Posts Tagged physical activity

[WEB] Exercise and Brain Repair

By Dr. Osman Shabir, PhD, Reviewed by Emily Henderson, B.Sc.

Physical activity is essential in maintaining a healthy lifestyle and is associated with reducing the likelihood of many diseases. Increasing evidence points towards the benefits of exercise on brain structure and function and could even delay or prevent the onset of many neurological conditions including Alzheimer’s and stroke.

Physical Activity
Physical Activity. Image Credit: Halfpoint/Shutterstock.com

Regular aerobic exercise and/or moderate physical activity (such as brisk walking) is associated with better overall health compared to those who have a sedentary lifestyle. In combination with a healthy balanced diet, exercise promotes improved cardiovascular, metabolic, and immune health and therefore is associated with a reduced likelihood of developing cardiovascular diseases and metabolic diseases such as diabetes mellitus.

Since the brain is a highly metabolically active organ with intricate links to the cardiovascular system, any susceptibilities to systemic diseases also have a negative impact on the brain, for example, cardiovascular diseases and stroke. Therefore, promoting a healthy lifestyle with exercise also has a beneficial impact on the brain’s health by enhancing neurovascular, neuroimmune, and neurometabolic function.

Cognitive Function

Many studies have found that adults (especially >65 years of age) who regularly exercise or perform some form of physical activity (walking, gardening, swimming, etc) tend to perform better in cognitive tests and as such are at a reduced risk of cognitive impairment and dementia compared to those who do not regularly perform some form of physical activity. Furthermore, performing physical activity and exercise can improve some level of cognitive and executive functions in patients with earlier stages of dementia.

Click here to read about brain development.

One of the main neuroprotective chemicals found in the brain are called neurotrophic factors which support neuronal and synaptic health and can improve cognition and mood. Reduction in neurotrophic factors can be detrimental to neuronal health and synaptic plasticity and may be implicated in the onset of neurodegenerative disorders. Even mild physical activity such as walking through to intense aerobic exercise all increase the levels of neurotrophic factors such as BDNF, and higher levels due to higher intensity exercise is positively correlated with better neural health and function.

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Rodent studies have given us mechanistic insights into how exercise is able to confer neuroprotective properties. For example, one month of voluntary wheel running in mice reduced the pathological and behavioral deficits associated with aging by increasing levels of BDNF as well as enhancing neurogenesis in the hippocampus. In addition, voluntary wheel running also led to the upregulation of nerve growth factor (NGF), insulin-like growth factor (IGF-1), and tight junction proteins in maintaining the blood-brain barrier.

Physical exercise has a direct effect not only on levels of BDNF and other neurotrophic factors but also upregulates levels of p75NTR and CREB – both involved in synaptic plasticity. Improving synaptic plasticity mechanisms directly leads to improvements in memory and cognition, whereas normal aging suppresses these mechanisms. Furthermore, aerobic exercise e.g., treadmill, increases the expression of pNDMA, PSD 95 & decreases DNA damage all contributing to stabilizing and preventing cognitive decline in healthy aging. However, it is important to note that “over-training” can lead to negative consequences with more DNA damage, for example.

Together, these maintain the cerebrovasculature preventing the infiltration of toxic compounds and chemokines that promote neuroinflammation, as well as enhancing both neuronal and synaptic function. Furthermore, the activation of microglia (the brain’s immune cells) was reduced by exercise thus protecting key brain regions from insult. Interestingly, exercise in mice modeling Alzheimer’s has been shown to reduce the levels of soluble beta-amyloid by enhancing glymphatic clearance as well as reducing white matter pathology leading to enhanced cognitive performance. These preclinical findings mirror clinical findings described earlier and provide a mechanism by which exercise can protect the brain, but also enhance its function, even in disease.

Stroke

Many of the above findings not only protect the brain but are able to repair and stabilize neurological damage such as through the increased production of neurotrophic factors for example. As such, exercise in the early stages of dementia can slow down and even reverse some of the damage.

Depending on the severity and location of a stroke, different challenges can present including impairments to activities of daily living. As areas of the brain are damaged, it is important to rehabilitate and repair some of the reversible damage as soon as possible for a better prognosis. Aerobic exercise has been shown to reduce the lesion size (volume) and protect the surrounding perilesional tissue from oxidative damage and inflammation in addition to increasing neurogenesis in the short term. This can be achieved by moderate forced exercise of around 10 minutes a day 5-7 times a week initiated within 48 hours after stroke. The earlier the better when it comes to forced exercise in the short-term outlook. The higher the intensity of exercise, the better the recovery and higher levels of angiogenesis within the perilesional area to support recovery.

In summary, exercise has a profound neuroprotective effect on the brain and regular exercise (especially aerobic) not only can improve brain function and enhance cognitive function and mood, but also delay, improve, or prevent the onset of neurological disorders such as stroke and dementia. In addition, performing regular exercise in earlier stages of the disease has also been shown to improve pathological and clinical outcomes.

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[Abstract] Effectiveness of walking training on balance, motor functions, activity, participation and quality of life in people with chronic stroke: a systematic review with meta-analysis and meta-regression of recent randomized controlled trials

Abstract

Purpose

To review and quantify the effects of walking training for the improvement of various aspects of physical function of people with chronic stroke.

Methods

We conducted a systematic search and meta-analysis of randomized controlled trials (RCTs) of chronic stroke rehabilitation interventions published from 2008 to 2020 in English or French. Of the 6476-screened articles collated from four databases, 15 RCTs were included and analyzed. We performed a meta-regression with the total training time as dependent variable in order to have a better understanding of how did the training dosage affect the effect sizes.

Results

Treadmill walking training was more effective on balance and motor functions (standardized mean difference (SMD)=0.70[0.02, 1.37], p = 0.04) and 0.56[0.15, 0.96], p = 0.007 respectively). Overground walking training improved significantly walking endurance (SMD = 0.38[0.16, 0.59], p < 0.001), walking speed (MD = 0.12[0.05, 0.18], p < 0.001), participation (SMD = 0.35[0.02, 0.68], p = 0.04) and quality of life (SMD = 0.46[0.12, 0.80], p = 0.008). Aquatic training improved balance (SMD = 2.41[1.20, 3.62], p < 0.001). The Meta-regression analysis did not show significant effect of total training time on the effect sizes.

Conclusion

Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in people with chronic stroke.

  • Implications for rehabilitation
  • Treadmill walking training is effective for improving balance and motor functions.
  • Overground walking training improved significantly walking endurance, walking speed, participation and quality of life.
  • Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in patient with chronic stroke.

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[Abstract] Associations Between Physical Activity Intensities and Physical Function in Stroke Survivors

Abstract

Purpose 

Impairment caused by stroke is a major cause of disablement in older adults. Physical activity has been shown to improve physical functioning; however, little research has been done to explore how physical activity of different intensities may affect physical function among stroke survivors. The purpose of this study was to examine the patterns of accelerometer-measured physical activity and the relationship between physical activity intensities and objective physical functioning and perceived functional limitations in stroke survivors.

Methods 

Stroke survivors (N = 30, mean age = 61.77 ± 11.17) completed the Short Physical Performance Battery and the Late-Life Function and Disability Instrument. Physical activity intensities were measured objectively using a 7-day actigraph accelerometer wear period and scored using the National Health and Nutrition Examination Survey cutoffs for sedentary (counts/minute ≤100), light (counts/minute 101–2019), and moderate to vigorous (moderate to vigorous physical activity counts/minute ≥2020) activity.

Results 

Multiple linear regressions controlling for age and time since stroke demonstrated that higher levels of moderate to vigorous physical activity predicted better Short Physical Performance Battery performance (β = .43, P = 0.04). For self-reported physical function, light physical activity predicted better basic lower limb function (β = .45, P = 0.009), better advanced lower limb function (β = .53, P = 0.003), better upper limb function (β = .37, P = 0.04), and higher total function score (β = .52, P = 0.002) on the Late-Life Function and Disability Instrument.

Conclusions 

These findings suggest that light activity as well as moderate to vigorous physical activity may contribute to better physical functioning in stroke survivors. Although moderate to vigorous physical activity significantly predicted the objective measure of physical function (Short Physical Performance Battery), light physical activity consistently predicted higher scores on all subscales of the Late-Life Function and Disability Instrument. Disabilities resulting from stroke may limit this population from engaging in moderate to vigorous physical activity, and these findings highlight the importance of light physical activity, which may offer similar perceived functional benefits. Future studies should focus on development of effective exercise interventions for stroke survivors by incorporating and comparing both moderate to vigorous physical activity and light-intensity physical activity.

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[ARTICLE] The Effectiveness of Virtual Reality Exercise on Individual’s Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review – Full Text

Abstract

Objective purpose: This review synthesized the literature examining the effects of virtual reality (VR)-based exercise on physiological, psychological, and rehabilitative outcomes in various populations. 

Design: A systematic review. 

Data sources: 246 articles were retrieved using key words, such as “VR”, “exercise intervention”, “physiological”, “psychology”, and “rehabilitation” through nine databases including Academic Search Premier and PubMed. 

Eligibility criteria for selecting studies: 15 articles which met the following criteria were included in the review: (1) peer-reviewed; (2) published in English; (3) randomized controlled trials (RCTs), controlled trials or causal-comparative design; (4) interventions using VR devices; and (5) examined effects on physiological, psychological, and/or rehabilitative outcomes. Descriptive and thematic analyses were used. 

Results: Of the 12 articles examining physiological outcomes, eight showed a positive effect on physical fitness, muscle strength, balance, and extremity function. Only four articles examined the effects on psychological outcomes, three showed positive effects such that VR exercise could ease fatigue, tension, and depression and induce calmness and enhance quality of life. Nine articles investigated the effects of VR-based exercise on rehabilitative outcomes with physiological and/or psychological outcomes, and six observed significant positive changes. In detail, patients who suffered from chronic stroke, hemodialysis, spinal-cord injury, cerebral palsy in early ages, and cognitive decline usually saw better improvements using VR-based exercise. 

Conclusion: The findings suggest that VR exercise has the potential to exert a positive impact on individual’s physiological, psychological, and rehabilitative outcomes compared with traditional exercise. However, the quality, quantity, and sample size of existing studies are far from ideal. Therefore, more rigorous studies are needed to confirm the observed positive effects.

1. Introduction

Over the past decades, the effects of physical activity (PA) on individual’s health have been well documented [1,2,3]. However, despite the well-known benefits of PA participation, according to the World Health Organization (WHO) approximately 25% of adults and 80% of adolescents around the world are physically inactive partly due to societal and lifestyle changes [4]. Exercise (i.e., planned, structured and repetitive PA) is often perceived as boring and hard, thereby causing adults and students shy away from PA-related behaviors after long days of work and/or school. Instead, individuals are more interested in leisure activities, such as video games, where entertainment can be obtained while relaxing (i.e., sedentary behavior). Thus, the combination of video games and engaging in PA (e.g., virtual reality (VR)-integrated exercise) may trigger their interest and improve their PA behavior.

In recent years, VR exercise has been recognized as a new approach to promote PA and health behaviors [5] and is becoming increasingly used in health promotion. Researchers have observed VR exercise to enhance the psychological benefits of exercise and increase the likelihood of long-term adherence to exercise [6,7]. VR is operationally defined as digital technology wherein sensory experiences, (e.g., visual, auditory, touch, and scent stimuli) are artificially created, prompting users to manipulate the objects within virtual environment [8]. In general, there are three types of VR: immersive, non-immersive, and interactive. Immersive VR utilizes head-mounted displays, body movement sensors, real-time graphics, and advanced interface devices (e.g., dedicated headsets) to simulate a completely virtual environment for users, whereas non-immersive VR utilizes an interface, such as a flat screen TV/computer screen, and requires the use of a corresponding keyboard, controller and/or joystick [9,10]. Interactive VR is centered on the user’s ability to interact with virtual objects through devices (e.g., gloves, digital glasses) which produce the sensation of manipulating real items, such as picking up an apple [11].

The development of VR technology and its utility during PA via its integration with traditional exercise equipment and rehabilitation practices has attracted attention in the fields of kinesiology and public health. As a therapeutic tool, VR offers the opportunity to intensify repetitive tasks and increase visual and auditory feedback, making VR therapy more interesting than traditional physical therapy and without posing any serious threat or physical limitations to participants [11]. Previous reviews have examined the effectiveness of VR exercise on physiological, psychological or rehabilitative outcomes. For example, researchers suggested that VR could promote the lower limb function of patients who suffered from stroke [12]. VR exercise has also shown to have a significant effect on the balance ability of patients who suffered from stroke, Parkinson’s disease (PD) or children with cerebral palsy (CP) [13]. Additionally, the effectiveness of the application of VR in psychological treatment in psychotherapy has been widely supported [14]. For instance, VR exercise has been observed to relieve anxiety and depression [15]. As for rehabilitative effectiveness, VR technology in disease rehabilitation has been widely applied, namely to help disabled patients acquire lost motor skills caused by injury or illness and ensure these individuals are able to carry out activities of daily living. As such, the effectiveness of VR exercise on physiological and rehabilitative outcomes have been mostly related and combined.

Thus far, a meta-analysis demonstrated the positive effects of VR exercise on balance function in stroke patients [16]. Similarly, another review suggested that VR was useful for enhancing motor control, functional, and cognitive abilities and balance in Parkinson’s patients [13]. Distinctly, the target populations of the studies within the preceding literature review were narrow and limited to specific diseases, such as strokes and Parkinson’s disease. However, there are other vulnerable populations who may benefit from VR exercise, such as the elderly who could benefit from improved balance and other physical abilities to facilitate better health-related quality of life (HRQoL). However, reviews examining the utilization of VR exercise to intervene in such populations are sparse. Moreover, many relevant reviews are outdated, and thus there is a need to synthesize more updated research. Furthermore, some reviews included single-case experimental designs (i.e., studies with no control group), and thus these reviews were not based on high-quality research and the findings need to be further explored. It has been suggested researchers should include more rigorous study designs like randomized controlled trials (RCTs).

Therefore, this review aimed to fill the existing research gaps. Specifically, most of the articles included in this review were RCTs. Even if some studies could not be randomly grouped on a large scale due to the sample limitations, studies were only included if there were control group(s) and employed a comparative analysis between experimental groups and control groups, as well as between baseline- and post-tests for the examined health outcomes. Further, the target population of this review was relatively extensive, including clinical and healthy populations, allowing the overall effectiveness of VR exercise to be established. Taken together, the purpose of this review is to systematically synthesize the literature examining the effects of VR exercise on the physiological, psychological, and rehabilitative outcomes in various populations.[…]

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[Abstract] Physical activity in people with epilepsy: A systematic review

Abstract

This study aimed to systematically review studies focusing on levels of physical activity (PA) in people with epilepsy (PWE) compared with non-epilepsy controls, and identify factors associated with PA in PWE. Intervention studies were also reviewed to consider the effects of psychological interventions on levels of PA, and the effects of PA-based interventions on seizure activity, psychiatric comorbidity, and health-related quality of life (HRQoL). PRISMA guidelines were followed. Searches were conducted using PubMed, Cochrane Controlled Register of Trials, PsycINFO, and Embase. Forty-six studies met inclusion criteria, including case-control, cross-sectional, and intervention studies. Assessment measures included questionnaires, activity trackers, and measures of physiological fitness. Twelve of 22 (54.5%) case-control studies utilizing self-report questionnaire measures reported that PWE were performing lower levels of PA, less likely to be engaging in PA, or less likely to meet PA guidelines than controls. The remaining studies did not find a difference between PWE and controls. Eight of 12 (67%) case-control studies utilizing exercise/fitness tests reported that PWE performed significantly poorer than controls, whereas in two studies PWE performed better than controls. One of three studies investigating the relationship between PA and seizure frequency found that increased self-reported PA was associated with having fewer seizures, whereas two did not find a significant relationship. All seven cross-sectional studies that included measures of HRQoL and depression/anxiety found a positive relationship between levels of PA and HRQoL/reduced levels of depression and anxiety. All four studies that used PA-based interventions demonstrated improvements in levels of PA and increased HRQoL. Study quality was almost universally low. In conclusion, there is some evidence that PWE engage in less PA than peers, and that interventions can improve PA levels and HRQoL. However, there is a need for more robust study designs to better understand PA in individuals with epilepsy.

Source: https://pubmed.ncbi.nlm.nih.gov/32396216/

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[Abstract] Impact of mHealth technology on adherence to healthy PA after stroke: a randomized study

ABSTRACT

Background

Physical activity (PA) is a key health behavior in people with stroke including risk reduction of recurrent stroke. Despite the beneficial effects of PA, many community-dwelling stroke survivors are physically inactive. Information and communication technologies are emerging as a possible method to promote adherence to PA.

Objective

The aim of this study is to investigate the effectiveness of a mobile-health (mHealth) App in improving levels of PA.

Methods

Forty-one chronic stroke survivors were randomized into an intervention group (IG) n=24 and a control group (CG) n=17. Participants in the IG were engaged in the Multimodal Rehabilitation Program (MMRP) that consisted on supervising adherence to PA through a mHealth app, participating in an 8-week rehabilitation program that included: aerobic, task-oriented, balance and stretching exercises. Participants also performed an ambulation program at home. The CG received a conventional rehabilitation program. Outcome variables were: adherence to PA, (walking and sitting time/day), walking speed (10MWT); walking endurance (6MWT); risk of falling (TUG); ADLs (Barthel); QoL (Eq-5D5L) and participant’s satisfaction.

Results

At the end of the intervention, community ambulation increased more in IG (38.95 min; SD: 20.37) than in the CG (9.47 min; SD: 12.11) (p≤.05). Sitting time was reduced by 2.96 (SD 2.0) hours/day in the IG and by 0.53 (SD 0.24) hours in the CG (p≤.05).

Conclusions

The results suggest that mHealth technology provides a novel way to promote adherence to home exercise programs post stroke. However, frequent support and guidance of caregiver is required to ensure the use of mobile devices.

Source: https://www.tandfonline.com/doi/full/10.1080/10749357.2019.1691816?scroll=top&needAccess=true

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[Abstract] Exergames in people with major neurocognitive disorder: a systematic review

Purpose

To systematically evaluate the efficacy of exergames in individuals with major neurocognitive disorder.

Materials and methods

PubMed, EMBASE and PEDro were systematically searched from inception until October 2019 for randomised and clinical controlled trials. Methodological quality of the trials was assessed with the PEDro rating scale or Risk of Bias in Nonrandomised Studies of Interventions-I (ROBINS-I), when appropriate. Grading of Recommendations Assessments, Development and Evaluation (GRADE) was used to assess the overall quality of the evidence.

Results

Eight trials, all of moderate to high methodological quality (i.e., PEDro score of 6 or higher or a Robins-I moderate quality score) were included. The overall quality of evidence was moderate to high according to the GRADE criteria. Improvements in gait, mobility and balance and beneficial effects on activities of daily living performance, cognitive function, fear of falls, quality of life and mood following exergaming were reported. Heterogeneity in outcome measures, intervention characteristics and included participants precluded a meta-analysis.

Conclusions

The current literature is of moderate to high quality and demonstrates that exergames have a wide range of physical and mental benefits in people with major neurocognitive disorder. More controlled trials are however needed to confirm the existing evidence before exergames can be recommended in treatment guidelines for people with major neurocognitive disorder.

Implications for rehabilitation

  • Exergames have many physical and mental benefits in people with major neurocognitive disorder

  • Exergaming can enhance gait, mobility and balance in people with major neurocognitive disorder

  • Evidence for beneficial cognitive effects of exergaming is emerging

via Exergames in people with major neurocognitive disorder: a systematic review: Disability and Rehabilitation: Assistive Technology: Vol 0, No 0

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[BLOG POST] How to Effectively Use Exercise as an Antidepressant

How to Effectively Use Exercise as an AntidepressantWe all know that exercise has unparalleled power to improve physical health. But did you know that science is showing that it is one of the best things you can do for your brain? This, in turn, benefits your mental health considerably. Research has confirmed that physical exercise improves memory and thinking skillsmood and creativity, and learning while reducing age-related decline, the risk of dementia and Alzheimer’s, and depression.

It’s that last one we’re going to focus on. You can incorporate regular exercise into your life as an effective preventative and treatment for depression. One Harvard study showed that exercise is every bit as powerful as medication for treating the symptoms and root causes of depression. Another meta-analysis said this:

The mechanisms underlying the antidepressant effects of exercise remain in debate; however, the efficacy of exercise in decreasing symptoms of depression has been well established. Data regarding the positive mood effects of exercise involvement, independent of fitness gains, suggest that the focus should be on frequency of exercise rather than duration or intensity until the behavior has been well established. The addition of self-monitoring techniques may increase awareness of the proximal benefits of exercise involvement, which is generally reinforcing to the patient.”

Why Exercise Helps Your Mood

As stated in the quote above, we don’t really know all the details of exactly why exercise helps depression. There are a couple of possible scientific explanations. Personally,  I think it’s most likely to be a combination of these.

Thermogenic Hypothesis

The thermogenic hypothesis suggests that the rise in core body temperature during and following physical activity causes the reduction of depression symptoms. Studies show that increases in temperature of specific brain regions, such as the brain stem, can lead to an overall feeling of relaxation and reduction in muscular tension. This produces a kind of “tranquilizer effect”.

Endorphin Hypothesis

The endorphin hypothesis proposes that the positive effects of exercise come from the increased release of endorphins during and following exercise. Endorphins are chemicals produced naturally by your nervous system to cope with pain or stress. They are often called “feel-good” chemicals because of their pain relieving and happiness boosting abilities. They might also be the body’s natural antidepressant. Endorphins correlate with a positive mood and an overall enhanced sense of well-being.

Monoamine Hypothesis

The monoamine hypothesis might be the most promising of the proposed physiologic mechanisms. This theory states that exercise leads to an increase in the availability of brain neurotransmitters, such as serotonindopamine, and norepinephrine. These brain chemicals largely determine mood and are often low in depressed people.

Distraction Hypothesis

As the name suggests, the distraction hypothesis suggests that physical activity serves as a distraction from worries and depressing thoughts. In general, distracting activities have been shown to have more influence on the management and reduction of depression than the use of more self-focused or introspective practices.

Self-Efficacy Hypothesis

The enhancement of self-efficacy through exercise may be another reason for its antidepressant effects. Self-efficacy refers to the belief that a person possesses the skills to complete a task to obtain the desired outcome. Depressed people often feel powerless to bring about any positive outcomes in their lives. This negative feeling perpetuates more negative self-evaluation, rumination, and patterns of thinking. Exercise may provide a depressed individual with a meaningful sense of mastery and control.

What We Do Know About How Exercise Improves Your Brain

In Spark: The Revolutionary New Science of Exercise and the Brain, psychiatrist John Ratey explores the neuroscience behind beneficial effects of aerobic exercise on anxiety, stress, depression, learning, aging, and attention deficit disorder. According to Ratey:

Even people who are overweight and who start exercising see improvements in mood and cognition in as little as 12 weeks.”

Moving your body increases the blood flow to your brain which elevates oxygen levels and triggers biochemical changes and increases in brain-derived neurotrophic factor (BDNF) production. BDNF is a protein produced inside nerve cells. It acts as a fertilizer to help them function optimally, grow, and make more new neurons.

These conditions encourage your brain to form new neural pathways and synaptic connections, a process known as neuroplasticity. Neuroscientists have noted that the hippocampus, which helps regulate mood, is smaller in depressed brains. Exercise supports nerve cell growth in the hippocampus, improving cell connections, which may help counter this and relieve depression.

The Benefits Continue After Physical Activity

While exercise certainly helps your brain while you’re doing it with increased oxygen, blood flow, and neurochemicals. as mentioned above, Ratey explains that it’s what happens AFTER exercising that optimizes the brain in the long run. When you exercise regularly, some of the ongoing effects of exercise include:

  • Exercise calms the amygdala, your brain’s fear center, raising the fight-or-flight threshold and decreasing anxiety.
  • It kick-starts the cellular recovery process by increasing the efficiency of intercellular energy production. This allows neurons to meet fuel demands without increasing toxic oxidative stress.
  • Exercise triggers the production of more receptors for insulin which means better use of blood glucose and stronger cells. It also increases the level of insulin-like growth factor (IGF-1). This helps insulin manage glucose levels and increases synaptic strength (LTP),  neuroplasticity, and neurogenesis.
  • Exercise elevates brain-derived neurotrophic factor (BDNF) production. BDNF is a protein produced inside nerve cells that acts as a fertilizer to help them function, grow, and make new neurons.
  • Exercise relaxes the resting tension in your muscles which breaks the feedback loop to your brain. Your brain figures if your body isn’t stressed, it doesn’t need to be either.

These changes combine to yield a brain that can keep cortisol in check, repair itself, and prevent the damaging effects of stress.

How to Effectively Use Exercise as an Antidepressant

Other Things To Consider

What Exercise Is the Best to Fight Depression?

Some studies show aerobic exercise to be the most beneficial for improving depression with running and walking topping the list. High-intensity exercise releases more endorphins – which is great if you can do it. But it’s good to know that there is also real benefit in low-intensity exercise sustained over time.

Two studies investigated the effects of running vs lifting weights in depressed people. Both experiments had very similar results. In one study, 40 women with depression either ran or lifted weights four times a week for eight weeks. In the second study, 90 depressed people were assigned aerobic exercise (jogging or brisk walking) or non-aerobic exercise (strength-training, stretching, relaxation, coordination and flexibility training) for 60 minutes, three times a week, for eight weeks. Both studies concluded that exercising clearly reduced depressive symptoms, but no significant difference in the activity performed was noted.

Of course, the best exercise for you is the one that you will do consistently and enjoy. It’s that simple.

How Much Exercise Is Enough?

Research has shown that burning 350 calories three times a week through sustained, sweat-inducing activity can reduce symptoms of depression as effectively as antidepressants. One study found that three sessions of yoga per week boosted participants’ levels of the brain chemical GABA, which typically translates into a better mood and decreased anxiety.

Any exercise is better than none and is going to give you some brain benefit. One study noted that a single ten-minute bout of physical activity in an academic setting boosted attention and problem-solving skills in kids. Another study observed mental health benefits after just 20 minutes of physical activity. The results also showed that more exercise and higher intensity correlated with better effects.

Conclusion

Exercise is a safe, effective way to help prevent and manage depression. It allows a person to use the natural processes of their own body to counter depressive symptoms and optimize brain health. Unlike medication, the side effects of exercise are other health benefits. Some side effects are protecting against heart disease and diabetes, improving sleep, and lowering blood pressure.

Exercise as a treatment for depression is a long-term solution, not a quick fix. You will want to pick an activity you can sustain over time. The key is to make it something you like and something that you’ll want to keep doing.

That’s a win/win!

via How to Effectively Use Exercise as an Antidepressant – The Best Brain Possible

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[Abstract] Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial – description of device use and physiotherapy support in the post-hospital phase

Purpose

To describe device use and physiotherapy support in the post-hospital phase of the AMOUNT rehabilitation trial.

Methods

We performed an evaluation of the support required for device use by participants randomised to the intervention group who received digitally-enabled rehabilitation in the post-hospital phase (n = 144). Intervention, additional to standard rehabilitation, utilised eight digital devices (virtual reality videogames, activity monitors and handheld computer devices) to improve mobility and increase physical activity. Participants were taught to use devices during inpatient rehabilitation and were then discharged home to use the devices for the remainder of the 6-month trial. Physiotherapist-participant contact occurred every 1–2 weeks using a health coaching approach, including technology support when required. Intervention datasheets were audited, and descriptive statistics used to report device use and support required.

Results

Participants (mean (SD) age 70 (18) years; 49% neurological health conditions) used an average of 2 (SD 1) devices (98% used an activity monitor). Eight percent of physiotherapy contact included technology support with 30% provided remotely. Support addressed 845 issues categorised under initial set-up and instruction (27%), education and training (31%), maintenance (23%) and trouble-shooting (19%).

Conclusion

Digital devices can be used for home-based rehabilitation, but ongoing technology support is essential.

  • IMPLICATIONS FOR REHABILITATION

  • Digital device use at home to support long-term management of health conditions is likely to become increasingly important as the need for rehabilitation increases and rehabilitation resources become more limited.

  • Technology support for set-up and ongoing device use is a critical enabler of home-based digital interventions.

  • Health professionals delivering home-based digital interventions require sufficient training and equipment and may need to vary the mode (e.g., home visit vs. telephone or video conference) depending on the technology support required.

via Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial – description of device use and physiotherapy support in the post-hospital phase: Disability and Rehabilitation: Vol 0, No 0

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[WEB SITE] Why Your Brain Needs Exercise

Why Your Brain Needs Exercise

Credit: Bryan Christie Design

Why Your Brain Needs Exercise

The evolutionary history of humans explains why physical activity is important for brain health

IN BRIEF

  • It is by now well established that exercise has positive effects on the brain, especially as we age.
  • Less clear has been why physical activity affects the brain in the first place.
  • Key events in the evolutionary history of humans may have forged the link between exercise and brain function.
  • Cognitively challenging exercise may benefit the brain more than physical activity that makes fewer cognitive demands.

 

In the 1990s researchers announced a series of discoveries that would upend a bedrock tenet of neuroscience. For decades the mature brain was understood to be incapable of growing new neurons. Once an individual reached adulthood, the thinking went, the brain began losing neurons rather than gaining them. But evidence was building that the adult brain could, in fact, generate new neurons. In one particularly striking experiment with mice, scientists found that simply running on a wheel led to the birth of new neurons in the hippocampus, a brain structure that is associated with memory. Since then, other studies have established that exercise also has positive effects on the brains of humans, especially as we age, and that it may even help reduce the risk of Alzheimer’s disease and other neurodegenerative conditions. But the research raised a key question: Why does exercise affect the brain at all?

Physical activity improves the function of many organ systems in the body, but the effects are usually linked to better athletic performance. For example, when you walk or run, your muscles demand more oxygen, and over time your cardiovascular system responds by increasing the size of the heart and building new blood vessels. The cardiovascular changes are primarily a response to the physical challenges of exercise, which can enhance endurance. But what challenge elicits a response from the brain?

Answering this question requires that we rethink our views of exercise. People often consider walking and running to be activities that the body is able to perform on autopilot. But research carried out over the past decade by us and others would indicate that this folk wisdom is wrong. Instead exercise seems to be as much a cognitive activity as a physical one. In fact, this link between physical activity and brain health may trace back millions of years to the origin of hallmark traits of humankind. If we can better understand why and how exercise engages the brain, perhaps we can leverage the relevant physiological pathways to design novel exercise routines that will boost people’s cognition as they age—work that we have begun to undertake.

FLEXING THE BRAIN

To explore why exercise benefits the brain, we need to first consider which aspects of brain structure and cognition seem most responsive to it. When researchers at the Salk Institute for Biological Studies in La Jolla, Calif., led by Fred Gage and Henriette Van Praag, showed in the 1990s that running increased the birth of new hippocampal neurons in mice, they noted that this process appeared to be tied to the production of a protein called brain-derived neurotrophic factor (BDNF). BDNF is produced throughout the body and in the brain, and it promotes both the growth and the survival of nascent neurons. The Salk group and others went on to demonstrate that exercise-induced neurogenesis is associated with improved performance on memory-related tasks in rodents. The results of these studies were striking because atrophy of the hippocampus is widely linked to memory difficulties during healthy human aging and occurs to a greater extent in individuals with neurodegenerative diseases such as Alzheimer’s. The findings in rodents provided an initial glimpse of how exercise could counter this decline.

Following up on this work in animals, researchers carried out a series of investigations that determined that in humans, just like in rodents, aerobic exercise leads to the production of BDNF and augments the structure—that is, the size and connectivity—of key areas of the brain, including the hippocampus. In a randomized trial conducted at the University of Illinois at Urbana-Champaign by Kirk Erickson and Arthur Kramer, 12 months of aerobic exercise led to an increase in BDNF levels, an increase in the size of the hippocampus and improvements in memory in older adults.

Other investigators have found associations between exercise and the hippocampus in a variety of observational studies. In our own study of more than 7,000 middle-aged to older adults in the U.K., published in 2019 in Brain Imaging and Behavior, we demonstrated that people who spent more time engaged in moderate to vigorous physical activity had larger hippocampal volumes. Although it is not yet possible to say whether these effects in humans are related to neurogenesis or other forms of brain plasticity, such as increasing connections among existing neurons, together the results clearly indicate that exercise can benefit the brain’s hippocampus and its cognitive functions.

Researchers have also documented clear links between aerobic exercise and benefits to other parts of the brain, including expansion of the prefrontal cortex, which sits just behind the forehead. Such augmentation of this region has been tied to sharper executive cognitive functions, which involve aspects of planning, decision-making and multitasking—abilities that, like memory, tend to decline with healthy aging and are further degraded in the presence of Alzheimer’s. Scientists suspect that increased connections between existing neurons, rather than the birth of new neurons, are responsible for the beneficial effects of exercise on the prefrontal cortex and other brain regions outside the hippocampus.

UPRIGHT AND ACTIVE

With mounting evidence that aerobic exercise can boost brain health, especially in older adults, the next step was to figure out exactly what cognitive challenges physical activity poses that trigger this adaptive response. We began to think that examining the evolutionary relation between the brain and the body might be a good place to start. Hominins (the group that includes modern humans and our close extinct relatives) split from the lineage leading to our closest living relatives, chimpanzees and bonobos, between six million and seven million years ago. In that time, hominins evolved a number of anatomical and behavioral adaptations that distinguish us from other primates. We think two of these evolutionary changes in particular bound exercise to brain function in ways that people can make use of today.

Graphic shows how increased production of the protein BDNF may promote neuron growth and survival in the adult brain.

Credit: Tami Tolpa

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For more, visit —->  Why Your Brain Needs Exercise – Scientific American

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