Strength training crucial for fitness
Dr Ravinder Chadha

Fitness entails speed, stamina, flexibility and strength. Aerobic activities like walking, jogging and cycling improve speed and stamina. Yoga exercises improve flexibility. However, strength training is getting neglected. Strength is a crucial component of fitness, which becomes even more important as one ages.

Adding strength training to one’s workout can help in improving power stability, functional capacity and the quality of life. A few months’ strength training can enhance walking speed, reduce fatigue after aerobic activities and add to one’s muscle power.

It has been established that strength training can be safe and effective for all age groups provided the programme is properly designed. For children push-ups and sit-ups are safe and effective ways to improve strength. Strength training, apart from increasing muscular strength, also enhances motor skill activities before jumping, sprinting, etc and decreases the incidence of injuries.

During adolescence strength training may increase the muscle size but in prepubescent the muscle size does not go up due to the deficiency of muscle-building hormone. Strength exercises with a stretch band/ tube have proved to be safe and effective, as one can derive the requisite smooth resistance without exerting undue strain on the muscles and joints. Strength training with maximum weight — power lifting — is not recommended for young people as it can cause injuries to long bones, low back and growth plates.

Strength training sessions should be scheduled on alternate days due to the fact that an increase in the muscle size and strength occurs during the period of rest.

The number of repetitions chosen for each exercise depends on the amount of resistance. The maximum resistance is the maximum weight you can lift at one time. It is safe to do 8 to 12 repetitions using 60 to 75 per cent of the maximum resistance. 

Rest is necessary between the sets so that the energy source is resynthesised. A shorter rest period of less than two minutes increases muscle and blood lactic acid leading to fatigue. A rest period of three-five minutes is recommended between the sets to enhance performance.

Some of the important strength training exercises are as under:

Hamstring curls: Stand in front of a chair and hold onto it. Bend the right knee with ankle weights, bringing the foot up behind you and keeping the right knee pointing towards the floor, and slowly come back. Repeat for 8-10 times before switching over to the other leg.

Knee lifts: Hold onto the wall or a chair for balance and bring one knee with ankle weights bent at 90 degrees up to the hip level, and slowly come back. Have 8-10 repetitions and then switch sides.

Calf raise: Step up on a stable platform or staircase with weight supported by the balls of feet. Place one hand against a wall for support. Tuck your one foot behind the other foot heel. With your back straight, rise on the toes. Hold on for a second and then return to the original position. Do 10 to 12 repetitions, then switch legs.

Wall push-up: Stand a few feet away from the wall and place yours hands on the wall at the shoulder level, a few inches wider than the shoulders. Keeping the back straight, bend elbows and push the body towards the wall until the elbows are at 90-degree angles. Push back to start and repeat for 10-15 times. 

Biceps curls: Sit or stand holding dumbbells in both hands, palms facing out. Curl the weight up towards your shoulder and return back. Repeat 8-10 times.

Triceps extension: Sit or stand and hold a dumbbell in the one hand straight up overhead and directly over the shoulder. Bend the elbow and lower the weight down a bit behind your head to about 90 degrees. Contract the back of the arm to pull the weight back and repeat 8-10 times. 

Strength training is thus an extremely important component of fitness and helps in the prevention of sports injuries and successful rehabilitation. It is imperative that a strength training programme is scheduled in a safe, effective and enjoyable manner to achieve optimal results. 

Laparoscopic removal of uterus—latest trend
Dr Pankaj Garg & Dr Lavleen Kaur

The most common medical reasons necessitating the removal of the uterus or hysterectomy are benign tumour of the uterus (uterine fibroids), abnormal uterine bleeding, endometriousis, genital prolapse and chronic pelvic pain. For most of these ailments, it is advisable to consider medical treatment first and hysterectomy should be reserved as a last resort.

There are three major approaches to remove the uterus

1. Through the abdomen (abdominal hysterectomy — AH) It requires a four-to-six-inch-long incision in the abdomen.

2. Through the vagina (vaginal hysterectomy-VH) —The uterus is taken out through a vaginal incision only. This is generally possible in cases where attachments of the uterus are lax or the uterus is prolapsed (coming out through the vagina).

3.Laparoscopic Hysterectomy: In this, surgery is done laparascopically and the uterus is delivered without making an abdominal incision.

First laparoscopic hysterectomy was done by Reich in 1989. LAVH or laparoscopic-assisted vaginal hysterectomy is increasingly becoming popular. Many women come to the doctor to say they want a “laser” hysterectomy. What they usually mean is a laparoscopically assisted vaginal hysterectomy or LAVH. In the years to come, laparoscopic hysterectomy will replace abdominal hysterectomy in most cases.

If a vaginal hysterectomy can be performed in the first place, there would be no point in adding the costs and complications of laparoscopy. Its greatest benefit is the potential to convert what would have been an abdominal hysterectomy into a vaginal hysterectomy. Another advantage of the LAVH may be the removal of the tubes and ovaries which on occasions may not be easily removed with a vaginal hysterectomy.

Almost all cases for which abdominal hysterectomy is indicated can be done as LAVH. Apart from this, the conditions in which vaginal hysterectomy is contraindicated (not possible) have become indications of LAVH.

The advantage of LAVH to the patient are many: miniature abdominal incisions (<1.2 cm), decreased post operative pain, shortened post-operative recovery, less blood loss and less need for blood transfusion, cosmetically better, fewer post-operative infections, fewer adhesions, shortened hospitalisation (<48 hours)

There are a few patients in whom LAVH is not advisable. For instance, patients with serious heart diseases and chronic lung disease should not be considered a good candidate for laparoscopic management. LAVH may also be more difficult in patients who have had previous lower abdominal surgery. The elderly may also be at an increased risk for complications with general anaesthesia combined with pneumoperitoneum (gas filled in the abdomen) needed for laparoscopic surgery.

Certain patients scheduled to be treated laparoscopically may have to be “converted” to open surgery during the operation because of dense adhesions, very large uterus size, heavy bleeding, intestine perforation or ureteric injury.

These days, laparoscopy is indispensable in managing patients of infertility. Laparoscopy plays an important role in ectoic pregnancy pregnancy in tubes instead of uterus), ovarian surgery, tuboplasty (tube reconstruction) and diagnostic work-up. It has a special role in surgery, in unmarried females because laparoscopy is cosmetically much better and leads to less adhesion formation which makes any future intervention easier and less complicating.

Dr Garg is Senior Consultant and Surgeon, Fortis Hospital, Mohali, and Dr Lavleen Kaur is a gynaecologist.

Eating fish may slow down memory loss

Houston: Eating fish at least once a week may slow down the process of memory loss in elderly people, a new study has found.

Fish is a direct source of omega-3 fatty acids, essential for neurocognitive development and normal brain functioning, according to the study by Chicago-based Rush University Medical Center.

Martha Clare Morris and her colleagues of the Medical Center analysed data collected from Chicago residents — 65 years and above — on their food habits and found that dietary intake of fish slows down the cognitive decline in thinking, reasoning, remembering and imagining.

The team first interviewed them between 1993 and 1997 and and then twice later after every three years.

The rate of decline was reduced by 10 per cent to 13 per cent per year among persons who consumed one or more fish meal per week compared with those with less than weekly consumption. The rate reduction is the equivalent of being three to four years younger in age. 

“Cognitive decline is common among older people and is very much associated with advancing age. Nonetheless, data from the United States and other countries indicate that it is a widespread and increasing public health problem,” it said.

Fish consumption has been associated with lower risk of dementia and stroke and recent studies have suggested that consumption of one omega-3 fatty acid in particular, docosahexaenoic acid (DHA), is crucial for memory performance in aged animals.

The study will appear in the December issue of Archives of Neurology. — PTI