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Research Bites

Yoke, Mary M. M.A., M.M.

ACSM's Health & Fitness Journal: May/June 2017 - Volume 21 - Issue 3 - p 31–33
doi: 10.1249/FIT.0000000000000289
Columns: Research Bites

Mary M. Yoke, M.A., M.M., is pursuing her doctorate in health behavior at the Indiana University School of Public Health, where she was previously a fulltime faculty member in the Department of Kinesiology. Before her position in Indiana, she was an adjunct professor at Adelphi University for 22 years, where she authored or coauthored numerous group exercise research studies. She is the author of four texts on fitness; she has presented in 11 countries and throughout the United States on a wide variety of health/fitness topics and has obtained 23 certifications. Her research interests include behavior change, positive psychology, motivation, and group fitness and personal training efficacy.

Disclosure:The author declares no conflict of interest and does not have any financial disclosures.

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In a study published in the Journal of Medical Internet Research, authors LeRouge et al. (5) examined which technologies baby boomers were ready to use for health purposes, explored potential barriers to usage of these health technologies, and sought to compare baby boomers with other age groups in terms of technology usage.

It is well known that adults generally have increasing health care needs as they grow older, and the baby boomer generation, born between 1946 and 1964, is no exception. Baby boomers now comprise the group between the ages of 53 to 71 years, and the growing impact of this largest segment of the population on the health care system has been dubbed the “gray tsunami” because health care costs related to aging are expected to swell.

New consumer health and fitness technologies and products have the potential to greatly enhance wellness and help control medical costs, as people become empowered to make better health decisions and are more likely to be connected to their medical providers and other caregivers such as health/fitness professionals. Because the baby boomers make up the largest older adult cohort in history, LeRouge et al. (5) reasoned that it is important to understand the barriers to consumer health technologies among members of this age group. Moreover, the authors were interested in exploring which technologies baby boomers were ready to use to promote healthy behaviors.

A total of 469 participants completed a Qualtrics survey, with 15.4% of respondents younger than baby boomers, 55% in the baby boomer age group, and 29.6% older than baby boomers. Baby boomers were found to be significantly more likely to use five technologies for health care purposes than the older group; these technologies were health information Web sites, email, automated call centers, medical videoconferencing, and texting. However, they were less likely than the younger group to use kiosks, smartphones, blogs, and wikis for health care purposes. The perceived barriers to health care technology identified by a majority of respondents were “don’t enjoy using,” “not appropriate,” “don’t know how to use,” “need more training,” and “don’t know what it is.”

The take-home message for fitness professionals? Baby boomers seem to be ready to use several technologies for health purposes. Familiarity is important and enhances the adoption of a new use. For example, if a person is familiar with texting on a smartphone, then the learning curve involved in sending an email on a smartphone is reduced. However, the authors found that significantly fewer older consumers are ready to use smartphones for health purposes than young consumers. Fitness professionals can help baby boomers adopt new technologies by providing set up, training, trial periods, feedback, and follow-up. It’s also important to provide baby boomers with technologies that are familiar to them, have clearly perceived benefits, and are relatively easy to use. Baby boomers are more likely to use new technologies than older age groups, but are less open to interactive technologies than younger consumers.

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The benefits of yoga and meditation have been explored and verified in numerous studies. However, more evidence is emerging regarding enhanced brain function as a result of contemplative practices. In an article by Gard et al. (4), resting-state functional brain networks were identified and assessed in experienced yoga practitioners, experienced meditators, and controls. A major finding was that yoga practitioners and meditators had significantly greater degree centrality in the brain caudate than the controls. What exactly does this mean?

Each of the two hemispheres in the brain has a caudate nucleus, which, among other functions, is critically important in processing information. Information from past experiences is used in decision making and in taking action in the caudate. The caudate nucleus also is where spatial information is integrated with motor behavior patterning and seems to be involved in memory, certain types of learning, emotion, language, and in the duration of deep, slow-wave sleep cycles.

Degree centrality in the brain caudate means that the caudate nucleus is a central node that is connected or linked (think of a social network) to many other regions of the brain, resulting in a complex network structure. The authors suggest that such connectivity explains the mechanism behind the documented improvements in mental health and well-being found in yoga practitioners and meditators in multiple other studies.

Gard et al. (4) conducted two studies: the first, experimental study involved 16 experienced Kripalu yoga practitioners, 16 meditation practitioners, and 15 controls. The second, replication study used 13 Vipassana meditation practitioners and 16 controls. Participants were matched for age and education levels. All participants had 5- to 7-minute, nonmeditating brain scans while at rest in an magnetic resonance imaging scanner. The degree centrality of the meditators, yoga practitioners, and control participants for the left and right caudate nuclei were calculated and compared. There were significant differences between the yoga practitioners and the controls, and between the meditators and the controls, but not between the yoga practitioners and the meditators, in terms of the central role of the caudate in brain organization. In other words, Kripalu yoga and meditation techniques seem to increase connectivity between various structures in the brain (more than 115 regions in the brain were found to be linked to the caudate nuclei).

Kripalu yoga is known as meditation in motion (3); practitioners are encouraged to breathe mindfully and maintain a meditative state while moving through yoga postures and to be internally directed by the body’s sensations to intuitively move to the next position or movement, the one that most suits the body/mind in any given moment. In Vipassana meditation, a great awareness of breath is used to maintain mindfulness in each moment as well, so the two practices share some important techniques and philosophies.

The Gard et al. (4) study is one of the few investigations of neuroimaging in yoga practitioners and the only study thus far to directly compare yoga and meditation practitioners by using brain scan data. The authors conclude by stating that the increased connectivity found in the MRI data may account for many of the positive benefits found in yoga and meditation, specifically improved behavioral flexibility, mental health, and well-being.

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In a recent randomized controlled trial, Dalleck et al. (2) measured the results of two 13-week exercise training regimens on 42 sedentary men and women (aged 44 to 83 years). One training regimen used the standard American College of Sports Medicine (ACSM) exercise program model, as outlined in ACSM’s Guidelines for Exercise Testing & Prescription, 9th edition (6). Training intensity was prescribed according to a percentage of heart rate reserve (HRR), with participants exercising during week 1 at 40% to 45% of HRR, and progressing to 60% to 65% of HRR over the course of 13 weeks. Resistance training used ACSM guidelines as well, with two sets of 12 repetitions performed at an intensity of 5 to 6 on the modified Borg rate of perceived exertion (RPE) scale. The bench press, shoulder press, lateral pulldown, seated row, biceps curl, triceps pushdown, seated leg press, seated leg extension, prone lying leg curl, and seated back extension and spinal flexion were performed using traditional weight machines; resistance was progressed every 2 weeks to maintain an RPE rating of 5 to 6 across the training program.

The second training regimen used the American Council on Exercise (ACE) Integrated Fitness Training (IFT) model. This model recommends that cardiorespiratory exercise intensity be performed according to ventilatory threshold, starting with heart rate less than ventilatory threshold 1 during weeks 1 to 4 and progressing to heart rate greater than or equal to ventilatory threshold 2 during weeks 9 to 13. ACE guidelines were used for the resistance and neuromotor training program as well, which lists certain multijoint and multiplanar exercises. Using free weights and machines that allowed for free motion (the range of motion is not limited to a specific arc), a stability ball circuit (hip bridges, crunches, Russian twists, planks), a lunge matrix, kneeling/standing wood chops, kneeling/standing hay bailers, dumbbell squats, standing one-arm cable rows, step-ups with dumbbells, assisted pull-ups, and dumbbell bench presses were performed for 2 sets of 12 repetitions each; resistance was progressed every 2 weeks to maintain an RPE rating of 5 to 6 across the training program.

All participants were assessed at baseline and at the end of the program; assessments included fasting blood lipid and blood glucose measurements, resting heart rate, resting blood pressure, percent body fat, waist circumference, stork-stand balance test, 5-RM bench press and leg press testing, and a modified Balke, pseudoramp cardiopulmonary exercise test. First and second ventilatory thresholds were determined. Participants were randomly assigned into the standardized protocol group, the ACE-IFT group, or a control group.

Results showed no difference between the two exercise protocols in terms of body mass changes, resting HR, or cholesterol levels. However, there were significant differences between the two experimental groups in V˙O2max, body fat percentage, systolic blood pressure, and muscular fitness, with the greatest improvements found in the ACE-IFT group. Bouchard et al. (1) also were interested in the issue of participant nonresponsiveness and/or adverse responses to an exercise program, which has been shown in the literature. A nonresponder is a person who, despite the maintenance of an exercise program, shows little improvement in V˙O2max, percent body fat, waist circumference, resting blood pressure, or cholesterol measures. Data obtained from the current study indicate that the ACE IFT regimen led to greater responsiveness in terms of results, and fewer incidences of nonresponse.

The authors suggest that one possible reason for the difference in the results between the protocols is the use of different exercise intensity prescription methods. The percent HRR method used in the standardized regimen is a one-size-fits-all method, which can be problematic when applied to the general population. Humans, it seems, are inherently variable! In contrast, the ventilatory threshold-based intensity prescription was individualized, and therefore resulted in enhanced fitness results and greater training responsiveness overall. The take-home message? Because individuals are unique and different from one another, we must acknowledge and adjust for variability whenever possible.

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1. Bouchard C, Blair SN, Church TS, et al. Adverse metabolic response to regular exercise: is it a rare or common occurrence? PLoS One. 2012;7(5):e37887.
2. Dalleck LC, Haney DE, Buchanan CA, Weatherwax RM. Does a personalized exercise prescription enhance training efficacy and limit training unresponsiveness? A randomized controlled trial. Journal of Fitness Research. 2016;5(3):15–27.
3. Faulds R. Kripalu Yoga: A Guide to Practice On and Off the Mat. New York (NY): Bantam; 2005. 432 p.
4. Gard T, Taquet M, Hölzel BK, Dickerson BC, Lazar SW. Greater widespread functional connectivity of the caudate in older adults who practice Kripalu yoga and Vipassana meditation than in controls. Front Hum Neurosci. 2015;9:137.
5. LeRouge C, Van Slyke C, Seale D, Wright K. Baby boomers’ adoption of consumer health technologies: survey on readiness and barriers. J Med Internet Res. 2014;16(9):e200.
6. Pescatello LS. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Baltimore (MD): Lippincott Williams & Wilkins; 2014. 456 p.
© 2017 American College of Sports Medicine.