Exercise Prescription for Heart Failure Patients
Although many physicians are weary about prescribing exercise for heart patients, a meta-analysis of recent research published in Evidence-based Cardiovascular Medicine reveals that exercise training these individuals can lead to many positive physiological adaptations. The studies all showed that both functional capacity and quality of life improved in heart failure patients after exercise training. Participants of the studies had to have been diagnosed with heart failure and have a baseline ejection fracture of less than 40%. Over 60,000 person-hours of exercise training were logged. The studies reported an increase in peak oxygen consumption anywhere between 17% (aerobic training), 9% (strength training), and 16% (inspiratory training). No deaths related to the exercise prescription were reported for the over 2,300 individuals participating in the various studies. Exercise training can be safe and extremely effective for heart failure patients. Proper physician supervision is necessary, but improvements can be gained through moderate amount of exercise for these individuals, translating into an increased quality of life in addition to an increased functional capacity. (Evidence-based Cardiovascular Medicine, 2004)

Back Surgery vs. Intensive Rehabilitation
Researchers from the Nuffield Orthopaedic Center in Oxford, England examined nearly 350 patients suffering from chronic low back pain to determine the effectiveness of back surgery treatment when compared to intensive rehabilitation. It is important to note that spinal fusion surgery treatment is nearly twice as expensive as intensive rehabilitation. Lower back pain is becoming more common every day. It has been reported that over 40 million citizens of the 25-nation European Union are affected by low back pain, with nearly half of those individuals sick days coming from the associated pain and discomfort of chronic low back pain. The findings of this study, published in the British Medical Journal concluded that as far as ultimate outcome was concerned, not much of a difference in pain relief existed between patients undergoing spinal fusion surgery and those participating in intensive rehabilitation involving exercise and cognitive therapy. The take home message of the research seems to be that although possibly beneficial, back surgery should be a secondary choice to intensive rehabilitation for both cost effectiveness and the fact that both treatments appear to have similar results. (British Medical Journal, May 2005)

Elderly People with Osteoarthritis Should Exercise
A study published in Evidence-based Healthcare: A Scientific Approach to Health Policy examined 250 individuals over the age of 60 suffering from knee osteoarthritis and found that regular participation in physical activity actually increased their ability to perform activities of daily living (ADLs). Individuals participating in the study suffered from one of the following criteria: knee pain on most days of the month, difficulty climbing stairs, getting out of a chair, shopping, walking 0.4 km or more, and getting in or out of a car. Subjects were divided into three groups: an aerobic exercise group, a resistance training group, and a control group which participated in monthly arthritis educational sessions. The aerobic group participated in a 10 minute warm-up, followed by 40 minutes of walking and a 10 minute cool-down, three times per week. The resistance training group also had a 10 minute warm-up and cool-down, with 40 minutes of weight lifting with dumbbells and cuff weights. Both programs were supervised in a facility for the first 3 months, followed by a 15-month home-based program. Both the aerobic and resistance training groups reported lower incidences of ADL disability than the control group. The take home message for personal trainers is to keep your aging clientele active and to educate them as to the importance of regular physical activity and the associated benefits. (Evidence-based Healthcare: A Scientific Approach to Health Policy, 2002)