Top 10 Beach Body Secrets – by Jason Minich

Beach BodyIf you know me by now, you can probably guess that the first thing I’m going to say is that anything that promises quick weight loss can quickly be tossed out the window. However, there are a few things that I would recommend if you want to drop a few pounds of body fat the right way… and possibly quickly. So, here is the list of my Top 10 Beach Body Secrets:

#1 – Get Your Mind RightFocus and commitment are the number 1 prerequisite if you would like to change your body. Ask yourself, If you could achieve anything with your body and you got everything you wanted physically, what would be different?

Honestly folks, what would that look like? How would it feel? If this is truly what you want for yourself physically, then what is stopping you from wholeheartedly committing to yourself? I suggest that you write it down. Put it on paper. Let’s stop dreaming and start achieving!

#2 – Remind Yourself Daily

You know as well as I do that we all have moments of weakness. We are human after all! Committing to a goal one day will not feel or look the same the next day. If you want to lose body fat, remind yourself daily about your goal. If you are a visual person, take a picture of yourself and hang it where you will see it every day. Or maybe a picture of what you want to look like will be better for you. Either way, at the beginning of the day, tell yourself exactly how the day will unfold in terms of physical activity and your eating. Otherwise, the day will get away from you and decisions will be made on the fly… and very often, those type of decisions are not the best.

#3 – Drink Water

Fat “burning” is affected by how well you are hydrated. Water is the single most important thing that you need to ingest. Every moment, a countless number of chemical reactions are taking place in your body. For each one, water is needed. Without the proper amounts of water, these reactions become inefficient. This can drain you of energy, cause your body to function poorly, lead to sickness, and your body may go into a water retention mode. Plus, dehydration can slow your metabolism (your body’s calorie burning processes) by nearly half of what it would be otherwise. A good, quick calculation would be to multiply your bodyweight (lbs.) by 0.5. This number would be the minimum amount of ounces of water per day that you should intake.

#4 – Exercise Vigorously

I should probably clarify this a little bit. What is vigorous for me may not be the same for you and vice-versa. You should exercise as vigorously as you can more days per week than you are not. Some days, this could be a longer duration workout. Other days, it may only be a 15 minute mini-workout. Either way, when you choose to do it, challenge yourself. There are people that I know who will be greatly challenged by standing up and down out of a chair 10 times and then walking a lap around the room. If that is you, so be it…but do it daily until it becomes easier. Then, increase the challenge. Others that I know can exercise much harder than that for 15 minutes and find a quick, beneficial workout that will burn a bunch of calories. Either way, challenge yourself to improve. If you want your body to change, you have to make it change! There are very few excuses for not being able to find time for a workout.

Which brings me to:

#5 – Be Consistent!

This could quite possibly be the most important bit of fitness advice that you will ever hear. Those who are the most consistent are the most successful. Exercise is not an “only when it is convenient” thing. The same applies when it comes to making good eating choices. Exercise and eating properly are not something that can be effective when approached with an “all-or-nothing sprint to the goal” mentality. Be the tortoise and not the hare. Your beach body can come faster than you think when you adopt this approach. However, progress is progress no matter how fast it comes. When using the correct methods, the only thing that will stop you from reaching your goal is quitting! The philosopher Aristotle said, “We are what we repeatedly do. Excellence, then, is not an act but a habit.” I agree.

#6 – Eat Food, Not Products

Our bodies were designed to eat, digest, absorb, and utilize food. The problem lies in the fact that most of us are completely confused on what food actually is. What is food? Is corn food? What about corn chips? Is a pork chop food? What about a hotdog that contains pork? Food that will give your body the nutrients it needs as well as allow you body to digest and absorb properly is very hard to find in a box or a can. If you want to get your body functioning well and are looking for that beach body, then eat foods that are as close to their natural source as possible! When trying to choose what to eat, the question to ask is “where did it come from?” The best choices are the ones that have an easy answer to that question. “It came from the ground!” “It came from a tree!” “It’s a fish from a river!” The worst answers would be something along the lines of, “well, this ingredient came from a food processing plant, this one came from a chemical plant, this one…well I’m not really sure what this one is, but this one is a berry extract!” So often today, we are given products to eat and are told that they are food. Don’t believe it. Not only are they stripped of nutrients, but your body usually doesn’t have to work very hard to digest it. Then, you are missing out on a significant amount of calorie burning that would come from digesting real food. Processed, refined food is basically pre-digested; which means that it can absorb very quickly which can quickly cause body fat storage.

#7 – Eat Lean Protein At Each Meal

Your body utilizes protein for countless purposes in the body. Plus, protein is used to rebuild and repair muscle tissue. Muscle is the active tissue in your body. It is what “burns” body fat. The only location in your body where body fat is broken down and converted into energy is inside of each muscle cell. Thus, to lose body fat, you must optimize the muscle tissue on your body. In order to do this, you need protein. Also, the act of digesting protein plays a large role in your daily caloric burn rate. Your body has to work hard to digest protein. Foods like eggs, chicken, turkey, buffalo, ostrich, salmon, shrimp, and lean beef are an important part of improving your metabolism. Try to avoid commercially raised livestock as much as possible. Free range meat and wild caught fish are much better choices.

#8 – Eat Every 3 Hours

If you are eating lean protein and good, quality carbs about every 3 hours throughout the day, then your body will incinerate body fat at a high level. I know that this sounds contradictory to almost every diet and weight loss center claim. However, if diets and caloric deprivation worked, then there would be no such thing as an obesity epidemic. Diets don’t work. Proper exercise and feeding the body what it needs DOES. Think of your metabolism as a fire burning inside of you. You need to feed the fire to get it to burn hot! If you want to know the real effects that caloric deprivation has on the body, then stay tuned for my article in the August newsletter.

I suggest that, regardless of time of day, you should seek out and be prepared for a meal every 3 hours that consists of visually-equal serving sizes of lean protein, a starchy carb, and a fibrous carb.

#9 – Exercise With Resistance

There are many ways to exercise and challenge the body. Most of them are great. There is no one video, exercise machine, or program that is the universal answer for everybody. However, in order to lose body fat, resistance exercise must be included at some level. The resistance can come from weights, rubber bands, machines, a wheelbarrow full of rocks, or in some cases even your own bodyweight. Whatever the source, you need to challenge your muscles. This is key. The fear of “bulking-up” has prevented many people from realizing their beach body dreams because they have avoided strength training. I suggest weights first, cardio immediately after. Modern technology and conveniences have caused our population to challenge their bodies much less than ever before. We simply pick-up, carry, and lift much less than we ever did before. As a result, many of us are simply not used to challenging the body. The resulting weakness and less muscle development leads to lower metabolism, higher fat accumulation, and low energy levels. If you want to lose fat, then lift weights (just do it properly…hint we would be happy to show you how.)

#10 – The Magic Bullet Only Shoots You In The Foot

Bottom line, there is no magic bullet. If there was, believe me, I would tell you! Starving yourself, wrapping yourself in a thermal body wrap, taking a pill, getting an injection, drinking a shake, electrocuting yourself, rubbing a cream on your skin, cleansing yourself, baking yourself in a sauna, and vibrating belts are examples of “Magic Bullets.” They DO NOT WORK. So stop wasting your time and money on them. Stop falling for them. Ignore them. Don’t give them the time of day. Stop grasping at straws and start exercising, feeding yourself properly, and stick to it!! Don’t stop!!

Exercise and Stress Relief – by Jason Eyanson, M.S.

Stress ReliefThere are a long list of areas that exercise has been studied to help with. These areas can range from physical to mental. One area that exercise can help reverse spans both the physical to the mental. This area is stress. Stress has been known to cause many adverse affects in people. It has been linked to things such as: headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety. Stress is also linked to doctor’s visits, in that 75-90% of these visits have something to do with stress and its affects. Also, 43% of adults suffer adverse affects of stress. Many of us go through our day-to-day lives ignoring many of the symptoms of stress, causing levels of stress and its affects to build. Stress, on the other hand, can have some positive effects on the body. There is eustress. This is stress that is exciting and fun. Often times this stress keeps us viral, and gets adrenaline pumping, making us feel energetic and excited.

If you allow stress levels to grow and build upon itself, the damage to the body can be great. However, there is a light at the end of the stress tunnel! One great way to reduce stress levels is by exercising. This is another thing on the list of positives from exercising! In the area of stress reduction, it can also help in those areas that cause stress. It affects the areas of self-esteem, sleep, and mood, to name just a few. How does exercise do this? Well let’s start with the physical aspects. During exercise, your brain releases endorphins. These endorphins are chemicals that make you feel good. Endorphins affect the pain receptors of the body, reducing the perception of pain. After exercising awhile, you can actually start to build a higher tolerance to stress and its effects.

So the next question would naturally be; how much exercise is needed in order for this to happen? With stress and exercise, even a little bit can go a long way. Start with 30 minutes of exercise three times per week. This is a good time for you to be able to decompress during the day. Exercise can let you take your stress out as well as is a diversion from the day-to-day stressors. As you are able to input exercise into your weekly routine, you can start exercising a few minutes longer each time. An ideal amount of time for exercise is between 30-60 minutes. Stress relief is another on the list of things that exercise is good for. You may start exercising for many different reasons, and end up gaining many positives as a result!

Alcohol, Fitness, and Little Known Secrets to Losing Body Fat – by Jason Minich

Fat Loss and AlcoholThere are several common misunderstandings when it comes to the consumption of alcohol and health. Many people believe that drinking a glass or two of wine each night will improve their heart health. Still others believe that hard liquor does not have as many calories as a beer. It could take a while to break down all of the aspects of alcohol and health; however, many common beliefs can be traced back to occasional “news” stories based upon research. The problem is that sometimes research can be misinterpreted in news stories and before long the misinterpreted research becomes common belief. I’m not saying that there isn’t a time and place for consumption of alcohol, however, the countless experiences that I’ve had with my Personal Training clients combined with knowledge of how the body works has led me to share with you a little bit about this.

The first thing that we should take a look at is what alcohol is exactly, and what does it do in our bodies? Regardless of the drink, whether it is beer, wine, liquor, or some kind of mixed drink… a certain percentage of that drink is made up of molecules of alcohol (otherwise it wouldn’t be an alcoholic drink, obviously!) Alcohol molecules are a type of sugar molecule. Alcohol is a simple sugar. Inside of our bodies, our digestive tract is designed to “break down” food such as starches and complex carbohydrates until it is a simpler molecule… or one that is capable of being absorbed into the bloodstream through the walls of the digestive tract. Simple sugars are foods that are already broken down to a point where they quickly absorb into our bloodstream. Basically, our bodies don’t have to work very hard to digest simple sugars. This can be reflected in how sugary snacks don’t ever seem to “fill you up.” In regards to alcohol, it is actually the “simplest” sugar molecule that there is… basically a super-sugar. In fact, while most sugars have to travel through the digestive tract until they reach the intestines to be absorbed, alcohol can be absorbed through the lining of the stomach. That’s how easy it is to digest.

With that knowledge, the next thing that is important to know is what happens in your body when simple sugars are ingested. First, when you eat or drink something that is comprised of simple sugars, you enter a momentary state of high blood sugar. The moment that sugars are absorbed through the digestive tract into the bloodstream, your body reacts by releasing the hormone insulin into the bloodstream in order to return the level of blood sugar to a normal level. Insulin takes the sugar molecules out of your bloodstream and into the muscle cells of your body that need it for energy or it stores the extra energy reserves in your liver. So, the release of insulin is the instant response that your body has to ingestion of simple sugars… including alcohol. Many people have heard of insulin and quite possibly, if they know anybody who is a diabetic, they think that it is some type of prescription drug. It is a hormone that is naturally produced in our bodies by the pancreas. Insulin is essentially a storage hormone. However, our bodies are always trying to maintain some type of balance. So, there is a second hormone that is produced by the pancreas that much fewer people have heard of before. It is called glucagon. Whereas, insulin is the storage hormone… glucagon is the release hormone. Its role is to essentially tell the body to release stored bodyfat from the areas of our body where it is stored, and send it into the bloodstream. If anyone is interested in “losing” bodyfat, this is important to know simply because fat loss is a two-step process. First, fat has to be released into the bloodstream using glucagon. Second, you “burn it off” when your muscles take the fat out of the bloodstream to use as energy. You absolutely cannot “burn off” bodyfat if it doesn’t make it into the bloodstream to begin with. Like I said, your body is always trying to maintain some type of balance. So when you eat or drink simple sugars, your blood sugar spikes, and insulin is pumped out of the pancreas in reaction to this… your body cuts way back on its production of glucagon. Essentially, bodyfat becomes “locked-in” to the fat storage areas of your body and cannot be released into the bloodstream for chunks of time after you ingest those simple sugars. It doesn’t matter if you are exercising vigorously during that period of time. Your body will simply use the sugars for energy and not your stored bodyfat. Want a surefire way to hold on to bodyfat despite your exercise efforts? Drink alcohol regularly or eat sugary foods daily. I don’t care if you call it your “daily fix”, your “little reward” for making it to your aerobics class this morning, you think that “a calorie is a calorie” despite what food it comes from, or you’ve been told that “it’s okay as long as you add it to your point total for the day”, that’s the way it is. Maybe it isn’t alcohol for you. Maybe it’s that muffin and orange juice each morning, the sugary latte, or perhaps your 100 calorie pack of cookies. Either way, it’s a saboteur of fat loss efforts and will make you hormonally incapable of burning bodyfat for a period of time. The “two” glasses of wine each night (or whatever your drink of choice is) will do the same thing to you. Whereas, normally your body will be “burning” a mixture of bodyfat and sugars throughout the evening and nighttime to use for energy… now it can’t use bodyfat for a chunk of that time (the length of time is different for everybody.)

You see, when you step back from it all and look at the big picture… you realize that our bodies are not robots. We are not machines. It is not as simple as “I ate 1,500 calories today and burned off 500 in my workout.” We are complex living beings with many things contributing to our overall body size, shape, and energy levels including hormones, genetics, environmental factors, and more. We cannot eat 1,000 calories a day to “leave enough calories in my day for my alcohol at night.” It doesn’t work that way… at least not entirely. My most successful clients are the ones that grasp the concept that ‘what you eat’ matters as much as… if not more than ‘how much you eat.’ Our workouts are not designed around ‘how many calories we can burn’… but rather ‘building the body in such a way that we are burning more body fat for energy all day and all night long.’ Bottom line is that if you control your simple sugar intake… you can very well be burning body fat while you sleep! I would rather have my clients burning fat 24 hours a day and not just focusing on burning calories during a workout. This comes through a combination of optimizing the muscle tissue on your body, mixing in an appropriate amount of cardiovascular activity, and eating in a manner that is supportive of what we are trying to accomplish. Dieting (excessively cutting calories or entire food groups) is terrible for you and not what we want. However, there really is no place for simple sugars in your nutritional needs. Simple sugars can certainly be an occasional treat. We just have to understand that there are consequences to any choice we make… and you have to weigh those consequences against what your goals may be. If it’s worth it to you to have your “daily fix”, then go ahead.

Let’s look at it this way, our world has made it easy to obtain and ingest alcohol, other simple sugars, or really anything we want. We no longer have to work for our food. We don’t have to grow it ourselves… or if we want something sweet… we don’t have to go find a beehive and collect some honey. Today we have bottles of the stuff on sale for cheap. We have unlimited sweet choices from honey, to cane sugar, to a slew a sugars made at a chemical plant, to candy, to readily available fruit (also simple sugars), to entire retail stores full of alcohol, to refined ‘white’ grains (also simple sugar… the complex carbohydrate parts have been removed), to many others too numerous to list. We live in a world of excess. We don’t have to work for any of it anymore. However, please remember that you do have control over 1 thing… Your Own Little World Around You And The Decisions That You Personally Make. Take control over your personal world. Understand that you don’t have to stop at McDonalds (or any other fast food restaurant) and get the sandwich with the simple sugar bun, overly fat ‘meat’ patty, and the rest of the junk that they put on it. There are other choices.

Remember when I mentioned that burning fat is a two-step process? First your body has to release the fat from the storage areas of your body into your bloodstream. As long as you are in the proper hormonal state (because of what you are eating), then the ‘fat release’ step is happening all of the time at various rates depending upon how active you are. Then you need to challenge the energy systems of your body enough to “burn off” the fat. This is done through the proper blend of exercises. At Catalyst Fitness, we help people with this every day. We find the proper blend of exercises to put them on the path to reaching their goals while taking into consideration current fitness levels, past or present injuries, available time, and much more.

If you are interested in having help finding the right blend for you, simply give us a call. Either way, have your cake and eat it too… as long as you know what it does to you.

Cold Weather Golf Conditioning – by Jason Minich

Golf ConditioningSummer is well over with now and the golf season is winding down. Sadly, many of us will soon be hanging up the golf shoes for the winter, if you haven’t already. Personally, my golf clubs will sit in the back corner of my garage until I decide to dust them off next spring. However, if you are like many golfers that I know and improving your game for next golf season is important to you, there is a chance that you may want to take a couple of lessons from a golf professional this winter. You may even practice your swing at an indoor range from time to time.What if I told you that I know of a way to make your golf swing better than ever? How would you feel if I said that, this winter, you could make swinging your golf club easier and much more consistent? What if you could noticeably increase your club head speed? Trust me when I say that you can do all of these things this winter. If you want to be a better golfer next year, then the cold weather season should be viewed not as the offseason, but more as pre-season.

No, I’m not going to tell you to purchase a new device that will dramatically improve your score. And no, we are not going to spend more time discussing another microscopic point about your swing. We are going to discuss the most important piece of equipment that you take with you out onto the golf course… our own body!

Many golfers make jokes about their own physical shape, but in the same breath complain about how poorly they played that day. I say, commit to making this year different. Don’t forget that without your body making them perform, those golf clubs in your bag (including that ultra-light over-sized titanium masterpiece) are nothing more than very expensive metal sticks.

For a great cold weather golf performance program, there are several general areas that need to be included. In my opinion, these are:

  • Overall Physical Shape
  • Core Strength and Stability
  • Flexibility
  • Balance
  • Proper Postural Alignment

Although the above named areas are separate areas of focus, they are all inter-connected and go hand-in-hand. Let’s take a look at each one.

Overall Physical Shape

Let’s face it many Americans are in horrible physical shape. When it comes to golf, if I’m being brutally honest, most players are in such poor shape that their swings are affected and must be altered quite a bit. By committing to a physical fitness program, even one that is not necessarily focused on golf, you will most likely feel much better and perform much better. Your program this winter should include overall body strengthening, moderate aerobic conditioning, and a few nutritional shifts. An oversized waistline doesn’t rotate very well through a golf swing does it?

Core Strength and Stability

The standard biceps curls and bench press need not apply here. You can have the strongest arms and legs in the world, but if they are attached to a marshmallow what difference will it make in your golf game? Not much. The power and speed of your club swing is increased by integrating core strength and stability with balance and coordination. The pattern of your swing is a series multi-dimensional movements. Core strength and stability integrated with these movement patterns, will allow you to be more consistent with your swing and more efficient at transferring the power generated in your lower body through to your club head.

Flexibility

I can’t say enough about the importance of flexibility. The bottom line is that golfers with poor flexibility hit the ball shorter distances, get injured easier, and are essentially limited in how they move. If you want to hit the ball farther, you need to create a greater angle between your shoulders and hips during the backswing. Many speak about the importance of having a flexible torso, but in my opinion, you should focus on the flexibility of your entire body since your entire body is involved in your golf swing.

Balance

Let’s look at this in a very basic way. Golf is played outside. Thus, your body and feet are never in exactly the same position twice on a golf course. When you swing a golf club, quite a bit of force and momentum is generated. Slight variations in terrain, weather, and lie of your ball will all affect your swing. If you want the direction of this forceful swing to be as consistent as possible, you must plan for these variations. Just going to a gym and doing a circuit on machines all winter will not achieve this. The environment created is far more predictable than that of a golf course. You must work on moving your body through space in various ways and on a variety of surfaces…not just moving the parts of a machine.

Proper Postural Alignment

Having good posture is key to hitting a great shot. When addressing the ball and preparing for your backswing, finding proper posture is crucial to beginning your swing in the correct plane of movement. Maintaining proper posture and body alignment is in direct relation to strength and flexibility. Overall body strengthening and stretching will help you to address the ball with proper posture. However, having someone observe your posture or taking a picture of your alignment during setup can be very helpful to determine what your problem areas may be. Then you can incorporate certain exercises and stretches to more effectively focus on them.

There are many other benefits of getting involved in a cold weather golf performance program that range from prevention of injury to overall enjoyment of the game. When trying to decide how to spend your cold weather months, just remember that the next golf season is only about 6 months away. In 6 months time, you can easily improve in all of the above mentioned areas. In 6 months time, you can feel better and perform better. In 6 months time, you can considerably improve your body… the most important tool you will take with you on the course! 6 months will be here exactly 6 months from now whether you like it or not. Why not like it?

Exercise and MS – by Jason Minich

Exercise and MSFor those who have been diagnosed with Multiple Sclerosis (MS), understanding what you can and cannot do is often challenging. MS is thought to be an autoimmune disease and is described as a progressive demyelinating disease of the white matter of the central nervous system. This means that the body’s own defense system attacks the substance that surrounds and protects the nerve fibers in the body. Plus, the nerve fibers themselves can also be damaged. Scar tissue is formed and nerve impulses traveling throughout the body are distorted. Since nerve impulses are the means by which our bodies communicate with themselves, this can cause a wide variety of symptoms and each person’s experience with MS can be quite different. Some of the clinical features commonly associated with MS are general fatigue and muscular weakness, as well as spasticity, ataxia, sensory disturbances, and cognitive dysfunction. 1,2

In the last 15 years, there has been quite a bit of activity and progress in the pharmacological arena. Although there is still no cure, numerous drugs have been and will continue to be tested for all stages of MS. However, it is important to take a look at what else can be done to improve the quality of life of patients diagnosed with MS. According to information provided by the National Multiple Sclerosis Society, there are many effective strategies available to modify the disease course, treat flare-ups, manage symptoms, and improve function and safety. One of the more commonly suggested strategies is to exercise. Exercise has been shown in numerous research studies to significantly improve the quality of life in MS patients. One such study took a look at how structured exercise affected MS patients both physically and psychologically. Considerable improvements were found in those who exercised when compared to a control group. Depression, anger, and fatigue were reduced while social activity, emotional behavior, and recreational pursuits increased. 3 In fact, excessive fatigue is commonly mentioned as one of the most frequent symptoms of MS patients and has been shown to be significantly reduced by controlled exercise.

What does all of this mean? Well, it means that if you have been diagnosed with MS, it is recommended and even encouraged that you exercise. Exercise can be a vital component of your treatment strategy. However, take it slow! Don’t overdo it. Progress yourself a little bit at a time. Pushing yourself to your limits or beyond them can have the opposite effect from what you desire. Remember, your nervous and muscular systems are already strained.

Before you begin an exercise program, check with your doctor to see if he or she has any recommendations for you. You may find that there are certain types of exercise that you should avoid. However, for many MS patients there are typically a wide variety of types of exercises that can be done such as light strength training, cardiovascular exercise, Pilates, balance training, swimming, and even some basic yoga.

Some things to consider when planning your exercise are:

  • Prepare your environment. Whether you choose to exercise at home or in a public setting, make certain that your surroundings are safe and not distracting. Remove objects that you could trip over or surfaces that you could slip on. Ensure adequate lighting and avoid blaring music.
  • Consider exercising with a friend or family member that understands MS and what challenges it represents to you. Plus, they could help to motivate you to stay consistent with your exercise program.
  • Begin with a short-duration workout and add to it a little bit each week.
  • Always warm-up before beginning exercise and cool-down when finished. Warming up prepares your body for exercise and helps to prevent injuries.
  • Stop if you begin to feel sick or experience pain.
  • Consult a Certified Fitness Professional that is experienced in working with those who have been diagnosed with MS. An understanding, qualified Fitness Professional can help you put together a program that is right for you.

Another important point to mention is that MS can often cause sensitivity to heat. Of course, an increase in body temperature occurs during exercise, thus try to be careful not to overheat. Some common recommendations include exercising during the cooler parts of the day, drinking plenty of cool fluids, and wearing cool and loose fitting clothing. If you are exercising indoors, try to have fans available to create some air movement. In the event that you feel disoriented or experience increased symptoms, stop exercising and allow yourself to cool down.

Keep in mind, if you have been diagnosed with Multiple Sclerosis, exercise can play a large role in maintaining the quality of life that you desire. MS affects the nervous system and exercise has been proven time and again to have a positive impact on the nervous system. When you are ready to start an exercise program, I highly recommend contacting your physician right away to inform them of your intentions. Once you have clearance from your physician, contact a qualified Fitness Professional to begin putting together a program that suits your needs. Lastly, relax and have fun with it!

References

1. Kesselring J. Multiple sclerosis. Cambridge Univ. Press, UK, 1997.

2. Krupp LB, Alvarez LA, La Rocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol 1988; 45: 435-37.

3. Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39: 432-441.