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Research Bites

Bracko, Michael R. Ed.D., FACSM

doi: 10.1249/01.FIT.0000298469.83371.d5

Benefits of Water Exercise for Fibromyalgia; Whole-Body Vibration Training; Exercise Helps Patients With Alzheimer's Disease; Crunches on a Stability Ball.

Michael R. Bracko, Ed.D., FACSM, is an exercise physiologist and director of the Institute for Hockey Research and the Occupational Performance Institute in Calgary, Canada. He is an associate editor for ACSM's Health & Fitness Journal® and works in three areas: 1) sports physiology, where he conducts research on the performance characteristics of female ice hockey players, teaches high performance skating, and serves as physiologist for the University of Alberta Women's Hockey Team and the U.S. Men's Deaf Olympic Ice Hockey Team; 2) the health and fitness industry, by contributing to fitness magazines, consulting, presenting at health and fitness meetings such as the ACSM's Health & Fitness Summit & Exposition; and 3) as an occupational physiologist, in the areas of back injury prevention, ergonomics, workstation stretching, and prework warm-up.

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This study is good news for people who have fibromyalgia and those who work with people with this condition. The researchers evaluated the effects of a 12-week water exercise program, followed by a period of detraining, on health-related quality of life and physical fitness on patients with fibromyalgia. These evaluations took place at the beginning of the study, after 12 and 24 weeks.

Thirty-four women, aged 35 to 73 years, with fibromyalgia were randomly assigned to one of two groups: exercise group (n = 17) who exercised for 60 minutes in waist-high warm water 3 times per week for 12 weeks or the control group (n = 17) who maintained their regular leisure time activities. The exercise group trained for 12 weeks, then detrained for 12 weeks.

The results show no differences between the exercise and control groups in health-related quality of life or physical fitness at the beginning of the study. After 12 weeks of water exercise, the training group showed significant improvements over the control group in health-related quality of life: physical function, body pain, general health perception, vitality, social function, role emotional problems, and mental health. The training group also showed significant improvements over the control group in physical fitness: balance and stair climbing with and without weights. After the detraining period, the training group had continued improvement in body pain and role emotional problems. All physical fitness benefits were lost after the detraining period. The authors conclude that water exercise is a good form of physical, mental, and pain therapy for women who have fibromyalgia (1).



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In this study from Spain, the investigators analyzed the effect of whole-body vibration on energy expenditure, respiratory exchange ratio, perceived exertion, and heart rate during and after a set of half squats performed on a stable surface and on a vibrating platform. Seventeen male university students were pretested to determine their ten-repetition maximum, then performed 2 weeks of familiarization training. The training protocol consisted of three, four, and five sets of a ten-repetition maximum. In a crossover design, group 1 performed the half squats on a stable surface for the first week; and group 2, on the vibrating platform. During week 2, the groups switched surfaces. The training protocol was followed by a posttest ten-repetition maximum test, five sets of ten repetitions on the vibration platform, and five sets of ten repetitions on a stable platform.

The results of the study show that energy expenditure and respiratory exchange ratio were significantly higher during the posttest while performing half squats on the vibrating platform compared with half squats on a stable platform(4.50 ± 0.72 kcal·min−1 vs. 3.84 ± 0.79 kcal·min−1 and 1.23 ± 0.13 kcal·min−1 vs. 1.16 ± 0.10 kcal·min−1). Energy expenditure stayed higher 5minutes postexercise after performing halfsquats onthevibrating platform (3.30 ± 0.66 kcal·min−1 vs. 2.70 ± 0.47 kcal·min−1). Rating of perceived exertion also was significantly higher immediately after and during a 5-minute recovery and after performing half squats on the vibrating platform. The authors conclude that for male university students, performing half squats on a vibration platform can achieve greater energy expenditure, can be included into a regular weight training program, and when combined with proper dietary changes and regular exercise, can be used for weight loss (2).

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This study investigated the effect of an exercise program on improving the ability to perform activities of daily living, physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with mild-to-severe Alzheimer's disease. One hundred thirty-four patients from five nursing homes in France participated in the study. The subjects were randomly assigned to the exercise program (n = 67) or to routine medical care (n = 67).

The subjects were assessed on their ability to perform activities of daily living with the Katz Index of Activities of Daily Living. Physical performance was evaluated using 6-meter walking speed, the "Get Up and Go Test," and the one-leg balance test. Behavioral disturbance, depression, and nutritional status were evaluated using the Neuropsychiatric Inventory, the Montgomery and Asberg Depression Rating Scale, and the Mini-Nutritional Assessment. The change in scores from baseline to 12 months was analyzed.

The exercise program consisted of a 1-hour twice-a-week program, separated by at least 2 days and included aerobic, strength, flexibility, and balance training. Exercises were individualized, accompanied by music, and based on the participants' behavioral readiness for the proposed program. Subjects assigned to the control group received routine medical care and had no exercise or behavior management training.

The results of the study showed that exercise program patients had a slower decline in activities of daily living than patients receiving routine medical care. The exercise group was significantly faster, walking 6 m (0.41 ± 0.16 m/s vs. 0.36 ± 0.19 m/s). There were no differences for the Get Up and Go Test, one-leg balance test, behavioral disturbance, depression, or nutritional assessment scores. The authors conclude that a simple exercise program can improve performance of activities of daily living and walking speed in patients with Alzheimer's disease. Improved performance of activities of daily living is important because it can improve a patient's quality of life and decrease institutionalization, risk of death, and burden for the caregiver (3).

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This study provides further evidence of the benefits of training with a stability ball. The investigators compared abdominal muscle activity (surface electromyogram [EMG]) while performing a crunch in two different positions on a stability ball with a crunch on the floor. Forty-one subjects (23 men and 18 women; mean age, 20.3 years) participated in the study.

Each subject performed a traditional "head, neck, shoulder blade crunch" on the floor followed by the same movement on a 70-cm stability ball. The crunch on the stability ball was performed in two positions: ball at the inferior angles of the scapulas and ball at the lower lumbar region of the back. Surface EMG was placed on right upper portion of the rectus abdominis, right lower portion of the rectus abdominis, and right external oblique. Subjects performed one set of eight to ten repetitions for each crunch.

The results indicate that when the stability ball was placed at the lower lumbar region, EMG activity was significantly greater on the upper rectus abdominis, lower rectus abdominis, and right external oblique, 31%, 38%, and 24%, respectively, compared with a crunch performed on the floor. A crunch performed on the floor elicited significantly greater EMG activity than for the upper rectus abdominis, lower rectus abdominis, and right external oblique, 21%, 29%, and 39%, respectively. And, a crunch with the ball at the lumbar region had significantly greater EMG activity for the three muscle areas, 66%, 93%, and 104%, respectively, compared with a crunch with the ball below the scapulas. The researchers conclude that a stability ball can enhance abdominal muscle activity and that ball position can make a crunch harder or easier depending on a client's level of fitness (4).

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1. Tomas-Carus, P., A. Hakkinen, N. Gusi, et al. Aquatic training and detraining on fitness and quality of life in fibromyalgia. Medicine & Science in Sports & Exercise® 39(7):1044-1050, 2007.
2. Da Silva, M.E., J.M. Fernandez, E. Castillo, et al. Influence of vibration training on energy expenditure on active men. Journal of Strength and Conditioning Research 21(2):470-475, 2007.
3. Rolland, Y., F. Pillard, A. Klapouszczak, et al. Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial. Journal of the American Geriatrics Society 55(2):158-165, 2007.
4. Sternlicht, E., S. Rugg, L.L. Fuji, et al. Electromyography comparison of a stability ball crunch with a traditional crunch. Journal of Strength and Conditioning Research 21(2):506-509, 2007.
© 2008 American College of Sports Medicine