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PubMed1987

Perceptions of physical therapy competencies in rheumatology. Physical therapists versus rheumatologists.

The purpose of this article is to report the differences in perceptions among three groups of respondents who assessed the importance of 80 competencies for entry-level physical therapists who treat patients with arthritis. Nonparametric statistics were used to analyze the responses of physical therapists and rheumatologists who completed a questionnaire regarding the competencies. I used the Kruskal-Wallis one-way analysis of variance to make group comparisons and the Mann-Whitney U test to complete pair-wise comparisons. The results revealed significant differences of opinion among the groups (p = .007) for 20 of the 80 competencies. The significant differences in opinion were among physical therapy clinical educators (n = 100), physical therapy arthritis health professionals (n = 108), and rheumatologists (n = 80). Although the results suggested that some groups perceived certain physical therapy competencies in rheumatology to be useful but not essential for the entry-level physical therapist to perform, considerable variability existed within groups. Despite the variance in opinions, teaching of these competencies should be included in the entry-level physical therapy curriculum or in clinical settings.

Arthritis↗
PubMed1996

Changes in physical strain and physical capacity in men with spinal cord injuries.

To determine longitudinal changes in physical capacity and physical strain during activities of daily living (ADL), 37 men with spinal cord injuries (C4/5-L5) performed an exercise test and various ADL on two occasions (T1 and T2; interval 34.5 +/- 1.5 months). Parameters of physical capacity were aerobic power (VO(2peak)) and maximal power output (PO(max)). Physical strain was estimated by the heart rate response relative to the heart rate reserve. VO(2peak) at T2 (1.75 +/- 0.55 1*min(1)) did not significantly differ from that at T1 (1.67 + 0.47 1*min(-1)). Absolute PO max improved (P < 0.05) from 64.9 +/- 25.9 (T1) to 71.7 +/- 27.2 W (T2), whereas relative PO(max) did not change. Activity level, time since injury, change in body mass, and occurrence of rehospitalization were the most important predictors of changes in physical capacity. Changes in relative VO(2peak) were related (P < 0.05) to changes in strain during transfers to the shower wheelchair (r = -0.39) and shower seat (r = -0.46), and during the curb ascent (r = -0.47). In conclusion, the hypothesized decline in physical capacity did not occur over the 3-yr period. Maintenance of physical capacity, which may in part be achieved through sport participation and improved medical care, together with avoidance of excessive body mass, may be useful to prevent high levels of strain during ADL.

Activities of Daily Living↗
PubMed2003

Physical activity and health related physical fitness in children with juvenile idiopathic arthritis.

OBJECTIVE: To obtain insight into the interaction between daily physical activity and components of health related physical fitness in children with juvenile idiopathic arthritis. METHODS: Forty five patients (10 male/35 female; mean (SD) age 8.9 (2.2) years) participated in the study. Body mass, height, skinfold thickness, number of swollen joints, and joint range of motion were determined. The maximal oxygen consumption (VO(2peak)) was assessed during a graded maximal bicycle exercise test. Daily physical activity levels were measured with a Caltrac activity monitor and a parental physical activity rating (PAL) on a five point Likert scale. RESULTS: Partial correlation coefficients (to control for age) between physical activity and indices of health related physical fitness showed significant relationships between Caltrac motion counts and absolute VO(2peak) (r=0.31) and relative VO(2peak) (r=0.34), but not with the indices of body composition. There was also a significant correlation between PAL and relative VO(2peak) (r=0.33). CONCLUSIONS: Physical activity was significantly related to cardiorespiratory fitness but not to body composition in children with juvenile idiopathic arthritis. A longitudinal follow up should show whether an active lifestyle protects for loss of aerobic fitness in this patient group.

Aging↗
PubMed2002

Achievement goal profiles in school physical education: differences in self-determination, sport ability beliefs, and physical activity.

BACKGROUND: Physical activity is a major public health issue as trends show inadequate levels of physical activity for health and rising levels of obesity. Understanding motivation for physical activity in youth by assessing their motivational profiles associated with school physical education could inform future interventions. AIMS: To investigate goal orientation and perceived competence profiles in young adolescents and to test the nature of differences between clusters on motivational and physical activity measures. SAMPLE: Boys (N = 427) and girls (N = 391), aged 11-14 years, from two comprehensive schools in England. METHOD: Cross-sectional survey using cluster analysis. RESULTS: Clusters reflecting 'highly', 'moderately', and 'lowly' motivated youth were found. Physical activity, incremental sport ability beliefs, and self-determined motivation were highest in the highly motivated cluster. Girls were under-represented in this cluster. CONCLUSIONS: High motivation towards physical activity is characterised by high task and high ego orientation, and high perceived competence. With only 38% of this group being girls, interventions are required to boost motivation for girls based on goal and self-determination approaches.

Achievement↗
PubMed2002

Weight criticism during physical activity, coping skills, and reported physical activity in children.

OBJECTIVE: National health guidelines advocate increased physical activity in children and adolescents, but specific goals are not being achieved. Data are needed on variables that influence children's decision to be active or sedentary. METHODS: We tested the association of weight criticism during physical activity (WCA) with attitudes toward physical activity and reported physical activity levels in children. We also tested whether these associations were moderated by children's ability to cope with weight criticism. Subjects were 576 fifth- through eighth-graders who completed a questionnaire on physical activity patterns, weight criticism history, and coping skills. RESULTS: WCA was more common among girls than boys and among heavier children. In multiple regression analyses, WCA was associated with reduced sports enjoyment, perceived activity compared with peers, and mild-intensity leisure activity. These associations, however, were moderated by problem-focused coping skills such that the relationships were attenuated in children who were better able to cope with weight criticism. Avoidant coping skills also moderated the relationship between WCA and sports enjoyment. CONCLUSIONS: Children who are the targets of weight criticism by family and peers have negative attitudes toward sports and report reduced physical activity levels, although these relationships may be buffered by certain coping skills. Assessing WCA and related coping skills may be clinically useful for identifying barriers to physical activity in certain children (eg, the obese) and may be a potential target for interventions.

Adaptation, Psychological↗
PubMed1996

Physical self-perceptions, aerobic capacity and physical activity in male and female members of a corporate health and fitness club.

As physical activity and fitness are believed to influence esteem and self-perceptions positively, the purpose of the study was to examine the relationships among participation in physical activity, aerobic capacity, and physical self-perceptions in 40 men and 33 women, members of a British corporate health and fitness club. Hierarchical multiple regression analyses indicated a significant linear relationship for men between scores on Physical Self-worth and composite scores on Participation in Physical Activity. Men's feelings regarding general physical self-worth may be an important determinant of their subsequent levels of physical exercise.

Adult↗
PubMed2006

Decision-making ability of physical therapists: physical therapy intervention or medical referral.

BACKGROUND AND PURPOSE: Opponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. SUBJECTS: Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. METHODS: A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. RESULTS: The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35-3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14-3.15) for critical medical conditions. DISCUSSION AND CONCLUSION: Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.

Adult↗
PubMed2001

Perceptions of older Latino adults regarding physical fitness, physical activity, and exercise.

Healthy People 2000 has identified the importance of physical activity for healthy aging, but little is known about what motivates older individuals, older Latino adults, in particular, to be physically active. The purpose of this research was to examine the perceptions of older Latino adults toward physical fitness, physical activity, and exercise. This study used a qualitative focus group design. The sample of Latino adults age 60 and older resided in Northeast Massachusetts and was recruited from community settings which serve older Latino adults. Three focus groups, consisting of four to eight individuals in each group, were conducted and audiotaped. Data analysis used a combination of open, axial, and selective coding procedures. Focus group participants viewed physical fitness as being able to do anything; the mind and body working together; and feeling "light," being healthy. Support was viewed as a motivator of physical activity and exercise and included community resources, group support, cultural unity, and health provider assistance Barriers of fear and a feeling of inappropriateness were identified by focus group participants. Although the study was exploratory and the sample size small, it provides useful cultural knowledge and information for community health and gerontological nurses. Knowledge about older Latino adults' perceptions of motivators and barriers to physical activity and exercise is a necessary first step for nurses to prescribe activities that will help improve functional independence and quality of life. Nurses can serve as links for older Latino adults in accessing community resources. Sociocultural factors that influence Latino adult perceptions must be assessed if health promotion program planning is to be tailored to meet individual and group needs.

Aged↗
PubMed1999

Gender differences in physical activity and physical fitness in young children in Crete.

BACKGROUND: To assess physical activity and physiological fitness parameters among six year old children and to determine whether there were any significant gender differences. METHODS DESIGN & SETTING: comparative study of a representative sample of boys and girls in school and at home. PARTICIPANTS: 569 children (305 boys and 264 girls) selected randomly from a total of 6153 registered in the 1st grade in 1992 on the island of Crete. MEASURES: assessment of physical activity was based on observational methods involving teachers and parents. Cardiorespiratory fitness was estimated by performance on the 20 meter Shuttle Run Test (20mSRT). BMI, skinfold thickness, Midarm Muscle Circumference (MMC) and hemoglobin were also measured. RESULTS: Both sexes were found to spend a very small proportion of their leisure time in Moderate to Vigorous Physical Activities (MVPA). More boys engaged in MVPA than girls at school and at home, but more girls were involved in physical activity-related lessons and classes out of school. Among the physiological fitness parameters, significant gender differences were found only for MMC. No significant gender difference was found in performance on the 20mSRT. CONCLUSIONS: The results indicate that in this culture stereotypic sex preferences in physical activity begin at a very young age, and that this differentiation cannot be attributed to gender differences in cardiorespiratory fitness. The social, environmental and possibly psychological parameters involved have implications for Health Educators and Physical Education Instructors in the appropriate targeting of physical activity promotion programs among young children.

Anthropometry↗
PubMed1993

[Physical activity or physical fitness as a predictor of ischemic heart disease? 17 years' incidence in The Copenhagen Male Study].

Physical activity in leisure time and physical fitness are strongly correlated, and both are inversely correlated to risk of ischaemic heart disease (IHD). Does it mean, however, that a very fit man has a lower risk of IHD, even if he is inactive? And does it also mean that an unfit, but active man, does not have a lower risk of IHD than an unfit sedentary man? In The Copenhagen Male Study we studied the joint effect of physical activity in leisure time and physical fitness. In 1970/71 4,999 men free from IHD aged 40-59 years were classified according to level of physical activity, and to level of physical fitness, ie indirectly measured maximal oxygen uptake, and their mortality was recorded over the next 17 years. In sedentary men, fitness was no predictor of risk of death from IHD. Age-adjusted baseline values were similar in later IHD cases and survivors: 32.3 versus 32.1 ml O2 x kg-1 x min-1, p = 0.91. In medium and highly active men, however, fitness was a strong predictor. The corresponding fitness values were: 33.1 versus 34.8 ml O2 x kg-1 x min-1, p < 0.001. The least fit physically active men had a lower IHD mortality rate (6%) than the least fit sedentary men (10%). Adjusted for age, social class, and smoking in a multiple logistic regression equation, this was estimated to a RR(95% C.I.) of RR = 1.7 (1.1-2.6), p = 0.03.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Changes of physical performance as indicators of the response to enhanced physical education.

The value of field performance tests in the assessment of a programme of enhanced physical education has been examined in a 3-factor study of students over all 6 primary school grades. The enhanced programme under review offered a one hour of required physical education daily from age 7 to 12 years, taught by a specialist physical educator. Control students from immediately preceding and succeeding classes continued with the standard programme, a standard single period of physical education per week taught by a nonspecialist. Subjects were classed by gender, environment (urban vs rural school) and the experimental intervention to allow analysis by MANOVA. Students in the experimental programme showed small but statistically significant gains in laboratory measures of aerobic power and muscle strength relative to controls. In general, these responses were mirrored by gains in scores on the Canadian Association for Health Physical Education and Recreation (CAHPER) field performance test battery. The latter tests also suggested gains of anaerobic power, coordination and muscular endurance. It is concluded that an enhanced programme of physical education can enhance function in primary school students, but the size of gains is not a strong argument for such programmes. Further, gains in performance test scores indicate the direction, but not necessarily the magnitude of programme responses.

Anaerobic Threshold↗
PubMed1999

Relationship between attitudes to health, body weight and physical activity and level of physical activity in a nationally representative sample in the European Union.

OBJECTIVE: To explore the factors that influence attitudes and beliefs about the effects of body weight and physical activity on health. DESIGN: Cross-sectional survey using a face-to-face interview-assisted questionnaire. SETTING: The survey was conducted between March and April 1997 in the 15 member states of the EU. SUBJECTS: Approximately 1000 adults aged 15 years plus from each country were selected by quota-controlled sampling; the total sample was of 15,239 persons (7162 males and 8077 females). Data were weighted by population size for each country and by age, gender and regional distribution within countries. RESULTS: Overall 27% of men and 35% of women reported not engaging in any form of recreational activity; rates were highest in those with a primary-level education (37% men, 43% women) compared with tertiary-level education (20% men, 25% women). Recreational activity levels declined with age and tended to be lowest in those who were more physically active at work. Eighteen per cent of respondents believed that physical activity was one of the two greatest influences on health; 13% mentioned body weight, 38% mentioned food, 41% mentioned smoking and 33% mentioned stress. Logistic regression was used to assess for the effects of gender, age, educational level, body mass index (BMI), smoking status, activity level and country on beliefs that body weight and physical activity influenced health. Primary-educated, overweight, ex- and non-smoking women were most likely to mention body weight as an influence; young tertiary-educated, thinner, non-smoking and active males were most likely to mention physical activity. There was wide variation across Europe in reported behaviour and beliefs, which persisted after taking account of all of the other factors in the regression model. CONCLUSIONS: Relatively few people in some countries believed body weight and physical activity were important influences on health. Many people mentioned stress and it might be possible to use this interest to motivate changes in physical activity to relieve stress. It may be important to take a more integrated approach to activity patterns that consider the role of work and recreation. Although social and demographic factors were important, after adjusting for these factors there was still wide between-country variation in reported attitudes, beliefs and behaviour. This will need to be taken into account in any activity promotion campaigns.

Adolescent↗
PubMed2006

Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls.

The authors tested whether physical self-concept and self-esteem would mediate cross-sectional relations of physical activity and sport participation with depression symptoms among 1,250 girls in 12th grade. There was a strong positive relation between global physical self-concept and self-esteem and a moderate inverse relation between self-esteem and depression symptoms. Physical activity and sport participation each had an indirect, positive relation with global physical self-concept that was independent of objective measures of cardiorespiratory fitness and body fatness. These correlational findings provide initial evidence suggesting that physical activity and sport participation might reduce depression risk among adolescent girls by unique, positive influences on physical self-concept that operate independently of fitness, body mass index, and perceptions of sports competence, body fat, and appearance.

Adolescent↗
PubMed2002

Use of health-care services, work absenteeism, leisure-time physical activity, musculoskeletal symptoms and physical performance after vocationally oriented medical rehabilitation-description of the courses and a one-and-a-half-year follow-up study with farmers, loggers, police officers and hairdressers.

The aim of this study was to evaluate the effectiveness of vocationally oriented medical rehabilitation (VOMR) carried out in institutions with regard to the use of health-care services, work absenteeism, leisure-time physical activity, musculoskeletal symptoms and physical performance during 112 years of follow-up. The prospective cohort study consisted of 265 patients from four different occupational groups (loggers, hairdressers, police officers and female farmers) who took part in VOMR courses in three inhouse phases, financed by the Finnish Social Insurance Institution, and who had chronic musculoskeletal symptoms in their back and neck. The subjective physical and mental strain of work, subjective neck-shoulder and low-back pain, use of health-care services and leisure-time physical activity were assessed with a questionnaires. The muscle strength of the upper and lower extremities and trunk was determined and maximal VO2 was measured using the direct maximal bicycle ergometer test. The subjective physical and mental strain of work, subjective neck-shoulder and low-back pain and physical performance showed positive significant development and improvement. The changes in the use of health-care services and work absenteeism were minor or insignificant. The general finding was that the results from the second phase of the VOMR courses did not differ from those of the third phase. VOMR courses had a beneficial effect on physical performance and subjective pain caused by neck and back musculoskeletal diseases of farmers, loggers, police officers and hairdressers within 112 years of follow-up, but VOMR courses did not decreased the use of health-care services.

Adult↗
PubMed1999

Physical activity patterns of African-American women with physical disabilities.

UNLABELLED: There is a dearth of research on the exercise and activity patterns of persons with disabilities, particularly minority women with disabilities. This lack of information makes it difficult for public health officials to set policy guidelines for this segment of the population. PURPOSE: The purpose of this study was to survey the exercise and activity patterns of African-American women with severe physical disabilities (N = 50). METHODS: The Physical Activity and Disability Survey (PADS) was created for subjects who have a severe limitation in movement and function (e.g., limited ability to stand or walk, needs an assistive aid to ambulate, needs assistance with activities of daily living). Reliability data were obtained on the PADS for interrater, test-retest, and internal consistency on the two subscales (Exercise and Activity). The Exercise subscale had an interrater reliability of 0.83 and test/retest reliability of 0.85. The Activity subscale had an interrater reliability of 0.68 and test/retest reliability of 0.66. Cronbach's alpha for internal consistency was 0.78 for the Exercise subscale and 0.68 for the Activity subscale. RESULTS: Results showed very low levels of exercise and general activity patterns in African-American women with physical disabilities. Only 8.2% of the sample participated in leisure-time physical activity, and only 10% engaged in aerobic exercise three or more days per week for at least 15 min. Unstructured physical activity (e.g., work-related activity, housework, gardening, shopping) was nearly absent. CONCLUSION: Our data suggest that the extremely low levels of self-reported physical activity in African-American women with severe physical disabilities expose them to a higher risk of secondary health conditions.

Activities of Daily Living↗
PubMed1996

Physical activity pattern in men and women at the ages of 16 and 34 and development of physical activity from adolescence to adulthood.

The aim of this study was to investigate gender-related differences in physical activity patterns at the ages of 16 and 34 and to analyse those factors that might contribute to an explanation of physical activity habits in adulthood. A randomly selected group, consisting of 220 boys and 205 girls, was tested in 1974 and reinvestigated in 1992 by means of a questionnaire. Eighty-eight per cent participated in the reinvestigation. At the age of 16 more boys (69%) than girls (51%) participated in some sports activity in their leisure time. The results showed an overall decrease in participation in vigorous physical activity, although participation in light physical activity remained relatively constant. At the age of 34, there was no difference in overall physical activity between men and women, but the men exercised more vigorously (44% vs. 29%). Early experience of physical activity at the age of 16 decreased the risk of becoming inactive in adulthood. At the age of 34 cohabiting for the men, and having children and high socio-economic class for the women, increased the risk of being physically inactive in adulthood, whereas positive beliefs about health effects of exercise decreased the risk for both men and women.

Adolescent↗
PubMed1983

Toward a physical approach to integrative physiology. I. Brain dynamics and physical causality.

This report treats the fundamental question raised by Yates [Am. J. Physiol. 238 (Regulatory Integrative Comp. Physiol. 7): R277-R290, 1980.]: "Why should neuroscience look to physics for its theories?" This is the viewpoint of an experimentalist who needs a physical approach to brain theories to interpret the results of physically oriented experiments on electroencephalogram and evoked potentials. The fundamental physical theories are briefly outlined; the phenomena of enhancement of brain potentials, frequency stabilization effects, and phase-resetting phenomena of populations of neurons in the brain are explained. The results of experiments are interpreted in the light of a variety of physical theories: coupled oscillators, induced magnetization, laser physics, and synergetics. Further, analogies with nonlinear mechanics, theory of dissipative structures, and the S-matrix formalism of quantum mechanics are provided to predict the brain's excitability. The homeokinetic approach of Iberall, the electromagnetic theory of Adey, and the quantumlike theories of Walter are discussed. It is concluded that brain scientists need an ensemble of physical approaches and concepts to understand various brain mechanisms.

Animals↗
PubMed2003

Established and recently identified coronary heart disease risk factors in young people: the influence of physical activity and physical fitness.

Epidemiological studies have identified several risk factors for coronary heart disease (CHD), many of which are present in young people. [For the purpose of this review, the phrase "young people" embraces both children and adolescents.] One such risk factor is hypertension. In adults, exercise is thought to have a positive effect on blood pressure levels; however, findings are inconclusive for young people. Despite its association with CHD, obesity is on the increase in Western society's young population; prevention and intervention during early years is needed. An active lifestyle is considered to have a beneficial effect on body fatness. Lipoprotein profiles are directly associated with CHD status. In adults, there is some evidence that physical activity and/or fitness have a favourable effect on lipoprotein levels. Although information regarding the younger population is more ambiguous, it tends to concur with these findings. High levels of lipoprotein(a), are considered an independent risk factor for CHD. Relatively little has been written on young people, although some studies have postulated a favourable relationship with physical activity. An inverse relationship between aerobic fitness and CHD has been confirmed in adults; an association is not as easily verified for young people. Physical activity is similarly deemed to have a beneficial effect on health status. A high-fat diet has been linked to CHD in adults, and evidence to date reports similar findings for young people. Smoking increases the risk of CHD and even moderate smoking during youth could have damaging long-term consequences. There is some evidence that smoking is related to physical activity and fitness levels in young people. In adults, high levels of homocyst(e)ine have been associated with CHD. As yet, little has been written on the relationship between physical activity or physical fitness and homocysteine status in young people. High levels of plasma fibrinogen have been linked to CHD. Several studies have explored the relationship between plasma fibrinogen and physical activity and/or fitness in adults, but findings are inconclusive; for young people, the ambiguity is even greater. C-reactive protein is a molecular marker for CHD but, to date, little attention has been given to this aspect, especially amongst young people. The link between high levels of plasminogen activator inhibitor-1 and CHD has been confirmed, although the essence of this relationship is not established. There is a paucity of data on the younger population and the relevance of collating such information is questionable. For the younger population, most research is limited to the established CHD risk factors and further investigations of recently identified CHD risk factors are needed.

Adolescent↗