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PubMed2002

Effectiveness of physical activity programs at worksites with respect to work-related outcomes.

This paper systematically reviews the literature on the effectiveness of physical activity programs at worksites with respect to work-related outcomes. A computerized literature search, a reference search, and a manual search of personal databases were performed using the following inclusion criteria: randomized controlled or controlled trial, working population. worksite intervention program to promote physical activity or physical fitness, and work-related outcomes. The study quality was evaluated using nine methodological criteria. Conclusions were based on a 5-level rating system of evidence. Eight studies (4 randomized controlled trials and 4 controlled trials) were identified, but their methodological quality was generally poor. The outcomes were absenteeism, job satisfaction, job stress, productivity, and employee turnover. The evidence of an effect was limited for absenteeism, inconclusive for job satisfaction, job stress and employee turnover, and nil for productivity. The scientific evidence on the effectiveness of physical activity programs at worksites is still limited. Because of the few high-quality randomized controlled trials, it is strongly suggested that this type of study be carried out. Future randomized controlled trials should pay special attention to the description of randomization, inclusion criteria, compliance, and analyses according to intention to treat.

Absenteeism↗
PubMed2005

Best practices for physical activity programs and behavior counseling in older adult populations.

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The article identifies key practices for promoting physical activity in older adults, with a focus on those with chronic disease or low fitness and those with low levels of physical activity. Key practices identified: (a) A multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement enhance adherence; (c) manage risk by beginning at low intensity but gradually increasing to moderate physical activity, which has a better risk:benefit ratio and should be the goal for older adults; (d) an emergency procedure plan is prudent for community-based programs; and (e) monitoring aerobic intensity is important for progression and motivation. Selected content review of physical activity programming from major organizations and institutions is provided.

Aged↗
PubMed2004

Identification of a TLR4- and TRIF-dependent activation program of dendritic cells.

Dendritic cell activation by Toll-like receptors (TLR) is crucial for the generation of protective immune responses. In addition to the common myeloid differentiation factor 88 (MyD88)-dependent signaling pathway, TLR4 engages the adaptor protein Toll/IL-1 receptor (TIR)-domain-containing adaptor inducing IFN-beta (TRIF), leading to interferon regulatory factor 3 (IRF-3) activation and type I interferon production. Using microarray expression profiling we now identify TRIF as a major regulator of the TLR4-triggered activation program of dendritic cells. We show that the expression of 47% of the genes that are responsive to TLR4 stimulation in wild-type dendritic cells is significantly altered in cells carrying a loss-of-function mutation of TRIF. Specifically, expression of IL-12, IL-18, and IL-23 was impaired in the absence of functional TRIF, suggesting that TLR4-promoted Th1 responses are TRIF-dependent. Furthermore, we provide evidence that TRIF regulates TLR4-mediated gene expression both by type I IFN-dependent and -independent mechanisms. Whereas dendritic cell production of CXCL10 and CCL12 was dependent on both TRIF and the type I interferon receptor, expression of IL-6 required TRIF but not type I interferon activity. Functional TRIF was also required for the normal induction of numerous genes considered important for host defense against diverse pathogens.Together, these data therefore identify TRIF as a crucial regulator of TLR4-dependent dendritic cell responses.

Adaptor Proteins, Vesicular Transport↗
PubMed1995

Predictors of nursing home residents' participation in activity programs.

Nursing homes are mandated by the Omnibus Budget Reconciliation Act (OBRA) to provide activity programs (U.S. Congress, 1987). Little information exists, however, as to residents' participation in activity programs. Using data from a Health Care Financing Administration project, the present study examines the relationship between resident characteristics and time participating in activities. Among 2,672 nursing home residents we found measures of resource use, cognitive abilities, depression, sense of initiative/involvement, activity repertoire, location preferences, and gender all to be significant in explaining the amount of activity time.

Aged↗
PubMedDate not supplied

Physical activity programs offered in substance abuse treatment facilities.

Responses from 50 practicing therapeutic recreation specialists indicate that physical activity programs are an important part of substance abuse treatment. Walking, games, sports, weight training, and aerobics were offered most frequently. Respondents expressed concern about their academic preparation in physical activities and offered suggestions for curricular revision. Recreation or activity therapists responding to this survey indicated that additional coursework would have prepared them more thoroughly to facilitate physical activity programs. Coursework suggested included: physical education, exercise programming, aerobics, aquatics, and physical assessment. Data indicated that over half the respondents received specialized training in physical activities after graduation through continuing education.

Adult↗
PubMed2003

Reducing fear of falling in seniors through education and activity programs: a randomized trial.

OBJECTIVES: To determine the relative effect of education and activity programs on fear of falling, balance, strength, and health status. DESIGN: A randomized intervention trial with two groups (education and activity); evaluators were blind to group allocation. SETTING: Motor performance laboratory at Queen's University. PARTICIPANTS: Thirty-eight community-dwelling seniors who reported a fear of falling and activity restriction but were free of neurological and mobility-limiting orthopedic conditions. INTERVENTIONS: Programs designed to reduce fear of falling were delivered weekly to groups of three to five seniors for 8 weeks, each session lasting 1 hour. The activity program included low-resistance exercises and weight-shifting activities. Education focused on identifying and reducing risk factors for falls. MEASUREMENTS: Balance confidence, activity level, limits of stability (LOS), isokinetic strength, and health status were measured twice preintervention (baseline), postintervention, and 6 weeks later. RESULTS: Both programs reduced fear of falling (P <.006) as ascertained from the balance confidence scores. Differential effects were observed in LOS (P <.05); activity improved balance, whereas education led to modest declines. Gains in perception of health status were limited to physical health for the activity group and mental health for the education group. Benefits were generally sustained at follow-up. CONCLUSION: Improved balance confidence is not intervention-specific, but associated changes in physical ability and health status are a function of the composition of the intervention program.

Accidental Falls↗
PubMed2005

[A 12-week physical activity program increases glucose-6-phosphate-dehydrogenase activity in Down syndrome adolescents].

In recent years it has been claimed that trisomic cells are more sensitive to oxidative stress since there is an imbalance in the hydrogen peroxide metabolism. We designed the present study to assess the activity level of antioxidant enzyme glucose-6-phosphate-dehydrogenase (G6PDH) of erythrocytes in 31 male adolescents with Down syndrome (mean age 16.3 +/- 1.1) after performing a 12 week aerobic training program. First of all, a significant increase of 14.9% in the catalytic activity of G6PDH was observed in male adolescents with Down syndrome when compared with age, sex and body mass-matched controls without trisomy. After 12-wk program its activity increased significantly compared to baseline value in Down syndrome individuals. Our data are consistent with previous evidence of the existence of higher oxidative stress in adolescents with Down syndrome when compared to the general population. We may also conclude that G6PDH activity was significantly increased after a 12 week exercise program.

Adolescent↗
PubMed2005

Home versus center based physical activity programs in older adults.

BACKGROUND: Physical inactivity is a leading cause of preventable death and morbidity in developed countries. In addition physical activity can potentially be an effective treatment for various medical conditions (e.g. cardiovascular disease, osteoarthritis). Many types of physical activity programs exist ranging from simple home exercise programs to intense highly supervised hospital (center) based programs. OBJECTIVES: To assess the effectiveness of 'home based' versus 'center based' physical activity programs on the health of older adults. SEARCH STRATEGY: The reviewers searched the Cochrane Central Register of Controlled Trials (CENTRAL) (1991-present), MEDLINE (1966-Sept 2002), EMBASE (1988 to Sept 2002), CINAHL (1982-Sept 2002), Health Star (1975-Sept 2002), Dissertation Abstracts (1980 to Sept 2002), Sport Discus (1975-Sept 2002) and Science Citation Index (1975-Sept 2002), reference lists of relevant articles and contacted principal authors where possible. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials of different physical activity interventions in older adults (50 years or older) comparing a 'home based' to a 'center based' exercise program. Study participants had to have either a recognised cardiovascular risk factor, or existing cardiovascular disease, or chronic obstructive airways disease (COPD) or osteoarthritis. Cardiac and post-operative programs within one year of the event were excluded. DATA COLLECTION AND ANALYSIS: Three reviewers selected and appraised the identified studies independently. Data from studies that then met the inclusion/exclusion criteria were extracted by two additional reviewers. MAIN RESULTS: Six trials including 224 participants who received a 'home based' exercise program and 148 who received a 'center based' exercise program were included in this review. Five studies were of medium quality and one poor. A meta-analysis was not undertaken given the heterogeneity of these studies. CARDIOVASCULAR. The largest trial (accounting for approximately 60% of the participants) looked at sedentary older adults. Three trials looked at patients with peripheral vascular disease (intermittent claudication). In patients with peripheral vascular disease center based programs were superior to home at improving distance walked and time to claudication pain at up to 6 months. However the risk of a training effect may be high. There are no longer term studies in this population. Notably home based programs appeared to have a significantly higher adherence rate than center based programs. However this was based primarily on the one study (with the highest quality rating of the studies found) of sedentary older adults. This showed an adherence rate of 68% in the home based program at two year follow-up compared with a 36% adherence in the center based group. There was essentially no difference in terms of treadmill performance or cardiovascular risk factors between groups. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). Two trials looked at older adults with COPD. In patients with COPD the evidence is conflicting. One study showed similar changes in various physiological measures at 3 months that persisted in the home based group up to 18 months but not in the center based group. The other study showed significantly better improvements in physiological measures in the center based group after 8 weeks but again the possibility of a training effect is high. OSTEOARTHRITIS. No studies were found. None of the studies dealt with measures of cost, or health service utilization. AUTHORS' CONCLUSIONS: In the short-term, center based programs are superior to home based programs in patients with PVD. There is a high possibility of a training effect however as the center based groups were trained primarily on treadmills (and the home based were not) and the outcome measures were treadmill based. There is conflicting evidence which is better in patients with COPD. Home based programs appear to be superior to center based programs in terms of the adherence to exercise (especially in the long-term).

Aged↗
PubMedDate not supplied

Improved program activities are associated with decreasing tuberculosis incidence in the United States.

OBJECTIVE: This study was conducted to determine whether improvements in tuberculosis (TB) program activities correlate with incident TB cases. METHODS: National TB surveillance data and program data from patients with pulmonary and laryngeal TB and their contacts were collected. These data were analyzed using regression models to assess the association between changes in incident TB cases and indicators of program performance (a time series of percent changes in program indices). RESULTS: A total of 1,361,113 contacts exposed to 150,668 TB patients were identified through contact investigations. From 1987 to 1992 (the period of TB resurgence and antedating increased funding), there was a decline in several measures used by TB programs for outcomes of contact investigations. From 1993 to 1998 (the period after increases in TB funds), there was an observable improvement in the program indices. Four program indices for contacts and two for TB cases (directly observed therapy and completion of therapy) were statistically associated (p < or = .01) with the decline in TB incident cases. CONCLUSIONS: These analyses suggest that expanded TB program activities resulted in the reduction in national TB cases and underscore the importance of treatment completion for TB disease and latent TB infection. Based on these results, we propose that further improvements in these activities will accelerate the decline of TB in the United States.

Antitubercular Agents↗
PubMed2006

A physical activity program to reinforce weight maintenance following a behavior program in overweight/obese subjects.

OBJECTIVE: To investigate the effects of a specific program to implement physical activity (fitness program) on weight loss maintenance, activity level and resting energy expenditure (REE). DESIGN: Observational study of subjects completing a behavioral program. SUBJECTS: In total, 200 overweight/obese subjects (36 males, aged 20-66 years; average BMI, 35.2 kg/m2). Program and measurements:The fitness program consisted of 12 bimonthly sessions, chaired by doctors and dietitians, involving groups of 8-12 subjects. Patients entered the program approximately 9 months after the end of behavioral treatment, during a weight loss maintenance period. The goal was set at a light-to-moderate daily physical activity (brisk walking), quantitatively measured by a pedometer; REE was measured before and after the fitness program by indirect calorimetry in a subset of patients. RESULTS: The fitness program restarted the process of weight loss in over 60% of subjects. At the end of the study, 84% of patients walked at least 5000 steps per day, compared with 24% at the beginning of the study. The probability of losing from 5 to 10% of initial body weight increased by 20% for any 1000 steps/day (OR, 1.20; 95% CI (confidence interval), 1.07-1.35), and that of losing more than 10% by over 30% (OR, 1.33; 95% CI, 1.19-1.49). REE increased significantly by 100 kcal/day (+7.5%), in spite of further weight loss (-1.8%). CONCLUSION: A specific fitness program in the weight maintenance phase after a behavioral program may significantly improve the long-term control of obesity.

Adult↗
PubMedDate not supplied

The relationships between delivery agents' physical activity level and the likelihood of implementing a physical activity program.

PURPOSE: To determine the relationships between delivery agents'physical activity characteristics and subsequent adoption of a physical activity promotion program for community implementation. METHODS: Agents responsible for county health promotion in Kansas (n = 91; 94.5% women; mean age = 43.0 +/- 11) completed interviews that assessed physical activity self-efficacy, value, and participation. Subsequent implementation of a physical activity program was monitored. The response rate was 100%. RESULTS: Fifty-five percent of the agents met Centers for Disease Control and Prevention (CDC) recommendations for physical activity, 35% were active but did not meet CDC recommendations, and 10% were inactive. On the basis of logistic regression analysis (Wald statistic = 7.63; p < .05), agents who met recommendations were more likely to adopt the program for their county (69%) than were agents who were less active (41%) and inactive (11%). DISCUSSION: The data suggest that increasing the proportion of delivery agents who meet the CDC recommendations for physical activity could be related with a higher proportion of communities implementing physical activity programs.

Adult↗
PubMed2001

An investigation of commitment among participants in an extended day physical activity program.

This study examined underserved youth participants' perceptions of commitment to an extended day physical activity program using Hellison's (1995) responsibility model. Seven participants ranging in age from 12 to 15 years participated in the study. Two personal interviews and a focus group interview were used to obtain participants' perceptions ofprogram commitment. Results revealed that program organization, personal characteristics, development of interpersonal relationships, and the program environment influenced their program commitment. Participants described the nature of commitment in terms of program behavior, emotional involvement, and program history. While the type of activity was cited as a positive influence on program commitment, the specific activity could also serve as a barrier to program commitment. Implications for program development andfuture research are offered.

Adolescent↗
PubMed1997

Effects of an aerobic activity program on the cholesterol levels of adolescents.

The purpose of this study was to determine the effects of a 15-week aerobic activity program on the total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels of 25 high school students, ages 14-17 years (experimental group = 14, control group = 11). Participants in the activity program exercised 4 days per week in a specially designed physical education class, while the control group participated in the regular physical education program. Results of the analysis of covariance found significant reductions in TC in the training group (control group Adj M = 190.2 mg/dl, experimental group Adj M = 173.1 mg/dl, p < .05), but no significant changes in HDL-C (control group Adj M = 49.8 mg/dl, experimental group Adj M = 50 mg/dl). While the exercise program appeared to have a beneficial effect on TC in 12 of 14 participants (86%), HDL-C also dropped in 12 of 14 participants (86%).

Adolescent↗
PubMed1990

[Physical activity program during working hours among industrial workers in Israel].

During 1984-1985, 540 employees of 2 pharmaceutical factories of the Teva concern participated in a physical activity program. To evaluate its effects on employees' health, the participants were randomly divided into 2 groups of equal size. The test group participated in regular physical exercise before lunch for 15 minutes, 5 days a week. The controls played social games for the same time periods while seated. The physical activity program included stretching, relaxing, and aerobic exercises. The program was carried out by employees who had been trained to be instructors by the researchers and were supervised by a professional teacher. During the 7 months of the study, adherence was about 90%. The results in test and control groups were determined by questionnaires. After 7 months, the test group clearly showed increased interest in sports activities, increased job satisfaction and work efficiency, and decreased fatigue during work.

Drug Industry↗
PubMed1977

Effects of a developmental physical activity program on children's body coordination and self-concept.

Significant increases in body coordination, little change in self-concept, and moderate negative correlations between these variables were found after 12 children participated in an 8-wk. developmental physical activity program. Apparently, while body coordination might be improved by participation in activity programs of short duration, these improvements may not necessarily be accompanied by increases in self-concept.

Child↗
PubMed2004

[Compliance of adults with diabetes to a physical activity program].

The present study was planned to verify if an adherence-enhancement activity program would be able to increase the frequency of exercising among sedentary diabetic patients. Twelve type 2 diabetic patients, one type 1 and one with secondary diabetes were included in the current study. Forty classes were first commanded by a teacher and then by a student. Adherence to the program was reinforced through a rewarding schedule. Six family members were encouraged to support physical activity. At home, each student registered his/her physical activity daily. Fitness evaluation and glycosylated hemoglobin were carried out before the program, at the end of the third month and at the follow-up. Nine participants completed the program and increased their physical activity at home. At the end of the third month, mean glycosylated hemoglobin of the patients persisting at the program was significantly lower than basal values. Involving family members contributed to promote adherence.

Adult↗
PubMed2006

Depressive symptoms and cognitive performance of the elderly: relationship between institutionalization and activity programs.

OBJECTIVE: The aim of this study was to assess the frequency of depressive symptoms and to evaluate cognitive performance of institutionalized versus non-institutionalized elderly subjects and to compare the effect of institutionalization and participation in the institution's activity programs on their cognitive performance. METHOD: A group of 120 elderly subjects with a mean age of 71 years and average schooling of 4.2 years was evaluated. The participants were divided into 3 groups: non-institutionalized (n = 37); institutionalized with activities (n = 37); institutionalized without activities (n = 46). The groups were matched for age, gender and educational level. The following assessment instruments were used: the Geriatric Depression Scale, the Mini-Mental State Examination, the Verbal Fluency Test and the computerized versions of the Hooper Visual Organization Test and the Boston Naming Test. The data were analyzed using one-way ANOVA and the Pearson's correlation test. RESULTS: The two groups of institutionalized elderly showed higher frequency of depressive symptoms when compared to non-institutionalized subjects and worse performance on the Verbal Fluency Test. The institutionalized group without activities had lower scores on Mental State Examination, Boston Naming Test and Hooper Visual Organization Test when compared to the other two groups (p < 0.05). CONCLUSIONS: Institutionalization of the elderly seems to be related to worse cognitive performance. Activity programs during institutionalization may be effective in minimizing cognitive functional loss.

Aged↗