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Anna didn't need the usual urging from nurses to walk the hospital corridors following cancer surgery. She was eager to begin, since walking had always been part of her life. Once home, she rebuilt her stamina by increasing her walking distance one day at a time.

Anna was doing more for her body, though, than building stamina. She was also lessening her chances of developing the depression that affects many who experience life-threatening medical conditions.

Vice President Dick Cheney and Larry King are among those who credit walking with helping to get them back to work following heart attacks and bypass surgery.

Walking, though, is not just beneficial for "after the fact" conditions. The ongoing Nurses' Health Study, involving 72,488 female nurses aged 40 to 65, shows walking briskly or with a good stride can lower the risk of stroke compared with an average or casual pace, and the same study shows that walking also reduces the risk of diabetes in women. Several other studies have already shown that exercise can reduce the risk of coronary heart disease. Also, the Journal of Obstetrics and Gynecology reported in October 2000 that exercise, such as walking, decreases the chance for certain types of ovarian cancer.

Walking also increases muscle strength; improves bloodflow; reduces the risk of hypertension; lessens lower back pain; increases the amount of good cholesterol; helps in weight loss; and since it is a weight-bearing exercise, it helps in maintaining strong bones.

Just as important, walking affects how we think. Even if individuals haven't walked during their younger years, small increases in exercise, such as walking, improve mental fitness, particularly for "executive control functions of the brain," involved in the ability to plan, coordinate, and schedule activities, says Arthur F. Kramer, cognitive neuroscientist at the University of Illinois. Participants at the university were randomly assigned to a walking program or a regimen of stretching and muscle toning. Walkers eventually Were completing an hourlong walk three times a week.

After six months the walkers' ability to switch tasks improved by 25 percent, while the toning and stretching participants showed little improvement. Kramer says that a possible explanation is that walking improves cardiorespiratory fitness, which, in turn, improves blood flow to the frontal and prefrontal areas of the brain, which control the executive function processes.

Also on the mental front, walking helps to overcome severe depression in some people on a par with antidepressant drugs. One of the theories is that exercise such as walking increases brain chemicals such as serotonin and norepinephrine, the same as antidepressant medications. Antidepressants may initially work more rapidly, but walking for 16 weeks has proved as effective in reducing depression and may work better in the long run to keep the symptoms from returning, says Duke University Medical Center psychologist James A. Blumenthal.

Blumenthal considers walking an alternative to drugs for certain people, and says it might be tried as a first line of treatment, rather than starting a person on antidepressants right away. "But it's different from writing a prescription. Other things could also contribute," he says.

Participants in the Illinois study had already been diagnosed with major depression, and had volunteered, which boosted their self-confidence, since it gave them a measure of control over their own body. Volunteers have also been more likely to stick with an exercise program than sedentary nonvolunteers. The walking was done in groups, providing support, which also helped to reduce depression.

Another reason walking might work is that it reduces stress, which often contributes to depression, even if it's mild, according to the National Institute of Mental Health.

Since the aged tend to have high levels of depression, several studies have been conducted to find out if exercise helps. It does, but removing aging stereotypes along the way is a plus. Studies at Harvard Medical School show that older people who receive subliminally delivered positive words about being old, such as "wise," "astute," and "accomplished," increase their walking speeds by 9 percent. Those who receive negative words about aging, such as "senile," "dependent," and "diseased," maintain the same walking speed they begin with.

The studies are important because a person's usual walking speed is a common measure of overall fitness, which tends to decrease 9 to 30 percent with advancing age, says Jeffrey Hausdorff, assistant professor of medicine at Harvard Medical School.

Just as important, though, according to Hausdorff, is "the role of self-expectations, attitudes and stereotypes on function. We all are aware how these things can influence our psychological state. Our studies suggest that they also influence our physiologic function. While a better attitude and positive outlook won't solve all problems, it may help to improve function."

# posted by Medical Information : 3:19 AM