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PubMed1999

Physical activity, physical fitness, and coronary heart disease risk factors in youth: the Québec Family Study.

OBJECTIVE: The relationships between physical activity, fitness, and CHD risk factors were investigated in 342 males and 268 females 9-18 years of age. METHODS: Daily energy expenditure, moderate to vigorous physical activity, inactivity, and television viewing time were estimated. Indicators of physical fitness included submaximal work capacity, quadriceps muscle strength, sit-ups, and the sum of six skinfolds. Risk factors included mean arterial blood pressure and fasting blood levels of triglycerides, LDL-cholesterol, HDL-cholesterol, and glucose. RESULTS: Canonical correlations between activity and risk factor profiles range from 0.22 to 0.45, while those between fitness and risk factor profiles range from 0.34 to 0.55, indicating that 5 to 20% and 11 to 30% of the variance in the risk profile is explained by activity and fitness, respectively. CONCLUSION: The results suggest that both physical fitness and level of habitual physical activity are strongly associated with CHD risk factors in this sample of youth.

Adolescent↗
PubMed2006

The physical inactivity matrix: lessons from the classification of physical inactivity interventions.

Physical inactivity (PI), a leading modifiable cause of disease and injury, is endemic in industrialised nations. Although considerable research has been undertaken in this field, we lack a system to synthesise the research literature to inform policy and identify research needs. The aims of this study were to (1) develop a system to classify physical inactivity intervention studies, (2) examine the distribution of PI interventions published in the peer-reviewed health literature using the system, and (3) consider implications for future research. We developed the Physical Inactivity Matrix (PIM), with 12 intervention points, created by the intersection of two dimensions: the intervention target (individual, physical environment and social/cultural environment) and the activity focus (transport, work/school, leisure and consumer). A formal search of the health research literature identified 529 eligible studies and each was classified into one of the 12 cells of the PIM. Most studies were categorised as: individual-leisure (68%), individual-work/school (12%) or social/cultural environment-leisure (13%). Only 4% targeted the physical environment. The findings of this initial application of the PIM support the call for greater investment in policies, interventions and research that focus on the relationship between the environment and PI, and transportation in particular. There would be merit in establishing the inter-rater reliability of the PIM and applying it to a wider variety of studies, including those published in the transportation and urban planning literatures. The PIM could be a useful tool for monitoring trends in research directions and funding levels over time and across countries.

Classification↗
PubMed2006

Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews.

BACKGROUND: A range of physical therapies (including airway clearance and physical training) are used in cystic fibrosis (CF). The aim of this paper is to summarise the main findings from Cochrane systematic reviews that have considered the evidence for physical therapies in CF. METHODS: All outcomes reported in relevant Cochrane systematic reviews are summarised. RESULTS: Review 1 provides some evidence from short-term trials of the benefit of airway clearance over no airway clearance in improved mucus transport but no definitive evidence from long-term trials to support the efficacy of airway clearance over no airway clearance; review 2 provides some evidence that conventional chest physiotherapy (CCPT) is at least as effective as other forms of airway clearance, but that patients may have a preference for self-administered treatments over CCPT; review 3 provides some evidence that positive expiratory pressure (PEP) is at least as effective as other forms of airway clearance; review 4 provides some evidence to support the use of non-invasive ventilation during airway clearance in patients with moderate to severe disease who have difficulty clearing sputum; review 5 provides some evidence of the benefits of different types of physical training. CONCLUSION: The Cochrane systematic reviews summarised in this paper provide some evidence to support the inclusion of physical therapies in the care-management plan of CF. They also provide information to steer the direction and focus of future research in this area.

Body Weight↗
PubMed1999

The role of physical therapy in improving physical functioning of renal patients.

Although not traditionally a part of the dialysis team, physical therapists can play an important role in improving the quality of life for dialysis patients. Physical therapists are trained to evaluate the presence of a functional problem such as back pain, muscle weakness, limited range of motion, balance disorder, alteration in gait, joint pain, neuropathic pain, sensory disturbance, loss of functional mobility, or alteration in posture. Many of these conditions are prevalent in the dialysis population. This article describes how a patient is referred to physical therapy, and once referred, how the patient is evaluated and treated, including goal setting and progression. It is thought that early referral of dialysis patients to physical therapy may prevent some of the functional deterioration typically seen in this population. The incorporation of physical therapy as part of the routine treatment plan may help dialysis staff to address many of the regular nonspecific complaints of fatigue, malaise, pain, and discomfort commonly experienced by dialysis patients.

Exercise Tolerance↗
PubMed2006

Causal ordering of physical self-concept and exercise behavior: reciprocal effects model and the influence of physical education teachers.

Does prior physical self-concept influence subsequent exercise behavior? On the basis of a large sample of physical education classes (2,786 students, 200 classes, 67 teachers) collected early (Time 1) and late (Time 2) in the school year, findings support a reciprocal effects model in which prior physical self-concept and exercise behavior both influence subsequent physical self-concept and exercise behavior. Whereas variables from the theory of planned behavior (TOPB; behavioral intentions, perceived behavioral control, exercise attitudes) also contributed to the prediction of subsequent exercise behavior, the effect of prior physical self-concept was significant for subsequent outcomes after controlling these variables, suggesting that the TOPB should be supplemented with self-concept measures. On the basis of multilevel models, there were systematic differences in these variables for students taught by different teachers that generalized over time and across different classes taught by the same teacher. Support for the reciprocal effects model was robust.

Adolescent↗
PubMed1996

Tracking of physical activity and physical fitness across the lifespan.

Although different indicators of physical activity and different methods of analysis are used, it appears that physical activity tracks at low to moderate levels during adolescence, from adolescence into adulthood, and across various ages in adulthood. Tracking of inactivity is less often studied. Measures of performance- and health-related physical fitness (strength, flexibility, motor fitness, aerobic power) track significantly across childhood and adolescence, but correlations are low to moderate. Limited data that span adolescence into adulthood indicate somewhat higher interage correlations for flexibility, static strength, and power. Data for different periods in adulthood are not available. Presently, it is common to criticize focus on motor and sport skills in physical education and competitive sports as contrary to health and fitness goals (e.g., James, 1995; Livingstone, 1994; Simons-Morton et al., 1988). There is a need, however, to distinguish between youth or community sports and highly specialized sport for the elite. Sports activities, be they competitive or recreational, are probably the major form of physical activity during childhood and adolescence, and perhaps in young adulthood. Though low to moderate, the tracking of various activity indicators, most of which include sport participation, suggests that sport activities during childhood and youth may form the foundation for activity habits in the future.

Age Factors↗
PubMed1998

Physical leisure activity level and physical fitness among women with fibromyalgia.

To determine selfreported physical leisure activity level and physical fitness in women with fibromyalgia we sent questionnaires to the female members of a local fibromyalgia association and the same questionnaire to the women in a population based cohort study. The fibromyalgia patients had higher physical leisure activity level, but lower physical fitness than the women in the population survey. The difference in physical leisure activity persisted even after controlling for a series of possible confounders, including employment status and work load in a logistic regression analysis.

Adult↗
PubMed2004

Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations.

Under a contract from the US Department of Health and Human Services, a multidisciplinary expert panel was appointed to review "the scientific literature regarding macronutrients and energy and develop estimates of daily intake that are compatible with good nutrition throughout the life span and that may decrease the risk of chronic disease." Within the overall context of the charge, the panel sought to quantify rates and components of daily energy expenditure in healthy adults with body mass indexes (in kg/m(2)) of 18.5-25, in growing children (in the 5th-85th percentiles of weight-for-length), and in pregnant and lactating women. The recommendation for adults became the daily energy intake necessary to cover total daily energy expenditure (TEE). For special cases, dietary macronutrients and energy to support child growth and pregnancy and lactation by women were considered. TEE was based on the results of doubly labeled water studies, and the TEE results were presented in units of physical activity level (PAL = TEE/BEE) and DeltaPAL, where BEE is the basal rate of energy expenditure extrapolated to 24 h. Most adults (66%) maintaining a BMI in the healthful range had PAL values >1.6, or the equivalent of > or =60 min of physical activity of moderate intensity each day. Hence, on the basis of the doubly labeled water data and the results of epidemiologic studies, the physical activity recommendation for adults was judged to be 60 min/d. The recommendation for children was for a minimum of 60 min/d. In conclusion, dietary and physical activity recommendations for healthful living are inextricably intertwined. Adequate physical activity provides protection against chronic diseases and helps to balance energy expenditure and intake.

Activities of Daily Living↗
PubMed2003

Habitual walking and its correlation to better physical function: implications for prevention of physical disability in older persons.

BACKGROUND: Our objective was to determine the association between participation in habitual physical activity (including walking, shopping, and indoor and outdoor activities) and leisure-time or sports activities on physical performance and fitness in older persons. METHODS: In an observational study, 123 predominantly ethnic Chinese participants aged 50 years and older were recruited from a health promotion program. Main outcome measures were bioelectric impedance for body fat composition, peak oxygen consumption (VO(2)max), gait speed, handgrip strength, and chair rise time. RESULTS: The mean age of participants was years. Those with a higher self-reported walking level had a better VO(2)max; every 1 minute per day increase in habitual walking increases VO(2)max by 0.096 (ml/kg)/min (95% confidence interval [CI] 0.027-0.165, p=.007) and is possibly associated with a faster gait speed; (95% CI 0.000-0.005, p=.078). There is an age-related rise in body fat composition, decline in VO(2)max, and slower chair rise time. Men had a lower body fat composition, better VO(2)max, and stronger handgrip. CONCLUSIONS: Habitual walking may impart important health benefits in terms of improvement in physical performance, fitness, and its implications for the prevention of physical disability in older adults. This also reinforces the theory that low- to moderate-intensity activities may improve cardiorespiratory fitness. There is an inevitable physiological age-related decline in physical fitness.

Aged↗
PubMed1990

An objective measure of physical function of elderly outpatients. The Physical Performance Test.

Direct observation of physical function has the advantage of providing an objective, quantifiable measure of functional capabilities. We have developed the Physical Performance Test (PPT), which assesses multiple domains of physical function using observed performance of tasks that simulate activities of daily living of various degrees of difficulty. Two versions are presented: a nine-item scale that includes writing a sentence, simulated eating, turning 360 degrees, putting on and removing a jacket, lifting a book and putting it on a shelf, picking up a penny from the floor, a 50-foot walk test, and climbing stairs (scored as two items); and a seven-item scale that does not include stairs. The PPT can be completed in less than 10 minutes and requires only a few simple props. We then tested the validity of PPT using 183 subjects (mean age, 79 years) in six settings including four clinical practices (one of Parkinson's disease patients), a board-and-care home, and a senior citizens' apartment. The PPT was reliable (Cronbach's alpha = 0.87 and 0.79, interrater reliability = 0.99 and 0.93 for the nine-item and seven-item tests, respectively) and demonstrated concurrent validity with self-reported measures of physical function. Scores on the PPT for both scales were highly correlated (.50 to .80) with modified Rosow-Breslau, Instrumental and Basic Activities of Daily Living scales, and Tinetti gait score. Scores on the PPT were more moderately correlated with self-reported health status, cognitive status, and mental health (.24 to .47), and negatively with age (-.24 and -.18). Thus, the PPT also demonstrated construct validity. The PPT is a promising objective measurement of physical function, but its clinical and research value for screening, monitoring, and prediction will have to be determined.

Activities of Daily Living↗
PubMed1995

Physical activity and physical fitness as protection against premature disease or death.

It is known from prospective studies that the incidence of coronary heart disease (CHD) is lower in the physically active compared with the sedentary part of the population, and the rate of CHD is lower with higher fitness level. In studies where both physical activity (PA) and fitness are assessed, only fitness, and not PA, appear to be an independent predictor of mortality from CHD. It is unclear whether other fitness components than maximal oxygen uptake (Vo2max) have a beneficial effect on the rate of CHD. Further, it seems likely that there is an upper threshold of fitness (Vo2max) above which no further improvement in risk factors for CHD is found. However, most middle-aged people have fitness levels below this threshold. There is no doubt that the middle-aged sedentary person benefits from physical activity regardless of type and intensity, and it may be easier to motivate a sedentary person to carry out moderate physical activity. However, it is likely that the best effect is achieved by performing physical activity of a type and intensity sufficient to improve the fitness level. Still, recommendations of type, frequency, duration and intensity are matters of debate.

Coronary Disease↗
PubMed1997

Injury proneness in infantry conscripts undergoing a physical training programme: smokeless tobacco use, higher age, and low levels of physical fitness are risk factors.

Musculoskeletal injuries represent an adverse event of strenuous physical activity. The aim of the present study was to identify pretraining factors that may predispose to such injuries. Risks of injury according to age, body composition, previous physical activity, physical fitness, use of smokeless tobacco (moist snuff) and smoking habits were determined in a population of 480 male conscripts in the army. Data were obtained by questionnaire, height and weight measurements, and from a 3000-metre run test prior to a 10-week period of basic military and physical training. Injuries were registered by doctors attached to the training camp. Every fourth conscript sustained one or more musculoskeletal injuries during the training period. Low back pain, overuse knee injuries, Achilles tendinitis, and sprains of joint capsules or ligaments were the most frequent diagnosis groups. Subjects aged 22 years and more, the least active persons before call-up, those who thought they were less fit than the average, the slowest one-third in the 3000-metre run test, smokers of more than 10 cigarettes a day, and snuff-takers suffered more injuries according to univariate analyses. Multiple logistic regression analysis showed that age, self-assessed physical fitness and snuff-taking were mutually independent risk factors of high statistical significance.

Accident Proneness↗
PubMed1992

The Tromsø study: physical fitness, self reported physical activity, and their relationship to other coronary risk factors.

STUDY OBJECTIVE: The aim was to investigate the associations between physical fitness, leisure physical activity, and coronary risk factors. DESIGN: This was a cross sectional study of a random sample of men and women, following a population survey. SETTING: The municipality of Tromsø, Norway in 1986-1987. PARTICIPANTS: All men born 1925-1966 and all women born 1930-1966 were invited to the survey; 21,826 subjects attended (81% of the eligible population): of these, 297 men and 312 women, randomly selected, attended the present study (attendance rates 94% in men and 89% in women). MEASUREMENTS AND MAIN RESULTS: Fitness was tested by bicycle ergometry. Physical activity was reported on a questionnaire. Multiple regression analysis was performed with fitness and leisure activity as dependent variables, and coronary risk factors as independent variables. Fitness and leisure activity were positively related (p less than 0.05). Prominent findings for fitness were negative associations with age and smoking (p less than 0.05), and positive associations with body mass index in both sexes (p less than 0.01). HDL cholesterol and systolic blood pressure were significant predictors of fitness in men (p less than 0.01). Smoking emerged as a strong negative predictor for leisure activity in women (p less than 0.01), and a negative relation between leisure activity and total cholesterol was found in men (p less than 0.01). CONCLUSIONS: The study indicates that coronary risk factors are more closely linked to physical fitness than to leisure physical activity.

Adult↗
PubMed1998

Developmental changes in energy expenditure and physical activity in children: evidence for a decline in physical activity in girls before puberty.

OBJECTIVE: To examine individual changes in energy expenditure and physical activity during prepubertal growth in boys and girls. METHODS: Total energy expenditure (TEE), resting energy expenditure, physical activity-related energy expenditure, reported physical activity, and fat and fat-free mass were measured three times over 5 years in 11 boys (5.3 +/- 0.9 years at baseline) and 11 girls (5.5 +/- 0.9 years at baseline). RESULTS: Four-year increases in fat ( approximately 6 kg) and fat-free mass ( approximately 10 kg) and resting energy expenditure ( approximately 200 kcal/day) were similar in boys and girls. In boys, TEE increased at each measurement year, whereas in girls, there was an initial increase from age 5.5 (1365 +/- 330 kcal/day) to age 6.5 (1815 +/- 392 kcal/day); however, by age 9.5, TEE was reduced significantly (1608 +/- 284 kcal/day) with no change in energy intake. The gender difference in TEE changes over time was explained by a 50% reduction in physical activity (kcal/day and hours/week) in girls between the ages of 6.5 and 9.5. CONCLUSIONS: These data suggest a gender dimorphism in the developmental changes in energy expenditure before adolescence, with a conservation of energy use in girls achieved through a marked reduction in physical activity.

Basal Metabolism↗
PubMed2002

Physical activity and health-related physical fitness in Taiwanese adolescents.

The relationship between physical activity and health-related physical fitness was evaluated in 282 Taiwanese adolescents 12-14 years of age. The subjects were randomly selected from the 7th, 8th and 9th grades in two junior high schools in Taiwan. Physical activity was estimated as total daily energy expenditure and energy expenditure in moderate-to-vigorous physical activity from 24-hour activity records for three days, two week days and one weekend day. Health-related fitness was assessed as the one-mile run (cardiorespiratory endurance), timed sit-ups (abdominal strength and endurance), sit-and-reach (lower back flexibility), and subcutaneous fatness (sum of the triceps, subscapular, suprailiac, and medial calf skinfolds). Physical activity is significantly and positively correlated with one-mile run performance and the sit-and-reach, but not with sit-ups and subcutaneous fatness. Overall, the strength of the relationships between estimated energy expenditure and specific fitness items in the total sample vary from low to moderate, with only 1% to 12% of the variance in fitness variables being explained by estimated energy expenditure. Comparisons of active versus inactive, and fit versus unfit adolescents provide additional insights. The more active (highest quartile) are also more fit in cardiorespiratory endurance and in the sit-and-reach than the less active (lowest quartile), and the more fit in the one-mile run (better time, lowest quartile) and the sit-and-reach (highest quartile) are more active than the less fit in each item, respectively.

Adolescent↗
PubMed2003

Relations among physical activity, physical fitness, and self-perceived fitness in Hong Kong adolescents.

The relationships between physical fitness, activity, and self-perceived fitness in adolescents in Hong Kong were investigated. Regular physical activity patterns, self-perceptions of fitness, and health-related physical fitness were measured in 201 secondary school students (M age = 13.8 yr.). The battery of fitness tests measured cardiovascular capacity, flexibility, muscular strength, muscular endurance, and body fat composition. The boys had a higher self-perception of their own fitness and exercised more outside school than the girls. Participation in physical activity was related to cardiovascular capacity, muscular strength, and body composition. Linear regression analysis indicated that exercise activity and body composition explained a portion of variance in the subjects' self-perceived fitness. These findings highlight the connections between physical activity, fitness, and self-perception of fitness and consequently the need for understanding the concept for better health-promotion strategies.

Adolescent↗
PubMedDate not supplied

American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity.

The American Cancer Society (ACS) has set aggressive challenge goals for the nation to decrease cancer incidence and mortality--and to improve the quality of life of cancer survivors--by the year 2015. To address these critical goals, the ACS publishes the Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These guidelines, published every five years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The American Cancer Society guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices for nutrition and physical activity to reduce cancer risk. This recommendation for community action underscores just how important community measures are to the support of healthy behaviors by means of increasing access to healthful food choices and opportunities to be physically active. The ACS guidelines are consistent with guidelines from the American Heart Association for the prevention of coronary heart disease as well as for general health promotion, as defined by the Department of Health and Human Services' 2000 Dietary Guidelines for Americans.

Alcohol Drinking↗
PubMed2001

Changes in attitudes and perceptions about research in physical therapy among professional physical therapist students and new graduates.

BACKGROUND AND PURPOSE: The physical therapy profession, through its published educational accreditation standards and its normative model of professional education, has addressed the importance of educating physical therapist students in the basic principles and application of research. The purpose of this study was to conduct a longitudinal study of students relative to (1) their perception of knowledge with respect to research, (2) their perception of what source should be used (evidence-based practice or traditional protocols) for clinical decision making, and (3) their perception of what should be used in a clinical setting for patient management. SUBJECTS: Thirty-six students during the final year of their professional program from a sample of 115 physical therapist students who requested 2 consecutive physical therapist classes completed the entire sequence of pretest and posttest survey administrations. Seventy-nine students did not complete the entire sequence. METHODS: A 10-item 5-point Likert-type questionnaire was designed by the authors to probe the students' attitudes and perceptions about research, their level of comfort and confidence in reading and applying research findings published in the literature, and their personal habits regarding reading the professional literature. An expert panel consisting of internal and external reviewers was used for construction of the questionnaire. The questionnaire was completed by the students immediately preceding their research methods course, immediately after the completion of that course, and following the second research course, which included statistics and development of a research proposal. The subjects also completed the questionnaire after 1 year of physical therapy practice. Friedman's analysis of variance was used as an omnibus test to detect differences across time. In addition, a follow-up analysis using the Wilcoxon signed-rank procedure to examine differences between baseline data and data obtained during each follow-up was done for all items to determine whether a difference occurred at a time other than at the final posttest survey administration. RESULTS: The students showed differences on 5 of the 10 items on the questionnaire during the study. DISCUSSION AND CONCLUSION: These items related to reading peer-reviewed professional journals, critically reading professional literature, relevance and importance of evidence-based clinical practice, and level of comfort with knowledge in research.

Adult↗