Exercise for Migraine?

(HIT) High Intensity Training reduces migraines. For many years, I have shared the benefits of high-intensity interval training (HIT) to patients. Now here is one more benefit to  HIT.

A new study reported at the 18th Congress of the International Headache Society 2017 suggests that high-intensity training resulted in significant reduction in the frequency of migraines.

Compared to moderate continuous exercise such as running for 45 mins up to 75% of your max heart rate, this study shows that HIT improves the following:

  • reduces migraine attack (# of migraine days per month)
  • improves cerebrovascular health and
  • maximize oxygen uptake

How often do I need to HIT exercise?HIT exercise

Twice weekly for minimum of 12 weeks. HIT consists of 4 consecutive sets of running exercise for 4 minutes at 95% of maximal heart rate followed by 3 minutes at 75% of maximal heart rate, for a total exercise time of  ONLY 28 minutes per session.

Why does HIT exercise work?

After a high-intensity training, it creates an “afterburn effect” which is not observed in moderate exercises.  This afterburn effect is more officially known as excess post-exercise oxygen consumption (EPOC). Basically, the more intense the exercise, the more oxygen your body consumes afterward.

If you don’t exercise on a regular basis, I would recommend building up your fitness level. This research seems to suggest that HIT exercise is better for health in long term at a shorter duration.

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What Really Makes Us Happy?

The Online Therapist

happy-person-jumping-happy-person-5I had a very interesting conversation recently on just this subject. My discussion partner was, at the time, pontificating about money. His argument went something like “Many people are only interested in the accumulation of wealth but once they have it, they are still not happy. It is not how much money you have but what you do with it that counts”. This set my mind working and it countered his rhetoric with the notion that this could well be applied to many other aspects of our lives. What if “it is not how much you have but what you do with it” could be looked at in relation to relationships, free time and so on. Could this be a basis for general happiness?

As humans, we are always striving for that extra that we think will make us happier… more money, a better relationship, better career, bigger house or…

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Does computer brain training really protect against dementia?

There are many different kinds of computer brain training games and apps in the market nowadays. Do they really help? Do all the games help or only some of them do? Is it just a waste of time or money? Is it just overhyped?

IMG_9088 (1)A 10-year randomized controlled trial study with healthy elderly adults (average age 73.6) shows that brain training can cut the risk for dementia nearly by 50%. This study was presented at Alzheimer’s Association International Conference 2016 by Dr. Edwards of the School of Aging Studies and Byrd Alzheimer’s Institute, University of South Florida, in Tampa.

Are all the training the same?

There are different programs and games. Some target the memory, some target reasoning, and some target speed-of-processing.

Memory testing is self-explanatory.

Reasoning training focused on the ability to solve problems that follow a serial pattern, such as identifying the pattern in a letter or number series or understanding the pattern in an everyday activity.

What is speed-of-processing? This is about the speed and accuracy of visual information processing while expanding the visual area over which a person could pay attention and make rapid decisions.

After 10 years, only individuals in the speed-of-processing demonstrated a statistically significant effect on cognition. This study gives some strong evidence that at least some types of cognitive training can indeed protect people from cognitive decline.

So what’s the real-world benefits?

  • quicker overall reaction times
  • safer on-road driving, reduced at-fault crashes, and maintenance of driving ability with age,
  • improvements in everyday functional performance,
  • protection against depression
  • and better self-rated health etc

It is not actually all too surprising that the speed of processing via the visual information processing has more impact on cognition. The majority of our daily sensory processing is through our eyes. In fact, visual examination is an important part of concussion testing. Perhaps there this type of speed of processing can also be used as part of concussion baseline testing.

The speed training used in the study is is available as an exercise called Double Decision. It is one of the exercises in BrainHQ ( www.brainhq.com ).

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Secrets for Keeping Active in Aging Men. What to do?

Many aging men are asking the question: how do I stay active? I have male patients, in their mid-60s and 70s, who are still going to the gym, skiing and playing basketball. Regardless of the exerci…

Source: Secrets for Keeping Active in Aging Men. What to do?

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Include eye test screens as part of Concussion screening

As concussion awareness rises, more parents and sport teams are doing baseline concussion screening. Many of these tests include balance and/or cognitive testing. Only some of them include eye test screening as well.


Photo credit: killy via Foter.com/CC BY-NC-ND

A brain injury is often only identified when moderate or severe head injuries have occurred, leaving mild cases undiagnosed and untreated. A mild head injury accounts for approximately 80% of reported trauma brain injury according to US department of defense statistics. That’s why it is important to develop simple tests that can identify mild cases. Tests that can also be done on field as well.

4 simple eye tests have been used by José Capó-Aponte, OD, PhD, from the Department of Optometry at the Womack Army Medical Center in Fort Bragg, North Carolina, as an effective screening tool for acute mild traumatic brain injury.

“Since approximately 30 areas of the brain and seven of the 12 cranial nerves deal with vision, it is not unexpected that the patient with traumatic brain injury may manifest a host of visual problems, such as papillary deficit, visual processing delays, and impaired oculomotor tracking and related oculomotor-based reading dysfunctions,” Dr Capó-Aponte pointed out.

The following tests were used by Dr Capó-Aponte and his team to identify reliable biomarkers of mild traumatic brain injury. The team looked for subtle visual changes that could be measured in the office or in the field.

  • Testing Pupil using a monocular infrared pupillometry:
  • near-point convergence
  • saccadic eye movement function with the King–Devick Test
  • Visual symptoms were assessed with the Convergence Insufficiency Symptom Survey (CISS).

These tests are used because patients with mild traumatic brain injury had significantly higher near-point convergence scores (receded near-point convergence) than control subjects, longer times to complete the King–Devick Test, and more symptoms on the CISS. The pupil test also revealed that average constriction velocity, average dilation velocity and time to 75% recovery of dilation were significantly different between mild traumatic brain injury and control subject.

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A Decrease in Muscle Strength in Aging Men, leads to an Increase Risk of Slips and Fall Incidents.

Dr. Ayse Zengin, PhD, Medical Research Council, Human Nutrition Research, Cambridge completed a study in the UK, looking at the relationship between muscle strength as men age and their risk of fracture and fall.men-950915_1920

Here are some highlights of the study:

  • A total of 301 men over the age of 40 years were involved in this study.
  • Lower limbs muscle force and power were measured by having the participants to perform a jumping mechanography, which involves a single two-legged jump on a ground reaction- force platform.
  • Why study men? While there are many studies done on bone and muscle strength in women,. there are relatively fewer studies of bone health in older men.
  • The Consequences of a Fracture in Men are Worse than in Women. Even though men have fewer fractures than women, they have increased mortality following a fracture.
  • As men grow older, their muscle strength drops, and this can serve as a significant predictor of bone fractures.
  • Muscle power is strongly associated with fall risk. An increased risk of falls is associated with decline in muscle power (a factor that reflects how fast someone can produce force)
  • Muscle Force and Power. Not Muscle Mass Alone. There is a far more rapid decline in muscle strength than muscle mass as men age. Younger and older men can have the same muscle mass, but older men cannot perform functional tests.

In another study conducted, in Australia

  • Mortality increases after hip fractures in women and more so in men. Little is known. 

These studies suggest that physical training involving strength and power in the lower limbs, may help to improve bone strength and decrease the risk of falling. Training should always involve some types of balancing as well.

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Pelvic Floor Exercise for Men

We often hear women doing pelvic floor exercise or Kegel exercise after giving birth. Men can also benefit from kegel exercise.

What are the benefits?

  • increase flood flow and nerve supply to pelvic region
  • prevention and treatment of urinary stress incontinence
  • improve sexual response and function

Here is a quick guide to Kegel Exercise for Men.


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Young Athletes. Play smart, play safe, and play hard!

The journey from backyard playing to a high level competitive arena for young athletes can be fun and rewarding. There will also be many challenges in between. Early morning practices, driving to T…

Source: Young Athletes. Play smart, play safe, and play hard!

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Osteoarthritis Doesn’t Mean the End of Your Workouts

Be Active Be Healthy

Many people stop working out with weights when they have been diagnosed with osteoarthritis (OA), usually because they experience pain. But don’t let that be you! Often your form and technique can be adjusted, and there are many exercises that you can perform that will not only be pain-free but help you to improve your strength and mobility.

Strengthening the muscles around the affected joint helps to keep the bones in their proper position. When the joint moves better, there is less stress. The endurance of the muscles needs to be increased as well, as Dr Cruz [link] mentioned earlier. The longer the muscles can withstand fatigue, the longer the joint is stable!

Let’s focus for now on the knee, since it is so commonly affected.

Technique: We always strive to keep the joint in alignment when working out. For example, your knee should always be in line with your…

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Spinal Osteoarthritis

Be Active Be Healthy

Doc, I was told that I have arthritis in my neck and lower back. Is it genetic or is it just aging?

This is a very common question I hear nearly daily. Some people may have a genetic disposition to Osteoarthirits (OA). Nevertheless, since we can’t change our genes or age, let’s focus on what we can change.

OA is most common in weight bearing joints, such as knees, hips and the spine. OA is also seen frequently in the shoulders and hands, with overuse and repetitive movements. It is common in the first toe (bunion) as well.

With OA in the knees, we may see swelling in the knees. With OA in the hands, we may see nodules in the fingers. OA in the spine may show with poor posture, such as forward head posture and poor sitting posture habits. Some people with OA in the spine may have…

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