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PubMed1993

Physical fitness and adults with mental retardation. An overview of current research and future directions.

The deinstitutionalization movement of the past 25 years has focused on the placement of people with mental retardation into community-based settings. There is a need for exercise- and health-related professionals to demonstrate a thorough understanding of the term mental retardation and all of the intellectual and behavioural ramifications that coexist with this condition before addressing the 'how to' of fitness evaluation. Therefore, the article outlines the range of intellectual and behavioural characteristics of this population, based on the level of retardation. Many researchers investigating body composition have reported that a disproportionate number of adults with mental retardation carry a percentage of body fat that would be considered unhealthy (e.g. it increases the risk of early onset of such diseases as hypertension and adult onset diabetes mellitus). Living arrangements (i.e. institution vs smaller residences) play a role in the prevalence of obesity. Many attempts of researchers to control weight in adults with mental retardation through caloric restriction, exercise, and a combination of diet and exercise, have had a varied outcome. Cardiovascular capacity is considered by most exercise physiologists as the major physiological indicator for overall fitness. The majority of researchers who have evaluated the cardiovascular fitness levels of adults with mental retardation have reported fitness levels representative of a very sedentary population. Therefore, one would expect a keen sense of urgency among researchers to develop training regimens targeted specifically for people with mental retardation. Many have been developed, but to date only 2 cardiovascular training regimens have been reported that specifically describe the necessary components of an exercise programme (i.e. frequency, duration, intensity) that would allow for reproducibility--a stationary bicycle routine using the Schwinn 'Air-Dyne' ergometer and a run/walk programme. Of these, only the programme using the Schwinn 'Air-Dyne' ergometer reported significant improvements in cardiopulmonary fitness. Researchers have demonstrated that: (1) body strength is valuable for recreation activities and activities of daily living; (2) competence in upper body muscular skills is a prerequisite for many available vocational opportunities; and (3) positive correlations have been established between muscular strength and industrial work performance in people with mental retardation. Therefore, there is a need for appropriate evaluation procedures for determining the muscular strength and endurance of people with mental retardation. The future directions for researchers and professionals concerned with the fitness status of people with mental retardation includes answering question such as: What will be the effect of obesity on general health status?(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed2001

Musculoskeletal fitness, health outcomes and quality of life.

The health benefits and quality-of-life outcomes of a fit musculoskeletal system (musculoskeletal fitness) are reviewed in this article. The World Health Organization suggests health is a state of complete physical, mental or social well-being and not merely the absence of disease or infirmity. Physical health includes such characteristics as body size and shape, sensory acuity, susceptibility to disease and disorders, body functioning, recuperative ability and the ability to perform certain tasks. One aspect of physical health is the musculoskeletal system, which consists of 3 components; muscular strength, endurance and flexibility. Muscular strength (dynamic) is defined as the maximum force a muscle or muscle group can generate at a specific velocity. Muscular endurance is the ability of a muscle or muscle group to perform repeated contractions against a load for an extended period of time. Flexibility has 2 components, dynamic or static, where dynamic flexibility is the opposition or resistance of a joint to motion, that is, the forces opposing movement rather than the range of movement itself. Static flexibility is the range of motion about ajoint, typically measured as the degree of arc at the end of joint movement. If strength, endurance and flexibility are not maintained, musculoskeletal fitness is then compromised which can significantly impact physical health and well-being. Many health benefits are associated with musculoskeletal fitness, such as reduced coronary risk factors, increased bone mineral density (reduced risk of osteoporosis), increased flexibility, improved glucose tolerance, and greater success in completion of activities of daily living (ADL). With aging, the performance of daily tasks can become a challenge. Additionally, falls, bone fractures and the need for institutional care indicate a musculoskeletal weakness as we age. The earlier in life an individual becomes physically active the greater the increase in positive health benefits; however, becoming physically active at any age will benefit overall health. Improved musculoskeletal fitness (for example, through resistance training combined with stretching) is associated with an enhanced health status. Thus, maintaining musculoskeletal fitness can increase overall quality of life.

Activities of Daily Living↗

PubMed2004

Public health and clinical recommendations for physical activity and physical fitness: special focus on overweight youth.

Numerous physical activity and physical fitness recommendations exist for youth. To date, however, no investigator has systematically reviewed these public health and clinical guidelines to determine whether the recommendations address overweight youth. This review examines youth-oriented physical activity and physical fitness recommendations for both the public health community and the clinical community, and assesses how overweight youth are specifically targeted by each of these two groups. Our review determined the extent to which the recommendations assessed four components of physical activity (i.e. frequency, intensity, duration and type) and four components of physical fitness (i.e. cardiorespiratory capacity, strength, flexibility and body composition). We further reviewed clinical recommendations to determine how they included two facets of the physician-patient encounter: assessment and counselling. After identifying all current physical activity and physical fitness recommendations for youth, we evaluated whether public health (n = 13) and clinical recommendations (n = 12) addressed physical activity and physical fitness for overweight youth. Findings revealed inconsistent, yet explicit, recommendations for the public health community where most organisations (12 of 13, 92%) included > or =3 physical activity components. In addition, organisations encouraged volumes of daily moderate- to vigorous-intensity physical activity for youth ranging from 30-60 or more minutes. Recommendations for the clinical community generally did not provide explicit physical activity and fitness recommendations to advise physicians on the assessment and counselling of patients and their families. Overweight youth were addressed within some recommendations (6 of 12, 50%) for the clinical community, but within few recommendations (2 of 13, 15%) for the public health community. To best inform public health and clinical communities, organisations developing future recommendations should include information fully documenting the decision-making processes used to develop the recommendations. In cases where mutual goals exist, public health and clinical communities should consider collaborating across agencies to develop joint recommendations.

Adolescent↗

PubMed2004

Fitness and physical activity in children with asthma.

Asthma remains the most common chronic disease in childhood, reportedly affecting up to 25% of children in Western urban environmental settings. There seems to be a common perception that asthmatic children have a reduced capacity for exercise. Surprisingly, there is conflicting evidence in the literature in relation to this position. In this review, we present an overview of the literature in which habitual physical activity and fitness levels, including aerobic fitness, of asthmatic and non-asthmatic children are compared. There is contradictory evidence regarding the aerobic fitness levels of asthmatic children and adolescents, and it remains unclear whether significant differences exist between asthmatic children and their non-asthmatic counterparts. There is limited information concerning the relative anaerobic fitness of asthmatic children and adolescents; however, this is also conflicting. During childhood and adolescence, asthmatic individuals seem to have physical activity levels comparable with those of the normal paediatric population. However, differences in physical activity levels may develop during the time of maturation from adolescence into adulthood. Accordingly, it is not possible to establish a definitive conclusion about the issue in either children or adults. Further research with well designed methodologies is needed in order to determine whether asthmatic children and adolescents have different aerobic fitness, anaerobic fitness and physical activity levels when compared with the normal paediatric population.

Adolescent↗

PubMed2003

A 6-year cohort study on relationship between functional fitness and impairment of ADL in community-dwelling older persons.

We measured functional fitness in older subjects and performed a follow-up survey for 6 years to clarify whether the level of functional fitness at a given point contributes to prediction of the subsequent occurrence of impairment of functions necessary for independent living. The longitudinal data were obtained for 391 persons aged 60 years or over, who were independently living in the community. Four items of functional fitness, i.e. the ability to perform standing/sitting movements, ability to perform traveling movements, ability to perform housekeeping movements, and ability to perform personal grooming activities, were assessed. The relationship between functional fitness and the risk of the occurrence of impairment of independence in daily living was evaluated using a binomial logistic regression model. In males, all the 4 items of functional fitness were significantly related to the risk of impairment of activities of daily living (ADL). In females, however, none of the items was significantly related to the risk of ADL impairment. In conclusion, functional fitness appears to be valid as a predictive parameter of future occurrence of ADL impairment in relatively healthy and independent elderly males. However, its validity in elderly females needs further evaluation.

Activities of Daily Living↗

PubMed2001

Functional fitness may be related to life satisfaction in older Japanese adults.

The relationship between functional fitness status and life satisfaction was assessed in older Japanese people from the perspective of quality of life (QOL). A total of 123 older men and women (M = 74.3 years, SD = 5.4) participated in the study. The questionnaire contained 21 questions covering eight structural factors pertaining to the feelings of life satisfaction in older people. The functional fitness test consisted of nine items representing the following five areas of fitness: muscular strength, agility, coordination, balance, and flexibility. The analysis revealed no overall correlation between the total fitness and the total life satisfaction scores, but some of the life satisfaction factors were significantly related to some functional fitness items (P < .01). The results suggest it is important for older people to maintain their functional fitness in order to manage a high quality of life.

Activities of Daily Living↗

PubMed1992

The influence of physical fitness on automatic and effortful memory changes in aging.

A cross-sectional study was carried out in order to determine the influence of cardiovascular fitness on age-related declines in cognitive performance. Forty-eight volunteers were divided into Young (n = 13, 18-27 years), Middle-Aged (n = 22, 60-65 years) and Old (n = 13, 65-88 years) groups and tested on a battery of cardiovascular, pulmonary, hemodynamic, and biochemical tests in order to assess physical fitness. Cognitive performance was evaluated by a variety of memory tasks distributed along an automatic-to-effortful processing continuum. Memory for location and frequency of occurrence were selected as representative of automatic processing, whereas, an auditory free-recall task was selected as representative of effortful processing. Age-related performance declines were observed for the free-recall task, but no such age-dependent association was observed for frequency and location memory. With regard to the influence of physical fitness; the Middle-Aged and Older participants were divided into High and Low Fitness groups and significant differences were observed between these groups for the effortful but not the automatic memory tasks. These data suggest that the relationship between physical fitness and cognitive performance in old age is task dependent. Furthermore, the apparent prophylactic effects of physical fitness on effortful memory, do not appear to extend to cognitive tasks requiring less effortful processing.

Age Factors↗

PubMed2000

A high level of physical fitness during thirties is a negative risk factor for colonic polyps during fifties.

This case-control study examined the relationship between the occurrence of colonic polyps in men in their fifties and the level of their physical fitness while in their thirties. The subjects consisted of 51 male Japan Self-Defense Forces officials in their fifties who had colonic polyps, as diagnosed by colonoscopic examination, and 46 control individuals. As an indicator of physical fitness between 30 and 39, we selected the best time recorded for each individual during that decade of life for the 1,500 meter Physical Fitness Test run. We calculated the odds ratio for polyps according to selected risk factors (including physical fitness), and a logistic regression analysis was used to adjust for possible confounding variables. Odds ratio (95% confidence interval, p value) for colonic polyps with physical fitness in the thirties was 0.36 (0.16-0.82, p < 0.05). With adjustment for the subjects' maximum Body Mass Index in both their thirties and fifties, and serum total cholesterol, the odds ratio was 0.39 (0.15-0.99, p < 0.05). We suggest that the occurrence of colonic polyps in men in their fifties can be reduced by maintaining a high level of physical fitness while in their thirties.

Adult↗

PubMed1993

The relationship of physical fitness to lipid and lipoprotein(a) levels in adolescents with IDDM.

OBJECTIVE--Increased physical activity and physical fitness are recommended therapeutic modalities in addition to insulin and diet in the management of children with IDDM. The aim of this study was to assess the fitness levels of adolescents with IDDM compared with healthy control subjects and to evaluate the relationship between physical fitness and metabolic control. RESEARCH DESIGN AND METHODS--We studied 59 patients with IDDM, 28 boys and 31 girls, age 15.6 +/- 2.5 yr, duration of diabetes 7.6 +/- 3.5 yr, HbA1 10.6 +/- 2.1% (mean +/- SD), and compared them with 18 healthy, nondiabetic control subjects, 9 boys and 9 girls, matched for age, BMI, and Tanner stage. Physical fitness was measured by VO2max during progressive bicycle ergometry. HbA1 was used to determine glycemic control. Lipid profile included fasting total cholesterol, HDL, LDL, Lp(a), and TG levels. RESULTS--Patients with IDDM had lower VO2max levels than control subjects (33.7 +/- 7.0 vs. 41.0 +/- 10.4 ml.kg-1.min-1, P = 0.001). Males with IDDM had lower VO2max than male control subjects, but diabetic and control females showed no difference. In IDDM patients, VO2max correlated inversely with HbA1, insulin dose, cholesterol, LDL, TGs, and Lp(a), but did not correlate with HDL, which correlated inversely with BMI. CONCLUSIONS--We conclude that the state of physical fitness is an important correlate of lipid levels and Lp(a) in adolescents with IDDM. We speculate that higher physical fitness levels in adolescents with IDDM may decrease the risk of CVD through modulating lipid levels.

Adolescent↗

PubMed1997

Resting intraocular pressure of steel factory workers is related to their physical fitness.

Intraocular pressure (IOP) has never been compared between hard working and sedentary subjects. The relationship between physical fitness and IOP is not clearly known. There are only two studies and their results are contradictory. The variability in their results may be due to several factors. Therefore, the present study was planned to investigate the relationship between working style, physical fitness and IOP after taking into account those factors that can affect IOP. One hundred fifty male volunteers of a steel factory were divided equally in two groups. The subjects of group 1 were sedentary worker, whereas group 2 subjects were actively engaged in heavy works requiring exertion. Physical fitness was evaluated by the measurement of maximum oxygen uptake with a Bechman O2 analyzer. IOP was measured with the Goldmann applanation tonometer. As compared to sedentary subjects, maximum oxygen uptake was significantly higher whereas IOP was significantly lower in those who did moderate or severe exertions. The maximum oxygen uptake difference between group 1 and 2 was found to be (mean +/- SD) 5.1 +/- 1.1 ml/kg/min (p < 0.001), whereas, IOP difference was 1.9 +/- 0.7 mmHg (p < 0.001). This study concludes that hard working is associated with physical fitness and physical fitness is associated with reduced resting IOP. It would seem reasonable at present not to discourage subjects who have ocular hypertension from exercise; perhaps, on the contrary, it should be encouraged to increase their physical fitness.

Humans↗

PubMed1998

Insertion gain versus median ear corrected coupler gain: a comparison of two fitting methods in new NHS hearing aid users.

Although hearing aid fitting by insertion gain measurement is known to be an accurate and reliable technique, it is rarely used routinely in the UK National Health Service (NHS) because of high demands on staff and time. This study investigated whether an alternative, more practical procedure of fitting by median ear corrected coupler measurements would be as beneficial to NHS patients. Forty patients took part in a double-blind cross-over study comparing the two fitting methods. Results show that the insertion gain fittings were significantly better than the coupler fittings in terms of both patient preference and speech discrimination in noise. It is concluded that, even with the limited response adjustments available, individual deviations from the median ear make routine hearing aid fitting by insertion gain measurement indeed desirable in the NHS.

Adult↗

PubMed2002

Opting for two hearing aids: a predictor of long-term use among adult patients fitted after screening.

This study is a follow-up of patients fitted with one or two hearing aids, approximately 10 years previously. Our patients were identified through population screening for hearing difficulties when they were aged 50-65 years. At the time, they had a trial of unilateral and bilateral fittings, and then they made their own choice to keep one or two aids. We found that 10 of the 12 who had opted for two aids and were available for follow-up 10 years later continued using at least one aid (83%, 95% CI 55-95). Six of the 17 who opted for unilateral fitting and were available for follow-up used a hearing aid in the long term (35%, 95% CI: 17-59%). Therefore, this study suggests that people who are identified through population screening, are bilaterally impaired, are willing to try bilateral fitting, and choose to continue with two aids, are likely to become long-term users of (one or two) hearing aids. Those who choose to continue with one aid after a trial of bilateral fitting are at high risk of rejecting the aid in the long term. Our sample is small, and we took a number of steps in the analysis in order to clarify whether these findings are reliable. We could not identify any confounding factors. The patients' preference for continuing with bilateral or unilateral aids after fitting was the only predictor of long-term use in our sample. Remarkably, bilateral preference was a better predictor of long-term use than the degree of hearing impairment. We discuss how this study provides useful information for planning population screening for hearing difficulties in middle age.

Aged↗

PubMed2003

Societal effects of hearing aid fitting among the moderately hearing impaired.

The objective of this study was to evaluate hearing aid fitting from a societal viewpoint, rather than the more traditional patient perspective. The effects of hearing aid fitting on generic quality of life (EuroQol), social functioning (SF36), auditory disability, productivity at paid and unpaid labour, and medical consumption, were assessed in a prospective study among 80 moderately hearing-impaired first-time hearing aid applicants. The study showed that hearing aid fitting solved problems with paid employment, but did not seem to affect unpaid work. Use of medical services remained relatively stable after first-time hearing aid fitting. The Amsterdam Inventory proved to be a useful questionnaire to assess the effects on hearing disability. No effects of hearing aid fitting on generic quality of life could be determined with the EuroQol, while hearing aid fitting did lead to an improvement in one aspect of generic quality of life; namely social functioning.

Adult↗

PubMed1985

Urinary iron loss and physical fitness of Kenyan children with urinary schistosomiasis.

Daily urinary iron loss and physical fitness were determined in Kenyan primary school children who had low-medium (16-177 eggs/10 ml adj) or high (200-1,194 eggs/10 ml adj) S. hematobium egg counts compared with a matched group of control or uninfected children before and after antischistosomal treatment with metrifonate. The 3 groups did not differ significantly before treatment in age, sex ratio, anthropometry or prevalence of other parasite infections. Before treatment, mean iron loss in the high egg count group (n = 14) was 652 micrograms/24 hr and was significantly higher than losses in the low-medium and control groups (losses = 278, 149 micrograms; n = 19, 12 respectively). Iron loss in infected children was correlated with egg count (r = 0.40) and log of egg count (r = 0.56, P less than 0.0003). After treatment iron loss decreased in the infected groups and post-treatment iron losses did not differ significantly. Physical fitness scores, measured with the Harvard Step Test, showed that the control group (score 81) was significantly more fit than the high egg count group (score 69) before treatment. Fitness scores improved significantly in both infected groups after treatment, and post-treatment fitness scores did not differ significantly between the 3 groups. This study provides evidence that relatively heavy infections of S. hematobium can cause urinary iron loss which, if it persists, is great enough to produce iron deficiency anemia and can also reduce physical fitness of children, but that both of these negative effects are reversible with treatment.

Child↗

PubMedDate not supplied

The relationship of physical activity and cardiovascular fitness to absenteeism and medical care claims among law enforcement officers.

BACKGROUND: Previous research has shown an inverse relationship between cardiovascular fitness and both absenteeism and health care costs. The documentation of these relationships with law enforcement officers will support the usefulness of providing health promotion programs for this population. METHODS: Data were collected over a one-year period to examine the relationship of physical activity and cardiovascular fitness to absenteeism and medical care claims among law enforcement officers (N = 734). RESULTS: Analysis of covariance indicated that sedentary officers were absent significantly more often than active officers; also, female officers were absent significantly more than male officers. Although proportionally more female officers than males scored above the 50th percentile on fitness (based on Cooper's norms), increased fitness for females was not related to decreased absenteeism. Increased fitness for male officers was related to decreased absenteeism. Medical care claims for a sub-sample of male officers (N = 363) were lower for more fit and more active officers, although this relationship was nonsignificant. DISCUSSION: These observational data strengthen the hypothesis that absenteeism levels of physically active officers are lower than those of sedentary officers. For females, the relationship of absenteeism to family issues associated with child care and pregnancy leave in the workplace appears worthy of examination.

Absenteeism↗

PubMed2004

The effects of residency on physical fitness among military physicians.

PURPOSE: Demands of medical residency training would be expected to result in physical deconditioning. This study determined the effects of residency on physical fitness. METHODS: A prospective cohort study of the change in physical conditioning during residency using the Army Physical Fitness Test as a standardized measure of fitness was conducted. Ninety-four active duty U.S. Army physicians were followed during their medical residency training from July 1999 to June 2002. Army Physical Fitness Test results from interval tests performed throughout residency were compared to baseline results at matriculation. Changes in total score, number of push-ups and sit-ups completed in 2 minutes, 2-mile run time, and weight were recorded. Correlations between initial and final scores were evaluated. RESULTS: All measured parameters worsened with statistical significance noted in the weight (p < 0.01), push-ups (p < 0.05), and 2-mile run (p < 0.01). Statistically significant negative correlations between initial and subsequent tests were noted in push-ups (p = 0.004), sit-ups (p = 0.0003), and total score (p = 0.0192). CONCLUSIONS: Physical fitness declines during medical residency training. This effect is most notable in residents with higher levels of fitness at the start of medical education. Further studies are necessary to evaluate for a similar decline among civilian residents.

Cohort Studies↗

PubMed2000

Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes.

BACKGROUND: Although physical activity is recommended as a basic treatment for patients with diabetes, its long-term association with mortality in these patients is unknown. OBJECTIVE: To evaluate the association of low cardiorespiratory fitness and physical inactivity with mortality in men with type 2 diabetes. DESIGN: Prospective cohort study. SETTING: Preventive medicine clinic. PATIENTS: 1263 men (50+/-10 years of age) with type 2 diabetes who received a thorough medical examination between 1970 and 1993 and were followed for mortality up to 31 December 1994. MEASUREMENTS: Cardiorespiratory fitness measured by a maximal exercise test, self-reported physical inactivity at baseline, and subsequent death determined by using the National Death Index. RESULTS: During an average follow-up of 12 years, 180 patients died. After adjustment for age, baseline cardiovascular disease, fasting plasma glucose level, high cholesterol level, overweight, current smoking, high blood pressure, and parental history of cardiovascular disease, men in the low-fitness group had an adjusted risk for all-cause mortality of 2.1 (95% CI, 1.5 to 2.9) compared with fit men. Men who reported being physically inactive had an adjusted risk for mortality that was 1.7-fold (CI, 1.2-fold to 2.3-fold) higher than that in men who reported being physically active. CONCLUSIONS: Low cardiorespiratory fitness and physical inactivity are independent predictors of all-cause mortality in men with type 2 diabetes. Physicians should encourage patients with type 2 diabetes to participate in regular physical activity and improve cardiorespiratory fitness.

Adult↗

PubMed1998

Anthropometric and health-related fitness characteristics in middle-aged obese women.

The purpose of this investigation was to determine the possible relationships between anthropometrical and health-related fitness parameters in obese middle-aged women. Twenty one obese (BMI > 27 kg/m2) and 12 control (BMI < 27 kg/m2) middle-aged females (35-45 yrs) participated in this investigation. Three series of anthropometrical measurements on the right side of the body were taken according to the O-scale physique assessment system. The Heath-Carter anthropometric somatotyping method was used and the ratio of waist to hip circumferences was calculated. The body composition was measured using bioelectrical impedance method (Bodystat-500, UK). The following health-related fitness tests used were: dynamic sit-up, hand grip, sit-and-reach, single leg balance and plate tapping. Physical working capacity (PWC) was measured using single ergometer test. Obese women possessed significantly higher (p < 0.05) values for skinfold, girth and breadth measurements. While the differences in somatotype indices were not statistically significant (p > 0.05) between obese and control groups, the transformation of somatotype characteristics to the effect sizes (ESs) revealed that these differences were large (ectomorphy: ES = 1.73; endomorphy: ES = 1.64; mesomorphy: ES = 1.71). Relative aerobic fitness (VO2max/kg, calculated from PWC) and dynamic sit-up were higher (p < 0.05) in control subjects, while obese women presented significantly higher values for hand grip strength. The thicker skinfold thicknesses increased the absolute value of PWC in obese group (r = 0.39-0.57; p < 0.05). In contrast, the thinner skinfold thicknesses in suprailiac and mid-thigh significantly increased the absolute value of PWC in control women. There were only a few significant correlations between girth and breadth measures, and health-related fitness parameters. In addition, somatotype characteristics seldom influenced the results of health-related fitness tests. Stepwise multiple regression analysis demonstrated that health-related fitness test items were more dependent on the anthropometrical parameters in obese than in control women.

Adult↗