WELLNESS
WALK YOUR WAY TO WELLNESS Movement and exercise has long been shown to be beneficial in managing chronic pain. For many of us, accustomed to exercising in gyms or fitness centers, the current pandemic has greatly impacted our exercise regimens. With the weather warming up, many of us are getting out of the house to take strolls around the neighborhood as a form of exercise. In fact, many healthcare providers will instruct their patients that are older, deconditioned, or suffer from comorbidities, to walk as a means of exercise and physical therapy. Walking is easy to perform, has a low risk of injury, and we do it every day. But is it enough? A study looking at 52 sedentary patients, aged 18-65 years with chronic low back pain were randomized into aerobic walking vs. active strength training for six weeks. The regimen included a 5 min warm up, 5 min cool down, and five minutes of intense walking on a treadmill. They found both groups improved to similar degrees. They also found that the moderate-intensity walking program done twice a week for six weeks improved functional performance and muscle endurance more for those suffering from chronic back pain. It is important to keep in mind that these studies are not referring to a leisurely walk in the park, but rather a brisk aerobic-style walk. The kind of walk that raises your heart rate and makes you sweat. I think that is where some patients mistakenly think that leisurely walking can replace a focused exercise program. The findings of a systematic review were inconclusive that leisurely walking improved acute and chronic low back pain. The American Heart Association recommends adults should engage in 150 minutes of moderate intensity exercise each week. It sounds like a lot, but it can be broken down into 30 minutes a day for five days a week. Even half of that is better than nothing. So what is moderate intensity and how is that measured? According to an article primarily targeting cardiovascular fitness, maximum oxygen uptake (VO2
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max) was regarded as the gold standard for the assessment of exercise quality. Based on this concept, walking speed, as well as a patient’s baseline fitness level, will determine whether a walking program will result in a significant increase in VO2 max (i.e be considered a moderately intense form of exercise). Another sign that you can use to monitor your exercise level (and one that you can actually measure yourself) is target heart rate. The American College of Sports Medicine and American Heart Association recommend you achieve 50% to 85% of maximum heart rate reserve for optimal cardiovascular fitness. If you don’t know your target heart rate, you can go to their website as a reference guide. Implementing An Effective Walking Program Implementing an effective walking program If you decide walking will be your primary form of exercise, you need to commit to doing it on a regular basis. Remember that the time spent walking, the distance walked, and intensity are vital components of your walking program. Just walking from your front door to the mailbox does not count. Slowly increase your distance every day. The Arthritis Foundation recommends starting out with 6,000 steps per day for more debilitated patients and has a Walk With Ease program online to slowly introduce yourself into a walking program. Some activity is better than none, but to truly benefit from a walking program, you need to work up to walking briskly. If you have a mostly sedentary lifestyle, start slow and don’t give up. Remember to stretch, warm up and wear supportive shoes. Also, pay attention to not only distance, but to your heart rate, and the intensity of your stride. Bottom line — any amount of activity will help you, so get started as soon as possible! Revitalize Medical Center is accepting new patients at their Glenview and Evanston locations. Schedule a consultation 847-834-4018 RevitalizeMedCenter.com Sheetal DeCaria, MD.
