Biomedical subjects

W Jack Rejeski

Publications and source records attributed to W Jack Rejeski.

8 recordsLinked to original sources

PubMed2003

Baseline balance and functional decline in older adults with knee pain: the Observational Arthritis Study in Seniors.

OBJECTIVES: To examine the cross-sectional and longitudinal effect of baseline balance, independent of multiple covariates (sociodemographic variables, comorbidities), on self-reported disability and several measures of functional performance. DESIGN: Observational Arthritis Study in Seniors was a community-based longitudinal study. SETTING: Data collection was conducted at an exercise science research laboratory. PARTICIPANTS: A cohort of 245 women and 235 men, aged 65 and older, with self-reported knee pain. MEASUREMENTS: Measurements of balance, self-reported disability, functional performance, strength, sociodemographic characteristics, disease burden (including radiographic knee osteoarthritis (OA)), and functional limitations were obtained on participants at baseline and 30 months. The four outcome measures (self-reported disability, stair climb time, car time, preferred walking speed) were also collected at 15 months. RESULTS: In cross-sectional analyses, baseline balance was significantly associated with each of the four outcome measures before adjusting for baseline knee strength. After adjusting for knee strength, baseline balance remained significantly associated with all functional performance outcomes and self-reported disability. In longitudinal analyses, baseline balance had a significant effect on car-time performance, whereby individuals in the lowest quartile of baseline balance scores declined in a quadratic manner from baseline to Month 30. CONCLUSION: Baseline balance, independent of strength and various other covariates, is an important component of performance for transfer and ambulatory tasks and for self-reported disability. Balance was predictive of change in performance over time only in a task that presented a significant challenge to the lateral mobility/stability of participants. Balance was not predictive of decline in ambulatory performance-based tasks or in self-reported disability.

Age Factors↗

PubMed2002

Do optimism and pessimism predict physical functioning?

Dispositional optimism has been shown to be related to self-report measures of health and well-being, yet little research has examined the relationship between optimism and more objective measures of functioning. The purpose of this study was to examine the relationship between optimism and pessimism and objective physical functioning. Four hundred eighty community-dwelling older adults with knee pain completed a measure of optimism and pessimism and were observed performing four daily activities (walking, lifting an object, climbing stairs, and getting into and out of a car). Results indicated that pessimism was significantly related to performance on all four tasks (p < .001), while optimism was related to performance only on the walking task (p < .05), after controlling for demographic and health variables.

Activities of Daily Living↗

PubMed2002

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life.

This study examined the effects of dietary weight loss and exercise on the health-related quality of life (HRQL) of overweight and obese, older adults with knee osteoarthritis. A total of 316 older men and women with documented evidence of knee osteoarthritis were randomly assigned to 1 of 4 18-month interventions: dietary weight loss, exercise, dietary weight loss and exercise, or healthy lifestyle control. Measures included the SF-36 Health Survey and satisfaction with body function and appearance. Results revealed that the combined diet and exercise intervention had the most consistent, positive effect on HRQL compared with the control group; however, findings were restricted to measures of physical health or psychological outcomes that are related to the physical self.

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PubMed2002

Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology.

This study examines and compares the effect of aerobic and resistance exercise on emotional and physical function among older persons with initially high or low depressive symptomatology. Data are from the Fitness, Arthritis and Seniors Trial, a trial among 439 persons 60 years or older with knee osteoarthritis randomized to health education (control), resistance exercise, or aerobic exercise groups. Depressive symptoms (assessed by the Center for Epidemiologic Studies--Depression scale) and physical function (disability, walking speed, and pain) were assessed at baseline and after 3, 9, and 18 months. Compared with results for the control group, aerobic exercise significantly lowered depressive symptoms over time. No such effect was observed for resistance exercise. The reduction in depressive symptoms with aerobic exercise was found both among the 98 participants with initially high depressive symptomatology and among the 340 participants with initially low depressive symptomatology and was the strongest for the most compliant persons. Aerobic and resistance exercise significantly reduced disability and pain and increased walking speed both, and to an equal extent, in persons with high depressive symptomatology and persons with low depressive symptomatology.

Activities of Daily Living↗

PubMed2002

Aging and physical disability: on integrating group and individual counseling with the promotion of physical activity.

This review examines selected conceptual models on physical disability that have been commonly employed in the study of chronic disease and aging, and suggests including self-efficacy beliefs and physical symptoms into the main pathway of the disablement process. The resulting model of disability has direct implications for integrating group and individual counseling into exercise prescription.

Activities of Daily Living↗

PubMed2002

Older adults in cardiac rehabilitation: a new strategy for enhancing physical function.

PURPOSE: This study contrasted the effect of a group-mediated cognitive-behavioral intervention (GMCB) versus traditional cardiac rehabilitation (CRP) upon changes in objective and self-reported physical function of older adults [mean (SD) age of 64.7 (7.5) yr] after 3 months of exercise therapy. METHODS: This randomized clinical trial enrolled 147 participants who were eligible for inclusion into cardiac rehabilitation. Baseline to 3-month changes in self-reported and performance related measures of physical function were assessed using a physical functioning questionnaire, a 6-min walk test, and measured MET levels. RESULTS: Paired t-tests revealed that participants made improvements in all measures across the first 3 months of the study, irrespective of group treatment (P < 0.001). General linear models including effects for baseline levels of physical function, treatment, and gender revealed that lower functioning men in the GMCB treatment made greater improvements than any other subgroup on the two performance outcomes: 6-min walk and measured MET levels (P < 0.01). Gender did not moderate change in self-reported level of physical function (P > 0.05); however, the lower functioning participants in the GMCB intervention experienced greater improvements in self-reported physical function than those in CRP (P < 0.05). CONCLUSIONS: Exercise therapy is a valuable intervention for improving physical function of older adults with cardiovascular disease (CVD) and those at increased risk for CVD. Baseline level of physical function and gender are important variables to consider when studying the relationship between exercise therapy and improvements in physical function.

Activities of Daily Living↗

PubMed2002

The unique and transient impact of acute exercise on pain perception in older, overweight, or obese adults with knee osteoarthritis.

This study examined the unique contribution of acute exercise to perceptions of pain in 32 older, overweight, or obese adults with knee osteoarthritis (OA), statistically controlling for the effect of diurnal variation, supplemental medication intake, and stress. Using an ecological momentary assessment method, 964 pain appraisals were recorded and coded into experience samplings that occurred either on a nonexercise day or before or following scheduled activity on an exercise day. Univariate and multivariate multilevel modeling analyses controlling for supplemental medication intake and stress revealed a quadratic trend in diurnal pain variations with the peak occurring mid-afternoon. Although pain was significantly elevated following exercise in comparison with the predicted diurnal pattern, pain reports later in the day following exercise were significantly lower than immediately following exercise. We conclude that the pain associated with acute exercise by older, overweight, or obese adults who have knee OA is transient. Findings are discussed in terms of the implications of exercise therapy for patients with knee OA.

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PubMedDate not supplied

A randomized, controlled trial comparing long-term and short-term exercise in patients with chronic obstructive pulmonary disease.

PURPOSE: To compare the effects of short-term (3 months) and long-term (18 months) involvement in an exercise program on self-reported disability and physical function in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 140 patients with COPD were studied in a randomized, single-blinded clinical trial. Self-reported disability and physical function were assessed using a 21-item questionnaire, a 6-minute walk, timed stair climb, and an overhead task. RESULTS: At the completion of the trial, participants in the long-term intervention reported 12% less disability than those in the short-term intervention (adjusted mean with 95% confidence interval, 1.53 (1.43-1.63) versus 1.71 (1.61 to 1.81) units, respectively; P=.016), walked 6% farther during 6-minutes (1,815.0 [1,750.4-1,879.6] vs 1,711.5 [1,640.7-1,782.3] feet, respectively), climbed steps 11% faster (11.6 [11.0-12.2] vs 12.9 [12.3-13.5] seconds, respectively), and completed an overhead task 8% faster (46.8 [44.4-49.2] vs 50.4 [47.8-53.0] seconds, respectively) than those in the short-term intervention. CONCLUSION: An 18 month exercise program results in greater improvements in self-reported disability and physical function in patients with COPD when compared with a 3-month exercise program. As such, long-term exercise should be recommended for all patients with COPD.

Age Factors↗