The huge benefits of tailoring exercise
What has really made a difference, she maintains, are her twice-weekly Pilates classes
Those who take regular exercise live longer than those who do not – though only a narrow margin separates the very from the moderately fit. The least fit, however, do badly with a three-fold increased risk of dying before their time. Thus the standard advice favours a regular daily dose of aerobic exercise of sufficient intensity to stress the capabilities of the heart – the simplest being a 60-minute walk brisk enough to increase the pulse rate.
This is, however, quite unrealistic for many – those with arthritic joints, chronic pain syndrome, neurological disorders and so on. Hence some alternative method of maintaining fitness is called for – as demonstrated unequivocally in a recent study comparing the merits of tai chi, the ancient Chinese martial art, with aerobic exercise in 200 people with the diffuse muscular pains of fibromyalgia. The tai chi, combining deep breathing with slow and gentle movements, proved much superior not just in improving “physical functional performance”, but promoting a general sense of wellbeing.
This principle of tailoring the form of exercise to the specific needs of individuals applies, too, to Parkinson’s, as described by an acquaintance, the severity of whose symptoms had warranted the procedure of deep brain stimulation – inserting electrodes into the affected part of her brain. This certainly helped her tremor and immobility, but what has really made a difference, she maintains, are her twice-weekly Pilates classes.
“I feel much stronger, and my balance has improved enormously,” she says. “I could not really control my arms and had real problems swimming in anything but a circle. Now I can do a whole length of the swimming pool in a straight line, backwards. It is very good for morale.”
Pressure points
Blood pressure, as all know, varies markedly depending on the time of day and in response to circumstances. Retired physician Oscar Jolobe was not particularly surprised that, when measured by his family doctor soon after he received a worrying call from his solicitor, it was raised, at 154/78. None the less, he decided on returning home to measure it with a home monitor, four to five times a day over the following week: “All the systolic pressures [the upper reading] were well within the normal limits of 100130.”
Had he not measured it himself, on the basis of that initial reading, he would have been labelled as having hypertension. The anxiety-generating implications of being at increased risk of stroke can, it was reported in this paper last week, push up the blood pressure on its own account.
It is impossible to know how often this might happen, but it emphasises how blood pressure must be measured correctly, a time-consuming but necessary rigmarole that entails the following: the patient sitting at rest in a chair for five minutes prior to measurement; avoidance of coffee, exercise and smoking for 30 minutes beforehand; removal of clothing under the cuff; repeated measurements and averaging of the results.
The failure to follow this procedure, it is claimed, “occurs commonly”, resulting in over-diagnosis and unnecessary treatment.
Cold comfort
The reader much troubled during the winter months by recurrent episodes of allergic rhinitis, followed by the classic symptoms of a head cold, has elicited several similar accounts. The initial symptoms, it is proposed, may be related to the method of keeping the house warm in winter, due, for example, to sensitivity to the dust thrown up in the air by heat rising from the radiators. A couple of readers report how, serendipitously, since being started on bone-strengthening vitamin D supplements for osteoporosis, they “have not had a cold since”.
This could just be coincidence – but an analysis of 11,000 people last year found that vitamin D “protected against upper respiratory tract infections overall”. The effect is certainly modest, but it would seem worth a trial.