A systematic review carried out by a team at the Peninsula College of Medicine and Dentistry has analysed existing studies and concluded that there are benefits to mental and physical well-being from taking exercise in the natural environment. Their findings are published in the leading research journal Environmental Science and Technology.

The research team, supported by the NIHR Peninsula Collaboration in Leadership for Applied Health Research and Care (PenCLAHRC, part of the NIHR family of health and research initiatives) in collaboration with the European Centre for the Environment and Human Health (ECEHH), analysed data from a number of sources including 11 randomised and non-randomised control trials incorporating information from 833 adults.

Eligible trials were those that compared the effects of outdoor exercise initiatives with those conducted indoors and which reported at least one physical or mental well-being outcome in adults or children.

The study found that most trials showed an improvement in mental well-being: compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalisation, increased energy and positive engagement, together with decreases in tension, confusion, anger and depression. Participants also reported greater enjoyment and satisfaction with outdoor activity and stated that they were more likely to repeat the activity at a later date.

However, none of the identified studies measured the effects of physical activity on physical well-being, or the effect of natural environments on sticking to exercise.

On balance this review has identified some promising effects on self-reported mental well-being immediately following exercise in the natural environment, as opposed to those reported following exercise indoors. This is a first step towards vindicating the positive effects of programmes such as the Green Gym and Blue Gym, and innovative interventions by medical practitioners that include exercise outdoors as part of holistic treatments for those suffering from depression and similar psychological ailments.

At present research analysts are working with a paucity of high quality evidence, and one significant outcome from this study is the urgent need for there to be further research in this area. Large, well-designed longer-term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully analyse the effects of outdoor exercise on mental and physical well-being. Studies are also required that measure the influence of such effects on the sustainability of physical activity.

Dr. Jo Thompson-Coon, PenCLAHRC Research Fellow, commented: “The hypothesis that there are added beneficial effects to be gained from exercising in the natural environment is very appealing and has generated considerable interest. By using the data currently available to us we have added strength to the link between mental and physical well-being and outdoor exercise, but further research and longer, tailor-made and focused trials are needed to better understand this link.”

The senior author of the study, Professor Michael Depledge, Chair of Environment and Human Health at the ECEHH, added: “Some 75 per cent of the European population now live in urban environments, so that increasing efforts need to be made to re-connect people with nature via programmes such as the Green Gym and Blue Gym. Our research, which brings together data from a wide variety of sources, adds significant weight to the case for spending more time in the natural environment as members of the public and their clinicians fight to counteract the negative outcomes of modern living, such as obesity and depression. We look forward to conducting the further research and trials required to establish the evidence-base for introduction of outdoor activity into general lifestyle to complement therapeutic intervention.”

Professor Stuart Logan, Director – Institute of Health Service Research and Director – PenCLAHRC, at the Peninsula College of Medicine & Dentistry, said: “This is just the sort of project that PenCLAHRC is designed to support. It reflects the aim of the National Institute for Health Research in establishing CLAHRCs around the UK – locally identified and undertaken research that translates to improved health and well-being and that both benefits the local community and contributes to the production of research evidence. This is an exciting project with immense potential.”

Source:
Andrew Gould
The Peninsula College of Medicine and Dentistry
Sports Medicine / Fitness From Medical News Today

http://www.medicalnewstoday.com

Issued by the US Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), the Dietary Guidelines for Americans, 2010 suggest that individuals look to HHS’ 2008 Physical Activity Guidelines for Americans for guidance on the amount and types of exercise needed for health benefits. For most adults, 150 minutes of moderate-intensity aerobic activity each week is required to achieve and maintain a healthful body weight. Adults also should include muscle-strengthening activities that involve all major muscle groups on 2 or more days a week. For children and adolescents ages 6 years and older, HHS recommends 60 minutes or more of physical activity per day, which can be achieved through “short bursts” of time. At least 3 days a week children and adolescents should engage in muscle-strengthening physical activity.

“We applaud USDA and HHS for explicitly stating the importance of physical activity in attaining and maintaining a healthful weight,” said physical therapist and APTA spokesperson Ethel Frese, PT, DPT. “However, for individuals who have led sedentary lifestyles, who are overweight or obese, or who have a physical disability becoming physically active or increasing activity can be a challenge. Physical therapists’ extensive knowledge of health conditions allows them to examine people of all ages and abilities and design safe and effective physical activity programs that help establish life-long habits of physical activity.”

Specifically, the new dietary guidelines include “key” recommendations that USDA says are “the most important in terms of their implications for improving public health.” The 2 key recommendations for balancing calories to manage weight are:

• Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors.
• Increase physical activity and reduce time spent in sedentary behaviors.

The new dietary guidelines come one month into 2011, just as many people who made New Year’s resolutions to get fit are abandoning them. In January, to help individuals keep their New Year’s resolutions while avoiding injury and working the major muscle groups of the body, APTA launched a month-long Twitter campaign that included 12 instructional videos featuring physical therapist and APTA member Robert Gillanders, PT, DPT. In the videos, Gillanders demonstrates correct posture and form for selected core, leg, shoulder, and arm exercises that can be done at home or at the gym.

Source:
American Physical Therapy Association (APTA)

Sports Medicine / Fitness From Medical News Today

http://www.medicalnewstoday.com

Simply taking more steps every day not only helps ward off obesity but also reduces the risk of diabetes, finds a study published on bmj.com today.

While several studies have shown that physical activity reduces body mass index and insulin resistance – an early stage in the development of diabetes – this is the first study to estimate the effects of long-term changes in daily step count on insulin sensitivity.

A popular guideline is to do 10,000 steps every day, though a more recent recommendation is 3,000 steps, five days a week.

The research, by the Murdoch Childrens Research Institute, Melbourne, involved 592 middle aged adults who took part in a national study to map diabetes levels across Australia between 2000 and 2005.

At the start of the study, participants completed a detailed diet and lifestyle questionnaire and underwent a thorough health examination. They were also given a pedometer and instructed how to use it. Participants were monitored again five years later.

Other lifestyle factors, such as diet, alcohol and smoking were taken into account.

A higher daily step count over five years was associated with a lower body mass index, lower waist to hip ratio, and better insulin sensitivity.

These associations were independent of dietary energy intake and appeared to be largely due to a change in adiposity (fatness) over the five years, say the authors.

The authors estimate that, in their setting, a sedentary person who takes a very low number of daily steps but who was able to change behaviour over five years to meet the popular 10,000 daily step guideline would have a threefold improvement in insulin sensitivity compared with a similar person who increased his or her steps to meet the more recent recommendation of 3,000 steps for five days a week.

They conclude: “These findings, confirming an independent beneficial role of higher daily step count on body mass index, waist to hip ratio, and insulin sensitivity, provide further support to promote higher physical activity levels among middle aged adults.”

Source: British Medical Journal

Diabetes From Medical News Today

http://www.medicalnewstoday.com/articles/213549.php

During February, American Heart Month, Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center, offers some easy steps to improve heart health and overall well-being throughout the year.

An estimated 58 million Americans are affected by heart disease, including nearly half a million women who die every year of heart disease and stroke. Yet, women continue to lag behind in their understanding of this disease.

“While we are making great strides in advancing the treatment of heart disease, we need to do more to encourage prevention and educate women about their risk factors,” says Dr. Andersen. “Educating women about this disease not only helps them to improve their own health, but women are more likely to spread the message of prevention to friends and family. When you educate a woman you educate a society.”

Step 1: Know your numbers. Your blood pressure, cholesterol and triglyceride levels are the most important numbers you will need to know before you begin on the path to good heart health. A normal blood pressure level is 140/85 or less, total cholesterol levels should be less than 200, and triglycerides less than 150.

Step 2: Start walking. Exercise is the fountain of youth. A simple 20 to 30 minute walk a few days a week can actually reduce the risk of premature death by more than 50 percent. Physical activity also improves sleep, reduces stress, elevates mood, reduces blood pressure, improves cholesterol, improves cognition and prevents memory loss.

Step 3: Laugh out loud. Laughter really is the best medicine. Just 15 minutes of laughter is about equivalent to 30 minutes of aerobic exercise with respect to our cardiovascular health. Laughter has also been linked to the healthy function of blood vessels, an increase of the brain hormones that improve mood, and reduction of pain and anxiety.

Step 4: Focus on your waistline, not your weight. Your waistline is a better measurement of your overall health than your weight because the amount of fat around your waistline is directly linked to high blood pressure and high cholesterol and can place you at increased risk for diabetes. Anything you can do to make your waistline smaller is definitely a step in the right direction. Liposuction doesn’t count!

Step 5: Get a good night’s sleep. Sleep is one of the most undervalued elements of our daily routines, but it is absolutely vital to good health. Lack of sleep increases your blood pressure, induces stress, increases your appetite and slows down your metabolism, dampens your mood and decreases your cognition.

Sources: NewYork-Presbyterian Hospital

Heart Diseasey From Medical News Today

http://www.medicalnewstoday.com/articles/213425.php

In an analysis that included data from 9 studies, having higher measures of walking speed among older adults was associated with increased length of survival, according to a study in the January 5 issue of JAMA.

“Remaining years of life vary widely in older adults, and physicians should consider life expectancy when assessing goals of care and treatment plans. However, life expectancy based on age and sex alone provides limited information because survival is also influenced by health and functional abilities,” according to background information in the article. There are currently no well-established approaches to predicting life expectancy that incorporate health and function. Gait speed, or walking speed, has been recommended as a potentially useful clinical indicator of well-being among older adults.

Stephanie Studenski, M.D., M.P.H., of the University of Pittsburgh, and colleagues conducted a study to assess the association of gait speed with survival in older adults and to determine the degree to which gait speed explains variability in survival after accounting for age and sex. The study included a pooled analysis of 9 participating studies (collected between 1986 and 2000), using individual data from 34,485 community-dwelling adults age 65 years or older with walking speed data available at the beginning of the study, followed up for 6 to 21 years. Participants had an average age of 73.5 years; 59.6 percent were women; and 79.8 percent were white. Gait speed was calculated for each participant using distance in meters and time in seconds. All studies used instructions to walk at usual pace and from a standing start. The walk distance varied from 8 feet to 6 meters. The average gait speed of the participants was 0.92 meters (3 feet) per second.

During the course of the study, there were 17,528 deaths. The overall 5-year survival rate was 84.8 percent; the 10-year survival rate was 59.7 percent. The researchers found that gait speed was associated with differences in the probability of survival at all ages in both sexes, but was especially informative after age 75 years. At this age, predicted 10-year survival across the range of gait speeds ranged from 19 percent to 87 percent in men and from 35 percent to 91 percent in women.

“Predicted years of remaining life for each sex and age increased as gait speed increased, with a gait speed of about 0.8 meters [2.6 feet]/second at the median [midpoint] life expectancy at most ages for both sexes. Gait speeds of 1.0 meter [3.3 feet]/second or higher consistently demonstrated survival that was longer than expected by age and sex alone. In this older adult population the relationship of gait speed with remaining years of life was consistent across age groups, but the absolute number of expected remaining years of life was larger at younger ages,” the authors write.

The researchers also found that predicted survival based on age, sex, and gait speed was as accurate as predictions based on age, sex, use of mobility aids, and self-reported function or as age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalization.

The authors suggest there are several reasons why gait speed may predict survival. “Walking requires energy, movement control, and support and places demands on multiple organ systems, including the heart, lungs, circulatory, nervous, and musculoskeletal systems. Slowing gait may reflect both damaged systems and a high energy cost of walking.”

The researchers write that there are a number of ways gait speed might be used clinically, including helping to identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit. Gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 meter (2 feet)/second. “In these patients, further examination is targeted at potentially modifiable risks to health and survival.” Also, gait speed might be monitored over time, with a decline indicating a new health problem that requires evaluation.

“The data provided herein are intended to aid clinicians, investigators, and health system planners who seek simple indicators of health and survival in older adults. Gait speed has potential to be implemented in practice, using a stop watch and a 4-meter [13 feet] course. From a standing start, individuals are instructed to walk at their usual pace, as if they were walking down the street, and given no further encouragement or instructions. The data in this article can be used to help interpret the results. Gait speed may be a simple and accessible indicator of the health of the older person,” the authors conclude.

JAMA. 2011;305[1]:50-58.

Source
Journal of the American Medical Association

Seniors / Aging From Medical News Today
http://www.medicalnewstoday.com/articles/212560.php

The studies in mice suggest that exercise turns on a genetic program that leads the heart to grow as heart muscle cells divide. It appears that shift in activity is driven in part by a single transcription factor (a gene that controls other genes). That gene, known as C/EBPb, was known to play important roles in other parts of the body, but this is the first evidence for its influence in the heart.

“We’ve identified a pathway involved in beneficial cardiac hypertrophy – the good kind of heart growth,” said Bruce Spiegelman of Harvard Medical School.

The findings may have clinical implications, particularly for those with heart failure or other conditions that make exercise difficult to impossible, the researchers say.

“This is yet another reason to keep on exercising,” said Anthony Rosenzweig of Harvard Medical School. “In the longer term, by understanding the pathways that benefit the heart with exercise, we may be able to exploit those for patients who aren’t able to exercise. If there were a way to modulate the same pathway in a beneficial way, it would open up new avenues for treatment.”

There may also be ways to optimize training regimens such that they tap into this natural mechanism more efficiently, Spiegelman added.

Researchers had known that heart muscle adapts to increased pressure and volume by increasing in size. That’s true in the case of exercise as it is in pathological conditions including high blood pressure. In disease states as opposed to exercise, those changes to the heart can ultimately lead to heart failure and arrhythmias.

In the new study, the researchers sought to better understand those differences using methods developed in the Spiegelman lab that allowed them to quantify changes in the expression of transcription factors in the heart at the genome-wide level in both exercised mice and those who had their aortas surgically constricted, a treatment that leads to a pathological increase in heart size.

The researchers found changes in 175 transcription factors in exercised mice and 96 in mice whose aortas were constricted. Importantly, the changes showed little overlap between the two animal models. For instance, the researchers said, 13 percent of the genes with differential expression following exercise have known or suggested roles in cell proliferation compared to less than one percent of those that changed with the surgery.

The researchers then zeroed in on one transcription factor, C/EBPb, which goes down about two-fold with exercise and a second that rises in turn. Studies in animals and cell culture showed that the decline in C/EPBb leads to changes that appear to be consistent with those that follow endurance exercise, including an increase in heart muscle size and proliferation. Those mice with lower C/EPBb levels also were resistant to heart failure.

That finding is key given that there is little prior evidence showing that the increase in heart size with exercise has direct benefits, the researchers say. The new evidence also gives important biological insights into the heart’s potential for regeneration of muscle.

Rosenzweig said it will be important in future studies to explore all of the players in the pathway and to provide even more definitive evidence that exercise leads to an increased rate of cell proliferation in heart muscle.

Source:
Elisabeth (Lisa) Lyons
Cell Press

Sports Medicine / Fitness From Medical News Today

http://www.medicalnewstoday.com/articles/212468.php

Here are five myths about physical fitness that some readers may find surprising.

Myth #1
You can reduce fat in specific areas of the body, by doing exercises that target those particular body areas.

On the face of it, that seems to make sense, but trying to burn fat in a precise spot where you want to lose it, simply doesn’t work.  The only way to burn fat is through exercise, expending more calories then you’ve ingested.  And exercise burns fat gradually, and from all areas of the body simultaneously, not just around the muscles you’re using. That doesn’t mean that you shouldn’t work the areas where you have extra fat though.  Doing so will build muscle there, and that will give that area a more toned look, when the fat over the muscle is reduced.

Myth #2
You must exercise regularly, in order for the exertion to benefit you.

There’s no doubt about it, getting truly physically fit requires many weeks of diligent effort.  With that in mind, many people believe, that if they can’t or don’t have the willpower to exercise several times per week, any lesser effort is wasted.  But, any amount of exercise is beneficial.

Even if you only take a walk occasionally, the effort can help lower your blood pressure, blood sugar, and cholesterol.  It probably won’t help you lose weight or build muscle, but it’s certainly worthwhile, from an overall health point-of-view.  And psychologically, sometimes when we start off exercising every now and then, we soon realize, that’s it not as difficult as we thought, and making time for exercise on a regular basis, is not as difficult as we might have believed.

Myth #3
Strength training will make your body too muscular.

Some people use weight training to develop large muscles.  Many others participate in order to increase their strength and tone their overall musculature, but are not interested in “bulking up.”  But if you follow a sensible strength-training regimen, there’s no need to end up looking like a bodybuilder.  On the contrary, without a positive genetic disposition for large muscle growth, any strength training results will be positive, but not excessive.

The “bodybuilders” pictured today spend many hours a week in the gym, performing many sets, with increasing weight resistance.  A more mainstream strength training program consists of 10 – 12 different exercises, at between 8 – 12 repetitions, utilizing all major muscle groups, twice-a-week.

Myth #4
Muscle turns to fat, if you stop exercising that muscle group.

Muscle cannot magically transform itself into fatty tissue.  There is no need to worry about your hard-earned, six-pack abs turning into jello, if your exercise routine is interrupted.  Muscles will shrink (atrophy), if not challenged regularly, with resistance exercises, and this may create a flabby, less-toned appearance, over time.  The missed exercise routine, with fewer calories burned, will also cause a reduced metabolism, making it much more likely, you will gain weight, as fat.

Myth #5
I’m too old to start exercising.

Aging, in many cases, brings an inevitable decrease in personal health status.  With that in mind, many people believe that, if they haven’t followed a regular exercise routine, starting later in life is futile.  Research has showed that nothing could be further from the truth.  Exercise can assist in the management of many health problems, common among the middle-aged and elderly.  As always, it’s extremely important to consult your physician, before embarking on a strenuous regimen, as they understand your physical condition better than anyone.  Unfortunately, although exercise is incredibly beneficial to most, because of prior medical conditions, certain individuals may not be able to participate safely.

Exercise myths may hinder people from embarking on a personal fitness program.  Knowing the truth, behind the myths, may alleviate those fears, and make it easier for individuals to pursue a healthy lifestyle correctly.

There are several benefits of exercising. It helps in preventing many diseases associated with old age. Most of the heart diseases, diabetes, arthritis and high blood pressure can all be prevented by doing exercise. Exercise is advised by the American Heart Association, the American Diabetes Association, the National Institutes of Health and the Arthritis Foundation. By having a half an hour long exercising session thrice a week, you can get rid of the diseases that occur with aging.

Maddi McDonough of Pembroke, Massachusetts is aged 66. She loves to exercise daily to stay fit. She takes around ten thousand steps every day. She has benefited tremendously from the regular exercise. Her cholesterol levels have gone down, her blood pressure is maintained and sciatica which had kept her bedridden has disappeared. She is one of the many people who have snapped pedometers onto their belts and joined the 10,000 steps club. She exclaims as to how she was able to hike up to the peak of Mt. Pilatus when she visited Switzerland. She says I was able to hike while others just waited at the lodge. She also did white water rafting in Colorado. I was even tempted to for bungee jumping in Australia, but I didn’t do it! she exclaims. It is important to exercise; the type of exercise doesn’t matter much. You need to exercise thrice a week in order to stay fit and healthy.

New developments are being made in the field of medicine. Earlier The Arthritis foundation used to advise rest to the patients of osteoarthritis. However with changing times, this concept also changed. Nowadays you either exercise or get the diseases, the choice is yours. Joints will become inflexible and stiff if you do not use them regularly. Exercise helps to build strong muscles near to the joints, keep the joints flexible. It also helps in reducing the joint pain. However the pain is not relieved completely. In addition to all this, exercise also controls weight, promotes better sleep, increases energy, increases self esteem and decreases depression.

Marilyn Boynton, a 68 year old described herself as an old broad. However things began to change when he started tap dancing at the age of 59. Initially she had a lot of back pain while dancing but instead of giving up she joined a fitness club. Now, her back pain has bettered.

You should not straight away start with strenuous exercises. You should always start with mild exercises and then gradually increase it. You can have some strain or injuries in case you jump to strenuous exercises straight away. To make your exercise successful, follow the following steps advised by the American Heart Association.

• You need to consult your doctor before you start out with any exercise program in case you are overweight, haven’t been active recently or have some chronic illness.
• You should do a number of exercises. You will get bored if do the same type of exercise regularly so choose a number of activities.
• You should start with mild exercises and then increase it slowly.
• It can get boring to exercise alone. Find out a friend and exercising will be much more fun!
• You must wear proper clothes and shoes while you are working out.
• You should exercise regularly, however there is no need to worry if you miss it for a day. Indulge in other types of physical activities to make up for it.
• Warming up is extremely important. You can have certain injuries if you do not warm up before the exercise. It is also important to cool down after the exercise.

You need to exercise to keep yourself healthy and fit. It is important if you want to lead a disease free life!

Diabetes mellitus is a condition or metabolic disorder where the body is in problem of taking glucose from the blood and delivering it to the rest of the body so that it can be used as energy.

Type I diabetes is recognized by the pancreas making too little or almost no insulin.

Type II diabetes, also known as adult onset diabetes, is characterized by the pancreas not producing enough insulin to manage glucose levels or the cells not responding to insulin.

It is important for a person who has diabetes to consult with a physician before beginning an exercise program. It is not good for people with diabetes to skip meals at all, but particularly not previous to exercise.

While insulin has many functions in the body, four are mainly vital during or after exercise:

1. Stimulation of glucose uptake into most cells of the body
2. Reserve of glucose release from the liver
3. Inhibition of the discharge of fatty acids from storage depots
4. Facilitation of protein synthesis in the body.

The usual decline in blood insulin during exercise in people without diabetes and in those with Type 2 DM allows the two most important fuels for exercise, carbohydrates and fats, to be mobilized and used by muscle.

Exercise is also known as physical movement and includes anything that gets you moving. Exercise causes the body to process glucose faster, which lowers blood sugar level.

So the question is what kind of Diabetes Exercise is suitable for diabetes control.

1. Aerobic exercise –

Aerobic exercise helps increases heart and breathing rate. This makes one breathe more sincerely and also makes the heart effort harder. It is fine to plan for a total of about 30 minutes a day, at least 5 days a week. Some of the examples of aerobic exercises: -

Take a fast walk either outside or on a treadmill

• Cycling
• Dance classes
• Swimming
• Jogging
• Tennis or badminton

2. Strength training –

Strength training, done numerous times a week, helps build strong bones and muscles. It can be done in following way

• You can join a gym to do strength training with weights or the alternative is to lift light weights at home

3. Flexibility exercises –

Flexibility exercises or stretching exercises helps keep joints flexible and also reduces the probability of injury during other activities. Gentle stretching for 10 to 15 minutes helps the body to warm up, as well as get prepared for aerobic activities.

4. Be on the move all through the day –

Being energetic helps burns calories. For this you can do following in daily life:

• Walk instead of driving whenever probable.
• Take the stairs in place of the elevator
• Work in the garden
• Park your car ½ kilometer before the market begin and go market by walking.

Exercise is necessary whether you have Type 1 or Type 2 diabetes. Exercise has the potential for diabetes control by non medical means, reduce the severity of the disease, and significantly reduce the risk of long-term complications. Exercise can mean the dissimilarity between “medical management” and “lifestyle management” of Type 2 diabetes.

Exercise will greatly help an individual with type II diabetes because of its helpful effects on insulin sensitivity. Exercise involving heavy weights may be terrible for people with blood pressure, blood vessel, or eye problems.

Diabetes Exercise, along with good nutrition, helps decrease body fat, which helps control glucose metabolism. Exercise and good nutrition provide real physical payoffs–they are essential to controlling diabetes. Exercise can help prolong your life and get better the quality of your added months and years.

Glucose levels should be tested before, and after exercise (but after 3 to 5 hours). Proper Diabetes Exercise and nutrition are the best forms of avoidance for type II diabetics.

Aerobic exercise increases insulin sensitivity and, along with proper nutrition, helps reinstate normal glucose metabolism by decreasing body fat. Don’t exercise outdoors on very hot or moist days. To avoid dehydration, drink a cup of cold water before and after you exercise. A personal trainer can help to set up a program for the Type 2 diabetic and help them to exercise properly. People with diabetes must use extra care in preparing for exercise plan because they lack insulin (Type 1 DM) or because the insulin they have is defective in its ability to stimulate glucose uptake (Type 2 DM).

Push-up Improvement with SGT Ken

Exercise clip discussing how to improve push-ups. Exercises demonstrated by SSG Ken Weichert. For more information please visit: www.startfitness.com *Assumes no association with the US ARMY or the Department of Defense
Video Rating: 4 / 5