Archive for August, 2012

Tai Chi Improves Breathing in COPD Patients

There is a growing body of research that suggests that the slow, rhythmic breathing during Tai Chi enhances the health of patients with chronic obstructive pulmonary disease (COPD).

Conventional pulmonary rehabilitation programs that focus on aerobic exercise and strength training can improve exercise capacity, quality of life, and symptoms in patients with COPD.

In addition to extending the breathing techniques taught in pulmonary rehabilitation, mind-body interventions such as Tai Chi integrate novel elements, such as progressive relaxation, imagery/visualization, mindfulness of breathing and overall body sensations, postural training, and coordinated patterns of breathing and movement.

“These therapeutic elements may allow Tai Chi to impact COPD symptoms and pathology via complex mechanisms not specifically targeted in conventional rehabilitation and therefore may be an effective adjunct to therapy,” says Peter Wayne, PhD, Director of Research, Osher Center for Integrative Medicine at Brigham and Women’s Hospital and Harvard Medical School.

Wayne is the author of the upcoming book The Harvard Medical School Guide to Tai Chi.

“Mind-body exercises may also allow patients with COPD to feel more confident about their ability to exercise and entice them to continue to exercise, which, of course, has the potential for lasting benefits.”

A new study published online today shows that Tai Chi can be used as an effective form of exercise therapy for people with COPD.

The Australian researchers found that short-form Sun-style Tai Chi done twice a week for 12 weeks could improve the exercise capacity and quality of life in people with COPD. The research published ahead of print in the European Respiratory Journal suggests that Tai Chi may be as beneficial as pulmonary rehabilitation.

“With increasing numbers of people being diagnosed with COPD, it is important to provide different options for exercise that can be tailored to suit each individual,” said lead author Regina Wai Man Leung from the Concord Repatriation General Hospital.

“The results from this small sample provide compelling evidence that Tai Chi is an effective training program for patients with COPD, and could be considered as an alternative to the usual exercise training program that are available in pulmonary rehabilitation.”

At Harvard Medical School, Wayne’s group has completed a small, pilot randomized controlled trial designed to determine the feasibility of administering a Tai Chi program to improve the quality of life and exercise capacity in COPD patients.

The Harvard Medical School researchers randomized 10 patients, average age 66, with moderate to severe COPD to 12 weeks of Tai Chi plus usual care or usual care alone.

The Tai Chi training consisted of a one-hour class, twice weekly, that emphasized gentle movement, relaxation, meditation, and breathing techniques.

“We looked at disease-specific symptoms and quality-of-life, exercise capacity, pulmonary function tests, mood, and self-efficacy,” says Wayne.

“Participants reported enjoying the Tai Chi program, and were able to participate without experience and adverse reactions to exercising.”

After 12 weeks, the Tai Chi participants said they felt significant improvement in chronic respiratory symptoms compared to the usual-care group.

The Tai Chi group also had slight improvements in their 6-minute walking distance, depression, and shortness of breath.

“Our conclusion: Tai Chi as an exercise appears to be a safe, positive adjunct to standard care and warrants further investigation,” says Wayne.

Led by Dr. Gloria Yeh, the Harvard Medical School group is now conducting a 10-fold larger trial sponsored by the National Institutes of Health comparing Tai Chi to both meditative breathing exercises (isolated out of the Tai Chi program) as well as to a non-exercise education program.

How to Avoid Injuries and Swim Like Michael Phelps

How cool was it to watch Michael Phelps anchor the US team to the 4 x 200 meter freestyle Olympic gold medal and, as a result, become the most decorated Olympic athlete ever.

Phelps is inspiring yet another generation of swimmers, both elite and amateur.

He even makes me want to hit the pool, or maybe swim a few hundred yards beyond the shore break next time I’m at the beach.

More than a million competitive and recreational swimmers have made swimming one of the most popular fitness activities in the United States.

More than one-third of swimmers practice and compete year-round and elite swimmers may train more than five miles a day, putting joints through extreme repetitive motion.

That kind of regimen increases the risk of injury, says Dr. Stuart Elkowitz of Somers Orthopaedic Surgery & Sports Medicine Group.

“With overuse comes fatigue and failure to adhere to proper stroke techniques, which in turn can lead to injuries,” says Elkowitz.

The most common sites of swimming injuries are, in order, the shoulder, the knee, and the neck.

Here are some of Elkowitz’s straightforward tips on how to avoid most of these injuries.

Swimmer’s Shoulder

If you log thousands of yards in the pool each day, you may use your shoulder as many as 2,000 times in a single workout.

Swimmer’s shoulder is an injury of the shoulder’s muscles and tendons due to overuse or poor swimming technique.

It manifests itself as pain and inflammation.

“Swimmers, like athletes who throw a lot, put a great deal of stress on their shoulders,” says Elkowitz.

In fact, more shoulder injuries are reported among swimmers than pitchers in baseball, he says.

Swimmer’s shoulder is most often associated with the freestyle stroke and also with the butterfly and backstroke.

Specific injuries may include rotator cuff impingement — pressure on the rotator cuff from part of the shoulder blade or scapula as the arm is lifted; biceps tendinitis – painful inflammation of the bicep tendon; and shoulder instability, in which structures that surround the shoulder joint do not work to maintain the ball within its socket.

“The most important factor in avoiding shoulder injury is to swim with correct technique,” says Elkowitz.

“A qualified swimming professional or experienced swimmer can assess your stroke and highlight mistakes.”

He recommends against over-training or training with tired muscles to minimize injury.

Also, avoid sudden increases in the number or intensity of your workouts; don’t overuse swim paddles, which put additional strain on your shoulders; and take care when using a kick-board with outstretched arms, as this can put your shoulders in a weak position.

Swimmer’s Knee

Swimmer’s knee is an injury generated by the stroke mechanics of the breaststroke kick.

When the legs extend, then are brought back together during the propulsive phase of the kick, the knee is subject to abnormal external rotation, which puts stress on the inner ligament of the knee, called the medial collateral ligament, and the hip.

To avoid swimmer’s knee, alternate swimming strokes and have rest periods during the year when you don’t swim the breaststroke, says Elkowitz.

He also suggests you warm up and stretch before a swimming session and do regular exercises for your hamstrings and quadriceps to strengthen your legs.

Swimming-related Neck Injuries

Swimming-related neck injuries are usually caused by incorrect technique.

Also take precautions to avoid neck muscle strain from overuse.

“When swimming the freestyle stroke, avoid over-rotation when lifting the head to inhale,” says Elkowitz.

Rotate your body more so your head remains aligned with your body when clearing the water.

When swimming the breast or butterfly stroke, keep your head aligned with the spine at all times.

In the backstroke, increase swim times gradually so your neck muscles have time to adapt.

Yes, I know I’ll never be like Mike in the pool.

But I’m sure there are some young swimmers out there who are ready to take aim at his Olympic record.

They just need to follow these safety rules if they want to have a long, successful career, as Phelps has had.