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Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial.

CONTEXT: Enhancing participation in long-term exercise may translate into improved long-term weight loss in overweight adults. OBJECTIVES: To compare the effects of intermittent with traditional continuous exercise on weight loss, adherence, and fitness, and to examine the effect of combining intermittent exercise with that using home exercise equipment. DESIGN: Randomized trial from September 1996 through September 1998. SETTING AND PARTICIPANTS: A total of 148 sedentary, overweight (mean [SD] body mass index, 32.8 [4.0] kg/m2) women (mean [SD] age, 36.7 [5.6] years) in a university-based weight control program. INTERVENTIONS: Eighteen-month behavioral weight control program with 3 groups: long-bout exercise (LB), multiple short-bout exercise (SB), or multiple short-bout exercise with home exercise equipment (SBEQ) using a treadmill. MAIN OUTCOME MEASURES: Body weight, body composition, cardiorespiratory fitness, and exercise adherence. RESULTS: Of 148 subjects, 115 (78%) completed the 18-month program. At 18 months, mean (SD) weight loss was significantly greater in subjects in the SBEQ group compared with subjects in the SB group (-7.4 [7.8] kg vs -3.7 [6.6] kg; P<.05). Mean (SD) weight loss for subjects in the LB group (-5.8 [7.1] kg) was not significantly different than for subjects in the SB or SBEQ groups. Subjects in the SBEQ group maintained a higher level of exercise than subjects in both the SB and LB groups (P<.05) at 13 to 18 months of treatment. All groups showed an increase in cardiorespiratory fitness from baseline to 18 months, with no difference between groups. Mean (SD) weight loss at 18 months was significantly greater in individuals exercising more than 200 min/wk throughout the intervention (-13.1 [8.0] kg) compared with individuals exercising 150 to 200 min/wk (-8.5 [5.8] kg) or less than 150 min/wk (-3.5 [6.5] kg) (P<.05). CONCLUSIONS: Compared with the LB group, subjects in the SB group did not experience improved long-term weight loss, exercise participation, or cardiorespiratory fitness. Access to home exercise equipment facilitated the maintenance of SB, which may improve long-term weight loss. A dose-response relationship exists between amount of exercise and long-term weight loss in overweight adult women.

Adult↗

Correlates of fitness for duty in hazardous materials firefighters.

BACKGROUND AND METHODS: From a statewide medical examination program, we identified firefighters who were deemed unfit for duty by attending physicians (ATTENDING FAIL, n=9) and those who would have been disqualified by the application of selected numerical criteria from the 1997 National Fire Protection Association (NFPA) guidelines (NFPA FAIL, n=27) and criteria from a Medical Workshop (WORK FAIL, n=16). The subjects who were unfit for duty or failed numerical criteria were compared with those who were fit for duty and passed all objective criteria (FIT group, n=302). All subjects were given an overall morbidity rating by a board certified internist. Comparisons on two surrogate measures of fitness, VO(2) max predicted and predicted coronary heart disease (CHD) risk, were also performed. RESULTS: We found a significant tendency towards worse results (e.g. higher blood pressure or lower spirometric function) among the three FAIL groups compared with the FIT group. The FAIL groups shared only a small overlap, however, with the firefighters with the highest morbidity ratings, lowest predicted VO(2) max, and highest CHD risks. Increasing morbidity was associated with higher age, lower spirometric function, lower predicted VO(2) max, increasing cholesterol, greater BMI, and higher predicted 10 year CHD risk. CONCLUSIONS: Although the presence of a single serious or poorly controlled condition may render an individual unfit for safe performance as a firefighter, examination of our cohort suggests that multiple risk factor models or overall clinical assessments are superior means of identifying firefighters with poor health status and increased CHD risk.

Adult↗

Factor M as a correlate of physical fitness: imagination or just more energy.

Determined whether 16PF scale scores could contribute significantly to the prediction of a measure of fitness. Sixty-three firemen from a large metropolitan area in the Southeast were Ss. Factor M contributed significantly to the prediction of one measure of fitness (i.e., treadmill time). The assumption cited in the literature that Factor M reflects "imagination" in individuals who score high on fitness measures was questioned. The article concluded that Cattell's earlier work relating high Factor M to high energy and endurance suggests a more logical interpretation of Factor M vis à vis measures of fitness.

Adult↗

Influence of catecholamine activity on the hierarchical relationships among physical fitness condition and selected personality characteristics.

Tested male Ss (N = 34) to determine how changes in the urinary excretion patterns of selected catecholamines and their metabolites affect the multivariate relationships involving variables that measure physical fitness condition and selected personality characteristics. Urine specimens were collected from each S after sleep and during occupational activities and analyzed for six catecholamine-related variables. Those measures were combined with six personality variables (MMPI) and a physical fitness score (Ismail Criterion), and subjected to first- and second-order factor analyses. The findings indicated an association between low physical fitness and high self-reported anxious depression during the occupational period, but not at rest. The changes in the factor structures were statistically mediated by changes in the concentrations of the biochemical variables across the collection periods. This suggests that the relationships between physical fitness and personality are augmented during catecholamine reactivity to occupational stress.

Adult↗

Assessing the influence of physical activity on health and fitness.

Increasing rates obesity and related chronic diseases in the United States and other parts of the world appear to be partly attributable to declining levels of physical activity. Given that adult obesity and chronic diseases often have their origins in childhood, there is a critical need to better understand how activity and fitness levels in childhood and adolescence shape health status in adulthood. The four papers in this series on physical activity draw on several longitudinal studies to examine the relationships between levels of physical activity and health-related fitness in childhood and adolescence to those in adulthood. These studies consistently demonstrate that adult activity levels and associated health outcomes are only modestly correlated with activity and fitness measures from childhood and adolescence. However, it appears that the methodological limitations in measuring activity levels may result in an underestimation of the importance of the influence of physical activity on health. Newer methods of measuring activity and energy expenditure offer to substantially improve our understanding of the influence of activity patterns on human health and fitness. Such information is necessary for promoting lifestyle changes that will reduce the risks of obesity and other chronic diseases.

Adolescent↗

Physical activity and fitness: pathways from childhood to adulthood.

Contemporary thinking in public health posits that childhood and adolescent physical activity and physical fitness may influence health status during childhood and adolescence, as well as throughout adulthood. This paper addresses the evidence dealing with potential associations of physical activity and physical fitness in childhood and adolescence to health status during childhood, adolescence, and adulthood. There are generally low to moderate relationships between childhood and adolescent physical activity and health (operationalized largely in terms of health-related physical fitness) and adult physical activity and health. A large part of the variability in health-related fitness is not accounted for by physical activity as assessed in the available studies. Nevertheless, the trends emphasize the importance of a lifestyle of regular physical activity during childhood and adolescence, which continues into and throughout adulthood, for the health and well-being of the individuals and populations.

Adolescent↗

Urban-rural contrasts in the physical fitness of school children in Oaxaca, Mexico.

The physical fitness of school children resident in an urban colonia and in a rural indigenous community in Oaxaca, southern Mexico, was compared. Two measures of performance-related fitness (standing long jump, 35-yard dash [32 m]) and four measures of health-related fitness (grip strength, sit and reach, timed sit-ups, distance run) were taken on 355 rural (175 boys, 184 girls) and 324 urban (163 boys, 161 girls) school children, 6-13 years of age. Urban children were significantly taller and heavier than rural children. Absolute grip strength did not consistently differ between rural and urban children, but when adjusted for age and body size, strength was greater in rural children. Explosive power (standing long jump) and abdominal strength and endurance (timed sit-ups) were better in urban than in rural children without and with adjustment for age and body size. Urban-rural differences in running speed (dash) and flexibility (sit and reach) varied by age group and sex. Younger rural children and older urban girls performed better in the distance run, whereas older rural and urban boys did not differ in endurance. The size advantage of urban children does not necessarily translate into better levels of performance- and health-related physical fitness. The observed differences may be related to activity habits associated with school physical education and lifestyle in the respective communities.

Adolescent↗

A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia.

Forty-two patients with primary fibromyalgia were randomized into a 20-week program consisting of either cardiovascular fitness (CVR) training or simple flexibility exercises (FLEX) that did not lead to enhanced cardiovascular fitness. Patients were supervised by the same medical fitness instructors. Patients in neither group had contact with members of the other group, and were blinded as to the exercise taught to the alternative group. Groups met for 60 minutes 3 times each week. The compliance rate was 90%. Thirty-eight patients completed the study (18 with CVR training and 20 with FLEX). Blind assessments (standardized in preliminary trials to achieve acceptable inter-rater agreement) were performed by the same 2 examiners. After 20 weeks, patients receiving CVR training showed significantly improved cardiovascular fitness scores compared with those receiving FLEX training (t[35] = -4.22, P less than 0.003). Logistic regression analysis showed clinically and statistically significant improvements in pain threshold scores, which were measured directly over fibrositic tender points, in patients undergoing CVR (t[35] = 2.21, P less than 0.04). There was also a trend toward improvement in pain scores (visual analog scale) in the CVR group, but this did not reach statistical significance. There was no improvement in the percentage of body area affected by fibrositic symptoms or the number of nights per week or hours per night of disturbed sleep (self-report inventories). However, compared with the FLEX group, the CVR-trained patients improved significantly in both patient and physician global assessment scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The influence of aerobic fitness and fibromyalgia on cardiorespiratory and perceptual responses to exercise in patients with chronic fatigue syndrome.

OBJECTIVE: To investigate cardiorespiratory and perceptual responses to exercise in patients with chronic fatigue syndrome (CFS), accounting for comorbid fibromyalgia (FM) and controlling for aerobic fitness. METHODS: Twenty-nine patients with CFS only, 23 patients with CFS plus FM, and 32 controls completed an incremental bicycle test to exhaustion. Cardiorespiratory and perceptual responses were measured. Results were determined for the entire sample and for 18 subjects from each group matched for peak oxygen consumption. RESULTS: In the overall sample, there were no significant differences in cardiorespiratory parameters between the CFS only group and the controls. However, the CFS plus FM group exhibited lower ventilation, lower end-tidal CO2, and higher ventilatory equivalent of carbon dioxide compared with controls, and slower increases in heart rate compared with both patients with CFS only and controls. Peak oxygen consumption, ventilation, and workload were lower in the CFS plus FM group. Subjects in both the CFS only group and the CFS plus FM group rated exercise as more effortful than did controls. Patients with CFS plus FM rated exercise as significantly more painful than did patients with CFS only or controls. In the subgroups matched for aerobic fitness, there were no significant differences among the groups for any measured cardiorespiratory response, but perceptual differences in the CFS plus FM group remained. CONCLUSION: With matching for aerobic fitness, cardiorespiratory responses to exercise in patients with CFS only and CFS plus FM are not different from those in sedentary healthy subjects. While CFS patients with comorbid FM perceive exercise as more effortful and painful than do controls, those with CFS alone do not. These results suggest that aerobic fitness and a concurrent diagnosis of FM are likely explanations for currently conflicting data and challenge ideas implicating metabolic disease in the pathogenesis of CFS.

Adolescent↗

Motor training and physical fitness: possible short- and long-term influences on the development of individual differences in behavior.

Individual differences in the behavior of young and adult animals have been documented in diverse species. Possible sources of such variation are of interest to scientists representing many disciplines, including behavior, genetics, and population and evolutionary biology. Two variables that may be important in the ontogeny and maintenance of behavioral differences are (1) individual physical (aerobic and anaerobic) fitness and (2) possible genetic variations underlying individual abilities to engage in, and to benefit from, motor training early in life. The differential development of aerobic and anaerobic capacities may play a significant role in the ontogeny of individual differences in the performance of various motor skills. There also may be short- and long-term consequences of variations in physical fitness that influence individual abilities to perform energy demanding acts during aggressive encounters, interactions with prey or predators, and courtship and breeding. Genetic studies of a limited number of species indicate that specific genotypes are correlated with individual variations in motor performance, even among conspecifics. Multidisciplinary research concerning possible relationships among the ontogeny of physical fitness, genetics, and variations in behavior is needed. Recent work on the relationship between individual differences in physical fitness and variations in the behavior of adult cold-blooded vertebrates provides a good model for comparative research on warm-blooded species.

Animals↗

Physical activity and physical fitness in African-American girls with and without obesity.

Lack of physical activity and low levels of physical fitness are thought to be contributing factors to the high prevalence of obesity in African-American girls. To examine this hypothesis, we compared habitual physical activity and physical fitness in 54 African-American girls with obesity and 96 African-American girls without obesity residing in rural South Carolina. Participation in vigorous (> or = 6 METs) (VPA) or moderate and vigorous physical activity (> or = 4 METs) (MVPA) was assessed on three consecutive days using the Previous Day Physical Activity Recall. Cardiorespiratory fitness was assessed using the PWC 170 cycle ergometer test. Upper body strength was determined at two sites via isometric cable tensiometer tests. Relative to their counterparts without obesity, girls with obesity reported significantly fewer 30-minute blocks of VPA (0.90 +/- 0.14 vs. 1.3 +/- 0.14) and MVPA (1.2 +/- 0.18 vs. 1.7 +/- 0.16) (p < 0.01). Within the entire sample, VPA and MVPA were inversely associated with body mass index (r = -0.17 and r = -0.19) and triceps skinfold thickness (r = -0.19 and r = -0.22) (p < 0.05). In the PWC 170 test and isometric strength tests, girls with obesity demonstrated absolute scores that were similar to, or greater than, those of girls without obesity; however, when scores were expressed relative to bodyweight, girls with obesity demonstrated significantly lower values (p < 0.05). The results support the hypothesis that lack of physical activity and low physical fitness are important contributing factors in the development and/or maintenance of obesity in African-American girls.

Black People↗

Fatigue after stroke: relationship to mobility, fitness, ambulatory activity, social support, and falls efficacy.

Fatigue is common and persistent in stroke survivors, yet it is not known how mobility deficits, fitness, or other factors, such as social support, relate to fatigue severity, or whether subjective fatigue contributes to reduced ambulatory activity. The severity of fatigue in a sample of 53 community-dwelling subjects with chronic hemiparetic stroke was examined, and relationships among fatigue and mobility deficit severity, cardiovascular-metabolic fitness, ambulatory activity, social support, and self-efficacy for falls were identified. Measures included the Fatigue Severity Scale, timed 10-meter walks, the Berg Balance Scale, submaximal and peak VO2, total daily step activity derived from microprocessor-linked Step Activity Monitors, the Medical Outcomes Study Social Support Survey, and the Falls Efficacy Scale. Forty-six percent of the sample had severe fatigue. Fatigue showed no relationship to ambulatory activity. Fatigue severity was associated with the Berg Balance Scale (p < .01) and falls efficacy (p < .01), but not with cardiovascular fitness variables. Patients with elevated fatigue severity scores had lower social support (p < .05) and poorer falls efficacy scores (p < .05) than patients reporting less fatigue. Only falls efficacy was predictive of fatigue severity (r2 = 0.216, p < .01). Further studies are needed to evaluate whether rehabilitation strategies that include not only fitness and mobility interventions, but also social/behavioral and self-efficacy components, are associated with reduced fatigue and increased ambulation.

Accidental Falls↗

Childhood fitness: what is happening? What needs to be done?

BACKGROUND: There is some controversy as to the fitness levels of U.S. school-age youth. Some experts claim that U.S. youth are fit. Others feel that there has been a decline, despite a recent adult fitness boom. METHODS: The purpose of this article is to examine the research conducted on the cardiovascular endurance and body composition levels of U.S. youth. Research studies noting the activity patterns of youth outside and during physical education are presented. The frequency and duration of physical education requirements are also reviewed. The effects of these patterns and requirements on cardiovascular endurance and body composition are presented. RESULTS: U.S. youth do not engage in physical activity, within our outside physical education, sufficient to develop cardiovascular endurance. Our youth are, therefore, at risk of developing a myriad of diseases associated with sedentary lifestyles. CONCLUSIONS: Exercise is known to have a prophylactic effect on disease, death, and disability. Young people must be instructed and encouraged to be involved in lifetime fitness activities if we are going to control health care costs, reduce disease incidence, and improve the overall quality of life of our citizens.

Adolescent↗

Physiological consequences of acculturation: a 20-year study of fitness in an Inuit community.

Surveys in 1969/1970, 1979/1980, and 1989/1990 assessed physical fitness among adult Inuit living in Igloolik, Northwest Territories, Canada, during a period of rapid acculturation to a sedentary lifestyle. MANOVA for age, cohort, and age-cohort effects indicated significant trends to greater skinfold readings [male (M) and female (F)] and body mass (F only), a lower handgrip and knee extension force (M and F), and lower step test predictions of aerobic power (M and F) in the more recent cohorts, with no change of forced vital capacity, 1-s forced expiratory volume, or hemoglobin level. By 1989/1990, continuing hunters tended to have thicker skinfolds than other villagers, and showed no advantage of aerobic power. The average fitness of the sample when tested in 1989/1990 was comparable with that of sedentary populations in Southern Canada, but a minority of villagers who now practiced regular sport had conserved the high levels of fitness that were observed in 1969/1970. We conclude that the fitness of this community appears to have deteriorated markedly as it has become more sedentary, and we thus recommend that health authorities develop methods of promoting an active lifestyle that are culturally appropriate to the populations of circumpolar settlements.

Acculturation↗

Fatigue and fitness modelled from the effects of training on performance.

The purpose of this study was to compare two ways of estimating both fatigue and fitness indicators from a systems model of the effects of training on performance. The model was applied to data concerning the training of a hammer thrower. The variations in performance were mathematically related to the successive amounts of training. The model equation was composed of negative (NF) and positive (PF) functions. The NF and PF were associated with the fatigue and fitness estimated in previous studies. Using another method, fatigue and fitness indicators were estimated from a combination of NF and PF. The influence of training on performance was negatively associated with fatigue (NI), and positively to fitness (PI). The changes in performance were well described by the model in the present study (r = 0.96, N = 19, P < 0.001). Significant correlations were observed between PF and PI (r = 0.90, P < 0.001) on the other. The absolute values and the time variations of PI and NI were closer to the change in performance than NF and PF. The NF and PF were accounted for mainly by the accumulation of amounts of training. On the other hand, NI and PI were accounted for rather by the impact of these amounts of training on performance.

Adaptation, Physiological↗

Periprosthetic modelling of femoral component fit using computed tomography data for total hip arthroplasty: a feasibility study.

The aim of the work was to create a new three-dimensional periprosthetic multi-criteria optimisation technique to identify the best six degrees of freedom transform to position a porous-coated anatomic cementless femoral component for three factors, including: first, maximisation of the degree of contact achieved between designated bone ingrowth surfaces and the periprosthetic bone; secondly, minimisation of the bone mass to be removed to accommodate the component and thirdly, the extreme constraint of the component to be positioned so that it does not project beyond the periosteum. Discrete integrals were computed over regions of interest derived from the polyhedral component mesh in transaxial CT scan planes, using a polygon scan-conversion algorithm. A new biomedical imaging volume rendering technique utilising dynamic virtual textures was developed to visualise the design trade-offs. Pareto-optima were identified for four femora that matched an average-sized component. The non-linear, multi-modal fit metric was quadratic near minima, with a narrow trough of equivalent fit values within 3mm of translation and 3 degrees of rotation with respect to the canal axis, and possessed a dependence most pronounced for distal-directed insertion against varus/valgus rotation. The study gives previously unavailable data on the three-dimensional femoral component fit and is the first report that demonstrates that fitting the implant using several design criteria in a multi-criteria optimisation scheme is feasible.

Arthroplasty, Replacement, Hip↗

Physical activity, physical fitness and respiratory function--exercise and respiratory function.

The aim of the study was to establish patterns of respiratory function in Northern Ireland and to examine the relationship between physical activity, physical fitness and respiratory function. We identified 1600 adults over 16 yr using 2 stage probability sampling. Physical activity was measured using a questionnaire, physical fitness from oxygen uptake while walking on a treadmill, and respiratory function using spirometry. The main outcome measures were a physical activity profile based on computer assisted interview, physical fitness by predicted VO2max, Forced Vital Capacity (FVC) and Forced Expiratory Volume (FEV1). We found that the main findings were of relationships between activity and FVC and FEV 1 which remained after adjustment for possible confounders in men, and between fitness and FVC and FEV 1 in both men and women although these were not sustained after adjustment for possible confounders.

Adolescent↗

A novel exercise for improving lower-extremity functional fitness in the elderly.

BACKGROUND AND AIMS: Many falls in the elderly are caused by tripping. After tripping, a certain level of lower-extremity functional fitness is necessary, in order to make protective responses and to avoid falling. The purpose of this study was to test whether our new exercise program (a square-stepping exercise: SSE) would improve lower-extremity functional fitness in the elderly. METHODS: Fifty-two individuals aged 60-80 years were divided into two groups (non-randomized control design); SSE (n=26) and controls (n=26). Lower-extremity functional fitness was defined as standing up from a lying position (agility), chair-stand in ten seconds (leg power), walking round two cones (locomotion speed), sit-and-reach (flexibility) and single-leg balance with eyes closed (balance). The SSE group participated in a six-month regimen of SSE once a week. SSE was performed on a thin mat of 250 cm by 100 cm, partitioned into 40 small squares (25 cm each side). SSE included not only forward steps but also backward, lateral and oblique steps, and step patterns were progressively made more complicated. Controls maintained their usual lifestyles. RESULTS: In the SSE group, significant improvements were observed in agility, leg power, locomotion speed, flexibility and balance. No significant changes were detected in any tests in the control group. CONCLUSIONS: The SSE program improved lower-extremity functional fitness, lack of which constitutes a risk factor for falls in the elderly. This program should be tested further to determine if it can effectively reduce the incidence of falls in the elderly.

Accidental Falls↗