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PubMed2000

Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality--16 y follow-up of middle-aged and elderly men and women.

OBJECTIVE: To investigate the independent associations and the possible interaction of body mass index (BMI), leisure time physical activity (LTPA) and perceived physical fitness and functional capability with the risk of mortality. DESIGN: Prospective 16y follow-up study. SUBJECTS: A regionally representative cohort of 35-63-y-old Finnish men (n= 1,090) and women (n= 1,122). MEASUREMENTS: All-cause, cardiovascular disease (CVD) and coronary heart disease (CHD) mortality were derived from the national census data until the end of September 1996 while the initial levels of BMI, LTPA, physical fitness and function were determined from self-administered questionnaires. RESULTS: After adjustment for age, marital and employment status, perceived health status, smoking and alcohol consumption, the Cox proportional hazards model showed that BMI was not associated with the risk of death among the men or the women. Compared with the most active subjects the men and women with no weekly vigorous activity had relative risks of 1.61 (95% confidence interval, CI, 0.98-2.64) and 4.68 (95% CI, 1.41-15.57), respectively, for CVD mortality, and for the men there was a relative risk of 1.66 (95% CI, 0.92-2.99) for CHD mortality. When compared with the men who perceived their fitness as better than their age-mates, the men with the 'worse' assessment had a relative risk of 3.29 (95% CI, 1.80-6.02) for all-cause mortality and 4.37 (95% CI, 1.80-10.6) for CVD mortality. Men with at least some difficulty in walking a distance of 2 km had a relative risk of 1.62 (95% CI, 1.05-2.50) for all-cause mortality when compared with those who had no functional difficulties. In addition, in the comparison with subjects with no functional difficulties, the men and women who had some difficulty climbing several flights of stairs had relative risks of 1.47 (95% CI, 0.97-2.23) and 2.39 (95% CI, 1.25-4.60) for all-cause mortality, respectively. For CVD mortality the relative risks were 1.85 (95% CI, 1.04-3.30) and 3.38 (1.22-9.41), respectively. CONCLUSIONS: Although BMI did not prove to be an independent risk factor for mortality from CVD, CHD or from all causes combined, perceived physical fitness and functional capability did. An increase in LTPA seems to have a similar beneficial effect on the mortality risk of obese and nonobese men and women, and the effect also seems to be similar for fit and unfit subjects.

Adult↗
PubMed2001

Survey of hearing aid fitting practices for children with multiple impairments.

The fitting of amplification on young children with multiple impairments in addition to hearing loss is a challenge faced regularly by audiologists. However, very little has been published on this topic in the audiological literature. The purpose of this survey was to document hearing aid fitting practices for this population within the United States. Specifically, audiologists who regularly serve children were asked to complete a series of questions on their educational preparation and their hearing aid selection, fitting, and verification practices for children with multiple impairments. For purposes of this survey, multiple impairments included vision impairment, mental retardation, physical impairment, and autism spectrum disorders. Findings from this survey suggest that children with special needs in addition to hearing loss are typically fit in the same way and with the same type of amplification as those with hearing loss only. In addition, differences were noted in hearing aid selection, fitting, and verification practices across work settings. Future directions and research needs are suggested.

Abnormalities, Multiple↗
PubMed2001

Parents' reactions and recommendations after diagnosis and hearing aid fitting.

This study was designed to explore parent reactions to the early stages of audiologic assessment and intervention. A total of 213 parents whose children were under the age of 6 years returned a mail survey. Respondents from 45 states participated. Parents were asked to (1) report the approximate age of diagnosis and hearing aid fitting; (2) comment on reasons for any delays encountered from diagnosis to fitting; and (3) respond to questions concerning their reactions to the initial fitting of amplification. The median age of identification was earlier than some previous investigations; however, substantial delays occurred between diagnosis and hearing aid fitting. Reasons for delay included the need for further audiologic evaluation, problems obtaining return appointments, illness of the child, and difficulties obtaining adequate earmolds. Parent reactions to hearing aids, once fitted, included concerns about appearance and questions about maintenance and use, but attitudes regarding hearing aids and their perceived benefits improved over time.

Adult↗
PubMed1997

A self-assessment tool to measure older adults' perceptions regarding physical fitness and exercise activity.

The purpose of this research was to qualitatively generate and psychometrically assess an instrument which assesses the self-perceived physical fitness and exercise activity levels of community-dwelling older adults and examines perceived factors which enhance or impede their exercise activity level. This research was carried out in two stages: qualitative and quantitative. Items for the instrument were generated through qualitative interviews with 23 community-dwelling older adults, 9 males and 14 females, with an age range of 63 to 82 years. From this qualitative study, 50 items were generated, representing nine categories of elements which enhance or impede physical activity. The 50 items were incorporated into a 4-point, forced-choice, Likert format instrument which was pilot tested for clarity and ease of administration with a convenience sample of community-dwelling older adults. Following the pilot testing, 41 items were retained. The 41-item instrument, entitled Physical Fitness and Exercise Activity Levels of Older Adults Scale, was categorized into the following subscales: Physical Fitness, Barriers, Motivators, and Exercise Frequency. Initial testing of the Physical Fitness and Exercise Activity Levels of Older Adults Scale seems to indicate adequate validity and reliability. Correlation coefficients for the total instrument, as well as the subscales, were significantly positive for both stability and internal consistency. Results with respect to predictive validity were mixed. The Physical Fitness and Motivators subscales were significant predictors of Exercise Frequency. Although the correlation between the Barriers subscale and Exercise Frequency was negative, it was non-significant.

Aged↗
PubMed2003

Contact lens fitting for post-radial-keratotomy residual myopia.

PURPOSE: To formulate guidelines for contact lens fitting following radial keratotomy and to achieve a relationship between contact lens fitting parameters and refractive and keratometric parameters. METHODS: Thirty-five eyes of 30 patients who had post-radial-keratotomy residual myopia were evaluated for contact lens fitting. The base curve was selected by 'hit and trial' method until a proper fit was achieved, following which an over-refraction was done and final power of the contact lens obtained. RESULTS: The mean contact lens base curve was 43.04 +/- 1.62 D, which was steeper than the postoperative keratometry by 2.35 +/- 0.74 D. The base curve and the postoperative keratometry were correlated by regression analysis (r = 0.895, P < 0.001). The mean overall diameter of the contact lenses was 9.64 +/- 0.08 mm. The mean contact lens power was 5.81 +/- 3.07 D, which was more myopic than the residual myopia by 2.79 +/- 1.67 D. Regression analysis showed definite correlation between the contact lens power and postoperative myopia (r = 0.854, P < 0.001). CONCLUSION: For correction of post-radial-keratotomy residual myopia, contact lens fitting parameters can be determined by a regression formula using keratometric and refractive values.

Adult↗
PubMed2002

A health-related fitness and functional performance test battery for middle-aged and older adults: feasibility and health-related content validity.

OBJECTIVE: To evaluate the feasibility and health-related content validity of 6 health-related fitness (HRF) and 3 functional performance (FP) tests among middle-aged and older persons. DESIGN: Cross-sectional methodologic study. SETTING: Field laboratories in 3 communities of northeast Finland. PARTICIPANTS: A regionally representative, community-based cohort of 55- to 79-year-old men (n=501) and women (n=632). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Health-related test exclusion rates (%) by age groups and odds ratios (ORs) of subjective health outcomes by fitness categories (least 20%, next 40%, most fit 40%). RESULTS: The health-related test exclusion rates increased with age, mainly because of musculoskeletal health limitations among the women and cardiovascular and musculoskeletal health limitations among the men. With the exception of dynamic back extension, 1-leg squat, 1-leg standing balance, and the 1-km walk among the women 75 years and older, 85% or more of the subjects qualified for the HRF tests and 95% or more for the FP tests. Strong and graded associations were found for cardiorespiratory and musculoskeletal fitness and the FP test levels with perceived health and functional ability status among both the men and the women (OR range, 2-31). The motor fitness test level was primarily associated with functional ability status. CONCLUSIONS: All the HRF and FP tests showed health-related content validity, and 4 of 6 of the HRF tests and all of the FP tests proved to be safe, with minor health-related test exclusions for middle-aged and older adults. The findings may help to target physical activity intervention toward persons at high risk for declining health and functional ability.

Age Factors↗
PubMed2002

The association of pain with aerobic fitness in patients with chronic low back pain.

OBJECTIVE: To investigate the association of aerobic fitness (VO(2)max) with pain intensity as reported by a sample of patients with chronic low back pain (LBP). DESIGN: Cross-sectional with partial longitudinal follow-up. SETTING: Outpatient interdisciplinary pain management program in a teaching hospital. PATIENTS: A convenience sample of 75 patients with chronic LBP. INTERVENTION: Patients reported pain intensity before and after undergoing a modified treadmill test. Peak VO(2) was measured by using indirect calorimetry. Predicted VO(2)max was determined by extrapolating peak VO(2) and heart rate values during testing to predicted maximal heart rate. MAIN OUTCOME MEASURES: Aerobic fitness and pain intensity before and after testing. RESULTS: No significant relation was found between pain intensity and predicted VO(2)max or aerobic fitness. CONCLUSION: There is no association between pain intensity and aerobic fitness. Deconditioning, defined as a lack of cardiovascular fitness levels normal for age and gender, therefore does not contribute to pain intensity in patients with chronic LBP.

Adult↗
PubMed2002

Increases in physical fitness during childhood improve cardiovascular health during adolescence: the Muscatine Study.

Longitudinal studies from childhood through adolescence have the potential of defining maturational changes in cardiovascular risk factors and may provide insight into the prediction of future cardiovascular disease. We assessed aerobic fitness, muscular strength, vigorous and sedentary activity, maturation, blood pressure, lipids, and body composition in 125 healthy children for a period of five years (mean baseline age, 10.5 years). All subjects were in pre- or early-puberty at baseline. After adjusting for age and gender and considering the confounding effects of growth and maturation, we examined whether changes in fitness and activity during the first four years of our study could predict cardiovascular health outcomes at year-five of our study. Change in muscular strength explained 4 % of the variability in year-five systolic blood pressure. Change in aerobic fitness explained 11 % of year-five total cholesterol to high density lipoprotein ratio and 5 % of year-five low density lipoprotein cholesterol. Changes in aerobic fitness and muscular strength explained 15 % of the variability in year-five adiposity and 15 % of the variability in year-five abdominal adiposity. Childhood health promotion programs that specifically target increases in physical fitness may help to reduce the increasing prevalence of adolescent obesity.

Adolescent↗
PubMed2002

Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood. Danish Youth and Sports Study. An eight-year follow-up study.

The purpose of this study was to determine if physical activity, aerobic fitness and isometric strength during adolescence were predictors of cardiovascular risk factor levels in young adulthood. The following measurements were carried out: maximal oxygen uptake (VO(2)max), maximal voluntary contraction (MVC) in four muscle groups, physical activity (questionnaire), blood pressure (BP), total cholesterol, high density lipoprotein cholesterol (HDL-C), triglycerides, anthropometric variables and body fat % (sum of four skinfolds). The data were collected from the Danish Youth and Sports study, an observational longitudinal study in which two measurements were carried out over an eight-year period. The findings in this study indicated that the relationships between the absolute levels of physical fitness and activity in adolescence and the subsequent level of CVD risk factors are weak. However, the changes in physical fitness and physical activity were related to the absolute levels of CVD risk factors in young adulthood, especially in men. Weak relationships were found between the changes in physical fitness/activity and changes in CVD risk factor levels in both sexes. In conclusion, many subjects changed their levels of physical activity and physical fitness between adolescence and young adulthood and the changes, especially in aerobic fitness, seemed to be the best predictor of CVD risk factor levels in young adulthood.

Adolescent↗
PubMed2003

Injury and fitness outcomes during implementation of physical readiness training.

This study examined injury and physical fitness outcomes in Basic Combat Training (BCT) during implementation of Physical Readiness Training (PRT). PRT is the U.S. Army's emerging physical fitness training program. An experimental group (EG, n = 1284), which implemented the PRT program, was compared to a control group (CG, n = 1296), which used a traditional BCT physical training program during the 9-week BCT cycle. Injury cases were obtained from recruit medical records and physical fitness was measured using the U.S. Army Physical Fitness Test (APFT, consisting of push-ups, sit-ups and a two-mile run). Injury rates were examined using Cox regression after controlled for initial group differences in demographics, fitness and other variables. Compared to the EG, the adjusted relative risk of a time-loss overuse injury in the CG was 1.5 (95 % confidence interval [CI] = 1.0 - 2.1, p < 0.01) for men and 1.4 (95 %CI = 1.1 - 1.8, p < 0.01) for women. There were no differences between groups for traumatic injuries. On the first administration of the final APFT, the EG had a greater proportion of recruits passing the test than the CG (men: 85 % vs. 81 %, p = 0.04; women: 80 % vs. 70 %, p < 0.01). After all APFT retakes, the EG had significantly fewer APFT failures than the CG among the women (1.6 % vs. 4.6 %, p < 0.01) but not the men (1.6 % vs. 2.8 %, p = 0.18); the gender-combined EG had a higher pass rate (1.6 % vs. 3.7 %, p < 0.01). Overall, the PRT program reduced overuse injuries and allowed a higher success rate on the APFT.

Adult↗
PubMed2006

Secular trends in the aerobic fitness test performance and body mass index of Korean children and adolescents (1968-2000).

There is increasing evidence that the aerobic fitness performance of children is declining, at least in developed countries. To see if there was evidence of similar trends in a non-Western country, this study analysed data on 6-18-year-old Koreans tested between 1968 and 2000 using distance runs ranging from 600 to 1200 m. All existing data on the results of children's aerobic fitness tests in Korea were collated. In addition to six individual studies, very large datasets were available from the Korean Ministries of Education, and the Ministry of Culture and Tourism. Data on a total of 22,127,265 6-18-year-old children were available in the form of group means and standard deviations. Data were collated for each age x sex x test group, and performances were expressed as percentages of the fitted values for the year 1992 to standardise across tests, ages and sexes. All age x sex x test groups were then combined, and curves were fitted using weighted regression. A two-linear segment model best described the pattern of change (r = 0.83, p < 0.001). There was a relatively slow decline (0.26 % per year) in the aerobic performance of Korean children between 1968 and 1984. After 1984, however, there was a steep decline in performance, averaging 0.80 % per year. The rate of decline was greater in boys, younger children and children from outside the capital Seoul. Changes in running performance showed a similar pattern to changes in estimated body mass index. Compared to other countries, there has been a sharp decline in Korean children's performance on tests of aerobic fitness, which has been concurrent with increases in estimated body mass index.

Adolescent↗
PubMed1998

Levels of physical activity, physical fitness and their relationship in the Northern Ireland Health and Activity Survey.

The aim of the study was to describe the physical activity and physical fitness profile of the population of Northern Ireland and to explore the relationship between physical activity and physical fitness. This was a cross sectional population study using a two stage probability sample of the adult population of Northern Ireland (aged 16+). The main outcome measures were physical activity profile based on computer assisted interview. Physical fitness using estimation of VO2max by extrapolation from submaximal oxygen uptake while walking on a motor driven treadmill. We found that males were more vigorously active than females (M 21%:F 6%) with a steep gradient of decreasing activity with age: 49% (M 52%:F 46%) were regularly active up to at least moderate intensity. Males (mean predicted VO2max 44.4 mls/kg/min; 16-74 years) were fitter than females (mean predicted VO2max 34.0 mls/kg/min; 16-74 years) and while there was a decline in predicted VO2max with age, there was wide variation within each age category. There was no statistically significant relationship between current or past activity and fitness after adjustment for possible confounding factors, with the exception of a relationship between fitness and activity in males so that the difference between no activity and habitual vigorous activity in predicted VO2max was 4.4mls/kg/min (10.1%).

Adolescent↗
PubMed2000

Clinical fit of Procera AllCeram crowns.

STATEMENT OF PROBLEM: Color stability, strength, and accuracy of fit are the main requirements for complete-ceramic crowns. The Procera AllCeram crown system is a CAD/CAM system used to fabricate individual complete-ceramic crowns that have a dry sintered, aluminum oxide core and appear to match clinical requirements. However, there are few articles about the clinical fit of all-ceramic crowns. PURPOSE: This in vivo study measured the accuracy of fit of Procera AllCeram crowns in anterior and posterior teeth. MATERIAL AND METHODS: The clinical fit of 80 anterior and posterior Procera AllCeram crowns was evaluated by a replica technique with a light body silicone to fill space between crown and tooth and a heavy body silicone to stabilize the light body film. After removal from the artificial crowns, the replicas were segmented, and measurements of the film thickness were performed with a light microscope. RESULTS: Medians of mean marginal gap widths were between 80 and 95 microm in anterior teeth and between 90 and 145 microm in posterior teeth. Medians of maximal marginal gap widths ranged from 80 to 180 microm in anterior teeth and from 115 to 245 microm in posterior teeth. CONCLUSION: The accuracy of fit achieved by Procera AllCeram was comparable to other conventional and innovative systems.

Adult↗
PubMed2004

Cardiovascular fitness, cortical plasticity, and aging.

Cardiovascular fitness is thought to offset declines in cognitive performance, but little is known about the cortical mechanisms that underlie these changes in humans. Research using animal models shows that aerobic training increases cortical capillary supplies, the number of synaptic connections, and the development of new neurons. The end result is a brain that is more efficient, plastic, and adaptive, which translates into better performance in aging animals. Here, in two separate experiments, we demonstrate for the first time to our knowledge, in humans that increases in cardiovascular fitness results in increased functioning of key aspects of the attentional network of the brain during a cognitively challenging task. Specifically, highly fit (Study 1) or aerobically trained (Study 2) persons show greater task-related activity in regions of the prefrontal and parietal cortices that are involved in spatial selection and inhibitory functioning, when compared with low-fit (Study 1) or nonaerobic control (Study 2) participants. Additionally, in both studies there exist groupwise differences in activation of the anterior cingulate cortex, which is thought to monitor for conflict in the attentional system, and signal the need for adaptation in the attentional network. These data suggest that increased cardiovascular fitness can affect improvements in the plasticity of the aging human brain, and may serve to reduce both biological and cognitive senescence in humans.

Aged↗
PubMed2002

Non-esterified fatty acid levels and physical inactivity: the relative importance of low habitual energy expenditure and cardio-respiratory fitness.

The fasting concentration of non-esterified fatty acids (NEFA) and the degree to which it declines during an oral glucose tolerance test are closely associated with insulin resistance and glucose intolerance. However, relatively few studies have described possible environmental determinants of NEFA concentrations. Physical activity is likely to be related to NEFA levels, but habitual activity level is difficult to quantify in epidemiological studies. In particular, it is unclear whether NEFA is more closely related to cardio-respiratory fitness or to habitual energy expenditure. In order to quantify these relationships, we analysed data from the Ely prospective population-based study in which 931 subjects underwent a glucose tolerance test with measurements of cardio-respiratory fitness and 4 d energy expenditure by heart-rate monitoring, a technique previously validated against whole-body calorimetry and doubly-labelled water. In order to estimate the latent variables of usual fitness and energy expenditure, a subset of 190 subjects underwent repeat testing on three further occasions over 1 year. In analyses adjusting only for age and sex, energy expenditure and cardio-respiratory fitness were both negatively correlated with the total area under the NEFA curve following the oral glucose load (standardised beta coefficients -0.030 and -0.039 respectively; both P<0.001) However, further adjustment for degree of obesity and bivariate measurement error suggested that the effect of energy expenditure was significantly greater than that for fitness (-0.047 and -0.005 respectively). These results suggest that the area under the NEFA curve in the oral glucose tolerance test, a measure of insulin sensitivity, is strongly associated with the habitual level of physical activity.

Adult↗
PubMed1997

Physical fitness as a function of psychological and situational factors.

The association between personality variables suggested by Rotter's social learning theory and indices of physical fitness was examined in a sample of U.S. college students. As predicted, both higher value placed on physical fitness and greater internal locus of control were related to selected indicators of physical fitness. In addition, gender of administrator affected performance on certain measures of physical fitness. The results suggest the need for longitudinal studies to evaluate the role of physical activity in mediating the relationship between personality variables and physical fitness.

Adult↗
PubMed1980

Physical fitness for physicians.

The typical workload of a physician probably is not sufficient to produce and maintain a state of physical fitness. A majority of physicians seem to be involved in recreational exercise. However, the necessary data are not available regarding the frequency, duration, and intensity of their exercise--let alone on maximum heart rates and oxygen consumption in exercise--to permit determining their levels of physical fitness. Among the many factors contributing to an overall state of physical fitness, cardiovascular and pulmonary fitness (ie, endurance) appears to be most important to the physician, whose work, with rare exceptions, requires endurance but not unusual strength. Activities most suitable to development of this type of fitness include fast walking, running, cycling, swimming, and circuit training. The exercise prescription should be expressed in terms of the heart rate to be reached, and the frequency, duration, and intensity of the activity to be performed.

Alcohol Drinking↗
PubMed2001

A fitting strategy for digital hearing aids based on loudness and sound quality.

In order to find an adequate fitting strategy for digital compression hearing aids a combination of two interactive fitting strategies was developed, one of these based on frequency specifice loudness (ScalAdapt) and the other based on overall loudness and on sound quality (Cambridge Procedure). This new fitting strategy was tested against the sound and overall loudness based strategy and against a prescriptive fitting strategy in a 2-weeks field test with questionnaires and in laboratory measurements, subjectively as well as objectively. With six sensorineural hearing impaired participants no straightforward results were achieved. Additionally, the different testing procedures indicate (in tendency) different fitting strategies to be superior. More subjects will have to be tested and innovative evaluation methods have to be considered.

Acoustic Stimulation↗