargement or thickening of the heart muscle) or cardiac remodeling (alterations in the size, shape, structure and function of the heart). Furthermore, these factors have been shown to be negatively associated with the incidence of cardiovascular disease, implying a relationship between hand grip strength and overall cardiac health. 
In a 25-year prospective cohort study (Honolulu Heart Program) Japanese-American men living in Oahu, Hawaii were studied in regard to hand grip strength and functional limitations and disability. Among healthy men aged 45-68 years old, results showed that hand grip strength was uniquely predictive of both functional limitations and disability when re-measured 25 years later. Researchers concluded that the maintenance of good muscle strength in midlife may create a protective effect against disability of old age, in large part by creating a greater safety margin and threshold of disability. 

An additional study examined 2,987  59-73 year old men and women to determine the possible connection between hand grip strength and health-related quality of life. Researchers concluded that lower grip strength was associated with negative outcomes in regard to reduced health related quality of life. Results suggested that low hand grip strength may present a link between sarcopenia (loss of muscle mass due to the natural aging process) and generalized frailty. Researchers stated that improvement of muscle mass and strength prior to the onset of chronic disorders would behoove the population and possibly prevent low health related quality of life measures. 

One study  looked at the association between grip strength and cardiovascular, respiratory and cancer outcomes in addition to all-cause mortality. This prospective cohort study of half a million UK participants showed a strong connection between grip strength and all cause mortality as well as mortality specifically from cardiovascular, respiratory, chronic obstructive pulmonary and cancer diseases. Researchers suggested that adding hand grip strength as a regular screening tool for health may be warranted.

Though it appears that hand grip strength may be a moderate predictor of health, there is far more involved in health outcomes than one screening tool or health measure. Therefore, it would behoove all of us to take into consideration all components of diet and lifestyle and stay away from relying on one test to measure overall health. Maintaining a pattern of dietary excellence, exercising regularly (5-6 times a week), for appropriate durations (45-60 minutes),  with adequate intensity, and staying hydrated will round out the approach of overall health a little more and present far greater results.