Science: Aerobic exercise reduces intraocular pressure and expands Schlemm's canal dimensions in healthy and primary open-angle glaucoma eyes
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10 months ago
david 4.2k
@david_fe

We already know that exercise lowers IOP over the long term.

This study shows a beneficial effect of aerobic exercise on Schlemm's canal, which is a key part of the aqueous humor outflow mechanism that maintains healthy IOP.

Summary

Purpose: Aerobic exercise has previously been reported to decrease intraocular pressure (IOP) in healthy subjects and there are concomitant morphological changes in the anterior segment of the eye including the Schlemm's canal. However, its effects on IOP and Schlemm's canal morphology in glaucoma patients needs further study.

This study investigates the effect of aerobic exercise on the IOP and Schlemm's canal dimension in both healthy and primary open-angle glaucoma (POAG) eyes.

Methods: The area and diameter of Schlemm's canal and IOP were measured in 35 primary open-angle glaucoma (POAG) patients (59 eyes) and 36 healthy subjects (72 eyes) before and after performing moderate intensity of aerobic exercise by running on a treadmill for 30 min. Schlemm's canal was imaged by swept-source optical coherence tomography (SS-OCT) for evaluation.

Results: In comparison with baseline values, mean IOP decreased significantly following aerobic exercise in both POAG and healthy eyes (both P < 0.001), in which the eyes of those with glaucoma showed a greater degree of reduction compared to healthy eyes (P = 0.002).

In comparison with baseline values, in both POAG and healthy eyes, the average cross-sectional area and diameter of Schlemm's canal significantly increased after aerobic exercise, supporting less outflow restriction of aqueous humor.

Among those with glaucoma, the significant reduction in mean IOP and increase in Schlemm's canal dimensions following aerobic exercise were observed in both untreated eyes (no glaucoma medications) and treated eyes (all P < 0.05), and there were no significant differences of such measurements between the two subgroups (all P > 0.05).

Conclusion: Aerobic exercise-induced reduction in IOP and an increase in Schlemm's canal dimensions in glaucomatous eyes as in healthy eyes. Further studies to evaluate the long-term effect of aerobic exercise on IOP control and Schlemm's canal morphology in POAG seem warranted.

Keywords: Aerobic exercise; Schlemm's canal; intraocular pressure; primary open-angle glaucoma.

iop:intraocular-pressure exercise Schlemms_canal • 2.2k views
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10 months ago
flyingpig • 100
@flyingpig

Thanks David! I have been reading articles with similar opinions but I think you are probably the guy with extensive knowlege.

I am in the process of getting self-tonometry device, and and my follow along question is

  • What's the definition of Aerobic exercise here? By heart rate?

I so call myself as runner, as running is my primary way to exercise my body (along with core /leg strength). I am trying to avoid pose like downward facing in core exercise (I hope plank is OK though) and I have questions about running.

I recently changed the pattern from Daily zone 1jogging(140 BPM 60mins + Zone 1 2-3 hours long run in the weekend) to more strenuous way dong running.

These days I only run 4-5 days /week instead of 7, replace some jogging with 2 hard sessions at my threshold/interval or high aerobic pace, so my heart rate will stay above 170 for 1-2 hours or even longer Not sure will this have any negative impact on my eye pressure?

Thanks!

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I hope plank is OK though

Not always. I personally don't do planks anymore because they raise my IOP. But side planks are OK for me and it's easy to find alternative core exercises.

What's the definition of Aerobic exercise here? By heart rate?

Yes. They used this methodology:

The prescribed HR range during exercise (between 60% and 80% of the estimated maximum HR [HRmax]) of each subject was calculated to monitor exercise intensity, where HRmax = 220 - age/minute.[25] All participants ran on a treadmill for 30 min, including a warm-up for 5 min.

2 hard sessions at my threshold/interval or high aerobic pace, so my heart rate will stay above 170 for 1-2 hours or even longer Not sure will this have any negative impact on my eye pressure?

Over the years, the FitEyes community has learned that one rule applies to everyone. As a generalization, I believe that training program will likely be OK, but we have a small number of reports of intense exercise raising IOP. In my case, it does not. I've done training similar to that with no negetive consequenses for my IOP -- I get similar IOP reduction even when I train very intensely. In contrast, I can give an example of a cyclist who gets an IOP spike only after intense training but not after moderate or easy training.

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10 months ago
flyingpig • 100
@flyingpig

Thank you! I have noticed that you and a few other FitEyes members are engaged in elite/sub-elite level training (intensity and duration wise). The information I have come across in this community is of extremely high quality when it comes to this topic.

Not always. I personally don't do planks anymore because they raise my IOP. But side planks are OK for me and it's easy to find alternative core exercises.

I know the actual pose/exercise and IOP affecting is individual specific, but seems it will take a while for me to get the device for self-tonometry, I want to get some advice from you as rule of thumb.

I indeed have bit doubt about plank, as I think could be considered as degraded version of downward dog pose? Is this because plank is facing down position? Also any position with facing down position is considered not safe for IOP-wise and I should avoid in general? Like Bear Crawl/Bird Dog/Mountain Climber etc.

Also, I know that position with head below chest is bad, so no standing toe reach, but how about glute bridge or toe touch crunch? Both exercise are stomach up but heart/leg will be in higher position than head, so I am bit confused with those kind of exercises especially with no access with Tonometer at the moment.

By applying those rules, sitting up exercise like Russian Twist sound most safe exercise to do?

Is that possible for you to share some core exercises you are doing? Not sure if it is too much to ask! :-)

Over the years, the FitEyes community has learned that one rule applies to everyone. As a generalization, I believe that training program will likely be OK, but we have a small number of reports of intense exercise raising IOP. In my case, it does not. I've done training similar to that with no negetive consequenses for my IOP -- I get similar IOP reduction even when I train very intensely. In contrast, I can give an example of a cyclist who gets an IOP spike only after intense training but not after moderate or easy training.

Again, although the information you provided is individual specific but it's a big relief to me! I do think FitEyes probably has one of most compressive findings on this topic, first hand and extensive "research" subjects. I am interested to know my results once I go the tonometer.

Appreciated!!

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I want to get some advice from you as rule of thumb.

Sure, I'm happy to.

... any position with facing down position is considered not safe for IOP-wise and I should avoid in general? Like Bear Crawl/Bird Dog/Mountain Climber etc.

Yes, in my experience that's a good general rule.

Also, I know that position with head below chest is bad...

Yes, so that leads to another general rule: I especially try to avoid exercises where I am face-down and my head is below heart level (e.g., pushups with feet elevated on a bench).

Further, the worst exercises in regard to IOP would be face-down, head below heart level and some restriction on free breathing. For example, some barbell row positions with heavy weights (and a tight belt) may create this situation.

how about glute bridge or toe touch crunch? Both exercise are stomach up but heart/leg will be in higher position than head, so I am bit confused with those kind of exercises especially with no access with Tonometer at the moment.

I think I can give you a general rule that may help. Consider how long you are in the position. With some exercises (e.g., pushups) you remain face-down with head below heart level for the duration of the set. With some other exercises, you enter that position at one end of the range of motion but then leave it at the other end. I believe that these "enter-exit" style reps are likely OK.

By applying those rules, sitting up exercise like Russian Twist sound most safe exercise to do?

Yes, but include the general rule about free breathing too. Also, this video might interest you:

Ab Exercises Ranked (BEST TO WORST!) - YouTube

Notice that when this expert demonstrates technique he is often holding tension in his face or briefly holding his breath. From the glaucoma perspective, those are two aspects of "poor" technique. Yet, they are very common, and we have to consciously untrain ourselves from doing that.

Of interest, look at how red his face is while he's doing the plank and side bridge twists.

While maintaining constant tension on the abs is considered a positive by some trainers, from the glaucoma perspective I prefer exercises where the tension is reduced at one end of the range of motion because that encourages free breathing. However, you can potentially achieve good breathing while maintaining constant tension on the abs if you are careful.

I love hanging and standing core exercises. There are probably hundreds of these variations. Here's one example that I like:

Hanging Knee Raise Oblique Crunch Exercise Video Guide | Muscle & Fitness

The hanging knee raise oblique crunch is a variation to the traditional hanging knee raise that strengthens the entire core including the lower abdominals, hip flexors and lower back. This exercise specifically targets the obliques while also improving stability in the upper back and shoulders.

In the video above, the trainer ranks hanging straight-leg raises in his middle category. However, as he suggests, with proper technique it can be improved. Like him, however, I prefer to use bent knees in this movement. Furthermore, I also use straps so there's less strain on my grip.

The single-sided slow carry is an example of a standing core exercise, but there are many, many more.

Unfortunately, the top-ranked core exercise in the video above is not a good one for intraocular pressure. Modifying his list, I'd rank the gymnast ab tuck above the sliding tuck. However, we could probably create a much better list. (I don't have a personal list because, after coaching for so many years, I now prefer the "intuitive" approach where I choose my exercises as I go by listening to what my body wants to do.)

I did not watch this next video, but it probably contains several good suggestions:

10 min STANDING ABS Workout (Intense & No Equipment) - YouTube

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Thanks David, your answer is very insightful, especially about the "enter-exit" analysis, I never thought about this (And yes, it sounds obvious and "common sense").

Now I have replaced plank to side plank and try to reduce facing down exercises as much as possible.

I also thought about standing core workouts before making the post, but those workouts seem very light (I could be wrong), by reading your answer I decided to spend more time and trying to make those standing core workouts "works" for me.

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Standing and seated core workouts can be even more intense they lying or prone versions in my experience.

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