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Exercise ETC's
Review of Exercise Related Research
May 15, 2010

Compiled by Chris Marino, MS, CSCS
Director of Education, Exercise ETC

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Reading the Fine Print on
Exercise Equipment

Understanding risk management is essential for all fitness professionals, and it requires more than simply having clients complete a health questionnaire. In today’s training environment, clients are more overweight, deconditioned and have more musculoskeletal issues than ever before. Simultaneously, the use of high intensity exercise along with various forms of equipment that are designed to make exercises more challenging have become commonplace, increasing the risk for muscle or joint injury or worse. Failure to properly progress clients or incorporating circus-like activities that have limited return to the individual can be costly decisions for any fitness professional.

For example, not too long ago a woman was awarded $1 million in a lawsuit against a Personal Trainer and gym in Texas for improper use of exercise equipment. The woman was performing standing exercises on the flat side of a BOSU ball when she fell and broke both wrists. The makers of BOSU were exonerated because they have a warning label on the flat side of the BOSU that firmly states "DO NOT STAND ON THIS SIDE." Have you ever read the bottom of your BOSU?

We encourage you to review your personal risk management system so that you can avoid unfortunate situations such as this. Educate your staff on safe and proper use of exercise equipment. Don’t be swayed by the latest Youtube phenomenon. Make sure that your equipment is in proper working order. Check your elastic tubing and stability balls for surface damage frequently. These are just a few steps you can take to make sure you’re not the next headline.

http://www.personalinjuryblogdallas.com/2009/12/woman-awarded-1-million-for-gym-accident.html

Quick Weight Loss = Lasting Weight Loss?

For overweight and obese individuals losing weight can have a profound impact on both quality and quantity of life. Once that fact is internalized most people can't take the weight off fast enough. Weight loss experts, however, will commonly advise a more gradual approach that creates a loss of 1 to 3 pounds per week, depending on baseline weight. This philosophy is based on previous research and experience that suggests using more practical and sustainable solutions that are also less likely to negatively affect hormones or metabolism.

Unfortunately, popular diets and media are creating higher expectations for overweight Americans that differ from this recommendation. These expectations are creating a challenge for weight loss professionals, for if the expectations for fast weight loss are not met motivation could be lost and dropout is likely. So, the question remains... what is the optimal rate of weight loss that promotes better health quickly and is sustainable? A recent study may be set to challenge professional beliefs after finding that faster weight loss might actually be more productive.

Researchers from the University of Florida evaluated the effects of varying amounts of caloric restriction on total weight loss over 6 months and maintenance of weight lost for 1 year thereafter. More than 250 obese middle-aged women were encouraged to consume a diet designed to facilitate either a 1/2 pound, 1/2 to 1 1/2 pound, or a 1 1/2 pound weekly weight loss. After 6 months, the groups had lost on average nearly 11 pounds, 20 pounds, and 30 pounds, respectively. Follow-up was completed 1 year after the initial 6-month weight loss period. Interestingly, all groups gained back approximately the same amount of weight over the course of the follow-up year.

In this study, it appears to have been more valuable to have lost a greater amount of total weight quickly instead of attempting to lose weight more gradually. It is important to realize, however, that popular media is leading people to believe that 5 to 7 pounds of weekly weight loss is desirable. Although this study indicates that there might be a benefit to faster weight loss researchers remained within the advisable range for rate of weight loss.

Nackers, L.M. et al (2010) The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race? International Journal of Behavioral Medicine. ePub ahead of print.

Does Taste Affect Dietary Compliance?

Low calorie, pre-packaged frozen meals are a convenient resource for many dieters who may be too busy to prepare food regularly. Unfortunately, if you're someone who relies on those meals regularly your interest may be more likely to wither and the success of your diet may be compromised. In a recent study, researchers found that people lost their taste for diet-brand frozen meals over time compared to equal higher-calorie options.

Thirty-six adults volunteered to eat one of two prepackaged meals over 5 consecutive days for lunch. The first group received a meal consisting of 567 calories of Spaghetti Bolognese, while the second group received the "diet" meal that contained just 374 calories. Researchers questioned the participants to determine their satisfaction with taste and satiation after each feeding.

Interestingly, although both meals were rated similar for taste at first, those eating the diet-brand rated the food 30% less favorably by the end of the week. Nonetheless, all reported feeling full throughout the entire week despite having experienced a decline in flavor ratings. Although purpose may override sensation for many dieters, the researchers believe this finding could be a reason for poor compliance among people who rely on diet-brand foods.

There are definitely many limitations to this study; however, this finding may indicate a need for greater variety in food selection among dieters. Moreover, frozen food options may not be the best solution for long-term weight management regardless of practicality.

Amy Norton. Taste for low-calorie alternatives may wane: study. Reuters Health. April 16, 2010.

O'Sullivan, H.L., et al (2010) Effects of repeated exposure on liking for a reduced-energy-dense food. American Journal of Clinical Nutrition. ePub online April 7.

Weight Gain Likely Post-Knee Replacement

Currently, more than 250, 000 Americans undergo knee replacement surgery each year. The vast majority of cases are a consequence of severe knee osteoarthritis, which causes significant pain, stiffness and often leads to a sedentary lifestyle and associated weight gain. It is generally assumed that individuals with severe knee osteoarthritis who have been physically limited would resume an active lifestyle and lose weight following total knee arthroscopy. Unfortunately, a recent study suggests otherwise.

Researchers at the University of Delaware evaluated body weight, perceptions of function, and quadriceps strength in 106 people who underwent single joint knee replacement, and 31 controls who exhibited no knee pain at baseline and 2 years post-operative. Participants who underwent surgery received post-surgical Physical Therapy.

Interestingly, over 2/3 of those who underwent knee arthroscopy gained an average of 14 pounds in the 2-year period, while 1/3 of participants lost 4 pounds on average. Comparatively, the control group's weights were unchanged. Additionally, the quadriceps strength in the group that gained weight decreased during the study, but not in the group that lost weight.

These finding were a complete surprise to the researchers as the consequences of weight gain post-knee replacement can be costly. Additional body weight can result in faster progression of osteoarthritis in the non-prosthetic knee joint, and thus a second knee replacement. Moreover, it can result in further de-conditioning and increase risk for cardiovascular or metabolic disease. Consequently, the researchers are advocating for greater education on nutrition and encouraging physical activity following knee replacement to prevent weight gain.

Zeni, J.A., and Snyder-Mackler, L. (2010) Most patients gain weight in the 2 years after total knee arthroplasty: comparison to a healthy control group. Osteoarthritis and Cartilage. ePub Online: doi:10.1016/j.joca.2009.12.005

Reuters Health. Many people gain weight after knee replacement. April 13, 2010.

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Exercise Management for Persons
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Sale: $129.50; Regular $259

This comprehensive reference gives you the latest ACSM exercise protocol and guidelines for 46 separate chronic diseases and disabilities -- virtually every special population group you can think of. This book from Human Kinetics should be in the library of every serious Fitness Professional. Course includes hardcover textbook, separate testing booklet and free, instant grading. Hardcover, 372 pages.

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Strength Training for Older Adults
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Strength training is necessary if your older clients want to maintain their function and improve their quality of life. Learn how to design age-appropriate programs that will help your older clients maintain their function.

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ACSM's Action Plan for Menopause
Sale: $59.50; Regular $119

Learn the physiological and psychological changes associated with menopause and the role exercise and nutrition have in helping to manage the hot flashes, mood swings and depression often associated with menopause. Published in conjunction with ACSM, this book will become a staple in your fitness and nutrition library. Course includes soft-cover textbook, separate testing booklet and free, instant grading. Softcover, 220 pages.

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Strength Training Past 50
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Injury Prevention & Rehabilitation for Active Older Adults
Sale: $129.50; Regular $259

This eye-opening program is geared towards the specific needs of healthy and active older adults. Taking a proactive approach to activity, you will learn how to keep the older client active while discovering appropriate training protocols for older adults who are recovering from an illness or injury. Course includes hardcover textbook, separate testing booklet and free, instant grading. Hardcover, 237 pages.

Credits: 18.0 ACSM; 18.0 AAAI-ISMA; 8.0 AEA; 18.0 AFPA; 18.0 AMFPT; 18.0 BOC; 18.0 IFPA; 18.0 ISSA; 18.0 NATA; 9.0 NCSF; 18.0 NDEITA; 18.0 NETA; 18.0 NFPT; 1.8 NSCA-CPT; 18.0 NSPA; 18.0 SCW-EDU; 1.8 SFA; 18.0 WITS.

Fall Proof!
Sale: $119.50; Regular $239

This newly revised (2010) textbook is written to address physical frailty and the risk of falling that accompany old age. FallProof! offers a multidirectional approach that incorporates strength training, flexibility training, core training and ambulation drills to teach you the most comprehensive plan yet for proactive fall-prevention programs. Course includes hardcover textbook, instructional DVD, separate testing booklet and free, instant grading. Hardcover, 309 pages.

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Exercise for Frail Elders
Sale: $89.50; Regular $179

The needs of the older client with health or orthopedic challenges take center stage in this innovative course. Learn how to safely program your client for maximal function with a lowered risk of overuse or repetitive stress injury. Course includes soft-cover textbook, separate testing booklet and free, instant grading. Softcover, 240 pages.

Credits: 1.6 ACE; 16.0 ACSM; 16.0 AAAI-ISMA; 16.0 ADA; 8.0 AEA; 16.0 AFPA; 16.0 AMFPT; 16.0 BOC; 16.0 CDR; 16.0 IFPA; 16.0 ISSA; 1.6 NASM; 16.0 NATA; 8.0 NCSF; 16.0 NDEITA; 16.0 NETA; 16.0 NFPT; 1.0 NSCA-CPT; 16.0 NSPA; 16.0 SCW-EDU; 1.6 SFA; 16.0 WITS.

ACSM's Action Plan for Osteoporosis
Sale: $59.50; Regular $119

Exercise plays a vital role in keeping bones strong, dense and healthy. This fascinating book from ACSM will offer new insight on the role of exercise, nutrition and supplementation in managing -- and preventing osteoporosis. Course includes soft-cover textbook, separate testing booklet and free, instant grading. Softcover, 208 pages.

Credits: 1.0 ACE; 12.0 ACSM; 12.0 AAAI-ISMA; 10.0 ADA; 6.0 AEA; 12.0 AFPA; 12.0 AMFPT; 10.0 CDR; 12.0 IFPA; 12.0 ISSA; 6.0 NCSF; 12.0 NDEITA; 12.0 NETA; 12.0 NFPT; 12.0 NSPA; 12.0 SCW-EDU; 1.2 SFA; 12.0 WITS.

ACSM's Action Plan for Arthritis
Sale: $59.50; Regular $119

If you have ever worked with -- or loved -- someone with this devastating disease you need this book! You'll explore safe, sane recommendations for exercise for the arthritic client and come away with a better understanding of the effect of this disease on function and quality of life, and how exercise can improve both! You will also learn about the effect of different supplements, such as glucosamine on this chronic condition. Course includes soft-cover textbook, separate testing booklet and free, instant grading. Softcover, 200 pages.

Credits: 12.0 ACSM; 12.0 AAAI-ISMA; 10.0 ADA; 6.0 AEA; 12.0 AFPA; 12.0 AMFPT; 10.0 CDR; 12.0 IFPA; 12.0 ISSA; 6.0 NCSF; 12.0 NDEITA; 12.0 NETA; 12.0 NFPT; 12.0 NSPA; 12.0 SCW-EDU; 1.2 SFA; 12.0 WITS.

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