Movement and exercise has long been shown to be beneficial
in managing chronic pain. For many of us, accustomed to
exercising in gyms or fitness centers, the current pandemic
has greatly impacted our exercise regimens.
With the weather warming up, many of us are getting out
of the house to take strolls around the neighborhood as a
form of exercise. In fact, many healthcare providers will
instruct their patients that are older, deconditioned, or
suffer from comorbidities, to walk as a means of exercise
and physical therapy. Walking is easy to perform, has a
low risk of injury, and we do it every day. But is it enough?
A study looking at 52 sedentary patients, aged 18-65 years
with chronic low back pain were randomized into aerobic
walking vs. active strength training for six weeks. The
regimen included a 5 min warm up, 5 min cool down, and five
minutes of intense walking on a treadmill. They found both
groups improved to similar degrees. They also found that
the moderate-intensity walking program done twice a week
for six weeks improved functional performance and muscle
endurance more for those suffering from chronic back pain.
It is important to keep in mind that these studies are not
referring to a leisurely walk in the park, but rather a brisk
aerobic-style walk. The kind of walk that raises your heart
rate and makes you sweat. I think that is where some
patients mistakenly think that leisurely walking can replace
a focused exercise program. The findings of a systematic
review were inconclusive that leisurely walking improved
acute and chronic low back pain.
The American Heart Association recommends adults should
engage in 150 minutes of moderate intensity exercise each
week. It sounds like a lot, but it can be broken down into
30 minutes a day for five days a week. Even half of that is
better than nothing. So what is moderate intensity and how
is that measured? According to an article primarily targeting
cardiovascular fitness, maximum oxygen uptake (VO2
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max) was regarded as the gold standard for the assessment of
exercise quality. Based on this concept, walking speed, as well
as a patient’s baseline fitness level, will determine whether a
walking program will result in a significant increase in VO2
max (i.e be considered a moderately intense form of exercise).
Another sign that you can use to monitor your exercise level
(and one that you can actually measure yourself) is target
heart rate. The American College of Sports Medicine and
American Heart Association recommend you achieve 50% to
85% of maximum heart rate reserve for optimal cardiovascular
fitness. If you don’t know your target heart rate, you can go to
their website as a reference guide.
Implementing
An Effective Walking Program
Implementing an effective walking program
If you decide walking will be your primary form of exercise,
you need to commit to doing it on a regular basis. Remember
that the time spent walking, the distance walked, and intensity
are vital components of your walking program. Just walking
from your front door to the mailbox does not count. Slowly
increase your distance every day. The Arthritis Foundation
recommends starting out with 6,000 steps per day for more
debilitated patients and has a Walk With Ease program online
to slowly introduce yourself into a walking program. Some
activity is better than none, but to truly benefit from a walking
program, you need to work up to walking briskly. If you have
a mostly sedentary lifestyle, start slow and don’t give up.
Remember to stretch, warm up and wear supportive shoes.
Also, pay attention to not only distance, but to your heart rate,
and the intensity of your stride. Bottom line — any amount
of activity will help you, so get started as soon as possible!
Revitalize Medical Center is accepting new patients at their
Glenview and Evanston locations.
Schedule a consultation
847-834-4018
RevitalizeMedCenter.com
Sheetal DeCaria, MD.
WELLNESS
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