Hemera/Thinkstock(WASHINGTON) -- Blood donations have been halted in two Florida counties being investigated as the epicenter of a possible outbreak of locally transmitted Zika virus, according to the U.S. Food and Drug Administration.
At least four cases of Zika infections in Miami-Dade and Broward counties are being investigated by the Florida Health Department as a possible outbreak of locally transmitted Zika. On Wednesday, the FDA asked all blood donation centers in both Miami-Dade and Broward counties to cease collecting blood until they can implement tests to check donor blood for signs of the Zika virus. The FDA also recommended that adjacent and nearby counties adhere to these requirements as well.
"These may be the first cases of local Zika virus transmission by mosquitoes in the continental United States," FDA officials said in a statement. "In consideration of the possibility of an emerging local outbreak of Zika virus, and as a prudent measure to help assure the safety of blood and blood products, FDA is requesting that all blood establishments in Miami-Dade County and Broward County cease collecting blood immediately until" officials can implement tests for Zika.
More than 1,650 people have been diagnosed with Zika within the U.S., but the vast majority have been people who contracted the virus while abroad. A small number of people contracted the Zika virus through sexual transmission within the U.S.
iStock/Thinkstock(TALLAHASSEE, Fla.) -- The Florida Health Department is now investigating four Zika infections that may have been transmitted locally.
More than 1,300 people have been diagnosed with Zika in the U.S. and virtually all contracted the disease while traveling abroad. A small number were due to sexual transmission of the disease.
If the investigation determines that Zika was passed on by an infected mosquito in Florida, it would be the first occurrence of a local transmission in the continental United States. Concern over a possible Zika outbreak has led the U.S. Centers for Disease Control and Prevention to offer assistance to the Florida Health Department.
After two new cases were reported, the Florida Health Department expanded its investigation and started going door-to-door to reach people in areas where the infections were reported. Sample collections, including urine samples, are being requested to determine if there are ongoing infections, according to the Florida health officials.
Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical School, explained to ABC News that an epidemiological investigation to determine if there is an outbreak can take time as many investigators fan out over neighborhoods to look for any sign of the virus in both insects and people.
Investigators will "try to figure out where the infection was likely acquired," said Schaffner. If they believe it was locally acquired, they'll start searching in different areas for the Aedes Aegypti mosquito that has been linked to the disease.
He also explained that urine tests are used to help identify a potential outbreak because they are easy to acquire and don't require medical staff as blood samples do.
"It can be very elaborate" to do these investigations, Schaffner explained. "As we talk about this, all of these investigations are very personnel dependent."
Should an outbreak of the virus be confirmed in Florida, Schaffner said the health department would likely send out mosquito control experts to spray affected homes with insecticides.
"They will actually have people going through backyards and looking at sites where they need to spray," he said.
iStock/ThinkstockBy DR. JENNIFER ASHTON, ABC News Senior Medical Contributor
Getting a flu vaccine for your child may be a little more painful this year.
A Centers for Disease Control and Prevention committee is recommending against any use of the nasal spray flu vaccine for the upcoming flu season. It seems it's not nearly as effective as the injectable form.
As a doctor, I've seen teens die of complications from the flu. As a mom, I vaccinate my kids every year.
Here are some tricks to have injections go more smoothly:
If the nurse or person giving the shot actually pinches the skin on the arm first, the body tends to focus on the pinch and not the needle.
Pushing a syringe slowly minimizes the pain of the liquid expanding in the muscle tissue.
Teaching kids that they are strong and can get through an injection is such a valuable lesson
Scott Clarke / ESPN Images(NEW YORK) — Tennis legend Chris Evert has opened up about how menopause impacted her marriage and influenced her divorce in 2006.
Earlier this week, Evert spoke on "The Forward Podcast with Lance Armstrong." The ESPN tennis analyst hinted that menopause partially contributed to the end of her 18-year marriage to Olympic skier Andy Mill.
"Andy and I, we're still a family...without living together," Evert, 61, said. "We had a rough couple years because I married [Australian golfer] Greg Norman, who's Andy's friend,"
The former tennis pro's subsequent marriage to Norman ended after just 15 months.
"I was going through menopause," she says, "stuff that, you know, that doesn't get talked about enough. What women go through [around age 50.]"
Evert told Armstrong that her relationship with Mill is solid. "We love each other and I can rely on him," the mother-of-three said. "When I'm dying in my bed, he'll be there...I'll be there for him and he'll be there for me."
After 18 grand slam titles and 18-plus years of marriage, Evert imparted what she learned from her life experience.
"You've got to be on top of your relationship the whole time," she said, "and I've learned that...as soon as you feel drifting away you get back there."
Purestock/Thinkstock(NEW YORK) -- A daily supplement or two has become routine for many Americans, but a report is highlighting how these substances can sometimes be harmful.
Consumer Reports outlines in a extensive report how producers of dietary supplements face little regulation from the U.S. Food and Drug Administration and why that can be dangerous for those taking supplements.
Supplements can have side effects and retailers and pharmacists may not understand how supplements can interact with a person's medication, the report said. Additionally, since supplements are regulated as food, the ingredients do not have to be proven safe and effective in the same manner prescription drugs are by the FDA.
Ellen Kunes, health editor at Consumer Reports, said consumers can't rely solely on the labels of supplements since they aren't bound by the same regulations as pharmaceuticals.
"Supplements have labels that don’t necessarily tell you what they are good for, how they are going to work, whether they will work," she said. "You can’t trust that they're going to work or that they will be safe just by looking at the label."
Consumer Reports found that an estimated 23,000 people end up in the emergency room after taking supplements every year.
Dr. Marvin Lipman, Consumer Reports’ chief medical adviser, pointed out that worried consumers can look for the USP (U.S. Pharmacopeia) label that means a company has verified what is on the label.
"There’s a paucity of products that are taking advantage of the approval process for responsible companies," said Lipman. " Without verification, you cannot be sure that what’s on the label is in the bottle."
Dr. Donna Seger, the director of the Tennessee Poison Control, said that many people do not think about the potential consequences supplements could have on their health. She said people shouldn't think of these substances as innocuous and should always check with their doctors first.
"People shouldn't be taking supplements who are on medication unless they checked with doctor," she said, explaining how different pills can have different substance amounts. "If you have 100 pills in bottle there might be a different amount in each pill."
The Council for Responsible Nutrition, a leading trade association for the dietary supplement and functional food industry, disagreed with the report pointing out that 150 million Americans take supplements.
"Overwhelmingly, dietary supplements are safe and play a valuable role in helping Americans live healthy lifestyles," the council said in a statement. "The industry is regulated by the FDA, and the robust regulations give the government the ability to remove unsafe products from the market. It is patently illegal for products to be sold as dietary supplements if they contain prescriptions or illegal drugs, and we urge the government to use its enforcement authority to protect consumers from those products."
Consumer Reports pointed out 15 specific ingredients in supplements that it says consumers should avoid, since they have dangerous side effects such as rapid heartbeat, liver damage and seizures. More information about supplements from Consumer Reports can be found here.
iStock/Thinkstock(WORCESTER, Mass.) — The ALS Ice Bucket Challenge, which went viral in 2014 as a fundraiser for research, has resulted in far more than just funny YouTube videos of people dumping ice-cold water on themselves for a good cause. Researchers credit the $220 million raised as key in funding a new study that has possibly identified a common gene that contributes to amyotrophic lateral sclerosis (ALS).
ALS is a neurodegenerative disease that affects nerve cells in the spinal cord leading to loss of control over muscles. Eventually, the disease leads to total paralysis and death.
In a study published in the Nature Genetics Journal researchers from various institutions including University of Massachusetts Medical School and University Medical Center Utrecht identified the gene NEK1 as a common gene that could have an impact on who develops the disease. Variants on the gene appear to lead to increased risk of developing ALS, according to preliminary findings. Researchers said they're anxious to understand more about the neurodegenerative disease that causes a person to lose the ability to control muscles and eventually leads to death.
Researchers in 11 countries studied 1,000 families in which a family member developed ALS and conducted a genome-wide search for any signs that a gene could be leading to increased ALS risk. After identifying the NEK1 gene, they also analyzed 13,000 individuals who had developed ALS despite no family history and found they had variants in that same gene, again linking that gene with increased ALS risk.
“The discovery of NEK1 highlights the value of ‘big data’ in ALS research," Lucie Bruijn, the chief scientist for the ALS Association, said in a statement. "The sophisticated gene analysis that led to this finding was only possible because of the large number of ALS samples available."
Multiple initiatives were started after the viral fundraiser started in the summer of 2014, including the Project MinE initiative aimed at creating a global gene sequencing effort with 15,000 affected people. Starting in the summer of 2014, the ALS Ice Bucket Challenge led to 17 million videos made with $220 million raised, according to the ALS Association. Of the total money raised, $115 million went to the ALS Association.
John Landers, co-author of the study and associate professor of neurology at the University of Massachusetts Medical School, explained that the funding helped create an international network of researchers to take on ALS.
“Global collaboration among scientists, which was really made possible by ALS Ice Bucket Challenge donations, led to this important discovery,” Landers said in a statement. “It is a prime example of the success that can come from the combined efforts of so many people, all dedicated to finding the causes of ALS. This kind of collaborative study is, more and more, where the field is headed.”
This is not the first time that the "Ice Bucket Challenge" was credited for leading to significant results. Last summer, a previously unknown protein was identified as an important marker for ALS, after researchers from Johns Hopkins found the TDP-43 protein tended to accumulate in people with ALS.
The funding windfall also helped get needed materials and devices to patients living with ALS, according to the ALS Association.
Courtesy Tina Turner(NEW YORK) -- Monday was bittersweet for two tearful families who met after a heart donation saved one teenager's life, after the other's was taken.
Albert Jeffries IV (Alj), 14, of Burlington, North Carolina received a heart transplant on March 10 after suffering his entire life from a heart disease called dilated cardiomyopathy, mom Tina Turner told ABC News.
On July 25, Turner, Alj and his brother Luke finally met the family who selflessly gave the gift of life four months ago, after experiencing their own tragic loss of a daughter and deciding to donate her heart.
"We were crying and falling to the floor," Turner told ABC News Wednesday of the meeting. "It was joyful and sorrowful -- too many emotions mixed into one. Just knowing this family gave their daughter's organs to save my son's life, it was so overwhelming."
On March 6, Katelyn Zimmerman, 14, and her brother Dylan, 13, died after being hit by a car while riding their bicycles near their home of Inverness, Florida, ABC affiliate WFTS-TV in Tampa Bay, Florida reported at the time.
Katelyn's grandmother Charlene Sweigart described her granddaughter as a loving, giving, caring person who enjoyed assembling bicycles with her younger brother Dylan.
"She was so mature, so beyond her years and that's what amazed me," Sweigart told ABC News Wednesday. "One day, [Katelyn] said, 'Maw Maw, I want to be an organ donor,' I told her that I was proud of her and I'm an organ donor and her great grandfather was. Three hours later, she was gone."
Katelyn's heart was donated to Alj in a life-saving surgery days later. Alj had waited for a heart for 99 days.
"Alj was near death," Turner said of her son. "He was on two heart drips by the end. The month Katelyn died was the year Alj was reborn."
At Carolina Donor Services in Durham, North Carolina, Alj's family was united with Katelyn and Dylan's dad Shawn, grandmother Charlene, Katelyn's twin sister Savannah and other relatives.
Balloons and butterflies were released at the event. Alj even dedicated an emotional letter to Katelyn's family, which read, "Thank you for being my miracle."
That day, Katelyn's family was able to hear her heart beating inside Alj's chest and Turner gifted each person with a recording of the sound.
"I'm ready to get out there and spread the awareness of organ donation," Turner said. "This is what life is all about. With life comes death and with death comes life. After Katelyn made that wish, her family didn't think twice about it. They saved our family from a lot of heartache."
iStock/Thinkstock(NEW YORK) -- Want to burn calories? Those Nordic walking machines apparently live up to the hype.
According to U.S. News & World Report, when done correctly, Nordic walking -- which mimics the motion of cross-country skiing -- can burn up to 40 percent more calories than regular walking, reduce knee and joint stress, boost oxygen consumption which benefits the brain, and help realign the body after a day hunched at a desk.
Dr. Pam Roberts, a family physician who teaches Nordic walking as a health and wellness coach at The Summit Medical Fitness Center in Kalispell, Montana, says walkers “are getting a higher level of fitness, but they're not feeling the drudgery of it.”
Nordic walking has a low risk for injury and can be done almost anywhere safe to walk, and with the right equipment.
"Anybody can take a walk, but this is so much more effective because you're using your upper body as well. The poles defray a lot of the tension and the stress from your knees and your joints," Bill Rosson, who co-founded HYVA, the Nordic walking organization in New York City, says.
It's a good idea to take a class from a certified Nordic walking instructor or watch a video online.
"You just have to get down the basic cues," Rosson says.
There's no harm, however, if you don't, he says: "Worst-case scenario: You get a nice walk."
iStock/Thinkstock(NEW YORK) -- Doctors may be able to screen men for Alzheimer’s at even younger ages, according to a new study presented Tuesday at the Alzheimer’s Association International Conference.
A study from the Mayo Clinic showed that Alzheimer’s, a disease that affects over five million Americans, is found in both men and women, contrary to the belief that this disease was predominantly found in women.
Researchers determined that men with Alzheimer’s had atypical symptoms and tended to be younger at diagnosis.
The study’s lead author, Melissa Murray, an assistant professor of neuroscience at the Mayo Clinic, said that researchers were able to collect data from a fairly large brain bank that provided insight into an entire community of people with Alzheimer’s dementia. What they found was striking.
“[In those with Alzheimer’s] men in their 60s were overrepresented," she said, meaning a higher number of men were affected in that age group than was expected by researchers.
For these men, the disease also had more involvement in a key part of the brain that controlled higher level function, possibly leading to death before the age of 70 for some patients. This possible "progressive" form of the disease could be why Alzhemier’s disease appears to affect more women according to current data. Women tend to be diagnosed with this disease at an older age and with a milder clinical course.
James Hendrix, the director of the Global Sciences Initiative at the Alzheimer’s Association, explained the challenges of diagnosing Alzheimer's disease with current diagnostic tools.
“Diagnosis of [Alzheimer’s] is messy and challenging, and is done through cognitive testing, which is not the same as an objective measure, like a biomarker," he said.
The most common symptoms of Alzheimer’s are memory loss that disrupts daily life, difficulty completing daily tasks, confusion with remembering time and place, challenges with problem-solving and issues with speech, according to the Alzheimer’s Association.
According to Hendrix, this study could have a tremendous impact on diagnosis.
“For people, in particular in their 60s, this disease impacts more men [and] that’s really important to understand from a diagnosis perspective," he said. “Why are we seeing women disproportionately affected? It’s because women live longer, but it’s more than that. Understanding these differences could help understanding Alzheimer's disease and what is causing this disease to help create strategies to lower Alzheimer's disease risk."
Experts are hopeful that new imaging technology can help determine why the disease appears to affect men and women differently.
New methods for diagnosis including Amyloid PET Imaging brain scans are in the process of being accepted by researchers, although major roadblocks, including Medicare coverage, could prevent these tools from being widely embraced.
Hendrix noted at the conference that vision and smell tests may also lead to earlier diagnosis of Alzheimer’s.
iStock/Thinkstock(AUGUSTA, Ga.) -- The first American patient to undergo a double hand transplant is speaking out about his experience this week. Seven years after making headlines, Jeff Kepner, 64, is drawing attention to the risks of experimental surgery by revealing he cannot move his transplanted hands at all.
"I have zero mobility with my hands," Kepner, 64, told ABC News. "I can’t hold a pencil."
Before deciding to get the transplant, Kepner, of Augusta, Georgia, spent 10 years as an amputee. Tuesday, he said he's been unable to work because of the trouble with his hands. He said he doesn't want to go through surgery again to remove the hands, since there would a risk that too much tissue would be taken and he wouldn't be able to use prosthetics afterwards.
Kepner's case has highlighted how patients undergoing experimental surgeries can face devastating consequences and risks long after they are hailed as medical marvels. While many patients with hand transplants are able to regain some use of their new hands, others run the risk of having no feeling or losing the transplant organ to immune-system rejection.
Dr. Vijay Gorantla, associated professor of surgery and administrative medical director of the Pittsburgh Reconstructive Transplant Program at University of Pittsburgh Medical Center, treated Kepner and said it's key that doctors make sure that patients truly comprehend the myriad of risks behind experimental surgeries.
"Setting expectations for patients is one thing, but making patients understand those expectations is another thing," he told ABC News.
Gorantla explained that in patients where these kinds of tissues are transplanted, the ability for nerves to regrow properly is a huge risk. The nerves must grow before the small muscles that allow for movement wither away after surgery. Gorantla compared it to a broken light bulb.
"You have a wire in the house and it’s connected to a socket and you switch it on but the bulb doesn’t glow because the bulb is dead," he explained. "If you compare the bulb to the muscle it doesn’t matter after some time to have electricity or cable if you lose the muscle."
Gorantla said it's key for patients to do physical therapy to ensure the nerves can get to the muscles again, but that there is always a risk. He pointed out the field of this kind of transplants, including hands, face, abdominal wall and uterus transplants is still new. It began in 1998 with the first face transplant in France.
"As with every procedure in medicine we have known risks and known benefits and known complications," Gorantla said. "There are things we just don’t know because of the novelty of the whole field. The age of the field is 15 or 16 years worth of data and that [data] generates from a few hundred patients."
Gorantla pointed out doctors must be clear about risks for patients and must also avoid "undue risks."
"There are no absolutes here and that’s why you have to face the specter of failure amidst the success," he said.
Kepner said he's frustrated by his lack of mobility and the fact that he feels he is in a worse position than he did before the surgery.
After speaking with doctors about his prognosis, he said, "I really had high hopes I would have feeling my hands."
But Kepner remains an example of the risks both patients and doctors take when heading into uncharted surgeries.
"I was in therapy for almost three years and after the third year I said 'Hey enough is enough,'" he said. "My fingers weren’t moving half an inch they weren’t doing anything."
When asked if he had advice for others considering similar experimental surgery, Kepner said they should consider what is right for them.
"If they want to do this that’s fine. I wouldn’t say anything negative," he said. "They’re getting better."
Ethan met the "Recycle Superhero" at the Sacramento Bee. Other stops during the day include the fire station, to meet the “Reuse Superhero,” and Frank’s Fat Restaurant, a popular restaurant where Ethan will perform a “standard trash pickup,” according to Make-A-Wish.
Ethan and his garbage truck will end the day at the capitol building in Sacramento, where Ethan will be recognized for his efforts to clean up the city.
Also along for the ride is Ethan’s dad, Jason, who dressed as a garbage man for the day. Nearly 7,000 people answered a call put out by Make-A-Wish to come cheer Ethan along on his journey.
“Ethan’s wish to be a garbage man for a day is a perfect example that anyone and everyone has the ability to grant a wish," Make-A-Wish America's Josh deBerge told ABC News. "Today we saw a local garbage man alongside thousands from the community of Sacramento, join together to make a six-year-old boy’s wish come true.”
The mayor of Rancho Cordova gave Ethan a key to the city Tuesday morning and Ethan is scheduled to receive a proclamation from the governor’s office.
liquidlibrary/Thinkstock(NEW YORK) -- The rate of cesarean sections and induced births in the U.S. has declined, reversing a decades-long trend of increased rates of obstetric interventions, according to a study published Tuesday in the Journal of the American Medical Association.
Researchers from multiple institutions, including the Rollins School of Public Health at Emory University, examined data from 25 million birth certificates detailing deliveries. They found measurable drops in the amount of obstetric interventions taking place in babies delivered both late pre-term (34-36 weeks of pregnancy) and early term (37-38 weeks of pregnancy).
Researchers found there was a decrease in obstetric interventions from 33 percent in 2006 to 21 percent in 2014 for early-term infants and a slight decrease -- from 6.8 percent to 5.7 percent -- for infants born in late pre-term births during this time period.
Unnecessary obstetric interventions have been an issue of growing concern because they can lead to additional complications. In 2011, one in every three pregnant women delivered their babies via c-section in the U.S., leading to medical officials becoming concerned that invasive procedures were being overused.
The lower rate of interventions is likely because doctors are now recommended by American Congress of Obstetrics and Gynecology (ACOG) to delay obstetric interventions to 39 weeks of pregnancy or later. ACOG encourages doctors to do non-medical interventions by providing more support during labor like having a doula.
Dr. David Hackney, a maternal fetal medicine doctor at University Hospitals Case Medical Center in Cleveland, Ohio, said more research should be done to answer the question of whether there “are fewer patients going into labor [needing obstetric interventions] or if we are intentionally delivering fewer babies this way.”
Hackney, who was not involved with the study, pointed out that medical research has focused on helping mothers later in their pregnancy, from 34-38 weeks, to improve medical and birth outcomes, and that that could have resulted in decreased need for medical interventions.
“It always feels good to have a long-standing public health and educational campaign [of decreasing medical interventions]," he said. You "can actually see the change in ... public health findings."
Tim Smith(FAIRFAX, Va.) — A Virginia baseball player was saved when his teammate administered CPR moments after he was struck in the chest by a baseball.
The Manassas baseball team was practicing for the Southeast Regional Tournament on July 14 when the catcher threw the ball and hit Steve Smith directly in the chest, according to Steve's father Tim.
"His heart stopped immediately," Smith said, who is also the team's coach. "When you get struck in the chest and there is about three hundredths of a second in between each heartbeat and basically if you are hit by something in that time, at the right speed, it stops your heart."
Smith said the whole team ran toward his son as he collapsed on the field.
"When I got to him he was stiff, like his body was trying to breathe but his eyes were rolled back in his head, and he wasn't responding," Smith recalled. "He was basically gone, I guess. He wouldn't wake up, he wouldn't respond. I was shaking him, trying to get him to take a breath. I yelled, 'Does anyone know CPR?'"
That's when Paul Dow, 17, came forward and immediately started performing CPR. Meanwhile, a parent on the sidelines called 911.
Smith said he was "walking around trying to stay calm, but not doing a very good job" as Paul performed CPR on his son.
Eventually Smith put his son and Paul, who was still performing CPR, in the back of his truck and drove them to the parking lot, where an ambulance arrived soon after.
EMS workers pulled out a defibrillator and were able to restart Steve's heart. Smith said 12 minutes had lapsed between the time Paul began administering CPR and when emergency workers successfully revived Steve.
Steve was then airlifted to a trauma hospital in Fairfax, where he stayed over the weekend, remaining mostly unconscious.
Smith said his son woke up on Sunday asking, "What's for breakfast?" and "What am I doing here?" He had no memory of what happened to him.
"If you look at him you'd never know that anything happened. He has a hole in his neck where they put the tube and a few nicks on his arms but other than that he doesn't have a scratch on his body," Smith said. "It's a miracle."
Paul, a close friend of the Smiths, learned CPR to become a lifeguard at the local pool. He received his certification just a few months ago.
Smith said his son's recovery was a miracle.
"Thanks be to God that Paul was there to give the CPR because there would have been brain damage at the very least if he didn't get air. God has his hand on it the whole way," Smith said."
He added that another family friend, who is a retired firefighter, was inspired to start a CPR class in the community after Steve's near-death experience. "There is so much good coming out of this, for the little bit of suffering we did, so much good is coming out of it," Smith said.
Courtesy Layla Luciano(NEW YORK) -- Layla Luciano is a New York City-based fitness trainer known for her high-intensity and exhilarating workouts. Luciano uses her 20 years of martial arts training to design workouts that activate both slow-twitch and fast-twitch muscle fibers, ensuring a complete body burning and calorie-torching workout.
The PACT Park co-founder will lead ABC News' Good Morning America viewers Wednesday in a live-streamed workout for “Workout Wednesday.” In the new series, top fitness personalities lead workouts that are live-streamed on GoodMorningAmerica.com every Wednesday morning.
Luciano's workout will feature shadowboxing and body-weight strength training moves.
Here are some of her kickboxing workout tips:
1) To get the most out of your strike, visualize an opponent or target to help you keep focus and keep your strikes from getting lazy and sloppy. If you think you are punching the air, it is definitely going to look and feel like you are punching the air.
2) Stand with your dominant side back.
3) Keep elbows close to your ribs and your knuckles next to your jawline to protect yourself. Never drop your hands even when shadowboxing.
4) Spread the legs slightly wider than your shoulders and pull your shoulder blades down to your back pockets.
5) Push your hips back and bend your knees to sit on your punches. This helps you to keep your legs and hips involved.
5) Take a small step on the jab (this is the only punch you do not turn your hips and shift your weight into).
7) Try to avoid standing in place before or after throwing punches (stick and move). It's a hit and run sport.
8) After you throw a series of punches and/or kicks (combos), get into the habit of adding a slip, duck or weave to develop a defensive habit and keep moving.
9) Shift your weight forward on the front leg while throwing dominant punch or kick: crosses, uppercuts, hooks and slipping to the left.
10) Shift your weight back to the back leg when throwing a lead punch or kick: hooks, uppercuts or slipping to the right.
And here are Luciano's tips to maximize your workout burn:
1) Changing up your training is important. Your body becomes accustomed to your routine so if you find yourself getting stuck in a rut and not seeing any changes, it's time to change it up. For example, simply varying the speed of your reps. Mix fast reps and slow reps to gain strength and muscle mass.
2) If you are training individual muscles, make sure to focus on the muscle you are working on. If you're doing a bicep curl, think about only your bicep doing all of the work. This will help with muscle recruitment and muscle growth.