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The mission of the City of Austin Parks and Recreation Department (PARD) is to Inspire Austin to learn, play, protect and connect by creating diverse programs and experiences in sustainable natural spaces and public places. The results of this survey will help to define current resident needs for parks and recreation, as well as shape the park system for future generations.

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Our Parks, Our Future: Austin Parks and Recreation Long Range ... - SpeakUp Austin!

Please note that the text below is not a full transcript and has not been copyedited. For more insight and commentary on these stories, subscribe to the This Week in Cardiology podcast, download the Medscape app or subscribe on Apple Podcasts, Spotify, or your preferred podcast provider. This podcast is intended for healthcare professionals only.

For the week ending March 17, 2023, John Mandrola, MD comments on the following news and features stories.

JAMA has published the RAPD HF trial first author Yogesh Reddy from Mayo clinic. An elegant cross-over study involving rate-adaptive pacing during exercise, presented at ACC seemingly challenged my excitement about a breakthrough pacing study from last month.

MyPACE published last month in JAMA-Cardiology, first author, Maggie Infeld, studied patients with HFpEF who already had pacemakers. These were special pacers in that pacing rates could be increased with preservation of normal PR intervals and without causing RV pacing.

They used 3 types of pacersthose with conduction system pacing (CSP) leads that pace the ventricle without causing RV dyssynchrony, CRT pacers which also preserve PR and prevent RV dysynchrony, and standard dual chamber pacers with atrial pacing.

myPACE did not focus on exercise pacing rate. Instead, they randomized patients with HFpEF to a personalized accelerated pacing program or usual care. The average heart rate in the active arm was about 75 vs 65 in the usual care.

They showed that QOL, BNP, patient activity and AF rates were all better in the higher pacing arm.

Crucially, due to the special pacemakers, myPACE researchers could increase pacing rates and know that the PR interval could be preserved, as well as synchronous biventricular contraction.

When I discussed myPACE, I was careful to say that implanting pacers willy-nilly in patients with HFpEF is not one of conclusions we should take from that study.

Instead, the notion that lower heart rates in patients with stiff ventricles is a dogma that may need to be overturned.

Now to the RAPID HF trial.

Reddy and colleagues recruited patients w HFpEF who met the criteria for chronotropic incompetence.

Basically, it is as it sounds: the inability to raise ones HR to what it should be during exercise. The problem here is that HR increases are highly variable, and it is also really hard to know what HR should be.

The study included 32 patients who had pacers implanted and did a crossover study wherein one group had AAI-R (or rate adaptive atrial pacing set to increase HR during exercise) vs no pacing. And thenafter a month washout period patients crossed over to no pacing vs rate-adaptive pacing.

The primary endpoint was oxygen consumption (VO2) at anaerobic threshold (VO2,AT)

They first showed in the pacing off groupthat HR during exercise did correlate with performance. They then showed that compared to no pacing, patients randomized to the rate-adaptive pacing had slightly higher rates during submax and peak exercise.

And the main results not a shred of difference. Also no diff in BNP, KCCQ.

And 6 patients had adverse events from the pacer. Effusion requiring drainage, lead induced TR, local skin reactions etc.

They obviously concluded that In patients with HFpEF and chronotropic incompetence, implantation of a pacemaker to enhance exercise heart rate did not result in an improvement in exercise capacity and was associated with increased adverse events.

The editorialists took an even more negative view of pacing in HFpEF. And you should read their editorialfirst author Dalane Kitzman

They make 5 major points:

Exercise limitations in HFpEF are complicated and have as much to do with peripheral oxygen uptake as cardiac dysfunction.

HFpEF is a quintessential systemic multiorgan disorder which neatly explains why cardiac drugs have generally failed.

The lack of benefit of RAPID HF is credible and they mention other pacing trials that have been negative.

They were swayed by the reduction of stroke volume with higher paced rates.

Since exercise performance depends so much on peripheral oxygen uptake at the skeletal muscle, they favor exercise programs as a way to help these patients.

My Synthesis:

These studies are apples and oranges. The patients and interventions were entirely different.

My excitement about HR revelations in HFpEF remains. A) We should not implant pacers for chronotropic incompetence Exercise performance, as outlined nicely in the editorial, is far more complex than a few more heart beats; B) the myPACE conclusions that avoiding extremely low heart rates continues to be a really fruitful strategy; C) The corollary to that is that beta-blocker withdrawal should be favored; and D) if pacing is used, it needs to be under the direction of an EP who is facile in modern pacing techniques.

I also remain enthusiastic about exercise as a potential therapy. The editorialists comments that a single bout of exercise in sedentary individuals evokes a nearly immediate, large increase in skeletal muscle gene transcription has enticing plausibility and while early studies of exercise show promise, we need more data in the pragmatic setting.

Last week I discussed CLEAR Outcomes, a trial of the non-statin cholesterol-lowering drug Bempedoic acid.

ACC featured another non-statin cholesterol lowering agent. It is MK-0616, an oral PCSK9i inhibitor. JACC published the phase 2 dose-ranging RCT .

PCSK inhibitors are already approved for LDL-C in high-risk patients. But these require a shot.

There is a race to develop oral PCSK9i. Merck is early with this orally bioavailable, renally-excreted, macrocyclic peptide that can bind PCSK9 with monoclonal antibody-like affinity at 1/100th of the molecular weight."

Nearly 400 patients were randomized to one of either 4 doses of the oral drug or placebo. The primary endpoints were percent change in LDL-C at week 8 and proportion with adverse events.

The drug resulted in statistically significant and large reductions in LDL-C. There was a graded dose response. And no signal of adverse events.

Comments:

Phase 2 studies are mostly for finding dosages to use in Phase 3 studies wherein the drug is assessed for reducing CV outcomes.

This is promising. The LDL-C reductions are substantial. But it has to show reductions in clinical outcomes. (it likely will).

Other companies are also developing oral PCSK9i. Merck, obviously, has a good start.

I dont treat patients with pulmonary arterial hypertension (PAH). But ACC brought pretty amazing news about a new drug, called sotatercept. A potentially major breakthrough in an uncommon but tragic disease.

Kudos to journalist Mitchel Zoler who has a wonderful explanatory news column.

PAH is a disease that involves proliferative remodeling of the small pulmonary arteries that leads to progressive narrowing and resultant right heart failure.

From my reading, there is altered signal signal transduction of the growth factorswhich is way above my pay scale.

Sotatercept is an engineered molecule that combines a section of a human immunoglobulin G molecule with a portion of the receptor for activin. This structure allows sotatercept to bind free activin molecules in a patient's blood, thereby removing a key driver of the pulmonary vascular wall remodeling that is at the pathologic root of PAH.

NEJM published results of the STELLAR trial, an RCT of 163 patients with PAH. The PEP was change in 6 min walk test. And it was highly positive for S.

The first eight secondary end points were significantly improved with sotatercept as compared with placebo,

Adverse events that occurred more frequently with sotatercept than with placebo included epistaxis, dizziness, telangiectasia, increased hemoglobin levels, thrombocytopenia, and increased blood pressure.

FDA has rendered this a "Breakthrough Therapy" designation and "Orphan Drug

The editorialists were excited, but also raised several cautions and concerns.

They questioned the generalizability of the findings, noting that the patients with PAH enrolled in the study were all adults who were clinically stable and an average of more than 8 years out from their initial PAH diagnosis, and more than 90% were on stable treatment for PAH.

The study cohort also had a disproportionately high enrollment of patients with idiopathic (59%) or heritable (18%) forms of PAH, and the 15% of patients in the trial with connective tissue disease represented a disproportionately low prevalence of this PAH subtype.

I mention this story in much the same vein as the oral PCSK9i. Its early, yes, and surely the drug will be incredibly costly, 3-4 in a 100,000k with this terrible condition, there may be disease modifying options. Emphasis on may be.

I am told by people in the know in the drug development space that Sotatercept is this first wave; there will be more therapies targeting this pathway.

A research team in the province of Alberta Canada have published a very important paper about medical adherence.

Soft thinking is such a problem in medicine today. We underestimate complexity far too often. Not considering the externalities of the punitive hospital readmissions reduction program is a shining example of soft thinking.

Canadian researchers tested the idea that eliminating copayments for high-value medications among low-income older adults who were at high CV risk would improve clinical outcomes.

Disparities in outcomes among low and high SEC is frequently discussed. High costs are seen as causal. Low-income adults would be most at risk for poor outcomes for not taking statins or other preventive meds.

Heck, higher use of preventive meds was held up as causal in the 40% reduction in CVD/MI in the SCOT-HEART trial wherein patients in CTA arm had higher use of these meds.

ACCESS was actually a 2x2 factorial trial testing both the waiving of copayments of high value meds and a self-management education and support program.

This paper presented at ACC and published in Circulation considered only the free meds.

Their primary outcome is notable: it was not use of medicines, it was actual outcomes: a composite of death, MI, stroke, coronary revasc, CV-related hospitalization over 3 years. I want to emphasize how important and notable this choice was. Many similar implementation science papers measured medicine adherence as an outcome. That, in my opinion, is a weak surrogate.

They enrolled nearly 5000 patients and followed them for 3 years. The rate of the primary outcome was not reduced in the group that had no copayments. 521 vs 533 events.

None of the components varied. Nor did changes in QoL or health care costs.

Statin adherence hardly budged. (0.72 vs 0.68). There was no difference in ACE-ARB adherence.

Authors Conclusion: In low-income adults at high cardiovascular risk, eliminating copayments (average $35 a month) did not improve clinical outcomes or reduce healthcare costs, despite a modest improvement in adherence to medications.

Comments:

First lets talk about patients. These were older patients. Mean income low. (No one was over $50K Canadian per year, which is like$ 38K per year in US dollars). Most were lower income. So even a minimal co-pay would be something. More than half had diabetes and established CAD. More than 80% had high blood pressure and high cholesterol.

I have long said that more healthcare often does not lead to more health. You have the insurance studies: RAND, the OREGON Health Insurance Experiment, and the Karnataka India experiment which all found that giving more preventive care did not significantly improve outcomes. You have the recent JAMA paper showing that states that expanded Medicaid did not lead to better CV care.

Journals, meetings, Twitter, are full up of association studies showing that patients who adhere to more GDMT do better. Low-income people do worse, because they dont adhere to meds as well, goes the thinking.

The problem is that prevention is far more complex than simply adhering to guidelines. Why have so few thought to say that the mere ability to adhere to 4 HF meds may be a marker for a healthier patient and it those other factors that lead to better outcomes.

Has it ever dawned on people to look at how small the absolute risk reductions are in some of these anointed therapies. Even statins, you are looking at 1-2% ARR. Thats fine, but people are complex, if you had a group that 100% took these meds and 0% did not, you could show differences.

But in the real world, where people have stressful lives, they are taking care of children, grandchildren, sick elders, difficult marriages or jobs, the idea of taking meds for a 1-2% ARR of a nonfatal event over the next decade isnt high priority.

Victor Montori from MAYO rings in my ear. Hes called for doctors to understand the work of being a patient and focus on minimally disruptive care. Pick the highest value thing a patient can do. Dinking around with a SBP of 145 might pale in comparison to helping a patient eat less salty snacks, or helping her carve out 15 min per day for a walk.

In retrospect... I think ACCESS may have been one of the best studies from ACC. Congratulations to David Campbell et al.

JAMA Network Open has published a survey of NHANES data from 1999-2018 looking at the prevalence of metabolically healthy obese patients.

This was defined as a BMI greater than 30, but no metabolic disorders, such as hypertension, blood glucose, or lipid issues.

Their cross-sectional study suggests that the age-standardized proportion of metabolically healthy obesity increased among US adults from 1999 to 2018.

Absolute numbers went from 10.6 to 15% in 2015-2018.

Here is my problem with this: I dont think the words healthy and obese belong in the same category. The mean age of these patients were mid 40s.

What do you think will happen to these patients in their mid-50s or mid 60s.

This is what I tell patients who are overweight. You may be skirting issues now, but to preserve quality of life in the future, not just cardiac health, but bone and joint health (mobility), we should work on strategies now.

I think we do a great disservice to patients with high BMIs, by declaring them metabolically healthy.

I always start my discussion by saying I am not a preacher, and I worship at the altar of liberty, and I recoil against all forms of coercion, but as your health adviser, I would encourage you to consider these strategies. Because, regardless, of your labs, having a BMI of 33 puts you at risk for future problems.

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Mar 17 2023 This Week in Cardiology Podcast - Medscape

One way to stay health? Kids at Saturdays Boyertown Wellness Fair were encouraged to try walking a tightrope (at top) as part of its obstacle course challenge

BOYERTOWN PA Six potential future James Beard culinary award winners arrived Saturday morning (March 18, 2023) at Boyertown Area Senior High School with food-laden platters in their arms, the glint of competitive spirits in their eyes, and broad smiles on their faces.

All were elementary school students.

And all were at the high school not only because they are talented chefs, but also because they wanted to teach the public that eating healthy can also be delicious.

The six were Finley Scheidler, in kindergarten at Boyertown Elementary School; Grace Monterano, in kindergarten, and Zoey Hapenovich, a first-grader, both at Gilbertsville Elementary; Madison Boardman, a second-grader at Earl Elementary; Zoey Davis (at right), a third-grader at Washington Elementary; and Evan Conver (above), a fourth-grader at New Hanover Elementary.

They were selected from among groups of competitors to become finalists in a Kids Celebrity Chef battle. It was one of many activities planned for the 16th annual wellness fair held by the Wellness Council of Boyertown. The council is one of several programs sponsored by Boyertown Area Multi-Service, and specifically looks to help area residents happily enjoy long, full, and satisfying lives.

Dont envy the panel of seven judges who were tasked with choosing a consensus favorite from the field of strong contenders, or members of the public who also cast votes for winners as the fair ended. They faced tough choices.

Scheidler offered up Banana Oat Cookies. Monterano supplied Loaded Bear Paw Apple Nachos. Hapenovichs dish was a Sassy Salad with Orange Vanilla Vinaigrette. Boardman brought Veggie-Packed Pizza Rolls to the table. Davis handed out her own Zoey Burger. Conver whipped up Brownie Batter Dip, accompanied by crunchies. Visitors to the chefs tables got to taste free samples of their entries.

As their guests chowed down the chefs described what was in their creations, why they represented healthier choices, and how they could be easily reproduced by anyone at home. They even distributed copies of their recipes for those ready to experiment.

Ultimately, the judges choice was Hapenovich and her Sassy Salad (above at left), the council later reported. First-place winner in the public vote was Boardmans pizza rolls (above at right), followed by Davis and her burgers in second, and the Monterano nachos, third.

The value of exercise also was a persistent theme Saturday.

Visitors could participate in a walk or a run and the days weather was beautiful for either. Three different presentations highlighting Zumba, crossfit training (above), and dance were held during a 90-minute period in the Bear gym. Senior citizens were invited to try their hand at a walking Bingo game. A physical obstacle challenge for kids also was set up in the Cub gym.

Sponsors for this years edition of the wellness fair were the Pottstown Area Health and Wellness Foundation, the Healthy Kids Running Series of Boyertown, Thrive Acupuncture Center, Keystone Running and Walking, Frecon Farms, Kimberton Whole Foods, Walmart, and Ritass Water Ice of Boyertown.

A list of 20 health-and-wellness related vendors introduced visitors to their services and products. All said they were impressed by the size of the attendance; some added they have been part of the fair for years.

Photos by The Post

Excerpt from:
Wellness Fair a Den of Healthy Eating and Exercise - The Post - The Sanatoga Post

The ability to see and maintain ocular health can often be taken for granted, but as one of the bodys primary senses, vision deserves protection and care. Maintaining ocular health involves the examination and assessment of all of the structures in and around the eyes to determine overall health and diagnose eye disease. Within Puget Sound Naval Shipyard & Intermediate Maintenance Facility, employees rely on their sight to avoid dangers, detect potential risks and perform daily tasks. Taking care of the eyes should be a priority just like eating healthy and physical activity.

According to PSNS & IMFs Occupational Safety and Health Manual Volume II, Chapter 8, employees are required to wear appropriate eye-protective equipment when working in eye-hazard areas or while performing eye-hazardous operations such as machining parts, handling chemicals, using power tools, working on pressurized systems and performing overhead work. Personal eye and face-protective devices can go a long way but may also be used in conjunction with machine guards, engineering controls, and rigorous manufacturing and personal safety practices. Protecting employees vision is something the shipyard takes seriously, and a robust eye-protection program is in place. Bob Neal, Code 106.22, Environment, Safety and Health Programs Office, industrial hygiene program manager, offers the following on eye wellness at PSNS & IMF:

The most significant risk to eye health in the shipyard is employees not wearing safety eyewear where required based on the presence of a hazard or signage. Eye injuries are one of the most preventable injuries. However, employees not wearing safety eyewear is the most reported personal protective equipment deficiency to code 106 every month.

Most injuries to the eyes for employees in the shipyard involveforeign bodies from work that occurs. In addition, Code 106 has had reports of foreign bodies to the eyes as a result of employees taking off their eye and face protection incorrectly. It is recommended that employees practice the shipyard bow. This is when an individual closes their eyes, bends over and removes eye and face protection, preventing debris that may have accumulated on their body or PPE from falling directly into the eyes.

If a point-of-use station is out of safety eyewear, employees can obtain a pair from the various logistics and kitting sites located throughout the shipyard.

As part of PSNS & IMFs mandatory training, eye wellness and protection are addressed. For more information on the shipyards eye protection program, visit the PSNS & IMF directives library or visit the Code 106 SharePoint page. Employees can also reach out to their shop or codes safety advocate who can assist with answering questions, conducting sight assessments of worksites, and assist with alternative safety eyewear. Additionally, the optometrist at the shipyard branch clinic can answer questions and provide assistance with prescription safety eyewear.

There are also ways to help maintain ocular health outside of the work environment. Some actions include:

Get regular comprehensive dilated eye exams.

Know your familys eye health history. Its important to know if anyone has been diagnosed with an eye disease or condition, since some are hereditary.

Eat right to protect your sight. In particular, eat plenty of dark leafy greens such as spinach, kale, or collard greens, and fish that is high in omega-3 fatty acids.

Maintain a healthy weight.

Wear protective eyewear when playing sports or doing activities around the home, such as painting, yard work, and home repairs.

Quit smoking.

Wear sunglasses that block 99 percent-100 percent of ultraviolet A (UVA) and ultraviolet B (UVB) radiation.

Wash your hands before taking out contacts and cleanse your contact lenses properly to avoid infection.

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With an eye toward the future: Taking care or your eyes should be ... - Naval Sea Systems Command

Work hard, play hard, and then take it easy at one of Worths favorite spa resorts.

Wellness vacations have become one of the fastest-growing trends in travel, and its no wonderthe pandemic fundamentally changed how we think about our health. Plus, the solitude of the lockdown caused anxiety and depression to spike worldwide. Hotels and resorts have responded with innovative new programs that address clients physical and mental needs, whether its a mindfulness treatment to relieve stress or diagnostic tests that help build a plan for lifelong longevity.

Worth has identified the best places to reboot your health, wellness, fitness, and even your palate in 2023. The choices for setting, treatment options, and activities are vastfrom a secluded desert oasis to a Japanese-inspired wellness center. These resorts offer packages that promise to transform your health, your well-being, and your approach to life.

Read on to find the perfect spa for your wellness journey in 2023.

Canyon Point, UT

Amangiri means Peaceful Mountain, a perfect moniker for this low-key but ultra-luxury retreat thats become a favorite amongst A-listers. At the border of Utah & Arizona, Amangiri rests among five national parks, several national monuments, and the Navajo Nation Reservation, which inspires its wellness and culinary offerings. Spa journeys are designed to restore hozho, Navajo for beauty, harmony, balance, and health. Signature treatments offer comprehensive programs for all that ailsGrounding, for those seeking reconnection, stillness, and perspective; Purifying, for those seeking lightness, breathing space, and a fresh start; and Nourishing, for regeneration, recovery, and healing. Movement Journeys take you into the stunning desert landscape for restorative treatments, including hikes, yoga, and Pilates. Depending on time and desire, these programs can also include guided canyon tours and walks on one of their via ferrata trails, one of which ends on an iron climbing path designed to traverse difficult mountain landscapes and spans over a 400 ft. gorge.

Walland, TN

Situated on a working farm surrounded by the Smoky Mountains, The Wellhouse at Blackberry Farm emphasizes the connection between the natural environment and the health of our bodies. Wellness programs are informed by the seasons, and ingredients for all treatments aim to utilize flowers, herbs, fruits, vegetables, and other healing elements from the farm and local area. Sign up for a Lavender and Vanilla Bourbon body drench, for example, or an Appalachian Body Purification scrub and mask created with ground coffee, sarsaparilla, honey, tobacco, and black silt clay. Understanding the why behind their approach is essential, so Blackberry offers Learning Lectures to help guests understand more about healthy lifestyle choices. New treatments available include Deep Healing Woods Offering: Flower Essence Foraging Meditation, a forest bathing experience where guests learn about flower essences through trailside foraging on the way to their mountaintop wellness platform; and, Slowing Down and Tending the Spirit with Charlotte Hardwick: in a small group setting, Charlotte will offer meaningful and intentional practices to balance and nourish both mind and body.

Morristown, AZ

If the idea of soaking in a natural spring creek under the sun surrounded by the beauty of the desert sounds like the perfect way to spend your time, then Castle Hot Springs is the spa for you. The historic resort was once a retreat for Gilded Age A-listers like the Vanderbilts, Astors, and Rockefellers. It remains one of the top spas in the U.S. due to its main attractiona network of mineral-rich, geothermically heated underwater streams that emerge into a succession of pools. Castle Hot Springs offers off-the-grid, immersive wellness experiences inspired by the unique elements of the surrounding desert. You can choose from one of their immersive wellness packages: Zen, Adventure, or Wellness Through Waterand the resort will build a custom itinerary based on your needs and desires. This May, theyre offering a Sleep Retreat3 nights centered on reforming your sleep habits, which sounds positively dreamy.

Lenox, MA

Located in a 19th-century manor nestled in the Berkshires, Canyon Ranch Lenox aims to give you the space, and the comfort, to focus on your well-being. When you book your stay, you are prompted to answer the question: What Leads You Here? Guests are encouraged to choose a Pathwaycurated experiences based on wellness intentions. Pathways Plus includes medical-based immersive experiences, like an Executive Physical in which you work with an integrative physician to evaluate your bodys processes and develop a complete health profile and plan. All overnight stays include meals, access to spa and fitness classes, and resort activities like hiking, paddle boarding, tarot card readings, and more.

Los Angeles

Cant get away to a desert-island retreat? Let me introduce you to the Fairmont Spa, an urban retreat that was part of a $2.5 billion renovation of the storied Century Plaza Hotel in LA. This showpiece features the most modern wellness treatments, like Biohacking, a program that combines infrared technology, neuroscience, and compression therapy to improve sleep quality, reduce stress, and support mindfulness. Available as a 30-minute Power Nap or a more extended block of 60 or 90 minutes. The spa also features signature facial treatments by Dr. Rita Rakus, one of the leading medical professionals in the world of anti-aging.

Kohler, WI

As the title (and brand) would indicate, the approach at Kohler Waters Spa is health through water. Located in the historic American Club in Kohler, WI, the spa offers a menu of hydrotherapy treatments like Glacier Springs, a full-body treatment that incorporates elements of warm and cold (including an ice massage!); Tranquil Tides, which begins with espresso body mud and ends with a magnesium-enriched bath; and a Stillness Bath, an immersive journey of the senses. The latter includes exfoliation, Vichy shower rinse, and moisturizer to promote better sleep and overall well-being. This April 21-23, theyre offering a Longevity and Wellness Retreat, a multi-day experience with a special culinary program, wellness plan, and fitness classes.

Water Mill, NY

The first boutique wellness destination in the Hamptons, Shou Sugi Ban House, is a 13-room retreat that has been on best of lists since its opening. Inspired by the principles of wabi-sabi and global wellness philosophies, the spa guides guests on a path to wholeness through reconnection to the natural world. Youll find specialized treatments like Hydrotherapy Circuitscontrast water therapy alternating between hot, warm, and cold water, to boost circulation, immunity, circulatory and digestive systems; and Sound Therapy, a healthy vibration that results in beneficial cellular-level response and has been shown to reduce stress, anxiety, and insomnia. You can also take to the air with Floating Meditation. This is similar to aerial yoga in that you experience weightlessness through the support of aerial silks and hammocks, all while being guided through a meditation session. Youll also find bodywork, beauty, and fitness programs, along with culinary offerings focusing on brain health, skin health, and nourishing your gut. Set in minimalist, Japanese-inspired buildings, Shou Sugi Ban House offers a place to reconnect with oneself immersed in the healing properties of nature

Calistoga, CA

It would be remiss for us to skip a wine country spa, which has so many incredible places to choose from. Our current favorite is Spa Solage, which rests on 22 acres in the heart of Calistoga, an area blessed with geothermal pools, low-key energy, and access to great wine. A retreat that can be experienced as a quiet solo getaway or as a shared experience with someone you love. Solage offers seasonal spa treatments, including the signature Mudslide treatment, which is a 3-part detoxifying treatment. Solange also offers mineral water therapies, a state-of-the-art fitness center with classes, and a yoga studio. Plus, guests can reserve Pelotons for their rooms, so you dont fall behind on your training. Specialized treatments that might inspire you to bring a friend include the Starlight Nights Bathhouse Experience, an ultra-private retreat that consists of a Mudslide for two, a rose petal bath, candlelight, a bottle of sparkling wine, and chefs bites.

Malibu, CA

Healthy and balanced living through outdoor activities and appreciation of nature are the guiding principles for opening The Ranch, an elite wellness retreat in Malibu, CA. Known for multi-day immersive health, weight loss, and fitness programs, Ranch activities include daily hikes, guided exercise, and locally sourced plant-based meals. And its intenseno option programs are a seven or 9-day commitment for a limited number of guests and include a 5:30 am wake-up call and 3-hour hikes, among other activities. The Ranch also runs a program in Italy and is expanding its footprint to the east coast with a new location just outside of New York City. The NY location will feature health programs that maintain the core elements of The Ranchhiking, fitness, yoga, deep tissue, and a plant-based diet, but those can be experienced over three or four days and in varying intensities. The goal is to offer more options for people who may have been apprehensive to try the program; and, to accommodate the busy schedules of New Yorkers.

Monticello, NY

A residential wellness center located in the Southeastern Catskills of New York, YO1 boasts 66 therapy rooms, a range of recreational activities, and myriad options for a customized health program. Treatment plans for Anxiety Management, Pain Management, Cholesterol & Hypertension, Insomnia, and more are available, as well as a menu of Ayurvedic therapies that you wont find anywhere else. YO1 was founded by Dr. Subhash Chandra as a place to practice self-healing, boost ones immune system, andlets get realdrop bad habits. First-timers might want to book a stay that includes unlimited Yoga and Meditation sessions, with the breakfast package, to ease into YO1.

YO1 Is offering 25 percent off their Winter Wellness

Package through March 31, 2023.

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10 Best Spa Resorts 2023 - Worth

The beautiful Caribbean Island of St. Thomson is a popular tourist destination around the world for its pristine beaches, wellness centers, and unique spa experience. From luxurious spas and yoga studios to world-class fitness centers, St. Thomas has numerous options for everyone to achieve the perfect mind and body wellness.

This article lists some of the best yoga studios, spas, and fitness centers in the incredible beach city of St.Thomas to have an ultimate pampering experience. So, let's start!

Related: St. Thomas, St. John, Or St. Croix: Which One Of The US Virgin Islands Is Right For You?

Located in the Virgin Islands, Spa To Go VI is a mobile spa service that offers a range of treatments in St.Thomson, making it a convenient spa option to enjoy in the comfort of your own space. The Spa offers a wide range of services, including facials, massages, body treatments, pedicures, and manicures with high-quality products. One of the highlights of this Spa is the fully customized experience. Clients can choose the type of massage, the time duration, and even the music that is played during the session, allowing for a truly personalized experience tailored to the individual's needs.

Located on the island of St. Thomas in the US Virgin Islands, Prna Spa is a luxury spa resort in California, nestled in the Frenchman's Reef, offering a wide range of treatments to help the guests relax and unwind in a serene setting. The guests at the Spa can achieve a state of inner peace and harmony through various treatments, including massages, body scrubs, facials, and wraps. They also offer specialty treatments such as hot stone massages, aromatherapy, and reflexology.

Marriott's Frenchman's Cove is among the best luxury resort located in the US Virgin Islands, featuring a full-service spa and fitness center offering various services and amenities for the guests to relax during their stay. The spa offers a wide array variety of treatments, including massages, facials, body treatments, and nail services, featuring private treatment rooms for guests to enjoy their treatments in a peaceful atmosphere. Additionally, the fitness center at the resort is equipped with state-of-the-art cardio and strength training equipment, providing group fitness classes, such as yoga and Pilates, catering to guests of all fitness levels.

Related:10 All-Inclusives That Are A Dream In St. Thomas

Abounader Fitness USVI is a popular fitness center located in St. Thomas, US Virgin Islands, offering a variety of fitness programs and services to help individuals achieve their fitness goals in a welcoming and supportive environment. The center is equipped with cardio and strength training equipment, including treadmills, weight machines, ellipticals, and free weights, offering a variety of group fitness classes, including Pilates, Yoga, Zumba, and boot camps. They also offer personal training services with certified trainers and personalized workout plans tailored to their specific needs and fitness level. Healthier lifestyle.

Rock Life CrossFit is a popular fitness center located in the US Virgin Islands. The center offers a challenging workout experience with a variety of functional movements, weightlifting, and cardiovascular training to help individuals improve their overall health. The workouts at Rock Life CrossFit are tailored to be scalable to suit individuals of all fitness levels. The center also hosts a variety of programs and classes, including, Olympic weightlifting, CrossFit, high-intensity interval training (HIIT) for uphill hiking, yoga, endurance training, and mobility.

Synergy Fitness & Wellness is a famous fitness center and wellness studio in St. Thomas, offering an array of programs promoting health, fitness, and wellness at all levels. The center features numerous group classes and personalized training, including yoga, Zumba, cycling, and Pilates, led by experienced and certified trainers helping with nutrition, exercise, and lifestyle changes for the participants to achieve their fitness goals.

Related: More Than A Beach: A Guide On Everything You Can Do In St. Thomas

Affiliated with Reebok, Reebok CrossFit St. Thomas is a premier fitness center located in US Virgin Islands. The center offers a comprehensive CrossFit workout experience designed to incorporate a range of functional movements, high-intensity cardiovascular training, and weightlifting. The center offers a variety of programs and classes, including CrossFit, Olympic weightlifting, and some special classes, such as gymnastics and mobility training.

Ambient Yoga and Freediving is a unique fitness center and wellness studio in the US Virgin Islands and is among one of the best places for an ultimate yoga experience and freediving classes with a holistic approach to fitness and wellness. The yoga classes at the center are designed to help improve flexibility, strength, and balance, led by experienced instructors providing a variety of yoga styles, including Vinyasa, Hatha, and Restorative Yoga. Besides yoga and freediving classes, the center offers other wellness services such as massage therapy and nutritional counseling.

Beeston Hill Health and Wellness is a full-service fitness center and wellness studio fully equipped with state-of-the-art cardio and strength training equipment, including treadmills, ellipticals, weight machines, and free weights. The center also offers a variety of group fitness classes, including yoga, Pilates, and spinning, with personalized attention and guidance to help participants achieve their fitness goals. The other services provided by the center include massage therapy, acupuncture, and nutritional counseling to promote relaxation, reduce stress, and improve overall well-being.

Located in St. Thomsan, 4 Elements Culinary and Wellness Center is a unique fitness and wellness center combining culinary education with fitness and wellness classes to provide individuals with a unique perspective on health and fitness. The programs at the center are targeted at maintaining a healthy and nutritious lifestyle while keeping fitness and well-being in focus. The fitness programs at the center feature various forms of yoga, helping members to achieve mind and body wellness.

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St. Thomas Wellness: Where To Find The 10 Best Spas, Yoga ... - TheTravel

Research Highlights:

Embargoed until 10:15 a.m. CT/11:15 a.m. ET, Friday, March 3, 2023

DALLAS, March 3, 2023 People who reported getting regular, uninterrupted sleep did a better job sticking to their exercise and diet plans while trying to lose weight, according to preliminary research presented at the American Heart Associations Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023. The meeting will be held in Boston, February 28-March 3, 2023, and offers the latest science on population-based health and wellness and implications for lifestyle and cardiometabolic health.

Focusing on obtaining good sleep seven to nine hours at night with a regular wake time along with waking refreshed and being alert throughout the day may be an important behavior that helps people stick with their physical activity and dietary modification goals, said Christopher E. Kline, Ph.D., an associate professor in the department of health and human development at the University of Pittsburgh. A previous study of ours reported that better sleep health was associated with a significantly greater loss of body weight and fat among participants in a year-long, behavioral weight loss program.

The researchers examined whether good sleep health was related to how well people adhered to the various lifestyle modifications prescribed in a 12-month weight loss program. The weight-loss program included 125 adults (average age of 50 years, 91% female, 81% white) who met criteria for overweight or obesity (body mass index of 27-44) without any medical conditions requiring medical supervision of their diet or physical activity.

Sleep habits were measured at the beginning of the program, at 6 months and at 12 months, through patient questionnaires, a sleep diary and 7-day readings from a wrist-worn device that recorded sleep, waking activity and rest. These measures were used to score each participant as good or poor on six measures of sleep: regularity; satisfaction; alertness; timing; efficiency (the percentage of time spent in bed when actually asleep); and duration. A composite sleep health score of 0-6 was calculated for each participant, with one point for each good measure of sleep health, with higher scores indicating better levels of sleep health.

Adherence to the weight loss program was measured by percentage of group intervention sessions attended; percentage of days in which each participant ate between 85-115% of their recommended daily calories; and change in daily duration of moderate or vigorous physical activity. Participants had an average sleep health score of 4.5 out of 6 at the start of the study, at 6 months and at 12 months. Participants self-reported their caloric intake each day using a phone app and researchers measured participants physical activity with an accelerometer worn at the waist for one week at a time at the start of the study, at 6 months and at 12 months.

After adjusting the sleep health scores for age, gender, race and whether or not there was a partner sharing the bed, the researchers found that better sleep health was associated with higher rates of attendance at group interval sessions, adherence to caloric intake goals and improvement in time spent performing moderate-vigorous physical activity. They found:

The decrease in group session attendance, caloric intake and in time spent in moderate-vigorous activity in the second six months was expected, Kline said. As one continues in a long-term behavioral weight loss intervention, its normal for the adherence to weight loss behaviors to decrease, he said.

Additionally, while there was an association between better sleep health scores and an increase in physical activity, it was not strong enough to be statistically significant, meaning that researchers cannot rule out that the results were due to chance.

We had hypothesized that sleep would be associated with lifestyle modification; however, we didnt expect to see an association between sleep health and all three of our measures of lifestyle modification, he said. Although we did not intervene on sleep health in this study, these results suggest that optimizing sleep may lead to better lifestyle modification adherence.

The studys limitations include that it did not incorporate any intervention to help participants improve their sleep, that the study sample was not recruited based upon participants sleep health characteristics, and that the overall sample population had relatively good sleep health at baseline. The sample was also primarily white and female, so it is unclear whether these results are generalizable to more diverse populations.

One question of interest for future research is whether we can increase adherence to lifestyle modifications and, ultimately, increase weight loss if we improve a persons sleep health, Kline said.

A second question for the researchers is how such an intervention would be timed to improve sleep.

It remains unclear whether it would be best to optimize sleep prior to rather than during attempted weight loss. In other words, should clinicians tell their patients to focus on getting better and more regular sleep before they begin to attempt weight loss, or should they try to improve their sleep while at the same time modifying their diet and activity levels? Kline said.

Improving ones sleep health is something everyone can do to improve their cardiovascular health and is a key component of the American Heart Associations Lifes Essential 8. Sleep was added in 2022 as the eighth component of optimal cardiovascular health,which includes eating healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight and controlling cholesterol, blood sugar and blood pressure levels.Cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined, according to the 2023 Statistical Update from the American Heart Association.

There are over 100 studies linking sleep to weight gain and obesity, but this was a great example showing how sleep isn't just tied to weight itself, it's tied to the things we're doing to help manage our own weight. This could be because sleep impacts the things that drive hunger and cravings, your metabolism and your ability to regulate metabolism and the ability to make healthy choices in general, said Michael A. Grandner, Ph.D., MTR. Grandner is director of the Sleep and Heath Research Program at the University of Arizona, director of the Behavioral Sleep Medicine Clinic at the Banner-University Medical Center in Tucson, Arizona, and was a co-author of the Associations Lifes Essential 8 cardiovascular health score. Studies like this really go to show that all of these things are connected, and sometimes sleep is the thing that we can start taking control over that can help open doors to other avenues of health.

Co-authors are Christopher C. Imes, Ph.D., R.N.; Susan M. Sereika, Ph.D.; Daniel J. Buysse, M.D.; Bonny Rockette-Wagner, Ph.D.; Zhadyra Bizhanova, Ph.D.; and Lora E. Burke, Ph.D., M.P.H. Authors disclosures are listed in the abstract.

The National Heart, Lung, and Blood Institute, a division of the National Institutes of Health, funded the study.

Statements and conclusions of studies that are presented at the American Heart Associations scientific meetings are solely those of the study authors and do not necessarily reflect the Associations policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Associations scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Associations overall financial information are available here.

Additional Resources:

The American Heart Associations EPI/LIFESTYLE 2023 Scientific Sessions is the worlds premier meeting dedicated to the latest advances in population-based science. The meeting will be held Tuesday-Friday, February 28 March 3, 2023, at the Omni Boston Seaport in Boston, Massachusetts. The primary goal of the meeting is to promote the development and application of translational and population science to prevent heart disease and stroke and foster cardiovascular health. The sessions focus on risk factors, obesity, nutrition, physical activity, genetics, metabolism, biomarkers, subclinical disease, clinical disease, healthy populations, global health and prevention-oriented clinical trials. The Councils on Epidemiology and Prevention and Lifestyle and Cardiometabolic Health (Lifestyle) jointly planned the EPI/Lifestyle 2023 Scientific Sessions. Follow the conference on Twitter at #EPILifestyle23.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the publics health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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For Media Inquiries and AHA Expert Perspective:

AHA Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

John Arnst: John.Arnst@heart.org 214-706-1060

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

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A good night's sleep may make it easier to stick to exercise and diet ... - American Heart Association

Sharie Murray noticed the benefits of getting kids moving during the pandemic.

The K-3 special education teacher and her colleagues at North Elementary School in Birch Run, Mich., started to use short exercise videos to keep students occupied during waiting times over Zoom, but Murray said getting students blood moving also helped them focus more during the virtual class periods.

It was amazing, Murray said. The [activity] break allows the kids to escape a bit, use their energy to perform a dance or workout piece or whatever, and then the kids are able to regroup and then focus on the task at hand. And once we were able to get back into the norm in class, we wanted to pilot it in person.

North Elementary and others in the Birch Run area school district have been ramping up short, four to five-minute activity breaks as part of InPACT, short for Interrupting Prolonged sitting with ACTivity, a University of Michigan-Ann Arbor program focused on boosting physical activity in classrooms to improve students fitness, attention, and mental health. In the process, researchers and educators hope to make the common class activity break more high-impact.

This isnt something new, but [schools] are just not doing activity breaks consistently and theyre running into too many barriers, said Rachael Hasson, an associate professor of movement science and the director of the Childhood Disparities Research Laboratory at the University of Michigan-Ann Arbor. There are so many things being put on a teachers plate right now. Sometimes classroom activity breaks and physical activity programs are just one more thing that teachers have to fit into their curriculum, one more thing that they have to try to organize.

While the vast majority of K-8 teachers report using at least some physical activity breaks in their classes, Hasson and her colleagues found that only about 1 in 5 teachers provide at least 10 minutes a day of moderate-to-vigorous activity during class. Thats the minimum recommended by the American College of Sports Medicine for school-age children and adolescents, and it requires exercise intense enough that a child boosts his heart rate and perspires, but can still talk without gasping for breath.

The need to get kids moving has become more urgent in the last few years. U.S. children and adolescents get 17 fewer minutes a day of even moderate exercise today than they did before 2020, and fewer than 1 in 10 of those ages 6-17 now meet the federal recommendations of at least 60 minutes total of moderate-to-vigorous daily exercise, according to the U.S. Report Card on Physical Activity for Children and Youth. Thats less than half the share of children who got enough exercise in 2018. And the drops in exercise were especially pronounced among students in poverty.

While activity breaks have gained traction in schools in the last decade, large-scale studies of physical activity in the classroom have shown mixed effects based on the wide variation in how schools implement them.

It appears from the outside that school is one of the ideal settings [to increase students activity levels, said Joseph Donnelly, professor of internal medicine and director of physical activity and weight management science at the University of Kansas Medical Center. He studies the long-term effects of school-based physical activity programs. Schools have the physical structure, a history of physical education, so theyre delivering some sort of movement, they have educated peopleit seems sort of like a no-brainer. But its very difficult in the modern school to get teachers on board to sacrifice time for physical activity.

Hasson and her colleagues found that higher-poverty schools tended to have more barriers to implementing physical activity breaks effectively: They had less free space, fewer resources, and teacher professional development options related to integrating physical activity in class, and more pressure to use school time only for academic instruction. And while most of the high-poverty schools Hasson studied did have student wellness policies, they focused mainly on nutrition rather than exercise. Classroom activity was not integrated into the schools broader plans for student wellness.

As a result, the higher-poverty schools averaged only about eight minutes of activity breaks a day, compared to 16 minutes a day in high-income, highly resourced schools.

That compounds over time as you look at that per week, per month, per academic year, considering all the different benefits that come with regular physical activity and engagement in the classroom, because high-resourced schools already have many different opportunities for kids to be physically active inside and outside of school, Hasson said. Thats why implementation and equity have to go hand in hand.

Teachers participating in InPACT were trained in how to manage classroom behavior during breaks, guide students exercise intensity using prompts and tempo cues, and arrange their classroom spaces to make it easier to transition to and from activities. Educators also had access to a library of 200 activities and short videos they could use during breaks.

Kristine Paquette, the principal of Birch Runs North Elementary, said some teachers use the activity breaks to reinforce lessons, such as kindergarten teachers using counting songs or phonics. But Heather Erwin, a professor of kinesiology and health promotion at the University of Kentucky and editor of the Journal of Teaching in Physical Education, said analyses of dozens of studies find activity breaks that include academic content dont seem to be more or less effective in boosting students attention and activity levels. Its more important that students keep their heart rates up over the break and do a few breaks over the course of the day.

You can have these exercise snacks these small bursts throughout the day, Hasson said, who structured InPACT around four-minute activity breaks scattered through the day. So, 20 minutes sounds very overwhelming to a teacher who has not implemented activity breaks, but we can start with one break, allow teachers to establish their classroom procedures and then they can increase it over time as the breaks become more comfortable for them and their students. Even with one minute, you can start to see improvements in energy and refocusing, but we have found that four minutes gives you a nice burst of energy and primes the brain for learning.

Paquette said her teachers use the activity breaks as much for mental well-being as for physical health. The school has integrated the program into its positive behavioral intervention and supports system for managing students with behavior issues.

We want healthy kids, we want physically fit kids. We want kids that are able to mentally self-regulate, Paquette said. At the outset, people were really concerned about time because time is always such a precious commodity. But we notice when teachers use it that it helps students stay in the classroom versus being sent to the office for a timeout of some sort or a reprimand.

Murray, North Elementarys special education teacher, said the breaks have been particularly effective for students with anxiety or attention-deficit disorders. She now uses five or more four-minute breaks over the course of a typical day, usually during transitions.

Movement was a huge behavior management piece for me personally, Murray said. You could have your lesson plan and think you have to hurry upget through chapter 6.5 before going to chapter seven because our standardized test is comingbut the more youre dealing with behavior the longer it takes, and if you stop and give them a quick break, youre not gonna be wasting as much time dealing with behaviors because theyve been able to exert that energy somewhere else.

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Students Need More Exercise. Here's How to Add Activity Without ... - Education Week

SAN DIEGO As mounting evidence points to the benefits of physical activity (PA) for patients with multiple sclerosis (MS), researchers at the Hospital for Sick Children in Toronto have developed a mobile app to encourage young patients with the disease to become more active.

The smartphone-based app provides tailored PA information, coaching advice, and tools to increase social connectedness.

A pilot study examining whether the intervention changes activity, depression, and fatigue levels should be wrapped up later this year, but it looks as though the app is succeeding.

Dr E. Ann Yeh

"The feedback we've gotten so far from our coaches is that the kids seem highly motivated," one of the creators, E. Ann Yeh, MD, professor in the Faculty of Medicine at the University of Toronto and director of the Pediatric MS and Neuroinflammatory Disorders Program at the Hospital for Sick Children, told Medscape Medical News.

Preliminary work showed that use of the app was associated with a 31% increase in PA.

They discussed this and other studies of the role of exercise in MS here at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2023.

Studies show that youths with MS who are less physically active are more likely to experience higher levels of fatigue and depression. Evidence suggests just 15 to 30 more minutes of moderate to vigorous physical activity (MVPA) makes a clinical difference in terms of improved depression and fatigue scores, said Yeh.

With moderate PA (for example, a brisk walk or raking the yard), the maximal heart rate (HRmax) reaches 64% to 76%, while with vigorous PA (which includes jogging/running or participating in a strenuous fitness class), the HRmax reaches 77% to 93%.

Yeh described vigorous PA as "the stuff that makes you sweat, makes your heart rate go up, and makes you not be able to talk when you're moving."

As it stands, kids get very little MVPA 9.5 min/d, which is well below the recommended 60 min/d.

Adults do a bit better 18.7 min/d of MVPA but this is still below the recommended 30 min/d.

Being physically active improves fatigue for adults as well as kids. Yeh referred to a network meta-analysis of 27 studies involving 1470 participants that evaluated 10 types of exercise interventions, including yoga, resistance training, dance, and aquatic activities. It found that exercise "does move the needle," she said. "Regardless of the kind of activity that was studied, fatigue seemed to improve."

The authors of that study ranked aquatic exercise as the most effective intervention. "It's possible that aquatics worked better because people who can't move well feel more comfortable in the water," Yeh told Medscape Medical News.

But she cautioned that the one study in the meta-analysis that found a "quite strong" effect of aquatic exercise was "very small."

With regard to depression, which affects about 30% of people with MS, Yeh told the meeting, "unfortunately, the data are less clear" when it comes to PA for adults,. One meta-analysis of 15 randomized controlled trials involving 331 exercising participants and 260 control persons found that only a few studies showed positive effects of exercise on depressive symptoms.

However, Yeh noted that in this review, the baseline depressive symptoms of participants were "above the cutoff level," which makes it more difficult to demonstrate change in depression levels.

Researchers have also described clear brain structural and functional effects from being physically active. For example, MVPA has been shown to affect brain volume, and it has been associated with better optical coherence tomography (OCT) metrics, which measures retinal thinning.

As for the impact of exercise on memory deficits, which is of interest, given the current focus on Alzheimer's disease, "the jury is still out," said Yeh. One 24-week randomized controlled trial found no difference in results on the Brief Repeatable Battery of Neuropsychological tests between participants who engaged in progressive aerobic exercise and control persons.

However, said Yeh, "the problem may not be with the intervention but with the outcome measures" and potentially with the populations studied.

It might be a different story for high-intensity exercise, though. A study by Danish researchers assessed the effects of a 24-week high-intensity intervention among 84 adult patients with mild-severe impairment.

The primary outcome of that study, which was the percentage of brain volume change, was not met, possibly because the study was too short. There were significant results for some secondary endpoints, including improved cardiorespiratory fitness and lower relapse rate.

"Even though on the face of it, it sounds like a negative study, there were important outcomes," said Yeh.

Research into the possible mechanisms behind positive effects of PA is limited with regard to patients with MS, said Yeh. Some studies have implicated certain circulating factors, such as the cytokine irisin and brain-derived neurotrophic factor, but more work is needed, she said.

"There is need for further mechanistic knowledge related to exercise in MS, and this must be accomplished through prospective, randomized studies."

While exercise likely makes some difference for MS patients, the problem is in getting them to be more active. "You can't just write a prescription," said Yeh.

"Patients should be doing whatever they can, but gradually, and should not go crazy at the beginning because they'll just burn out," she said.

She stressed that patients need to find what works for them personally. It's also important for them to find ways to be active with a friend who can be "a motivator" to help sustain PA goals, said Yeh.

Patients can also look online for remote PA programs geared to people with MS, which popped up during the pandemic.

Commenting for Medscape Medical News, Marwa Kaisey, MD, assistant professor of neurology at Cedars-Sinai Medical Center, in Los Angeles, California, who co-chaired the session highlighting the presentation, praised Yeh's "excellent talk," which highlighted the "strong benefit" of exercise for patients with MS.

"As a clinician, I often talk to my patients about the importance of physical exercise and have heard countless anecdotes of how their workout programs helped improve mood, cognition, pain, or sleep."

However, she agreed there are several areas "where we need more data-driven solutions and a mechanistic understanding of the benefits of physical exercise."

The pilot study was funded by the Consortium of Multiple Sclerosis Centers. The MS Society of Canada funded early work on the app, and the National MS Society is funding the trial of the app. Yeh receives support from the MS Society of Canada. Kaisey reports no relevant financial relationships.

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2023: Session 6.2. Presented February 25, 2023.

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Physical Activity a Growing Priority for Patients With MS - Medscape

Pilates is a form of low-impact exercise with moves that help strengthen your muscles while improving posture, mobility, and flexibility. This exercise program, which was developed in the early 1900s by Joseph Pilates, is designed to coordinate your breathing with your body movements resulting in more body control.

Originally known as "controlology," Pilates offers a number of health benefits including improving your mobility, helping to manage pain, and building muscle endurance. Typically, workouts last about 45 minutes or longer in a class setting, but there are some Pilates workouts you can do in 20 to 30 minutes at home.

Keep reading to find out how Pilates can impact your health as well as how to implement a program at home.

Pilates is a low-impact exercise program that's good for any age. Whether you are bored with your current fitness routine or you are just looking to exercise more and improve your flexibility, Pilates may be exactly what you are looking for. Here is an overview of some of the potential health benefits of Pilates.

If you are looking to improve your functional movementthe type of movement that helps you complete everyday tasks like walking, sitting, standing, and carrying thingsthen you may want to consider Pilates. Not only can it help your movements become more fluid, but it also can help you develop more balance and stability.

In fact, a study found that people who practiced Pilates for 1 hour, three times a week for eight weeks showed increased balance, stability, and mobility. What's more, the study participants showed more improvementor scored higher on their functional movement screeningsthan the group performing yoga.

Pilates also is great for anyone looking to build muscle strength and endurance. This is largely due to the concentrated effort and control it requires to perform the moves.

For instance, one older studyfound that people who did 1 hour of Pilates twice a week for 12 weeks experienced significant increases in both abdominal endurance and upper-body muscular endurance.

Meanwhile, another study found that people who completed two Pilates sessions a week over three months showed improvements in lower body strength and postural balance. And, a study of postmenopausal women found that Pilates helped strengthen their upper body, lower body, and abdominal muscles.

There is emerging research suggesting that Pilates may be useful for coping with different forms of pain. In fact, in one preliminary study on those with fibromyalgia found that people who consistently participate in Pilates may experience less anxiety and more pain relief.

There also is some evidence that Pilates may be useful in reducing pain caused by osteoarthritis. A randomized controlled study found that people with knee pain benefitted more from doing Pilates than conventional therapeutic exercise.

Pilates may even be useful during pregnancy and lead to better labor and delivery outcomes. For instance, a randomized clinical trial of pregnant women found that those who participated in Pilates twice a week during pregnancy had improved labors with fewer C-sections, episiotomies, and obstructed labor. They also had lower blood pressure and more flexibility.

Like many exercise programs, Pilates can boost your mood and help manage symptoms of anxiety and depression. Some of this boost in energy and mood may be related to the mind-body connection that occurs when practicing Pilates, as well as the fact that working out can boost your endorphinsor those feel-good hormones.

What's more, there are plenty of studies illustrating the positive impact Pilates can have on your mood. For instance, a meta-analysis of eight Pilates studies found that those who practiced Pilates reported fewer symptoms of anxiety and depression. They also had more energy and were less fatigued.

Researchers note that Pilates may be particularly useful for those who live sedentary lifestyles. Not only is it a low-impact way to stay active, but it can be particularly instrumental in improving quality of life.

In fact, one small study of sedentary women ages 61 to 67 showed that those who did 30-minute Pilates mat and equipment-based sessions twice a week for six months experienced significant improvements in their quality of life.

While Pilates and yoga are both low-impact, bodyweight workouts that emphasize the mind-body connection, they were created with different roles in mind. For instance, Pilates has a greater focus on building strength and stability in your core and your spine and was initially introduced by Joseph Pilates to dancers and other athletes recovering from injuries.

Meanwhile, yogawhich began in India thousands of years agohas more of a meditative focus. It blends the use of different poses (or asanas) with breathing techniques. And although both Pilates and yoga build core strength, yoga is more focused on stretching and expanding your consciousness through movement.

You can benefit from either discipline, especially because both build flexibility and strength, but Pilates is often more useful for physical rehabilitation. It also can help build your core strength. Meanwhile, yoga may be better for cardiovascular health, especially vinyasa yoga, which tends to be faster paced.

If you are interested in giving Pilates a try to see if it is right for you, you may want to try a few exercises at home first. Doing so, can help you get familiar with the movements and help you decide if you like it before joining a class or finding a studio.

What's more, there are plenty of online resources that allow you to practice the discipline in the comfort of your home. Here are some Pilates moves you can try, but keep in mind there are many more options than what is listed here.

Perhaps one of the most popular Pilates move is "the hundred," which is named after the 100 beats your arms make while holding your legs extended and your head and shoulders off the mat. Many times, this move is used at the beginning of a Pilates class. Here is how you do the hundred.

If your goal is to target your backside including the hamstrings, inner thighs, and obliques then the shoulder hip bridge is the move for you. Here is how to do the move.

People who are looking to really challenge their abdominal muscles, often want to try the roll up. That said, if you are new to Pilates, the best place to start is with the supported roll back and then transition to roll up once you have built up some strength. Here's how to do the supported roll back.

Once you have mastered the supported roll back, you may want to give the roll up a try. However, if you have low back pain or a low back injury, this exercise may not be right for you. At least talk with a healthcare provider before giving it a try.

Based on how difficult it is to master the roll up, it is not surprising that proponents of Pilates claim that this move can be more effective than traditional sit-ups or crunches. Here is how to do the roll up.

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Pilates: What It Is and How It Can Benefit You - Health.com

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