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November 2003

The Ins And Outs Of Exercise Benefits

Four newly released studies have shown that regular, moderate physical activity has a markedly positive effect on older adults, overweight women, and people recovering from surgery—adding yet more proof of the tangible benefits of exercise.

The first study, conducted by researchers at Wake Forest University and published in Health Psychology, looked at 123 people ages 50 to 80 who had heart problems or heart disease risks. All subjects involved were inactive and not able to perform activities such as walking or stair-climbing. One group of subjects undertook supervised exercise and received advice on preventing heart disease; the other group underwent the same program, but also received group counseling. Researchers concluded that the group that received counseling did better on a treadmill test, showed increased confidence in walking, and showed a larger increase in weekly physical activity. Similarly, researchers at the University of Pittsburgh took a two-pronged approach in their study of 200 overweight women, with results published in The Journal of the American Medical Association. The study showed that women who exercised moderately on a regular basis, in addition to following a low-fat diet, lost the same amount of weight as those who worked out vigorously in addition to dieting. The year-long study showed that exercise duration, rather than intensity, is what controls weight loss.

Another study, also published in JAMA, concluded that women who exercised moderately had an 18% lower risk of breast cancer compared to women who were inactive. That study, which looked at 74,000 women ages 50 to 79 who walked briskly between 75 and 150 minutes each week, appears to back up scientific claims that exercise protects postmenopausal women from breast cancer through eliminating fat, which produces estrogen, and decreases the levels of an estrogen-related hormone.

Finally, a study recently conducted on laboratory rats by a research team at the University of Missouri-Columbia suggested that moderate exercise prior to surgery not only helps the body get into better shape, but also aids in postoperative recovery. Researchers studied rats that were crippled in an attempt to simulate bed rest. The rats who had gone through exercise before surgery recovered, while the other, inactive rats were not able to learn to walk again without aid. According to an AP report on the study, Marybeth Brown, leader of the research, said the experiments showed that an accelerated recovery and an exercise program before a period of inactivity are inextricably connected.

The Cap Will Go On

In late September, Federal District Court Judge Emmet G. Sullivan ruled that the Centers for Medicare and Medicaid Services (CMS) can continue to enforce the $1,590 cap on Medicare therapy payments that went into effect on September 1, 2003.

Many people and groups were not pleased by the decision, including Robert Hayes, president of the Medicare Rights Center, Washington, DC, one of the organizations that brought the lawsuit. “It’s not good news for people who have had strokes or who have chronic diseases like multiple sclerosis,” he says. “They might lose their chance at regaining mobility and other functions.”

The ruling was based on a suit filed in June by the Medicare Rights Center, Easter Seals, and the American Parkinson Disease Association that claimed that the Bush Administration failed to provide notice of the new limitation in coverage to many of the 41 million Americans enrolled in Medicare. The Administration initially agreed to hold off on implementation of the cap from January to July 2003. After the suit was filed, the Administration agreed to delay implementation until September 1 and promised to advise in writing at least 90% of people with Medicare that the cap was going into effect.

In his ruling, Judge Sullivan said he found that measures taken by CMS to notify Medicare beneficiaries of the cap were adequate.

Many groups, including the American Association of Physical Therapists, are continuing to urge the Administration and Congress to place an additional moratorium on the cap, in an effort to eventually repeal it entirely.

More States Passing Chronic Pain Awareness Legislation

At least five states have now passed legislation, or are in various stages of passing bills, regarding chronic pain research and awareness, with recent Congressional activity showing that this trend appears to be going national as well.

Legislators in Delaware, New York, Maryland, Arkansas, and Mississippi have passed, or are trying to pass, bills on chronic pain. The Delaware General Assembly recently passed a bill that formed a program to raise awareness about reflex sympathetic dystrophy syndrome, a little-known neurological disease, also known as complex regional pain syndrome, that usually develops in response to a medical procedure or traumatic injury. That bill was influenced by a similar bill passed by lawmakers in New York state in 2002.

In Maryland, the state General Assembly recently passed a law that established a state advisory council on pain management, while Arkansas legislators passed a bill earlier this year that provides physicians with more freedom to prescribe drugs for chronic pain without fear of losing their licenses. That bill is also influencing others, with physicians in Mississippi pushing for a similar measure.

And the trend has gone national as well. Congressman Michael Rogers (R-Mich) has introduced a bill called the National Pain Care Policy Act, which would authorize creating six regional research centers and establishing a national research center for pain and palliative care. That bill would also authorize a White House conference on pain care and require the government to develop a national awareness and outreach campaign. Incidentally, Congress has declared the current decade the “Decade of Pain Research.”

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