Aquatic Therapy - Healing Water

Aquatic Awareness for Breast Cancer Survivors

2010-10-11T07:51:00.000+02:00

What are some AEA Certified Professionals doing?

National Breast Cancer Awareness Month (NBCAM) is now celebrating 26 years of awareness, education and empowerment. While October is recognized as National Breast Cancer Awareness Month, NBCAM, along with Susan G. Komen for a Cure and other organization operate year round in providing education and support for breast cancer survivors.

AEA Certified Professionals are also doing their part in advancing the cause. As the cooperation between the medical and fitness communities increases and the benefits of water exercise for breast cancer survivors are better understood , AEA fitness professionals are stepping up to provide specialized programming in their communities.

Many of these AEA professionals are survivors themselves and they are now sharing valuable information and education from lessons learned on the journey.

Debby Visconti, a survivor of six years, is an AEA certified instructor in Rochester, Michigan and has been offering an Ai Chi class for breast cancer survivors for the past four years. “My clients have improved mentally and physically because we have applied our Ai Chi to daily living and it has truly helped us relieve stress and form friendships,” says Visconti.

Ai Chi is a water exercise and relaxation program performed using a combination of deep breathing and slow, broad movements of the arms, legs and torso in flowing continual patterns. “The Ai Chi movements help increase range of motion for survivors and it trains us to apply positive thoughts of healing and forgiveness,” adds Visconti. She promotes her classes in her community through oncologists, surgeons and local cancer foundations who she says are happy to support the program.

Catherine Shade is featured in AKWA Magazine’s, In the Spotlight, in the current October/November issue. Catherine, a registered nurse in Columbus, Ohio, became a breast cancer survivor in 1998 and an AEA certified instructor in 2002. After a right mastectomy, removal of lymph nodes and reconstruction; she went on to be diagnosed with lymphedema in her right arm. “This is when I began my journey to help other breast cancer survivors and lymphedema sufferers,” says Shade. In 2006 she started a class, Making Waves, which was the first of its kind to specifically help women with lymphedema after breast cancer surgery. She has had over 140 women participate in her class since 2007, thanks to grant funded money from the Susan G. Komen for the Cure, Columbus Affiliate. These funds were provided from The Race for a Cure which is held in May every year. Catherine is now also teaching other programs for survivors in her area. Her experience as a registered nurse and her accrued knowledge of the lymphatic system and breast cancer has helped her create a very detailed and solution oriented approach to her fitness programming. “I am currently working on a workshop and home study for instructors to teach the basics of my water exercise program and the therapeutic benefit of water exercise so that they can teach my style of class to other women suffering from lymphedema,” says Shade. She says she also hopes to collaborate with Mary Essert on future projects to benefit cancer survivors.

Considered a pioneer in the aquatic fitness industry for her work regarding breast cancer and other special populations, Mary Essert has been involved internationally in presenting and teaching swimming, safety, water fitness, and therapeutic intervention techniques since 1949. After surviving two bouts of cancer, she has shifted her focus to specialize in aquatics for individuals with breast cancer, arthritis and fibromyalgia. In 2009, she received the Arkansas Governor's Council Award for Fitness Leadership in the Senior Category. Her other awards include life time achievement and recognition from AEA, AAHPERD, ATRI, USWFA and more. Mary offers workshops, educational CD-ROMS and online courses that provide education and exercise recommendations for practitioners and survivors.

The healing lure of the water provides promise for survivors and opportunities for AEA certified professionals to provide much needed services in their communities. As a non profit fitness organization pledged to advancing aquatic fitness worldwide, AEA is dedicated to supporting their efforts and dedicated to supporting future development in education and aquatic training specific to breast cancer survivors. Who better to lead others to hope and health than dedicated AEA professionals?

Aquatic Therapy, Water Therapy or Hydrotherapy

2009-12-14T22:40:00.005+02:00

Introduced to Britain by bathhouse-loving Romans, hydrotherapy is now recognized for its potential to promote well-being, reduce anxiety and alleviate chronic pain - and you don't even have to be able to swim to reap the rewards

What is it?
It's believed that the thermal properties of water assist healing. The body's reaction to hot and cold water causes the nerves at the surface of the skin to carry impulses deep into the body. This reaction is thought to lessen pain sensitivity, stimulate the immune system, aid lymphatic drainage and increase blood circulation. So, whether you're taking a long, languorous bath, standing under an icy-cold shower, or spending two hours in a saline flotation tank, you are in effect harnessing the healing power of water.

Is there any evidence?
In 1994, researchers in France published a study in the Journal of Rheumatology to assess the effect of hydrotherapy on chronic lower back pain. Over three weeks one group of suffers was treated with medication, the other treated with both medication and hydrotherapy. Results showed that the patients receiving hydrotherapy showed significant improvement in flexibility and a noticeable reduction in pain intensity.
A US study in the late 90s confirmed these findings. The 40-person study carried out at the University of Minnesota showed that 85% of participants would chose a whirlpool bath over a still one and that, while both baths reduced participants' anxiety levels, the whirlpool bath reduced participants' reactivity to stress.

Where does it come from?
The healing properties of water were recognised by the ancient Egyptians in 2000BC. The Romans were also strong believers in the power of hydrotherapy. The UK was slower off the mark, although historical research suggests that from as early as AD1138 people traveled from all over England to Bath to wash away infirmities.
The ancient tradition of bathing has gradually evolved into several modern treatments including the Jacuzzi, Watsu (underwater shiatsu), Jahara, flotation tanks, the Vichy shower and thalassotherapy, which involves immersion in seawater pools of different temperatures and degrees of salinity.

Who can do it?
Everybody can benefit from hydrotherapy, even those who can't swim (hydrotherapy treatments such as the Vichy shower and Watsu do not require you to support yourself in water). Hydrotherapy particularly benefits those suffering from arthritis, fibromyalgia and back pain, and those who have had joint replacements. Insomniacs may also find hydrotherapy beneficial, because water has a deeply soothing and relaxing effect on the body.

What results can I expect?
Immersion in warm water often has a satisfyingly soporific effect. Much like taking a hot bath, hydrotherapy is likely to leave you both physically and mentally relaxed. Hunger is also a common after-effect.
Flotation is generally the most invigorating of hydrotherapies. An hour-long float has been likened to having the same restorative effect as a four-hour sleep.

Contra-indications
Children, the elderly and anyone who is pregnant should avoid extremes of temperature because of the risk of fainting or shock. Discontinue treatment immediately if you experience light headiness, and rest for at least 20 minutes after any treatment to allow your blood pressure and body temperature to normalize.
Treatment may not be suitable for people suffering from: open wounds or skin infections, a stomach virus, severe breathing difficulties, incontinence or a raised temperature.
Hydrotherapy should never be undertaken if you are under the influence of alcohol.

Aqua Jogging Exercise for Longer Healthier Life

2009-06-27T06:16:00.005+03:00

Millions of active adults are finding that one of the secrets to a longer healthier life can be found at the local pool. Research shows that a regular water exercise program can slow down and even turn back the aging clock. Aqua jogging in deep water offers the cardiovascular conditioning of aerobics, the strength training of lifting weights, and the stretching benefits of yoga all in one, 30-minute workout.
It’s never too late to take the plunge and begin enjoying water’s age-defying benefits.

Heart healthy
Water exercise has been proven to help normalize blood pressure and aid in the prevention of heart disease. Water workouts can duplicate real movements like walking and lifting–making everyday activities faster and easier.

Growing stronger
The water provides resistance in all directions, so both sides of the muscle pair can be strengthened simultaneously for an effective time-saving workout. Muscles respond to strength training at any age and the water is especially effective at targeting hard-to-reach muscles–including the abdominals and lower back.

Living fit
Water workouts sharpen a person’s mental focus, helping seniors maintain and, in some cases, even improve memory. In addition, joint friendly aquatic workouts improve flexibility, balance and response time, reducing the risk of injury.

Mini-retreat
The water gently massages the body during the workout helping to dissolve stress, relax the mind and rejuvenate the spirit. People who exercise in water sleep better, have more energy and experience fewer medical problems.

Hassle-free
Deep water exercise with a flotation belt, is easy to learn, keeps hair dry and doesn’t require any swimming skills. Workouts can be as simple as water walking or more advanced, such as interval training classes.

Circle of friends
Local pools offer a fun social environment and fitness classes are a great way to build a supportive community of friendships. Research shows that people who exercise in pairs or groups stick to their programs longer and have a higher success rate.

by Juliana Larson, B.S. L.M.T. an award-winning aquatic specialist and author of “Water Dance” (Paper Chase Press, 1999).

Water Runners

2009-06-27T06:00:00.001+03:00

More than 2.2 million Americans have discovered the benefits of deep water running. This summer thousands more are expected to take the plunge into this new exciting form of exercise.

“Since I started Aqua Jogging I have lost 60 pounds, decreased my body fat from 24% to 14% and significantly lowered my blood pressure,” says Tim Tift. 54-year-old chairman of the University of California-Irvine PE Department. “My metabolism is up, I feel a lot better, and I am revitalized.”

What’s amazing is that Tift made these gains in a little more than one year. As chairman of his own physical education department, Tift added deep water exercise with the AquaJogger Buoyancy Belt to his department’s program. Not only did he join the classes, but he taught them! The rest is history.

Tift is one of the growing number of people of all ages and nations who have discovered exercising in water allows you to work out when conditions otherwise would not allow. For example, injuries, excess weight, surgeries, orthopedic conditions and back ailments all prevent millions of people from getting the exercise they need to recover properly and regain general good health. Water running is a great solution for fitness and recovery.

Water running isn’t just low impact, it’s no-impact. Since your feet do not touch the bottom in deep water, running in the deep end with an AquaJogger is a non-weight bearing activity. You get all the benefits of the toughest aerobics class or cross country run, with none of the impact on bones, tendons and ligaments. That’s why exercising in deep water is one of the fastest growing exercise trends in the country.

Health minded people of every age and ability are taking advantage of this fun, stress-busting way to burn fat, tone muscles, recover from injury and get sluggish cardiovascular systems moving again.

Principles and Benefits of Aquatic Environment for Rehabilitation

2009-06-27T05:57:00.002+03:00

Usually when you are up to your neck in something you’re in trouble, but research shows that being up to your neck in water may be just what you need. Dr. Bruce E. Becker, who has published, taught, and researched extensively on aquatics, wrote an article titled “Considering the Biologic Aspects of Water” which was published in April 1995 in Advance for Directors in Rehabilitation. His article included the latest information and research on the physiological changes that occur when the body is immersed in water. The following points are summarized from Dr. Becker’s article to provide you the benefit of his observations.

Although water is the oldest rehabilitation modality, few understand the magnitude, variety, and rapidity of its healing effects. Yet much research over the centuries validates these effects, and recent research adds further understanding: The aquatic environment produces physiologic changes that help remove metabolic waste, improve cardiac function, lower blood pressure, and assist the body in tissue healing.
In regard to the circulatory system, Dr. Becker stated that: “Immediately after a person is immersed, water begins to exert pressure on the body…Central venous pressure rises with immersion to the chest and increases until the body is completely immersed… Cardiac volume increases by nearly one-third with immersion to the neck…Since the ultimate purpose of the heart is to pump blood, its measure of performance is the amount of blood pumped per unit of time.” This is called cardiac output and “submersion in water to the neck depth increases cardiac output, 32% at rest.” “Therefore the claim that water exercise is not aerobically efficient is faulty. In fact, it may be the ideal cardiovascular conditioning medium.”

“Like the circulatory system, the pulmonary system is profoundly affected by immersing the body to the thorax. Part of the effect is due to blood shifting into the chest cavity, and part is due to compression of the chest wall. The combined effect alters pulmonary function, increases the work of breathing, and changes respiratory dynamics. In fact, expiratory reserve volumes decrease by 75 percent at neck immersion, with vital capacity decreasing only slightly …The combined effects of these changes increase the total work of breathing by 60 percent. Thus for an athlete used to land-based exercise, water-based exercise is a significant workload challenge to the respiratory apparatus. If water training time is sufficient, this challenge can improve the respiratory system’s efficiency.”

“Water immersion positively affects the musculo-skeletal system as well, particularly with vasoconstriction. On land, for instance, sympathetic vasoconstriction tightens the resistance vessels of the skeletal muscle to resist blood pooling. But in water, immersion pressure removes the biologic need for vasoconstriction, thus increasing muscle blood flow. In fact, resting muscle blood flow increases by 225 percent during neck immersion”
“Aquatic immersion creates many effects upon renal blood flow and the renal regulatory systems. For instance, the flow of blood to the kidneys increases immediately upon immersion, which produces an increase in urine production, as well as sodium and potassium excretion. Sodium excretion also increases as a function of depth due to the shifting of circulating central blood volume.”

Immersion up to the neck during deep water running is often utilized for its conditioning effect.” Although some controversy exists about the optimal training program for athletes who need joint off-loading during a recovery period, it is known that aquatic exercise can indeed increase conditioning in that population. In fact, water running equals land running in its effect upon maintaining VO2 max. When training intensities and frequencies are matched.”

“Similarly, when aquatic exercise is compared with land-based equivalent exercise in its effect upon maximum gains in VO2 in unfit individuals, aquatic exercise achieves equivalent results.”

“Water-based exercise programs may be used to sustain or increase aerobic conditioning in athletes who need joint offloading… Studies, have shown excellent cross-over benefits.”
Through understanding the principles and benefits of aquatic physics, coaches, trainers, athletes and rehabilitation clinicians can design aquatic programs that complement and enhance land-based programs to provide increased levels of fitness and function.

Water Walking

2009-06-27T05:41:00.001+03:00

Water fitness is one of the fastest growing low-impact activities in the country. Here’s why millions are taking the plunge.
Water walking is an effective workout, is easy to learn and requires no swimming skills.
Vertical water fitness combines the toning of weight training, the cardio benefits of aerobics and the enhanced flexibility gained through yoga - in one, 30-minute fat-burning workout.

Water is a natural and instantly adjustable weight-training machine, providing resistance in all directions to tone and strengthen the muscles.
Studies show water workouts effectively burn fat, and strengthen the abdominals–without doing a single sit-up.
Low-impact aquatic workouts are joint-friendly and help prevent and heal injuries.
Buoyancy equipment, such as the patented AquaJogger belt, suspends the body securely and comfortably, supporting the head and neck out of the water, so hair stays dry and glasses or contact lenses can be worn.

by Carol Kennedy, M.S., is the Fitness/Wellness Program Director at Indiana University.

Aquatic Fitness - The Gentle Way to Get Fit

2009-06-27T04:38:00.001+03:00

Who does not want to be fit and healthy? But what do you do if your usual training programme on land gets too monotonous or your joints actually start to ache? A good alternative is to work out in water, the healing effects of which many cultures have taken advantage of for over 2500 years.

The term aqua fitness encompasses the modern versions of traditional water aerobics, which range from gentle exercise via muscle strengthening to intensive cardiovascular training. The American Olympian Mary Sanders sparked enthusiasm for aqua sports in the early 1990s. She developed a health-oriented whole body training programme in the water as part of the course that she later taught at the University of Reno. Now, aqua fitness programmes are often standard in many fitness studios, swimming clubs as well as hotels and sports centres all over the world.

Non-swimmer? Jump in!
You don't need to be an excellent swimmer to benefit from exercise in the refreshing water. As you are in a vertical position when doing aqua fitness programmes, unlike swimming, inexperienced participants are also able to do the exercises in the familiar upright position.
In principle, this form of water sport is suitable for everyone. The physical weightlessness and the fact that the intensity of the exercise can be controlled mean that pregnant women, the elderly, unfit and overweight people can train without putting themselves at risk, as can people with musculo-skeletal complaints, rheumatism, asthma, osteoporosis and even cardiovascular diseases. The only exceptions are acute illnesses, for the rule of thumb concerning those is no sport, neither on land nor in water!

In Archimedes' wake
Aqua fitness today is still governed by what Greek scientist Archimedes discovered as early as the 3rd century BC, namely, that the person exercising has to work against a high resistance owing to his physical weightlessness and the force of the water. As such, his movements are curbed, which makes them both more difficult and better, as sudden strain on muscles and joints is not possible. At the same time, the cardiovascular system is strengthened and endurance and muscle strength increased. Comparable exercises on land do not have the same effect, because against the force of water, our bodies have to work considerably harder, and thus the exercise is that much more effective. After all, resistance in water is 900 times that of air.

Strengthening body and mind
The water resistance can be deliberately increased with additional aids like dumbbells or so-called aqua mitts, gloves which increase the surface area of the hand, to strengthen particular muscles and improve bone mass. The stimulus of the water resistance promotes calcium storage and cell construction in the bones and thus even counteracts the feared condition osteoporosis.

The positive massage effect of the water on the skin, muscles and connective tissue must also not be forgotten. And improved circulation leads to tauter skin. In addition, co-ordination of movements when floating promotes our sense of balance and ability to concentrate. However, the cooling effect of the water can cause minor to major overexertion without the person realising, although the risk of injury is generally regarded as minimal.

Contemporary aqua fitness
Aqua walking offers a light introduction to aqua fitness. Participants practice walking movements in waist-high water, which are more effective than the same movements on land especially for increasing strength and endurance. This is the perfect first course for inexperienced participants in particular.

Aqua jogging is a fat-burning, high-intensity method of training. It takes place in deep water, with participants positively swaying in the water, as buoyancy aids like swim belts or life jackets prevent contact with the floor. It has been proven that jogging in water, which is a very demanding form of exercise, for at least 30 minutes two to three times a week, promotes strengthening of the leg muscles by 20 to 40 percent.

Aqua aerobics, aqua step and aqua dancing are derived from the courses offered by traditional fitness studios. They place increased demands on the participant's flexibility and co-ordination, but offer an effective workout which is a lot of fun. An instructor at the poolside leads the group in the water by demonstrating various steps.

Aqua boxing is a real power training session. Participants fight against an imaginary opponent and the force of the water using martial arts movements derived from classic boxing or the popular sport of Thai boxing. This form of exercise reduces everyday stress to a minimum, while greatly improving flexibility, strength and co-ordination.

Aqua stretching is a slower, relaxing form of exercise to achieve mental balance. Stretching movements are made easier by the upward swell of the water, while the lightly heated water reduces muscle tone and thus makes the muscles altogether softer and able to stretch more.

Incidentally, many health insurance companies also understand the importance of the positive effects of aqua fitness on our health and thus sometimes pay wholly or partly for certain aqua courses. So if you don't fancy dry exercises anymore but also want to benefit from the power of water, there is only one thing to do: Jump in!

Researchers: the Positive Effects of Ai Chi Movements

2009-06-26T12:36:00.008+03:00

By Lori Thein Brody and Paula Richley Geigle

Ai Chi movements can be used to improve movement efficiency of clients who have chronic pain, arthritis, fibromyalgia, chronic obstructive pulmonary disease, balance deficits, diabetes, multiple sclerosis, or other neurological and orthopedic problems. Ai Chi can be used in groups or individually, requires no equipment, and allows the hair and face to stay dry. This head-out position is important for non swimmers who would benefit from exercise in the water. Additionally, because the philosophy and breathing in Ai Chi are similar to those of land-based Tai Chi, many of the benefits seen in Tai Chi are applicable to Ai Chi.

Many of the benefits of Ai Chi come from breathing and relaxation. These benefits include those of exercise and the effects related to the relaxed contemplative state (Berger and Owen 1992; Taylor-Piliae and Froelicher 2004). The expanded range and cardiovascular benefits that arise from Ai Chi training have proved beneficial for patients with chronic pain, arthritis, chronic obstructive pulmonary disease, diabetes, and balance impairments. Ai Chi can also promote relaxation with clients who are coping with high stress levels (Courtney 2000; Jerath 2006; Vargas 2006).

Musculoskeletal and Chronic Pain
Practicing slow movement techniques and diaphragmatic breathing increases relaxation; decreases muscular tension; improves symptom management (Arpita 1982; Monroe, Ghosh and Kalish 1989; Koh 1982; Sancier 1996; Courtney 2000); and facilitates recovery from problems associated with low back pain (Bhatti 1998), scoliosis, carpal tunnel syndrome, musculoskeletal injury or surgery, and sports injuries. These techniques have also been used successfully to improve balance (Queiroz et al. 2007) and improve symptoms associated with chronic disorders such as rheumatologic diseases, fibromyalgia (Berman and Singh 1997), and arthritis. Tai chi has been show to improve osteoarthritis symptoms, self-efficacy, tension levels, and satisfaction with general health status (Hartman et al. 2000). Tai chi has also been shown to increase lower-extremity muscle strength and endurance (Lan 2000).

Tai chi and Ai Chi follow the same precepts of slow, fluid, rhythmic movement with controlled breathing that can positively affect postural stability and falls in the elderly. Several studies have examined the effects of tai chi on balance and on the risk of falls in older people. In one survey of people age 70 and older, those who participated in tai chi training reported improvements in their daily activities, whereas others who participated in balance training alone reported no such improvements (Natural Standard). A 2004 study clearly demonstrated that tai chi training could lead to statistically significant improvements in functional balance in older persons (Li 2004). In another study, researchers observed that tai chi practice is valuable for improving physical balance (Tsang and Hui-Chan 2005).

Long-term practice of tai chi can improve muscular strength in the lower body, particularly around the knees and ankles, as much as long-term jogging, according to another published study (Xu 2006). Another study found that tai chi participants had stronger feelings of self-efficacy and less fear of falling than did older adults who did not practice tai chi (Fuzhong et al. 2005). These findings are good news for older adults who are looking for gentle movement alternatives that provide powerful conditioning benefits.

Dynamic balance ability is an independent predictor of quality of life (Karinkanta et al. 2005), so if older-adult practitioners of tai chi are stronger, feel more confident, and experience less fear than their peers do, they are likely to experience a higher quality of life than those who do not have the same level of conditioning.

Ai Chi creates musculoskeletal benefits that are derived from the effects of buoyancy, gentle and controlled movement, and coordinated breathing. Clients who experience back, neck, or shoulder pain unresponsive to other interventions may find respiration to be the missing link. A key component of many head, neck, and shoulder pain syndromes may be secondary inspiratory muscle overuse (Gallagher 2005). Diaphragmatic breathing can cultivate relaxation, myofascial function, and lumbopelvic stabilization (Gallagher 2005). The stress response to pain traditionally increases muscle tension, which usually leads to more pain (Turner, Ersek, and Kemp 2005). Diaphragmatic breathing can decrease the stress response.

The Ai Chi coordination of breathing and movement allows muscles to produce graceful, flowing movements of the trunk and extremities. This activity can lead to development of core control and alignment for all movement, not only Ai Chi movements (Queiroz et al. 2007), if properly cued and trained (see figure 7.14). Alignment, balance, and stabilization skills can be improved with properly trained slow movement techniques (Tsang and Hui-Chan 2003, Yan 1998, Wolfson 1996, Wolf 1996). Balance learned in the water (an unstable medium) translates well to land.

Along with arthro-kinematic effects, the active Ai Chi motions recruit specific muscle groups and preserve the contractile property of soft tissues. Relaxation done before range of motion will minimize or eliminate monosynaptic spinal reflex (Pal, Velkumary, and Madanmohan 2004). Submerging the joints lessens the joint compression and edema (Cole and Becker 2004). The properties of water combined with the Ai Chi movements can improve range of motion and overall mobility. From a musculoskeletal viewpoint, range of motion is an effective means of maintaining the integrity of connective and soft-tissue structures.

Cardiopulmonary, Vascular, and Metabolic
Positive cardiovascular effects have been found in studies of tai chi training (Lai et al. 1995). Studies of physiological measures during cycle ergometry have shown that oxygen uptake and work rate in the tai chi group were significantly higher than in the control group. Other studies have shown increased cardiorespiratory function, soft-tissue flexibility, and increased strength in community-dwelling older persons who participated in tai chi one to four times per week (Schneider and Leung 1991).

Practice of the slow movement techniques and diaphragmatic breathing has been shown to activate the parasympathetic inhibitory nervous system, decrease heart rate, decrease blood pressure, improve respiratory and cardiovascular function, decrease oxygen consumption (Lai et al. 1995; Jerath 2006; Bowler, Green, and Mitchell 1998; Fried 1993; Pal, Velkumary, and Madanmohan 2004), create a neutral respiratory quotient, and decrease blood lactate and blood lipid levels (Chopra 1989; LaForge 1997; Moyers 1993). Diaphragmatic breathing has been shown to decrease autonomic instability and improve heart rate variability (Pal, Velkumary, and Madanmohan 2004).

A stress response produces increased respiratory rate, decreased tidal volume, and a shift to thoracic breathing. Ai Chi breathing can inhibit neural responses (Gatti 2003). Eliciting a parasympathetic or inhibitory response will enhance vagal modulation, decrease heart rate, and improve respiratory synkinesis (Courtney 2000), thus improving breath function. Clients with respiratory impairments that affect their ventilation can benefit significantly from the synchronized Ai Chi breathing cycle (Vargas 2006). Research has shown that implementation of diaphragmatic breathing exercises decreased postoperative complications in patients who underwent cardiac or pulmonary surgery (Chumillas et al. 1998; Vraciu and Vraciu 1977).

Decreased blood pressure and anxiety are a result of the relaxation that accompanies diaphragmatic breathing (Cheung 2005; Gatti 2003). Essential hypertension (high blood pressure of unknown cause) is common in our society. The Ai Chi breathing mode of treatment is beneficial in decreasing essential hypertension. Research has shown that blood pressure decreases by 3 to 15 mm Hg in studies of regular diaphragmatic breathing exercises (Grossman et al. 2001; Schein et al. 2001). The breathing, however, must flow and be continuous. Breath holding creates detrimental effects on the heart and overall health, including elevated blood pressure and a decrease in blood oxygen levels.

Psychological, Neurobiological, and Cognitive
The practice of slow movement techniques with diaphragmatic breathing increases alpha electroencephalogram activity; produces right hemispheric activation; decreases sympathetic nervous system arousal and increases awareness; decreases hypothalamic–pituitary–adrenal activation (Martinsen 1993; Miller, Fletcher, and Kabat-Zinn 1995; Wang et al. 1993; Dychtwald 1986; Courtney 2000; Singh 1998; Ross 2001); and improves the psychological state associated with chronic diseases, anxiety and depressive disorders, anger management, and stress-related dysrhythmias. Stress can contribute to problems such as back pain, neck tension, headaches, fibrocystic nodules, muscle spasms, indigestion, heartburn, stomach ulcers, palpitations, shoulder and upper-chest pain, insomnia, disturbed sleep patterns, anxiety, depression, breathlessness, nausea, and fatigue (Rakel and Mercado 2007). Diaphragmatic breathing has been shown to decrease the stress response and alleviate depression, anxiety, and insomnia (Rakel and Mercado 2007; Tweddale, Rowbottom, and McHardy 1994; Cholz 1995). Stress increases muscular tension and vasoconstriction, thus decreasing blood flow throughout the body (Rakel and Mercado 2007). Tension in the neck causes muscular neck pain and headaches, tension in the stomach affects digestion, and tension in the body increases blood pressure. Relaxation through diaphragmatic breathing reduces blood pressure and the workload on the heart and decreases muscular tension.

Researchers attribute gains in brain function to the amount of oxygen that the brain receives during movement. The brain uses the glucose that it receives (delivered by the oxygen) as fuel for thought. Movement increases production of a brain chemical called brain-derived neurotrophic factor (BDNF), which stimulates the growth of nerve cells in the brain and curbs the development of Alzheimer’s disease as well as other age-related brain degeneration (Astin et al. 2003). Water, movement, and music are used to encourage a state of relaxed awareness. With increased awareness, the breathing and relaxation learned in Ai Chi can be transferred to other life situations. If the breathing and relaxation associated with Ai Chi can be used to aid healing when they are simply remembered, the actual Ai Chi session is doubly valuable.

Endocrine
Practicing slow movements with diaphragmatic breathing has been shown to decrease epinephrine, cortisol, serum growth hormone, thyroid-stimulating hormone, prolactin, adrenocorticotropic hormone, and beta-endorphin (Arpita 1982; Monroe, Ghosh, and Kalish 1989; Morales 1994; Keleman 1989; Gallagher 2005; Sancier 1996). An endogenous opioid is an endorphin that is a product of the endocrine system (Farrell 1986). It is a hormone that has a biochemical similarity to drugs like morphine. The endorphins are best known for their analgesic qualities and their assistance with mood control. Other effects that are more widespread include the regulation of appetite, temperature, and respiration (Hoffmann 1997; Rama 2007). Improvements in immune system functioning, weight maintenance, and overall disposition because of hormone regulation can be side benefits from the practice of Ai Chi.

Staying Active with Rheumatoid Arthritis

2009-06-12T08:57:00.003+03:00

Exercising, without a doubt, has many benefits for everybody, no matter the age. However, when joint stiffness and battling pain becomes a daily burden, it is understandable that people who suffer from rheumatoid arthritis think twice about exercising. Why cause more soreness in the muscles and pain in the joints to the already aching body?

Rheumatoid arthritis is usually diagnosed with taken x-rays by a physician who looks for joint inflammation and deformity, nodules of the skin, and other inflammation in other parts of the body. A final diagnosis will be based on a pattern of symptoms, such as the symmetrical distribution of inflamed joint. A blood test will also confirm an abnormal antibody count in patients with arthritis.
Rheumatoid arthritis inflammation comes and goes. When the disease is flaring up, it is usually accompanied by fatigue, low energy levels, loss of appetite, fever, joint pain and stiffness. This occurs mostly in the morning and movement is gained throughout the day. About 1.3 million Americans are diagnosed with rheumatoid arthritis, with women three times more affected than males.
Chronic inflammation can lead to cartilage and bone damage, as well as muscle weakness. But regular exercise can help you stay healthy and increases your sense of well being, despite this painful disease.

There are three fitness components that should be focused on: flexibility, strength training and cardiovascular exercises.

Flexibility includes moving each joint through the full range of motion to increase your mobility in each joint. A flexible joint reduces the risk of injury and helps in daily functional tasks.

Strength training or resistance exercises will strengthen the muscles and ligaments around the joint. Therefore, any muscle weakness that would naturally occur will be counteracted. Stronger muscles are less likely to get injured compared to weaker muscles. Depending on severity of arthritis, isometric exercises are better to start with than isotonic. Isometric exercises are basically exercises where there is no joint movement, but the muscles are still working. For instance, pressing the palms of both hand together will engage the muscles and increases strength. The increase of strength, however, is limited and eventually strength training through the range of motion (isotonic) should be included.
Walking is the first step to improve cardiovascular fitness. This weight bearing exercise helps to build muscles and stamina at the same time.
Exercises such as water aerobics, swimming and biking are great, since those are non-weight bearing exercises. When the knees and hips are hurting, exercises that don’t carry your body weight might be helpful. They keep you moving without putting extra stress on the joints.
The properties of the water makes moving even more comfortable than walking on land. The water exerts resistance around all body parts and moving through it engages all muscles. In order, to get the cardiovascular benefit, it is important though, not to just float in the water. Getting the heart rate up and staying in your heart rate zone is most important for improvements. Note that for water exercising the heart rate is 15-20 beats lower than on land exercises due to water resistance.

Research: Thalassotherapy, Exercise and Education improve Fibromyalgia Symptoms

2009-06-12T07:46:00.006+03:00

Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life

Zijlstra TR, van de Laar MA, Bernelot Moens HJ, Taal E, Zakraoui L, Rasker JJ.
Department of Rheumatology, Medisch Spectrum Twente Hospital, Enschede, The Netherlands. t.r.zijlstra@worldonline.nl
April, 2005

OBJECTIVES: To study the effect of a combination of thalassotherapy, exercise and patient education in people with fibromyalgia.

METHODS: Patients with fibromyalgia, selected from a rheumatology out-patient department and from members of the Dutch fibromyalgia patient association, were pre-randomized to receive either 2(1/2) weeks of treatment in a Tunisian spa resort, including thalassotherapy, supervised exercise and group education (active treatment) or treatment as usual (control treatment).
Primary outcome measure was health-related quality of life, measured with the RAND-36 questionnaire. Secondary measures included the Fibromyalgia Impact Questionnaire, the McGill Pain Questionnaire, the Beck Depression Inventory, tender point score and a 6-min treadmill walk test.

RESULTS: Fifty-eight participants receiving the active treatment reported significant improvement on RAND-36 physical and mental component summary scales. For physical health, differences from the 76 controls were statistically significant after 3 months, but not after 6 and 12 months. A similar pattern of temporary improvement was seen in the self-reported secondary measures. Tender point scores and treadmill walk tests improved more after active treatment, but did not reach significant between-group differences, except for walk tests after 12 months.

CONCLUSIONS: A combination of thalassotherapy, exercise and patient education may temporarily improve fibromyalgia symptoms and health-related quality of life.

PMID: 15695301 [PubMed - indexed for MEDLINE]

read more on Fibromyalgia Syndrome (FMS) Study & Research

Balneotherapy at the Dead Sea for Knee Osteoarthritis

2009-06-11T07:41:00.004+03:00

Intermittent balneotherapy at the Dead Sea area for patients with knee osteoarthritis.

Sherman G, Zeller L, Avriel A, Friger M, Harari M, Sukenik S. Department of Medicine D, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
February, 2009

BACKGROUND: Balneotherapy, traditionally administered during a continuous stay at the Dead Sea area, has been shown to be effective for patients suffering from knee osteoarthritis.

OBJECTIVES: To evaluate the effectiveness of an intermittent regimen of balneotherapy at the Dead Sea for patients with knee osteoarthritis.

METHODS: Forty-four patients with knee osteoarthritis were included in a prospective randomized single-blind controlled study. The patients were divided into two groups:
Treatment group (n=24): treated twice weekly for 6 consecutive weeks in a sulfur pool heated to 35-36 degrees C
Control group (n=20): treated in a Jacuzzi filled with tap water heated to 35-36 degrees C.
Participants were assessed by the Lequesne index of osteoarthritis severity, the WOMAC index, the SF-36 quality of health questionnaire, VAS scales for pain (completed by patients and physicians), and physical examination.

RESULTS: A statistically significant improvement, lasting up to 6 months, was observed in the treatment group for most of the clinical parameters. In the control group the only improvements were in the SF-36 bodily pain scale at 6 months, the Lequesne index at 1 month and the WOMAC pain score at the end of the treatment period. Although the patients in the control group had milder disease, the difference between the two groups was not statistically significant.

CONCLUSIONS: Intermittent balneotherapy appears to be effective for patients with knee osteoarthritis.

PMID: 19432036 [PubMed - indexed for MEDLINE]

Positive & Negative Energy Effects on Water Crystals, Research by Dr. Masaru Emoto

2009-05-26T20:41:00.004+03:00

Research From Dr. Masaru Emoto, says that human thoughts are directed at water before it is frozen, images of the resulting water crystals will be beautiful or ugly depending upon whether the thoughts were positive or negative. Emoto claims this can be achieved through prayer, music or by attaching written words to a container of water. Since 1999 Emoto has published several volumes of a work titled Messages from Water, which contains photographs of water crystals next to essays and "words of intent".

Thalassotherapy for Fibromyalgia: Aquatic exercises in sea water vs. water pool

2009-05-26T19:11:00.008+03:00

A Randomized Controlled Trial Comparing Aquatic Exercises in Sea Water and Water Pool

The aim of this study was to evaluate the effectiveness of aerobic exercise in water pool compared with aerobic exercise performed in sea by women with fibromyalgia (FM).

A total of 46 patients were randomly allocated into two groups: pool group (23 patients) and sea group (23 patients) that performed the same aerobic exercise program.
Patients were evaluated baseline and after 12 weeks using: VAS, number of tender points, FIQ (Fibromyalgia Impact Questionnaire), SF-36 (short-form health survey), PSQI (The Pittsburgh Sleep Quality Index) , and BDI (Beck Depression Inventory). Both groups improved significantly in post-treatment for all the evaluated variables.

There were no significant differences between two groups, except for BDI (F=2.418, P<0.0001). href="http://www.ncbi.nlm.nih.gov/pubmed/18600327">PMID: 18600327 [PubMed - indexed for MEDLINE]

de Andrade SC, de Carvalho RF, Soares AS, de Abreu Freitas RP, de Medeiros Guerra LM, Vilar MJ. Division of Rheumatology, Department of Clinical Medicine, Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil. sandra.andrade.fisio@gmail.com

Water Exercise and Fibromyalgia Pain

2009-05-25T10:48:00.008+03:00

Water exercise or water aerobics is the easiest workout for people with fibromyalgia pain

Warm water can be very comforting. The exercise gets blood flow to muscles and tendons. And if you're in the water, your joints are not being stressed during exercise. Water offers resistance, which helps muscles get stronger.
You don’t need to know how to swim for a water exercise class. In some classes, you work out in shallow water with your head completely above water. In other water aerobic classes, you bob in deep water (with foam belt or life jacket).
The natural buoyancy of water helps you move so you can do exercises that would otherwise be painful. These exercises can be done with an instructor or physical therapist in a heated facility or in a pool.
We're talking 30 minutes, four times a week. That's all. It can make a big difference.

What is hydrotherapy?

2009-05-22T16:49:00.000+03:00

The benefits of “water healing,” or hydrotherapy have been recognized for thousands of years.
Water healing is one of the oldest, cheapest and safest methods for treating many common ailments. We know from personal experience that water is not just for cleansing, but for making us feel better. When you settle into that tub of hot water, after a strenuous day, you know you’ll feel much better when you’re done, for hot water relieves fatigue and prevents stiffness.

Water healing at home couldn’t be simpler. Walk-in baths are good for whole body treatments. In the whole body treatment, the water has to come to shoulder level. You will also be treating your bottom, hips, and lower abdomen. Then there is the foot bath, the vapor bath, and various others concentrating on specific parts of the body. Adding various healing herbs to the water increases the value of the bath.

The Full Bath should be about 90 to 95F (32 to 35C) and shoulder deep. A warm bath is soothing to the nerves and helpful for bladder and urinary problems, mild colds, and low fevers. Adding herbs helps to soften and moisturize, and can stimulate or relax. The hot bath should last at least 20 minutes.

Hydrotherapy is especially beneficial for ailments affecting the abdomen and the reproductive system, inflammations, pelvic congestion, cramps, hemorrhoids, menstrual problems, and kidney and intestinal pains.

For tired feet, a warm Hydrotherapy foot-bath is recommended. While an alternating hot and cold foot-bath is said to promote circulation in the legs, help varicose veins, insomnia, headache and high blood pressure.

Remember that the application of heat is soothing, easing muscle tension and relieving pain. Heat also improves circulation by causing blood vessels to dilate. Cold can either be stimulating or soothing.

Water healing is helpful in maintaining metabolic function, and in making us feel much better, and is easily accomplished right in our own homes.

You can use baths to either immerse the entire body or simply the affected body part. Hot full-immersion baths can help with arthritic discomfort and conditions where muscles are in painful spasm, such as fibromyalgia. For a neutral (or tepid) bath the temperature should be neither too hot nor too cold. These are mainly used for relaxation purposes and to treat stress-related ailments such as insomnia, anxiety, and nervous exhaustion. Cool baths can relieve irritation and itching caused by hives or other skin disorders.

Serotonin in Fibromyalgia and Chronic Fatigue Syndrome

2009-05-22T12:32:00.003+03:00

Serotonin is a neurotransmitter that helps regulate a lot of your bodily functions. Along with melatonin, serotonin is especially involved in your sleep cycle. Melatonin helps you fall asleep, while serotonin helps you wake up feeling refreshed. At least, that's what serotonin and melatonin do in people who are fortunate enough to have the right amount.
A growing pool of research suggests that people with fibromyalgia (FMS) may have low levels of serotonin. Experts are split, however, as to whether serotonin levels are high or low in people with chronic fatigue syndrome (CFS or ME/CFS). Some studies show that the problem in ME/CFS may lie in low serotonin-receptor activity, which could mean that the brain isn't using serotonin properly, even if plenty is available.

Low Serotonin
No neurotransmitter acts alone. They all work together in a complex web of activity that scientists are really just beginning to understand. Still, experts have been able to associate different neurotransmitter imbalances with certain conditions and symptoms and find some ways to help boost or decrease activity.
Serotonin activity takes place in several areas of your brain, and even elsewhere around the body (where it acts as a hormone). Those different areas of your brain use serotonin differently, and they also contain several different kids of receptors that also influence how serotonin is used.
Low serotonin levels are associated with many physical and psychological symptoms. Examples of physical symptoms include:

Fatigue in spite of adequate rest
Disturbed sleep
Changes in appetite
Hot flushes and temperature changes
Headaches

Examples of psychological symptoms include:

Changes in libido
Mood disturbances
Depression
Irritability

When serotonin levels are extremely low, additional symptoms may include:

Muscle cramps
Bowel & bladder problems
Rapid, uncontrolled thought processes
Emotional numbness
Emotional or behavioral outbursts
Escape fantasies
Memory torture (dwelling on or reliving your most traumatic experiences)
Thoughts of harming yourself or others

Several disorders improve with medicines that increase the availability of serotonin, including depression, insomnia, restless leg syndrome, irritable bowel syndrome, headaches, obsessive-compulsive disorder, anorexia, bulimia, social anxiety, phobias, Attention Deficit Disorder (ADD/ADHD), post-traumatic stress disorder, and alcoholism.

High Serotonin Levels & Serotonin Syndrome
Naturally occurring high levels of serotonin aren't associated with many symptoms. However, taking too much of a drug that raises serotonin levels can cause a dangerous condition called serotonin syndrome. If you suspect serotonin syndrome, you should get emergency medical help as soon as possible.
Symptoms of serotonin syndrome include:

Confusion
Agitation
Profuse sweating
High fever
Muscle rigidity
Fluctuating blood pressure

With treatment, serotonin syndrome typically resolves within a few days. In rare cases, it can be fatal.

Increasing the Availability of Serotonin
Several prescription drugs on the market increase the amount of serotonin that's available to your brain. In people with FMS and ME/CFS, the most common ones are selective serotonin re-uptake inhibitors (SSRIs), such as Prozac (fluoxetine), Paxil (paroxetine) and Zoloft (sertraline); or serotonin norepinephrine re-uptake inhibitors (SNRIs) such as Cymbalta (duloxetine) and Savella (milnacipran), which are two of only three FDA-approved fibromyalgia treatments.

If you prefer natural treatments, several dietary supplements have been linked to higher available levels of serotonin. They include:

SAM-e
5-HTP
St. John's Wort
Rhodiola rosea

The simplest way to boost serotonin levels is by getting more sunlight.
There are not a lot of research confirming that food can boost serotonin levels in your brain, and it could take prohibitively huge amounts to have the desired effect. Some that are commonly believed to help include:

Carbohydrate-rich foods, especially before bed (for an energy boost during the day, add protein)
Complex carbohydrates, including grains, beans and many starchy foods
Watermelon
Dark chocolate (only in small amounts)

By Adrienne Dellwo, January 26, 2009

Sources:

Amino Acids. 2008 Jan 15. [Epub ahead of print] All rights reserved. "Theanine, gamma-glutamylethylamide, a unique amino acid in tea leaves, modulates neurotransmitter concentrations in the brain striatum interstitium in conscious rats."
Goldstein, J. Alasbimn Journal2(7): April 2000. AJ07-5. "The Pathophysiology and Treatment of Chronic Fatigue Syndrome and Other Neurosomati Disorders: Cognitive Therapy in a Pill."
Psychoneuroendocrinology. 2008 Feb;33(2):188-97. All rights reserved. "Genetic evaluation of the serotonergic system in chronic fatigue syndrome."
2007 The Trustees of Columbia University. All rights reserved. "Serotonin and foods?"

Fibromyalgia and Low Dopamine Levels

2009-05-22T11:53:00.008+03:00

Dopamine is a neurotransmitter that is produced in several areas of the brain, including the substantia nigra and the ventral tegmental area. Dopamine is also a neurohormone released by the hypothalamus. Its main function as a hormone is to inhibit the release of prolactin from the anterior lobe of the pituitary.

Dopamine has many functions in the brain, including important roles in behavior and cognition, voluntary movement, motivation and reward, inhibition of prolactin production (involved in lactation), sleep, mood, attention, and learning.

Processing of pain
Dopamine has been demonstrated to play a role in pain processing in multiple levels of the central nervous system including the spinal cord, periaqueductal gray (PAG), thalamus, basal ganglia insular cortex and cingulate cortex. Accordingly, decreased levels of dopamine have been associated with painful symptoms that frequently occur in Parkinson's disease. Abnormalities in dopaminergic neurotransmission have also been demonstrated in painful clinical conditions, including burning mouth syndrome, fibromyalgia and restless legs syndrome.
People with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) generally have low dopamine levels as well. Symptoms of both conditions include both cognitive effects as well as movement and balance problems.

Low Dopamine
No neurotransmitter acts alone. They all work together in a complex web of activity that scientists are really just beginning to understand. Still, experts have been able to associate different neurotransmitter imbalances with certain conditions and symptoms and find some ways to help boost or decrease activity.
Low dopamine levels are associated with the following symptoms:

Stiff, rigid, achy muscles
Tremors
Impaired fine motor skills
Cognitive impairment
Inability to focus attention
Poor balance and coordination
Strange walking pattern (gait), frequently with small steps

High levels of dopamine, on the other hand, are associated with addiction, euphoria, hyperstimulation, excessive focus, suspicion, and the inability to separate what is important from what isn't. If you're taking medication that increases your dopamine levels, you should let your doctor know if you have symptoms of high dopamine, which is associated with psychological side effects.
Neuroleptic (antipsychotic) drugs lower dopamine levels.

Increasing the Availability of Dopamine
Drug treatment of low dopamine levels may include stimulant therapy with Ritalin, Concerta and Methadate (all of which contain methylphenidate).
There are not a lot of research confirming that food can boost dopamine levels in your brain, and even if it can, it would take prohibitively huge amounts to have the desired effect. In spite of the lack of hard evidence, some practitioners recommend:

Tea (black or green)
Apples, bananas & watermelon
Blueberry extract
Red wine
Beets, beans & legumes
Chicken
Cheese
Eggs
Fish
Wheat germ

Supplements believed to help raise dopamine levels include:

NADH
L-Theanine (supplement form of amino acid unique to black and green tea)
Omega-3 fatty acids, from fish oil or flax seed oil
Rhodiola rosea

A note on tea & theanine: Studies show theanine increases both norepinephrine and dopamine while lowering glutamate levels, all of which can have a positive effect on those of us with FMS and ME/CFS. Research is mixed, however, on how theanine impacts serotonin levels. If you decide to try theanine, track your symptoms to see if serotonin-related symptoms get worse.
While it's generally safe to experiment with these kinds of foods, don't expect miracles and avoid extreme changes to your diet. Be sure to make changes slowly, and track your dietary changes and symptoms in a symptom journal to get an accurate gauge of what may be helping. You should always work with your doctor to decide what methods to try and how successful your treatments are.

Sources:

Amino Acids. 2008 Jan 15. [Epub ahead of print] All rights reserved. "Theanine, gamma-glutamylethylamide, a unique amino acid in tea leaves, modulates neurotransmitter concentrations in the brain striatum interstitium in conscious rats."
Goldstein, J. Alasbimn Journal2(7): April 2000. AJ07-5. "The Pathophysiology and Treatment of Chronic Fatigue Syndrome and Other Neurosomati Disorders: Cognitive Therapy in a Pill."
Nutritional neuroscience. 2006 Oct-Dec;9(5-6):251-8. "Dietary supplementation with blueberry extract improves survival of transplanted dopamine neurons."
Progress in neuro-psychopharmacology and biological psychiatry. 2008 Jul 1;32(5):1243-50. Epub 2008 Apr 7. "Resveratrol, a red wine polyphenol, protects dopaminergic neurons in MPTP-treated mice."
Psychoneuroendocrinology. 2008 Feb;33(2):188-97. All rights reserved. "Genetic evaluation of the serotonergic system in chronic fatigue syndrome."
wikipedia

Watsu Therapy can bring relief form Fibromyalgia

2009-05-19T06:15:00.005+03:00

One form of fibromyalgia treatment that is being used to treat common fibromyalgia symptoms is Watsu. This form of therapy is the latest treatment for fibromyalgia and can bring relief from a variety of fibro symptoms. Watsu therapy can provide individuals with relief from fibromyalgia; but what exactly is Watsu therapy and what kind of symptoms can this fibromyalgia natural treatment help to alleviate?

What is Watsu Therapy?
How Does Watsu Therapy works?
Health Benefits of Watsu Therapy

Fibromyalgia Syndrome and Watsu Therapy
Watsu therapy can be effective in the treatment of fibromyalgia because it helps to alleviate common fibromyalgia symptoms such as widespread pain, muscle twitching and weakness, as well as promotes relaxation.
In addition to being an increasingly popular alternative fibromyalgia treatment, Watsu is also used to treat such conditions as: arthritis, post-traumatic stress disorder. It can also be used as part of post-mastectomy therapy.

read more about:

Effects of Pool-based Exercise vs. Balneotherapy on fibromyalgia patients

2009-05-15T12:14:00.012+03:00

Altan L, Bingöl U, Aykaç M, Koç Z, Yurtkuran M.
Rheumatic Disease and Hydrotherapy Section, Uludağ University Medical Faculty, Atatürk Rehabilitation Center, Bursa, Turkey. lalealtan@uludag.edu.tr
Sep, 2004

OBJECTIVE:
The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome (FMS) patients.

METHODS:
Fifty female patients diagnosed with FMS according to the American College of Rheumatism (ACR) criteria were randomly assigned to two groups: group 1 (n=25) with pool-based exercise, and in group 2 (n=25) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks. In both groups, pre- (week 0) and post-treatment (weeks 12 and 24) evaluation was performed by one of the authors, who was blind to the patient group.
Evaluation parameters included:

pain
morning stiffness
sleep
tender points

by:

global evaluation by the patient and the physician
fibromyalgia impact questionnaire
chair test
Beck depression inventory

Statistical analysis was done on data collected from three evaluation stages.

RESULTS:
Twenty-four exercise and 22 balneotherapy patients completed the study.
Pretreatment (week 0) measurements did not show any difference between the groups.
In group 1, statistically significant improvement was observed in all parameters ( P<0.01) style="color: rgb(255, 102, 0);">CONCLUSION:
The results of our study showed that pool-based exercise had a longer-lasting effect on some of the FMS symptoms, but statistical analysis failed to show a significant superiority of pool-based exercise over balneotherapy without exercise. While we believe that exercise is a gold standard in FMS treatment, we also suggest in light of our results that balneotherapy is among the valid treatment options in FMS, and further research regarding the type and duration of the exercise programs is necessary.

PMID: 14508601 [PubMed - indexed for MEDLINE]

Aquatic Therapy Effects on Fibromyalgia Symptoms

2009-05-15T07:18:00.005+03:00

Munguía-Izquierdo D, Legaz-Arrese A.
Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.
Dec, 2008

OBJECTIVES:
To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia (FM) and to determine exercise adherence levels.

DESIGN:
A randomized controlled trial.

SETTING:
Testing and training were completed at the university.

PARTICIPANTS:
Middle-aged women with FM (n=60) and healthy women (n=25).

INTERVENTION:
A 16-week aquatic training program, including strength training, aerobic training, and relaxation exercises.

MAIN OUTCOME MEASURES:

Tender point count (syringe calibrated)
health status (Fibromyalgia Impact Questionnaire)
sleep quality (Pittsburgh Sleep Quality Index)
physical (endurance strength to low loads tests)
psychologic (State Anxiety Inventory)
cognitive function (Paced Auditory Serial Addition Task)
adherence 12 months after the completion of the study.

RESULTS:
For all the measurements, the patients showed significant deficiencies compared with the healthy subjects.
Efficacy analysis (n=29) and intent-to-treat analysis (n=34) of the exercise therapy was effective in:

decreasing the tender point count
improving sleep quality
improving cognitive function
improving physical function
Anxiety remained unchanged during the follow-up.

The exercise group had a significant improvement of health status, not associated exclusively with the exercise intervention. There were no changes in the control group. Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program.

CONCLUSIONS:
An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology. The therapeutic intervention's effects can be assessed through applicable tests in the clinical practice.

PMID: 19061736 [PubMed - indexed for MEDLINE]

Laughter Yoga And Arthritis

2009-05-14T04:37:00.002+03:00

Laughter may not be the most scientific alternative, yet it has proved right the old adage that it is the best medicine. A good laugh has the ability to ease pain as a result of disease or injury.

Laughter offers respite from arthritis stress and provides both physical and mental relief.
Approximately 350 million people worldwide have arthritis and almost the same number suffers from spondylitis. Nearly 40 million persons in the United States alone are affected by arthritis, including over a quarter million children!

Both arthritis and spondylitis are debilitating disorders with inflammation of the joints. Arthritis is frequently accompanied by joint pain and the common symptoms include pain and limited function of joints. Inflammation of the joints in arthritis is characterized by stiffness, swelling, redness, and warmth.

The most common form of arthritis is osteoarthritis caused by the wear and tear of cartilage and the other is other is rheumatoid arthritis which is an inflammation resulting from an overactive immune system. Among the spondylitis family, Anklyosing spondylitis is the primary disease and is a form of chronic arthritis that primarily affects the spine.

Documented research has proved that laughter has enormous benefits on one’s physical, mental and emotional health. It is more than just a physical response. It is a great workout that boosts the immune system, increases circulation and the threshold for pain.
Scientific studies show that laughter has positive effects on the heart, blood vessels, stress hormones, mental health and family relationships. These health benefits of laughter all contribute to smoother overall functioning, which in turn speeds injury healing and helps manage chronic pain.

Laughter Yoga And Arthritis
Laughter Yoga – a healing force
Laughter is a Natural Pain Killer
Laughter increases mobility

Laughter Yoga – a healing force

2009-05-14T04:36:00.003+03:00

Positive emotions: It has been proven by psychoneuroimmunologists that negative emotions, such as anxiety, depression and anger, weaken the immune system of the body, thereby reducing its capacity to fight infections. Laughter helps to increase the count of natural killer lymphocytes in the bloodstream and also to raise antibody levels.

Realizing the significance of laughter, Indian physician Dr. Madan Kataria started laughter clubs and developed Laughter Yoga, a unique exercise routine followed by millions worldwide. It combines laughter exercises with deep yogic breathing to provide a complete workout for health and wellness. People who participate in laughter clubs have reported remarkable reduction of pain and improvement in physical mobility and flexibility.

Laughter Yoga And Arthritis
Laughter Yoga – a healing force
Laughter is a Natural Pain Killer
Laughter increases mobility

Laughter is a Natural Pain Killer

2009-05-14T04:35:00.003+03:00

Laughter increases the levels of endorphins – the body’s natural pain killers. Norman Cousins, an American journalist who was suffering from an incurable disease of the spine, benefited from laughter therapy in a situation when all painkillers were ineffective. Cousins found that 10 minutes of laughter gave him an extra two hours of pain-free sleep.

Endorphins released as a result of laughter may help in reducing the intensity of pain in those suffering from arthritis, spondylitis and muscular spasms of the body. This provides immediate pain relief typically lasting for 2 hours. It can relieve headaches, muscular and joint pain and is powerful enough that a number of practitioners have undergone surgery using laughter instead of anesthetics!

The release of these beta endorphins also causes the adrenal glands to manufacture cortisol, which is natural anti-inflammatory and is wonderful for arthritis.

Laughter Yoga And Arthritis
Laughter Yoga – a healing force
Laughter is a Natural Pain Killer
Laughter increases mobility

Laughter increases mobility

2009-05-14T04:34:00.001+03:00

Arthritis is often aggravated by lack of exercise and movement, particularly later in life with retirement and reduced physical mobility. Laughter Yoga provides a complete massage of all mid-body organs and is the most effective method to promote circulation in the lymphatic system. The combination of natural pain killers with movements in laughter exercises makes Laughter Yoga a powerful tool for physiotherapy. Many practitioners have reported reversal of ‘frozen shoulder’ and other movement limitations due to stroke, arthritis, and injury.
Benefits of laughter have thus been recognized and prescribed. Belly laughter as practiced in Laughter Yoga is a great way of activating deep breathing facilitating better control of chronic diseases. Laughter is a safe, easy and economical method to enhance good health and longevity.

Laughter Yoga And Arthritis
Laughter Yoga – a healing force
Laughter is a Natural Pain Killer
Laughter increases mobility

Jahara Therapy (video)

2009-02-11T18:00:00.001+02:00

Watsu Therapy - Part 1 (video)

2009-02-11T15:23:00.001+02:00

Watsu Therapy - Part 2 (video)

2009-02-11T15:21:00.001+02:00

Aquatic Therapy Benefits

2008-08-16T15:30:00.002+03:00

Aquatic therapy is an excellent therapeutic low impact activity for individuals of all abilities. Aquatic therapy activities can be done in either indoor or outdoor pool facilities and consist of cardiovascular endurance and conditioning exercises. These include walking, jogging, jumping, swimming, kicking, and other continuous rhythmic activities that elevate metabolism and improve cardiovascular function.

Benefits of Aquatic Therapy

Improves muscle tone and strength.
Improves endurance.
Increases cardiovascular function.
Improves self esteem.
Reduction in gravitational force provides therapeutic benefits.
Provides psychological benefits.
Overall improvement in quality of life.
Increased circulation, endurance, flexibility, range of motion, balance, and coordination.

Buoyancy
Acts as support for the spine or extremity that may be weakened due to disease, injury, surgery, or immobilization.
Makes it possible for people to achieve a position of comfort for exercise not possible on land.
Flotation devices and "noodles" help individuals with disabilities maintain buoyancy.

Benefits of Shallow Water Walking

Increased metabolism and strength.
Reduction of muscles that have atrophied due to injury, illness, or general use.
Improved balance and coordination.
Recreation and socialization.
Water walking requires no swimming ability, which makes it possible for non-swimmers to participate.

Benefits of Deep Water Running

Reduction in force to joints makes this activity mostly pain free.
Mainly used for back rehabilitation programs to develop muscular and cardiovascular endurance.

Benefits of Hydrostatic Pressure

Helps reduce blood pressure in those with hypertension while exercising in the water due to the effects of hydrostatic pressure.
Edema of lower extremities is relieved during physical activity in water.

Aquatic therapy also has been shown to reduce levels of spasticity among individuals undergoing rehabilitation.

The Jahara Technical Development History

2008-08-14T11:07:00.005+03:00

Jahara® development begun in 1995, when Mario Jahara was hired as an aquatic specialist by an upscale resort in Southern California.

Mario was then a successful author, with 2 body-therapy books released in Portuguese, and an advanced Shiatsu and aquatic-bodywork teacher. He had extensive training in body-structure related methods, including the work of Françoise Mézières and Frederick Matthias Alexander.

His aquatic training at the time, although extensive, proved inadequate to his professional day-to-day needs. After injuring his back while treating a heavier client, Mario started to experimentally use a Styrofoam flotation device in his sessions. This flotation device was to became Jahara's characteristic Third Arm.

Mario also developed a series of moves using his legs to support the client. This technique avoided lifting the client out of the water while doing many maneuvers. He called this class of movements Saddles.

At the time he also developed the TCS (Triangular Cervical Support) — one of the signature methods of Jahara® — as a way to protect the neck of his clients while floating them.
Jahara® was first demonstrated to a group of aquatic therapists in May 1996, in Berkeley, California, USA. The original, anatomically-sound techniques presented instantly captured the interest of the students.

That first introductory class quickly became a fully-fledged program — initially offered in several states in the USA, and then internationally.

Today, Jahara® is considered a most influential method. Many of its original ideas and techniques, like the Saddles, Aquatic Footwork™, TCS™ and ActivExercises™ were adopted, to some extent, by other aquatic bodywork methods.

Jahara® was born based in clear principles, and the soundness of its methodology has been attested by the countless well-known aquatic teachers and professionals who have honored us as students.

The Jahara

2008-08-14T11:02:00.003+03:00

Jahara® is an aquatic therapy method founded in body awareness, healthy body mechanics and the gentle power of water. It consists of micro-adjustments of the structural alignment of the body.

These adjustments are done through the ActivExercises™ and Aligned Floating™ — when the Jahara® Specialist floats the client utilizing a number of slow, continuous circular movements.

Jahara's gradual, purposeful movements, together with the warm water, bring about relaxation and a feeling of well-being to the client.

Jahara® brings about an overall sense of expansion. Aided by a flexible flotation device, called the Third Arm™, the Jahara® Specialist provides precise support to the body structure. This support, combined with gentle traction, elongates the spine and decompresses the neuro-musculoskeletal system.

Jahara® is rooted on the understanding of two fundamental elements: the body structure and the unique physical properties of water.

This understanding is basic to healthier body mechanics. It means sound, safe treatments for clients, and is the key that enables the aquatic specialist to work regularly for many years feeling better and better in their own body.

The Jahara® Program is designed to help students develop their kinesthetic sense and learn to work in the water without effort by relying on practical knowledge rather than physical strength. Ultimately, this effortlessness makes the Jahara® Specialist "invisible" in their practice, allowing the gentle power of water to become the foreground.

Healing power of water

2008-08-10T13:34:00.003+03:00

Drink at least two litres a day and you will soon see the difference - glowing skin, weight loss, less cellulite, better immunity and a huge boost to your energy levels'

Water is one of the most basic things on Earth and essential to good health, yet we thoughtlessly throw away gallons every day. Used properly, water can revolutionise our lives.

We need the liquid for day-to-day survival, yet we often ignore our body's cries for more water, at a grave cost to health and well-being.

It is estimated that 90% of us are chronically dehydrated. Drink just five glasses of water per day and you will cut your risk of developing breast cancer by 79%. The same amount of water will make you 45% less likely to develop cancer of the colon.

Many of the common complaints which plague most people's lives, such as tiredness, headaches, dry skin, low immunity, cellulite, indigestion and weight gain, are caused by day-to-day dehydration.

If you suffer from one or more of these conditions, you may change the quality of your life immeasurably simply by ensuring you drink two litres of water a day.

Being properly hydrated will help to keep you in peak health. Our bodies are 75% water, but if this level drops by just 2% then we become dehydrated. As soon as this happens, our bodies slow down and begin to operate less efficiently.

A detox give the body a chance to rest so it can cleanse itself. In just 18 days on the Water Detox programme, your body can effectively start again with a clean slate, feeling fabulous.

The Water Detox will help you to tackle health problems - from niggling persistent tiredness or wrinkled skin to more long-term concerns such as weight gain and high blood pressure.

The secret of the detox is simply in the quantity of water you consume. As well as drinking two litres a day, you get an additional litre from food on a nutritional plan which contains at least 50% water.

Once you begin to drink the correct amount of water, you will soon notice improved levels of energy, glowing skin, weight loss, reduction in cellulite and an improved immune system.

It does not matter whether you drink bottle or tap water, but bottle flavoured waters are not permitted on the Water Detox because they almost certainly will be full of sugar and artificial flavours.

It should take you only two or three days to get used to drinking the correct amount of water. To get the best results, you will need to follow a few simple rules:

Drink at least two litres of water a day.
On a hot day, increase the daily amount by at least half a litre. Make sure at least one-and-a-half litres of the water is still (not sparkling) water.
The water should be fresh and, ideally at room temperature.
Spread your water intake over a day, ideally drinking a glass an hour.
When you exercise, drink throughout the workout and afterwards. This extra water is in addition to your two daily litres.
Coffee, tea, alcohol and fruit cordials do not count as water.
As soon as you get up, drink a glass of water to rehydrate you from the night before.
Drink a glass of water before lunch and supper to dampen your appetite and to stop you from drinking water with your food, which decreases the absorption of nutrients.
Make sure you have had at least 1½ litres of water before 6pm.

The 18-day Water Detox Programme

It is vital to drink enough water and to eat the right foods to get the most benefit from the detox.

Certain food types contain up to 50% water, and in some cases up to 95%. Concentrating on these foods will lead to the best nutrition and hydration, though you still need to drink at least two litres of water a day.

You should not eat anything that is not on the programme because this may slow the process or even reverse it. You should particularly avoid diuretics, as they could cause you to lose the same volume of water and more. These include alcohol and drinks containing caffeine, such as colas, coffee and tea.

Exercise is important because it speeds up the cleansing process - but drink throughout your workout and consume at least an extra litre of water per hour of exercise.

When we sleep, we lose water through sweating and the normal metabolic processes. So start the day with a large glass of water, followed by a breakfast which is high in water content. Yogurt and fruit are excellent. Make the first meal of the day 'high hydration'.

It is also advisable to exclude certain herbs, such as juniper, dandelions and nettle teas, which encourage the body to expel fluids.

Also avoid foods such as curries and spices which increase body heat and use more fluids than normal.

During the 18-day water detox, you can eat oily fish, oils, yogurts, potatoes, beans and pulses, vegetables, fruits, rice and salads.

For each of the 18 days, you should drink at least two litres of plain water and eat at least three full meals or five small meals a day. You must eat at least five portions of fruit, five portions of fish, beans or pulses, one portion of rice, and one portion of oil or cheese per day.

You can eat as much as you like of any food which is permitted, but this is the minimum that you should consume.

The cheeses and oils do not always have a 50% water content, but I have included them to ensure that you get a balanced diet. I recommend sheep's and goat's products rather than those made from cow's milk because they are much more easily digested by the human body and much easier to tolerate.

Eating raw foods will maintain fluid levels and help to preserve the nutrients. Aim to eat half of your foods each day raw.

To keep food succulent and with the right level of water, you must use the right cooking methods. Always try to use any of the juices, essences or fluids that come out of the foods for dressings, sauces or gravy to pour back over them. Steaming will also leave your food moist and juicy.

The best way to ensure you don't lose fluids during cooking is to add them. Choose stews, soups, smoothies and long drinks. Select the foods which you like best and find easier to prepare.

Eat your main meal during the day and not late in the evening. It is better to have four or five light meals a day than to have a huge plate of food three times a day, which can cause big surges and drops in energy and blood sugar.

If you are tempted to snack, remember that 75% of hunger pangs are requests from our bodies for water. Each time you feel hungry, have a glass of water. If, after 20 minutes, you are still peckish, then eat something, as long as your snack is one of the food allowed. Yogurt, hummus and crudites are a good idea.
The Water Detox diet is not a diet, but a healthy way to cleanse your body. It will also help you to lose any excess weight.
Extracted from Water Detox: Total Health and Beauty in 8 Easy Steps by Jane Scrivener

The facts about water

75% of our hunger pangs are signals of thirst
Our brain is 75% water
Blood is 92% water
Bones are 22% water
Muscles are 75% water
Brain cells are 82% water
Moderate dehydration can cause headaches and even dizziness
On hot days, sweating can cause you to lose up to 16 glasses of water a day
The body loses as much water when asleep as when awake
Mild dehydration slows the metabolism by as much as 3%
A 2% drop in hydration can slow mental recall

How it can effect your body
Drinking water improves the efficiency of all major body organs. The liver, lungs, skin, kidneys and intestines all use water as a vehicle for cleansing. Inadequate quantities of water slow the system down and can causes you to suffer from constipation, grey skin, infections and swollen glands.

Dehydration
Simple day-to-day dehydration can cause tiredness, bad circulation, high blood pressure, headaches, dizziness, aching joints, dry skin, urinary infections, slow metabolism, low immunity, stress, cellulite, weight gain and indigestion.

The Liver
The largest internal organ, the liver works to detoxify the body by taking in 'poisons' such as additives and alcohol. A severely overtaxed liver can lead to lethargy and, in extreme cases, jaundice.

The Kidneys
The kidneys cleanse the blood and regulate potassium and sodium levels. Overworked kidneys can cause tiredness, or, more seriously, kidney infections and kidney stones.

The Intestines
Food passes through the stomach into the intestines. The goodness is absorbed and waste eliminated. Digestion takes about eight hours from consumption to elimination in a healthy body, but more than 24 in a dehydrated one.

The Lymph System
Lymph, absorbs dead cells, excess fluids and other waste products and takes them to the lymph nodes, which are under your armpits and in the areas of your groin and knees. Here, the waste is filtered and eventually fed to the eliminatory organs - skin, liver or kidneys - to be passed out.

The Lungs
The lungs filter pollution and toxins, including cigarette fumes and chemicals from the air we breathe. The lungs are full of little air sacs which fill with inhaled air. The lungs then expel carbon dioxide and waste water.

The Skin
The skin sweats out waste products such as salt, uric acid, ammonia and urea. Its condition is an excellent indicator of the condition of internal organs. Spots and a pale skin can be one of the first signs that we have not been taking care of ourselves.

Fibromyalgia - Exercise in warm water is good start, study says

2008-06-05T09:39:00.004+03:00

by medical journalist Evra Taylor Levy and emergency physician Eddy

In the world of medicine, many diseases and conditions are clear-cut and relatively easy to diagnose and treat. Unfortunately, fibromyalgia isn't one of these, but the ambiguity of the symptoms doesn't diminish the very real pain its sufferers experience. This week's HealthWatch takes a closer look at this debilitating illness and some recent research that suggests relief might be found at the pool.

What is fibromyalgia?
Fibromyalgia is an increasingly common chronic condition that has stricken roughly 3% of world population. It afflicts women at least four times more often than men and often occurs after the age of 50, sometimes worsening with age.
It affects the muscles and tendons and ligaments, which connect muscles to bones. Its main symptoms are fatigue, muscle spasms, weakness, stiffness, and pain in the joints and muscles in areas of the body known as trigger points or tender points. Some of these are located in the neck, shoulder, back and thighs and can be extremely sensitive to even light touch. Rheumatologists, who are the doctors specialized in the care of this condition, make the diagnosis in part by probing these points: a painful reaction is often a sign of fibromyalgia.
There isn't one definitive cause of fibromyalgia, but physical trauma, like a car accident, can trigger it.

What is its impact on daily lives?
The effects of fibromyalgia are more than just physical; it also takes a huge emotional toll. Insomnia is common, along with the depression brought on by chronic pain and the social isolation of not being able to participate in one's usual activities. Loss of independence is also a factor. Time off work can have an enormous financial impact on fibromyalgia sufferers - as well as on society as a whole. A recent U.S. study of associated health-care expenditures reported virtually the same very high cost for fibromyalgia as for osteoarthritis, even though the latter is much more common.

How is it treated?
There's no cure for fibromyalgia, so the focus is on improving quality of life through symptom relief. Antidepressants are sometimes prescribed - they boost serotonin levels, acting as a mood-enhancer. Injections of painkillers or steroids in trigger points can also reduce pain. Walking or riding a stationary bike will improve endurance and boost energy, and low-impact aerobics can be useful if one's condition allows.

The study
Cost-utility of an eight-month aquatic training for women with fibromyalgia: a randomized controlled clinical trial, by Narcis Gusi, Arthritis Research & Therapy, February 2008.

Why are there possible advantages to a pool-based program?
When immersed in water to the level of the upper abdomen, a woman carries less than one-third of her real weight, thus enabling movements and promoting flexibility that might not be possible on land. Warm water is also immediately soothing to painful limbs. So for someone with fibromyalgia, exercising in a pool is both more feasible and more likely to result in benefits.

What kind of study was this?
Investigators in Spain and Portugal recruited 34 women with fibromyalgia and randomly assigned them to two groups. The 17 women in the study group underwent hour-long, supervised exercise training sessions (hydrotherapy) in a swimming pool for eight months. The 17 women in the comparison group performed their usual activities.

What were the main findings?
Patients in the swimming program had reduced pain, as well as increased strength, flexibility and endurance. They also had improved sleep, better mood and increased confidence in being able to perform their daily activities.
These researchers were also interested in the economics of this type of program. They conducted an analysis to determine whether the costs of an aquatic program are offset by the reduced health-care expenses (medications and doctor visits) and increased productivity through their ability to return to gainful employment. Here again, the authors concluded that hydrotherapy is beneficial and cost-effective. This is, of course, dependent on the availability of such a program, guided by a qualified instructor, access to a swimming pool, and whether registration is sufficient to make the program viable.

Are there any concerns with this study?
Although this is a small study, it's worth noting that hydrotherapy has been researched in eight other studies, all with fairly consistent results. One caveat is that these studies also suggest that the benefits partially fade after program completion and that either longer enrollment periods or long-term commitments might be necessary for sustained benefit.
One lingering concern is that since the patients in the comparison group did not interact socially with fellow fibromyalgia patients as did the ones in the study exercise group, many of the benefits noted in this study may have resulted from the social support received, instead of warm water and exercise. An earlier study, which gathered fibromyalgia patients in warm water baths without exercise in the control group, showed that the addition of exercise mediated the benefits seen.

So what should fibromyalgia patients do?
Unlike medications, which generally carry some risk of side effects, a warm water aqua-fitness program is unlikely to be harmful. The benefits of a regular exercise program, pool-based or not, have a clear-cut track record for improving one's general health. So if possible, this approach should be considered seriously in patients who have even a moderate case of fibromyalgia. Important considerations are that this study demonstrated positive results after an eight-month program in a pool set at 37 degrees. It's possible that shorter programs in cooler water might not work or work as well.

read more about:
Fibromyalgia Syndrome (FMS)
Fibromyalgia Syndrome (FMS) Study & Research
Thermal Aquatic Bodywork: Hydrotherapy, Aquatic Therapy or Water therapy
Aqua Aerobics
The Healing Power Of Water
The Healing Properties of Water

Fighting Sclerosis

2008-06-05T09:07:00.002+03:00

During the month-long awareness campaign about Multiple Sclerosis conducted in Pune-India, May 2008, hydrotherapy and yoga emerged as the major solutions to the problem.

Multiple Sclerosis awareness month was observed in May and several functions were held in the city towards the purpose.

Multiple Sclerosis (MS) is a chronic nerve disorder caused by destruction of the insulating layer (myelin sheath) surrounding neurons in the brain and spinal cord, say neurologists.

It is an autoimmune condition in which the immune system attacks the brain, leading to demyelisation that affects the central nervous system (CNS). Demyelisation occurs when the insulating layer surrounding neurons in the brain and spinal cord are destroyed. Nerve messages are sent more slowly and less efficiently, says Dr Sanjay Suratwala, spinal surgeon.

It may cause numerous physical and mental symptoms, and often progresses to physical and cognitive disability. Patches of scar tissue, called plaques, form over the affected areas, further disrupting nerve communication.

The name multiple sclerosis refers to the scars (scleroses - better known as plaques or lesions) in the white matter, he explains.

Most people have their first symptoms between the ages of 20 to 40; symptoms rarely begin before 15 or after 60. Women are almost twice as likely to get MS as men, especially in their early years. Interferon therapy when initiated early protects both the myelin sheath and neurons from early damage, thereby leading to better prognosis and a better quality of life.

According to neurologists, exercise can also help. Attitudes about exercise and MS have changed dramatically in the past few decades. More recently, on the basis of research that concluded that exercise provides multiple beneficial effects, appropriate forms of frequent exercise programmes are now strongly recommended for people with MS.

Exercise produced improvement in walking problems, muscle stiffness and weakness. There were also emotional benefits, such as decreased depression and anger.

Regular exercise may reduce low back pain and prevent osteoporosis, a decrease in bone density that may occur more frequently in MS.

There are many possible exercise programmes for people with MS. These may include stretching exercises, walking, running, swimming, and a whole range of other exercises that may be appropriate for all levels of physical functioning. In addition to these conventional methods, exercise may be obtained by unconventional approaches, such as yoga.

The two things that have helped a lot are:

Hydrotherapy: A form of exercise that is particularly helpful for some people with MS is hydrotherapy, or exercising in water. Hydrotherapy offers several benefits. A cool water environment may be a way to exercise without overheating. In addition, the buoyancy of the water provides support that makes movements easier and allows individuals to perform movements that they could not otherwise do on land.
Exercise is a simple approach that produces many health benefits and is generally safe. Working with a physical therapist or other appropriate professional may develop an exercise programme safely.

Yoga: Contrary to popular belief, the primary aim of yoga is not to assume the most extreme possible posture. Rather, the focus of yoga is on technique. Yoga may be modified so that people with severe arm or leg weakness, pain or other limitations, may do it. Yoga is usually well tolerated. To obtain benefits from yoga, it should be done on a regular basis for weeks to months. Difficult postures and vigorous exercise should be avoided or done cautiously by people with fatigue, heat-sensitivity, or balance difficulties, pregnant women, and people with lung, heart, or bone disease.

by Anuradha Mascarenhas

Fibromyalgia

2008-05-14T10:07:00.001+03:00

What is it?
Fibromyalgia is a chronic condition that causes pain all over the body, and severe fatigue. It affects 2-3 per cent of the population and around nine out of 10 sufferers are women. It's the most common cause of chronic, widespread pain in the UK, but is frequently misdiagnosed. In some cases sufferers are told they are imagining their symptoms. Because of this, it takes on average three to five years to get a correct diagnosis.

What are the symptoms?
Pinch the skin at the top of your shoulder, near the base of your neck, for a few seconds - now imagine that pain all over your body. This is how many fibromyalgia sufferers feel, but everyone's symptoms will differ. 'They vary from person to person, ' says Pam Stewart, chair of the Fibromyalgia Association UK. Pain is the most common symptom and it can be widespread, or felt only in certain places. Sometimes it may only be mild, but at other times it can be overwhelming. The severe tiredness may make daily life hard. Other symptoms include poor sleep, irritable bowel syndrome (IBS), headaches and migraine, lack of concentration, sensitivity to light or smells, feeling confused, anxiety and depression.
The symptoms can also vary within each person,' says Stewart, 'so you may suffer from IBS, aching, tiredness, and restless legs syndrome, but you may not suffer from them all, all of the time.'

What causes it?
Fibromyalgia can develop at any age, but usually hits between the ages of 30 and 60. The exact is still unknown, but there are many theories. It often develops after a trauma such as a car accident, a viral infection, childbirth, or an emotional event such as divorce. Stress is a common trigger. Research has found sufferers often have poor sleeping patterns, so this could be a cause rather than a symptom. Other studies have found fibromyalgia sufferers have lower-than-normal levels of serotonin - the 'happy' chemical - in the brain, but why or how this may trigger fibromyalgia is not yet known.

How is it treated?
'Many sufferers will go to their GP with all these separate symptoms until someone finally joins up the dots,' says Stewart. 'Until then, many sufferers are told they are hypochondriacs or just being lazy.' Fibromyalgia can often be confused with other conditions such as chronic fatigue syndrome. To diagnose it, there is a simple test your GP can carry out. A small amount of pressure is applied to 18 points on the body and if severe pain is felt in at least 11 points, plus the sufferer has experienced widespread pain for at least three months, then fibromyalgia is diagnosed.
There is no cure, but there are a number of ways to relieve symptoms. Treatment often includes painkillers and prescription drugs to treat sleep problems and anxiety or depression, but they may not work for everyone.

There is no quick fix. It is often a case of changing your whole lifestyle and learning to manage your symptoms.' Eating a healthy, balanced diet, doing gentle exercise and having counseling to help you cope are often recommended - many sufferers say they are back to 'normal' after following this regime. Tackling any sources of stress is also very important.
A number of herbal supplements may help. 'Herbal practitioners will use herbs that influence different systems and symptoms,' says Trudy Norris from the National Institute of Medical Herbalists (www.nimh.org.uk). 'These may include relaxants and stimulants - sometimes at the same time. Ginseng may be used to boost the immune system and help the body cope with stress; willow may be indicated to relieve rheumatic pain; while meadowsweet may be given to soothe the digestive system, kidneys and inflammation.' Taking pre- and probiotics for IBS can also help. Other therapies include yoga, acupuncture, osteopathy and massage to help you relax. Hydrotherapy - exercises and bathing in warm water - has also been shown to be very effective.

What is Watsu Massage

2008-02-01T19:00:00.003+02:00

Watsu and its associated techniques were developed in the early 1980s by Harold Dull, director of the Harbin School of Shiatsu and Massage, in California. Watsu is an aquatic massage therapy that incorporates the principles of Zen Shiatsu and adapts them for effective use in warm water. It combines elements of massage, joint mobilization, shiatsu, muscle stretching and dance in warm water to correct ailments and promote healing. The name Watsu is derived from an amalgamation of the terms ‘Water’ and ‘Shiatsu’.

How does Watsu Massage Therapy work

2008-02-01T18:59:00.006+02:00

Watsu combines the benefits of Shiatsu and aquatic therapies to provide a gentle and deep stretching massage therapy. The weightlessness experienced in water allows the massage therapist to ease the restrictions in the muscles and joints and manipulate your body in ways that are not possible on land.
A typical Watsu session lasts for about an hour. The treatment is carried out in a pool of warm water. You should bring along a swimsuit and towel. The massage therapist will provide you with small floats to prevent you from going underwater. At the same time, the therapist will support your head and lower back. The actual massage involves a series of continuous flowing manipulations and stretches followed by periods of rest. The warm water supports your body weight and at the same time relaxes your muscles.
The series of manipulations and stretches are so gentle and harmonious that you do not even realize that their body muscles are being stretched and massaged. Watsu massage helps to release muscular and joint restrictions, relaxes the body and mind, and promotes stretching of the muscles.

Watsu = Water + Shiatsu

2008-02-01T18:59:00.004+02:00

Benefits of Watsu Therapy

2008-02-01T18:30:00.003+02:00

Watsu is a passive form of aquatic bodywork / therapy that supports and gently moves a person through warm water in graceful, fluid movements. Watsu promotes a deep state of relaxation with dramatic changes in the autonomic nervous system. Through quieting the sympathetic and enhancing the parasympathetic nervous systems, Watsu has profound effects on the neuromuscular system.

The sympatholytic effects of Watsu lead to enhancement of the parasympathetic nervous system. Physiological changes then occur throughout the body. These changes may include:

Decreased heart rate.
Decreased rate of respiration
Increased depth of respiration
Increased peripheral vasodilatation
Increased smooth muscle activity (digestion)
Decreased activation of striated muscles (skeletal)
Decreased spasticity
Decreased muscle spasm
Decreased Reticular Activating System activity
Enhanced immune system response

Watsu helps decrease muscle tension and increase range of motion. The support of the water provides relief from compression forces in the joints. The movements through the water provide gentle stretching into all ranges for the spine and extremities while these joints are unloaded.

Clients report decreased pain as Watsu decreases their muscle spasm and muscle guarding, increases their range of motion, and promotes profound relaxation. Many clients also report a decrease in their emotional pain.

Therapists utilizing Watsu as part of their aquatic therapy treatment programs report the following improvements in their clients:

1. Immediate Benefits With First Session

increased range of motion
increased muscle relaxation
decreased muscle spasm
decreased spasticity
decreased pain

2. Long-term Benefits After Multiple Sessions

improved sleep patterns
improved digestion
improved healing and immune system response
greater decreases in pain
decreased anxiety
many clients report a decrease in their emotional pain

Watsu is being incorporated into aquatic therapy treatment programs in hospitals, clinics and rehabilitation centers around the world. Therapists are impressed by the benefits for so many of their clients. Some of the many populations who have benefited include those with

traumatic brain injury
spinal cord injury
strokes
Parkinson’s Disease
arthritis
cerebral palsy
chronic pain
fibromyalgia
ankylosing spondylitis
post mastectomy
post thoracic surgery
post traumatic stress disorder.

Many clients report that nothing else is as effective in decreasing their pain and improving their ability to move.

The above is from Benefits of Watsu® For People With Orthopedic, Neurologic And Rheumatologic Special Needs by Peggy Schoedinger, PT

Peggy Schoedinger is an instructor of Watsu 1, 2 and 3 who who has taught Watsu since 1990 in Aquatic Therapy seminars on five continents. She has used Watsu in thousands of hours of work with those with special needs. She has contributed an expanded chapter on Watsu for those with Special Needs in the third edition of the Watsu book.

Water Exercise Guide

2008-02-01T10:31:00.004+02:00

••••••• L E G S •••••••

Running and Walking:

Position your body with your head, shoulders, hips, and feet vertically aligned. Using a modified running/marching motion, coordinate your leg and arm movements as in running.

Cross Country Ski:
Body is vertically aligned and legs and arms are straight. Scissor legs forward and backward from the hip, leading with your toes. Coordinate the arms and legs as in Cross Country Skiing.

Sit Kicks:
Sit as if in a straight back chair with your thighs stabilized. Alternating legs, kick out from the knee, then pull your heel back as if trying to kick your buttocks. Try to make the water boil in front of you.

Straight Leg Toe Touch:
Body is in a vertical position. Keeping legs straight, bring each leg near the surface and return it to the starting position. Alternating left and right, reach for toes with your opposite arm and bring the other arm behind you. This is a strong movement and is not recommended for people with back pain.

Tires:
This move is similar to the football drill of running through two parallel lines of tires. The body is open and vertical. Have your legs turned out and feet flexed as you alternate pushing down with each leg.

Open and Close:
Begin with vertical posture, arms and legs straight and toes pointed down toward the bottom of the pool. Open and close arms and legs by extending straight limbs out to the sides of your body and returning to the starting position.

Rock Climb:
A full-body exercise similar to running except the movement is like climbing a ladder diagonally. Reach forward with one arm into the water and then pull it through past your hip. Bring your opposite knee toward your chest and, at the same time, push the other leg straight back until it is fully extended.

••••••• ARMS •••••••

Sweep In:
With DeltaBells just below the water surface and arms held out to the sides, sweep arms forward and pull DeltaBells straight back toward chest. Extend arms out to your sides and repeat.

Breast Stroke Arms:
Begin wit DeltaBells just below the water surface and arms relaxed at your sides. Extend arms directly in front of your body and sweep out to the sides.Return DeltaBells back to the starting position and repeat.

Bicycle Arms:
With elbows bent and DeltaBells submerged in front of your chest, vigorously roll DeltaBells in a bicycle motion. Reverse direction.

Punch Out:
With body slightly leaning forward, punch arms downward and away from chest. Alternate arms back and forth like a pair of pistons.

Punch Down:
With elbows bent and DeltaBells held in at your sides, alternate pushing DeltaBells down into the water. Keep movements close to your sides.

Touch in Front/Touch in Back:
With DeltaBells submerged at your sides, bring both DeltaBells together touching the front of your body. Bring DeltaBells around your body, touching in back.

Scoop Under:
With DeltaBells near to the water's surface and arms held to your sides, flex and extend at your elbows as you pull DeltaBells in towards arm pits.

Curls:
With elbows bent and arms held tightly at your sides, alternate pulling equipment down into the water. Vary moves by gripping DeltaBells palm up or palm down.

Cross Country Ski:
With DeltaBells held close to your sides, alternate swinging straight arms in front and in back of your body. Keep arms close to your sides.

••••••• A B D O M I N A L S •••••••

Jack Knife:
Assume a reclined position with hips submerged and lower legs at the surface. Using your abdominal muscles, curl forward lifting chest toward knees. As you gain strength in your abdominals, focus on keeping your legs straight and maintaining lower leg position.

Double Knee Crunch:
Assume a reclined position with hips submerged, knees bent, and lower legs at the surface. Using your abdominal muscles, curl forward reaching chest and knees toward each other. Extend and repeat.

Obliques:
Assume a reclined position with legs together and knees bent. Twist knees to one side. Keeping legs together, twist to the opposite side.

Cross Over Crunch:
Lie on your side with knees drawn in toward chest. Focus on crunching in at your side as you pull both upper and lower body in toward your waist. Change sides and repeat.

Diamonds:
Begin with body in a vertical position, bottoms of your feet pressed together, and knees turned out from the hips. Lift and lower heels, squeezing buttocks on the lowering motion.

Double Knee Tuck:
This move is similar to double knee crunch except the body is positioned with the front facing down. Holding your DeltaBells at your sides, pull bent knees up to your chest, tightening your abdominal muscles. Extend legs while squeezing your buttocks tight.

PowerStick

2008-02-01T06:53:00.004+02:00

Aqua Trend Water Workout Station

2008-02-01T06:41:00.003+02:00

Aqua Gym

2008-02-01T06:37:00.003+02:00

Hydrotherapy to Reduce Swollen Ankles

2008-01-30T09:24:00.003+02:00

Alternating hot and cold showers to the legs are commonly recommended by Naturopaths to help general circulation in the legs. Researchers at the University of Lund, Malmo General Hospital, Sweden have found that alternating cold and hot water therapy does indeed improve on systolic blood pressure and patients’ walking ability. In a prospective case study with repeated measurements before and 1, 4 and 12 months after treatment.

Twenty consecutively included patients, 11 women and 9 men (mean age 73.9 yrs), with intermittent claudication according to clinical examination and ankle-arm systolic blood pressure participated in the study.

Alternate hot and cold hydrotherapy of the legs were given at ten 25-minute treatments during a three-week period. The outcome measures were maximal walking ability, walking ability before pain and systolic blood pressures of toe, ankle, arm.

The results revealed that 14 patients (70%) reported reduced pain after treatment and walking. Among those who reported improved walking ability one year after treatment, systolic blood pressure in both right and left ankles and toes increased. e.g. right toe increasing from an average of 72 to 86. Improvements of systolic blood pressure in left and right leg and changes of walking ability were correlated.

Showering the legs of patients suffering from swollen ankles and painful walking was therefore found to improve walking ability and reduce high blood pressures, and that these benefits could be sustained up to 1 year later. The re-port recommends that this form of hydrotherapy should be considered as an additional alternative to conservative treatment of intermittent claudication.

Elmstahl 5; t.ilja B; Bergqvist D; Brunkwall J Hydro-therapy of patients with intermittent claudication: a novel approach to improve systolic ankle pressure and reduce symptoms. mt Angiol (ITALY) Dec 1995, 14 (4) p389-94

Hydrotherapy and Exercise for Pulmonary Disease

2008-01-30T09:20:00.003+02:00

Researchers at the Division of Rehabilitation, Kusatsu Branch Hospital, Gunma University Hospital, Japan have found that exercise in hot spring water may be a useful aid to patients suffering from chronic obstructive pulmonary disease.

Respiratory function and arterial blood gas were examined before and after a two-month exercise program performed in a pool filled with hot spring water.

Twenty two patients (average age 71 years old) with stable chronic obstructive pulmonary disease (12 cases of bronchial asthma and 10 cases of pulmonary emphysema) were treated between 1991 and 1994.

Breathing was significantly improved after the exercise combined with hydrotherapy program

Kurabayashi H; Kubota K; Machida I; Tamura K; Take H; Shirakura T Effective physical therapy for chronic obstructive pulmonary disease. Pilot study of exercise in hot spring water. Am J Phys Med Rehabil (UNITED STATES) May-Jun 1997, 76 (3) p204-7

Hydrotherapy Improve Walking For Primary Varicose Veins

2008-01-30T09:14:00.002+02:00

Many naturopaths have traditionally recommended hydrotherapy to aid venous circulation and alleviate symptoms for patients suffering with varicose veins. A research study conducted at the Department of Physical Medicine and Rehabilitation, University of Vienna has found that the traditional wisdom of naturopaths is correct in that hydrotherapy can play an important role in the treatment of primary varicose veins.

In the study, sixty-one patients suffering from primary varicosity were divided into 2 groups, one receiving regular hydrotherapy, the other no such treatment for 3 1/2 weeks.

Objective evaluation of the competence of the venous valves showed an apparent benefit in the control group in respect to light reflex rheographic venous filling time. The leg volume changes, however, indicated a stronger and more persistent reduction in the treatment group. The same improvements were found for ankle and calf circumferences, which were reduced significantly only in patients treated with hydrotherapy. Furthermore some (although not all) of the subjective symptoms were found to be more improved in the treatment group.

In conclusion, the researchers stated that their findings suggest that primary varicose veins can be helped significantly by hydrotherapy and should be considered as an adjunct to other forms of treatment.

Ernst F; Saradeth T; Resch KL. A single blind randomised, controlled trial of hydrotherapy for varicose veins. Vasa (SWITZERLAND) 1991, 20 (2) p147-52

Hydrotherapy Study on Pain and Wound Healing

2008-01-30T09:05:00.002+02:00

A study at Southeastern Louisiana University, School of Nursing, USA has found that hydrotherapy can help alleviate pain and assist in wound healing of patients who have undergone major abdominal surgery.

Patients who have major abdominal surgery often experience pain because of increased tension on muscles and tissues at the abdominal incision site. Also, pain can be caused by pressure created from trapped anesthesia gases in the intestines. Both of these consequences can cause increased anxiety and stress resulting in poor pain management and this, in turn, may affect tissue regeneration.

An intervention, such as whirlpool therapy, can enhance relaxation and promote pain relief and normal wound healing. This study was designed to examine the effects of whirlpool therapy on pain and surgical wound healing in adults having major abdominal surgery. Sixty-three patients (43 female and 20 male), aged between 25-60, participated in the study of repeated measures of pain and surgical wound assessments over a 3-day period.

Statistical tests for repeated measures revealed that the patients in the hydrotherapy group experienced significantly less pain than the other patients for three consecutive days. Also, statistical tests for repeated measures of wound healing revealed less signs of surgical wound inflammation in the hydrotherapy group over the 3-day period. The report concluded that the intervention of whirlpool therapy promoted some degree of comfort and positive signs of wound healing.

Juve Meeker B Whirlpool therapy on postoperative pain and surgical wound healing: an exploration. Patient Educ Couns (IRELAND) Jan 1998, 33 (1) p39-48

Hydrotherapy Study on Childbirth

2008-01-30T08:56:00.002+02:00

Researchers at the Department of Obstetrics and Gynaecology. University of Liverpool, United Kingdom have confirmed earlier research findings that hydrotherapy is extremely beneficial for pregnant mother-to-be during labour.

The use of birthing pools (luring labour is increasing in the United Kingdom, and researchers felt the need to establish whether this was justified by investigating the value and safety of hydrotherapy as a birthing aid.

The study was performed in a District General Hospital in Liverpool where a group of 100 women of low obstetric risk used the birthing pool at some stage (luring their labour’s and a control group of 100 women were matched in terms of age, parity and obstetric history hut laboured and delivered without the use of a birthing pool.

The main outcome measures were operative delivery rates, duration of labour, analgesic requirements. perineal trauma and Apgar scores at 1 and 5 minutes.

The results showed that those women who used the birthing pool had significantly reduced operative delivery rates, a shorter second stage of labour, reduced analgesic requirements and a lower incidence of perineal trauma. The women who used the birthing pool also required significantly less analgesic aid.

The report concluded that hydrotherapy during labour significantly aids the labour process, minimises the use of analgesic medications md should he considered as a safe and effective birthing aid.

Aird IA; Luckas MJ; Buckett WM; Bousfield P. Effects of intrapartum hydrotherapy on labour related parameters. Aust N Z J Obstet Gynaecol (Australia) May 1997, 37 (2) p137-42

Hydrotherapy Study on Asthma

2008-01-30T08:33:00.001+02:00

Two recent studies have shown that hydrotherapy has a role to play in the treatment of asthma. In one study (1) conducted at the Division of Medicine, Misasa Medical Branch, Okayma University Medical School, the clinical effects of spa therapy (swimming training in a hot spring pool inhalation of iodine salt solution) were examined in 52 patients with steroid-dependent in-tractable asthma (SDIA). Beneficial clinical effects were found in 36 of the 52 (69.2%) patients with SDIA. The benefits were higher in the patients between the ages of 41 and 50 (87.5%) and between 51 and 60 (84.2%) than in those in the other age groups.

As far as the benefits of the spa therapy for patients with specific types of clinical asthma, the efficacy was found to be higher in patients with type Ia-2 (83.4%), type lb (77.8%) and type 11(80.0%) than in those with type Ia-I (54.2%).

The researchers also found that decreased function of the adrenocortical glands expressed by low serum cortisol levels improved after the spa therapy, and this was accompanied by a reduction in the dose of glucocorticoids necessary to control asthma attacks.

A further trial (2) conducted at the Division of Medicine, Misasa Medical Branch, Okayama University Medical School, Japan revealed similar findings. In this study, 37 patients with steroid-dependent intractable asthma were examined focussing on the improvement of ventilatory function following spa therapy. All of the patients had been on long-term corticosteroids therapy before spa therapy.

The results found that Spa therapy improved the values of ventilatory parameters significantly, especially in patients with type II asthma and the re-port went on to recommend Spa therapy to help improve the condition of small airways disorder in patients with steroid-dependent intractable asthma.

(1) Tanizaki Y; Kitani H; Okazaki M; Mifune T; Mitsunobu F; Honke N Clinical effects of complex spa therapy on patients with steroid-dependent in-tractable asthma (SDIA).Arerugi (JAPAN) Mar 1993, 42 (3 Pt 1) p219-27
(2) Tanizaki Y; Kitani H; Okazaki M; Mifune T; Mitsunobu F; Ochi K; Harada H; Kimura I Spa therapy improves ventilatory function in the small airways of patients with steroid-depend-ent intractable asthma (SDIA). Acta Med Okayama (JAPAN) Jun 1992 46 (3) p175-8

Hydrotherapy Study on Rheumatoid Arthritis

2008-01-30T08:24:00.002+02:00

A recent study found that hydrotherapy is particularly beneficial for arthritis sufferers. One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to receive hydrotherapy, seated immersion, land exercise, or progressive relaxation.

Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and again at a 3-month follow-up.

The results showed that all patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. The patients' belief that their pain was controlled by chance happenings decreased, signifying not just improvement in their condition but also in their belief to be able to manage their symptoms.

However the data revealed conclusively that the hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only) than the other patients. And at the follow-up measurement, the hydrotherapy patients maintained the improvement in emotional and psychological state.

The report concluded that although all patients experienced some benefit, "hydrotherapy produced the greatest improvements", and the researchers stated that there is clear evidence of the benefits of hydrotherapy for arthritis sufferers to support the continued use of this therapy as an effective adjunct treatment.

Hall J; Skevington SM; Maddison PJ; Chapman K A randomized and controlled trial of hydrotherapy in rheumatoid arthritis.Arthritis Care Res (UNITED STATES) Jun 1996, 9 (3) p206-15

Rett Syndrome

2008-01-24T08:59:00.001+02:00

Rett syndrome is a childhood neurodevelopmental disorder characterized by normal early development followed by loss of purposeful use of the hands, distinctive hand movements, slowed brain and head growth, gait abnormalities, seizures, and mental retardation. It affects females almost exclusively.

The disorder was identified by Dr. Andreas Rett, an Austrian physician who first described it in a journal article in 1966. It was not until after a second article about the disorder was published in 1983 that the disorder was generally recognized.

The course of Rett syndrome, including the age of onset and the severity of symptoms, varies from child to child. Before the symptoms begin, however, the child appears to grow and develop normally. Then, gradually, mental and physical symptoms appear. Hypotonia (loss of muscle tone) is usually the first symptom. As the syndrome progresses, the child loses purposeful use of her hands and the ability to speak. Other early symptoms may include problems crawling or walking and diminished eye contact. The loss of functional use of the hands is followed by compulsive hand movements such as wringing and washing. The onset of this period of regression is sometimes sudden.

Another symptom, apraxia — the inability to perform motor functions — is perhaps the most severely disabling feature of Rett syndrome, interfering with every body movement, including eye gaze and speech.

Individuals with Rett syndrome often exhibit autistic-like behaviors in the early stages. Other symptoms may include toe walking; sleep problems; wide-based gait; teeth grinding and difficulty chewing; slowed growth; seizures; cognitive disabilities; and breathing difficulties while awake such as hyperventilation, apnea (breath holding), and air swallowing.

What are the stages of the disorder?

There are four stages of Rett syndrome. Stage I, called early onset, generally begins between 6 and 18 months of age. Quite frequently, this stage is overlooked because symptoms of the disorder may be somewhat vague, and parents and doctors may not notice the subtle slowing of development at first. The infant may begin to show less eye contact and have reduced interest in toys. There may be delays in gross motor skills such as sitting or crawling. Hand-wringing and decreasing head growth may occur, but not enough to draw attention. This stage usually lasts for a few months but can persist for more than a year.

Stage II, or the rapid destructive stage, usually begins between ages 1 and 4 and may last for weeks or months. This stage may have either a rapid or a gradual onset as purposeful hand skills and spoken language are lost. The characteristic hand movements begin to emerge during this stage and often include wringing, washing, clapping, or tapping, as well as repeatedly moving the hands to the mouth. Hands are sometimes clasped behind the back or held at the sides, with random touching, grasping, and releasing. The movements persist while the child is awake but disappear during sleep. Breathing irregularities such as episodes of apnea and hyperventilation may occur, although breathing is usually normal during sleep. Some girls also display autistic-like symptoms such as loss of social interaction and communication. General irritability and sleep irregularities may be seen. Gait patterns are unsteady and initiating motor movements can be difficult. Slowing of head growth is usually noticed during this stage.

Stage III, also called the plateau or pseudo-stationary stage, usually begins between ages 2 and 10 and can last for years. Apraxia, motor problems, and seizures are prominent during this stage. However, there may be improvement in behavior, with less irritability, crying, and autistic-like features. An individual in stage III may show more interest in her surroundings, and her alertness, attention span, and communication skills may improve. Many girls remain in this stage for most of their lives.

The last stage, stage IV — called the late motor deterioration stage — can last for years or decades and is characterized by reduced mobility. Muscle weakness, rigidity (stiffness), spasticity, dystonia (increased muscle tone with abnormal posturing of extremity or trunk), and scoliosis (curvature of the spine) are other prominent features. Girls who were previously able to walk may stop walking. Generally, there is no decline in cognition, communication, or hand skills in stage IV. Repetitive hand movements may decrease, and eye gaze usually improves.

What causes Rett syndrome?

Rett syndrome is caused by mutations (structural alterations or defects) in the MECP2 (pronounced meck-pea-two) gene, which is found on the X chromosome (see section on "Who gets Rett syndrome" for a discussion of the importance of the involvement of the X chromosome). Scientists identified the gene — which is believed to control the functions of several other genes — in 1999. The MECP2 gene contains instructions for the synthesis of a protein called methyl cytosine binding protein 2 (MeCP2), which acts as one of the many biochemical switches that tell other genes when to turn off and stop producing their own unique proteins. Because the MECP2 gene does not function properly in those with Rett syndrome, insufficient amounts or structurally abnormal forms of the protein are formed. The absence or malfunction of the protein is thought to cause other genes to be abnormally expressed, but this hypothesis has not yet been confirmed.

Seventy to 80 percent of girls given a diagnosis of Rett syndrome have the MECP2 genetic mutation detected by current diagnostic techniques. Scientists believe the remaining 20 to 30 percent of cases may be caused by partial gene deletions, by mutations in other parts of the gene, or by genes that have not yet been identified; thus, they continue to search for other mutations.

Is Rett syndrome inherited?

Although Rett syndrome is a genetic disorder — resulting from a faulty gene or genes — less than 1 percent of recorded cases are inherited or passed from one generation to the next. Most cases are sporadic, which means the mutation occurs randomly, mostly during spermatogenesis, and is not inherited.

Who gets Rett syndrome?

Rett syndrome affects one in every 10,000 to 15,000 live female births. It occurs in all racial and ethnic groups worldwide. Prenatal testing is available for families with an affected daughter who has an identified MECP2 mutation. Since the disorder occurs spontaneously in most affected individuals, however, the risk of a family having a second child with the disorder is less than 1 percent.

Genetic testing is also available for sisters of girls with Rett syndrome and an identified MECP2 mutation to determine if they are asymptomatic carriers of the disorder, which is an extremely rare possibility.

Girls have two X chromosomes, but only one is active in any given cell. This means that in a child with Rett syndrome only about half the cells in the nervous system will use the defective gene. Some of the child's brain cells use the healthy gene and express normal amounts of the proteins.

The story is different for boys who have an MECP2 mutation known to cause Rett syndrome in girls. Because boys have only one X chromosome they lack a back-up copy that could compensate for the defective one, and they have no protection from the harmful effects of the disorder. Boys with such a defect die shortly after birth.

Different types of mutations in the MECP2 gene can cause mental retardation in boys.

How is Rett syndrome diagnosed?

Doctors diagnose Rett syndrome by observing signs and symptoms during the child's early growth and development, and conducting ongoing evaluations of the child's physical and neurological status. Recently, scientists developed a genetic test to confirm the clinical diagnosis of this disorder; the test involves searching for the MECP2 mutation on the child's X chromosome. Given what we know about the genes involved in Rett syndrome, such tests are able to confirm a clinical diagnosis in up to 80 percent of all cases.

Some children who have Rett syndrome-like characteristics or MECP2 genetic mutations do not fulfill the diagnostic criteria for the syndrome as defined below. These persons are described as having "atypical" or "variant" Rett syndrome. Atypical cases account for about 15 percent of the total number of diagnosed cases.

A pediatric neurologist or developmental pediatrician should be consulted to confirm the clinical diagnosis of Rett syndrome. The physician will use a highly specific set of guidelines that are divided into three types of clinical criteria: essential, supportive, and exclusion. The presence of any of the exclusion criteria negates a diagnosis of "classic" or "typical" Rett syndrome.

Examples of essential diagnostic criteria or symptoms include having apparently normal development until between the ages of 6 and 18 months and having normal head circumference at birth followed by a slowing of the rate of head growth with age (between 3 months and 4 years). Other essential diagnostic criteria include severely impaired expressive language, repetitive hand movements, shaking of the torso, and toe-walking or an unsteady, wide-based, stiff-legged gait.

Supportive criteria are not required for a diagnosis of Rett syndrome but may occur in some patients. In addition, these symptoms — which vary in severity from child to child — may not be observed in very young girls but may develop with age. A child with supportive criteria but none of the essential criteria does not have Rett syndrome. Supportive criteria include breathing difficulties; electroencephalogram (EEG) abnormalities; seizures; muscle rigidity, spasticity, and/or joint contracture which worsen with age; scoliosis; teeth-grinding; small feet in relation to height; growth retardation; decreased body fat and muscle mass (although there may be a tendency toward obesity in some affected adults); abnormal sleep patterns, irritability, or agitation; chewing and/or swallowing difficulties; poor circulation of the lower extremities with cold and bluish-red feet and legs; decreased mobility with age; and constipation.

In addition to the essential diagnostic criteria, a number of specific conditions enable physicians to rule out a diagnosis of Rett syndrome. These are referred to as exclusion criteria. Children with any one of the following criteria do not have Rett syndrome: enlargement of body organs or other signs of storage disease, vision loss due to retinal disorder or optic atrophy, microcephaly at birth, an identifiable metabolic disorder or other inherited degenerative disorder, an acquired neurological disorder resulting from severe infection or head trauma, evidence of growth retardation in utero, or evidence of brain damage acquired after birth.

Why are some cases more severe than others?

The course and severity of Rett syndrome vary from individual to individual. Some girls have symptoms from birth onward, while others may have late regression or milder symptoms.

Because females have two copies of the X chromosome and need only one working copy for genetic information, they turn off the extra X chromosome in a process called X inactivation. This process occurs randomly so that each cell is left with one active X chromosome. The severity of Rett syndrome in girls is in part a function of the percentage of cells with a normal copy of the MECP2 gene after X inactivation takes place: if X inactivation turns off the X chromosome that is carrying the defective gene in a large proportion of cells, the symptoms will be mild, but if a larger percentage of cells have the X chromosome with the normal MECP2 gene turned off, onset of the disorder may occur earlier and the symptoms may be more severe.

Is treatment available?

There is no cure for Rett syndrome. Treatment for the disorder is symptomatic — focusing on the management of symptoms — and supportive, requiring a multidisciplinary approach. Medication may be needed for breathing irregularities and motor difficulties, and antiepileptic drugs may be used to control seizures. There should be regular monitoring for scoliosis and possible heart abnormalities. Occupational therapy (in which therapists help children develop skills needed for performing self-directed activities — occupations — such as dressing, feeding, and practicing arts and crafts), physiotherapy, and hydrotherapy may prolong mobility. Some children may require special equipment and aids such as braces to arrest scoliosis, splints to modify hand movements, and nutritional programs to help them maintain adequate weight. Special academic, social, vocational, and support services may also be required in some cases.

What is the outlook for those with Rett syndrome?

Despite the difficulties with symptoms, most individuals with Rett syndrome continue to live well into middle age and beyond. Because the disorder is rare, very little is known about long-term prognosis and life expectancy. While it is estimated that there are many middle-aged women (in their 40s and 50s) with the disorder, not enough women have been studied to make reliable estimates about life expectancy beyond age 40.

What research is being done?

Within the Federal Government, the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Child Health and Human Development (NICHD), two of the National Institutes of Health (NIH), support clinical and basic research on Rett syndrome. Understanding the cause of this disorder is necessary for developing new therapies to manage specific symptoms, as well as for providing better methods of diagnosis. The discovery of the Rett syndrome gene in 1999 provides a basis for further genetic studies and enables the use of recently developed animal models such as transgenic mice.

One NINDS-supported study is looking for mutations in the MECP2 gene of individuals with Rett syndrome to find out how the MeCP2 protein functions. Information from this study will increase understanding of the disorder and may lead to new therapies.

Scientists know that lack of a properly functioning MeCP2 protein disturbs the function of mature brain cells but they do not know the exact mechanisms by which this happens. Investigators are also trying to find other genetic mutations that can cause Rett syndrome and other genetic switches that operate in a similar way to the MeCP2 protein. Once they discover how the protein works and locate similar switches, they may be able to devise therapies that can substitute for the malfunctioning switch. Another outcome might involve manipulating other biochemical pathways to compensate for the malfunctioning MECP2 gene, thus preventing progression of the disorder.

Where can I get more information?

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
http://www.ninds.nih.gov

Information also is available from the following organizations:International Rett Syndrome Foundation
4600 Devitt Drive
Cincinnati, OH 45246
admin@rettsyndrome.org
http://www.rettsyndrome.org
Tel: 513-874-3020

Easter Seals
230 West Monroe Street
Suite 1800
Chicago, IL 60606-4802
info@easterseals.com
http://www.easterseals.com
Tel: 312-726-6200 800-221-6827
Fax: 312-726-1494

National Institute of Child Health and Human Development (NICHD)
National Institutes of Health, DHHS
31 Center Drive, Rm. 2A32 MSC 2425
Bethesda, MD 20892-2425
http://www.nichd.nih.gov
Tel: 301-496-5133
Fax: 301-496-7101

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

Study on fibromyalgia: effectiveness of 16-week aquatic training program

2007-12-19T12:05:00.002+02:00

Aquatic therapy works for the fibromyalgia patient

OBJECTIVES: To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia (FM) and to determine exercise adherence levels.

DESIGN: A randomized controlled trial.

SETTING: Testing and were completed at the university.

PARTICIPANTS: Middle-aged women with FM (n=60) and healthy women (n=25).

INTERVENTION: A 16-week aquatic training program, including strength training, aerobic training, and relaxation exercises.

MAIN OUTCOME MEASURES: Tender point count (syringe calibrated), health status (Fibromyalgia Impact Questionnaire); sleep quality (Pittsburgh Sleep Quality Index); physical (endurance strength to low loads tests), psychologic (State Anxiety Inventory), and cognitive function (Paced Auditory Serial Addition Task); and adherence 12 months after the completion of the study.

RESULTS: For all the measurements, the patients showed significant deficiencies compared with the healthy subjects. Efficacy analysis (n=29) and intent-to-treat analysis (n=34) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality, cognitive function, and physical function. Anxiety remained unchanged during the follow-up. The exercise group had a significant improvement of health status, not associated exclusively with the exercise intervention. There were no changes in the control group. Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program.

CONCLUSIONS: An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology. The therapeutic intervention's effects can be assessed through applicable tests in the clinical practice.

SOURCE: Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008 Dec;89(12):2250-7.

Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain. dmunizq@upo.es

A Randomized and Controlled Trial of Hydrotherapy in Rheumatoid Arthritis

2007-10-27T09:47:00.003+02:00

Hall J, Skevington SM, Maddison PJ, Chapman K.

OBJECTIVE: The aim of this study was to evaluate the therapeutic effects of hydrotherapy which combines elements of warm water immersion and exercise.

It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately. METHODS: One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month followup.

RESULTS: All patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. Belief that pain was controlled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At followup, hydrotherapy patients maintained the improvement in emotional and psychological state.

CONCLUSIONS: Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy.

Introduction to Ai Chi

2007-08-04T23:02:00.007+03:00

Ai Chi is a water-based total body strengthening and relaxation progression that bridges East and West philosophies, and integrates mental, physical, and spiritual energy. It combines Tai-Chi concepts with Shiatsu and Watsu techniques, and is performed standing in shoulder-depth water using a combination of deep breathing and slow, broad movements of the arms, legs, and torso. The Ai Chi progression moves from simple breathing, to the incorporation of upper-extremity, trunk, lower-extremity, and finally total body involvement.

Ai Chi was created to help aquatic practitioners (including aquatic exercise instructors, personal trainers, and aquatic therapy and rehabilitation practitioners) and students enjoy the water in a flowing yet powerful progression. It is an efficient exercise program that increases oxygen and caloric consumption through correct form and positioning in the water, a perfect relaxation technique for highly stressed, over-challenged clients, and is ideal for creating improved range of motion and mobility.

Jun Konno, ATRIC, creator of Ai Chi, is one of Japan’s foremost swimming and fitness consultants and the President of Aqua Dynamics Institute (Japanese chapter of AEA). Since 1986, he has worked to promote aquatics in Japan and is Chairman of the Executive Committee for Japan’s National Aquatic Conference.

Benefits of Ai Chi

Flexibility and core (abdominal) strength are the benefits most mentioned by aquatic exercise instructors. The trunk stabilization/balance and pain management benefits of the program are the two most frequently cited by aquatic therapists. Clients’ comments include: "a soothing experience," "mind and body relaxation," and "a symphony for my body." Such benefits increase with practice. As a person becomes more familiar with the program, relaxation will be improved, with a focus on the smallest movement of the hand, wrist, or eyes, and improved mental alertness.

Water lessens edema in the joints, which allows clients to improve range of motion and mobility. The soft, round flowing motions strengthen core muscles while providing a soothing experience, and the flowing movements of Ai Chi can increase metabolism and blood circulation. Studies show that simply breathing while submersed to the shoulder in water can increase oxygen consumption from 7 to 25 percent. This, in turn, increases caloric consumption.

Potential Benefits of Ai Chi

-Improved flexibility, range of motion, and general mobility
-Improved metabolism and caloric consumption
-Better blood circulation
-Re-vitalized energy circulation along important accupoint meridians
-Renewal of vital organs
-Improved liver efficiency
-Decreased stress, insomnia, depression, anger, fatigue, anxiety, and confusion: the water and music can help to free the body of stress and to encourage a state of relaxed awareness
-Increased mental alertness
-Creates "design sense" (a feeling that you’re doing what the body was designed to do) and therefore, improves kinesthetic sense (our perception of how we move)

Physical Movement Principles

Roundness, continuity, naturalness, and slowness. Slowness allows reflection and self-observation. It is an excellent approach to teaching movement, especially if a person is fearful of changing movement patterns. Clients need to challenge habitual movement patterns through continual self-assessment. There is a Japanese proverb that says, “Willow does not break under weight of snow.” Stiff or inflexible branches, bones, and psyches will break, yet the pliant willow will not. Pliant bones, connective tissues, and psyches won’t break: Ai Chi can help to make one pliant.

Movements must flow (not forceful in the beginning of a move but of equal force throughout the move). Work towards continuity with a continual flow between exercise movements. Flowing movements integrate mental, physical, and spiritual energy. Ai Chi is flowing, soft, round movements executed with a profound inwardly directed focus. It requires a non-judgmental attention to self.
Move with the water (muscles and joints will relax and eyes become partly closed). Move naturally until the motions flow easily, with no straining. Ai Chi should be done slowly, gently, and quietly. By eliminating all other thoughts, you’ll achieve a unity of movement and consciousness. Awareness of the mind’s presence in the various parts of the body is taught through the techniques of Ai Chi. With that training, we can acquire greater degrees of health, fitness, and longevity than through physical training alone.

Repetition. Deep relaxation can only occur when you feel stable in the water and confident in your ability to follow the progression: repetition allows us to do this. The repetition in Ai Chi is for relaxation, not for evaluating success or failure. The challenge for those who are addicted to outward movement is a change in perspective. Jonathan Miller, famous English physician and writer, said, "In living things all restlessness is directed toward the achievement of tranquility." In Ai Chi, the focus is on tranquility, rather than the precision and rigidity of traditional exercise.

Pelvic mechanics and alignment. Correct alignment is crucial. Twists created by the trunk stability movements are neutralizing, cleansing, and organic. They improve digestion and remove sluggishness, and are effective in relieving backaches, headaches, and stiffness in the shoulders and neck. After Ai Chi positioning is taught, natural, continual movement and slowness are taught, and then breathing is incorporated.

Ai Chi Can Assist with the Following Health Conditions

Chronic disorders and other diseases such as pain management:
-Fibromyalgia
-Arthritis
-Cancer (especially mastectomy)
-Multiple Sclerosis MS
-Cerebral Palsy CP
-Immunodeficiency Disorders

Respiratory disorders:
-Asthma
-Chronic Obstructive Pulmonary Disease
-Pulmonary Rehabilitation

Cardiovascular problems:
-Congestive Heart Failure
-Angina
-Stress-related Cardiac Arrhythmias
-Mitral Valve Prolapse
-Cardiac Rehabilitation

Circulatory disorders:
-Hypertension and Migraine Headaches

Metabolic disorders:
-Eating Behaviors
-Weight Control
-Type II Diabetes
-Type I Diabetes
-Obesity

Psychological problems:
-Chronic Fatigue Syndrome
-Anxiety and Depressive Disorders
-Anger Management
-Stress-Related Dysthrthmias, and Violence

Musculoskeletal or orthopedic disturbances:
-Low Back Pain
-Scoliosis
-Carpal Tunnel Syndrome (or any repetitive stress syndrome)
-Musculoskeletal injuries and surgeries
-Balance Deficits
-Prenatal
-Sports Injuries
-Accident and Fall Prevention

Neurological Disturbances:
-Cerebral Vascular Accidents CVA (strokes)
-Traumatic Brain Injury

Endrocinological Disorders:
-Immunodeficiency Disorders
-Fatigue
-Menopause Therapy
-Hormonal Management

Facility Requirements

Water temperature recommended for Ai Chi is 86ºF to 92ºF. Lower water temperatures can be used after an adequate warmup or with varied breathing patterns such as in the ashtanga yogic technique. If clients become chilled, stop the program. Blood and oxygen must be moving to the extremities to allow for full ROM. If the client is chilled, blood will be shunted to the vital organs (not the extremities) and muscles will tense. This is not conducive to relaxation and the full ROM Ai Chi movements.
Space requirements are about 25 square feet per person in water that is 12 to 18 inches lower than the person’s height.

Practitioner Education

Because of the different levels and depths of Ai Chi, any practitioner can use the program. The best practitioners will be those who understand the bodymind: the body, its disease processes, and the mind are connected.
Jun Konno, creator of Ai Chi, states that anyone, regardless of the depth of training, background, or type of training, should be able to teach Ai Chi. Ai Chi’s basic movements and breathing concepts always turn out the "way they were meant to be," and good teachers will use the Ai Chi principles to evolve into excellence through their own desire to grow.he circular movements create harmony, based on a principle of yielding to, rather than resisting the natural flow.

Ai Chi Movements

2007-08-03T22:07:00.003+03:00

Breathing

Beginning position:
Begin with your feet in a wide stance.
Point your knees and toes somewhat out and keep your back straight.
Both arms are forward (90-degree shoulder flexion), palms down (pronated) with thumbs touching each other.
Bend your knees until the water is at shoulder level and your arms are resting easily at the water surface.
Your weight is evenly balanced.
Chin is relaxed and slightly down.
This is the beginning position.

Contemplating
Step 1:
inhale - You will get a little "taller" in the water, your chin will come up and back slightly, your diaphragm will fill, and your rib cage will "open."

Step 2:
Exhale easily through your mouth and turn your palms down while returning to beginning position. You will get lower in the water, your chin will relax, your rib cage will "close," and your diaphragm will empty.

Step 3:
Repeat 5 to 10 times.

Step 1: Inhale through your nose and turn your palms up.

Step 2: Exhale through your mouth, turn your palms down, and let your arms lower in front of your body (shoulder extension).

Step 3: Inhale easily through your nose while turning your palms up and lifting your arms (shoulder flexion) slowly back to the water surface.

Step 4: Repeat steps two and three 5 to 10 times.

Step 5: Exhale through your mouth, turn your palms down, and let your arms lower in front of your body (shoulder extension).

Enclosing
Step 1: Exhale easily through your mouth while turning your palms down and bring your hands together in front of you until your thumbs touch each other (horizontal adduction).

Step 2: Inhale through your nose while turning your palms up and opening your arms to the sides (horizontal abduction). You will get a little "taller" in the water, your chin will come up and back slightly, and your rib cage will "open."

Step 3: Repeat steps one and two 5-10 times.

Folding
Step 1: Exhale easily through your mouth, turn your palms down, and bring your right arm over to the left so the thumbs of both hands touch each other, while shifting your weight to your left leg. Stay facing forward.

Step 2: While keeping your weight on your left leg, inhale through your nose, turn your palms up, and watch your right hand as you return your right arm to your right side.

Step 3: Exhale easily through your mouth, turn your palms down, and bring your left arm over to the right so the thumbs of both hands touch each other, while shifting your weight to the right leg.

Step 4: While keeping your weight on your right leg, inhale through your nose, turn your palms up, and watch your left hand as you return your left arm to your left side.

Step 5: Repeat steps one through four 5 to 10 times.

Accepting
Step 1: Exhale easily through your mouth, turn your palms down, and bring your right arm over to the left so the thumbs of both hands touch each other, while pivoting both feet 90 degrees left so you're facing the left side. Your weight is evenly balanced between both legs.

Step 2: While still facing left, inhale through your nose, turn your palms up, and pull both arms back so that your rib cage feels fully opened. At the same time, shift your weight back on the right leg so that you're leaning back slightly. The trunk must be stable.

Step 3: While still facing left, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, shift your weight forward onto the left leg so you're leaning forward slightly.

Step 4: Repeat steps two and three flowing smoothly 5 to 10 times.

Step5: Inhale through your nose, turn your palms up, bring your right arm back to the right side, while pivoting both feet 90 degrees right so you're facing front.

Step 6: Exhale easily through your mouth, turn your palms down, and bring your left arm over to the right so the thumbs of both hands touch each other, while pivoting both feet 90 degrees right so you're facing the right side. Your weight is evenly balanced between both legs.

Step 7: While still facing right, inhale through your nose, turn your palms up, and pull both arms back so that your rib cage feels fully opened. At the same time, shift your weight back on the left leg so that you're leaning back slightly.

Step 8: While still facing right, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, shift your weight forward onto the right leg so you're leaning forward slightly.

Step 9: Repeat steps seven and eight flowing smoothly 5 to 10 times.

Step 10: Inhale through your nose, turn your palms up, and bring the left arm back to the left side, while pivoting both feet 90 degrees left so you're facing front

Accepting with Grace
Step 1: Exhale easily through your mouth, turn your palms down, and bring your right arm over to the left so the thumbs of both hands touch each other, while pivoting both feet 90 degrees left so you're facing the left side. Your weight is evenly balanced between both legs.

Step 2: While still facing left, inhale through your nose, turn your palms up, and pull both arms back so your rib cage feels fully opened. At the same time, shift your weight back completely onto the right leg, lean back slightly, and lift your left leg straight in front of you.

Step 3: While still facing left, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, lower your left leg so your torso is upright again.

Step 4: Repeat steps two and three flowing smoothly 5 to 10 times.

Step 5: Inhale through your nose, turn your palms up, and bring your right arm back to the right side, while pivoting both feet 90 degrees right so you're facing front.

Step 6: Exhale easily through your mouth, turn your palms down, and bring your left arm over to the right so the thumbs of both hands touch each other, while pivoting both feet 90 degrees right so you're facing the right side. Your weight is evenly balanced between both legs.

Step 7: While still facing right, inhale through your nose, turn your palms up, and pull both arms back so that your rib cage feels fully opened. At the same time, shift your weight back completely onto the left leg, lean back slightly, and lift your right leg straight in front of you.

Step 8: While still facing right, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, lower your right leg so your torso is upright and tall.

Step 9: Repeat steps seven and eight flowing smoothly 5 to 10 times.

Step 10: Inhale through your nose, turn your palms up, and bring your left arm back to the left side, while pivoting both feet 90 degrees left so you're facing front.

Rounding
Step 1: Exhale easily through your mouth, turn your palms down, bring your right arm over to the left so the thumbs of both hands touch each other, while pivoting both feet 90 degrees left so you're facing the left side. Your weight is evenly balanced between both legs.

Step 2: While still facing left, inhale through your nose, turn your palms up, pull your arms back so that your rib cage feels fully opened. At the same time step your right leg back and shift your weight back so you're leaning back slightly.

Step 3: While still facing left, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, lift your right leg straight in front of you and lean forward slightly. Bring toes to fingertips.

Step 4: Repeat steps two and three flowing smoothly 5 to 10 times.

Step 5: Inhale through your nose, turn your palms up, bring your right arm back to the right side, while pivoting both feet 90 degrees right so you're facing front.

Step 6: Exhale easily through your mouth, turn your palms down, bring your left arm over to the right so the thumbs of both hands touch each other, while pivoting both feet 90 degrees right so you're facing the right side. Your weight is evenly balanced between both legs.

Step 7: While still facing right, inhale through your nose, turn your palms up, and pull your arms back so that your rib cage feels fully opened. At the same time, step your left leg back and shift your weight back so you're leaning back slightly.

Step 8: While still facing right, exhale through your mouth, turn your palms down, and bring both arms together so the thumbs of both hands touch each other. At the same time, lift your left leg straight in front of you and lean forward slightly. Bring toes and fingertips together.

Step 9: Repeat steps seven and eight flowing smoothly 5 to 10 times.

Step 10: Inhale through your nose, turn your palms up, bring your left arm back to the left side, while pivoting both feet 90 degrees left so you're facing front.

Flowing
Step 1: Exhale easily through your mouth and turn your palms down while letting your arms lower and cross in front of your body. Knees and toes are pointed out and your back is straight.

Step 2: Inhale through your nose, keep your elbows in at your waist, turn your palms up, and open your forearms to the side. Simultaneously cross your right foot over the left and bend your knees slightly. Shoulders are relaxed.

Step 3: Exhale easily through your mouth, turn your palms down, and lower and cross your arms in front of your body. At the same time step your left foot to the left side so you have returned to the position in step one.

Step 4: Repeat steps two and three moving smoothly 5 to 10 times to the right.

Step 5: Inhale through your nose, keep your elbows in at your waist, turn your palms up, and open your forearms to the side. At the same time, cross your left foot over the right and bend your knees slightly.

Step 6: Exhale easily through your mouth, turn your palms down, and lower and cross your arms in front of your body. At the same time step your right foot to the right side.

Step 7: Repeat steps five and six moving smoothly 5 to 10 times to the left.

Step 8: Inhale through your nose, keep your elbows in at the waist, turn your palms up, and open your forearms to the side.

Enoy Ai Chi
No two Ai Chi sessions will be the same, and that’s as it should be. Every movement will have variations according to what you, your body, and your psyche want that day. It’s fine to eliminate movements, put them in a different order, and change the tempo or the number of repetitions. Because we’re all different and Ai Chi serves each of us differently, we will all perform Ai Chi differently. Experiment with Ai Chi, be free and non-judgmental with yourself, and remember, "However your progression turns out is exactly how it was meant to be."

Aqua aerobics

2007-03-23T19:58:00.004+02:00

Aqua aerobics is the performance of aerobic exercise in shallow water such as a swimming pool. In some areas it is known as AquaFit or "water aerobics", and is a type of resistance training.
Aqua aerobic workouts usually combine a variety of techniques from land aerobics, including walking or running backward and forward, jumping jacks, mimicking cross-country skiing, along with various arm movements. The workout also may incorporate equipment such as flotation devices.
In addition to the standard benefits of any exercise, the use of water in aqua aerobics supports the body and reduces the risk of muscle or joint injury. The mitigation of gravity by flotation stretching, and can allow a greater range of motion. The mitigation of gravity makes aqua aerobics safe for any individual able to keep their head out of water, including the elderly. Exercise in water can also prevent overheating through continuous cooling of the body. Most classes last for 45-55 minutes.
Aqua aerobics requires access to a pool either in the home or via facilities, and in addition to any membership fees to access facilities, classes may cost extra. Although aquatic exercise greatly reduces the risk of injury, not as many calories are burned as would be in some other activities. Though aquatic activities in general expend more energy than many land-based activities performed at the same pace due to the increased resistance of water, the speed with which movements can be performed is greatly reduced.

Aquatic Therapy or Pool Therapy

2007-03-08T08:36:00.002+02:00

Aquatic therapy or pool therapy consists of an exercise program that is performed in the water. It is a beneficial form of therapy that is useful for a variety of medical conditions. Aquatic therapy uses the physical properties of water to assist in patient healing and exercise performance.

One benefit of aquatic therapy is the buoyancy provided by the water. While submerged in water, buoyancy assists in supporting the weight of the patient. This decreases the amount of weight bearing which reduces the force of stress placed on the joints. This aspect of aquatic therapy is especially useful for patients with arthritis, healing fractured bones, or who are overweight. By decreasing the amount of joint stress it is easier and less painful to perform exercises.

The viscosity of water provides an excellent source of resistance that can be easily incorporated into an aquatic therapy exercise program.

This resistance allows for muscle strengthening without the need of weights. Using resistance coupled with the water’s buoyancy allows a person to strengthen muscle groups with decreased joint stress that can not be experienced on land.

Aquatic therapy also utilizes hydrostatic pressure to decrease swelling and improve joint position awareness. The hydrostatic pressure produces forces perpendicular to the body’s surface. This pressure provides joint positional awareness to the patient. As a result, patient proprioception is improved. This is important for patients who have experienced joint sprains, as when ligaments are torn, our proprioception becomes decreased. The hydrostatic pressure also assists in decreasing joint and soft tissue swelling that results after injury or with arthritic disorders.

Lastly, the warmth of the water experience during aquatic therapy assists in relaxing muscles and vasodilates vessels, increasing blood flow to injured areas. Patients with muscle spasms, back pain, and fibromyalgia find this aspect of aquatic therapy especially therapeutic.

It is important to know however, that aquatic therapy is not for everyone. People with cardiac disease should not participate in aquatic therapy. Those who have fevers, infections, or bowel/bladder incontinence are also not candidates for aquatic therapy. Always discuss this with your physician before beginning an aquatic therapy program.

Low Impact Water Aerobics

2007-03-08T08:21:00.005+02:00

If you want to do aerobics but find that they are just too difficult for you, then there is a solution. It is called low impact water aerobics. These don’t require that you do high impact strenuous exercises that leave you feeling tired and sore. This is the main reason that people give up and stop their exercise program. It is just too hard to continue for a long period of time for many people. If you find that you fall into this category then you will find that low impact water aerobics can provide you with many benefits. They will help you stay in form without as many problems.

People love the fact that low impact aerobics don’t make you feel so sore and drained of energy like high impact aerobics do. You don’t have to try and do all the jumping around which makes it safer for people with weak joints and muscles. Some parts of the low impact water aerobics are very similar to other programs. For example, you will have warm ups, stretching and cool down exercises. Many water aerobics include dance steps that make it fun to do. You will receive a really good workout that will leave you energetic and feeling wonderful. Most of them also last for around forty-five minutes.

If done correctly low impact water aerobics can be very beneficial. They will help your body burn more calories and help you to lose weight and feel better. They are much easier to perform and help to improve the cardiovascular muscles. These exercises are done in chest deep water and really do help to strengthen your muscles. Your muscles will become more flexible while you are building up their strength. The resistance that the water provides helps out in this area but does not put pressure on your body that can cause you to become sore.

People of all ages can receive benefits from these exercises, even children. Low impact water aerobics are wonderful for elderly people that can’t do other more strenuous ones. It can help them to stay in form without running the risk of doing damage to their bones or joints. It is also wonderful for pregnant women because it is safe for the baby. Anyone that has been sick or that is simply out of form can also benefit greatly from low impact water aerobics. Basically, if you want to get in form the fun, exciting and safe way, then low impact water aerobics may be what you are searching for, you should give it a try.