Exercise an Important Aid in Addiction

The following is a contributed post and does not necessarily reflect the views of exercise basics. 

Contributed by Jen Pooley

The benefits of exercise have long been hailed in scientific literature; various studies prove the existence of a link between a physically active lifestyle and a lesser risk of obesity, Type II diabetes and heart disease. Recent findings, however, also indicate that exercise has an important role to play in mental conditions like anxiety and depression. It is also an important part of many rehabilitation programs at leading centers in the US, owing to its ability to help stave off addiction. These are just some of the most interesting findings on the link between exercise and addiction:
  • Exercise keeps the youth smoke-free. A study published by scientists at the University of Michigan showed that teens who engaged in regular sport where less likely to have smoked cigarettes or abused marijuana. Statistics have remained stable similar since the mid-1990s. Preliminary studies also indicate that exercise effectively decreases the demand for nicotine in laboratory animals.

  • Exercise curbs drug abuse during the stages of initiation and maintenance. Exercise also prevents drug abuse from escalating and lessens episode of bingeing. A study published in the journal, Frontiers in Psychiatry (Mark Smith et al, 2011), explains that the extent of addiction is often dependent on what takes place during various stages of consumption. There is a link, for instance, between the rapid transition from initial drug experimentation to regular patterns of drug use, and later problems with abuse and dependence. Laboratory studies have shown that rats that were initiated to an addictive drug and engaged in exercise, self-administered significantly lower rates of the addictive substance than sedentary rats. In the same way, rats who were physically active opted for lesser amounts of the addictive substance during the ‘maintenance’ phase (i.e. the post-initiation phase). Those that exercised also had less dramatic escalation of drug use and less bingeing episodes. The latter in particular is of great interest, since drug binge episodes are associated with higher overdose rates.

  • Exercise can aid in combatting depression. A study carried out by M Babyak et. al. set out to assess the effect of aerobic exercise, sertraline therapy, or a combination of exercise and sertraline therapy, in 156 adult volunteers suffering from major depression. Scales of depression were measured via the Diagnostic Interview Schedule and the Hamilton Rating Scale for Depression, as well as through self-reporting via the Beck Depression Inventory. After four months, participants in all three groups showed significant improvements in depression; however, after 10 months, subjects in the exercise group had significantly lower relapse rates that those in the medication group. Those who engaged in physical activity during the follow-up period also had a lesser chance of being diagnosed with depression after follow-up. This led researchers to conclude that exercise can play an important role in the treatment of depression.
Activities like yoga and Pilates, in particular, have been used successfully to combat depression and anxiety, which is why they are often used as complementary treatments in top rehabilitation centers in the U.S. A recent study on Pilates showed that depressed women in a residential center for abused women who did 20-45 minutes of Pilates a day, three days a week, had significantly higher levels of serotonin and a 34 per cent decline in depression.
  • Exercise reduces stress. When addicts are in the process of rehabilitation, they are forced to face acute episodes of stress as they are forced to control carving and as worry begins to set in about the effects of their addiction on their relationships with others and their future. Studies on women undergoing radiotherapy for breast cancer have shown that yoga significantly reduces cortisol levels and lessens fatigue.
Behavioral/psychological mechanisms that contribute to the beneficial effects of exercise: M Smith et.al. (2011) note that there are various reasons why exercise can be so efficient in dealing with addiction. Firstly, the fact that exercise can decrease the self-administration of drugs can decrease the “relative reinforcing strength of the drug when both are concurrently available.” Secondly, since exercise decreases depression and anxiety, it reduces risk factors for abuse/relapse. Finally, the positive effects of exercise on our well-being and self-esteem result in a lower likelihood of substance abuse. Interestingly, “accumulating evidence shows that exercise influences many of the same signaling molecules and neuroanatomical structures that mediate the positive reinforcing effects of drugs.” As the Mayo Clinic notes, exercise is beneficial for everyone: “The health benefits of regular exercise and physical activity are hard to ignore. And the benefits of exercise are yours for the taking, regardless of your age, sex or physical ability.” 


Why I Dislike the Rear Lat Pulldown and You Should Too.

The wrong way

When I go to the gym I sometimes feel like I have to wear blinders to stop myself from seeing all the poorly executed exercises - or made-up, dangerous exercises. Let me be clear here, I don't really care if someone is doing squats and they have to wide a base or don't go to parallel, What I do care about is someone swinging a kettlebell over their head like they are Conan the Barbarian. I let it all slide because I know people don't like a random bearded man coming up to them to tell that what they are doing is probably going to end up in injury.

One thing that I have a hard time letting go is people doing the rear lat pulldown. The exercise really irks me, mainly because of people's flawed reasoning for performing it and because I think that the risks of the exercise outweigh whatever benefits one thinks it has over the front lat pulldown

The righ way
Firstly, neck position. Most of the people I see doing a rear lat pull down have terrible posture. They wrench their neck forward and slam the bar down at the CT junction. Like every other exercise, posture and spinal alignment are very important. if you're throwing yourself this far out of alignment, then it's a definite no-no.

Secondly, going along with the neck position, when somewhen flexes they neck so far forward they often times do a sort-of semi-crunch at the bottom of the movement. I cringe thinking about it, and I sort of picture Gollum from lord of the rings, with creepy bent over position.

Ok, so not everyone does the rear-lat pulldown with such terrible posture. I can hear you saying, "but I sit upright, retract my scapula and pull straight down behind my head. Why can't I do this?" Well, you can if you want to, but what benefit are you getting from doing it this way over doing the lat pulldown in front? Some people say they feel it more, or that the muscles in your back work harder, well I call bullshit. EMG studies show that the most effective position for activation of the latissimus, posterior deltoid, and teres major is the wide-grip front lat pulldown.

So even those of you with good posture are not getting the benefits you seek from doing the pulldown behind your head. What you are doing is placing your shoulder in a more externally rotated position which horizontally with horizontal abduction (a provacation test for shoulder sublaxation by the way), pinning your scapula to your back with excessive retraction during the movement, and putting added stress on the joint capsule. all this culminates to a high-risk-low-reward situation in which the only thing your increasing is the chances of anterior shoulder instability/dislocation, and impingement.

What are your thoughts? Do you still think it better to do the rear-lat pulldown? To be fair, I've seen people doing front lat pulldowns in a way that is much more dangerous (and stupid) than doing a rear lat pulldown with good posture. However, the key to any exercise is to do it as safely and as efficiently as possible, in this case the front lat pulldown wins.

Pugh, G. M. (2003). A Biomechanical Comparison of the Front and Rear Lat Pull-Down Exercise. Unpublished Masters Thesis. University of Florida.

Signorile, J. E., Zink, A. J., and Szwed, S. P. (2002). A Comparative Electromyographical Investigation of Muscle Utilization Patterns Using Various Hand Positions During the Lat Pull-down. Journal of Strength & Conditioning Research, 16(4), 539-546.   

NPTE Sample Questions

So when I was preparing to write the NPTE I wanted to get my hands on as many sample questions as a possibly could. While there are resources out there, they can be a little bit pricey. I figured that I would create a practice exam for the prospective candidates that had a little more affordable sticker price. Now, with that being said, I highly highly highly recommend scorebuilders NPTE complete study guide and the online advantage program. I found that the exams included in the study guide and the online program were very close to the format of the actual NPTE, and the study guide is very comprehensive and easy to follow. It was my main resource when preparing. Anyway, here is a sample of the questions I plan to have in my practice exam, which I hope to have completed in September for those of you taking the October Exam. 
  1. A patient presents with ipsilateral loss of proprioception and paralysis, as well as contralateral loss of pain and temperature sensation. What spinal cord injury does this describe?
    1. Anterior Cord Syndrome 
    2. Brown Sequard Syndrome 
    3. Central Cord Syndrome 
    4. Posterior Cord Syndrome

  2. A patient reports low back pain with shooting pain into both legs as far as the knee and a feeling of pins and needles that, sometimes, reaches as far as the ankle. He has been informed by his physician that he has sciatica. Which of the following does not mimic the symptoms of sciatica?
    1. Piriformis syndrome 
    2. Sacroiliitis 
    3. Spondylolisthesis 
    4. A tumor located at the spinal nerve root of L1-L2

  3. A 55-year-old patient presents with an ulcer on the lateral aspect of their ankle and has a history atherosclerosis with an Ankle Brachial Index (ABI) of 0.7. Which of the following would the patient most likely exhibit?
    1. COPD 
    2. Obesity 
    3. Poorly Controlled Diabetes Mellitus 
    4. Varicose Veins

  4. A patient’s EKG is shown in the picture to the right. What heart rhythm does the patient exhibit? 

    1. Atrial Fibrillation 
    2. Sinus Bradycardia 
    3. Sinus Tachycardia 
    4. Ventricular Tachycardia

  5. While working in a Skilled Nursing Facility, you are asked to complete an assessment on a 73-year-old patient who has been diagnosed as having a left sided CVA. Which of the following would you not expect the patient to have?
    1. Ataxic movement of bilateral upper limbs 
    2. Difficulty understanding words written or spoken
    3. Hemiparesis of the right leg
    4. Slow, deliberate movements

  6. A 65-year-old African American male patient, who admitted to smoking at least a pack of cigarettes a day, has to urinate more frequently at night, has swollen feet and ankles, and muscle weakness. Which of the following is he most likely experiencing symptoms of?
    1. Exacerbation of COPD 
    2. Left Sided Heart Failure 
    3. Right Sided Heart Failure 
    4. Sickle Cell Anemia

  7. Upon examination of a 23-year-old female patient with complaints of shoulder pain you find that the patient has a painful arc, painful palpation of deltoid tuberosity, weak external shoulder rotation, and a positive Hawkes-Kennedy test. Which of the following muscles is least likely to be a contributing factor to the patient’s pain.
    1. Infraspinatus 
    2. Supraspinatus 
    3. Teres Major 
    4. Teres Minor

  8. Which of the following responsibilities would be most appropriate to delegate to a Physical Therapy Assistant.
    1. Continuation of established treatment plan
    2. Developing an exercise plain for a patient 
    3. Mobilizing a patient for the first time
    4. Taking patient history

  9. An ABG reading shows the following values: pH 7.28, paCO2 49. The patient also has a heart rate of 110bpm. What condition is the patient experiencing?
    1. Acute Respiratory Distress Syndrome 
    2. Metabolic Acidosis 
    3. Metabolic Alkalosis 
    4. Respiratory Acidosis

  10. A 30-year-old man has burns covering his chest, abdomen, and right arm. According to the rule of nines, what percentage of his body has been burned?
    1. 18% 
    2. 22.5% 
    3. 27% 
    4. 31.5%
Answer Key
  1. B
  2. D
  3. C
  4. C
  5. A
  6. C
  7. C
  8. A
  9. D
  10. B
Please let me know your thoughts about the questions, be it about the difficulty, if you want some explanation of the answers, if they're just worded funny. It's hard to be critical of your own work.

Getting my 2.5lbs Weights!

I've been informed by the folks and Blink fitness - after my numerous suggestions - that I can expect to see 2.5lbs weight plates by mid-august. I want to take credit for the fact that they're getting the plates, but they were probably planning on it anyway. Still, it's good to think that they actually took my suggestions on board. Now if they get a couple more oly bars and a dedicated bench press I'll be super happy.

Aside from that I don't have anything really interested to add. I am planning on making and NPTE practice exam. If that's something you great people think would interest you let me know. I know when I was preparing to write the exam I wanted to get my hands on as many practice exams as possible, but those suckers can be expensive! It'll probably be a long-time in the works, but keep an eye out here for updates. 

I hope everyone is having a fantastic first weekend of August. 

Muscle and Motion Update

So a couple years ago I wrote a review of the muscle and motion software. You should definitely go give it a read, the program is fan-freaking-tastic. If you're at all interested in functional anatomy then you'll love it. I just wanted to shine some light on recent updates from muscle and motion.

The biggest thing I want to get across is that they are constantly updating the body of work contained in the program. I get an email every month letting me know about the updates that are happening within the program, so there's no way I can be all inclusive. However, here's a small list of some of the updates over the past 2 months:

-  Cable Triceps Extensions
-  Machine Triceps Extensions
-  Lying Leg Curls

-  Core Muscles - short movie
-  Single leg Lateral Raise [Target your proprioceptive system |  Frontal plane VS Scapular plane]
-  Shoulders Combined Raise [Target your lower trapezius]
-  Front Raise [Shoulder impingement syndrome]
-  Decline Crunch [How to Do an Ab Crunch?... ]
-  Examples for training the abdominal muscles
    in their stabilizing function.

Aside from that, the user interface remains about the same as it did from when I reviewed the program at first, which is nice, because I found it to be very user friendly. There are also helpful video tutorials about exercise physiology, developing a workout routine, kinesiology, and more. I strongly encourage any kinesiology or physiotherapy student to purchase it, but give it a trial first to make sure you love it. You can click the link in my left side bar to be taken directly to the free trial download. Or, if scrolling back up is too time consuming, click right here. If you're an educator, you may have the option of getting a discounted full version as well.