|Posted by mandlfoxworth on November 18, 2018 at 8:15 PM|
Research suggests that exercise slows PN progression. But only REGULAR exercise. We are far more likely to exercise regularly if we enjoy it. Research on the interaction between social support and medical treatment research may throw a little light on this.
My wife & I like the video lectures sold by “The Great Courses”. This week we watched the course “Stress and Your Body.” It was a great experience, setting off all kinds of thoughts, including one about exercise and PN. The lecturer, Stanford neuroscientist Robert Sapolsky, was explaining why it is so hard to demonstrate a link between stress and Cancer. He explains that one of the big problems with cancer research studies, especially big studies with lots of participants, is getting patients to actually do the treatment being tested. Why would a patient in a clinical trial not take treatments that could save that patient's life? Does this make any sense?
Well, yes, it does. Cancer treatments can hurt. They can have horrible side effects. The treatment, recovery or travel may involve a significant amount of time. Participants often have significant control over the execution of their treatments. People cancel or not keep appointments. They skip pills or injections or other aspects of the treatment. They fib about it. This kind of behavior can (and often does) damage or ruin research results.
How can the researchers minimize this bad behavior? In some cases, a useful approach may be to arrange for social support. Sapolsky described a famous breast cancer study by Stanford’s David Spiegle. The patients were required to participate in an intensive social support group as part of a study on re-occurrence of breast cancer. Initially, the results suggested that being in a group reduced stress and increased survival rates. However, the results could not be consistently replicated. Why? When they looked more closely at the data, it turned out that group participation tends to minimize failure to comply. When in a group, the patients tend to support each other in complying with the treatment plans. “Did you take your meds today? Have you eaten? Do you feel awful? Yeah, me too. Let’s go get something to eat right now. …..” That is, being in a group can directly influence our participation in the treatment plan.
In the case of the Spiegle study, which was designed to measure the direct effects of being in an intensive support setting, the effects of this unexpected increase in treatment compliance were large enough to muddy interpretation of the results. We don’t know if reducing stress with social support can improve cancer survival, but we do know that social support can increase willingness to stick with a difficult cancer treatment.
What does this suggest to me about exercise for PN patients? Do something you enjoy. Social interaction can be a significant part of that enjoyment.
From 2004 to 2011 I used my Wii game system (mostly my Wii Fit with its balance board) to do exercises every morning at home before work. Loved it. Like the way runners love to get out in the morning and run. By 2012 my PN made it impossible to keep using my Wii Fit. I could no longer balance on the balance board.
My wife and I have used water aerobics on and off for more than 40 years. Sometimes together, sometimes separately. My wife and I now regularly do water aerobics. In a physical sense, it is great exercise for me. Supported by the water, I can move my legs and feet in ways my impaired balance would not otherwise allow. I enjoy it. But what keeps me coming is the opportunity to be among people I enjoy. I talk. And talk. I try to respectfully listen to our long-suffering teacher, but not to the exclusion of sufficiently socializing. For me, this is a winning combination. I enjoy my water aerobics.
Until about a year ago I was in a gym. It was good. I liked the way it made me feel. But in terms of enjoyment, it did not hold a candle to my socializing-enhanced Water Aerobics class. It was solitary. It was easy to skip (though I usually went).
For the past year, instead of the gym, I substituted home PT exercises and an aerobic exercise at home with my dog. I can no longer safely do that particular aerobic exercise (and the dog is getting noticeably older). Now, I am wondering if should go back to the lonely exercises on the machines at the gym. I’ve tried Silver Sneakers and could not do it (no balance). Chair Yoga looks like it would be social, but I’m unsure if it offers the wide range of exercise types offered by the gym. I think what I need is a social group of coffee drinkers who meet at the gym and then go visit and talk afterwards. Not sure how to find them.
MY (and Dr. Sapolsky’s) POINT: We will only REGULARLY do exercise if we enjoy it. Social interaction can be one of many factors that contribute to that enjoyment.