quarta-feira, 29 de julho de 2015

DEPRESSION AND EXERCICE



Depression can be helped by exercise


Summary

Depression can be helped by regular exercise. Physical activity causes brain pleasure centres to be stimulated and leads to feelings of wellbeing. Exercise can also be effective in the treatment for anxiety.

Regular exercise can be an effective way to prevent or manage mild anxiety and depression. Physical activity causes brain pleasure centres to be stimulated and leads to feelings of wellbeing. Some research studies indicate that regular exercise may be as effective as other treatments like medication to relieve milder depression. Generally, exercise has a place in treatment as part of a comprehensive approach to the illness.

Depression explained


While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood – it’s a serious condition that has an impact on both physical and mental health. One in five women and one in eight men will experience depression at some point in their lives. 

Depression is a complicated condition, which can involve a number of contributing factors such as genes, environment, lifestyle, brain activity, psychology and personality. 

Depression, health and heart attacks


On average, depressed people only exercise about half as much as people who aren’t depressed. This lack of cardiovascular fitness puts a depressed person at an increased risk of heart attack. It also seems that depression and exercise influence each other – a sedentary lifestyle increases the risk of depression and depression increases the likelihood of a sedentary lifestyle. 

Exercise and depression study


One research study compared the effects of exercise and drug therapy in treating depression in older people. 156 men and women with depression were divided into three groups. Over 16 weeks, one group took antidepressants, the second group undertook an aerobic exercise program and the third group used both medications and exercise.

Selected results include:
  • The participants in all three groups improved.
  • The participants taking antidepressants improved the fastest.
  • 68.8 per cent of participants in the combination group were no longer classified as clinically depressed after treatment.
  • 60.4 per cent of participants in the exercise group were no longer classified as clinically depressed after treatment.
  • 65.5 per cent in the medication group were no longer classified as clinically depressed after treatment.
However, when the research done on adolescents and young people is pooled, there are not many studies and, although some benefits are found for depression and anxiety, the benefits are relatively small. 

Serotonin – the brain chemical


Serotonin is an important brain chemical (neurotransmitter) that contributes to a range of functions, including sleep and wake cycles, libido, appetite and mood. Serotonin has been linked to depression. 

Some researchers have found that regular exercise, and the increase in physical fitness that results, alters serotonin levels in the brain and leads to improved mood and feelings of wellbeing. Some research indicates that regular exercise boosts body temperature, which may ease depression by influencing the brain chemicals.

Benefits of exercise


Apart from changes in brain activity, other things that may help explain the benefits of exercise include:
  • The person experiences a boost to their self-esteem because they take an active role in their own recovery.
  • Some forms of exercise, such as team sports, are also social events.
  • Physical activity burns up stress chemicals, like adrenaline, which promotes a more relaxed state of mind.
  • An enjoyable bout of exercise may be distracting enough to break the vicious cycle of pessimistic thinking.
The physical benefits of regular exercise include:
  • improved cardiovascular fitness
  • reduced risk of premature death
  • reduced cholesterol level
  • reduced blood pressure
  • maintenance of healthy weight
  • improved muscle tone.

Exercise suggestions


Before deciding on any exercise plan, consult with your doctor, especially if you haven’t exercised for some time. Some ways you can use exercise to help manage depression are:
  • Choose a range of fun activities.
  • Ask a family member or friend to be an exercise partner, as lack of motivation is one of the key characteristics of depression.
  • Exercise two to five times per week.
  • Make the length of each exercise session at least 30 minutes.
  • Exercise at around 60 to 70 per cent of your maximum heart rate. To calculate your maximum heart rate, subtract your age from 220.
  • Remember to thoroughly warm up and cool down.
  • Try to live a more active lifestyle – walk instead of using the car for short trips, or use stairs instead of lifts and escalators when possible.

Things to remember

  • Research suggests that regular exercise may be effective in preventing depression and also in treating mild depression.
  • A sedentary lifestyle increases the risk of depression, and depression increases the likelihood of a sedentary lifestyle.
  • Regular exercise alters brain chemistry and leads to improved mood and feelings of wellbeing.
  • People who suffer from anxiety also improve when they exercise regularly.

Myotherapy



Physical Therapy-Miotherapy


Summary


Myotherapy is a form of physical therapy used to treat or prevent soft tissue pain and restricted joint movement. The philosophy of myotherapy is founded on Western medical principles including anatomy, physiology and biomechanics. Techniques may include massage, stretching, acupressure and myofascial dry needling.

yotherapy is a form of physical therapy used to treat or prevent soft tissue pain and restricted joint movement caused by muscle or myofascia dysfunction. Myofascia are the thin, fibrous sheets of tissue that surround and separate muscles. Ligaments and tendons are comprised of bundled myofascia.

The philosophy of myotherapy is founded on Western medical principles including anatomy, physiology and biomechanics. You don’t need a referral from a doctor to make an appointment with a myotherapist.

Symptoms of soft tissue pain


Pain that is caused by muscle tissue or muscle fascia (myofascia) is called myofascial pain. Symptoms can include:
  • deep and constant aching
  • muscle tightness
  • sore spots in the muscle (myofascial trigger points)
  • reduced joint mobility
  • stiff joints
  • numbness
  • recurrent tingling, prickling or ‘pins and needles’ sensation
  • unexplained tiredness.

Myotherapy can treat a range of disorders


Myotherapy can be used to treat a wide range of disorders including:
  • overuse injury such as tennis elbow or shin splints
  • some sports injuries
  • tension headache
  • pain caused by poor posture
  • some types of chronic back pain
  • some types of joint pain, such as shoulder impingement syndrome
  • muscle sprains.

What to expect at your first myotheray appointment


For your first appointment, take any medical test results (such as x-ray films) that relate to your condition. The myotherapist will ask many questions about your symptoms. Tell them about your medical history, including prior illness and surgery. Give them a list of all the medicines you are currently taking. This information is kept in strictest confidence and is used by the therapist to help pinpoint the cause of your symptoms.

The myotherapist will examine and manipulate the affected joints and associated muscles, and test your reflexes. This initial examination is thorough and helps the myotherapist to find out if the symptoms are myofascial. The myotherapist may refer you to other healthcare professionals for further diagnosis or treatment, depending on your medical condition.

Myotherapy techniques


Treatment depends on the diagnosis. Myotherapy uses a range of techniques including:
  • massage, including sports and remedial techniques
  • gently moving the patient’s affected body part through its range of motion (passive stretching)
  • hot or cold therapy
  • transcutaneous electrical nerve stimulation (TENS) therapy
  • trigger point therapy (acupressure)
  • myofascial dry needling.
Most people with myofascial dysfunction will have pain relief within one to three sessions. Each session typically lasts one hour.

Self-help suggestions


The myotherapist will explain your condition in detail. Dietary changes could be recommended. The myotherapist may advise treatments to use at home including:
  • exercises and stretches specific to your condition
  • self-administered massage
  • heat packs
  • ice packs
  • relaxation techniques including meditation.

Ongoing management with myotherapy


The myotherapist will work with you to identify factors that may be making your condition worse (such as poor posture, scoliosis or overtraining) and help you find ways to avoid or reduce these aggravating factors.

If something cannot be changed (for example, arthritis or age-related changes to spinal discs), the myotherapist will develop a pain management program. This may involve referral to other healthcare professionals. 

For acute or persistent joint pain, always see your doctor.

Finding a myotherapy practitioner


Suggestions for finding a practitioner include:
  • Contact the Australian Association of Massage Therapists and ask for a list of members in your area.
  • Ask your doctor or healthcare professional for a referral.
  • Ask your friends for word-of-mouth recommendations.

Things to remember

  • Myotherapy is a form of physical therapy used to treat or prevent soft tissue pain and restricted joint movement.
  • The philosophy of myotherapy is founded on Western medical principles including anatomy, physiology and biomechanics.
  • You don’t need a referral from a doctor to make an appointment with a myotherapist.

Epilepsy

Epilepsy




Summary

Having epilepsy does not mean a person cannot exercise. Physical activity can reduce the risk of epileptic seizures. However, since seizures can occur suddenly and without warning, a person with epilepsy needs to ensure their exercise and sporting activities are as safe as possible. Water safety is critical for a person with epilepsy

Epilepsy is a disorder of brain function that takes the form of recurring seizures. Our thoughts, feelings and actions are controlled by brain cells that communicate with each other through regular electrical impulses. A seizure occurs when sudden, uncontrolled bursts of electrical activity disrupt this regular pattern.

This can be confined to just one part of the brain or it can occur right across the brain. Communication between cells becomes scrambled and our thoughts, feelings or movements become momentarily confused or uncontrolled.

Different types of seizures will affect people in varying ways, depending on where in the brain the seizure is occurring and what functions that part of the brain controls. Seizures can disrupt any function the brain controls – movement, thoughts, sensations, behaviour, and the person’s level of consciousness.

Exercise and epilepsy


Exercise is good for everyone, but it also has important benefits for people with epilepsy. People with epilepsy and their families are commonly concerned about seizures during exercise and this fear often results in overprotection, feelings of isolation and needless restrictions on activity. 

While seizures during exercise are rare, it is important to understand how exercise affects both epilepsy and seizures, and what to do if a seizure occurs. 

In many cases, a seizure occurs suddenly and without warning, so a person with epilepsy needs to make sure their exercise and sporting activities are as safe as possible at all times. 

Exercise and epileptic seizures


It is extremely rare for a person to have a seizure while exercising. Rather than triggering seizures, your epilepsy may improve with exercise. Although the reasons are unclear, studies demonstrate that abnormalities on EEG (a test that measures the electrical activity of the brain) decrease during exercise.

Overall fitness and a feeling of wellbeing have been shown to help reduce seizure frequency. People feel better and may improve their seizure control with regular exercise. One report suggests that exercise improves self-esteem and social integration regardless of seizure control. It has also been shown that regular exercise reduces the number of overall health complaints, such as muscle pains, sleep problems, depression and fatigue.

Most sports activities are safe as long as people avoid overexertion, dehydration and hypoglycaemia (low blood sugar). If a seizure occurs, it is most likely to be after the exercise (15 minutes to three hours later).

Exercise safety issues and epilepsy


Be guided by your doctor, but general safety considerations include:
  • Before starting any new exercise program, consult with your doctor or specialist.
  • Pre-exercise screening is used to identify people with medical conditions that may put them at a higher risk of a experiencing a health problem during physical activity. It is a filter or ‘safety net’ to help decide if the potential benefits of exercise outweigh the risks for you. Print a copy of the pre-exercise screening tool and discuss it with your doctor or exercise professional.
  • Avoid known seizure triggers.
  • Always take your medication as prescribed and have an adequate supply available.
  • Stay well-hydrated and drink or snack on something with sugar in it.
  • Don’t continue exercising if you feel faint, lightheaded, nauseous or dehydrated.
  • Don’t overexert yourself – know your limits.
  • Make sure your coach and possibly teammates are aware of your condition and know what to do if you have a seizure.
  • If involved in solo exercise, consider wearing a medical alert bracelet or pendant, so people can easily identify you have epilepsy.
  • Wear protective gear appropriate to your sport, such as a helmet or knee pads.
  • Always wear a life jacket when involved in water sports.
  • Let family or friends know your walking, jogging or exercise route before you leave and how long you will be out.
  • Consider carrying a mobile phone with an ICE (in case of emergency) telephone number listed.

Risky activities and epileptic seizures


In addition to the above, people with uncontrolled seizures need to be especially careful when engaging in more risky activities and should seek advice from their doctor before engaging in:
  • Contact sports, scuba diving, bungee-jumping and boxing
  • Solo aerial sports such as hang-gliding and skydiving
  • High altitude activities such as mountain-climbing
  • Motor sports
  • Horseback riding
  • Gymnastics
  • Ice activities such as skating or hockey
  • Skiing
  • Solo water sports such as sailing or sailboarding.

People with epilepsy whose seizures are difficult to control need to have someone with them who knows what to do if they have a seizure, and is able to carry out the necessary seizure first aid.

Discuss your sports aspirations with your doctor. With adequate planning and precautions, you can take part in a wide range of activities.

Water safety and epilepsy


Water safety is particularly crucial, because a person who experiences a seizure while alone in water will almost certainly get into difficulty and may even drown. Suggestions include:
  • Be alert – showers, baths, pools, spas and the ocean can be dangerous for anyone experiencing seizures.
  • Swim with companions who are aware of your condition and who are physically strong enough to support you and know what to do if you have a seizure.
  • Swim in supervised areas, such as in a public pool with an attendant or at the beach between the flags, where lifeguards are on patrol.
  • Tell the pool attendant or lifeguard that you have epilepsy and the type of seizures you experience. You may need to brief them on how best to help you, if they don’t already know.
  • People with epilepsy, even if well controlled, should never swim alone.

Anti-epileptic medications and exercise


Anti-epileptic medications are the most common treatment for epilepsy and seizures, but some of the side effects may influence your performance, including:
  • Fatigue and tiredness – which can be a problem for active people
  • Other problems – such as blurred vision or problems with concentration, impaired coordination and slower response times
  • Exercise – can alter the levels of anti-epileptic medications in the blood. People taking anti-epileptic medications who exercise regularly should discuss with their doctor the need to have their blood levels monitored (especially in the first few months of training)
  • Anabolic steroids – don’t take anabolic steroids, as they interfere with anti-epileptic medication levels in the blood
  • Anti-epileptic medications may lead to bone loss (osteopaenia and osteoporosis) – large studies suggest a doubling of fracture risk in people with epilepsy. Weight-bearing exercise can help prevent these conditions. Discuss appropriate activities with your doctor.

Exercise-related epilepsy triggers


It is important to exercise sensibly. You could trigger a seizure minutes or hours after exercise if you unnecessarily strain your body. Exercise-related risk factors could include:
  • Extreme fatigue
  • Lack of sleep
  • Dehydration (and electrolyte loss, due to severe dehydration)
  • Hyperthermia (elevated body temperature)
  • Hypoglycaemia (low blood sugar levels).

Suggestions to help you avoid these triggers include:
  • Make sure you take your medication according to your doctor’s directions.
  • Drink plenty of water before, during and after exercise.
  • Don’t push yourself to the point of physical exhaustion.
  • If you are feeling very hot and tired, slow down or stop.
  • Make sure you have at least two rest days every week.
  • Make sure your diet is nutritionally adequate.
  • Get plenty of rest and good quality sleep.
  • Limit or abstain from alcohol.


Things to remember

  • Exercise is good for everyone, but it also has important benefits for people with epilepsy as the condition may improve with exercise.
  • Take all necessary safety precautions while exercising.
  • Anti-epileptic drugs can affect sporting performance.