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PubMed1996

Leisure time activity and physical fitness in patients with epilepsy.

PURPOSE: To assess social and physical activity by means of a controlled study based on a questionnaire and standardized clinical tests of physical fitness. METHODS: In this controlled study, we assessed several issues of social and physical activity in 136 patients with epilepsy and 145 controls by using a questionnaire. In addition, we investigated physical fitness based on physical parameters such as body mass index and body composition and standardized tests of aerobic and muscle strength endurance and physical flexibility in 35 adult patients and 36 healthy controls. RESULTS: Leisure time habits both at home and outside the home were mainly similar except for visits of friends, which were significantly reduced in patients. Although the general attitude toward sports and physical activity was positive in both groups, and although controls judged sports to be dangerous significantly more often (p = 0.007), controls participated in regular sports significantly more frequently (p = 0.005). The clinical study demonstrated a lack of physical fitness, as suggested by the questionnaire data. Statistical analysis demonstrated significant differences of aerobic endurance (p < 0.001), muscle strength endurance (p < 0.001), and physical flexibility (p < 0.001) in favor of the control subjects. The body mass index was significantly higher in patients (p = 0.03), whereas the body composition revealed a higher body fat ratio only in female patients (p = 0.04). CONCLUSIONS: We conclude that patients with epilepsy suffer from a considerable lack of physical fitness that might have an important impact on their general health and quality of life. In addition to overprotection and reduced mobility, the questionnaire revealed insufficient knowledge among health professionals and sport instructors as a major factor contributing to these results.

Adolescent↗
PubMed1995

Does physical activity improve sleep in impaired nursing home residents?

OBJECTIVES: To determine if two physical activity programs of varying intensity would result in improved sleep among incontinent and physically restrained nursing home residents. DESIGN: Controlled trials of two physical activity programs. SETTING: Seven community nursing homes in the Los Angeles area. PARTICIPANTS: Residents were included if they had urinary incontinence or were physically restrained. Sixty-five subjects were studied. Mean age was 84.8 years, 85% were female, mean length of residency in the nursing home was 19.9 months, and mean Mean Mini-Mental State Exam score was 13.1. INTERVENTION: The first physical activity program involved sit-to-stand repetitions and/or transferring and walking or wheelchair propulsion. These activities were performed every 2 hours during the daytime, 5 days per week for 9 weeks. The second, less frequent physical activity program involved rowing in a wheelchair-accessible rowing machine plus walking or wheelchair propulsion once per day three times per week for 9 weeks. MEASUREMENTS: The physical function measures reported here include mobility endurance (maximum time walking or wheeling) and physical activity as measured by motion sensors (Caltrac). Nighttime sleep was estimated by wrist activity monitors. Nighttime sleep measures included total time asleep, percent sleep, average duration of sleep, and peak duration of sleep. Daytime sleep was measured by timed behavioral observations of sleep versus wakefulness performed every 15 minutes during the day. RESULTS: Nighttime sleep was markedly disrupted in both groups at baseline. Across all subjects at baseline, the average total sleep time was 6.2 hours and the percent sleep was 72.0%, but the average duration of sleep episodes was only 21.2 minutes and the peak duration of sleep episode averaged only 83.8 minutes. During the daytime, subjects were observed asleep during 14.5% of observations. Although there was improvement in mobility endurance in the intervention subjects compared with controls (MANOVA F = 4.36, P = .042), there were no differences in the night and day sleep measures at follow-up testing. Even among a subgroup of intervention subjects who showed a 30% or greater improvement in mobility endurance, sleep did not improve at follow-up compared with baseline. CONCLUSION: This study supports our previous findings of marked sleep disruption in impaired nursing home residents. In addition, despite documented improvements in physical function with activity, we did not find improvements in sleep in the intervention versus control groups. These results suggest that increasing daytime physical activity alone is not adequate to improve sleep in impaired NH residents. Future efforts to improve sleep in this population should take into account the multifactorial nature of sleep disruption, including individual health problems that effect sleep and the disruptive nature of the nighttime NH environment.

Aged↗
PubMed1999

Status of the year 2000 health goals for physical activity and fitness.

In Healthy People 2000, the national strategy for improving the health of the American people by the year 2000, lifestyle factors such as physical inactivity are major determinants of chronic disease and disability. Despite the documented benefits of exercise in enhancing health and reducing the risk of premature death, only 1 of the 13 physical activity and fitness objectives of Healthy People 2000 has been met or exceeded. Although progress toward 5 objectives for the year 2000 has been made, 3 objectives are actually farther from attainment. Coronary heart disease death rates (Objective 1.1) have declined, and the prevalence of overweight people (Objective 1.2) has increased. Overall physical activity in adults (Objectives 1.3 and 1.4) and strengthening and stretching activities in children (Objective 1.6) have increased, but reduction in the percentage of sedentary persons (Objective 1.5) has showed no change. The proportion of the population adopting sound dietary practices combined with regular physical activity to attain appropriate body weight (Objective 1.7) has declined. Even though participation in daily school physical education (Objective 1.8) has shown a decline during the past several years, students who are enrolled in physical education classes are spending more time performing physical activities (Objective 1.9). The proportion of work sites offering employer-sponsored physical activity and fitness programs (Objective 1.10) has increased substantially, surpassing the year 2000 goal. Data to update progress for increasing physical activity levels of children (Objectives 1.3-1.5), community exercise facilities (Objective 1.11), clinician counseling about physical activity (Objective 1.12), and improvement in personal self-care activities (Objective 1.13) are not yet available.

Adolescent↗
PubMed1992

Strengthening physical self-perceptions through exercise.

Two studies examined the effects of physical activity/exercise on physical self-perceptions, self-efficacy, body satisfaction, fitness and relationships among these variables. In study 1, 34 female undergraduates participated in a 10-week exercise/activity program. Participants were selected from existing classes forming a weight training, aerobic exercise and activity control group. Results revealed changes in physical self-perceptions, strength, and body composition over the 10-weeks. Improvements in physical self-perceptions and fitness occurred independent of exercise/activity group. Groups differed in the perceived importance attached to physical self-perceptions. Correlations among the measures revealed relationships among physical self-perceptions, body satisfaction, global self-esteem, and fitness. In study 2, we hypothesized that weight training would have a greater effect on physical self-perceptions and body image perceptions than physical education activity classes. Thirty-seven males and 28 females were selected from existing classes forming a weight training and activity group. Results revealed no significant changes in physical self-perceptions, body image, or global self-esteem over the 10-week program, while strength and physical self-efficacy improved. Correlations among measures from both studies offer preliminary support for Sonstroem and Morgan's model for the examination of self-esteem in exercise settings.

Adolescent↗
PubMed2004

Clinical reasoning strategies in physical therapy.

BACKGROUND AND PURPOSE: Clinical reasoning remains a relatively under-researched subject in physical therapy. The purpose of this qualitative study was to examine the clinical reasoning of expert physical therapists in 3 different fields of physical therapy: orthopedic (manual) physical therapy, neurological physical therapy, and domiciliary care (home health) physical therapy. SUBJECTS: The subjects were 6 peer-designated expert physical therapists (2 from each field) nominated by leaders within the Australian Physiotherapy Association and 6 other interviewed experts representing each of the same 3 fields. METHODS: Guided by a grounded theory method, a multiple case study approach was used to study the clinical practice of the 6 physical therapists in the 3 fields. RESULTS: A model of clinical reasoning in physical therapy characterized by the notion of "clinical reasoning strategies" is proposed by the authors. Within these clinical reasoning strategies, the application of different paradigms of knowledge and their interplay within reasoning is termed "dialectical reasoning." DISCUSSION AND CONCLUSION: The findings of this study provide a potential clinical reasoning framework for the adoption of emerging models of impairment and disability in physical therapy.

Data Collection↗
PubMed2004

[Importance of conservative treatment and physical load restriction to the course of Osgood-Schlatter's disease].

Osgood- Schlatter's disease is one of most common causes of knee pain in young patients. In 2000-2002, 171 young patients were consulted for Osgood-Schlatter's disease in the Departments of Orthopedics and Traumatology in Kaunas University of Medicine. There were 41 (24%) females and 130 (76%) males; the age ranging from 10 to 27 years. Patients were divided into two groups: the first group (92 patients) underwent conservative treatment and physical load restriction; the second group (79 patients) had no physical load restriction or they neglected reduced physical load guidelines. In the first group 52 patients were treated by conservative measures and physical load restriction, while 40 patients had only physical load restriction. Pain disappeared faster (approximately after 13 months) in the first group patients, who were treated conservatively and had reduced physical load, compared to patients, who had only physical load restriction (pain disappeared approximately after 15 months), p<0.05 (p=0.0008). Pain disappeared faster in patients who had only physical load restriction (approximately after 15 months) compared to the second group patients who had no physical load restriction (approximately after 16.5 months), p<0.05 (p=0.006). There was 1 complication (encapsulated ossification producing pain) in the first group, compared with 8 complications in the second one (2 patients with 3 type avulsion fracture, 1 patient with 2 type avulsion fracture, and 5 patients with encapsulated ossification producing pain). Complications were treated intraoperatively. Physical load restriction is important for beneficial course of Osgood-Schlatter's disease and prevention of complications.

Adolescent↗
PubMed2005

Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers.

BACKGROUND: Current evidence does not support an annual screening physical examination for asymptomatic adults, but little is known about primary care provider (PCP) attitudes and practices regarding an annual physical examination. METHODS: We conducted a postal survey (32 items) of attitudes and practices regarding the annual physical examination (in asymptomatic patients 18 years or older) of a random sample of PCPs (specializing in internal medicine, family practice, and obstetrics/gynecology) from 3 geographic areas (Boston, Mass; Denver, Colo; and San Diego, Calif). RESULTS: Respondents included 783 (47%) of 1679 PCPs. Overall, 430 (65%) of 664 agreed that an annual physical examination is necessary. Three hundred ninety-three (55%) of 712 disagreed with the statement that national organizations do not recommend an annual physical examination, and 641 (88%) of 726 perform such examinations. Most PCPs agreed that an annual physical examination provides time to counsel patients about preventive health services (696/739 [94%]), improves patient-physician relationships (693/737 [94%]), and is desired by most patients (572/737 [78%]). Most also believe that an annual physical examination improves detection of subclinical illness (545/738 [74%]) and is of proven value (461/736 [63%]). Many believed that tests should be part of an annual physical examination, including mammography (44%), a lipid panel (48%), urinalysis (44%), testing of blood glucose level (46%), and complete blood cell count (39%). CONCLUSIONS: Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests. Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems.

Adult↗
PubMed2000

Physical training for asthma.

BACKGROUND: Physical training programmes have been designed for asthmatic subjects with the aim of improving physical fitness, neuromuscular coordination and self-confidence. Habitual physical activity increases physical fitness and lowers ventilation during mild and moderate exercise thereby reducing the likelihood of provoking exercise -induced asthma. Exercise training may also reduce the perception of breathlessness through a number of mechanisms including strengthening respiratory muscles. Subjectively, many asthmatics report that they are symptomatically better when fit, but results from trials have varied and have been difficult to compare because of different designs and training protocols. OBJECTIVES: The purpose of this review was to assess evidence for the efficacy and effectiveness of physical training in asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, Sportdiscus and Science citation index. SELECTION CRITERIA: Randomised trials in asthmatic subjects undertaking physical training. Subjects had to be 8 years and older. Physical training had to be undertaken for at least 20 to 30 minutes, 2 to 3 times a week, over a minimum of four weeks. DATA COLLECTION AND ANALYSIS: Eligibility for inclusion and quality of trials were assessed independently by two reviewers. MAIN RESULTS: Eight studies could be included in this review. Physical training had no effect on resting lung function or the number of days of wheeze. Physical training improved cardiopulmonary fitness as measured by an increase in maximum oxygen uptake of 5.6 ml/kg/min (95% confidence interval 3. 9 to 7.2). There were no data concerning quality of life measurements. REVIEWER'S CONCLUSIONS: In people with asthma, physical training can improve cardiopulmonary fitness without changing lung function. It is not known whether improved fitness is translated into improved quality of life.

Asthma↗
PubMed2005

Interventions for promoting physical activity.

BACKGROUND: Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity. OBJECTIVES: To assess the effects of interventions for promoting physical activity in adults aged 16 years and older, not living in an institution. SEARCH STRATEGY: We searched CENTRAL (Issue 4, 2001), MEDLINE, EMBASE, CINAHL, PsychLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (from earliest date available to December 2001) and reference lists of articles. SELECTION CRITERIA: Randomised, controlled, trials comparing different interventions to encourage sedentary adults not living in an institution to become physically active. Studies required a minimum of six months follow up from the start of the intervention to the collection of final data and either used an intention to treat analysis or, failing that, had no more than 20% loss to follow up. DATA COLLECTION AND ANALYSIS: At least two reviewers independently assessed each study quality and extracted data. Study authors were contacted for additional information where necessary. Standardised mean differences and 95% confidence intervals were calculated for continuous measures of self reported physical activity and cardio-respiratory fitness. For studies with dichotomous outcomes, odds ratios and 95% confidence intervals were calculated. MAIN RESULTS: The effect of interventions on self reported physical activity (11 studies; 3940 participants) was positive and moderate, with a pooled standardised mean difference of 0.31 (95% CI 0.12 to 0.50), as was the effect on cardio-respiratory fitness (7 studies; 1406 participants) pooled SMD 0.4 (95% CI 0.09 to 0.70). The effect of interventions in achieving a predetermined threshold of physical activity (6 studies; 2313 participants) was not significant with an odds ratio of 1.30 (95% CI 0.87 to 1.95). There was significant heterogeneity in the reported effects as well as heterogeneity in characteristics of the interventions. The heterogeneity in reported effects was reduced in higher quality studies, when physical activity was self-directed with some professional guidance and when there was on-going professional support. AUTHORS' CONCLUSIONS: Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness, but not on achieving a predetermined level of physical activity. Due to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. Future studies should provide greater detail of the components of interventions.

Exercise↗
PubMed2004

Are US adults with arthritis meeting public health recommendations for physical activity?

OBJECTIVE: To estimate the prevalence of US adults with self-reported, doctor-diagnosed arthritis (without specifying the type of rheumatic disease) who are meeting the US Surgeon General's recommendations for physical activity. METHODS: Using population-based survey data from the 2001 Behavioral Risk Factor Surveillance Survey, we classified respondents according to their arthritis status and their level of physical activity (i.e., physically inactive, insufficiently active, or meeting recommendations). Prevalence data were weighted to take account of the complex sampling design, and were broken down by a variety of demographic characteristics such as race, education, and body weight. RESULTS: Nearly one-quarter (23%) of US adults reported having doctor-diagnosed arthritis. Among adults with arthritis, 23.8% were physically inactive, 38% reported insufficient levels of physical activity, and 38.3% reported meeting the recommendations for physical activity. The highest prevalence of inactivity in adults with arthritis was found among those subjects with fewer than 8 years of formal education (47.6%), those with 9-11 years of education (35.5%), those who were African American (35.4%), those whose age was > or =65 years (31.1%), and those who were Hispanic (30.4%). CONCLUSION: Despite the benefits of physical activity, more than 60% of adults with arthritis do not meet the physical activity recommendations. Efforts should be made to ensure that adults with arthritis are made aware of the benefits of physical activity, and that interventions are prescribed to assist these individuals in becoming more physically active.

Adolescent↗
PubMed1986

Echocardiographic left ventricular mass and physical activity: quantification of the relation in spinal cord injured and apparently healthy active men.

To assess the relation of echocardiographic left ventricular (LV) mass to reported physical activity, 2 groups of subjects with widely different physical activity levels were evaluated: 50 men with spinal cord injuries and 166 apparently healthy, active men. Multivariate analysis revealed that reported physical activity was a significant independent predictor of LV mass index (LV mass/body surface area) in both injured patients and healthy, active subjects after controlling for age and blood pressure. The relation between LV mass index and physical activity (linear regression) was similar for both groups; LV mass index = 0.00321 (physical activity) + 82.8 and LV mass index = 0.00335 (physical activity) +88.4 for patients and healthy active subjects, respectively. These results suggest that physical activity as assessed by self-report is associated with echocardiographically detectable differences in LV mass in groups with widely divergent physical activity levels. In addition, for each of these groups 1,000 kcal/week of physical activity apparently results in a change of approximately 3 g/m2 in LV mass index. This information may have practical use for correction of LV mass for the effects of physical activity.

Adult↗
PubMed1993

Accuracy of the College Alumnus Physical Activity Questionnaire.

The validity and reproducibility of the Physical Activity Index from the College Alumnus Questionnaire (PAI-CAQ) were determined in 78 men and women (21-59 yr) with a broad range of physical activity habits. The PAI-CAQ was computed as the sum of energy expended in stair climbing, walking, and sports and recreational physical activity recalled from the past week. Data were validated against measures of cardiorespiratory fitness, body fatness, motion detection, and physical activity records. All physical activity was recorded by participants for six 48-hour periods. Each day of the week, including weekends, were represented at least twice in the physical activity records. Age-adjusted correlation coefficients between like activities on the College Alumnus Questionnaire and physical activity records ranged from 0.25 to 0.65 in men and 0.28 to 0.86 in women. Correlations between the PAI-CAQ and validation criteria that reflected total and heavy-intensity physical activities were higher (r = 0.34-0.69, p < 0.05) than for lighter-intensity physical activities and motion detection expressed in MET-min.d-1 and kcal.d-1 (r < 0.35, p > 0.05). Test-retest reproducibility was higher over 1 month (r = 0.72) than over 8 and 9 months (r = 0.34 and 0.43) (p < 0.05). Energy expended in walking and stair climbing was underestimated on the College Alumnus Questionnaire, resulting in lower PAI-CAQ scores, as compared to the physical activity records.

Adult↗
PubMed2006

Midlife physical activity and mobility in older age: The InCHIANTI study.

BACKGROUND: Among older adults, loss of mobility represents a critical stage in the disablement process, whereby the risk for disability is significantly increased. Physical activity is a modifiable risk factor that is associated with reduced risk of losing mobility in older adulthood; however, few studies have examined physical activity performed earlier in life in relation to mobility later in life. METHODS: Data from a population-based study of 1155 adults aged 65 years and older living in the Chianti region of Italy in 1998-2000 were analyzed in 2005 and 2006. Participants retrospectively recalled their physical activity levels in midlife and underwent mobility testing and medical examination. Two objective mobility outcomes were examined as a function of past physical activity: the Short Physical Performance Battery (SPPB) and the ability to walk 400 meters. RESULTS: Older Italian adults (mean age 74.8, standard deviation 7.3) who engaged in higher levels of physical activity in midlife were significantly more likely to perform better on the SPPB than individuals who were less physically active in midlife. In addition, failure to complete the 400-meter walk test was significantly less likely among physically active men (Level II) (odds ratio [OR] = 0.37, 95% confidence interval [CI] = 0.15-0.93) and very active men (Level III) (OR = 0.23, 95% CI = 0.09-0.63) when compared to men who were less active (Level I) in the past (p for trend, 0.008). These associations remained after adjustment for demographic factors, medical conditions, and physiologic impairments. CONCLUSIONS: Older adults who reported higher levels of physical activity in midlife had better mobility in old age than less physically active ones.

Aged↗
PubMed2001

Association between self-reported physical activity and vascular reactivity in postmenopausal women.

Short-term exercise training has been associated with improved endothelial-dependent vasodilation, but the impact of long-term habitual physical activity on vascular reactivity is not established. We studied the correlation between self-reported, habitual physical activity and vasoreactivity in non-smoking, non-diabetic, postmenopausal women (n=34, mean age 65.6+/-7.4 years). Vasoreactivity was evaluated by the percentage and absolute change in brachial artery diameter in response to reactive hyperemia induced by occlusion-release, and in response to cold pressor testing (CPT). Habitual physical activity was assessed by a standardized questionnaire based on participant recall. Our results indicate that 64.7% of the women were exercising-to-sweat > or =1x/week, 4.8 flights of stairs were climbed/day, 5.0 city blocks were walked/day and 29.4% participated in moderately physically demanding daily activity. There was a significant association between the number of city blocks walked daily and exercising-to-sweat > or =1x/week with brachial artery percentage and absolute change to CPT (P<0.05). Women who reported a moderately physically demanding daily activity had a significantly greater brachial reactivity percentage change in response to CPT compared with those performing less demanding daily activity (2.0+/-3.6 versus 1.4+/-7.0%, P<0.05). The response to reactive hyperemia was also greater in those women reporting moderately physically demanding daily activity compared to less active women (6.5+/-5.4 versus 5.8+/-5.9%, P=n.s.), but this did not reach statistical significance. Stepwise, multivariate analysis adjusting for body mass index and HDL-cholesterol eliminated the association between physical activity and brachial reactivity in response to CPT, suggesting that physical activity may affect vasoreactivity via these mechanisms. This study suggests that moderate levels of self-reported physical activity are associated with a greater brachial reactivity in response to CPT and supports the recommendation that moderate intensity physical activity may be cardioprotective in postmenopausal women.

Aged↗
PubMed2002

Effectiveness of physical activity interventions for older adults: a review.

OBJECTIVE: This review evaluates the effectiveness of physical activity interventions among older adults. METHODS: Computerized searches were performed to identify randomized controlled trials. Studies were included if: (1) the study population consisted of older adults (average sample population age of > or =50 years and minimum age of 40 years); (2) the intervention consisted of an exercise program or was aimed at promoting physical activity; and (3) reported on participation (i.e., adherence/compliance) or changes in level of physical activity (e.g., pre-post test measures and group comparisons). RESULTS: The 38 studies included 57 physical activity interventions. Three types of interventions were identified: home-based, group-based, and educational. In the short-term, both home-based interventions and group-based interventions achieved high rates of participation (means of 90% and 84%, respectively). Participation declined the longer the duration of the intervention. Participation in education interventions varied widely (range of 35% to 96%). Both group-based interventions and education interventions were effective in increasing physical activity levels in the short-term. Information on long-term effectiveness was either absent or showed no difference of physical activity level between the study groups. CONCLUSIONS: Home-based, group-based, and educational physical activity interventions can result in increased physical activity, but changes are small and short-lived. Participation rates of home-based and group-based interventions were comparable, and both seemed to be unrelated to type or frequency of physical activity. The beneficial effect of behavioral reinforcement strategies was not evident. Comparative studies evaluating the effectiveness of diverse interventions are needed to identify the interventions most likely to succeed in the initiation and maintenance of physical activity.

Aged↗
PubMed2002

Toward a better understanding of the influences on physical activity: the role of determinants, correlates, causal variables, mediators, moderators, and confounders.

BACKGROUND: For research on physical activity interventions to progress systematically, the mechanisms of action must be studied. In doing so, the research methods and their associated concepts and terminology become more complex. It is particularly important to clearly distinguish among determinants, correlates, mediators, moderators, and confounder variables used in physical activity research. This article examines the factors that are correlated with and that may have a causal relationship to physical activity. METHODS AND RESULTS: We propose that the term "correlate" be used, instead of "determinant," to describe statistical associations or correlations between measured variables and physical activity. Studies of the correlates of physical activity are reviewed. The findings of these studies can help to critique existing theories of health behavior change and can provide hypotheses to be tested in intervention studies from which it is possible to draw causal inferences. Mediator, moderator, and confounder variables can act to influence measured changes in physical activity. Intervening causal variables that are necessary to complete a cause-effect pathway between an intervention and physical activity are termed "mediators." The relationship between an intervention and physical activity behaviors may vary for different groups; the strata by which they vary are levels of "moderators" of the relationship. Other factors may distort or affect the observed relationships between program exposure and physical activity, and are known as "confounders." CONCLUSIONS: Consistent use of terms and additional research on mediators and moderators of intervention effects will improve our ability to understand and influence physical activity.

Behavioral Sciences↗
PubMed2003

Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting.

BACKGROUND: Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program. METHODS: A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol. RESULTS: There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure. CONCLUSIONS: Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted.

Adult↗
PubMed2002

Physical activity, metabolic issues, and assessment.

Considering the important health consequences of physical activity and aerobic capacity, current guidelines recommend that all individuals should be physically active all or most days of the week. Relatively little is known about physical activity patterns or aerobic capacity of individuals who have disabilities, but existing data clearly show a disturbing pattern of low levels of physical activity and aerobic capacity in most, if not all, populations who have disabilities. More research is needed on all populations who have disabilities, not only documenting current levels of physical activity and aerobic capacity but also investigating potential strategies for improvement. Unfortunately, the techniques available for measuring physical activity have significant shortcomings. DLW shows considerable promise, but it is expensive and not appropriate for population studies. All other techniques have significant shortcomings in regard to tracking individual physical activity patterns, but they might provide valuable insight regarding group behavior. Although maximal exercise testing is the gold standard for measuring aerobic capacity, this technique is difficult to use in many populations that have disabilities. Few protocols have been validated for use with individuals who have disabilities, and indiscriminant use of protocols developed for nondisabled populations is inappropriate when testing individuals who have disabilities. Submaximal testing could be of considerable utility, but few protocols have been validated. For most populations that have disabilities, submaximal tests designed to predict VO2peak are not valid, given the altered disability-specific physiological responses, which usually result in gross overpredictions. Submaximal tests designed to compare (either intra or inter individual comparisons) physiological responses at predetermined submaximal work rates show considerable promise. Both populations of children who have disabilities that are discussed herein exhibit low levels of physical activity and aerobic capacity, which is consistent with most of the literature for any group that has disabilities. Although the mechanisms for producing lower levels of activity and aerobic capacity differ among children who have mental retardation and children who have CP, the outcome is similar in both populations. Appropriate testing methodology differs between these populations, and the different mechanisms involved demonstrate the disability-specific nature of research in children who have disabilities, which also illustrates the difficulty of producing general guidelines for exercise and physical activity interventions. Current data clearly show the need for improving both physical activity patterns and aerobic capacity in most children who have disabilities. Failure to accomplish this goal will ultimately have considerable negative health outcomes for individuals who have disabilities.

Child↗