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Yet another expert, Harriet Hall.
   
From: http://www.sciencebasedmedicine.org/?p=205

Why do we help these experts publish their damaging blogs on our website? We would be expected to try to hide this sort of thing as much as possible if the allegations made were correct. This undaubtedly excellent researcher, Harriet Hall MD, was able to draw all these negative conclusions based upon her expertise gathered during a distingueshed career in the Air Force. She did not have to bother with such simple details as trying the ROM herself and wondering how such a "scam" as the ROM can be on the market for over 18 years without having been sued out of business for these knee injuries and heart attacks that she imagines would be the result of using the ROM machine.


Harriet admits in her blog: "I know I should exercise regularly, but I’m congenitally lazy and am ingenious at coming up with excuses."  She is making our point. If the ROM does in only 4 minutes all we have claimed it to do for over 18 years, since 1990, then it is the answer to Harriet's problem. She will actually start and stay on an exercise program for the rest of her then longer and healthier life.

Following is her short biography:

Harriet Hall, MD, also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colon

4 Minute Exercise Machine

I know I should exercise regularly, but I’m congenitally lazy and am ingenious at coming up with excuses. There’s an exercise machine that sounds like the end of all excuses, a dream come true. You’ve probably seen the ads in various magazines. The ROM Machine: “Exercise in Exactly 4 Minutes per Day.” It claims that you can get the same benefit, at home, from 4 minutes a day on the ROM as you can from 20 to 45 minutes aerobic exercise plus 45 minutes weight training plus 20 minutes stretching at the gym. It allegedly balances blood sugar and repairs bad backs. It is for everyone from age 10 to over 100.

Does this sound too good to be true? That’s usually a clue that it is too good to be true. I was skeptical and I sent in for the company’s free DVD. There were more clues in the DVD. They had testimonials from 2 chiropractors, several trainers, and lots of satisfied users, but they didn’t have recommendations from a single medical doctor or scientist. In fact, they mentioned a couple of doctors who disputed their claims, including one cardiologist who told his patient that kind of strenuous exercise could kill him. To prove you could get a good workout from the machine, they put people on it, got them to huff and puff and sweat a lot, and then got them to say, “That was a real workout!”

They said Tony Robbins uses the machines - but he also exercises 1 ½ hours a day (down from his previous 3). They said Tom Cruise and John Travolta bought the machines. That’s not much of a recommendation. Those guys also bought Scientology’s stories about Xenu and Thetan levels.

The machine looks like a futuristic mechanical octopus, with parts going every which way. It weighs 405 pounds and requires 5 by 11 feet of floor space. It costs $14,615.00. They explain that it is still the cheapest way to exercise because of all the time it saves. You use the “rowing machine” end of the machine for 4 minutes one day and the “stair-stepper” end of the machine for 4 minutes the next day, allowing 48 hours for each muscle group to recover. There is a flywheel that automatically adapts resistance to any user. “ROM” stands for range of motion, and this machine really does put a lot of muscles through a large range of motion while simultaneously providing anaerobic muscle-building and aerobic exercise.

I watched the demonstrations on the DVD and got cold chills. They are recommending that anyone, even a frail 100 year old, should get on these torture devices and stress themselves to the max. It can’t be good to stretch muscles that way if they aren’t used to stretching. That kind of intense aerobic plus anaerobic exercise sounds like a recipe for a heart attack. And just watching the lower extremity exercises made my knees cringe. They require stepping up about 3 feet, bending knees into configurations that put the joints at tremendous mechanical disadvantage. They look like they were designed to create knee replacement customers. Orthopedic surgeons tell patients with knee problems to build up the supporting muscles by straight leg raising exercises and other exercises with restricted range of motion.

There’s often a small truth behind a big claim. There are studies showing benefits of high-intensity interval training (HIIT). The package the company sent me with the DVD included reprints of 3 studies.

The first is a Canadian study that didn’t use the ROM machine, and it didn’t use the 4 minute continuous exercise protocol. It started with 30 minutes of continuous milder exercise, progressing to short (15 to 90 second) bouts of intense exercise interspersed with short rest periods. It showed that the HIIT group burned more calories than the control group, presumably because muscle metabolism was raised to higher levels and continued to burn fat after the exercise period. Interesting, perhaps, but not directly applicable to the ROM machine or its 4-minute protocol.

The second study, from Japan, showed more improvement in VO2max (an indicator of aerobic capacity) with HIIT than with endurance training. Instead of 4 minutes on the ROM, this protocol involved a stationary bicycle, a 10 minute warm-up period, and 20 second bouts of exercise with 10 second rests between bouts. Again, interesting but not applicable to either the ROM machine or the 4 minute exercise protocol.

The third study was done with ROM machines in 1995 at USC and was reported directly to the company. I found a webpage quoting the author of that study:

The study was NOT a published research study and I would never recommend the ROM for just 4 minutes, as compared to a 30 min aerobic workout. ALL I showed for them was that VERY unfit subjects can increase their aerobic capacity by working 5 days/week on the Rom for 4 min, but these were VERY unfit subjects.

He sounded a bit miffed.

These studies can be found on the company’s website, along with a couple more studies that are equally unimpressive. Readers of this blog will have no trouble seeing that none of these studies support the advertising claims.

I consulted experts in several disciplines. The consensus was that 4 minutes’ exercise is better than none but that the ROM provides a complete workout only if you make up your own definition of complete workout. The injuries and heart attacks it might cause must be weighed against any good it might do. And its price is way out of line with manufacturing costs. You might want to buy it as a status symbol or a work of modern art, but if you want an effective exercise program you should probably spend your $14,615.00 elsewhere.

It annoys me that these questionable ads are appearing in reputable science magazines like Scientific American. I’ll write more about that next week.

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21 Responses to “4 Minute Exercise Machine”

  1. vinnyon 16 Sep 2008 at 8:28 am

    Harriet, thank you for taking the time to evaluate this scam. I also looked at this machine and wondered if there is some truth to their claims. Being a fan of Scientific American, prevented me from laughing at these ads and consider them more seriously than they deserved. If the price tag wasn’t so steep, I would probably have considered buying this device.

    Incidentally I recently tried high intensity interval workout and I did lose about 5 pounds in a 2 week period without other adjustments to my daily life. I jogged for several minutes, and then sprinted at my top capacity for about 10 seconds, and then repeated this about 10 times. After this 2 week period though my knees really started to ache and I could no longer continue. Following this, I had to jog extremely slowly, at roughly about walking pace. This is very easy on my joints, I do build up a mild sweat, and I lost another 3 pounds in one week. The time difference is also not that wide as I now jog for 45 minutes, as opposed to 30 minutes previously.

  2. Mike Kandeferon 16 Sep 2008 at 8:58 am

    Not only advertisements, but also articles about legitimate research implying support for “woo”:

    http://www.sciam.com/article.cfm?id=arranging-for-serenity

  3. overshooton 16 Sep 2008 at 9:26 am

    As for

    I know I should exercise regularly, but I’m congenitally lazy and am ingenious at coming up with excuses.

    I set up a “media room” with the only “furniture” being an exercise machine (stairs in my case, others prefer stationary bicycle.) Want to watch Bringing Up Baby? Then hop on and start stepping.

    Admittedly, this is annoying given the amount of NWB I’ve had this year but it sure works whenever I’m able to use the equipment at all.

  4. sashenon 16 Sep 2008 at 11:11 am

    Harriet,

    I wish your “research” into the ROM was more thorough than what you described above.

    Instead of simply looking at promotional material, I’ve *used* one of these machines. It doesn’t force anyone to overstretch or overexert themselves; quite the opposite. The range of motion is what you put yourself through, no more. The effort is what you put into it, no more. You can have a stroll-in-the-park workout if you like, or you can push as hard as you want.

    Anyone can use the machine at whatever level their fitness allows.

    The quote you cited simply highlights that there hasn’t been adequate research done. His study was on unfit subjects, but his comment about using the ROM under any other circumstance is merely conjecture.

    Similarly, your comment, “The injuries and heart attacks it might cause…” Excuse me? Do you have any research to substantiate the claim that this machine is in any way dangerous? If not, why combat unsupported promotional material with unsupported attacks? That you perceived danger through your observation of marketing material does not mean that their IS danger

    If you watched a video of a bodybuilder lifting weights, you would conclude that resistance exercise is dangerous and should be avoided… but that’s an incorrect conclusion based on insufficient information.

    If I’m not mistaken, any form of overexertion can lead to injuries and health problems, and emergency rooms and orthopedic surgeon’s offices have their fair share of people who’ve been hurt running, weight lifting, doing yoga or aerobics. Clearly, though, it’s not the activity itself that’s dangerous, but the performance of the activity.

    Regarding pricing, I’m sure you aren’t privy to the actual manufacturing costs and and I’m sure you know that manufacturing cost is only one factor in pricing.

    This product is clearly marketed to a particular demographic and presents the value proposition to speak to that market. I’m sure you know physicians who charge significantly more than their peers, in part, because they’re catering to a different market and have different financial goals; that’s their prerogative just as it’s the maker of the ROM’s to determine his business model.

  5. sashenon 16 Sep 2008 at 11:26 am

    (oh, I hate when I make the their/there typo)

  6. clgoodon 16 Sep 2008 at 12:03 pm

    My favorite part of their web site:

    “EXPERTS” ARE VERY MUCH MISTAKEN Experts in all fields of knowledge are guardians of the status-quo. Anything that differs with their beliefs is immediately dismissed by them as untrue. Their reasoning goes as follows: “I do not even have to waste my time looking into anything that differs with my knowledge and beliefs, because I know absolutely everything there is to be known about my field of knowledge, therefore anything that conflicts with my beliefs must be false.” That sort of reasoning of course is dumb circular reasoning and it automatically precludes any new insights because NEW means different, if it would not be different it would not be new. The few “experts” who have dared to think outside the box and have tried the ROM just once for 4 minutes have become instant converts and believers in a 4 minute workout for cardio, muscle strength and flexibility. To learn how all this can be accomplished in only 4 minutes with our ROM machine, please click on “Q & A” (questions and answers).

    Trust us! We’re experts!

  7. vinnyon 16 Sep 2008 at 12:32 pm

    Shashen, I guess after spending 15k on that machine you feel the need to defend your decision. Regardless of what your defense effort, it will continue to look like a foolish act.

  8. vinnyon 16 Sep 2008 at 12:32 pm

    Shashen, I guess after spending 15k on that machine you feel the need to defend your decision. Regardless of what your defence effort, it will continue to look like a foolish act.

  9. Harriet Hallon 16 Sep 2008 at 12:51 pm

    sashen said,

    “You can have a stroll-in-the-park workout if you like”

    Maybe so, but the claim in the ads is that you can get a complete workout comparable to an hour and a half in the gym. The promotional material clearly encourages people to exert strenuously. Even their own video featured a cardiologist saying that strenuous exercise would be dangerous for his patient, and they clearly implied that the patient was wise to ignore his doctor’s advice.

    Since you have used the machine, perhaps you can tell me: is there an option to set the “stair-stepping” function so that the range of motion of the knee is minimized? If so, it would relieve my concerns about abusing at-risk knee joints, but then it would also discredit the claim that the machine gives a full ROM workout.

    Granted, it’s not the tool, it’s how it’s used. I don’t doubt that it could be used safely as part of a rational exercise regimen. I just object to the company’s claims and instructions for use.

    You said “his comment about using the ROM under any other circumstance is merely conjecture” I don’t recall that he said anything about using the machine under any other circumstance.

    You seem particularly motivated to defend this machine. Just curious: did you buy one?

  10. sashenon 16 Sep 2008 at 1:08 pm

    Ah, Vinny, very clever.

    But I don’t own one of the machines, so I have nothing to rationalize.

  11. sashenon 16 Sep 2008 at 1:34 pm

    Hi Harriet,

    They’ve obviously made a marketing decision to highlight how intense the workout can be. In certain circles this is a good ploy.

    Regarding setting the range of motion for either exercise, there’s nothing you need to set. You simply don’t move as much. That is, you control the range of motion from start to finish. The ROM doesn’t push you past your range. In fact, this is one reason why the machine works for people like me — 5'6? — and someone a foot taller without needing to make adjustments to the moving parts (you move the foot plate for the rowing).

    Again, I hear that you doubt it can be used safely, but upon what is your doubt based? Marketing material designed to target people who respond well to “intense.” (There seem to be two ways to advertise fitness equipment: “INTENSE” and “it does everything for you”)

    Having USED the machine and not just looked at the marketing, I believe it can be used safely. In fact, toward the end of a 4 minute workout, you’re so fatigued that you’re often using very little force through a much smaller range of motion. And because the resistance is determined by the flywheel speed, the ROM “adjusts” to match your workload. If you choose, you could just start at that same level and stay there for as long as you like.

    Their claims may be a bit hyperbolic and their instructions may be a bit macho, but I trust that people on this site have the ability to not only see through some of that, but to counter it with well-reasoned argument rather than mere opinion.

    Regarding the comment about the study, I may have added some interpretation to it… by highlighting that the study was done with very unfit people, I concluded that “I would never recommend the ROM for just 4 minutes, as compared to a 30 min aerobic workout” was a generic recommendation for an average population.

    Now what cracks me up about saying 4-minutes of high intensity isn’t as good as 30 min of aerobic is, again, a personal experience. I’m a 46 year old sprinter. I’ve only run more than 1/2 a mile a three times in my life. When I’m on a bike, my maximum time of continuous pedaling is rarely more than 20 seconds. In fact today’s workout at the track took me 6 minutes, with only 42 seconds of that involving running.

    But each time I’m evaluated my VO2 max and aerobic capacity is on par with marathon runners. As far as I know those results are in keeping with the 4-minute Tabata protocol referenced by ROM.

    Finally, I’m motivated less to defend the machine than point out the issues I see with the style of the attack on the machine. There have been a number of posts here that used less-than-stellar reasoning to attack CAM and I’ve thought about commenting about that before. It just happened that this is a domain where I have certain knowledge which inspired me to chime in.

    I don’t think it’s fair to demand that CAM practitioners support every claim they make with peer reviewed journal articles and then criticize them with mere opinions, impressions or educated guesses, especially when our comments are based on limited information.

  12. Harriet Hallon 16 Sep 2008 at 2:25 pm

    I said “I don’t doubt that it could be used safely”
    Sashen said “I hear that you doubt it can be used safely”

    Where did you hear that, Sashen?

    After criticizing the quality of my evidence, you offer a testimonial, saying “each time I’m evaluated my VO2 max and aerobic capacity is on par with marathon runners”

    That doesn’t count as evidence for anything.

    My resting pulse rate is 56, comparable to that of a trained athlete, when I don’t get any exercise at all. Maybe I should claim that not using the ROM machine and not exercising at all improves my fitness. :-)

  13. sashenon 16 Sep 2008 at 2:40 pm

    Re: “used safely” — Oops… misread what you wrote. My apologies.

    With my testimonial, I’m merely suggesting that long-slow training isn’t the only way to build aerobic capacity. My understanding is that the Tabata protocol (20 seconds on, 10 seconds off, for 4 minutes) demonstrated this.

  14. Harriet Hallon 16 Sep 2008 at 3:08 pm

    Building aerobic capacity is one thing. Getting “the same benefit, at home, from 4 minutes a day on the ROM as you can from 20 to 45 minutes aerobic exercise plus 45 minutes weight training plus 20 minutes stretching at the gym” is an entirely different kettle of fish.

    You say the Tabata protocol is 20 seconds on, 10 seconds off, for 4 minutes. The ROM protocol is 4 minutes on. That’s a very different kettle of fish too.

    It would be so simple to randomize a group into 4 minute ROM vs long gym regimen and compare their fitness after a month or two. One wonders why they haven’t done that simple test.

    I can think of a very uncharitable hypothesis as to why they haven’t, but I’ll be nice and just say they should not make the claim before they do the test.

  15. wertyson 16 Sep 2008 at 7:01 pm

    Can I suggest that the only person who might be able to use this device safely at home would be a fitness instructor who was married to an exercise physiologist ?

    The claims themselves are quite clearly misleading and exaggerated, and Dr Hall is right to point out that any promotional literature should not discourage people looking for a quick fitness fix from following the same sensible advice as everyone else.

    Having had plenty of experience at starting over in exercise programs, and an accumulation of soft tissue injuries from poor pacing, I can offer anecdotal evidence that high intensity exercise should be used sparingly as part of a comprehensive training program, and should NOT be conducted unsupervised at home…

  16. […] Is the 4 Minute Exercise Machine a waste of time, space, money . . . and anything else you can think… - It’s hard to believe that a product bought by Tom Cruise and John Travolta wouldn’t do what it supposed to [rolling eyes]. […]

  17. vinnyon 17 Sep 2008 at 9:14 am

    Sashen,
    I could use some advice from a sprinter. I need to lose weight and increase my leg speed. I tried doing sprints every other day for 2 weeks and this was very hard on my knees. I do slow jogging now and it has helped with weight loss, but I still need to increase my speed. Do you have any recommendations?

  18. sashenon 17 Sep 2008 at 10:48 am

    Hi Vinny,

    Interestingly, the research shows that sprinting speed is more a function of strength (mass-specific force, to be exact) than of leg speed. Average people demonstrate leg swing speed that’s not much slower than world-class sprinters.

    That said, improving neuromuscular coordination by running SHORT distances (10-30m) at 90-100% of your max speed has been shown to help sprinting speed (”you’ve got to practice running faster to run faster”).

    If you’re hurting your knees, there’s a good chance you’re overstriding (having your foot land in front of your center of mass rather than under it).

    A great resource for sprinting is http://www.bearpowered.com/ (look for the very provocative ebook with a strength program I’m using, and make sure to check out the forum).

    Regarding weight loss, I’m sure there are a lot of opinions on this blog. It sure seems to be calories in vs. calories out — I dropped 20 pounds after increasing my calories out through sprinting and strength training and decreasing my calories in by 15-20% through intermittent fasting (skipping breakfast and lunch twice a week, or skipping breakfast daily… and having normal-sized healthy meals otherwise).

    Info on the latter (which will probably generate some opinions) at http://www.eatstopeat.com/

  19. […] READ THE REST OF THIS ENTRY AT “SCIENCE BASED MEDICINE” […]

  20. Lame-Ron 17 Sep 2008 at 4:42 pm

    Thanks for the review; I’ve noticed the ROM ads in Forbes and have always been curious.

    My take is that the machine is not entirely illegitimate, but is a scam, nonetheless.

    There are 2 primary factors to incurring a training stimulus: intensity and volume. Either one will produce a positive response, but neither one by itself will be as effective as both combined. The ROM machine apparently focuses almost exclusively on the intensity component, which is not in itself illegitimate. But claiming that it is ‘equivalent’ to a longer (and presumably less intense) workout, is like comparing apples to oranges. Intensity and volume are different training stimuli and thus produce different responses, aka sprinters versus marathoners. Furthermore, you are all well aware of the different ways the body behaves at different heart-rate thresholds in terms of how it fuels the muscles, etc, which is another reason why it’s not a straight-up comparison.

    My experience is with weights, so that is my perspective. The body will eventually stop responding to the same stimulus, so it must be changed up. This usually takes the form of increasing the weights (and thus the intensity.) However, the concurrent result is an increase in the volume, which can tax the recovery system beyond its limits. Reducing the reps/sets correspondingly would alleviate this, but you can see that before long you’d be stopping training entirely. As a result, seasoned lifters have to condition their body to handle the increased volume in order to handle the increased intensity. In powerlifting circles this is often accomplished by such mundane activities as dragging/pushing a weighted sled around in pursuit of “General Physical Preparedness.” Which is a glorified way of saying “conditioning.” You can not indefinitely increase intensity without increasing the body’s ability to handle increased volume.

    Is the ROM machine worthless? No. Is 4 minutes on it equivalent to 20 minutes on a stepper? No, though perhaps people seriously out of shape would see similar results (on only a few metrics, however.) Will it maintain a moderate level of fitness at 4 mins per day? Yes. Would it produce better results at 10/15/20 mins per day? Yes. Is it worth 14k either way? Not in my mind.

  21. […] I’m frequently asked, “Is what that ad says really true?” Three recent inquiries have been about products advertised in Scientific American. An ad may acquire a certain cachet by appearing in a prestigious science magazine, but that doesn’t mean much. Scientific American’s editorial standards apparently don’t extend to its advertising department. I remain skeptical about the claims for all three of these: Juvenon, the StressEraser, and the ROM exercise machine. I discussed the ROM machine last week. […]