Oak Street Medical Blog

If you are a regular reader of the Oak Street Medical blog, you'll recall that I wrote a post few weeks ago about a research trial demonstrating that as little as 15 minutes of exercise daily is beneficial when it comes to physical well-being and longevity, and that the benefit increased the more one exercises. To continue with that "keep moving" theme, I want to focus on two more recent studies published about on the gains of physical activity, specifically yoga and Tai Chi.

Yoga and back pain

The first was a paper published in the Annals of Internal Medicine by a group of British researchers, who were able to show that practicing yoga can lessen back pain. From a group of 313 adults with chronic back pain, those who participated in a 12-week yoga program had improved back function for up to a year afterward, compared to those who had "usual care" for back pain.

The yoga classes included breathing and relaxation techniques, as well as poses to improve strength and mobility. Those who were assigned to do yoga were encouraged to practice a couple of times a week at home. Before and after the 12-week program, the participants filled out questionnaires on how much trouble they had with daily tasks, their pain and general health. They reported noticeable improvement, especially in function.

Tai Chi and Parkinson's

Another research trial showed that Tai Chi helps people suffering from Parkinson's disease. Tai Chi is an ancient Chinese exercise that can be practiced nearly anywhere. The study was led by Oregon Research Institute (ORI), researchers right here in Eugene, OR.

Tai Chi, with its slow, graceful movements, has been shown repeatedly to improve strength and aid stability in older people with various ailments. In the latest study, led by Fuzhong Li of the Oregon Research Institute, Tai Chi was tested in 195 people with mild-to-moderate Parkinson's. The participants attended twice-weekly group classes of either Tai Chi or two other kinds of exercise, stretching and weight training.

After six months of classes, the Tai Chi group did significantly better than the individuals in the second group; both groups were tested for balance, walking and other measures. Tai Chi training was also helpful in reducing falls. The improvements in the Tai Chi group continued for three months of follow-up evaluations.

How to get started

In Eugene and Springfield there are many outlets for yoga and Tai Chi, and videos can be found online. A quick YouTube search reveals several beginners' videos that can serve as an introduction to either discipline.

"Keep moving" is my mantra, one that I try to pass on to others. Medical research supports its advantages. Incorporating regular physical activity in one's life, even in the presence of chronic neurologic disease, can be beneficial.

Based on this, I would certainly encourage anyone with back pain, Parkinson's or another disease that affects mobility to do just that - keep moving.

And I'll see you out there!

Did you know that exercising for as little as 15 minutes a day could extend your life?

In an experiment conducted in Taiwan on over 400,000 people, participants who exercised just 92 minutes a week had a 14 percent lower death rate after eight years.

Even better, the death rate dropped to 18 percent when participants exercised for 30 minutes per day, and 22 percent at 45 minutes per day. In other words, we begin to benefit from exercise at a minimum of 15 minutes per day, but the more we exercise, the better.

The World Health Organization has its own recommendations on exercise for adults and older adults. These guidelines are more specific and have become the standard advice physicians provide their patients.

The guidelines state that we should be doing 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. For example, this would be 30 minutes 5 days per week for moderate exercise or 15 minutes five days per week for more intense activities. As long as the exercise is done in sessions of at least 10 minutes, the benefit is the same. So just as in the Taiwanese study, 15 minutes can be enough.

How to gauge moderate and intense exercise
Your predicted maximum pulse rate (beats per minute) is roughly 220 minus your age in years. Moderate exercise is when your average pulse rate is 60-75 percent of your predicted maximum, while vigorous exercise is 75-90 percent. 

Here’s a quick calculation: While exercising, simply take your carotid pulse, found at your mid-neck, for 15 seconds – if you need help finding this pulse point, ask your doctor to show you – and multiply by 4 to measure your pulse and determine your level of exercise.

An easier way might be to simply see how you feel during exercise. If you are exercising hard enough to feel warm and even break a sweat but can still hold a conversation, this is considered moderate intensity. The moment you can no longer hold that conversation, you have crossed over to vigorous exercise.

Does work count?
A patient will often tell me that he or she doesn’t have an exercise program but are active on their feet at work. Does this constitute enough exercise? While it is good to be active during the day, as it burns more calories than being sedentary, most active occupations likely would not replace a formal exercise program. 

Remember that the bursts of activity need to be at least 10 minutes in length to be beneficial. It is widely thought that a ‘leisure-time’ exercise program is what is required to feel better, live longer and reduce risk for chronic disease.

Following these general guidelines about exercise have been demonstrated to reduce risk for practically every medical problem, such as heart attack and stroke, breast cancer, colon cancer, depression, high blood pressure, hip fractures and osteoporosis, and diabetes. This is why I advocate that people incorporate exercise into their daily routines.

In an era of concern over personal well-being and expensive health care, being active is an easy and inexpensive way to make a difference in both areas.

If you have been inactive, it is wise to see your doctor for a brief screening exam before starting an exercise program. This is also an opportunity to individualize your exercise regimen with your doctor’s help. 

Get the miles in and I’ll see you out there!