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PubMed2004

[Cardiorespiratory fitness. Importance of sports for health].

Epidemiologic studies have established that physical activity is associated with substantial improvements in cardiovascular prognosis. The effect of physical activity appears to be in the order of traditional risk factors such as smoking or hypercholesterolemia. The strength of evidence is best for intensive activity, corresponding to an energy expenditure > 6 METs (metabolic equivalent). Cardiorespiratory fitness can be determined directly by using treadmill- or bicycle-based exercise stress testing. Exercise stress testing in healthy subjects shows that in the lowest quintile of fitness distribution, cardiovascular morbidity and mortality are greatly increased. Prognosis improves significantly when reaching a higher level of fitness (better than the worst 20%). Physical activity exerts beneficial effects on cardiovascular risk factors and on subclinical atherosclerosis (e. g., endothelial function, progression of atherosclerotic plaques), and it reduces cardiovascular endpoints. An increase in cardiorespiratory fitness by 1 MET brings along a risk reduction of approximately 20%. Physical exertion itself is associated with an increased risk of sudden cardiac death, which is alleviated, however, by regular training. All in all, the risk-benefit relation is very favorable and better than for most other interventions.

Cardiovascular Diseases↗
PubMed2004

[Check of hearing aid fitting].

A qualified hearing aid fitting is only possible if the ENT doctor not only prescribes the device, but also conscientiously checks the comparative adjustments made by the hearing aid acoustician. In deciding, which of the tested hearing aids achieves the best and most appropriate improvement of hearing, the physician should first thoroughly study the acoustician's fitting protocol, which contains comparative results of all devices tested. The subjective satisfaction of the patient with his hearing aid can be determined in a detailed conversation or with a special questionnaire. The examination of the otoplastic is as necessary as the improvement of speech discrimination under free field conditions, especially with additional noise. With in situ measurement, the individual transmission characteristics of the hearing aid and the otoplastic are tested in a few minutes. Conscientious control of the fitted hearing aid is only possible with loudness scaling. The scaling function shows clearly whether the fitted aid has adequate amplification, is not too loudly adjusted, and whether the field of pleasant hearing has been considered.

Audiometry, Pure-Tone↗
PubMedDate not supplied

Physical fitness of urban American children.

The Bruce treadmill protocol was used to evaluate the exercise endurance in a pediatric urban population. The sample population consisted of 525 healthy children 4 to 18 years of age (303 males and 222 females). Endurance time increased with age in males and increased up to 10 to 12 years of age in females, thereafter leveling off. Results were compared with those of a widely used standard reference of normal for treadmill exercise testing in children. Mean endurance times were significantly shorter compared to those of the reference study (p < 0.03). When the subjects were grouped in percentiles based on the reference study, 61% of males and 81% of females performed below the 25th percentile. There was a strong negative correlation between body mass index and endurance time (p < 0.0001), suggesting that obesity is a major contributor to decreased physical fitness. Compared to subjects in the reference study, children from a large U.S. metropolitan area have markedly diminished exercise endurance times, suggesting poor physical fitness. Inactivity with consequent lack of fitness, if unchecked, are likely to lead to cardiovascular disorders in adulthood. Efforts should be made to encourage physical fitness in children.

Adolescent↗
PubMedDate not supplied

Effects of gender and aerobic fitness on cardiac autonomic responses to head-up tilt in healthy adolescents.

Cardiovascular autonomic responses to orthostatic challenges are affected by gender and cardiorespiratory fitness in adults. However, little is know about the effects of these factors in healthy adolescents. We studied 41 adolescents (20 boys and 21 girls) aged 12-17 years, divided into aerobic fitness tertiles based on the results of a maximal treadmill exercise test. Cardiac autonomic modulation was assessed by heart rate variability (HRV) analysis of 5-minute RR interval recordings before and after 70 degrees head-up tilt maneuver. HRV was analyzed by time (TD) and frequency domain (FD) methods. TD was analyzed by standard deviation of the RR intervals and the root mean square of successive differences of RR intervals. The power spectral components were studied at low (LF) and high (HF) frequencies and as the LF/HF ratio. We did not find any differences in TD and FD measures before and after tilt in either gender or fitness groups, except for a higher heart rate response for boys. These results suggests that cardiac autonomic responses to head-up tilt in healthy adolescents are not affected by gender or aerobic fitness.

Adolescent↗
PubMed2001

Rigid gas-permeable contact lens fitting in LASIK patients for the correction of multifocal corneas.

BACKGROUND: Laser in situ keratomileusis (LASIK) has recently become the most commonly performed refractive surgery procedure. Results are promising in correcting low to moderate myopia. Most complications occur during the surgeon's learning curve. One of the complications is a decentration of the ablated area that causes monocular diplopia and a nocturnal halo phenomenon due to a multifocality of the corneal surface overlying the entrance pupil. The corneal shape is significantly altered after LASIK. We evaluate the efficacy of rigid gas-permeable contact lens designs and fitting techniques used in eight eyes with multifocal LASIK ablations to correct haloes and impaired night vision complaints. METHODS: We used large-diameter tetra-curved rigid gas-permeable (RGP) contact lenses for visual recovery in eight eyes of seven LASIK patients. We used the power on the transition zone of the corneal topographic map, 0.2 mm outside the ablated refractive area, for selection of the back optic zone radius of the RGP contact lenses. Procedures for lens fitting are described. Visual acuity (high-contrast logarithm of the minimum angle of resolution, LogMAR) was measured before- and 6 months after contact lens fitting. RESULTS: Large-diameter tetra-curve RGP lenses with a mean diameter of 11.85 (SD 0.16) mm were successfully used in LASIK patients with multifocal corneas. Mean best spectacle-corrected visual acuity was +0.3 LogMAR (SD 0.19; in Snellen equivalent, 20/40) and improved significantly with the contact lenses to +0.08 LogMAR (SD 0.11; in Snellen equivalent, 20/25, P=<0.01). During the follow-up period of 16.7 months, the average daily wearing time of the lenses was 12.5 h. Contact lenses with a standard geometry were not useful due to excessive movement and inadequate centration. CONCLUSIONS: Contact lenses with large diameters, in combination with selection of the back optic zone radius 0.2 mm peripheral of the refractive ablation zone, facilitate contact lens fitting to restore best-corrected visual acuity in LASIK patients with multifocal corneas.

Adult↗
PubMed2006

Daily physical activity and its relation to aerobic fitness in children aged 8-11 years.

A positive relationship between daily physical activity and aerobic fitness exists in adults. Studies in children have given conflicting results, possibly because of differences in methods used to assess daily physical activity and fitness. No study regarding daily physical activity and fitness in children has been published, where fitness has been assessed by direct measurement of maximum oxygen uptake and related to daily physical activity intensities by accelerometers. We examined 248 children (140 boys and 108 girls), aged 7.9-11.1 years. Maximum workload and maximal oxygen uptake (VO2PEAK) by indirect calorimetry were measured during a maximum bicycle ergometer exercise test. Exercise capacity was adjusted for body mass and (body mass)2/3. Daily physical activity was evaluated by accelerometers, worn around the waist for 4 days. Mean accelerometer counts and time spent in vigorous physical activity were calculated. VO2PEAK was correlated with mean accelerometer counts (r=0.23 for boys and r=0.23 for girls, both P<0.05), but somewhat better with time spent in vigorous activity (r=0.32 for boys, r=0.30 for girls, both P<0.05). All results remained virtually the same regardless of the method used to adjust for differences in body size.

Body Size↗
PubMed2006

The effect of physical activity and physical fitness on plasma adiponectin in adults with predisposition to metabolic syndrome.

The purpose of this study was to measure changes in plasma adiponectin (ApN) over 24 months of exercise intervention in middle age adults with a predisposition to metabolic syndrome and to determine if changes in ApN were more affected by physical activity or physical fitness. Thirty-six subjects completed a 24 months home-based exercise program (cycling>or=three times per week, >or=45 min/session at 50-65% of VO2peak). Body composition, blood samples, and physical fitness were studied at baseline and after 12 and 24 months of participation in the study. The prescribed physical activity was monitored via self-reported exercise diary to determine MET levels, hours, and exercise compliance. Two-tailed repeated measures ANOVA and Spearman Rank Correlation Coefficients were used to detect significant differences and associations between the variables. ApN increased significantly (P<0.05) after 12 months in males (n=17; 5.3+/-1.9-7.0+/-3.0 microg ml-1) but not in females (n=9; 8.6+/-3.8-11.5+/-4.0 microg ml-1). The net change in ApN over 24 months was significantly correlated to the net change in VO2peak (physical fitness) (r=0.66; P<0.001), whereas exercise intensity was negatively correlated to DeltaApN over 12 months (r=-0.4; P<or=0.04) and 24 months (r=-0.45; P<or=0.02). Based on our results, an improvement in cardiorespiratory fitness of 15% increased plasma ApN concentration. Our findings suggest that moderate physical activity performed over many months induces positive changes in the plasma ApN concentration in adults with a predisposition to metabolic syndrome.

Adiponectin↗
PubMed2002

The effect of a combined intervention on body mass index and fitness in obese children and adolescents - a clinical experience.

UNLABELLED: We assessed the effect of a weight management programme on body weight, body mass index (BMI), and fitness in obese children and adolescents. The study was designed as a longitudinal, non-randomised, clinical experience of a 3 and 6 month combined dietary-behavioural-exercise intervention. A total of 177 obese children (age 6-16 years) participated in the 3 month programme, of whom 65 completed the 6 month intervention. A group of 25 age- and maturity-matched obese children who did not participate in the structured programme served as controls. Body weight, BMI, and fitness were evaluated at baseline, and after the 3 and 6 months intervention. Body weight and BMI were significantly reduced ( P<0.05), and endurance time significantly increased ( P<0.0005) following the 3 months intervention. Obese children who continued the programme for 6 months maintained the decrease in BMI and further improved endurance time. In contrast, obese children who did not participate in the structured programme gained weight, increased their BMI, and improved fitness less significantly. Gender, pubertal status, and the degree of obesity had no influence on BMI changes. Children without parental overweight had significantly greater decreases in BMI compared to children of obese parents. CONCLUSION: a combined, structured multidisciplinary intervention for childhood obesity results in decreased body weight, decreased body mass index and improved fitness.

Adolescent↗
PubMed1998

Fitness for work after surgery for lumbar disc herniation: a retrospective study.

This report retrospectively evaluates fitness for work in 3956 cases of surgery for lumbar disc herniation between 1992 and 1994. Patient records were derived from a database including all interventions of the insured population of the largest Belgian sickness fund. The datafile consisted of 126 cases of percutaneous nucleotomy (nucleotomy group), 286 cases of lumbar disc surgery with fusion (fusion group) and 3544 cases of standard lumbar disc surgery (standard group). Fitness to resume work within 12 months after intervention was obtained in about 70% of the patients in the standard and nucleotomy groups but in only 45% of the patients in the fusion group. Ten medicosocial factors were related to fitness for work as outcome measure. Incapacity for work more than 12 months after intervention was defined as a bad outcome. Logistic regression was used to test the combined relative significance of the different variables. For the standard group a long duration of work incapacity before intervention, older age, lower benefit, employment as a blue-collar worker, a long duration of hospital stay and unemployment were significantly associated with a poor outcome. Related factors for the fusion group were a long duration of work incapacity before operation, a long duration of hospital stay and unemployment. For the nucleotomy group, no factor was significantly associated with a poor outcome. For the total group, discectomy combined with fusion was significantly related to a poor outcome whereas a standard discectomy and a percutaneous nucleotomy did not differ in their impact on fitness for work.

Adult↗
PubMed2002

Cardiorespiratory fitness and physical activity as risk predictors of future atherosclerotic cardiovascular diseases.

Physical fitness and activity status are well-documented risk predictors of cardiovascular and total mortality. The purpose of this article is to show how cardiorespiratory fitness predicts atherosclerotic cardiovascular diseases. Measurement of maximum oxygen consumption (VO(2max)), defined with or without ventilatory gas analysis during exercise testing, can provide a good estimate for cardiorespiratory fitness, which is an independent marker of the early disease. Low VO(2max) has been shown to be comparable with elevated systolic blood pressure, smoking, obesity, and diabetes in importance as a risk factor for mortality, as well as a predictor of coronary artery disease and the progression of atherosclerosis. Cardiorespiratory fitness represents one of the strongest predictors of mortality, emphasizing the importance of exercise testing in everyday clinical practice. In the future, well-defined, disease-specific training programs for exercise prescriptions in different risk groups are needed as a clinical tool.

Arteriosclerosis↗
PubMed2006

Exercise, fitness, and cardiovascular disease risk in type 2 diabetes and the metabolic syndrome.

This article highlights research supporting the concept that increased physical activity and cardiorespiratory fitness attenuate risk of cardiovascular disease, type 2 diabetes, and the metabolic syndrome. Increased activity and fitness also attenuate risk of developing cardiovascular disease in persons who have type 2 diabetes or the metabolic syndrome. Although controversial, relationships between physical activity/physical fitness and type 2 diabetes/metabolic syndrome are largely independent of body weight. Thus, physical inactivity and poor cardiorespiratory fitness are not only important determinants of cardiovascular and metabolic diseases, but they can also be considered common features of these conditions, much like traditional risk factors such as obesity and insulin resistance.

Cardiovascular Diseases↗
PubMed1987

Prophylactic effect of aerobic fitness on cardiovascular arousal among individuals with a family history of hypertension.

Among normotensive individuals, a family history of essential hypertension is generally associated with elevated levels of cardiovascular arousal during stress. In contrast, aerobic fitness is associated with lowered levels of cardiovascular arousal during stress. It was therefore hypothesized that during psychosocial stress, subjects with a family history of hypertension who were aerobically fit would respond like subjects who did not have a family history of hypertension, and both of those groups would show less arousal than subjects with a family history of hypertension who were not aerobically fit. The predicted patterning of responses was found with heart rate, diastolic blood pressure and systolic blood pressure. The results are discussed in terms of the prophylactic effects of fitness for individuals with a family history of hypertension.

Arousal↗
PubMed1992

Anxiety, depression, physical fitness, and all-cause mortality in men.

The association of low physical fitness with an increased risk of mortality is independent of physiological risk factors, but psychological variables such as anxiety and depression have not been evaluated as possible confounders for all-cause mortality. The purpose of this study was to evaluate the possible confounding effects of anxiety and depression on the relation between physical fitness and mortality in male patients who were given a preventive medical examination between 1977-1986. Physical fitness was measured by maximal exercise treadmill testing. Anxiety and depression were measured by the Clinical Analysis Questionnaire. During follow-up, 83 men died. These cases, aged 19-76 yr, were combined for analyses with 323 randomly selected comparison subjects aged 19-80 yr. The crude odds ratio (95% confidence intervals) for dying in the unfit men was 2.0 (1.1,3.5) compared to the physically fit men. This finding was essentially unchanged after adjustment for anxiety (2.0 (1.1,3.5)), depression (2.1 (1.2,3.8)), or anxiety and depression (2.1 (1.1,3.5)). The increased risk of death in unfit men is not confounded by anxiety or depression. Thus, the higher all-cause death rate in unfit men cannot be explained by higher levels of anxiety or depression.

Adult↗
PubMed1979

Relationships among cardiorespiratory fitness, regular physical activity, and plasma lipids in young adults.

Relationships between physical activity and plasma lipids and between cardiorespiratory (CR) fitness and plasma lipids were investigated in 152 young adults. There were no significant correlations in either females or males between the physical activity indicators and any of the plasma lipids investigated. CR fitness, as indicated by treadmill test duration, showed a small but statistically significant sexes, an association that may well underestimate the true relationship because of the limitations of the study. Plasma triglycerides were negatively correlated with CR fitness in the males. It was suggested that the two fitness components, aerobic capacity and percent fat, may be related to certain plasma lipids differently in males than in females.

Adolescent↗
PubMed1989

Relationship between aerobic physical fitness and ventilatory control during exercise in young swimmers.

The aim of this study was to specify in young trained swimmers, during progressive exercise, whether different aerobic physical fitness goes along with differences in breathing pattern and in mouth occlusion pressure used as a non-invasive index of neuromuscular output. Ten children (aged 10.5-16 years) with high VO2 max (57.6 +/- 3.6 ml.min-1.kg-1) and ten children (aged 11-17 years) with moderate VO2 max (44 +/- 3.8 ml.min-1.kg-1) realized a maximal exercise test on a cycle ergometer. During the last minute of each power level we measured the following parameters: VO2, VCO2, VEBW, f, VTBW/TI,TI/TTOT, as well as mouth occlusion pressure (P0.1) and 'effective impedance' of the respiratory system (P0.1/VTBW/TI). Our results showed that at a same VCO2, children with high VO2 max had significantly lower P0.1, P0.1/VTBW/TI and f than children with moderate VO2 max and same VEBW/TI. At different levels of VO2, in the twenty children of the two groups, we have found significant correlations between VO2 max of each subject and P0.1 (P less than 0.01), P0.1/VTBW/TI (P less than 0.001). At a same VO2, children with a higher VO2 max showed significantly lower P0.1, P0.1/VTBW/TI at all levels of VO2 and lower VEBW and VTBW/TI at high level of VO2. At a same VE, the two groups of children showed the same values of VT/TI and f. In conclusion this study shows first, that different aerobic physical fitness does not go along with different breathing pattern, and second, that swimmers with high physical fitness have a lower ventilatory response to exercise but a higher ventilatory and neuromuscular efficiency during exercise than children with moderate physical fitness.

Adolescent↗
PubMedDate not supplied

Improvements in physical fitness of Kenyan schoolboys infected with hookworm, Trichuris trichiura and Ascaris lumbricoides following a single dose of albendazole.

We studied physical fitness with the Harvard step test (HST), in primary schoolboys infected with hookworm (91% baseline prevalence), Trichuris trichiura (94%) and Ascaris lumbricoides (39-40%) who received a single 400 mg dose of albendazole or an identical placebo. Boys were examined, allocated at random to placebo or albendazole groups, treated, and re-examined 7 weeks later. The 2 groups did not differ significantly before treatment in age, anthropometry, haemoglobin levels, prevalence or intensity of the 3 helminth infections, or in initial HST fitness scores and heart rates. Seven weeks after treatment, the albendazole group (n = 18) exhibited significant improvements in fitness scores and heart rates at 1, 2, 3, and 4 min after the HST while in the placebo group (n = 15) these quantities had not changed significantly. After treatment, the albendazole group had significant decreases in the logarithmic egg counts for hookworm (80% reduction in arithmetic means) and A. lumbricoides (100% reduction); T. trichiura egg counts did not change significantly. The placebo group showed a borderline increase in the logarithms of hookworm egg counts and no significant change in T. trichiura and A. lumbricoides egg counts. Multiple regression analysis showed that the significant linear predictors of increase in HST score after treatment were decrease in resting heart rate after treatment, and decreases in hookworm egg counts and logarithms of A. lumbricoides egg counts after treatment. We conclude that single dose treatment with albendazole, despite continual exposure to reinfection, can allow improved physical fitness in schoolboys in areas where soil-transmitted helminths and protein-energy malnutrition are highly prevalent.

Albendazole↗
PubMed1983

Physical fitness programming for health promotion at the worksite.

Exercise enthusiasts and health professionals have recommended that physical fitness programs be implemented in the occupational setting. Such programs are promoted on the basis of expected benefits to both the employee and employer. The potential for benefit to the employee seems substantial, since a sizable body of knowledge links regular exercise to improved functional capacity and reduced risk for development of certain chronic diseases. The available literature provides some direct evidence that exercise programs can improve the health status of employee groups. Specifically, programs may generate improvements in cardiorespiratory fitness and cardiovascular health and promote long-term adherence to exercise. The physiological goals can be attained with programs that provide 20-30 min of moderately intense "aerobic" activity 3 or more days per week. Several factors are known to affect adherence of employees to company-sponsored fitness programs. Of particular importance are program leadership, motivational schema, program activities, convenience of participation, and social support. It is recommended that, where feasible, supervisors of employee fitness programs (a) secure professional leadership, (b) provide on-site or other facilities that maximize convenience, (c) allow participation across the widest possible time span, (d) provide programs offering a wide range of activities, (e) attend carefully to evaluation, recognition, and other motivational concerns, and (f) incorporate a comprehensive health promotion perspective.

Adult↗
PubMed1988

Injury prevalence and associated costs among participants of an employee fitness program.

The prevalence, cost, and type of injury among participants of an employee fitness program and nonexercising co-workers were studied over a 2-year period from 1984 to 1985. The purpose of the study was to determine whether participants of an employee fitness program (n = 2,871) experienced a greater risk of injury and resultant higher costs than nonparticipants (n = 3,233). Overall, there were no significant differences in the rate or cost of injuries among the various participation levels (from 0 to 3 or more times per week). However, the data indicated that individuals who occasionally participated in the fitness program experienced a greater, but nonsignificant, risk of injury (6.3 per 100 persons who exercised less than 1 session per week, and 7.7 per 100 persons who exercised 1-2 sessions per week) than nonparticipants (5.7 per 100 persons). Injury prevalence was lower among individuals who exercised 3 or more sessions per week (5.4 per 100 persons) as was the resultant per capita cost of injuries ($32 vs $42 for nonparticipants). We conclude the impact of exercise at an onsite health and fitness facility on overall injury rates and costs among employees is negligible.

Adult↗