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Wheelchairs: friend or foe?

A wheelchair is really no more than a seat on wheels - a
helpful instrument that provides its users with greater
mobility, more freedom and, occasionally, a better parking
space. But are wheelchairs as helpful as they could be? That's
just what researchers nationwide hope to find out in their
study, "Life on Wheels."

Dr. Helen Hoenig, lead researcher of the study, says that
using a wheelchair could actually harm users it if causes their
muscles to atrophy. Hoenig reasons that this may happen to
wheelchair users if they don't exercise the muscles they
normally would when walking.

Hoenig says that, in other cases, using a wheelchair can
just be downright annoying or even impossible to the users.

"A lot of wheelchairs end up in closets because a frail
spouse can't lift it into the trunk of the car, or it won't fit
through the door to the bedroom or bathroom." And while many
public facilities provide ramps and larger doorways, these
measures do not always accommodate elderly wheelchair users and
many other users - a theory the researchers are investigating
in a sub-study with collaborators at Boston University.

"Legislation placed in effect to benefit persons with spinal
cord injury or congenital disabilities may not be sufficient
for a frail older person who doesn't have the same cardiac
function or upper body strength as a younger person," Hoenig
says. For example, while a ramp may be sufficient for a younger
wheelchair user who has the upper body strength to push his or
her wheelchair up the ramp, a ramp may not be sufficient for a
less fit elderly wheelchair user who does not have the upper
body strength to do the same.

Hoenig hopes the study will help researchers determine the
inherent flaws in wheelchairs as well as the problems that
public facilities pose to wheelchair users so they can improve
wheelchairs and the environment for those who lead "lives with
wheels."

Chicken Pox With a Vengeance

If you managed to escape the itchy bumps and unsightly scabs
from chicken pox as a child, you have nothing to worry about,
right? Think again.

For some, the varicella-zoster virus remains latent in their
bodies for years, and when they become elderly, it comes back
with a vengeance in the form of shingles -- a manifestation of
the same virus but one that causes blisters and tremendous
pain. Unfortunately, no preventive measure existed for shingles
- but that now may be changing.

Dr. Kenneth Schmader, a geriatrics professor at Duke and the
Veterans Affairs Medical Center in Durham, will begin a
national trial in December to test a vaccine for shingles in
13,000 older adults. "We're hoping that the vaccine will boost
the immune system so it will recognize the virus and prevent
shingles," Schmader said. "However, if it doesn't, we're hoping
the vaccine will at least lessen the severity of the
illness."

With 600,000 cases of shingles diagnosed each year in the
U.S., Schmader said the vaccine could have substantial health
impact on older Americans.

Add More of the Good Things

So you've crested the hill, and you're cruising down the
slope. You're wiser, but heavier, and your blood pressure is a
tad high from all those holiday treats. Not to worry - there is
hope for you and your hypertension, and it lies in the produce
and dairy sections of your nearest grocery.

In the latest research aimed at combating a serious public
health threat, researchers at Duke have found that simply
eating more fruits, vegetables and low-fat dairy foods can
significantly lower a person's blood pressure without weight
loss or salt restriction. They believe this diet, combined with
lower salt intake and weight loss, may reduce blood pressure
even more, an idea which they are currently studying.

"This dietary regimen is quite novel because it doesn't
require the same degree of food deprivation as do current
dietary treatments," said Dr. Laura Svetkey, referring to the
universally accepted therapies of weight loss and salt
restriction. "Instead, patients can add healthier foods, a
practice which may be easier for people to maintain on a
long-term basis."

Called the DASH diet for Dietary Approaches to Stop
Hypertension, the ongoing research project is in its second and
third phases of testing at Duke and other centers around the
country. Having found that the diet works, researchers are now
testing it in combination with universally accepted therapies
such as salt restriction to see if the multi-pronged attack
works better than each therapy alone. And early next year,
Svetkey will be recruiting patients for the PREMIER study, in
which they'll teach patients how to add the DASH diet and other
healthy lifestyle approaches to their routine.